To think the breast is best strategy is all wrong

[SheepOrWine]

Just back from the health visitor clinic where I was at in front of an entire wall (no exaggeration) telling me why breast is best. Apparently for one young woman it was the best decision she EVER made. This morning I read about another study which "proves" that breast is best (presumably because the many, many existing studies on this are not enough and they needed another one?) At my NHS antenatal breastfeeding class, more than half of the allocated time was dedicated to the benefits of breastfeeding.

Has anyone ever been persuaded to breastfeed by a poster or a news article? Is there anyone out there who seriously has not yet heard the "breast is best" message? Does the NHS just think women are a bit stupid but if you tell them to do something enough times they will do it?

Wouldn't this money be better spent on helping those women who want to breastfeed to do so successfully? Three months ago I was on a postnatal ward with DD where I received conflicting and often incorrect breastfeeding advice. Every time I buzzed for support a frazzled looking HCA or midwife would come and glance at the latch say "yeah that's fine" and walk off. I asked four times to see the breastfeeding advisor but she never arrived. I was discharged without anyone observing a feed.

8 weeks on I gave up breastfeeding as I just had enough of all the various problems I was having with it and for which I was completely unprepared. Before I had DD the posters were useless as like most women, I already knew I wanted to try to breastfeed. And now, post-breastfeeding, all these posters do is just make me feel guilty. What a waste of money.

I would have thought at the moment they need to focus on those that stop BF in weeks 1 and 2, by providing more targeted support and access to help if needed. Midwife and HV were next to no help at all to me regarding breastfeeding, and simply put pressure on me to continue at all costs (including my sanity, I suspect!).

Obviously, yes they need to continue with encouraging people to BF right from the beginning, but I think the next priority should be those that stop in weeks 1 and 2, as I would imagine the main reason is stress, difficulty with latching on, struggling with BF in general, and lack of support.

lady I agree with that. Someone up thread was told not to waste their money on bottles and formula as they'd be setting themselves up to fail. What odd advice. It's the sort of thing I can imagine my NHS antenatal class lady saying.

I think women should be encouraged to have an emergency bottle or two of ready made formula in the cupboard. I had to send my DH out to the nearest 24 hour tesco at 3am because we were so unprepared, I shudder to think of that night now. It was awful.

quack I would love to hear from whoever heads up the campaign and find out more about what their strategy and success criteria is, and who they are trying to target. I presume they must have done some kind of analysis in order to get government funding...

My experience of breast feeding was the most miserable 3 months of the 57 years I have spent on this planet.

I hated it . Utterly hated every minute of it. I was bullied and shamed into breastfeeding by midwives, health visitor and a so called NCT " feeding counsellor " who was singularly the stupidest and nastiest woman I've had the misfortune to meet

" Breast is best for baby" was her parroted response to everything.

I'm very sceptical that my son , as the child of 2 wealthy , graduate, professional, non-drinking, non smoking, non obese, parents got any benefits from being breast fed which he would not have got from his socio-economic background had he been bottle fed from the start.

The figure that seemed to come out strongly from skim reading the survey was the number that initiated BF and that figure had risen by something like 5% since the 2005 survey. So perhaps that is the focus.

But I worry that they are just increasing the number of women set up to fail in the early weeks. Though I didn't notice whether the the % continuing in that early phase had changed much. I didn't see anything on the impacts of 'failing' or struggling to BF on maternal mental health, which is somethings that interests me.

Cynically, I'd say that it is cheaper to raise BF rates by bombarding women with leaflets abtenatally and pressing the issue in antenatal appointments which are scheduled to happen anyway than to provide the manpower to support those who struggle in the early weeks as every home visit must be expensive.

I do wonder whether it would have made any difference to me if the local BF support volunteer hadn't been on holiday the week after I had DD1. Obviously a decent non-volunteer service would be expected to arrange holiday cover.

Midwife and HV were next to no help at all to me regarding breastfeeding, and simply put pressure on me to continue at all costs (including my sanity, I suspect!)

I so agree. My mental and physical health were unimportant to them.

metalmidget it may be annoying to hear, but there is no way you should still be sore when feeding at 5 weeks. And cluster feeding for 12 hours with such short breaks is unusual. Sometimes a latch can appear perfect but be very much not perfect inside...have you had a second opinion?

