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!

Writerwannabe oooh, what did she say when you said that?

It is anecdotally often murmured amongst general nurses that midwives tend not to focus on other conditions that mothers have, or understand the full implications of them. But that would be hotly denied by Midwives I'm sure.

But in order to appreciate other conditions fully you probably have to be in contact with them a lot, so MWs simply might not have the exposure to non-gynae issues that general nurses do. And I guess you can't expect them to. They are specialised nurses at the end of the day.

That said,they should read the bloody notes.

I think justashopgirl has it right with "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. The amount of non first time mum's I heard saying they were giving up breastfeeding because the baby didn't feed for long enough and not understanding the colostrum thing was shocking!

I can't even remember if they asked me how I was going to feed but I think they asked if I wanted to give him a feed when we were having skin to skin and later when he was having problems latching they asked if I wanted them to help hand express (which they did) or to give some formula. And they helped me squeeze my nipple into his mouth so he learnt how much he needed to open his mouth to be able to feed. I was grateful for the help to be honest.

writer I had a similar issue with things being in my notes not being picked up ("they didn't tell us that" - I don't know who they are but it's in black and white on the first page of my notes!)

annarose - exactly. They knew I was under Consultant care and my health conditions were the reason for my section so I assumed they would know about them. Mind you, they didn't do any form of admission paperwork at all, I was just shown to a bed and left to it.

When I challenged her she took my drug chart from the end of the bed (I was on pain relief for the section) and after flicking through it she said, " We don't have any record of you being on medication, what are you taking and how much?"

She then got quite snotty and said I really shouldn't be taking medication if it wasn't prescribed

I was taking Epilim at the time writer and I believe the guidance has changed since then as I took it through my entire pregnancy.

I too was encouraged to express which I did but I was in agony. I'm talking nearly 15 years ago now by the way, bitter

ff babies don't do as well as bf and cost the NHS more?! what a ridiculous thing to claim.

my dd was exclusively Breast fed and apart from some sniffles around teething she has never been significantly poorly enough to cost the NHS a penny. she has also crawled, walked and talked sooner than anyone her bf counterparts.

ff is down to class and poorer people do it, are you actually for real? If i was measured by class I and most of my friends are middle class there is approximately a 50/50 split across ff v bf.

it is dangerous attitudes like this that cause the ill feeling towards the question of "are you going to Breast feed" and why do many people on this thread would feel insulted by it being asked

exclusively bottle fed bloody autocorrect

wannabe well said. It's the lack of continuity of care, the fact that staff don't know the patients medical history, and either don't care enough to find out or don't have time to find out. Although frankly neither of those are a good enough excuse, since the effect of dismissing a patient's medical history could be, in the worst case scenario, fatal.

red, I think 'I will be required to ask you this again' would piss me off even more. Is my answer not good enough the first time? Why can they not just have 3 choices? Bf, ff, or 1st colostrum feed THEN ff ? Then if people find the colostrum feed a positive experience they might try to bf anyway. Job done.

I also thought there was a social class link?

In my job (working with health visitors) we cover a very large geographical area (about 1700 children on the case load) and there is a very marked difference between those in the poorer areas and those in the more affluent areas regarding breast feeding rates.

Haven't read the thread - sorry!

I think it depends what you are going to do next, my experience post birth w dd, was horrendous. With stated 'support' from midwives, but actually all doing their best to undermine me.

(Background I had a longish labour then emergency section) so all gave different instructions, then shouted at me for not following their instructions, not noticing that I was totally tripping on pain meds (hallucinating etc), shouting at me constantly not holding dd enough, holding her when I was falling asleep (yeah that will be painkillers) not opening the curtains round my bed enough... Came out of hospital a neurotic mess... Not breast feeding.

Chuff off would be my response probably but my milk didn't come through properly with either of my babies.

Just answering the OP, my reaction would be to cry. After radical breast surgery I am no more able to BF than DH is, and to be asked if I wanted to try would be very upsetting.

Am shocked they didn't do an admission! I haven't gone in yet (32 wks here) but is that commonplace?

I'll admit I just assumed there'd be a full admission done - I'm a general nurse and we ask & document everything when you arrive at the ward. Top to toe - even sleeping patterns.

