Why are breastfeeding rates so low in the UK?

[Olivebrach]

So related to the news about the Royal College of Midwives changing their policy saying mothers have the right to formula feed and the stigma around formula needs to change ect..

I get it that for people that breastfeeding doesnt work out for/isnt easy, they shouldnt be made to feel like a failure. And the 'breast is best' mantra can be upsetting if that is what you desire to do but it doesnt work out.

But considering the breastfeeding rates are so low in the UK (1 in 200 babies are breastfed at the age of 1). The "mantra" and policy atm currently isnt working to up bf rates..? Clearly more people are formula feeding.

So in your opinion..
what should be done to increase breastfeeding?
And why do so few women end up breastfeeding?

AIBU to think the rates need to improve?

I desperately wanted to breastfeed both DC.
With DD I had been in hospital for 5 days, I was really struggling with bf. I asked (begged) for help and a midwife snapped at me and told me that if I didn't figure it out I wouldn't be allowed to go home. I asked for formula there and then.
With DS I was too ill to bf so my DP had to feed our DS formula. I felt like a complete failure both times.
DD is now 12 and DS is 3 and I still feel guilty whenever the subject is brought up.

Listening to young women talk, their breasts are for their men, a sexual tool and not meant for feeding their babies. More education is needed imo.

I live in the US and have had 3 babies here. The facts are that more women here are BF and they don't have their tits out and there aren't annoying campaigns. The reasons for this are:

1. Every single workplace has a lactation room for pumping. My sister was pumping in her office with her door closed. My employer offered the same even if you were not senior enough for an office. You shut the door and cracked on. Everyone knew you don't knock or enter if the door was shut.

2- Breastpumps are readily available at low/no cost. You can rent hospital grade pumps for $50 a month at the hospital I delivered at. This cost is fully covered by Medicaid.

3- There are lots of LCs available on the L&D ward and postnatal wards. All the nurses help with latching and most have completed LC certifications. They have all gear including creams, shields, nipple guards and pads available and send you home with supplies.

4- Most health insurance covers part or all of the cost of a night nurse. Many families will spend the money to have this help during the first 2 weeks to month.

5- Tongue tie is checked by the nurses and LCs. There is zero wait for this to be fixed. They fix it with laser so healing is faster.

6- shortest hospital stay allowed is 48 hours. This gives nurses a chance to help new mothers.

If you want the NHS to be able to help improve BF rates it's going to take ££££. Denmark has new mothers stay in hospital until BF is established (if that's the choice) and most successfully BF. Both countries spend more as a % of GDP than the U.K.

I don't think women in the uk "have their tits out" either...

What's wrong with having your tits out?

(When feeding a baby. I'm not talking about just talking then out and presenting them to anyone that walks by...)

And anyhow, it's not like a whole lot of breast is usually visible... I probably used to wear dresses that exposed more cleavage when I was younger. (And noone complained about that....)

Where I live the vast majority of women seem to breastfeed. My NCT group of 8 all did, some for over a year. You see toddlers feeding at playgroup all the time. I fed my first for over a year but I'm fairly sure that information isn't recorded anywhere. Still going at 10 months now.

I think postnatal wards are largely to blame. Even though I was desperate to feed DD, the support was so dire it almost didn't happen after day 2.

Just my opinion of course -

1 Lack of honesty about what bf is really like.

That it does hurt initially
That it takes practice, it's a new skill for mum and baby that takes time and practice and sometimes support to sort out
Cluster feeding
Feeding more in run up to growth spurt, ill health doesn't mean baby isn't getting enough.
Teeth - they rarely if ever bite. If they do nibble there's ways to teach them not to.

2 other people's attitudes!

Prudishness
Displaced guilt if they didn't
Over sexualisation of breasts
Laws around bf being legal in public not being enforced
Bf mum's not being supported when feeding in public especially, but also lack of support from partners and family

3 lack of expert support

Many midwives & hv are clueless on bf so can't support bf mum's. I've seen ridiculous comments on here and heard them in real life. Myths being perpetuated by supposed professionals. So I think MUCH more training on bf is required

Also shitty prudish attitudes from supposed professionals - if a dr/hv/midwife thinks and says it's wrong to bf boys, to bf past a few weeks/months new mum's are more likely to second guess their decision.

