Manchester Maternity Unit to no longer supply free formula

[BoastingByStealth]

menmedia.co.uk/manchestereveningnews/news/s/1459696_st-marys-hospital-bans-free-formula-milk-to-make-mums-breastfeed-instead

Does anybody disagree with this new policy?

Apologies if this has been done before, I'm just in the middle of a debate about it, and wanted to canvas opinion.

It's already the norm in London to take your own formula

Are they doing it to achieve Unicef baby friendly status ? unicef stuff here

majority of people in hospital are ill and no able to plan what to take in with them
Babies a re hopefully not ill and parents have loads of time to pack formula.
If you can't afford formula then wtf are you doing having children!

entropygirl nice post, I mostly agree. But I don't think there is anything like the stigma linked to CS that there is about FF (although accept that CS Mums might feel differently so apologies if I have a blinkered view of this). Nobody implies to a CS Mum that they didn't do the best for their baby, or that they just didn't try hard enough, or 'almost every woman is capable of giving birth naturally'. And in my NHS ante-natal classes they discussed the possibility of CS, looked at where it would take place, what would happen etc. so we were all a little bit prepared for it. Nothing is said about feeding apart from BF is the land of milk and honey and FF is A Bad Thing to be avoided.

But I do agree, everything you put makes sense, that's how it should be.

D

Many hospitals do this these days. I don't know of any research showing " other areas that have tried this have found their exclusive breastfeeding rates fall because lots more mums bring formula "just in case" and once it's in the bag it's more tempting to use it, rather than having to ask someone and wait while they explain where it is or get it for you." Have you just made that up, HearMeRoar? Or is there some decent evidence this has happened?

I would like to see the effect on bf rates of these policies, though - it could raise them or lower them, I have no idea.

The maternity units I am aware of that do this always have formula available, for free, for crisis moments. No one tells a mother who's upset and struggling and sure she wants to give formula, and whose baby urgently needs milk, that she has to send out for it.

Mothers who need to be shown how to formula feed safely by making up the powder correctly should be shown how at home - there really is not time in the average 48 hours a mother and baby are in hospital for formula powder demos. A home 'teaching session' by the community midwife makes more sense anyway.

This has nothing to do with being a 'stick' to beat mothers with - that's over-dramatising the situation. It's not forcing anyone to do anything. If breastfeeding does not work out, then of course support and understanding are needed - and formula supplied as a stop-gap until the parents can supply their own.

Delia, Im still confused as to how having to provide your own formula is more of a stigma than asking the MWs for the hospital supply. I completely understand that you feel slightly upset that it didn't work but probably most of the guilt comes from yourself. I don't blanket judge mums who FF because I imagine there is a whole host of reasons why they made that choice or it was made for them. I'm only judgey about people who wince at the thought of BF as if it's unnatural and icky.

I really don't think having to provide your own is somehow making mums feel bad. It should just be the norm like having to provide your own baby clothes and car seat. All mums should take some with them just in case as nobody knows how birth, especially first birth is going to pan out. Incidently, I packed two ready made cartons even with my fourth despite being fairly sure BF would go well having BF the other 3. This was simply because you just never know.

But surely the vast majority of mothers dont have babies without having a clue about how to make up a feed? Even if you weren't sure, the instructions are on the tin and the ready made stuff just gets poured straight into a sterile bottle.

I'd be livid if one of my ante natal classes was taken up with this. I was annoyed enough that it was called 'parentcraft' and then was mostly about labour and birth with very little about parenting. I wanted to go along and learn about the stuff that wasn't obvious.

I've either got a bunch of very unlucky friends, or the number of people unable to breastfeed is much higher than we are led to believe (particularly on here, where I have read things like 'almost every woman can breastfeed').

Or perhaps the support and help to enable women to BF isn't there or they don't get that help?

