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?

Re all the 'its because women have to go back so early' - this is a genuine, non-goady question but what percentage of women go back before 6 months? Because I'm planning to and have been made to feel very unusual, but perhaps that's my social group/Mumsnet bias? I tried to look for a statistic and couldn't find one in a quick search. I might be wrong but my impression is that women aren't giving up breastfeeding before 6 months to go back to work in very high numbers.

Some good points made on this thread.

As a EBF mum I feel a lot of reverse stigma. It can be difficult to discuss breastfeeding here and in RL without being made to feel like you are showing off, or being goady. If you discuss the struggles you’ve had, sometimes others project and think you are implying they aren’t trying hard enough.

Even on this thread PPs have implied that the views of those who EBF are less relevant. Why? There were several key times that I considered changing to FF so surely my experiences and reasons for deciding to continue EBF are very relevant to the discussion.

The result is going through tough times like mastitis, bleeding nipples etc but not being able to discuss it. Nor being able to share the great experiences I’ve had since getting through that stage.

I think it's culture.

All my mums side of family breastfed - great gran, granny, my mum, my aunts, my cousins...... There were lots of tales of one boob bigger than other due to favouritism, soreness, sleepless nights etc - and I understood it was just a case of getting on with it, and it got easier. I'd also grown up seeing my mum feed younger brothers, aunties feed and my mums cousins breastfeeding. It just seemed normal.

Anyway my husband's side all formula fed. His sisters tried and soon gave up (on mother in laws advice). I don't think his family have a breastfeeding culture.

It just doesn't work for some people. I was induced at 37+5 as my daughter was measuring big.

In my opinion she was always meant to be a big baby (family history) and had a lot of catching up to do which breast milk couldn't support. She was starving and we were both miserable as hell for 6 weeks.

In the hospital they encouraged me to top up with formula as she had quite bad jaundice, and I was made to feel like it was my fault that this had happened, as I was breastfeeding.

I tried expressing and combi feeding, but she would have a 5oz bottle of EBM and be screaming for more an hour later.

I finally decided that for my sanity I couldn't continue, as long as baby is fed THAT is all that's important, and mothers shouldn't be made to feel as though they are caring for their baby any less than a breastfeeding mother.

She is now 4 months old and the happiest little girl in the world, I am happy with my choice but feel like more support wouldn't have gone amiss!

The "information" you get before, as louiselouie says, needs not to be based on lies. A strong word maybe, but I felt completely lied to, confused because surely this is easy and should be working and I just need to suck it up. But then after all that, in what's actually a short space of time but feels like decades, I felt angry. And throughout I was exhausted (probably because I should have had a blood transfusion which is another story) but my God, the lies they tell you.

Then yeah, your family see you spiralling I to hell and step in, as they would! Also a really good HV in my case.

The health bods need to stop lying to women and treating us like children. Maybe then, with some actual SUPPORT and information on what to expect, how to mix feed, they'll start to get the rates up. But not before then.

It’s a real shame that there doesn’t appear to be good bf support for women here in the UK. Given that NHS is always short of money, and had to prioritise, would there be a better way to help all new mothers rather than relying just on NHS?

It is difficult in the early days, and real practical help from experienced people is invaluable. But you also need support from partner, family and friends. It sounds like this is also often not forthcoming.

For example, with very new babies, I took it that my job was to feed baby. I was lucky enough to be with someone who agreed with this and thought that his job for the first few weeks was to feed me and look after other things, like housework. We didn’t have anyone else close by to help out, but it seemed to work.

Of course, I was lucky to have a helpful partner, and not everyone has that luxury. And maybe I was lucky not to get all the comments from family that baby needs ff to thrive until later.

I don't understand either. I'm from a country where breastfeeding is the normal and I was very surprised when I found out that in the UK it wasn't.

I could understand and still can't.

In a country with so much support and reassurance about natural births (instead of cesarians which surprisingly in my country is the norm!) I don't know where the lack of support for the natural way of feeding a baby come from.

And before I'm flammed, I breastfed both of my children, and no, it wasn't straight forward and it wasn't easy; I had mastitis, babies with tongue ties, and all the problems in the book. You name it I have been through it. Still I persisted, and through tears sometimes.

Why haven't I gave up then? Because I knew there was no formula out there on the shelves that would be better for them and their growing body and immune system than their mother's milk.

I left aside my pain, my struggles, my sleep and only focused on what was the best for that tiny human being that I decided to bring into this world.

When I hear any mother saying they prefer to formula feed so they can eat whatever they want and also drink alcohol, I think is utterly selfish and I feel very sorry for the poor baby.

