MNHQ here: what you told us about breastfeeding... and why some of you stopped

[RowanMumsnet]

Hello

It's World Breastfeeding Week this week, and as part of our campaign for Better Postnatal Care we ran a survey with just over 1000 MNers with children under 5 asking them about their experiences of infant feeding. Many thanks to all who took part (it was a bit of a whopper).

We've got lots of really interesting information from you about breast and bottle feeding and your experiences of it, which we will use to inform our campaign - but for today we're focusing on the difficulties women encounter when they want to breastfeed (which 87% of respondents said they had wanted to do).

You can see the results here and our page about what we think the most common breastfeeding barriers are (based on the survey results) here.

In summary:

Among women who had wanted to breastfeed but had stopped within the first 24 hours, their reasons for stopping included:

The baby could not latch well: 41%
I felt I didn’t know what I was doing: 27%
I needed more help/support: 23%
It just felt incredibly difficult: 22%
Too physically painful: 15%

Among women who had initiated breastfeeding but had stopped by six weeks, their reasons for stopping included:

The baby wasn’t latching on properly: 56%
Worried I wasn’t producing enough milk: 42%
Breastfeeding was painful: 39%
I was overwhelmed/exhausted and something had to give: 34%
I found it difficult to express milk: 32%
I was worried the baby wasn’t gaining enough weight: 24%

Just ahead of the birth:

33% said they felt a lot of pressure to breastfeed;
47% were worried they would not be able to breastfeed; and
36% said they felt anxious about breastfeeding.

74% of respondents agreed with the statement: ‘There is too much emphasis on telling women why they should breastfeed, and not enough on supporting them to breastfeed.’

Among those who were still breastfeeding at six weeks, face-to-face support from healthcare professionals or breastfeeding counsellors was rated the most effective intervention, with 71% saying it contributed to their success. Partners' support was rated the best, with 81% saying their partners/spouses' support was excellent or good.

Many women found breastfeeding painful at first. Even among those who were still breastfeeding at 6 weeks, 31% agreed that ‘breastfeeding hurts/is uncomfortable’. Concerns about poor latch and milk supply also run throughout the survey results.

Among those who had stopped breastfeeding by six weeks, 34% agreed ‘I was overwhelmed/exhausted and something had to give’, and 22% agreed that ‘breastfeeding felt relentless’. Among all those who breastfed at any stage, 45% reported finding it difficult during ‘periods when the baby breastfed constantly or very frequently’.

Perhaps not surprisingly, women who had breastfed before were significantly more positive and relaxed about breastfeeding subsequent children. When compared with first-time mums, veteran breastfeeders were more likely to want to breastfeed (92% vs 87%), less likely to feel pressured to breastfeed (21% vs 39%), and felt much more confident directly before the birth about breastfeeding (54% vs 30%).

Have a look at our breastfeeding barriers page and tell us what you think - do our findings echo your experience? What can be done to really support women when they need it? What sorts of interventions did you have that helped you - or what would you have liked that you didn't get?

We will use these findings to work with health organisations to see if we can get better, more useful support for women who want to breastfeed.

Thanks
MNHQ

I felt no pressure to breastfeed from any HCP at any point. In fact with DS1 who was in SCBU, apart from showing me how to hand express and then showing me the breast pumps I had no actual interaction about feeding. They were happy if I expressed but they were also happy if he had formula instead. They didn't care if we went home bottle feeding, formula or ebm, or if we were mixed feeding or exclusively breastfeeding. As long as DS1 was being fed and gaining weight that was all that mattered to the hospital staff.

I did ask the HV about various issues we were having with breastfeeding, but she wasn't very helpful and again had the attitude that it wasn't relevant how DS1 was fed. She did tell me about breastfeeding cafes but I never got a chance to go to one. I did my own research, on here and Kellymom, and managed to solve my own problems. The HV was surprised that I had managed to get to exclusively breastfeeding and that my DS1 was gaining weight without formula top ups.

It was fairly similar with DS2 four years later. Again in SCBU, tube fed again with the whole expressing rigmarole. This time there was a lactation person on the ward who was a bit more helpful, but there was the same attitude that as long as DS2 was being fed and gaining weight it didn't matter how. We again went home bottle feeding a mix of EBM and formula, and we gradually moved to 100% breastfeeding over the course of a few weeks. The HV this time round was again somewhat surprised at this, and no support or advice was offered.

tiktok Wed 02-Aug-17 16:34:33
"bexley, *itsgood and cory - three different and highly revealing experiences, there - revealing of just how poor the support can be.

