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

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

and you did this by mentioning me by name ....

"I assure you, people like me are not part of the problem under discussion here."

If you usually start an apology with language like "Cory, let me square that particular circle for you.", then I can't see how you can help reinforcing any perception that people like you are part of the problem. This is not the language of listening, it's the language of telling.

Yeah Tiktok. That was not cool. You are usually more measured than that.

The gist of your message is that the mothers are the problem, not the support. It is that kind of thinking that creates issues in the first place. If one person has an issue then it probably is them with the problem. If all of these women are having issues then isn't it a problem with the approach of BF support to people who present with issues that aren't typical?

RidingMyBike, your story - a baby already dehydrated by day 5 - is worrying and awful for you :(

It's possible you did not have sufficient milk. It's also possible you had sufficient, but your baby did not access it effectively or often enough for some reason.

It takes skilled support and observation from the start of BF plus letting the mother know what to watch for from the first moments, to stop a situation getting to day five with a dehydrated baby.

This is what is so often lacking. For example, in your case, you and your baby should have been observed for effective transfer of milk from the very first day, and checks made on his poos (effective milk transfer produces changing poos from day three - if it's still full-on meconium or nothing, then that's a warning sign).

The point is that dehydration is avoidable - hand expression of colostrum can get the milk if the baby isn't yet managing it.

I don't think mothers are the problem.

That's a wilful misinterpretation of what I said.

Mothers - and fathers - are sometimes insistent on everything being fine. It's understandable. No one can expect them to diagnose SN, or even to be fully aware of what effective BF looks like. In other situations, mothers are worried something is wrong, and their hcps don't spot it and reassure them and tell them to stop worrying.

In either case, it's a lack of informed, skilled support.

Sorry if I sounded patronising, cory. I thought I was being as direct to you as you were to me - I misjudged. I could have been more nuanced and explainsed that I was not saying that everyone's situation was the same.

At the risk of seeming like we're ganging up on TikTok (not my intention) this was part of my point earlier in the thread..

A PP presented a problem they had with the information they had been given and although your response was polite TikTok, reading your response it was clear that you didn't believe the PP. You were asking who gave her that information and how they counted her milk ducts before telling her that wasn't where the milk was made anyway and how you had never heard of such a thing but were prepared to be shown evidence to the contrary...

Your response really felt like it placed the responsibility on the PP and had already made up your mind regardless of the evidence the PP may have presented.

Forums like this are difficult, in that we are all reading information and responses with our own interpretation of inflection and meaning and that's why I think that language is really important around this issue in particular. It may just be a choice of language causing the confusion here but that's how your response read to me.

I do want to just clarify too that my real issue and my absolute wish for feeding support for women is that support is given for the woman first, the method of feeding (in this case breastfeeding) second.

At the moment, the support feels like it is for the act of breastfeeding itself, rather than the woman doing the feeding and I think that needs to change if more women are to choose to breastfeed and once the choice is made, accomplish their feeding goals.

Luna, how can me saying 'please let me know - I have an open mind about this' - mean I did not believe what the poster said?

I challenged the info she had - politely, as you say :)

I don't want daughters of heavy smokers to read what she said, and assume they will not be able to breastfeed, at least not without evidence, which I don't think the poster will be able to provide. Not her fault - I suspect someone has said something about milk ducts and her mother smoking, and this someone might well have a doctor or nursing degree, so why would she not believe them? She might have had a scan or ultrasound investigations that counted her milk ducts - while I have never heard of this being done, again I have an open mind. But milk ducts are unrelated to milk production anyway, so it takes us nowhere!

Should I have said 'interesting and unusual info. Can you tell me more?'

Thanks for apology, tiktok. You still haven't got that my real problem was not with you being as direct as I was, but in not recognising that you used my name to promote your own agenda and then tried to backtrack by claiming you hadn't been speaking about me at all (despite explicitly citing my name).

I do have problems with people in an advisory/professional role jumping to conclusions born from past experience rather than from the case in front of them and then refusing to recognise what they're doing. Many years of trying to get the right kind of treatment for to children with SN have told me that this is a terrible waste of resources and frequently leads to misdiagnosis.

It seems to me that since you recognise this as a problem in other professionals, you should also recognise that this, not some imagined directness, was my problem with your posts. You can be as direct and blunt as you like as long as you a) don't pretend I have provided evidence of something I haven't b) frankly accept that you have said what you have c) listen to what I am actually saying. Direct is fine. Obfuscating is not.

You say yourself that one of the problems with health professionals is that they should listen more: have you listened to my last 2 or 3 posts?

I will never forgive the 'Breastapo' for how they made my partner feel, and how dangerously underweight and dehydrated my little girl got due to their manic insistence of breast feeding.