Of course there are mothers who try to bf and give up and that's absolutely fine, but those who don't even try just because formula feeding is "easier" ( I don't think it is at all), look very very selfish to me.

I'm a huge supporter of breastfeeding and would be delighted if it had more support from the midwives. Encouraging more formula feeding is disgraceful.

Babies need their mother's milk. End of.

@reallyanotherone I completely agree with you. I really felt pressure to stop bf by So many unnecessary comments about feeding her too much/her not sleeping through yet and so on. You can never over feed a bf baby breast milk.
I do agree they should look more into why women who really wanted to bf ended up giving up.
I am still bf DD who is 13 months. Thought I would make a list of things that went for and against me bf.

Why I very nearly gave up

• how hard it is at the start bad latch/very painful, so tiring, frequency/cluster feeding
• lack of awareness of how hard it is I thought I was failing. At one of the classes the midwife said if your doing it right (good latch) it should not hurt. It might be uncomfortable at the start but not painful. I personally think she was wrong to say this. Yes it shouldn't hurt but at the start very few babies latch perfectly straight away until they do it will be painful. I wish I knew that at the start so I didn't think I was doing it wrong
• pressure from others/comments as I mentioned already.

Why I managed to bf
-very supportive DH who went to classes with me etc and remembered more than me at times. Stayed up with me throughout the night during the first few weeks of cluster feeding. I now remember them nights fondly

• I stayed at the hospital two nights after having DD where there was a support team who helped me. They said I didn't have to go home until I felt comfortable feeding.
• a local support team in my area who came doing home visits when I asked
• DH family have all bf so their advice. It was when my DSil quite simply said yes it's bloody hard at first. I realised I was normal after all.

So all in all I realise I was lucky to have a good support network. I think that is why I bf successfully. I have gone back to work part time now and still bf so not sure I agree with the work reason.

I had amazing BF support at the hospital, and from an online FB group comprising volunteers once I came home. Without it I don’t think I could have managed it, and bf actually was v easy for me (easy latch, not painful). I still had well meaning people asking if the baby was getting enough and telling me she seems hungry and wants some formula. There isn’t widespread support for breastfeeding. And wide availability of formula. Women in countries with far worse may leave routinely feed for longer than here!

Babies need their mothers milk. End of.

No they don’t. Otherwise all the babies born to mothers who can’t breastfeed or who died in childbirth wouldn’t be here.

Babies need to be fed.

Even on this thread PPs have implied that the views of those who EBF are less relevant. Why?

Not all those who EBF - but those who found it easy and without issue, yet assume they are the fountain of all knowledge as to why rates are low and spout (what is to some, including me) nonsense about boobs being for men, formula being seen as ideal due to marketing, and now some bollocks about Love Island, as if their judgemental beliefs that no formula feeders ever tried or put their baby's needs first are fact for every individual who ever gave formula.

I’ve bf both my babies, first to 15 months and am 3 months in second time round. This is my experience.

Lots of information antenatally and in hospital about how great breastfeeding is and the benefits but not much practical help when baby is here, due to overstretched staff. First port of call is to hand over the formula.

Absolutely dire postnatal care leaving me feeling very vulnerable about my broken down stitches and uncaring midwives.

NHS staff clueless and in denial about tongue tie. Both my babies had tongue tie missed by various different NHS staff, even my second who lost more than 10% of his birth weight. My first baby’s tongue tie wasn’t picked up until he was 17 weeks old and that was by a private lactation consultant. My HV told me not to “waste my money”.

The lactation consultant who has snipped both tongue ties is horrendously busy all the time with people who are struggling to breastfeed their babies too for the above reasons.

Wrong information and advice constantly given out. If I had a penny for every time I heard “I didn’t have produce enough milk” I’d be rich.

Mothers who couldn’t breastfeed their babies due to lack of support (as explained above) feel guilty (because all they’ve been told for months is that they should breastfeed) and often project this onto new mums which therefore makes them doubt themselves and encourage them to give formula. Vicious cycle.

Obsession over “giving baby a bottle so you can have a break” in society. I don’t need a break from my tiny babies. Obsession and anxiety from everywhere about babies not taking bottles and will starve when Mum goes back to work, even if baby is 9+ months and eating solids.

Whilst formula companies are not allowed to advertise first milk, they do a great job in their adverts of promoting their follow on milk by implying “moving on” is the next step.

Disapproving looks from people in public when I dared to feed discretely, luckily no negative comments - yet!

Negativity on social media about breastfeeding.

