To ask how you'd feel if your midwife asked you this question?

[SeattleGraceMercyDeath]

I'm a midwife at a large unit currently going for BFI status and we have been instructed to ask all women regardless of their stated intentions if they want to give their baby a breastfeed.

So even if a woman comes in very clear in their mind that they want to bottle fees and for whatever reason they don't want to breastfeed we have to ignore that and ask them if they will offer a breastfeed instead.

I have had a heated debate with the breastfeeding coordinator as I refuse to do it as I feel it will undermine my relationship with the bottle feeding women I look after.

So if you have made the decision to bottlefeed how would you feel if your midwife ignored that information and instead asked you to give your baby a first breastfeed, would you as the coordinator feels, think that you might have your mind changed or would you think 'that midwife hasn't listened to a word I say' and feel under pressure or made to feel guilty.

I'm prepared to have my mind changed but it just feels so wrong to me!

I wouldn't be offended if you prefixed it, as others have said, with an explanation that it's a requirement for you to ask. At my 5 day pp midwife appointment they sent OH out of the room and asked if I was a victim of domestic violence because it was a requirement for them to ask all new mums. IME none of the midwives who've dealt with me over the course of two pregnancies has ever talked to me, they ask questions whilst filling in gaps in the notes so I wouldn't be offended, I'd just assume it's a gap that needs filling like everything else.

Of course if youre taking meds that could harm your baby youre going to ff.

I ebf both babies.
I think it is a horrendous question to ask.
I'd love bf to be the norm, and ff not to be the default, but if people have made a decision - and lets face it, there isn't a lack of info about - it should be respected. Especially immediately post birth when some women can be feeling vulnerable, and the person asking is seen to be in a position of authority.

I wouldn't have minded and to be honest I would have given it a go. g guess it's people like me they are trying to target

I like however's approach.

I had the opposite- M/w asked me if I planned on breastfeeding (yes). Then told me in that case she'd give baby aptamil, as that was most like breast milk, for her first feed, while I "recovered"

I'd have preferred to have been asked if I was ready to bf.

As part of pre-natal care, can you warn mothers? Tell them they will be asked of they'd like to breastfeed immediately after birth, as some women find they feel differently with a newborn in their arms. If they don't want to, they just say no and a bottle will be prepared.

I was never asked how I wanted to feed until after the birth. If you choose beforehand to bottle feed, surely it's the same, you get asked how you want to feed. Wording it "do you want to breastfeed" can't cause much offence as long as the decision not to is accepted?

Its not horrendous.
But it seems a bit silly to ask if someone has already decided to ff.
I cant see it being helpful tbh.

I can't breastfeed. (Double mastectomy). It was right there in my mat notes, but the midwives still asked how i was planning to feed SEVERAL times. I would have probably been really upset if someone has asked/told me to breastfeed directly. But maybe not, I'd just given birth and wasn't in the mood to take offence!

I'd also question whether or not it would be effective in encouraging BF, phrasing it that way.

it would piss me off, and prefacing it with something about being required to ask would just make me feel like someone on a production line, not an individual, who is meant to be receiving care specific to their situation.

Not everyone who chooses not to bf is doing so because they can't be arsed trying. There are valid reasons,such as medication and past surgery, why someone might formula feed from the start. And if you already feel shitty about that decision being beyond your control, it's particularly horrible to then be made to feel guilty about it.

Tango, I sympathise. There were people who asked how I was feeding DD despite knowing I was undergoing chemo (cancer diagnosed when she was 8 weeks). It's always good for HCPs to actually read notes!

If someone has very recently told you personally that they intend to ff then it would be an odd thing to ask. In that case (presumably a minority) I'd say "This is the point where I ask you formally for our records whether you want to give a bf" to register that you personally know the answer but this is the bureaucratic bit. Also, ff but giving a colostrum feed first is a worthwhile option which a mother with a declared intention to ff (eg because she has to return to work immediately) may not have considered, so it's worth presenting as am additional option unless she's HIV positive or something.

Actually. Even as an advocate of bf i dont think its helpful at this stage.

I wouldn't be happy. I remember being annoyed when my breastfed baby was given a bottle against my wishes ( because I was asleep). Such a fuss is made about us being in charge, holding our notes etc, yet our views are undermined so often. If I said I was bottle feeding I would expect that to be respected, not ignored.