'Support' does not mean cheerleading, or meaningless praise or encouragement.....'support' means knowledgable, effective help that enables a mother to overcome challenges, that spots when things are not working well before a crisis develops, and which allows a mother to feel capable and in control. "

Afraid I think that is a very unfair verdict on the highly trained breastfeeding counsellors I saw. The professionals I saw did spot that a problem was developing, but I was so taken up with the idea that I had to be a breast-feeder that I didn't want to listen. It took quite a while before I let myself be persuaded (by anxious HVs) to see a doctor, and when he had dd admitted to the ward straightaway, I felt almost offended. I had so completely internalised the idea that if you only feed on demand with a correct latch your baby will be fine because babies are made to do this.

After dd had been hospitalised, the bf counsellor spent ages helping me to carry on breastfeeding, pumping, syringe feeding and all the rest of it. Far, far more than cheer-leading. The problem was rather that the help was so good that it persuaded me to hold out- and with hindsight I wish I hadn't.

What I lacked was not good breast-feeding support, it was the knowledge that breast-feeding support isn't everything, and that other things might be wrong which would demand something completely different from me as a mother.

I wasn't talking about your specific situation, Cory. How on earth would I know precisely the support you got? You've only just described it. I was talking generally.

I breastfed both of mine for about a year - they both just stopped by themselves around that point. I was really glad I did it, it was massively convenient and saved me lots of money. BUT it was horrendously difficult for the first few weeks, especially with my first. It hurt a lot, despite the fact that my latch was generally good once my daughter managed to get on. Which was another problem - it could take twenty minutes or so to get her on, which made me feel frustrated, panicky and depending on who else was there, embarrassed.

I hadn't expected the problems with leaking that I experienced: nobody told me about it. It was embarrassing and cumbersome having to mess about with breast pads and shells while holding a baby. And I had various physical issues caused by breastfeeding too. It took me until the 8 week point to feel like I could confidently feed anywhere and be reasonably sure nothing would go wrong.

What got me through it was the support of my NCT friends, most of whom were going through the same thing, and professional advice. In particular I happened to be signed up to a pilot called Build Your Baby, which was all about trying to give babies good nutrition. It meant I had a midwife come and see me in the ward and then phone me up every few days to see how I was getting on. She didn't really do much in the way of practical advice, because I was doing everything right - she just gently told me how well I was doing and encouraged me to keep going. Sounds like nothing but in that sleep-deprived, exhausted first week or two, her voice on the phone almost made me cry with relief that someone was being nice to me when I felt so inadequate.

I think women need more realistic advice and information before they give birth, and masses of encouragement and support while getting breastfeeding established. It doesn't need to be expensive: just someone kind and well-informed who will really listen.

I still feel incredibly angry and sad about my breastfeeding experience.

After a very long labour and EMCS, my daughter latched on once - and I pulled her off after 5 minutes because it felt horrible and tickly. I hadn't slept in ages and was on alot of drugs, my mental state was not good so I assumed the funny feeling was because of that. I couldn't get her to latch on again and they wouldn't let me leave unless I managed a proper breastfeed or I gave her a bottle. I had to leave the ward, I still hadn't slepy and just needed to get home so agreed to FF her.

My daughter didn't latch on for 8 weeks, but I expressed when my milk came in. I hated expressing, it made me feel very agitated and angry and I actually punched furniture and pulled my own hair out while I was doing it. It was like after 5 minutes of doing it someone would just inject me with some mad drug that made me feel sad and angry. I did a bit of research and came across DMER and thought it was that for a bit.

DD did latch on after 8 weeks. I cried with happiness, I'd worked so so hard to get breastfeeding to work. And amazingly I didn't get the horrible angry feeling that I got with the awful machine - at first.

Over half the feeds I gave my daughter I'd get so angry and agitated but unlike the expressing where I was angry with the machine and myself when I fed my daughter I just felt angry with her and like I hated her

Every HCP I spoke to either thought it was PND or DMER or both. It wasn't DMER, I confirmed this with the criteria the Lactation Consultant who got DMER medically recognised provided. I did go on to develop PND but I feel it was seperate from the breastfeeding anger. I did find stuff to do with nursing aversion/breastfeeding agitation on the internet but there's not really and proper treatment for it apart from distraction and vitamins - none of which helped me.

Thankfully I stopped being so stubborn about breastfeeding and stopped pretty quickly but it was an awful and scary experience that left me feeling like an absolute monster. I didn't really bond with my daughter until I stopped trying to breastfeed and feel very bitter about all the lost time in my daughter early weeks that I wasted on it.

I'm now pregnant with number 2 and I've been thinking about what to do with this one. I'm very tempted to FF from birth because I just had such an awful time with BF last time and all the 'support' I recieved was shit.