Our first few weeks of parenthood were made miserable by uncaring and unfeeling HV's and family centre staff insisting we persist with BF our little girl, despite it clearing not working. We were shuttled between 4 different family centres and the Children's Hospital, being made to feel inadequate and poor parents.

My partner stayed awake for 24 hrs to try and feed our little girl. The state of both of them was extremely distressing.

Eventually one HV broke with the ' party line' and said "well , you could try a bottle and see if she takes to it, but it will take time" . I sprinted to ASDA whilst she was still there , returned with the formulae, set it up and watch my little baby girl gulp down two and half bottles. She was starving.

It took all my restraint not to throw the HV out of my house. For me her and her colleagues were directly responsible for how hungry my daughter was, and how distressed and exhausted my partner was. I just asked her to leave and never come back. As a family unit, things improved at an incredible rate for us, daughter fed, partner slept, I was involved and didn't have to stand by helpless watching.

Now I have to read self congratulatory messages everywhere from BF mothers who think they are superior to formulae feeding mothers because they ' persisted' and overcame the ' struggle' . My partner couldn't have done more without hospitalising herself and our baby.

The most important to thing is to feed to your baby, whether that is BF or bottle. Sod the support for BF mothers, what about the support groups for bottle feeding mums made to feel inadequate and lazy?

Do the best for your baby. That's being a good parent.

Your situation sounds terrifying @Bobbydeniro69. Do you think you might be able to make a formal complaint about the HV, Children's Hospital etc and their insistence on your partner breastfeeding? If your baby was losing/not gaining weight then feeding them should be the priority not insisting on breastfeeding above all else. To let that situation continue for weeks is appalling.

Maybe go back and read the post Tiktok - if you think it's ok and I am not adding anything here that's fine - it's only my opinion after all. We all have plenty of those.

I expect though, that you would expect people to believe that the only 2- 5% of women can't breastfeed. Would you be able to provide a medical or scientific journal confirming this is the case within the UK?

I understand that this is information has been taken gathered through observation, but by whom? What size was the sample? Who was the sample made up of? It's presented as fact all of the time and although I haven't been able to track down a copy of this research myself, or have it sent to me by anyone who quotes it, I am expected to respect and believe it.

I don't want women who have had bad experiences, or who are in the middle of a difficult experience at the moment to read this and either assume they will be able to breastfeed when they may not, or assume that they are some kind of freak of nature because they can't.

So that takes us nowhere.

cory, you have very high expectations. This is a conversation. It is not a counselling session. I do listen, however.....maybe I use the language of 'telling' in a conversation on a talkboard. Should I not?

I am sorry I used your name - not really to promote my own agenda but really to acknowledge your sharing of experience, which appears to me to show you should have had better support....as I explained. I now wish I hadn't used your name. You are using my acknowledgment as a way of insisting that I did not listen to you, I have continued not to listen to you, and that I jumped to conclusions.

When I explain what lies behind my belief that many individuals are missing out on appropriate support - including you - you tell me all I am doing is using my past experience, and then I am refusing to recognise what I'm doing.

It does matter to be clear, even in a conversation, even in a fast moving one, where nuances get lost and different experiences are bunched together.

So: I mentioned you and two others as examples of situations which underlined the need for better support for breastfeeding. I was not saying your experiences of support were identical, but did go on to generalise about the sort of support on offer (your own situation had not been described in detail at that point). You came back and emphasised that your support was tip-top and not lacking at all. My rejoinder to that was that it did appear to be lacking, because it was not appropriate to you - you described how your child was skinny and not thriving and that you should have ff earlier and the SN had not been recognised or even thought about. Good support would have brought all that into to mix and discussed it with you , I think....but of course I wasn't there and maybe it was fully discussed and the hcps could not have done any more . It's possible.

Assassinated Beauty

You're just in a fog at the time, going from hour to hour. We were just another set of anonymous new parents to them. In one children's centre my partner was left sobbing in the waiting room whilst they closed the clinic for day and left, just leaving us to wonder what the hell was happening.

In another the number of posters promoting breast feeding was in double figures, with absolutely nothing for mothers that couldn't. It was the last thing we wanted to see.

My way of ' fighting back' I guess is to share my experiences on forums like this, and if it helps one new parent that is struggling to tell the Breastapo to sod off and do what is right for THEIR baby, then that will be enough. I always say to expectant parents, if I have one bit of advice it's try BF, but don't let your baby go hungry and don't sacrifice your own health.

I just wish there was more support for bottle feeding parents. Formula feeding at the very least helps the father get involved and feel like is contributing ,and indeed bonding, at a very early stage. I remember feeling energised no matter the time of day or night as I worked the steriliser , cleaned bottles and made formula up!.

[I find the use of the word "Breastapo" to be very jarring and tbh puts me off a bit from engaging with you as it's so confrontational.]