I'm not sure, it would depend when it was asked. I formula fed all mine from the get go and straight after birth, I was asked how I was going to feed the baby and when I said formula, the midwife just went and got it for me.

I do remember a comment being made when I was pregnant with dd1 at a 20 week midwife appt, along the lines of you'll be breastfeeding then, but I think I just said something very vague and it was never mentioned again. With my third I brought it up at a midwife appt, just to double check if I needed to bring formula in with me and was very clearly told - up to you how you feed your baby.

Anyway, I'm not sure how I'd feel, I'd probably have a quick ffs under my breath

I BFd - but would not have even thought about giving the first colostrum feed if I had intended to bottle feed - I don't think many women would have thought about that.

I would see the question as presenting an extra "option" and not be offended at all.

I work in a shop and HAVE to say stuff to every customer - e.g. If you fill in online feedback you could win a voucher. Some customers find the concept to be gambling and deeply offensive - we don't know until we ask.... not asking is not an option if we want to stay in employment.

I hate the pressure to ask EVERYONE and feel for you...

I think it's a good idea. I changed my mind about everything else during labour (started out with pool and hippy whale music, 15hrs later ended up with every drug they could throw at me) so I can see how, if I'd been set on ff, I may have changed my mind once my baby was in my arms.

Obviously this doesn't apply to women who can't bf due to meds etc. But others who can theoretically bf - and just thought they didn't want to - may have changed their minds. I don't think there's harm in asking.

Dislaimer - I was so off my head on diamorphine after having DS that the midwife could've asked me just about anything and it wouldn't have occurred to me to take offence. I was just happy DS was finally out.

Thats fine, but you are putting your medical needs before your babies'

That's the most passive aggressive thing I've ever heard. When you give birth, does your life no longer count, then? It's not too late to complain, Storm - do you feel up to it??

I would be . If by some freak of nature I had another baby I would ff from birth (having had 2 just lose weight, no way would I go through that again) I would point this fact out forcibly.

So yanbu. Why don't they support women with feeding properly if they really want an increase in breastfeeding?

The most useful advice I ever got from a midwife was she thought that I made the right decision ff exclusively dd2. I was upset and it helped me. Older mw, one of those who I imagine doesn't always follow the rules.

and in terms of putting medical needs first the one thing children do need is a mother who us as healthy as possible.

I think bottle feeding and giving one initial bf are not mutually exclusive.

I afraid I am on your side with this, I take medication which means I cannot breastfeed as it would kill my daughter. so if you then proceeded to insist on discussing breastfeeding with me after knowing this then I would be extremely p*ssed off and would be making a formal complaint.
breastfeeding is great but it is not the be all and end all of being a good mum. it is a choice and should be viewed as such. your breastfeeding coordinator is why I have such an issue with the whole concept of "breastfeeding support"

Where I work (as a midwife) we no longer ask women antenatally what their feeding intentions are. We encourage skin to skin for all after birth. We ask then for the first time......I think then the idea is that if a baby is skin to skin, rooting about near the breast then maybe the mum will be more likely to think she might try b/f.

Dunno, how likely that is to improve rates.

I do think its sad that when I ask you can see some women almost look scared to tell you they want to use formula. I make it as clear as I can that their decision is fine whatever it is.

Maybe you could suggest to your boss not discussing it in the antenatal period. Our IFC reckons that there is research showing that this method improves bf rates. And then you won't have the potential of upsetting mums who've already said they're a/f.

I would not be offended . First time mums sometimes find the thought of breastfeeding horrific but after giving birth they may feel differently so it is probably worth asking, but no pressure. I would just have appreciated more help with establishing BF

If they want to improve breast feeding rates they should think about having people who are Trained to encourage mother's who want to give it a go and make sure the baby is postioned correctly and feeding rather than have HCP who when asked for advice say quickly yes baby's latched on they rush off so of course the second d they go baby latches off this happened to me first time around I had a small baby 5lb 14 Oz at full term and a very traumatic birth and I was/w neurotic new mother I breast fed for about 24 hours before I switched to formula ,second time around I formula fed from the start .

I wish you had been my midwife