Oh wise MNetters I need some advice of attitudes to BF, not sure how to deal with this

[Restrainedrabbit]

Firstly it's probably worth reading this thread to get the background to this story :) www.mumsnet.com/Talk/am_i_being_unreasonable/1145574-to-take-my-17-week-old-baby-to-my-CBT-appointment

In a nutshell I was discharged from CBT against my wishes because the powers that be felt that having my baby with me during sessions was not helpful - despite the fact that she slept through it all etc! Anyway after much to and fro-ing and debate I made a complaint to the PCT with the following letter (have deleted names etc).

Dear Mr ***,

I am writing to you to discuss my concerns regarding my experience of the service in . I have complained verbally via the complaints line at * however despite lengthy discussions the issues remain unresolved.

I self referred to the service via the GP after suffering from and for a number of years. My problems got significantly worse after the births of my three children. I requested CBT in October 2009 and finally had access to the service last May (2010), it was decided that telephone treatment would not be approriate and I was offered Stage 3 face to face treatment which started in August last year. However due to the birth of my youngest daughter in October 2010, my lovely () therapist taking annual leave and subsequently leaving the service all together my treatment was rather disjointed and thus despite forming a solid therapeutic relationship any progress made has inevitibly been minimal. Therefore when I resumed treatment in January it was decided to give me 16 sessions due to the treatment being previoulsy disjointed. I resumed therapy with * and had two sessions before it was decided (by the service) that bringing my 3 month old breastfed baby along to the sessions was both limiting the 'usefulness' of the treatment because merely having her in the room was, in their opinion, a distraction despite DD2 sleeping through or feeding throughout the sessions. In addition it has been argued that the full breadth of tools available can not be utilised, further probing into this has revealed that the method of panic induction to demonstrate what a panic attack is and why could not be used. I remain unconvinced that the exclusion of this method would be detrimental to the overall success of the therapy.

My issues are as follows:

1. Despite fully appreciateing that it is improssible to always accurately estimate demand for a new service the length of time to access therapy was rather excessive.
2. Not initially being offered slots outside of the 9-5 window despite the service being 'open' from 8 til 8. Was finally provisionally offered a 7pm slot but was subsequently told that this would not be possible and offered 6.30pm slot instead. However this coincides with the final breastfeed of the day with my daughter (a 7pm slot would be just about do-able). Poor communication has characterised my experience with the service.
3. Not being able to take a breastfed baby to tretament disadvantages those mothers that choose to feed their babies this way, if I had severe PND then how would I be able to access treatment?! This could appear to be discriminatory as it excludes a clearly defined section of the community from being able to receive the same standard of treatment/care as everyone else.
4. Not having my opinions taken into consideration, I feel that despite repeatedly stating that I would rather continue with treatment and bring my baby with me I have been railroaded into being discharged from the service against my wishes. If my problems could have waited a few years then I wouldn't have referred when I did. Surely if I am prepared to accept that the full range of options open to me may be restricted through bringing my baby to therapy I should be allowed to continue as normal. As an aside my daughter has slept or fed through the sessions.
5. Being offered a sub-standard therapy i.e. telephone therapy when assessment has already indicated that my problems are too deep seated and complex to be resolved this way. This seems unreasonable and unsatisfactory.

With regards to how I would like my concerns and complaints to be resolved, I would like to be able to resume face to face treatment as soon as possible.

Kind regards

Restrained Rabbit

Anyways the outcome is that today I have been offered face to face therapy again with my daughter in tow however if I have a male therapist I must 'feed discretely' and he must leave the room. If female I must allow her to leave if she wants to. I must also sign a contract saying I will do the above, the reason for this is so I am aware of my boundaries and what is and is not acceptable in the therapy room. When I said I felt that they were implying that BF is distasteful or sexual - and that I find the implication of that highly offensive I was told that 'management' feel that BF is something that should be done in private and is not for public consumption!!?? I pointed out that this is also discriminating against BF mothers as a FF mother would not be treated in the same way!?

There is lots more information but this is long enough already so it may be a AIBU by stealth

Help! What should I do? Am I being over sensitive?

excuse terrible grammer in title! LOL

I don't think you're being unreasonable, really, I imagine your point is that by leaving the room it interrupts treatment. Speak to a breastfeeding support organisation to find out what is done for employers/public places that have similar issues. I think it's important you get your treatment, above all. Their attitude to BF is a kind of side issue, but because it may interrupt your treatment, it's probably right to question it.