In countries where there really is no option but to BF, almost all women can do so. Obviously a part of the reason is there really is no choice, but also that this means that their Mum, their Grandmother, their Aunts and most of the women around them would not only have BF themselves and so support women to BF, but will have a broad experience of the wide range of problems that can and do occur when getting BF established and will know how to overcome these. This is a key thing missing from our society and often the support that women are most likely to acess if they need help is not the most experienced and women aren't always sure where else to get help and they certainly aren't referred on to anywhere such as NCT or LLL. All too often, when any problems with BF occur, formula is suggested, as opposed to proper help.

lovingthecoast I do take on board what you said, and maybe you're right, that it's the pre-birth info that's not right. I was pretty well up on birth options, pain relief, CS etc. but not so much on BF, and I didn't think I was naive at the time. A lot of pro-BF would I imagine be completely against MWs advising to bring formula just in case.

There are A LOT of people, particularly on here, who do keep trotting out the 'almost every woman can breastfeed' line, to the extent that I think it is made out to be easier than it really is. You can do all the prep and pre-reading in the world, but there's not a lot out there that says it's really hard and you should prepare to fail. I know why, because they want to encourage everybody to try, but they don't really then see that through to its logical conclusion, which is full support, and a percentage failure rate despite best efforts.

FWIW I had bottles and formula at home 'just in case' but thought in hospital I would get the support and coaching needed to ensure my baby was fed.

D

When DD was born in hospital 9 weeks ago, formula was provided. In fact, you were not allowed to take in your own formula. You can indeed buy the same little ready made bottles they give you in hospital now at Asda (possibly elsewhere but have only seen them at Asda). They are very expensive but obviously ideal for use while in hospital.

Personally though, I think that a newborn baby has the same right to be catered for in hospital as the mother. There are many reasons why a baby is FF - to think it's always a simple choice is just idiotic.

My local hospitals have had this for a couple of years.The support for bf was also very good when I had DD 8 weeks ago and generally is in my area in Wales. DVD's before, good post natal support from midwives after birth, local bf groups. My GP said yesterday that now most mums are breastfeeding that the babies are all healthy and his job is much easier because of this! I took in some cartons just in case but totally wasn't necessary due to support provided,

You are right, of course. There does need to be more support. Maybe I was just lucky as the aux nurse who helped me establish BF in hospital was fantastic and told me it would take a while and that it would hurt. She warned me about the toe curling pain you get with latching on at first and that my nipples would be sore and I'd probably cry whilst doing it for a week or so. All this was reassuring when it felt like nothing was coming out, DS was screaming in hunger and it felt as though he was gnawing away at me.

But I don't see this issue as affecting that one. I think as long as mums to be are made aware of the policy beforehand and supplies are kept for emergencies then there should be no problem.

There wasn't free formula ten years ago when my son was born. I am surprised that the hospital has taken so long to change its policy.

My son was given free formula on instructions of a paediatrian. I think its fair that free formula is given when there are medical problems as new mothers and babies are entitlted to free prescriptions.

I did manage to breastfeed for two years although the inital weeks were very hard. I hope the money saved goes towards paying for more midwives.

Deliaskis - I totally hear what you are saying on the stigma side of things and also the totally inexplicable assertions of the NHS that all women can BF and even more inexplicable that it is easy to get going. I think it was a cochrane review i read that put the numbers at 5% not able. I obviously understand the drive to promote BF but that cannot extend to cherry picking information or outright lying. Remembering from my antenatal course I think that gives you:

BF
5% cant
40% never try.

C-section (I'm going to get this wrong)
15% emergency
10% elective

So if someone is formula feeding it is 8 times more likely it was a lifestyle choice than a medically based one. But on average someone in possession of a C-section scar had it because they needed it.

But the fact of the matter is that you KNOW you were in the 5%, you know you gave your baby the best possible start medically available to you and anyone who assumes you didn't can get knotted.

entropy you see with your stat there, 60% try, but 60% don't continue, and I reeeeeeally wish there was more help available for those.