I was keen to breastfeed and had a similar experience to frecklesmcspeckles with tough birth, 37 hours in active labour due to various cock-ups, ventouse delivery and several blood transfusions afterwards. My body was in shock.

After a week in hospital and still trying to breastfeed with hardly any sleep my DD was losing weight drastically, as figgygal pointed out I didn't THINK I wasn't producing enough milk. I just wasn't. HV and consultant told me to stop and to give DD a bottle ASAP. I was back in hospital and sobbing on a bed when another nurse with some breastfeeding role (and no idea of my background) started grilling me about why I wasn't persisting with breastfeeding. I was beside myself with guilt and incredibly upset and told her to go away. She didn't give a flying fuck about me or how I was supported as a mother.

My DD is gorgeous and healthy and in couldn't love her more. I have suffered with PND and other health issues for 5 years as a result.

My experience was shit. I support anyone who wants to breastfeed and I know there are many benefits (I have three degrees in STEM subjects - I get it). But those that want to preach to/judge others for their choices can just go fuck themselves.

In summary there should be information available and support for the mother's informed choice. The end.

@Figgygal exactly the same
Issue for me. No doubt the "everyone has milk" brigade will be on here soon but I know I didn't with DD1 and I very much view formula as having saved her life.

On another note when our mums had us they got a week in hospital with support to learn to feed . Now you are kicked out in 24 hours with little support. If the NHS wants people to bf they need to support and not just lecture. And I don't mean the strange "breastfeeding buddies" who appear gormlessly in your room and stand there not knowing what to say when there is a problem, I mean proper medical staff who know what they are doing.

It's a really simple message from me.

Both of my children arrived surrounded by medical professionals, nearly 20 people for the first one.

The second we were home, a few minutes with a HV for a couple of days.

The hardest bit was not pregnancy or birth but being sent home and learning to feed for both of us.

Feeding problems caused me to have 3 more lots of surgery (breast abscess) and weeks of mental deterioration. Bare bones support from the NHS at this point. A week wait for a GP etc.

BF had been explained in 5 minutes - it's best for mum & baby and it's really easy. Look this plastic dolly can do it.

The support balance needs to shift from a heavy hospital pregnancy/birth focus to something slightly beyond the birth.

Just my thoughts. I know others are different but I had almost zero support, no response from breast feeding support helplines or my GP/HV. No BF groups near by.

It's how I came to MN.

I breastfed both of mine until about 18 months. I am a professional biologist and farmer's daughter so had either read up extensively or experienced issues around animal lactation before I had the eldest. Nothing much was going to derail me from just getting on with it, whatever support I was (or was not) offered. I realise that not everyone shares my willfulness though. Both times I was the only one on the post natal bay of 4 that was Bfing. Most of my peer group of friends had various issues that resulted in them not BF beyond the first few weeks.
It was my determination and positive encouragement from a HV that got me through the painful early weeks with my first baby and the conviction that bottles and sterilising would be a faff I could well do without. Once the early weeks were over, which also coincided with regaining some of my physical mojo post birth, I loved it and would happily feed anywhere I needed to.
Just because I am an advocate though, I am not judgmental about anyone who can't get on with it as I am firmly of the belief that it is each to his own when it comes to this issue, or indeed, any other aspect of parenting. This thread provides more than enough evidence of why BF is not for everyone. Even so, I think the rates could be improved at quite a small cost of initial investment to the NHS. Primarily by ensuring there is investment in practical support - providing lactation specialists and BF peer supporters ante-natally in the community, post-natally in the community and on all maternity wards.

In my experience, breastfeeding is all promotion & little practical support. I say that as a HCP.

I think it's interesting that now, in the 21st century, almost every other situation where formal 'support' is offered, its purpose is to enable the person being supported to make their own choices, be in control of their own life and to be independent. These are fundamental values. And yet the 'support' offered in relation to infant feeding is completely the opposite - it imposes its own value judgements on women. I accept that there is evidence about the benefits of breast milk, but I strongly agree with all the comments made about the lack of recognition of the impact on the woman as a person, on her mental health, or on the family unit.

My DD1 is now ten years old, and like many posters above, my feelings from that time of having lost myself, of being out of control and at the mercy of the 'advisors' - even though for a relatively short time until I switched to FF - are still raw.

BF had been explained in 5 minutes - it's best for mum & baby and it's really easy. Look this plastic dolly can do it.

That's how the midwife in the NHS antenatal classes did.

It's so tragic,i can only laugh.

@myleshuntswigs yes it is this very strange result that after you go through this traumatic experience that you survive but expect to feed your baby for the next x months you're told no, don't care what shit you went through in there you don't get the all singing and dancing mummy sticker.