You don't have to fix the world, just fix your world.

how long is your therapy session?

WHile I tend to agree that having a sleeping baby with you is unlikely to interfere with your therapy, a feeding baby is quite likely to do so. Even if you do it unconsciously, you are still focusing on other things than your therapy - and to get the best outcome, you do need to focus on it.

So - your appointments were within working hours, presumably preventing your partner from looking after your DD while you went; but the 6:30 appt, could you not have expressed for that one and got your partner to feed your DD so you could go unencumbered?

I understand you want to be with your DD etc. but I do feel that the Service have been quite accommodating to you, considering and that you have been less willing to bend your routine/principles.

As far as the new thing - a male therapist leaving the room while you feed and a female one being given the choice/right to do so - that makes perfect sense. The male, it is for his own protection as much as yours. The female may have her own ishoos around bf'ing, and if it makes HER uncomfortable, what right have you got to insist she puts up with it?

I think you are being overly precious about it, tbh - and I am a big pro-bf'ing person! But do understand the counselling relationship and how easy it is to be distracted from doing the hard work you need to do by having a small baby in the room.

As for discrimination - I suspect that if you were NOT bf'ing, you would not have got special dispensation to bring your baby with you.

The CBT is being provided on the NHS, right? The same NHS that is 'promoting' (if you can call it that) breastfeeding. The same organisation that has made and airs and distributes this dvd to all pregnant mums.

What terribly mixed messages they are sending.

Do you have a local NCT/ABM/LLLI/BfN counselllor or a support group that can champion your cause. Does your trust employ a Infant Feeding Co-ordinator?

Finally, you could challenge them legally as breastfeeding in all public places is protected under the 'provision of goodd, services etc etc' clause of the Sexual discrimination act.

Rabbit - plenty of people in the field would ask you to consider a different form of therapy than CBT....there is a respectable school of thought that would actually counsel against any treatment for PND that does not involve the baby in every way, including having the baby as a vital and active ans present participant in the therapy, especially when young.

Check out other forms of help - you can PM me if you would like links.

tiktok - I don't think she suffers from PND though.

Rabbit FWIW I had counselling from a bereavement midwife type specialist after a late pregnancy loss and I brought my 15-24 month old there who wasn't even breastfeeding by then. He used to sit in the pushchair for an hour eating and playing with toys while I cried my little heart out! He was there for an hour every week. The counsellor never suggested it could be a problem, how could it be? Without being able to take him I wouldn't have been able to access treatment.

It sounds like they are trying to protect themselves from any claims that the therapist behaved inappropriately (i.e. by seeing your breasts). I know it sounds insane as its you that wants / needs to BF in the sessions. It is obviously not sexual but they are trying to protect themselves from anyone who would suggest it is sexual. Remember when they do breast clinics you have to have a chaperone or sign a thing waiving the right to a chaperone. I can understand why you feel shit about it but if I were you (given that you need the treatment) I would ask for a female therapist.

Oops, nor she doesn't, MummyBerryJuice.

Sorry, Rabbit.

Breastfeeding is protected under the Equality Act 2010 which states that service providers should not refuse to provide a service (which they did), provide a lower standard of service (which they are as the sessions will be disjointed and limited if the therapist has to leave if I need to breastfeed - could take 20mins out of an hours session) and provide a service on different terms (I am being asked to sign a contract, no equivillant service user has to do this).

I have two main issues - the implication that breastfeeding is something 'disgusting' and sexual and that I am being provided a significantly lesser service because I am breastfeeding. In response to someone who asked about having a later session and giving my daughter a bottle of expressed milk, my husband works long hours and is unable to leave early in addition we have no family locally that can help.

Ironically if I had not had a change of therapist and break because of the first one leaving I'd be finished by now and DD2 would be less disruptive as she would have been younger :(

I agree with whoever said it sounds like they are trying to protect the male therapist from any accusations of impropriety.

FWIW, I had a male CPN who used to come to my house to see me, and I BF in front of him and the male psychiatrist with absolutely no issues.

That whole 'not for public consumption' thing is nonsense. Really seems like someone in management is uncomfortable with BFing and is turning their personal issues into policy.

So don't think you are being oversensitive at all.

Thanks yank :) good to get other peoples perspective on it.

