"Breastfeeding advice unhelpful"- BMJ

[EauRouge]

Here. (Think this is what was being hinted at yesterday)

I agree that breastfeeding support in this country is totally lacking but I don't see how changing the advice will help- how about providing more and better support?

'Like Napacab have hurt this advice that 'if it hurts you're doing it wrong'. I suffered pain and cracked nipples but the MW said my latch was fine. I pushed on through and nothing has changed except the pain has gone. I don't know why advice is so contradictory but however expert somebody is, surely when they are talking about how BF feels, they have to draw on their own experience which can only ever be quite limited and personal, and yet every woman and every baby is different?'

But the latch probably was wrong, we have so many midwifes saying this to women in our area, they just arent trained to know what a good latch look's like. Also the pain often does go away as baby gets bigger and things natrualy change (but how many women have suffered needlesly or given up by this point as the pain was to much to bear).

So more traing for midwifes or more train breastfeeding supporters visiting hospitals would surly help with this.

And yes we do have all our own personal expreances but a well trained peer supporter should have been debrifed about there own personal expreances and trained to lision to women and the problems they are having. We are not supposed to talk to women about our own experances at all and we well aware that every women and baby feeding pair is different. So good traning does cover all of this, but this isn't what midwifes are getting. I still find it shocking that as a BfN helper I am better trained then most midwifes and HV in breastfeeding.

How a latch looks does not determine if it is a 'good latch'. There are 2 important things- does it feel comfortable and is the baby getting milk effectively. If you and your baby are both hanging upside down swinging from the light fitting then it's fine, if that is what works for you.

Yeah, but you know what tiktok, mums who are BFing can equally sometimes adopt a tribal 'BFing mum' identity - it's not always foist upon us by others.

I certainly spent months of my life obsessing with mum friends about how what we did was different to what other mums did. There were lots of things (maybe not dungarees and lentils!) that became ludicrously over-significant as we all tried to identify like-minded mums. Not only feeding method but also slings versus buggies, cloth nappies, favourite baby books, etc etc. I think it all reflected our lack of confidence and that awful feeling of just not knowing.

Later you look back and feel like a right twat really bad for having made these crazily superficial judgements - part and parcel of becoming a mum, I fear ...

Being 'tribal' is part of being human, boobmeister. It's not surprising breastfeeding/formula feeding mothers do it, too.

That doesn't make it right, or supportive.

I had DD here in the US. I had every resource available to me (out health insurance paid for a lacation consultant for 24hr support - they helped me with her latch and had me do skin to skin for 4 days straight) and I wasn't able to breastfeed because my milk didn't come in. I had an emcs due to preclampsia and the drugs they gave me inhibit your milk coming in about 2% of cases. I fell in that 2%, ironic as I also fell into the tiny minority of females who get pregnant while on the pill.

No one old me this so I tried for 5 days in the hospital, I dreaded the next feed everytime and DD was screaming due to hunger from when she was pulled from me until she got her first bottle. I was exhausted as I fed for 50mins every 2 hours. It was only when I went to DD's paediatrian's appointment the day after we were discharged did the dr, who is a mother of 4 and the only dr from DD's group who didn't see her in the hospital, started to ask questions as I had no engorgement. She pulled up my hospital files and called my obn to ask why no one had checked my lack of engorgement before leaving the hospital. She had me switch to formula as DD had gone for 8lb 8oz to 7lb 1oz and she later told me she was worried about my physical and mental health. I lost 30+lbs over 5 days in the hospital and she weighed me in her office as I looked gaunt. I had lost another 5lbs and my blood pressure was high.

Breastfeeding doesn't always 'work'. There is nothing wrong with formula, just as there is nothing wrong with jarred baby food. It was a personal decision that I made based on advice from the Dr and my cousin who also had a CS and stuggled for a month to BF but got there in the end (she is in Canada and had wonderful support too).

