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!

"would you not like to give a bf first" - sounds passive aggressive pressuring
"would you like to also give a first BF for the colostrum" - sounds like you support the choice to FF but are pointing out an extra option.

It wouldn't bother me at all but I breastfed both mine, controversially I don't really understand why women don't even want to try it but it's none of my business. I don't understand why it would be so offensive to be asked!

Agree with stirrup but even you could make it sound like a skill-learning session you were offering. "It's part of my job to offer to show you the basics of breastfeeding - would that be useful/interesting?"

justashopgirl yes I definitely prefer that wording and can see how that might actually work without offending.

To clarify it's not that I think asking if you'd like to give a breastfeed is in itself an offensive question, it's when you've already stated a preference and then that appears to be ignored in favour of pushing an agenda that it can become an irritant.

Must sleep, post nights, becoming wordy and unintelligible!!

I'd think "here we go, another midwife who just isn't listening" and be anxious to get away from you and back home.

The more HCP I meet who try to dissuade me/bully me from making my own legitimate and reasonable choices the less likely I am to even bother engaging with future ones.

I'm grateful that you understand how women might be offended and off-put by the question, Seattle, and that you're willing to challenge it. I wish there were more like you and less sheep.

I think this is a conversation that should be had by the ante natal midwives during pregnancy, not straight after birth when women are exhausted and vulnerable.

Also, what Starlight said: 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.

I get so cross at all these initiatives and policies to improve the number of women who start breastfeeding. I wish they'd focus more resources on the huge number of women who do start off breastfeeding but give up quickly because they haven't been helped to find the right position/have tongue tie diagnosed/etc.

i had my DS by emergency C-section under GA. I lost a lot of blood and was in ITU over night.

I was well enough the next day to join my DS in the maternity ward.

When he started crying for a feed, I said to the MW that I wanted to try and BF. She told me that because of how big he was (10lb 5ozs) and how poorly I had been, that it was probably not a good idea. It would have taken too much out of me. My friend who is a student MW tells me that was wrong advice and we would have been fine.

I would have liked encouragement.

wannabe the reason some people would take offence may be because the ability to breastfeed is out of their control (surgery, medication). To then be told that 'I have to ask you this because it is our policy' indicates that the important thing here is not your welfare, or your child's welfare, or the overall health of the nation, but statistics and box ticking, and special awards, and career progression for whoever came up with the idea in the first place.

The problem isn't so much that the nhs doesn't support breastfeeding, it's that it doesn't support new mothers at all.

I understand that if you are hospital based then you only meet mum at the point of labour/birth but surely you read their notes? if so and they clearly state the mum wants to ff then I wouldn't mention anything but if there is nothing can it be broached more along the lines of "is there anything I can do to help with baby's first feed?" surely that gives mum the option. to raise their wants to bf or ff?

I think it's fine if you ask in the right way :) Don't start by asking how they intend to feed the baby, ask if they would like to feed the baby and assume they are going to breastfeed, if they aren't they'll just say so. If they say they intend to bottle feed it's not too difficult to say something along the lines of 'OK :) Do you have everything you need or is there something I can get for you or even if you aren't intending to continue breastfeeding would you like to give the baby a few feeds first for the colostrum then move onto a bottle?'

Yanbu, asking them to do it is wrong if they've already said no, surely that won't get baby friendly, as stage 3 is asking womens views. Why not say after delivery, 'I know you don't want Breastfeeding, but do you want skin to skin' then their still getting all the other benefits?

I wouuoldn't mind, perhaps phrase it as,if you wanted to try bf I would glady help you. but if you don't that's fine too

At my Antenatal class recently the MW was talking about BFing and relating how she had a woman upstairs right now on the postnatal ward who she was pressurising to feed colostrum first.

Now she of course didn't use the word "pressurising" but tbh it sounded that way to me "And I just explained to her about giving your baby the best defences blah blah blah blah....." And I could just picture her standing over this exhausted woman giving her best BFing lecture.