Honestly I’m not surprised the rates are so low.

@LeahJack all kinds of medicines can be prescribed over the Internet with nothing other than the person's word for their medical history.

Yes. But they are not breastfeeding. Those drugs will have been rigorously tested in controlled environments to establish that it is safe to prescribe them like that, plus after that enormous amounts of people will have taken them which also acts as an informal control group because when millions of people take something and very few of them don’t drop dead or become very ill without explanation or then you can be pretty sure it’s safe. Plus they will know definitively what the risks are (say if you have asthma).

If you are breastfeeding none of those safeguards exist which is why you can’t just prescribe OTC and there is a warning. Any data that there is will be sketchy and will probably need a professional to interpret it.

For example, there have been x neonatal deaths reported from taking this drug breastfeeding and x post 6 months deaths although we don’t how many women take it but x number have reported to us that they have. It won’t say definitively ‘don’t take this drug it might kill your baby’ or ‘this is safe for your baby’, but a doctor looking at information like that with a better idea of how widely drugs are prescribed and neonatal death rates plus the health of any baby and mother concerned is going to be able to make a better call on whether that is an acceptable or unacceptable risk than a pharmacist behind a counter. Which is why the warnings are on there. And why what happens with drugs for non-breastfeeding people is irrelevant.

The OP above didn’t say speak to the BFN and then take medical advice. She said HCPs who advise weaning don’t know what they’re doing and the BFN do. (Incidentally the BFN might not even be able to adequately explain a risk factor to a lay person adequately or be completely sure they understood whether or not it applied to them, it may not be as simple as ‘do you have asthma’).

If someone knows that their HCP is just giving generic advice and there are no further complications then if the BFN advise them that they don’t believe it should be avoided and the mother chooses to trust them then that’s up to them.

But they shouldn’t just assume that the doctor has advised that because they don’t know what they’re doing or they don’t understand because of horrible society.

It may well be that when they see data like the example I gave above they will, in their independent, professional judgement, deem it an unacceptable risk. Whereas a pharmacist who works for an organisation with a clear bias whose success is judged by how many women breastfeed may be less inclined to err on the side of caution. I know whose advice I would prefer to take.

The sort of advice in the original post is the sort of advice that sends women who’ve been advised to wean rushing off to call the BFN and then buy tablets without checking why they’ve been advised to wean or having the full facts. It’s bad advice.

Right, so what needs to happen? How do we get clear, helpful information about breastfeeding to women who want to, without making women who don’t feel pressurized. How do we fecourage and support women who want to bf without making them feel guilty if they stop? How do we support women who bf without doing things that sabotage their attempts, like pushing formula top ups, and not telling them it’s perfectly normal for babies to lose weight initially and for there to be no milk for the first 3 days?

@LeahJack the BFN don't prescribe. No one can rush off and buy tablets. They will need prescribing, or they will be over the counter and the pharmacist should apply the usual checks when dispensing those.

You seem to think the BFN are run by people who want to jeopardize babies in order to show how many women they've helped to continue breastfeeding. Which seems a bit of an odd stance on an information service.

bertrand

You give women factual information on both kinds of feeding and the benefits and risks. You make them aware they have services where they can access support and advice and offer specific options and signpost where necessary. You can offer advise on available support as many times as you want unless you’re asked to stop. You offer advice sensitively and without judgement precisely as this guidance suggests.

The problem with saying you want to encourage women but not pressurise them is that the line between the two can be very fine. A way of avoiding that is basing it more on facts and information and making sure women have that rather than basing it on playing on the emotions of the mother. That makes the line between the two much firmer.

@LisaSimpsonsbff lots of women who are self-employed, and there are more and more of them. Some have the money to take longer off but couldn't because they would lose their business.

Most I know mixed fed, like the women in my family who had to return to work after 3 months.

However they all have put up with sh*t from HCP who had boxes to tick on bf rates for doing so, even if they had additional reasons for mix feeding.

Most women want to feed - papers I've recently read report about 80% initiate bf. The support just isn't there though. A lot of women and their partners feel shame and stigma about feeding in public. There's also really inconsistent and poor advice when women hit problems. Work is a factor but we have poorer rates than other countries where women tend to return to work much sooner. It's a problem with how our culture over sexualises breasts, fails to invest in bf support and the widespread negative cultural beliefs about bf.

Bertrand

The answer is self-fulfilling. We as mums can support and encourage our daughters, our sisters and our friends in breastfeeding and I hope it will begin to be normalised pnce again through the generations. Family support is far more powerful than anything medicalised. For those of us who were discouraged from breads by family members, this is a cycle that can be broken. I don’t think the NHS can fix this one.