I do hope you are able to put in complaints about the service that you experienced, as that may help other parents not experience it in future.

Is it possible for you to expand on why you felt you needed permission from the HCPs to use formula, rather than just using it when it was clear that your baby wasn't gaining weight?

Luna I think you are mixing me up with someone else.

I think any use by me of the 95 per cent stat (and I can't now remember precisely what I said!) would point out that it's done on observation of what happens in bf-friendly societies where social and cultural factors undermining breastfeeding are not present, and that it's hard to separate physical inability to make sufficient milk from social and cultural factors impacting on the whole thing.

"I expect though, that you would expect people to believe that the only 2- 5% of women can't breastfeed."

I would never say this - I 'expect' people to at least consider that not being able to breastfeed is a complex and nuanced issue, and probably on a spectrum.

I don't expect anyone to believe that only 2-5 per cent of women 'can't breastfeed'. Primary lactation failure - when a woman produces not a drop of milk - is very rare. Not producing enough milk is far more common, but in societies where everyone expects to breastfeed it's unusual, so there are clearly other things going on.

I defintely think you are mixing me up with another poster....

ok, apology accepted. And yes, I do have high expectations of you, tiktok. Generally fulfilled: I have followed your posts for many years. You work hard on promoting breast-feeding on this forum, this is where many expectant and new mothers come for support, and where older mothers come to debrief, getting it right is important. You are trying to achieve this something, it is something worth achieving, of course expectations matter.

To be fair, I probably should outline at this point what would have helped me a) in this situation b) generally during the following 10 years pre-diagnosis.

The more I think about it, in my individual situation the problem was not individuals but a general discourse which assumed that the only things that stand in the way of breast-feeding mothers is either attitude or societal pressure. In other words, things which I could overcome by simply doing what was right and not listening to other people. So can you imagine why I didn't listen to HVs when they started telling me there were problems with my breast-feeding? It wasn't because they weren't telling me, it was because (exactly like you in your earlier post), I assumed if somebody told me my committed breast-feeding wasn't working they just couldn't be good enough at their job.

Even here, if physical problems are mentioned, they are usually limited to things which can be easily diagnosed in the moment, like tongue tie or latch problems.

Just a paragraph here and there to say "in a rare few cases you may find that there is some unexplained cause which can not be remedied by these measures" would have helped me. Just an openness among breast-feeding promoters that not everybody who comes online has the same experience just because it is statistically most likely.

Ehlers Danlos is probably virtually impossible to diagnose in a small baby as there are no blood tests- though I will admit I now think it should have been picked up when dd was about 4, as that is when she began to be very obviously different from other children. Better knowledge about the condition in general would be good- but that goes for paediatric consultants as well as HVs.

So before diagnosis, what would have helped was to know that sometimes breastfeeding can be affected by something that has nothing to do with maternal input. Just a line in the book we were given at ante-natal classes. Just a word during ante-natal classes.

bobby what your partner and you went through is awful. Complain - it's not too late.

Please don't use the word Breastapo. It's horrendously belittling to holocaust victims and insulting to bf supporters, who may be ill-trained and poor as in your case, but they are not Nazis.

Sorry for jumping in here but that is an interesting question assasinated. With dd1 I felt the same. I was too scared and ashamed to suggest formula myself and the blessed relief when someone said "shall we try a bottle?" Was immense. I was terrified of being judged and labelled as a poor mum.

And something tiktok said resonated as well about insisting that the skinny baby is fine with regard to dd2. I was on the whole pleased with feeding and had lots of praise heaped on me by HCP and friends. At last I had joined the club.

Little niggly doubts I had that all was well were pushed to the back by "trust your boobs!". That was until the HV came and we realised dd was actually losing weight fairly alarmingly. It was only then that I started to let myself say "actually, I am not sure her nappies are wet enough and not enough poo either". It would seem that she was put off properly feeding by CMPI so was comfort suckling. Unknown to me my supply had also dwindled meaning I struggled to top up from expressed milk.

It took me days to be brave and ask the GP for prescription formula to supplement her intake. It was a proper deep breath moment. And when the HV said again "but you must keep BF!" By this time I felt confident enough to say that I intended to but I needed the back up of formula to keep her healthy.

I am now back to almost exclusively BF her at 6 weeks.

I needed to trust what I actually knew myself not the cheerleading which goes on around us. The draw of being part of some exclusive club is strong and can means we lose perspective

OK, cory :)

I apologise for the use of a derogatory term, I think it's obvious I am not ' horrendously belittling holocaust victims' . I can see how the language is insulting to BF supporters.

When you are a new parent, you are assuming all the professionals are there to do the best for you and your baby, not to just to promote government policy. Quite frankly, for a new parent to go up against the health visitor and children's centres would take a level of confidence we didn't possess.