And she triumphantly said "And she's thinking seriously about it right now! I'd say she's going to do it!" And whilst the MW seemed very nice and was probably operating from a very sincere place, I just thought "Well of course she's considering it now, she'll do anything at this stage for you to shut up and leave her alone"

Then later a different MW came in (who didn't even introduce herself so God knows who she was) and asked us all to put their hands up who was intending to FF, and then proceeded to inform them that they didn't know how expensive it was going to be, that due to Sodium levels you could only use Evian or Volvic to make up the bottles (!!!) and with the cost of Formula etc., it was going to cost 1.5K a year!

Then said "Now I'm not trying to put you off or anything...." And Bless his heart my DH let out the biggest snort of derision! Loved him a bit at that moment, lol.

Even though we're gonna try BFing we both thought it was disgracefully manipulative.

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.

^^ This is what people higher up the chain in so many organisations miss, and I think it is particularly emotive in the NHS. Targets should be less important than peoples needs/wants.

I breastfed in the hospital but having had a crappy tear-filled and uncomfortable first night home we gave DD a bottle of formula. I'm eternally grateful for the community midwife who saw us the following day (who I'd never met before) and clearly discussed my options with me, including mixed feeding and switching altogether to FF. She said they want a happy mum and a happy baby. She made it very clear it was my decision. The push push push of breastfeeding that comes down from higher in the NHS I feel all too often leaves people feeling like shit or with a bad taste in their mouths.

I think JustAShopGirl has got the wording right - much better given as an additional option.

I think I would be annoyed to be honest. I thought long and hard about how I wanted to feed my babies and I would assume other mothers do too. Being asked if I wanted to try breastfeeding when I had already stated my intention to bottle feed would have felt like the midwife wasn't giving my decision any attention at all.

For the record I bf all 4 of my children

i just told my midwife .no thanks i find the idea of a baby sucking my nipples repulsive .and she looked horrified and buggered off .maybe not a nice thing to say but she certainly did,nt harrase me again .and before the breast feeding mafia start .it was my choice to bottle feed .each to there own .

treaclesoda - I would like to think that the midwives would know if you are on medication that means you can't breast feed and would read notes to see what the woman had previously stipulated about feeding - however, I know this is absolutely not the case

On my second day on the ward after my c-section I was taking my medication for my epilepsy and my beta blockers which I take for abnormal heart rhythms and a passing midwife saw me, looked confused and asked me what I was taking tablets for. I was gobsmacked and said "Are you telling me I've been on this ward two days and nobody has even read my notes to the point you don't even know I have epilepsy and a history of SVT?!

I couldn't believe it.

If things like that are trivial to midwives and medical notes disregarded then I can't imagine they would be bothered to read about previous conversations about feeding choices....

It is your choice but I still find that statement unbelievably sad.

aprilanne - do you find it repulsive? Or was it just your way of successfully getting her to bugger off

I think if a patient is telling you that they dont want to bf, I would warn them that at some point you have to ask them again. And when you do ask, preface it with 'I am required to ask you this'. I think most people know that professionals have rules and guidelines to adhere to. By making it clear that you have to ask, you are fulfilling your prof. duties whilst at the same time, not pressurising the patient.

I chose to formular feed due the epilepsy meds I was on combined with the fact lack of sleep could trigger a seizure so I needed DH to help out as much as possible.

When I developed mastitis, the consultant & midwife both told me it was my own fault for not breast feeding and discharged me without giving me any medication.
My GP turned up at home the following day and went ballistic, thrust a prescription into DH's hand and told him in no uncertain terms I was to go to bed for the next 24 hrs.
The mastitis was far worse than the C-section.
With my second I had to go straight from the maternity hospital to the GP to get antibiotics again. They just wouldn't give them to me, despite my tears of pain. Fuckers.

springiton - can I ask what epilepsy needs you take? My epilepsy nurse spoke to me about the risks of breast feeding in relation to sleep deprivation and encouraged me to express so DH could give a bottle and let me get some sleep.

Bf dc1 was an absolute nightmare. Hated it & drove me to edge.

Tried to keep open mind with DC2 but as soon as born, I knew I didn't want to put myself through it again. Had mw asked, I'd have said "no". Had mw pushed it I'd have said " no really, I understand why you think I should or might want to but really, no". I wouldn't have got upset. But then I had brilliantly normal deliveries and felt fine afterwards. Someone feeling more fragile might be different.