Tiktok I'm not saying that it's right that BFing has an image problem. I'm just saying that I think it does. If people come away from a book thinking 'I don't relate to this' there's a problem.
What if people are shying away from breastfeeding groups and getting the help they need because they feel as if they don't fit in. Then you just end up preaching to the converted, when presumably pro-BFing orgs would like to appeal to the whole social spectrum?

tiktok - I feel angry/sad about the divisiveness too. The most extreme reactions I have experienced have come from people who have exclusively fed for 6 months and then breastfed to two years. It is a small group of mothers I know who have followed everything to the letter - because in one way or another they were fortunate to have relatively easy babies. Next to these people I feel like a failure - standing next to the average person, they would say I did really well (had to mix-feed DS1 because of health related problems at 4 months and DS2 bf'ed for 6 months and stopped at 10 months).

I feel the divisiveness is created in part by the attitudes of these mothers - I feel some women think that if you can't you are a bit flakey, and it almost seems that they define themselves as a good mother in these terms. The attitude needs to change about what defines a good mother and also for people to be more helpful in practical terms instead of just saying "you should..".

Very surprised than only 1 pc of babies are breastfed exclusively until 6 months. I would have thought more like 10 pc.

More support is definitely needed and it mut be specialised. Of the 10 people I consulted before BF finally started to work, only 2 actually realised what the problem was (tongue tie), helped me solve it and then taught me how to BF properly.

I disagree wholeheartedly with the focussing of scarce resources on disadvantaged areas: everybody can find breastfeeding difficult and making it harder to access help by locating it in out of the way locations that are difficult to reach when you are still recovering from the birth is cruel. I was lucky that DH took three weeks off and could drive me to the various health centres where help could be found on different days of the week, but if I had had to get there on my own or rely on home visits I simply could NOT have done it. The midwives stopped coming after 10 days because we had a car, yet I was too ill to drive. The health visitor came once, mistook my mother for a maternity nurse and said "see you in clinic", despite me being too ill to walk or drive to it, let alone taking a taxi (too near, so taxis would not come, plus I could not lift the car seat).

Focus resources on medical need, not on perceived advantage/disadvantage.

I expected breast feeding to be easy and natural
The reality was more akin to torture

Why oh why did nobody tell me to expect that?

Sui g I think I read that the figure is surprising because the meaning of 'ebf' used is very strict. So if you use breast milk only, but start on the mashed carrot at 24 weeks, for example, you wouldn't be included in the figures.

I gave birth 7 weeks ago. There was no mention of bf by MWs in my ante natal care, just asked how I intended to feed so a box could be ticked. I was not offered any ante natal classes or post natal HV run group, as I was with DC1- apparently these have been cancelled to save money (or perhaps they were never offered to second time mothers). At no point in hospital did a MW advise on bf, check latch etc. (I was in for 4 nights). They just said, "is she feeding and weeing and pooing- good" and rushed off. One MW was an exception, advising that I should feed on one side for a decent amount of time so DD would reach the hindmilk WTF it was day two, my milk hadn't even come in yet! When I was at home, I complained to a community MW that DD fed for a long time, and she told me straight away to top up with formula; it is only by coming on MN that I know that cluster feeding is normal.
It is a miracle I think that anyone manages to bf successfully given the care, advice and support available.

onelittlefish - I am sorry that you were made to feel like that. I bf a long time but I promise you that I do not judge women who did not do that, I felt like a bit of a weirdo and out of synch with everyone else. It suited us but I completely understand it is not for everyone (or they try and they can't), I hate all the guilt around it. I know a group of women who make me feel totally inferior because my DS has the odd McDonalds and watches TV. But they are just living how they want to live and I avoid them if poss!

I bf two babies over a year each. The support in hospital was awful!
To brest feed well you need someone to check your latch EVERY time. It takes a couple of days to work it out.
With my first no one checked, i ended up with cracked bleeding nips and agony. ( only carried on because im a stubbern pig, i failed to have a water birth, something was going my way)
with my second child i buzzed them every time and i forced them to check ( lots of huffing and puffing)

As for the exclusive feeding for six months, i though this was proven to be poor advice now.....iron levels....

The mwives are just too busy ( one complained at me for buzzing her to pass me the baby, c section in a bed that didn't lift) they offer a poor service. Not saying it is them at fault but really they have no time, understanding or care. When you have had a baby you need them, really you do. And if your reaing midwives a c section is major f@@@@@@ surgery, tough love is inappropriate.