*discouraged from breastfeeding not from breads!!

Autocorrect fail!

@LeahJack the NHS can't provide unbiased advice on birth methods, so to expect them to do it on bf and ff is pie on the sky.

In mine & my daughters’ experience Tongue tie, culture & lack of support are the major factors in problems breastfeeding.
My first daughter was tongue tied, only ‘discovered’ after 6 weeks of absolute agony feeding. The next three daughters had no tongue tie & were easy to feed. Fed all 4 till 18months or so.
27 years later my first granddaughter was identified as tongue tied at birth & ‘snipped’ at 4days old & feeding was fine after that.
By the time my next two granddaughters were born the local hospital no longer routinely snipped TT, waiting list was 4weeks and feeding was horrendous & very painful.
I paid privately for them both to be snipped at a week old & they could then latch on easily and they are still EBF at 16months.
All the women in my family & friends EBF so it was ‘normal’ for my daughters whereas my daughters’ friends’ mothers generally didn’t & neither do they.
Support from Breastfeeding support workers is essential but in my area they have been cut in the last year & responsibility passed to the overstretched midwife team who readily admit they don’t have the expertise or time that the Lactation specialists had.

Agree with what most other people have said about the BFN Drugline. I used to refer callers to them regularly. Most of the calls were about prescription medication. Things like "my doctor wants to put me on an anti-depressant, which ones can I take while breastfeeding?" or "I think i've got an infection, how do I time taking my antibiotics so that as little as possible is in my milk" or similar.

There are a very few drugs which are absolutely and totally incompatible with breastfeeding. Of the top of my head the main ones are Lithium and chemotherapy drugs. As others have said with other ones, and especially those which are not specifically licensed for pregnant mothers, GPs have to cover their own arses. I don't blame them for that at all. The BfN helpline is about providing data to help mothers make informed decisions. They know all about things like half lives of medicine - how long it stays in your system and how much trasnfers through milk. They can help a mother who is being prescribed anti-depressants manage her schedule of feeding and taking tablets to reduce the amount of drugs getting into her milk to practically zero. They can suggest alternatives to suggested medications. They do NOT prescribe and they do NOT tell mothers to take something or not to take it. The advice is ALWAYS to go back and talk to your GP, armed with the information you've been given.

In my personal experience, doctors and consultants are pretty poorly informed. I had my gallbladder out when my eldest was about 7 months old and still breastfed - I was told that the general anaesthetic meant that I absolutely had to stop breastfeeding. No negotiation. No advice on pump and dump or discussion about how long the drugs would stay in my system. That's the sort of situation which the BfN and a breastfeeding counsellor can help with. It doesn't mean you have to stop. It just means you have to know how the drugs are affecting you and what you need to do until they clear your system.

My experience of having my second baby was arriving in the morning in labour then leaving before lunchtime with baby strapped in her car seat , the whole stay was 4 hours (you could be in longer for an appointment). Then pretty much just being expected to get on with life with an energetic two-year-old and household to run and still feeling pressure to maintain a good standard (clean home, decent food, time/effort spent with my toddler)

DH was back at work after 12 days. Visitors came in dribs and drabs but soon stopped.
It's a world away from the days of a week long stay in hospital then being encouraged to rest at home and establish feeding whilst family and friends help you

@LeahJack the BFN don't prescribe. No one can rush off and buy tablets

The original post referred to OTC drugs, in particular it referred to warnings which said ‘don’t take without medical advice if you are breastfeeding’ and suggested that these were warnings nonsense purely put for “arse covering purposes”. I’ve been referring to OTC drugs all the way through. The BFN are a bit irrelevant to prescribed drugs anyway as they’re just another source of information a patient can request their prescriber consults and they may or may not agree with their advice.

You seem to think the BFN are run by people who want to jeopardize babies in order to show how many women they've helped to continue breastfeeding.

I didn’t say that. I said that decisions on breastfeeding drugs are often made on the basis of individual professional judgements. And when people decide which professional judgement out of two conflicting ones they want to trust they should be aware of potential influences on those opinions. And, yes, working for an aggressively pro breastfeeding organisation will probably influence that. It won’t mean they’ll tell you to take dangerous drugs, but it might mean if something is borderline they could have a lower threshold for doubts being passed.

I also think it’s very interesting that you seem to be getting very worked up about any questions about the BFN’s decision making but you seem to be perfectly happy with statements about doctors giving out bad advice because they don’t know what they’re doing.

Your own bias is showing a bit there.