I'd agree with Yank.

The whole 'leaving the room' thing sounds a bit odd - for example, I don't think you'd get this in a GP's, or at a baby clinic (and I know people who've bf'd while seeing the GP or while their baby is having injections). I'm not entirely sure why therapists should be any different.

I can see other situations too where you would have no choice but to take a baby with you. My 14 m.o. DS, for example, will not be left with anyone but me or DH (and that's been the case for 7 months now). If I had to access a service while DH is working, I'd have no choice but to take DS along - I can't leave him with anyone else.

It isn't always easy to leave a BF baby. Plenty of them refuse bottles (so expressing isn't an option) and cluster feed, especially in the evenings. My DS is 4 months, a bottle refuser and cluster feeder and I still can't leave him for more than an hour max before he is screaming for me. So I have every sympathy with you OP and think you are being treated outrageously - I agree with you that it's as if bf is something shameful/sexual from the way they are talking.

Fucking hell. Hardly an advert for this supposed baby/BFing friendly NHS is it. Twats.

Sorry no advice but I hope your complaints are taken seriously, they've treated you and your baby very badly.

It's not just the hour you are there it is he travel time each way you have to take into consideration, so they abu to ask you to leave such a young baby at home for more than half an hour.

Yank said it well

YANBU! I think you should keep pushing. You are bang on target in your last post regarding a lesser service. It is discriminatory.

I agree with mummyberry totally mixed messages from the NHS. We had the 'breast is best' message given to us repeatedly (back in October) and my hospital is going for some kind if breastfeeding promotion status. At the very least they should be addressing how they encourage breastfeeding mums to access the CBT service and how to make it easier.

I assumed initially that the reluctance to have DD2 with me was that it would impede and dilute the service offered and said that I was prepared to accept that in order to undergo therapy ASAP however the more recent conversations have flagged up this issue of the breastfeeding causing a problem.

If I could afford to go private right now I would, ironically I am supposed to be receiving help for anxiety and this is not helping :(

You have to point out to them that is not helping with your anxiety.

I have also had a male CPN and they volunteered the info that I could bring ds and should just go ahead and do whatever to make him comfortable (he would not sit there quietly!). But it was a mental health service for families, so perhaps they are more switched on to breastfeeding needs?

In your case 'Management' sound like idiots. I do not think you are being over sensitive.

Their response is absolutely extraordinary. What PCT would do that?? Who in the PCT wrote to you?

People who may be able to help you:

• Your GP. Who's about to get all the budget for these services, and should be able to apply considerable pressure
• La Leche League
• The PCT medical and nursing director, the PCT PALS service, the PCT CEO
• The local media (the mere threat of which may kick someone up the arse)

I've contacted the Equality Commission's helpline and they are looking into the legalities of it for me, will suggest a letter format to send to the Trust to try and resolve this.

One psychiatrist I saw insisted I leave 7 week old ebf DD2 and 22m/o DD1 (also bf but not exc.) with the receptionists at the MH unit when I had an appointment with him.

He was horrified I was bfing my DD2 on meds (that are the safest out of the safest class for bfing mothers) and then insinuated I was forcing DD1 to bf as I got sexual gratification out of bfing her.

Funnily enough I walked out of the appointment, sadly I walked in fine and not at all PND/OCD-ish and came out a suicidal wreck unable to bf either of of my DDs with out vomiting but that is by the by.

I, as part of any further treatment I recieved, insisted on never seeing this man again and that anyone I did see kept their mouth shut about any personal opinions on bfing. It worked and 3 years later I am on the mend (still bfing on the meds though!).

I hope you can get a resolution to this and you get the therapy you were promised, with out any caveats/clauses/restrictions.

This is so incredibly stupid and you are not being over sensitive but why not get on with your treatment now, try to put up with their guidelines and maybe set a date in a few months time to complain about it.

I guess I feel by accepting their guidelines and signing the contract I am implying that I agree with their attitudes and that it is ok to have these attitudes. Part of me just wants to say 'sod it' and get on with the therapy but another part of me thinks that this is not just about me, what about those that feel to vulnerable to say no or who accept forced discharge as they are not able to fight their corner?

This service is part of the IAPT programme (Improving Access to Psychological Therapies) which was developed to ensure that more people with anxiety/depression etc are able to access therapy easily. These attitudes, IMHO, go against the ideology of this programme :)