what is the best way to talk about breastfeeding antenatally?

[tiktok]

There is an idea that discussions about feeding choices in the antenatal class or elsewhere before the birth 'make' women feel distressed and guilty if they subsequently don't breastfeed, or don't breastfeed for as long as they wanted to.

Are these discussions responsible for these feelings? Or do they make them worse? Or do women's feelings of disappointment and sadness get turned in on themselves, so they blame themselves, when other circumstances/people/events have been the reason behind the use of formula.

What do you want from antenatal discussions about feeding?

I have to say the most valuable 'education' I had was observing the experiences of my friends - fortunately all of them successful breastfeeders. It gave me confidence and also a realistic idea of what breastfeeding means in terms of time commitment and potential problems. Mumsnet is probably a pretty good substitute if you don't have friends with older kids!
Antenatally I found the most useful approach to be a factual and problem-solving one - I went to an excellent class which focussed on positioning and gave other practical advice about trouble-shooting. it was aimed at people wanting to breastfeed so no need to compare breast and formula feeding - it was just about teaching techniques.
I'm not sure what can be done antenatally to help people feel better if it doesn't work out - I'm not even sure that it is appropriate for antenatal teaching to be aiming to do this. I think its natural to feel upset if you can't breastfeed and you wanted to - I feel upset that I couldn't mixed feed once I went back to work, but I don't think that's anything to do with what anyone told me before I'd given birth!

Couldn't agree more Highlander - I too feel well-informed for if there is a next time as a result of reading mumsnet.

Of course I would have found the info on the back of the formula tin more than adequate had I not been stressed out to the max after 8 days of hell with a starving ds. I was in a right state - couldn't even read the bloody tin! If I'd have known in advance how to use it it would really have helped.

Just found this thread and wanted to comment .. when I started bf dd it was the singular most difficult "task" I have ever had to master. Cracked nipples, dreading feeds, crying and refusing to feed in the middle of the night etc etc etc. Obviously it got easier and I carried on to 7mths.

However, at no point during antenatal care was it mentioned that bf could be painful or difficult, just that it was the "best" thing for baby. I am not stupid and I read a lot of pregnancy and baby literature, but nothing could have prepared me for bf. I suppose midwives are more concerned with getting you through the birth in one piece than scaring the pants off you with this next huge hurdle to overcome.

Mumsnet (esp Aloha, Mears and Tiktok) gave great advice and certainly kept me going for a lot longer than i would have on my own.

The antenatal bf workshop that I went to was inspirational for me and really helped me when I had tremendous problems getting feeding established - ds was a sleepy baby who wouldn't open his mouth and who also learnt to pretend to suck!

The workshop had a couple of "real" bf mums come along to describe their experiences and one of them had had real difficulties. I remember thinking "If xxx could do it, then so can I". This girl ended up feeding through a nipple shield for a full year, as it was the only way that her son would accept the breast. But she had been on the point of establishing a 100% expressing regime.

The other girl at the work shop had a monster baby - looked about a year old at 6 weeks, so it was good to see the contrast between the 2 babies (xxx's was also aobut 6 weeks), and to know that they were both healthy babies.

The "wrong" thing about the workshop (run at the Maternity Hopsital by the bf counsellor/midwives) was that it was just that - a workshop that you signed up to separately. So only those that had already committed to bf went along. And in a way, I can see why the coverage in the "formal" antenatal classes would be less enouraging, because I don't recall them ever going particularly into the potential problems you might face. I was able to be realistically committed to bf - I knew that I might have problems, but that I could get support.

It also helped that the sister in charge of the labour Wards was very pro bf and chaired the BF Strategy Group (or something like that). She gave me good advice, both directly,while I was still in hospital (slightly extended stay due to jaundice and light therapy) and also by enouraging me to go to the BF support group even while I was still in hospital (came to take ds' security tag off and shunt me along the corridor to where the support group met).

The support that I had afterwards from the hospital was fantastic - I continued to go to the support group untilI went back to work. They lent me an expressing macine when ds failed to gain weight, referred me to the paeditrician when he still didn't gain weight, but didn't hassle me at all, as he was obviously thriving despite his sutbbornly flat growth curve. (The consultant asked me how my dad was, said to stop with the faff of expressing and just enjoy my manifestly healthy baby! )

I had only planned to bf ofr 3 months, 3 months became 6 months and in the end I did it for 13 months.