The first hv I had on returning to uk, not only had never bf but wasn't a mother and had NO experience of sole responsibility childcare! How the hell she was thought to be suitable to be a hv I do not know! She was completely useless while also being dictatorial. If anyone reading this has any input on who is allowed to be a hv PLEASE not people like this!!

4 lack of medical knowledge

It's incredibly rare that someone really CAN'T bf (prob get flamed for this but it's true).

I'd fall in that stat of no longer bf by age 1, not because I didn't want to or try to. Endo made my milk dry up at almost 9 months. GP and hv said there was nothing could be done. I later found out I could have been given:

Meds to treat the endo that would allow my body to settle and prob start producing milk again, instead I was put on meds that contraindicated bf.

Meds to actually stimulate milk production

Support to continue bf.

5 ff is normalised -

Tv shows, films and SO many ads for formula. I'd like to see more bf mum's on tv (I'm sure there's a great reality show idea in there), encourage (but not demand of course) celeb mum's to bf when on talk shows, show/indicate on fictional shows/films bf mum's.

Ads not only informing of rights and benefits, but tips for bf mum's, tips for dads and other relatives on how they can be more supportive, bf mum's saying honestly how they found it.

Personally I'd pass a law that every ff ad MUST show AT LEAST one bf mum, show that bf mum's and ff mum's can be friends/support each other but I really think that would help normalise bf. Although banning of formula ads altogether would be far better.

Penggwynn

• It hurts like fuck only for first few weeks while its established. Once established its quite a pleasant/soothing feeling
• You are tied to the baby 24/7 again, only while establishing and even then you get breaks if you have a decent supportive family/partner - and that applies no matter how you feed! If partner is shit and leaves it all to mum that's no easier with ff
• Expressing is an undignified, messy mess takes practice - just as making up formula does
• You're judged for having a glass of anything you fancy or eating anything you want lets be honest as a new mum you're judged on all you do anyway
• Your boobs end up huge and veiny and then deflate like popped balloons not true for everyone. I suspect this is more likely if you don't bf as the body doesn't get an adjustment period
• You can end up feeding far more often than you would with a bottle not necessarily, some ff babies like to feed little and often and certainly newborns do this anyway
• Nights are worse than with a bottle could not disagree more. Once established its really easy to just fetch baby from wherever and plonk on boob, I found ff a total pita! Especially at night! Screaming hungry baby having to wait for bottle to be made/at least fetched and warmed means they wake properly and take longer to go back to sleep

Ff is also bloody expensive! Steriliser, bottles, teats, formula...

Then also when out and about it can be a pain finding somewhere to warm bottle plus unless you can afford ready made you're limited on how long you can be out for as formula only safe for a few hours.

Lazypuppy would you not consider expressing?

If a woman makes a fully informed choice to ff, all well and good, but I feel lots of women who want to bf are not getting the support and encouragement they deserve.

If anything we're heavily biased AGAINST bf in this country.

I had dd in Europe and bf in public absolutely no problem at all. In the uk the snotty looks and on one occasion actually being told I was 'disgusting' for bf - in bloody MOTHERCARE of all places! Was ridiculous. There were also very few places available to bf that were physically comfortable, but I think I'd find that easier now as there are more benches/seating provided in shopping malls etc. This was around 17 years ago and lack of seating was even an issue for my now ex mil who has a disability at the time.

It is getting slightly better, I have younger friends who've bf and say they've never had a negative comment privately or publicly, but they still get dirty looks.

"Maternity leave. If you need to go back to work then the baby needs to be weaned before that."

Expressing, legally your employer has to provide somewhere to rest. However, I agree the law needs improving here. I think employers should have enable expressing with paid breaks and suitable storage facilities - something good employers do but which isn't yet legally required. Employers who are supportive generally find employees return to work sooner (I know I'll be asked for a link and I have posted one before can't currently find it - will keep looking, unless someone else posts one). NOT saying that would work for everyone but if it would for some surely that's a good thing?

