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 breastfed and I just cant understand why some people would be so irate at a simple question. How you feel before and after birth is different, don't know why it's an offensive question

If your birtjplan said you wanted to lie down and bond for as long as possible and the midwife suggested trying standing up and going to the toilet would you be outraged then?

Thanks for all the responses so far, the way it's supposed to be done I think is at delivery at the point of giving the first feed we're supposed to offer assistance with a breast feed irrespective of method of feeding.

We are then supposed to be 'checked up on' by our colleagues in the form of a questionnaire asked to the women to see if this (amongst other things) was done (don't get me started on how inappropriate I find this).

I see there isn't a huge consensus and fwiw I don't tend to discuss feeding until the baby is physically in the mothers arms but maybe I should broach it earlier in labour if timely to do so and then discuss further with those mothers who are undecided or who maybe haven't even thought about it (can't believe there are many of them!)

I'm not sure there is a sensitive way to ask a woman who has made a choice to do one thing if she wants to do something else. I know if it were me I'd probably be polite in my response but would inwardly be thinking 'were you not even listening to me?' And that would probably colour my view of the askee as someone who has an agenda other than supporting me in my choices.

I wouldn't have minded in the slightest being asked. Would have just said no and carried on ff.
If I'd been asked a second time though, my response would have been slightly different!

Viva I think one of the BFI standards is not to ask about method of feeding antenatally and I'm pretty sure we have adopted that in community as a matter of course. I know on various breastfeeding updates we've been told not to ask women how they intend to feed and just assume they will be breastfeeding I think. Maybe I need to read up on it all again. The inspectors are in soon!

Well if they're not being asked in community just don't ask on labour ward until after the baby's arrived.

I plan on ff for many reasons none of which are medical related, I do realise that once baby is here I might change my mind.

My midwife asked at my booking appointment if id had any thoughts on feeding and I said I planned on bottle feeding because of x, y, z, she told me I didnt need to explain myself and as long as my baby was fed she couldnt care less how it was done.

I was more than happy with this approach but will be pissed off if anyone tries to push breastfeeding when ive already said no, I dont mind being asked after birth if id like to try as long as when I say no the subject is dropped.

I formula fed both of mine from birth and I wouldn't have minded you asking if you pre empted it with "I'm sorry I have to ask you this...." because I think every formula feeding mum knows the nhs is geared towards persuading women to bf so if I thought you were just doing your job I wouldn't have minded (although I'd be annoyed with the nhs itself for making you ask the question when you knew I was already ffing).

Is it just the midwifery unit that will be bf friendly or the whole hospital?

I ask because my DD and I were admitted to baby ward when DD was 6 days old because she wasn't regaining birth weight.
we were told the hospital supported breastfeeding but in reality they merely allowed it to happen on the premises. I got fuck all support and couldn't even see the bf counsellor because she was on holiday.
As a result we were formula feeding within 2 weeks and I was quite bitter and distressed about it for a year.

What I did feel the second time around d was pretty much ignored when I made it Abundently clear I was formula feeding and nobody could really be bothered with baby or me he ended up back In hospital less than 24 hours later with a raging urine infection despite being declared medically fit!

I'm surprised at all the negative responses. I bottle fed 2 children and wouldn't have been at all offended at someone asking if I would be happy to give one first breast feed before starting with bottles... It's not something most people would think of themselves (myself included) and there are loads of studies that show just one colostrum feed can give a massive boost to babies. It seems like a pretty good idea. I'm sure that it would be within the rules of this new initiative to not ask new mums who have already told the mw that they have had a mastectomy or are on incompatible drugs etc but for all mums who say 'I've chosen to ff' I see no harm in asking if they would be happy to give one colostrum feed first?

I was asked several times antenatally what my intentions were and in spite of it being well documented that morphine crosses the barrier and would almost certainly have killed my daughter. there was no excuse at all, they had had to manage my withdrawal during pregnancy as it was a huge shock after years of being told o couldn't have kids.

the community midwives were lovely as we're the hospital ones. my health visitor on the other hand was a complete and utter bitch!