I don't know if I would fall into the 5% you see, I don't know if that is only people with an actual medical problem (as in physiological) that means they don't produce milk (I sure did), or that it is actually not possible for the baby to get it out (I could express some). So I don't think I am one of the 5%.

I look around my PN group, and think, in this group at least, over 85% of us tried, and yet only 30% ever had any real success, so over half of us tried and failed, and that group is largely ignored in any of these 'how to encourage more BF' campaigns, decisions or discussions. What we needed was support.

It's probably a different issue I suppose, but when you're right there in the middle of it, it's all very much linked.

D

NotJustClassic Yes I was worried about that. It only supports the hypothesis that there is less stigma for C-sections because a lower percentage are lifestyle choices. Also I think the distinction between (shall I call it cosmetic) C-section and medically advised is clearer?

When people say they had a hard time establishing breast feeding they can mean a whole range of things. Some hard times end in BF, and some in FF. Of the FF some would always have ended that way regardless of any thing the mother could do and some might have ended differently with more support etc.

Following on from entropygirl's posts, I think this is the point:

Breastfeeding is the biological norm. Therefore, there are no benefits of breastfeeding, but there are risks of formula feeding (which are well understood and not in dispute).

However.

The risks of formula feeding need to be compared and contrasted with (and this isn't necessarily the entire list):

• The risk to the baby of not thriving/starving if the mother is unable to breastfeed and donor breastmilk isn't available
• The risk to the mother of not taking essential drugs (of whatever type) if they are not safe while breastfeeding
• Other risks/issues which are individual and personal to a specific family where there is a physical choice whether to BF or FF (ie where the mother is physically able to BF). For instance, a mother who has been sexually abused may be psychologically unable to BF because it would be just too distressing for her. For instance. And many other reasons.

To state that formula feeding is a risk to health and that the NHS should not be supporting it is reasonable - provided that the statement is made in the context of the above (ie within a balance of other risks).

It's a linguistic detail which is important, though, because to put breastfeeding on a pedestal and to call it "best" implies that formula is "normal". While it clearly is "most common" it's not in any sense biologically normal.

So, this is quite different to saying that "a FF baby who would not otherwise have been able to be fed (for whatever reason) has been put at risk by being FF". That statement makes no sense. A FF baby who would not otherwise have been able to be fed would be at "somewhat" [understatement of the year emoticon] greater risk without the life-saving and life-giving formula that we (thank goodness) have available to us.

The baby friendly initiative does require no free formula available (except in emergencies, etc) but it also requires hospitals to offer more support for breastfeeding, in various ways. It's supposed to be a two-part scheme! It has been shown to improve initiation of breastfeeding, but not rates at one month, so there is a lot more community support required.

I had all the support in the world - a mum who bf, a mil who bf, aunts who all bf. With dcs 3 & 4 I had bf support workers etc. I have always had very supportive hvs. And yet... only 1 of my 4dcs has bf for longer than 10wks.

To be perfectly fair, there are a number of reasons for this - certainly with dc1 but to be told that I am damaging their health is truly damaging to my mental health.

I don't know how you get around this. BF is best, therefore formula is inferior. Accepted. And you need to promote the benefits of BF to increase take up. But how to avoid people like me feeling like the worst kind of shit by telling me I'm damaging my children?

Well, I don't know how to get around that.

Delia, why do you think it is that so many mums in your PN group were unable to BF successfully? Do you think it could be to do with expectations?

I wonder if too many women expect it to be a romantic, snuggly bonding experience rather than expecting it to be painful, utterly exhausting and bloody. Maybe if more women had realistic expectations then they would make it through those first few awful weeks at the beginning.

Im not saying it's their fault they have these expectations but they need to be debunked if women are to manage to do it for longer.

But the point is, button, that you're not damaging your children. You have no other option if BFing didn't work out and you are living in an age where there IS an option.