"I was refused medication to increase my supply." Can I ask why and also say I'm sorry you went through that?

I agree women are discharged from post-natal wards FAR too early and this has ramifications for many issues postnatally. As I said I had dd overseas. Emcs and dd in scbu we were kept in 10 days. Dd was tube fed the first week and it took a while for my milk to come in (something else mothers aren't told - that it can take longer after complicated births/c section), but I was encouraged to express and then to start bf. I've had several friends who've been told that because their baby has been tube or ff initially due to birth problems that bf is no longer possible - total lie!

Other women who had not had complications were still kept in 3-4 days - to get support for bf, in case of infections and frankly just to get a bit of recovery time! It's appalling that's gone in the uk. A friend had her dd in uk just a few months earlier - discharged AGAINST her wishes 2 HOURS after birth. Readmitted a week later with infection, treated with meds contraindicated with bf and offered/discussed no other options, developed pnd (any bloody wonder?!).

I agree too that vilifying mothers who occasionally ff or mix feed is not helpful. Nor is vilifying mothers who choose to ff BUT I think it is useful to discuss with them why they chose to do so.

BigPinkBall - totally agree, see it on here too! Yes if a woman WANTS to go to weddings and hen do's etc weeks/a few months after giving birth fine and she should be supported but FAR more common is they're PRESSURED into doing so when they're not ready/willing.

Societally we need to LEAVE new mothers to decide for themselves how they want to manage those early days. This of course is largely because parenting, definitely motherhood are not respected as important roles in society (until the kids go 'off the rails' - then it's all the parents fault!).

Out of my friends and family it's about an even split, those who bf though rarely did it beyond 6 months. Mainly as they felt it was seen as 'weird' which is ridiculous. We need to normalise bf (inc mix feeding) without vilifying ff.

Op pre-formula mothers who really couldn't bf had babies fed by family or friends who were bf their own child (the rich paid wet nurses), or improvised with 'normal' cow milk with added sugar, evaporated milk, weaning much earlier etc but yes babies were sicker and died formula absolutely has its place, not least for babies left motherless (rare but still happens - I almost died I was VERY lucky as was dd, that we have modern medical knowledge and facilities).

Kw1091 - did you bf? Are you adequately trained on tongue tie, cluster feeding, colic, weight loss in bf babies? Because honestly ime uk training was inadequate and this thread rather confirms that. All well and good vaguely saying you support mum's but is that support practical and effective?

Re hospital conditions for rest - uk hospitals are shit for this now and I speak as an ex nurse. We need to go back to strict routines and visiting restrictions and noise control. Sleep is IMMENSELY important in healing and the nhs seems to have forgotten that (plus hoards of visitors is a recipe for hospital acquired infections!)

I enjoy breastfeeding, breastfed my ds to 1 and a half and currently breastfeeding my baby. I find it convenient and easy so am continuing to do it exclusively.

I have friends and family who have chosen to mix feed from the beginning or early on or move to formula entirely. They have weighed up the pros and cons and felt that formula helps them to parent better. They can give it just before bed to ensure baby sleeps longer, can wear what they like when going out, can share feeds and be away from baby longer. They know that supposedly' 'breast is best' but use formula as an aid, it is a pretty amazing invention, and does it really make any difference in the great scheme if things?

A couple of friends also panicked in the early days when their babies weren't putting on as much weight as they thought they should, there is an obsession with weight at the beginning, and therefore thought they weren't able to provide enough so mix fed. I think when you introduce formula your milk tends to start to dry up slowly so you move to formula in the end. I can understand this as my dd lost weight (never had that issue with ds) and I was very worried and considered formula but she managed to make it back quite quickly. With formula you can check exactly how much they are getting.

Oh and every baby I know born recently has had a tongue tie which can make feeding so painful. I don't understand why they don't snip them in hospitals. I had to wait a month for ds so if it had been painful I would have switched in that time.

And still the same old shit from posters who have no place in this dis ussion keeps on coming.The complete patronising ignorance as to why many mothers don't bf shown by those that do is quite interesting and probably play a massive part as to why figures are so low.

