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AIBU?

Bf rates uk vs us

292 replies

Silkyanduna · 22/03/2019 14:36

Just found out my American sil is expecting and she said they only get 6 weeks maternity and that’s pretty standard for the US. This made me think how much I would have struggled to breastfeed past this point if I had had to go back to work. With the uk in comparison having pretty good maternity leave AIBU to question why the Uk breastfeeding % is lower than in the US ?

OP posts:
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NewAccount270219 · 26/03/2019 22:21

I didn't feel BF was excessively pushed either - my midwife explicitly said not to be afraid to consider formula if feeding didn't go well because 'the last thing we want is babies being readmitted' (which I think is fair, if a little gloomy since she was watching the baby feed just fine when she said it!). I actually wonder if there's been a swing back in recent years to supporting all feeding choices? (which I think is great if so). On a previous one of these threads someone was talking about the attitudes she'd encountered which sounded awful - but it did turn out her DC was 28 and she made it sound like this was a completely representative example of the current situation!

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Gth1234 · 27/03/2019 00:12

There's not much difference. both the UK and US are increasingly lands of snowflakes. The US has a good deal more backbone though, than the UK.

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edgeofheaven · 27/03/2019 00:31

Haven’t RTFT but in the US breast pumps are covered under health insurance. Most working women there (have a lot of family there) will pump at work and top up with formula during the day but BF directly at home. I don’t know anyone my age (mid 30s) in the US who didn’t BF at for at least 3 months.

Among my British friends I am very weird as I BF for more than 12 month exclusively.

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HelloToMyKitty · 27/03/2019 06:02

I actually wonder if there's been a swing back in recent years to supporting all feeding choices?

There’s been some pressure to support all feeding choices, which isn’t a bad thing. However, they should support and encourage BF for population-level benefits.

WIC has been able to improve BF rates among lower-income mothers, all without taking away the formula option. This is a positive thing, IMO, as this is exactly the cohort that will see the most benefit.

Anecdotally, I believe going back to work earlier doesn’t necessarily negatively affect BF rates, as is often assumed here on MN. I often hear working mums mentioning BF as a way to “reconnect” with their baby after a day’s work. So there’s obviously some cultural reasons for the difference.

Also, workplaces are required to accommodate nursing mothers, so it’s easier to keep up a pumping schedule and have milk ready for daycare staff.

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SnuggyBuggy · 27/03/2019 08:16

I do remember there being something in the news about maternity hospitals having to support both. The situation where women aren't well supported to BF but HCPs are reluctant to advise about safe FF isn't brilliant. I get not wanting to normalise FF but if BF hasn't worked out it's important that it's done safely.

I wonder if having to go back to work earlier if anything encourages some women to BF as a way of helping to keep the bond when there is a lot of separation from a baby. Ive also heard of baby wearing and co sleeping being used in a similar way as a way to reconnect after being at work.

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NewAccount270219 · 27/03/2019 08:36

Yes, I wanted to use BF as a way of reconnecting when I went back to work. Unfortunately DS almost immediately developed a bottle preference and after a bit of a struggle to keep going I gave up after a month - apparently he wasn't so fussed about reconnecting, he just wanted milk!

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clairemcnam · 27/03/2019 18:44

edgeofheaven Do you mean your baby only had breast milk until 12 months and no ither food? Because that is not recommended.

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AssassinatedBeauty · 27/03/2019 18:54

I doubt that's what edgeofheaven meant. People still say "exclusively" after introducing solids at 6 months, when they mean they aren't using any formula. Of course the introduction of solids means that the baby isn't exclusively having breastmilk but I think most people understand what women mean when they use the term.

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clairemcnam · 27/03/2019 19:17

Okay well that is different. I think most women breastfeeding when solids are introduced, do mixed feeding, just because it is easier.

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AssassinatedBeauty · 27/03/2019 19:20

I don't know, most women I know who breastfed kept going when introducing solids. I did, twice, because I found it easier than starting with bottles and formula.

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Oliversmumsarmy · 27/03/2019 19:23

Dd had only breast milk and Milky Ways until she was 3. Refused to eat anything else.

I paid for lunch at nursery for a year. Apparently she sat with all her friends and chatted with them as they helped themselves to sandwiches

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pinkgloves · 27/03/2019 19:36

Okay well that is different. I think most women breastfeeding when solids are introduced, do mixed feeding, just because it is easier.

What are you basing this statement on? Not what I've encountered at all

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clairemcnam · 27/03/2019 20:12

Okay maybe I am wrong. Just my experience then.

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SnuggyBuggy · 27/03/2019 20:25

Apparently you can just breastfeed until 12 months or more and the baby will be ok. It's just that there usually isn't any need to avoid complimentary solid food for that long.

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clairemcnam · 27/03/2019 20:33

I thought it was risky not to introduce solids until that late as it increases the risk of allergies? So yes the baby can survive, but not recommended.

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SnuggyBuggy · 27/03/2019 20:36

No I can't see it being recommended, baby won't starve but I imagine that could be an issue later on. I guess if you only had access to food that was risky for a baby maybe, not sure why else you'd wait that long.

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LaurieMarlow · 27/03/2019 20:37

Apparently you can just breastfeed until 12 months or more and the baby will be ok.