Rant over.

I was lucky that my Mum had mainly breastfed and I saw my older sisters all breastfeed - not without difficulty and problems either - so I knew what to expect. Or thought I did. When I had DD I struggled massively with breastfeeding. She wanted to feed all the time. And I mean, all the time. If she wasn't latched on, she screamed. She put on weight so slowly she dropped 4 centiles in the first two months. I put up with all the comments of 'oh isn't she tiny' and the comments from my NCT group who all had huge chubby babies and breastfed without problem.

I joined a breastfeeding cafe and met some lovely women who I'm still friends with now. The lady who ran it was not a breastfeeding counsellor or a midwife - she was the nurse at our GPs who thought that there should be a breastfeeding cafe. She couldn't give much advice other than general encouragement, but having a cup of tea made for me and a biscuit offered, once a week probably saved me from going mad some weeks.

I stuck with it, through bloody nipples, mastitis and thrush. Partly because I'm bloody minded and partly because I have a serious martyr complex and sometimes, I hate to be beaten. DD slowly began to put on weight. She still clung to the 2nd centile but she was putting on weight. So here I am today - 16 months on and I'm still breastfeeding.

Mums I know who bottle fed, did so for various reason. Some because they never wanted to breast feed, some because their babies couldn't seem to latch on or they felt they didn't have enough milk and some because they found breastfeeding much harder than they ever imagined and needed a break. Two stopped specifically because they found breastfeeding 'unnatural' and felt 'dirty' doing it. Those are not my words, these are things they both said to me when we talked about it. They didn't find other people dirty or unnatural breastfeeding but that is how it made them feel. I don't why they felt like this, and I'm not sure they do either.

What I'm trying to say is that the whole issue of how people feed their babies is complex and people may breastfeed or bottle feed for so many reasons it's hard to generalise. I think that there is need for more support but also more 'normalisation' of breastfeeding. There are some many adverts for formula milk, and babies on soaps are all bottle fed for example. I think that for a lot, if not most, of people now, when they think about feeding a baby they would think of bottle feeding. I think that needs to change if breastfeeding is to become the 'norm' again.

Onelittlefish it's a bit dismissive to say that those who breastfed exclusively to 6 months only managed it because they had "easy babies" don't you think?
Me and my son had a really difficult start to bfing - cup fed for nearly a week before he latched then problems with sore nipples etc but in the end we did make it to 6 months of exclusive bfing. It wasn't easy actually,it was really bloody hard at times, but we did it. The biggest initial difficulty in many ways was ignoring all the shite advice I was given in hospital and afterwards and seeking out decent support through other channels.

I wouldn't presume to make judgements on how hard or easy your situation was as i have not experienced it. It seems fair to expect the same non-Judgemental attitude back.

Also the fact that I followed the advice (although I only bfed to 18 months not two years) doesn't mean that I think those who did things differently are not such good mothers. I did the best I could same as anyone else does, my actions are not a judgement on anyone else's.

Aside from those who decide to FF for whatever reasons (many discussed here) I agree with a couple of other posters, that all the (loosely classified) 'support' in the world can be pretty much redundant as long as things like tongue tie aren't checked at birth.

How hard can that be? Ask mother how they intend to feed, if BF, check for fricking TT before whiffling on about positioning, latch, nipple shields, top-ups, etc. I appreciate this would require extra training & resources & therefore money the NHS doesn't have, but surely by NOT checking, they're compromising infant nutrition, & discharging women from their care who are still in pain, however many midwives, HVs, GPs, BFCs, friends etc have given what would otherwise be excellent 'support' (can you tell I'm bitter & twisted about this issue??)

The NHS & NCT advice & support I got would have been great IF my issues had 'only' been those of latch/positioning (and I by NO means want to diminish the problems caused by poor technique, cos I had them too!) but it took 5 weeks of agony, hours on this brilliant forum, and £100 of my own cash to establish that DS had practically no tongue mobility.