I would still maintain that there could be me more support from professionals for mothers that can't BF, or simply don't want to. I think too often they are made to feel like failures or bad mothers and this simply isn't the case.

Again, I apologise for offence caused with my terminology.

I've never seen tiktok use the 98%/95% statistic and I've been on here the best part of a decade.

I agree, it's a baffling statistic and I am not sure where it comes from, I've never seen it quantified, it's usually bandied around with barely any sympathy or understanding, either. Furthermore it's CLEARLY not true within the UK, because many more women than this mythical 2-5% experience problems with breastfeeding so strongly that they are forced to stop.

It's really hard to strike a balance sometimes between validating a person's lived experience and not wanting to spread misinformation. But certainly nobody should ever be insisting that anyone can breastfeed if they "try hard enough". It's enormously hard for many women, and nothing to do with effort.

crisps - really interesting perspective. It takes a lot of confidence and skill and sensitivity for an hcp or other bf supporter to raise the issue that breastfeeding is not going well and a baby is not thriving. They don't have to say 'how about formula?' and I have an aversion to giving 'permission' to grown up people to use formula :) Everyone knows formula exists, after all, and all mothers know there is no law against using it....but they can be in denial about the extent of the baby's lack of well-being.

In the best of helping situations, there will be a dialogue between people with equal respect for one another. And then you can get something happening that addresses the problem. You can talk about donor milk, or expressing, or nursing supplementer gadgets and, yes, formula.

What I sometimes see is a skinny baby whose weight and/or charts make you weep, and a mother with a gang of (often online) pals urging her to keep going and to ignore anyone who suggests all is not well :( :(

Thanks, Bertie....and you put it well about striking a balance between people's own experience and their way of interpreting it which is totally valid but which may mislead other women into an unhappy experience of their own.

There is so much rubbish on the internet (and everywhere else) about breastfeeding. Every day you get it on mumsnet, and that's only one tiny corner of the web. We know that parents get a ton of information and support from other parents and the contact and genuine friendship people have is wonderful. But it has its downsides.

I still hope no one goes away from this thread seriously wondering if the fact their own mother smoked during pregnancy meant their own milk ducts did not develop so breastfeeding was bound not to happen...yet a poster was told this somehow, and while this might be even comforting for her, it's really not going to help anyone else.

(Still open minded as to whether there is any truth in that assertion, though).

With some benefit of hindsight I do feel that HCP just cannot win actually. I needed someone to say it was ok to try something different the first time around. It did, however end my BFing journey as the support ended as soon as she drank from a bottle. I know others who might have been angry or upset and this is where the skill and sensitivity comes in.

And yes, having other options suggested such as donor milk and SNS would have been good but I think we are some way from that in my health authority. Personally, now, I am fine with a wee touch of formula and I think it helped me gather the emotional strength to get to grips with my new diet and take on BFing dairy free.

"I was terrified of being judged and labelled as a poor mum."

Yep, I ignored the niggly feeling that it wasn't all ok because everyone kept telling me it was fine, his latch was amazing, his nappies were fine, it's normal not to have time for a pee between feeds, that's just cluster feeding, breastfed babies don't always put on weight as fast...

So clearly the issue was me...

And I was already fighting against the assumption from HCP that I was struggling because I was young.

So I kept going and kept going until they told me not to.

Actually, I think 'permission' is important. The system trains us to do what HCP tell us and the language that is used to advertise BF is very emotive and persuasive. If you couple that with post birth hormones and the desperation to do well for your baby then you have a quite a toxic mix.

Permission is probably the wrong word though. How about reassurance? All that needs to be said is that it is ok if you've given it your best try and that you and your baby are in bits. It's ok to mix feed if you need to or switch if you have to. That's all it takes.

The friend I have spoken about of perilous threads (gestation diabeties, prem baby) is perminently damaged by her BF experiences and the facts that once she had tried everything that the BF support, lactation consultant, NCT peer supporter suggested and her baby still wasn't feeding properly, putting on weight etc then there was a deafening silence from all of them. Just nothing. It was the health visitor that eventually, and very carefully, suggested it was ok to give formula. That maybe formula wasn't poison.

However, by this point, she had been convinced by the language of 'just keep trying' and 'it'll happen if you really want it' that it was her fault. That guilt is a powerful, powerful thing. It still haunts her. She now spends hours a day hand making organic weaning food (because he 'had too much processed food as an infant').

I'm probably never going to get agreement with some people on here about this but 'permission' or 'reassurance' is important. When mentally vulnerable new mothers have been backed into a corner by false advertising and the pressure of expectation then they need help to come to the best decision for them and their child. This is the main thing that needs reviewing in BF support training. Knowing when to stop in and help someone let go of something that is destroying them.