Believe me, if we could square the circle properly I'd be really, really happy. No peer supporter or breastfeeding counsellor wants to do anything other than to help mums and babies. That's the whole purpose of all the years of training and unpaid volunteering that we do. To upset people is to do entirely the opposite of what the aim of our work is.

I don't know :( :( :(

I don't think it's unreasonable to expect people to bring in their own formula if that's how they intend to feed.

In the event of a baby not bf or issues with a mother's health, they do have supplies which they can use. They just don't give it out routinely.

But it was a choice - certainly with dc 3 & 4. Hundreds of years ago I'd have had to spend the 22 out of 24 hours in each day feeding and if my baby (as one that didn't thrive spectacularly) managed not to die before it was weaned it would probably have made up for lost time then. If it was bf at all costs then I could have continued. So it was my choice to stop (not with dc1 though). Because I would not maintain 22/24hr feeding given the choice.

It's all too damn emotive. That's what it is. And people like me who wish with every ounce of their being that they could have done it, whilst pretending that we're over it - we've made our peace with the fact that it's not worked out, really aren't and we feel like crap when this sort of debate comes along.

I guess I need to learn and stay away from this sort of topic. It only ever ends in tears.

D I was focussing on the starting stat because of the nature of this thread. Not providing FM in the few days after birth is surely aimed at getting people to try rather than getting them to continue.

It must be very difficult feeling that you could have done this if you had had more support and then having to read about the benefits risks etc.

This is just so messed up. The NHS seem wrapped up in a little world in which everyone can easily BF setting a large number of women up for a painful heartbreaking experience.

I think this may be about having a peer support group. In my antenatal class we had someone who was stuck in for a month prior to labour who saw all the problems pit falls and miscommunications concerning BF. She also noted which MW were actually useful at sorting problems and gave us the heads up about the huge disparity between the theory that its easy and the fact. When, one by one it was our time, she was there to help us pick up the pieces when things went wrong. Everyone in our group BFed for at least 2 months and all but one are about to hit 6 months. The one that had to stop at 2 months had serious issues that resulted in an operation.

So apart from training to be peer supporter and lobbying the NHS to change their website to reflect reality I dont know what to suggest. I probably wont make a good peer supporter as I was one of the extraordinarily luck ones who had a baby that was busy latching on while I was still not properly concious after the GA and have had a couple of weeks of mild soreness since. I am also, as has been noted on this thread, genuinely prone to bouts of crass idiocy and failing utterly to realise how people other than my target audience will take what I say.

buttonmoon :( :(

Like organic says, no one is saying 'buttonmoon is damaging her children' or 'buttonmoon's children have had their health damaged by formula feeding'.

The stats are dispassionate. They are not personal. On a public health level, we know that formula feeding leads to worse health outcomes. On an individual level we haven't got a clue what the effect might be. And as has been said, if you compare it to babies not being fed at all, then clearly ff has benefits on an individual and public level :)

It's ok to feel sad, disappointed, angry and even betrayed sometimes, if you ended up not bf after planning to do so. It's also ok to be grateful for formula and relieved that the struggle to breastfeed was not so prolonged everyone ended up too miserable to see any enjoyment in feeding. It's also ok to feel all of those things at the same time :) Mostly women who start off feeling sad, disappointed etc etc find that time lends some perspective and comfort, and I hope that happens to you.

What is not ok is to say 'please pretend that it does not make any real difference how babies are fed, because it's hurtful'....and to criticise any message that deviates from the bland and rather meaningless 'breastfeeding is better than formula'.

But Button how does providing your own formula make any difference to how you feel about your experience? I guess that's why I'm confused on this thread. The hospital are not saying they will not provide it nor are you allowed to bring your own. Nor are they saying you need to go through some humiliating ritual in order to FF. Just that you need to bring it with you.

In fact, I would hav ethought it was less emotive to be able to just walk into the kitchen bit and pick up a sterilised pack, take it back to bed and empty a carton of milk into it than it was to have to ask for milk each time.