My own personal soap box crusade, maybe, but support should include simple physiological checks that can make the difference between BF and not.

re the 1% statistic, I imagine that it's so low because it excludes people like me: I'm still BFing DS now at 19 months (less snuggly and cute, more wrestling a tiny bear) but he had two or three bottles of formula in the first week of his life, so he's not been 'exclusively breastfed.' I'd call him exclusively breastfed in that after day 7 that was all he got, plus we didn't introduce solids till after 6 months - but according to most surveys he's not ebf.

rachelwalsh - my statement was not an accusation of all mothers, or saying that all people are like this, or even that all people who breastfeed have easy babies. However, daft myths about breastfeeding are perpetuated for a reason - myths like "it is natural" or "it is easy", they all come from somewhere.

If I was to go back 5 years my BF'ing would have satisfied WHO Guidelines - what fantastic discovery in 5 years has made my BF'ing attempts unsatisfactory? The advice used to be to wean at 4 1/2 months. I would like to know what changed and what development made it 6 months.

[joins Mombo on the CHECK FOR TT YOU NUMPTIES! soapbox and does a little dance]

well that feels better!

I think i misunderstood you onelittlefish, I thought you were saying that the ones who followed to the letter only managed it because they had easy babies.

I agree that unrealistic expectations of bfing being "easy" or "natural" are unhelpful - perhaps in a society where we had all seen bfing for a young age and had plenty of experience to draw on around us from female relatives etc then that might be more accurate. In my case and the case of everyone else I know it has been a learned skill and a hard graft at times too.

I must be weird because I actually really like breastfeeding.
If I want to go out, I'll leave a bottle of formula but if I'm around I'll feed him myself. I guess that means my baby's not been ebf, even though he's 11 months and still enjoying the boob.
I am a million miles away from the earth mother stereotype - work, wear make-up, like clothes and have never owned a sling (they scare me).
I think I was lucky in that all my boys have been good with it - even the last one who was a month early. Being in the NICU with nurses trying to make me feed by the clock made me really understand why lots of women struggle - because I'd successfully fed two older children, I had the confidence to keep going.
I wish people would stop getting so upset about BF - If you can, great; if you can't move on.
I've never had a "natural" birth (3 c-sections) but I don't let it worry me; likewise, if you can't or don't want to breastfeed, it has ABSOLUTELY no reflection on your parenting abilities.
We are all mothers who try to do our best, often in tricky situations.

I am commenting here only on the OP and the linked article.

In my view the 6 month exclusive breastfeeding recommendation should be scrapped (well not scrapped exactly, but refocussed - see below). In its place should be much stronger encouragement and support for women to breastfeed in the first instance, even if that is only for a couple of days. Those early days and weeks are the most crucial of all, and yet it is clear that many women (I know because I was nearly one of them) are being put off from persevering in those early times because the holy grail of 6 months seems so totally unachievable.

In reality, if a woman gets the support to reach, say, 6 weeks then it is likely things will be working well and who then is going to give up and switch to bottles voluntarily? Someone who gets to 6 weeks will likely continue for much much longer without any nannying being required.

The 6 months recommendation should be refocussed to make it clear that it's about refraining from solids until 6 months (or as close to 6 months as possible as each baby is different). That applies whichever feeding method is being used.

It a socity issue though and changing socal norm's is never going to be an easy road.

Yes breastfeeding is natural, as it's how nature intended us to feed our young BUT it is a learn skill and in culters where it is normal they don't have as many problems feeding as we do. Why becuse women grow up seeing other's feeding there baby's, they learn form a young age how it is done. Not only do a low no of people breatfeed in our country but we're not supposed to do it in public or cover up (so a lot of people would tell us). How are we ever supposed to learn unless someone then spends time teaching us this skill.

A good example of this is of primates in Zoo's when they haven't grown up seeing other animals feed and care for there young they just don't know what to do with them. We have to show them video's and send in feeding mum's to teach them.

onelittlefish - the guidlines actualy changed longer then 5years ago it was I belive 2004 (although this information seemed to take some time to be taken up by HV as my sister was also told to wean at 4months after they had changed the guidlines) that the UK changed there guidlines and the reasion being new reasarch into the development of baby's guts.