Yep, been told the same thing by two of the hospital midwives and three different community midwives. To be fair, the horrendous marathon cluster feeds are pretty rare (three days in five weeks, all fairly recently). The health visitor put it down to a growth spurt (He is a rather substantial child, he's put on 19oz in two weeks).

quack I agree about the impact on maternal mental health.

I was told antenatally that breastfeeding reduces the risk of PND. I suspect that truth behind that "fact" is that successful breastfeeding may reduce the risk of PND.

I would think that attempting to breastfeed then having to give up but being made to feel guilty about it would increase the risk of PND. But by that stage you'd be counted as a formula feeder.

I was told antenatally that breastfeeding reduces the risk of PND. I suspect that truth behind that "fact" is that successful breastfeeding may reduce the risk of PND

Yes , yes, yes. I'm sure if I had continued I'd have cracked up. At 2 and half months I had excruciating pain and nausea and was feeding pretty much constantly day and night. I was lucky if I got a 2 hour gap between feeds. I could not leave the house.

YY. In fact that was being suggested by the last IFS - that women stopping breastfeeding before they wanted to is a huge contributor to PND. It's not that BF has a magic preventative effect, it's the feeling of failure.

Which is bonkers. Why the fuck do we have a system which sets women up to fail?

UK has it all wrong IMO. It's actually quite shocking - it used to be that UK had better BF rates than other countries but now we have some of the worst in the world. Terrible attitudes from (most not all) HCPs of just blind pressure/"encouragement" with no actual practical, helpful support. If you want it, invariably you have to know where to look which means lurking on breastfeeding supporting internet forums, generally, because the organisations which support breastfeeding don't make enough money to advertise their presence except for word of mouth, and yet because they're independent agencies NHS staff appear to be forbidden from recommending or signposting them. Despite shit-all training on useful BF knowledge. Despite knowing they don't have the time to sit with a new mother for the amount of time it takes to establish breastfeeding confidently.

It also doesn't help to demonise formula use. In countries with high BF rates formula isn't treated like some hush hush thing. It's treated practically as a tool, as it should be. NB this does not mean formula advertisers should be given free rein. I don't trust them. But ridiculous policies like "We can't show you how to make up a bottle" and no discussion of mixed feeding are supremely unhelpful. FFS, mothers are adults, with brains.

YANBU. I remember that "best decision I ever made" poster from when I had my son, who is nearly three. It pissed me off then and makes me feel irrationally angry thinking about it now. Seriously in a whole lifetime of decision making breastfeeding is the best one?

I struggled so much to feed him, the pain was horrendous. I remember in the two weeks I expressed trying to heal my shredded nipples sitting connected to a pump in floods of tears desperately trying to find information on formula feeding as an option and I couldn't find anything from the NHS to help me make an informed decision. All I found were forum posts which all descended into bunfights on the issue.

I really think there does need to be more breastfeeding support, although I did get quite a bit and still couldn't do it. Not campaigns designed to make people feel guilty at what is a really vulnerable time.

OK my son is going to be 17 next week so please excuse my ignorance as I think that things may have changed.
Please can someone tell me this?

When you have a baby in an NHS hospital do the staff not show you how to prepare the bottles and make up formula before you are discharged any more?

When you have a baby in an NHS hospital do the staff not show you how to prepare the bottles and make up formula before you are discharged any more?

My son was born in 1990. I was given no choice in hospital other than to breastfeed. It was never discussed. The midwives assumed I would be breastfeeding.

I needed advice from health visitor on how to stop breastfeeding and how to introduce formula as (a) I could not stand it any longer and (b) I was going back to work full time. She refused to give me any advice as "she could not promote formula".

My son was born in 1990. I was given no choice in hospital other than to breastfeed
I am surprised at that because I thought that this whole intense BF drive was a more recent phenomenon. Now I know different.

My son was born in 1999 and when he was first born the nurse gave my Mum a bottle to feed him with and then on the day before I left the hospital me and some other ladies were shown how to sterilise the bottles and make up the formula from powder as in the hospital the formula was in pre-made bottles.