That’s not the medical advise anywhere.

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clairemcnam · 27/03/2019 20:40

Also at 6 months, the iron stores your baby is born with usually need replenished by solids. So your baby could suffer from a severe lack of iron.
Sure if you were in a starvation situation you would continue to try and breastfeed. But otherwise it is a bad idea.

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AssassinatedBeauty · 27/03/2019 20:40

I don't think very many women if any just breastfeed till 12 months. Unless they're forced into it by a baby that won't take solids, and I would expect anyone in that position would be getting medical help. And giving their baby vitamins.

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clairemcnam · 27/03/2019 20:45

I remember years ago an article in the press about how in the UK SS had intervened when a breastfeeding mother refused to introduce solids. She was reported by her GP. But obviously that is only one case.

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SnuggyBuggy · 27/03/2019 20:47

The only person I can think of had a baby with a medical condition that was affecting swallowing. I'm guessing they used supplements

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StoryBookorTwo · 27/03/2019 20:53

I agree with pp that many new mums may not know what normal breastfed babies do re feeding patterns etc. It's a bit disconcerting for example that only colostrum comes out at first, it's such tiny amounts and doesn't seem like enough at all until you realise how tiny a just born baby's tummy is and that weight loss in first week is expected.

Even midwives can be misinformed - my baby lost 7% body weight in first 5-7 days which is totally normal for a breastfed baby (I think it's 7-10% normal and anything higher is a return to hospital)

The midwife told me 5% was normal (which it is for ff babies) and that I should go back to maternity unit and that I'd probably be told to supplement with formula

I was in absolute bits until my husband did a quick google and found that it was totally normal. The midwives at hospital were astonished to see us back, said we were doing a great job and sent us on our way!

The midwife still suggested formula next time we saw her.

Now over a year and baby has still never had or needed any. Of course if it was in her best interests we'd have used it but luckily bf has been great for us (after a really difficult and extremely painful start with mastitis, bleeding nipples, 24 hour feeding and all sorts - at that time being told wrong info by a midwife could have changed our course but I'm so glad we persevered)

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BertieBotts · 27/03/2019 21:46

There are actual lactation consultants in the hospitals there. Whereas our hospital midwives are too run off their feet to be able to offer breastfeeding advice, and if they do have time, only about half of them have useful knowledge about it, too many give unhelpful advice or "support" - do they still grab the baby and your boob and try to mash the two together and then appear surprised when it doesn't work? I don't know that I've heard of that particular speciality lately but I have heard the old rubbish about not letting them feed for more than X minutes every Y hours in case they get tired and the constant insistence on top ups, for spurious reasons and completely without any plan to solve the underlying issue is still rife. Tongue ties, poor latch frequently missed leading to painful feeds, unsettled babies, poor weight gain. Incorrect/inappropriate advice can lead to poor milk transfer or low milk supply and introduction of formula without a long term plan (and I have never, ever heard of top ups being suggested WITH a long term plan - I hope it DOES happen, somewhere - but I've never heard of it) tends to lead to full formula feeding before long.

Then post birth, I do think the overall support in the UK is better as you can have community midwives come out to you (I found these tend to be better at breastfeeding support, because they have more time, but some still lack the knowledge) and then health visitors, but the breastfeeding specific support - again health visitors usually have shocking breastfeeding knowledge, there are a handful of good ones, but again, if you get given poor info here, you are potentially set up to fail. And if you ask your health visitor or midwife about ongoing breastfeeding support, you'll be extremely lucky if they even know any exists. Whereas in the US, while you don't have the support from the hospital and there are no community health visitor type services, most health insurance packages will pay for lactation consultant services and women know that lactation consultants exist because they will have been offered their services in hospital. So if they decide to seek further advice, while they may still encounter poor advice, for example through their paediatrician, that's not the only option presented to them.

It's not about leaving work because many working mothers in the US pump milk - many many more than in the UK to the extent that this is pretty much normal. By the time mothers are returning to work in the UK their breastfeeding status is irrelevant because the biggest drop offs happen in the first 2 weeks and then 6 weeks. It's very rare to return to work that early in the UK. In addition almost half of mothers in the UK take over 9 months' maternity leave, at which point a child can simply be left with food and drink during the day with their milk intake largely confined to first and last thing at morning/night. (I couldn't find a figure any more up to date than 2008, so average maternity leave might be shorter these days).

More mothers start breastfeeding in the UK but then at every comparison point after that our rates are lower than in the US (despite higher start rate) - meaning our drop off rate is much, much sharper and this is despite much heavier formula manufacturing there and lack of state funded healthcare - and I truly believe it is because our front line support only sometimes helps, often misses problems, often actively harms individual women's breastfeeding journey, and most women are not aware of other (better quality) sources of breastfeeding support. Whereas in the US, although the front line support is not available to all women where it is available it tends to be good, and women tend to be aware of (even if not all are able to access) the availability of high quality support ongoing.

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BertieBotts · 27/03/2019 21:54

Why is mixed feeding easier when starting solids? I haven't come across this any more. What is easier about it? I do think it's fairly common to introduce formula at about 4-6 months in preparation for a return to work, especially if the mum plans to return between 6-9 months.

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BertieBotts · 27/03/2019 21:54

Any more? Before. I need to go to bed sorry.

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