I did return the favour and went to a number of the bf workshops as an example of a bf mum - and met mums later at the support group who told me that I had been the one who had inspired THEM (just as xxx had for me)

Our hospital is Baby Friendly Accredited. There are a number of things that have to be in place to achieve BF status - see here

Women are no longer asked antenatally how they are planning to feed their babies. In an effort to try and change the 'culture' around breastfeeding, it is the normal to ensure women have information about breastfeeding in order to make an informed feeding choice. All women are offered breastfeeding workshops. At the workshops there is discussion about how to breastfeed and practicing positioning and attachment with dolls. The down sides such as painful nipples, engorgement, mastitis are discussed and how to avoid that happeneing. Treatments are discussed too. B/F mothers come and share their experiences.

Making women decide at the beginning of their pregnancy how they are going to feed limits their choices. They may say they will bottle feed and find that they change their mind later- only to feel that they are not 'allowed' to change their minds as they are all set for bottle feeding.

At delivery the mother is encouraged to have skin-to-skin contact. Often the baby will start to root looking for the breast. The midwife will ask if the mum wants a hand to breastfeed. If she has categorically decided to bottle feed she says, 'no thanks, I am bottle feeding' to which I reply 'that's fine, what milk would you like?'.

Some mums say that they weren't sure what to do, and when they see the baby searching to suck, they try breastfeeding. In that scenario many women are pleasantly surprised how nice it feels. Other women say they don't like it and don't want to continue. No problem.

I have seen women change from bottle to breast because their baby vomits at all formula feeds. I have seen women change from breast to bottle because they don't like it. You cannot preplan whais going to happen.

Women who know for definate that they are going to bottle feed are given information as requested. A small group demonstration of making up bottles can be dome for postnatal bottle feeding mums. There is absolutely no value ,as Tiktok has said , in doing antenatal bottle feeding demos. That is a well researched, documented fact. Some hospitals have stopped providing ready made feeds so that women are taught and observed making up feeds safely. There is something to be said for that. Midwives and HV's will go over sterilising and making up feeds when asked.

As a midwife I cannot recommend one formula over another because there is not one that is better than another, except in the case of prescription milks for identified feeding problems.

My hospital was also baby friendly accredited.

But as I say, making the workshops separate means that only those already thinking of bf go along - so they are the only ones who learn about the potential problems (as well as the joys of course!) I'm not sure it would have done anything to support "waverers" - who may not even have realised how helpful the workshop would have been and therefore not signed up.

The video we had in the antenatal class, from memory, just went through the stats and how "natural" it should be. It also went on about Norway, where they have reversed the trend towards bottle feeding.

The Queen Mums didn't have any formula made up - so I presume that the midwives/auxilliaries then helped/demonstrated to those mums who were formula feeding how to make up a feed. The new mums also then learn the reality of having to make a feed while a baby is needing a feed, as opposed to just having it "on tap"!

Glasgow still has a very high proportion of bottle feeders - which is highly post code related. Interesting that no-one has raised the post code correlation in the recent discussions!

Who runs these antenatal bf workshops? Can anyone let me know where/how to book? Thanks, Dinny

At my hospital it was just notices on a noticeboard in the maternity Outpatients department that you signed up for.

You chose the date and the format (they had some "plain" workshops, some for "Mums & Dads" and some for "Mums & Grandmothers" - I took my Mum along, although she was the only gran-to-be there) that was best for you.

Could you contact your midwife, NCT or La Leche League to see what might be available in your area.

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I think it would have helped to have met the local BFC antenatally, even if they were not actively promoting it then, so that when I did need to phone them I could have felt less hesitant in picking up the phone and more at ease. I wished I had phoned her weeks earlier as it really did only take a call to help and intervention sooner might have avoided later problems.

Perhaps a sort of meet your midwives,HV,BFC etc type scenario, these are the baby clinic times etc

I so agree secur; I know that if I had had access to the 'truth' in advance I would have done some advance research about the things I could have done to try and rectify my own horrendous experience. I really do think the potential difficulties should be hammered home antenatally. When I suggested this my own midwife said they don't tell you about it so as not to put you off bf. This is just bs - if I had known I would have been mentally prepared and armed with information. Plus I'd have made sure I knew how to do bottle-feeding as a backup. I found it really stressful having to hurriedly acquire all the bottle feeding equipment I needed and learn how to do it when I was in such a panicky state.

The best piece of advice I got - which I clung to during the early days - was that most people give up in the first 3 weeks. Our antenatal class M/W basically said if you can get past 3 weeks then you're pretty much sussed. So for about 3 weeks of pain I kept telling myself I could get through it past 3 weeks. And I did - 17 months in the end

I don't remember anything practical about b/f from the classes - just that statistic of 3 weeks - which really fired me up to get past that. I never dreamed of b/f for 17 months - it just ended up that way.