I agree with the poster above that the support needs to be there for those who want to try.

Definitely don't push it. I just wish there had been more support for me when I wanted to try breast feeding! Nobody helped, baby was very hungry a few hours after birth and I couldn't get a latch so I had to give up and give the bottle instead. Colostrum was expressed so I'm happy about that but it still upsets me a little bit that I couldn't breastfeed and didn't have the support.

Viva I don't generally ask until the baby has arrived (mainly because I don't think about it until then!) but I'd then find myself in the situation of saying 'how are you going to feed your baby?' 'Oh I'm going to bottle feed' 'would you not like to give it a breastfeed first?' and I'm not sure how that then comes across.

Maybe I'm overthinking this!

That would nark me off.

There seems to be quite a few of us that feel we were not supported when we wanted to give breast feeding a go and this seems to be the case in RL too why don't NHS bosses focus on this Instead? I suppose its like everything in the NHS they can't see the bleeding obvious !!

I would have been royally pissed off tbh.

It would just feel (yet again) that I was not listened to (and to then be asked again by another midwife doing the questionnaire would have probably tipped me over the edge!).

What Stirrup said. Find a way of saying it that makes it clear you've remembered what the mother's wishes were, but that you have a box to tick.

I have a family member's partner who had her baby as a teenager and found out very late on she was pregnant. She didn't have time to access any courses or get much support in before her DS arrived. She had decided to bottle feed but when I had my DS she told me that she would have liked to have tried breastfeeding but didn't know how to. She would have valued a midwife asking her if she wanted to give it a go and then supporting her. She said she also had no idea at the time why breast milk was better than formula etc.

So in her case you would have a mum who would have given it a go just for being asked that simple question.

The thing is it's been proven that if every new mother breastfed life expectancy would increase across the population, some illnesses would be virtually irradiated and NHS spending would severely reduce, all in just one generation.

So it's in everyone's interests for breastfeeding rates to increase and the government are also keen to push it also. Sadly they don't always realise you can't force someone to do something they don't want to and if someone is determined to formula feed then they proberly already know about the health problems that can come along with that and are not going to be swayed by hearing lectures and been repeatedly asked to breastfeed.

Personally I think the time and effort would be better spent offering decent support to those who do choose to breastfeed and hopefully increase numbers that way as it becomes more normalised.

Ask the BF, in writing, wtf they are trying to achieve. What outcomes are they looking for.

Initiation if BF is pretty high already. It is continuation and confidence in the process that needs work. Tell the bf coordinator to concentrate on that.

You also need to explain that you have a duty of care to each woman and will therefore make the decision on a case by case basis whether to follow her instruction.

Put it in writing so your arse is covered.

Personally I would think it fine as you aren't asking then to breast feed as their feeding choice, but just put the baby to the breast as a one off. It's hardly the same thing.

Just acknowledge you accept their decision to formula feed but that as part of your role you have to ask if they'd be prepared to just give that first feed and the reasons why.

Explain you aren't pressuring them, you aren't asking them to breast feed any more than that one occasion but is it something they would consider so the baby could have some colostrum.

I don't understand why anyone would take offence to that.

would you think 'that midwife hasn't listened to a word I say'

This.

I would out this question to mothers before the baby is born - and I mean that as in broach the subject when she is still pregnant. Me and my community midwife had the discussion about feeding when I was 30 weeks pregnant.

The scenario you gave up thread where you would ask a mom at birth about feeding and how if she said she was going to FF and your response would be to ask if she'd give a beast feed first really doesn't sit right. I would find it very inappropriate. That would definitely come across as pressure and as though you had completely ignored what the new mother had said and disregarded her decision.

I generally meet woman for the first and only time when in labour though so I don't get the opportunity to discuss it any earlier. It's either in labour or as they are contemplating the first feed.

I want to help improve breastfeeding rates for those women who want to breastfeed but might struggle But I'm not on some mission to convert and I struggle with how to ensure I meet the prescribed targets but don't alienate the person who is most important in the scenario.