(No) postnatal breastfeeding support

[TryDrawing]

Hi Ladies,

This is almost a bit off topic but I don't know where else to post it. I'm trying to work out if there's anything I can do to improve breastfeeding support in my area.

Breastfeeding initiation rates in my area are relatively high for the UK. I think that the high breastfeeding initiation rate doesn't mean that women are having no difficulty, just that they are more likely to start. But there is so little postnatal support for breastfeeding. The volunteer run groups lack sufficient expertise to help everyone and are overwhelmed anyway. It's not enough.

The local hospital has one specialist breastfeeding midwife, and it is a minor part of her job (~2 days per week). The community midwives that I came into contact with had too great a workload and too little expertise to give any support beyond the absolute basics. It's not enough.

I have trained as a peer supporter but it's not enough. Who is going to help me when I have my next child? Will I have to go through another 4 months of hell, dragging my husband and children with me? I didn't have PND, I just couldn't get my daughter to feed less often than hourly, day and night. It was relentless and I still don't know why.

I want to do more. Another hospital in my region has an IBCLC on staff, another trainee IBCLC, and another couple of part time breastfeeding support workers. It's not enough but it's better than nothing. It's over an hour's drive away though.

Would writing to PALS at my local hospital help? My MP? I think he has bigger fish to fry. Is there anything I can do?

I didn't really mean to bring my story in to this, but it illustrates why i want to try and change things. I'd really appreciate any suggestions you all might have to help me.

[MummyWeatherwax]

I agree, in the 5 days DD and I were in hospital, we received no help, despite repeatedly asking.

There was no breast feeding coordinator/advisor, no suggestion that I express while DD was in SCBU (she was given formula before I even saw her, after EMCS). The midwives insisted she needed formula, as 'jaundiced babies cannot cope on only breast milk'. Advice on how to give her first feed consisted of pulling a screen round us in SCBU.

We ended up paying for an IBCLC to come in. She fixed our problem in literally ten minutes, and 25 weeks later, DD is still ebf.

The ridiculous thing is that I was keen to feed, had my Mum with me, who had fed me herself, a supportive DH and had watched videos, attended classes etc. We weren't a difficult case, no TT, reluctant baby or anything. I just needed to be shown a position to feed where DD wasn't on my CS wound.

I nearly gave up. So what hope do other mums have, with less support or inclination, or more difficulties?

Oh, but there was a poster in the kitchen telling us that formula is not as good for babies...

[ICompletelyKnowAboutGuineaPigs]

I agree, BFing support is variable. I was advised by the hospital staff to give DS FF because he was feeding very regularly and my milk obviously wasn't 'good enough'.

It was better with my DD (diff. hospital) but still not very comprehensive. A BFing support group run by a very knowledgeable and enthusiastic leader helped me - but these only work if you can get women to go in the first place. I know a few people who have switched to FF in the hospital just so they can go home.

Not sure what the solution is but I think writing to PALS and your MP are good places to start. Sorry I can't offer any practical advice but wanted to sympathise as I agree things could be much improved.

[TryDrawing]

I nearly gave up, too MummyWeatherwax and I had all the support from my family that anyone could wish for. I think I'm going to have to find the money to pay for an IBCLC next time. I didn't know they existed last time. My midwives assured me they were all "breastfeeding trained". Ha.

I've thought about this a bit more since last night and I think my problem with the current set-up is that everybody who isn't lucky enough to find breastfeeding easy loses.

Everyone gets bombarded with pro-bf messages during pregnancy but no details of the reality that it can be hard and painful (even if you're doing it "right").

Mums who decide to ff get very little support as the midwives are encouraged not to promote ff.

Mums who want to bf but struggle and end up ff feel guilty, as though it was their personal failure, and not a total lack of support.

Mums who want to bf, struggle but somehow manage to force themselves through have a miserable start to their child's life.

It just seems to be accepted that women have to somehow get themselves through it. That it's not worth spending money on postnatal support. In which case, why both spending the money on antenatal breastfeeding promotion? We're being set up to fail, and blame ourselves.

[Kveta]

is there a LLL group near you? or a baby cafe?

I am lucky that we have good support locally here - but you do have to be pro active in using the support. Many people I know who didn't bfeed did know about the LLL, and the local bfing clinic, but didn't use them - then complained that there was no support.

And anyone who mentions that there are support networks in place is considered patronising/a hippy/to be pushing bfing.

so it is difficult.

however, it would be nice if there was joined up thinking, and all HVs and community midwives either knew how to support new mums, or who to direct them to if unable to provide support themselves.

[Phineyj]

TryDrawing I couldn't agree more. I did give up and it was partly because I knew of two women who had actually ended up being admitted to hospital with their babies because the babies were so dehydrated/hungry. It is just plain daft IMO to carry on with something that isn't working for the baby, but you do feel guilty because of all the posters etc. The reality is that you are trying to get the hang of something potentially difficult and painful when you are already at a very low ebb. And I had an independent midwife! Unfortunately I can't see any solution that doesn't cost money but treating women like adults and being honest (not alarmist) about potential difficulties would help.

[Phineyj]

By the way there are lots of clinics/groups round here but if your baby arrives at Xmas as mine did, not much is open, and I couldn't see how to get to them when I couldn't drive or get the pram out of the house post CSection. It felt like an assault course, just to feed the baby! I suppose the main issue is you need the help in person and very quickly.