The majority of mothers try and want to breast feed,they aren't turned off it by Love Island. They aren't swayed by seeing formula. Formula isn't the food of the devil.

We do need to find a way of talking about this without upsetting each other. What everyone wants, is for every woman to feed her baby the way she wants to, if al all possible. So, if she chooses to ff that's fine. And if she chooses to bf and it goes well that's fine too. But there seem to be so many women that want desperately to bf but it doesn't work for them. For some of these there wil be insurmountable physical reasons why it doesn't work. For others, it's damaging in mental health terms. But that still leaves a lot who want to bf but ir doesn't work. And that's where the work needs to be done, surely? Women often seem to be given crap advice- for example, HCPs often seem to not know that it's quite normal for milk not to come in for a couple of days (lots of examples on this thread of HCPs panicking on day 1) and that some weight loss is perfectly normal. Tongue tie is often brought up, but there seems to be mixed research on this. I read one paper that suggested it was largely placebo. Which is fine-but a sickening disappointment if you're expecting it to be a solution and it isn't. I'm not sure what the answer is, but I do worry that in these resource strapped times, it's much cheaper and easier to say "it's every woman's right to bottlefeed" (which is right, of course) and ignore the women who want to bf but for whom it doesn't come easily.

I think if formula wasn't demonised so much and more women encouraged to mix feed properly and under guidance during tricky periods more would continue to breast feed. I know I would have.

That breastfeeding and a routine led baby are not compatible at least for the first few months. Feeding will not be four hourly but much more frequently.

I bf but I don’t know a single bf baby that sleep through at weeks old, whereas all ff babies did.

I am so pleased that I bf but it meant that all the responsibility was on me and I couldn’t get a break and was knackered

Actually the relaxed weight loss is ok approach caused 2 of my 3 to be very ill and lead to our breast feeding failure.

Excellent post Bertrand. Completely agree there are some women who want to ff and that's fine. But there are plenty who start out wanting to bf but it doesn't work out and that's where efforts should be focused

It's very scary and isolating having skinny babies nobody else is really concerned about. Pretty sure it lead to my PND too.

But if formula wasn't demonised and the 'breast is best' message wasn't pushed in the wrong ways, and we had HONEST information about both bf and ff.....Then I'm sure breastfeeding 'failure ' wouldn't be such a big deal for many of us. I felt totally brainwashed that bf was the only option, that formula was bad. And I nearly killed myself trying to bf, when really there was no need.

I think this statement will cut the judgement and guilt and hopefully lead to less of an all or nothing approach. It doesn't need to be.

Charolais what the hell are you talking about?
Well the fact that I bf 3 babies all of whom needed to be fed in the night because they did not sleep through until 11months, 4 years and 16 months. And when they needed milk in the night and I was ebf it was ME not dh that was up, feeding and resettling. Co sleeping helped at times and yes I 'had a job to do to me a good mum' but also an actual job at times.
I was determined to bf and too lazy in the day to faff with bottles but the sleep deprivation made me want to ff (and nothing wrong it I had)
The op asked for reasons why bf rates were so low and I suggested this is one of the many reasons
So glad you had a wonderful calm peaceful time with no sleep deprivation.
Maybe you should write a book about how to be such a good mum as that was your job to do

I think if formula wasn't demonised so much and more women encouraged to mix feed properly and under guidance during tricky periods more would continue to breast feed. I know I would have

Mix feeding can be tricky. It can work, but for many women it doesn’t solve the bf problem and leads into complete ff within weeks.