She refused to give me any advice as "she could not promote formula"
That is appalling. If you could no longer BF and she didn't want to teach you about FF that to me is tantamount to saying that she would prefer your baby to starve. Absolutely appalling.

When I gave birth three months ago the hospital had a rule that they would not provide you with formula, you had to bring your own. If you were breastfeeding and it wasn't working out then they might bring you a bottle of formula if you asked for it but you had to pretty much beg.

I didn't see anyone ask for advice on how to make up formula so I'm not sure what support was actually available - the formula feeders all just seemed to be getting on with it. It could be that if they had asked, someone would have shown them what to do.

The hospital antenatal class was very biased against formula feeding, however. We were "shown" how to breastfeed (with lots of compliant dolls who all latched on perfectly and certainly did not have tongue tie, reflux, jaundice etc) but not told how to make up a bottle. We were just told all the reasons why breastfeeding is better than bottle feeding.

Current NHS advice is to feed on demand even if formula feeding, but this wasn't covered at all. We were just told that a bottle fed baby is more likely to overfeed (dubious advice? I'm not sure what the facts are on that one)

When I first switched to bottle feeding I assumed it meant feeding to a schedule because that's the impression you get from the back of a formula tin!

I want us to normalise breastfeeding. The research on its benefits is still being done. I'm interested most in the effect on gut health.

So to be honest, breast is best and whilst FF is fine, it's nowhere near as good. It is of course just one factor in the health of a baby. But it is a big one.

Let's not shame those who are lucky enough to be able to do it so easily. I totally agree there should be more support but there are still far, far too many people who find it "disgusting".

I have huge sympathy when it doesn't work out and I had this with one of my own. I'm always amazed though when some mothers just don't try after a few days as its too "hard" or "tiring".'I wish there was more focus from HV on how to make it less so e.g. Eating enough

It's all very well telling the mums, no one told DS! He was early and just couldn't do it. He never opened his mouth once to latch, he just slept. We had enough trouble getting him to take a bottle. I never understood why all the propaganda was pressuring me, it just made me feel like crap.
Anyway he's 4 now and amazing so all's well.

So to be honest, breast is best and whilst FF is fine, it's nowhere near as good. It is of course just one factor in the health of a baby. But it is a big one.

I'm not sure that is correct. You also have to take account of socioeconomic factors, mother's lifestyle and health pre and post conception and post birth.

The Case Against Breast-Feeding - The Atlantic
www.theatlantic.com/magazine/archive/2009/04/the-case-against-breast-feeding/307311/

Not sure what you mean by "shaming those who are lucky enough to be able to do it so easily"

Charlie

What about women who don't want to do it? Do you think it's ok a woman to be told what she can and can't do with her own body? Or is that unimportant when you're a mother?

So to be honest, breast is best and whilst FF is fine, it's nowhere near as good. It is of course just one factor in the health of a baby. But it is a big one.

People are misunderstanding statistics. When you run a trial or an observational trial you look at a large number of people because if you don't, you don't have the statistical 'power' to find effects.

The statement 'breastfeeding is associated with better outcomes in...blah blah' is true. But this does not mean it's best for everyone

It's a really important point. Eating lots of apples is associated with better health, for example, but if you're allergic to apples or you really really dislike apples then there's no mental/physical benefit to you.

what works on a population level is not what's best for the individual 100% of the time

When you make public health policy you're aiming at the population. When you talk to the individual mum and baby it's what is best for them. This is such an important distinction

I really believe that a stressed mum is bad for the baby. So even if the breastmilk is better nutritionally if mum is very unhappy and stressed about it she should be able to bottle feed without feeling pressured to do breast. Too many women feel like failures. This is wrong. We should support both choices and help the mothers who want/need it.

The nhs has a duty to educate women about the health benefits of breast feeding and support them in thir efforts to breastfeed

Vlier - absolutely! At my ante natal classes there was one woman there who did not want to breastfeed - no criticism - she was given tips on formula feeding and her choice was supported.
I agree that support when establishing breastfeeding is vital. I was in hospital for 7 days (Baby born outside UK) and found breast feeding really hard at first. Without support from midwife I would definitely not have continued.