[TryDrawing]

Kveta There is an LLL group in a town about 45 mins away. But I went to 3 different local groups, with midwives, HVs and peer supporters and none of them could help. I didn't know if LLL would be better and I was in no fit state to drive for 45 mins.

I guess that my mistake was expecting that my midwives and HVs would be able to support me, or at least would know where I could get support. On a Friday, their only suggestion aws to go the the baby cafe on Wednesday. That was about 120 feeds away for me.

Phineyj that's the problem exactly. The choice you're given is "use formula or your baby will starve and have to go to hospital". Not "You're obviously struggling to breastfeed, I'll refer you to a specialist".

I've seen babies on the postnatal ward given formula just because they don't seem to be feeding "right". Their terrified mothers consent because they're told that their baby is becoming dehydrated. But no blood tests are done to confirm this. And no further bf support is offered

If breastfeeding can have such a significant effect on health outcomes for mothers and children, it is worth investing in. But the investment needs to be concentrated postnatally. The (slightly flawed) message that breast is best is out there. Surely more women openly, successfully and happily breastfeeding is going to do more to promote it than posters in hospital toilets.

[piprabbit]

Have you contacted the Maternity Services Liaison Committee at your hospital? They should be interested in working to improve BFing support.

FWIW some brilliant midwives at my local hospital are doing great work to support infant feeding by setting up the www.feedingtogether.com/ website with FB page and twitter feed. They are very good at giving advice and responding to questions they get on-line. Unfortunately management don't seem as bothered about maintaining the numbers of actual real live people (professional or volunteer) to support new mums .

[EauRouge]

I would have suggested asking your PCT/local council about applying for UNICEF Baby Friendly status, but it's all a bit up-in-the-air at the moment because of the way everything is being restructured.

One of my nearest hospitals is Baby Friendly and gives out LLL/NCT local numbers in the front of that red book that all new mothers get, and give out details of all the Baby Cafes and LLL meetings and stay in contact with local BFCs. They also have NCT peer supporters doing the rounds and have a great scheme where new mothers can request a call from a peer supporter 48 hours after going home to see how things are going. Maybe these are some things you could suggest to the hospital?

Or maybe do a bit of fundraising to get copies of some decent breastfeeding books in the post-natal ward for new mothers to read?

If you wanted to get really involved then how about looking into breastfeeding counsellor training?

You are right, mothers are being set up to fail. There is only the illusion of choice and no support either way.

[TryDrawing]

SuffolkNWhat don't even get me started. 7 months it took for me to get onto the ward. Guess how long it took the bounty lady who applied at the same time? Yes, a week.

[piprabbit]

Oh - is your hospital working towards earning Unicef's Baby Friendly Initiative recognition? That should push them into providing better support. Perhaps you could ask them about that? Other hospitals are getting accredited - are they getting left behind?

[piprabbit]

x-post with EauRouge.

[TryDrawing]

Piprabbit There is a pretty good fb group, run by the bf support workers at the other hospital in our area. It's concentrated around the groups local to them, but they will answer all questions. I'm now giving the details to every mum I see on the ward as I know it's their only realistic chance of help. I'll look into contacting the Maternity Services Liaison Committee.

The hospital doesn't have Baby Friendly Status, I'm going to casually ask a few questions. Funnily enough, the hospital where I had dd does have it but they told me that they couldn't support me postnatally as I live outside their area.

Fundraising for books on the ward is a great idea, EauRouge I'll see what the other peer supporters think about joining in. I think I would like to train as a breastfeeding counsellor. Funny, because it couldn't be more different to my day job (engineer).

[midori1999]

Whilst I agree that BF support is very poor in some areas, I don't think the only problem is lack of support. I think a huge part of the problem is that formula has been so normalised in our culture and breastfeeding is seen as something 'special', not normal.

We have excellent support in my area. I'm not saying it couldn't be better, but we have specialist BF midwife/HV run support groups, Breastfeeding clinics four days a week, UNICEF baby friendly hospitals, infant feeding advisors available at both of the local maternity units who really know their stuff and are very passionate, an antenatal class devoted to infant feeding, usually with a peer supporter talking/available to chat to, an excellent peer support service which can include antenatal referral or usually includes referral within several days of birth and a La Leche League.

Often ladies 'on the books' of our peer support service sever contact with the peer supporter and it's because they have switched to formula. I know peer supporters are limited in what help they can actually offer, but I'm not sure what greater support you can have than a peer supporter you can contact any time day or night and who, if they can't help you will immediately find the person you need to see who can help you?

[piprabbit]

They will be being measured on numbers of mums initiating and maintaining bfing - it would be interesting to see what their metrics look like. There's quite a bit of information on the Chimat website but I think it only goes up to 2010 - your PCT should have up to date quarterly figures.

[TryDrawing]

Wow midori999 your area sounds amazing. Do you mind saying which PCT it is so i can move there give the details to the infant feeding coordinator who is, bless her, actually trying to get some support in place in the face of overwhelming apathy and inertia. If you don't want to put your location on here, maybe by pm?

The set up you've described is pretty close to what I think we need, with consistent, expert support available to those who need it.

Piprabbit well according to that data, bf initiation rates for my local PCT as a whole are not fab. So I guess that explains why the support is concentrated at the other hospital, as bf initiation must be really low there. But it's not much use to us here having good support an hour away...

[midori1999]

I'll PM you TryDrawing.

It's not perfect, by any means, services such as the BF clinics can be very busy, but the support is there. Sadly, two of the local BF support groups have recently closed due to zero attendance, despite both being 'relaunched'.