My baby, once she got the hang of formula and bottles, completely refused the breast. Took a week from starting to mix feed to complete ff.

i worked on infant nutrition in DH so I know the research and the data. our rates at starting to BF are similar to other countries (that have higher BF rates at 6 months). However most mothers stop feeding very quickly. we hear things like 'my baby didn't want it/my body couldn't produce' etc. the reality is our UK boobs are the same as the Scandi nation's tits and they have 90% BF rates at 6 months. the difference is the lack of support we get to start and continue to BF (by NHS and by mums own families and friends). The lack of NHS support is crucial. Not BF is normalised because in the 50s processed cows milk (formula) was seen as superior and pushed onto mothers. now we have many mothers (particularly working class) that have no familial experience of BF and find it sexually linked i.e. 'weird'. of course mums should have personal choice. by the way to contradict some other posters, breast fed babies are not usually overfed. this is far more prevalent amongst bottle fed babies because the milk flows into them much faster from a bottle. also breast milk has 3 'layers'. the first is thin - a thirst quencher. the middle layer is like the main course while the final amount is creamier and signals to the baby that they are getting full.

other benefits include cost (zero for the milk although there is lanolin, breast pads and nursing bras to consider)
calorie output - 500 calories a day to make that milk! thats 500 less on your hips!
convenience - eg i fed by babies while they were getting shots, while setting off on a plane etc. stops them crying/makes them happy
for most mums it delays the start of your periods. getting an extra 11 months period free was GREAT!

btw there are lots of health benefits that the govt won't yet talk about because the evidence is not yet strong enough.
however while the support for BF is so poor in the UK I don't blame any mother for giving up. the mum's state of mind is super important.

“Actually the relaxed weight loss is ok approach caused 2 of my 3 to be very ill and lead to our breast feeding failure.”

You obviously got seriously crap medical advice if nobody noticed that your babies were losing dangerous amounts of weight and that’s awful.

But it’s also crap medical advice to tell women that they have to top up or give up bf because their baby is losing weight in the first few days.

And we definitely need to stamp out the brainwashing. What are the main sources of that? HCP?

Because at 2am on a busy postnatal ward I was watching YouTube videos of how to at a baby to latch. I can only imagine that the assumed as it was my second I knew what I was doing, except I FF my first and no one asked. I had a great midwife when I got home luckily (12hrs after birth) and she recommended a bf consultant because there are so many things they are not allowed to say while working for NHS. These included advice on mix feeding or at least introducing a bottle, that nipple confusion was pretty much bollocks, giving a dummy etc. Because of them I managed to BF until I went back to work at 7m.

“not allowed to say while working for the NHS”

People often say this- is there any evidence for it or are GCP getting the wrong end of the stick somehow.It seems a bit odd when there is plenty about ff and mixed feeding on NHS websites and when loads of women come out of hospital bottlefeeding.

And actually-introducing mixed feeding early can cause problems with supply- so not always bollocks!

I used to be a breastfeeding counsellor. A properly trained one. I had to pay for the membership of the organisation which trained me by myself. Do the training in my spare time. Find "cases" to observe and help by myself. Once qualified. I struggled at every step of the way to get into mother and baby groups or NHS breastfeeding support groups to be an extra pair of hands and expert help. The health visitors didn't want me there, they were threatened by the fact my training was better than theirs, they wanted DBS checking for each separate group at my own expense, wouldn't let me bring my own baby (to a breastfeeding group!), wanted me to do a separate NHS course which was inferior to what I'd done already, lost my number, didn't return calls....

So more support is needed, but when presented with someone who wanted to help and had the skills to help, the NHS turned me away. And you need total buy-in from the NHS as how else are breastfeeding counsellors going to get into places where new mums who need help are?

Also totally disagree that there is a "stigma" around formula. It;s the norm. Everyone (well, the overwhelming majority) does it. It's the default solution when your baby isn't sleeping or gaining weight enough. Culturally, breastfeeding is seen in some parts of the UK as something very weird and only something that lentil weaving hippies do and even then, for a month then it's onto the bottles.

The formula companies did an amazing job when their product was introduced to convince everyone that it was the modern, progressive way of feeding your baby and we fell for it in the post war eras. Nothing much has changed and the breastfeeding advocates and NHS are fighting against multi-million pound glossy adverts by the formula makers. Everyone complains about breastfeeding being "pushed down their throats" and it might feel like that in a hospital or GP surgery, but in everyday life you see formula advertised regularly on TV, on teh internet, in magazines, they run "helplines" and give away freebies. It's everywhere and reversing the "formula as the default" position is exceptionally tough.