Its a bit dodgy if they don't know you have a previous history, isn't it? Its very much leaving it in the hands of the doctors to know whats going on with the patient, isn't it? But the MW are just as liable in court.

(sorry, don't want to derail thread)

I agree that asking mothers if they would like to give a colostrum feed is the way to go about ,explaining the benefits,unless it is contraindicated.
Im sure here must be a list of exceptions to the policy.

Re: the healh benefits and reduction in illhealth..,it doesnt just relate to babies
Proven that BF reduces the risks of some conditions in the mother,often dramatically.
Ie Breast and ovarian cancer and Alzheimer's disease.
I had a breast lump and the first question I was asked was did I BF and for how long.

Sorry I posted then buggered off out.

This was nearly 4 years ago, wouldn't remember the midwife or anything. As I said I knew I wouldn't BF, I think there was some sort of push going on at the hospital at the time as during the hospital tour one of the midwives spoke about BF, with a very enlightening 'it's a proven fact that babies who are breast fed feel more loved by their mums'

It's a good job I'm not the sensitive type because id feel pretty shit that while I was putting my medical needs first my baby felt unloved

annarose - I'm a nurse too hence why I was so shocked about the shoddiness of it all

This is awful. Baby friendly is a great idea. But it needs to be mum friendly too - the mum is the one providing that link between hospital and the baby's care, so surely it's most important to be mum friendly in order to then be baby friendly.

I like the idea of asking about a colostrum feed, because that feels like something different to breastfeeding and less like you're trying to push an agenda OR ignoring what's just been said.

I don't like the wording "Do you want to try" either. It implies that it's going to fail. I suppose it's probably meant more in a "Do you want to try the strawberry flavour and see how you like it?" than "Do you want to try climbing Mount Everest some day?" but to me it comes across as the latter.

I do always read the notes (whether it's before a baby is born or not depends on the situation) however method of feeding is not generally documented due to aforementioned policy of it not being discussed as we're supposed to assume BF is occurring. Obviously things like HIV tend to be made very clear at handover although even that's not clear cut as women with a low viral load, can and do breast feed.

I wouldnt mind to be asked in a way of " would you consider a breast feed?" and trust me im stubborn because i know that it is something that a health care proffessional should be encouraging but then if it was followed by pressure or guilt tripping then i would be really annoyed and i would immediately not gel with that person.it might be good in a way because some wonen might be undecided but pressure would be wrong.Just deliver the message as you like,as long as you said it in some way you did what they asked....

If you already knew that I wanted to FF then at best I would think that you were forgetful or a bit dim (and probably wouldn't want you to care for me as those aren't great attributes in HCP).

If it was in my notes already then I would probably be pretty angry. When I had DD there were plenty of things in my notes that mattered and it was clear that they weren't read. I pieced together the care I needed by overhearing other women's care and suggesting that I might need the same, given that I had similar circumstances. I had to explain my birth and subsequent complications to 3 community MW in a row which I found upsetting and the first could have read my discharge notes or written it down for her colleagues.

It being apparent that notes aren't read gives a poor impression of care.

I'm also grown up enough to make my own decisions about feeding my baby. That needs to be respected. Particularly at times when I might be vulnerable and exhausted.

I don't see the problem really, so long as it's asked nicely and without pressure.

"Would you like to try a breastfeed?"
"No thanks, I'm going to bottle-feed"
"OK, well if you need any help let me know"

If the question is asked in a non judgemental way then it's fine, a simple chat and Mum's wishes are respected. However if it's what I got them it's most definitely not fine. I gave the colostrum feed initially but DD could not get the hang of it at all and started to lose weight drastically. Her blood sugars dropped and she came very close to going into SCBU. I was told that formula would not be allowed on the ward at all and we would not be discharged until we had established BFing. The 'counsellor' (I use that phrase in it's loosest term) grabbed my tit at one visit and shoved it into DD's mouth causing pain to both of us . In the end I got a family member to bring in some bottles and cartons, stabilised her myself through a day of really good feeds and discharged us with a promise to make a strong complaint about the hospital policy. They apparently changed it shortly afterwards..