I don't understand it at all. I would have been home far sooner with support and encouragement. As it was I was 5 days in and exclusively bottle feeding when leaving. No efforts from anyone after day 1 bottle, I was just a shit mum.

On an aside, I never want others to go through what I went. I went private anyway natal for my next two (after my horrific experience when dc1) and it was a world away. 10 years on it still haunts me though. What would you advise, should I "complain" now?? Who to?? About what?? I genuinely was so traumatised I want to help others not be. But what can I do at this late stage??

@sonicboomboom our midwife dropped the plastic dolly on its head after delivery through the fake pelvis. Cracked me up

Freckles

Mine (who, incidentally, had never given birth) told us that labour wasn't painful, just intense, and there was no need to make any noise or have pain relief; a nice calming photo of a tropical beach with palm trees was given as an example of pain relief we could use if we needed some.

She then proceeded to demonstrate a totally silent birth with the dolly shoved up her tunic. Pursed her lips for 5 seconds and oh! Out popped the dolly.

Sonic that sounds like a Little Britain sketch!

Freckles yy exactly that. Very much a "shit mum" label because, forget all that pregnancy and birth stuff, you needed support with something that seems to be held up on a pedestal to such a disproportionate extent that if you can't do it, for whatever reason (don't care la la can't hear you), it must be because you're lazy or ignorant and you're not prepared to do what's right for your child (sigh).

I keep meaning to go back to the hospital to go through what happened but have never felt strong enough tbh and I'm worried it's too late now.

The more I think about it, the more annoyed I am that the options were worried about not producing enough milk and worried that the baby wasn't gaining enough weight.

They do not "broadly cover" the issues of not physically producing enough milk or having a baby that does not gain weight.

They totally buy into the ideas that women stop breastfeeding because they can't see how much milk their baby is having or they think their baby isn't gaining enough weight because charts are often based on bottle fed babies.

It's not being worried if there's actually not enough milk, it's not being worried if your baby doesn't gain weight.

It's not some nebulous hysterical new mother issue, those are actual physical issues that happen.

tiktok Wed 02-Aug-17 21:01:43
"I wasn't talking about your specific situation, Cory. How on earth would I know precisely the support you got? You've only just described it. I was talking generally."

errr... how is any poster to take this post

"bexley, itsgood and cory - three different and highly revealingexperiences, there - revealing of just how poor the support can be.*

to mean "well, I wasn't talking about cory"?

You mentioned my name and specifically said I was an example of poor support when I hadn't mentioned anything of the kind.

What I had actually said in my pp was that I received "highly trained and sympathetic support". The fact that I said "highly trained" was intended to suggest that they knew what they were doing: if I had meant to imply that they were highly trained but ignored all their training to indulge in general cheerleading, I would have said so. It seems a bizarre conclusion to draw from what I did say.

This is precisely the kind of thing that worries me and many others: being told what your experiences must have been when you have given no evidence of this. I was lucky not to come across it as a new lactating mother, but I have come across it in the medical profession since.

I hope you don't find me overly aggressive, tiktok: I do hugely admire your work and you are usually very good at listening.

But that post was an example of something that has caused dd and me a lot of problems in life: experts deciding which pattern she fits into without really listening to what she has to say. "You have x problem, therefore your life experience must be an example of y".

I am sure it was entirely innocent and unintentional on your part, but the poster (whether on this or the other thread) who mentioned gas-lighting was not completely out.

I think anyone who advises other people about any medical or social issue needs to constantly be aware of this: "Am I asking this other person what their experience has been or am I telling them?" Just now, you were telling me. By name.

I didn't THINK I didn't have enough milk, I KNEW I didn't because my five day old had been diagnosed with hypernatraemic dehydration (which can kill or cause brain damage) and was in SCBU being tube fed formula.

More awareness that actually the milk might not really be there and the reasons for that (in my case PCOS, diabetes, long labour, blood loss, baby with tongue tie were all factors in the milk being really delayed).

Cory, let me square that particular circle for you.

The highly trained and sympathetic support you had from staff, and the encouragement you had from family, was not appropriate or right for you.

It was not able to engage you in spotting your daughter was not thriving. You did not go into details about what this support consisted of, so I probably did fill in the gaps with some presumption of what happened - but it is based on knowledge and experience that hcps may be trained and sympathetic but they don't recognise possible SN, and they don't overcome parental denial that BF is not going well.

Overcoming parental insistence that their skinny babies are actually doing just fine, thank you, is part of being highly trained and sympathetic.

But as I said, I was speaking generally without focusing on your particular circumstances in that post.

If I got all that wrong, then sorry - I do listen to parents, I do believe their experiences and I assure you, people like me are not part of the problem under discussion here.

Tiktok that comes across to me that what you just wrote to Cory as incredibly patronising