I wish somebody had told me that "flat nipples" doesn't mean, well, flat. As in, one of mine looks just fine to me, thank you, and not at all like the illustrations of flat nipples, but it's not quite perky enough, particularly when I'm all puffy from being on a drip for 24 hours.

And bottlefeeding isn't always faster; my baby rarely nurses for food for more than 15 minutes (since about 3 weeks) but almost never gets through a bottle in less than 30, sometimes 60, and once DH in a bloody-minded mood stuck it out for 90. She gets one bottle of EBM a day. And that's on the bottles she likes, after reducing ex-commando DH to tears on two different kinds she doesn't like. (Made me feel a lot better about my difficulties getting a good latch, let me tell you -- he wasn't immediately post-partum or in pain, and the nipples were certifiably OK. Perhaps somebody should point out that feeding a screaming baby is just hard, no matter what you do it with.)

Funny, my sister is saying the same thing to me - promise you'll stick it out for a month. It does seem if you stick at it for a few weeks then it will work (she says hopefully!)

My only knowledge of breastfeeding came from two friends who had both bf exclusively for months with virtually no problems at all. I just assumed it would happen naturally and couldn't believe it when my dd didn't regain her birthweight by 4 weeks. Even after her first couple of weigh-ins I was so clueless I didn't really accept that things were going wrong, I just assumed it would all come right in the end. I refused to supplement with formula because I had no idea that mixed feeding was so common and was horrified by the idea that I couldn't feed dd all by myself. By the time I admitted to myself there was a problem it was too late to do anything about it. My milk was going, I was too upset and exhausted to act on the advice I was given and eventually I gave up altogether because i started to believe that my milk wasn't doing anything at all for dd. With hindsight I think the problem was caused by not feeding often enough in the early days. dd was very sleepy, and I'd been told to feed on demand. No-one ever told me what to do if she didn't demand. She was a big, healthy baby with a strong suck, and things started off really well in hospital. We should have been an ideal breastfeeding team, and I can't bear it when I think that I failed for such a stupid, simple reason. If only someone at some point had told me I needed to wake her up and feed her more frequently. So obvious now, (and maybe so obvious to midwives that they don't think to mention it at ante-natal classes) but at the time I had no idea - I thought babies knew instinctively what they needed to do.

Beatrice, you were badly let down at the time you needed support and good information - yes, babies who don't wake for feeds need to be woken and offered the breast, abd all babies should be given skin to skin contact which maximises the chance of being able to respond when they need to feed. I am so sad for you...if this is a recent experience, perhaps you would feel able to write to the hospital and tell them what happened.

I don't know whether I'm repeating what other people have said, but my hospital did an excellent breast feeding workshop. The most useful part of which was when 8 newish mothers came and answered group questions and generally chatted about their experiences. We mums-to-be were moved around from circle to circle so we got to listen to 8 different points of view, and the mums fed while they talked which was a great way of demonstrating the different ways people position their babies. The kind of experience that we would all be more likely to get if we came from the large families of yore where mothers and aunts would be the models.
I was contacted when dd was 8 weeks old by the coodinator who chatted about how things were going and asked me to be one of the returning mums. I was happy to do it, partly because I had been very lucky and had had no problems and wanted to try and be an example of hassle-free (apart from endless feeds and sleepless nights) feeding. There were plenty of other mums returning (some who'd had real problems which they'd managed to overcome) and it gave me a real boost being part of the whole process. And dd was an angel! And I was at the till in Hennes last week and a mum with her dd came up to me and said she recognised me from when she was pregnant and attending, and that she'd gone back because she felt that she might be able to help too.

Yes, Tiktok, it's a recent experience (dd is 16 weeks) but I don't really blame the hospital. I think the problem was that I had been so confident that it would work and in the beginning it seemed to be going so well, so i didn't ask for enough help. She latched on and fed brilliantly straight after the birth. The first time she cried in the night I just picked her up and put her to the breast and it seemed to go fine, so I thought we'd cracked it. The next day I asked a midwife to check that dd was latched on properly and she said it was fine (although she hadn't actually seen me latch her on.) So i guess they thought I was OK and didn't offer me any more help. Perhaps hospitals should have a policy of actually checking that bf mums have fed every three or four hours and ticking this off on a chart, as they do with drugs etc.