A breastfeeding support question - how can those offering the support do it best?

[hunkermunker]

What questions should a midwife (or other HCP) be asking you to establish how you feel about infant feeding, in order to provide the right level of information and support for you?

Personally, I think not enough emphasis is put on how a woman feels about breastfeeding - is she very keen to do it, did she have a bad experience last time, etc, etc.

Is there anything else? What would you have found/did you find most useful wrt bfing? Is there anything that's a definite no (I'm assuming judgement of any sort is Not Good here)?

Some recognition of how hard it is in the early weeks really - I had no idea before I started how much I would struggle. My midwife was great, turned up one morning to find me struggling, took DS off me, made me a cup of tea and gave me a hug. Once I'd been discharged from her though the HV didn't really give me any support, she just said "well he's gaining weight well so you must be doing it right". To be fair I never sought out any specialist advice, struggled on and now it's fine (apart from the biting but that's a different story). Not sure if that answers your question! Sorry!

I had rl support from a wonderful mw (although not in the hospital where I gave birth, and it took me ten weeks of hell to find her...) and what helped me most was her hands-on, matter of fact attitude.

Now I know that's not for everyone, but it was just what I needed. I didn't want mws who were nervous to come too close to my boobs and stood at a distance saying, "well, his latch looks okay to me... you could try moving his arm I guess?" what I wanted was someone who said, "right, I'll move that arm like that, and you can see his lip isn't bent back over your areola and..." so on.

What I also found useful was that although she was hands-on and basically attached ds for me, she also showed me exactly what she'd done so I could do it myself.

Other thing I wish I'd had was more support re: bfing antenatally. All the focus seemed to be on ffing, how to make up bottles, how to sterilise, that sort of thing.

I was asked half a dozen times how I planned to feed my baby and when I said "bfing" it was like, "oh okay great" tick in a box and don't mention it again.

Definite no - all those bloody myths that keep getting trotted out!!

SM, the emotional support and recognition of it being tough to start with is a good point. Bit of appropriate sympathy with accompanying helpful well-informed advice, maybe?

Mossy, yes, antenatal support could be much better often. Much more could be done there, but workloads often massive there - busy clinics, etc

That's interesting about your antenatal support FSMP - was that individually, or as part of an antenatal class? My NHS antenatal group made a list of pros/cons of bf/ff, with the focus very much being on bf. In fact the m/w specifically said that she obviously had to promote bf, but that support would be available just the same if people chose to ff. We also got to watch a video (albeit brief) on how to bf.

Um, not sure about the answer to your question really hunker, as never really went anywhere (other than MN) for bf support.

I do think that offering to loan a video on bf is a good idea though, as some people will doubtless want to watch it on their own.

Sympathy was definitely what I needed - baby blues hit me quite hard and I needed a lot of hugs! I took a lot of comfort from the fact that my MW was obviously speaking from personal experience too.

CSWS, it was antenatal classes (NHS) that taught how to make up feeds - all about how these days you have to make up feeds individually not keep them in the fridge. But the tick boxes were at my individual mw appts that you have every couple of weeks.

Hi Hunker. I was given absolutely no information about bf before having either of my kids. I found that you are told throughout your pg that breast is best but there is no support once you've had the baby. The first midwife who came to see me after having my first was completely disinterested and refused to send round the bf counsellor because she thought I was doing it right (even though I was bleeding). My midwife who came round after my second was born told me that she wouldn't be able to get anyone to help me in time and I would have to find my own help. It's no wonder I gave up very early on with both.

I agree with Supermonkey that you should be told how difficult it will be and to hang in there and find out where to get help. I was completely naiive before having my first baby and assumed bf would be easy.

The best thing I did was read 2 different books on bf when I was pregnant (I had bf my first and really wanted to bf the 2nd) - this meant I absolutely knew it wasn't supposed to hurt, that they had growth spurts & that you had to rest and eat/drink well too. I had already been a member of the NCT for several years and involved in branch level - that meant I knew a bf counsellor and she let me attend her talk in a NCT antenatal class.

We locally had drop-in clinics at the hospital too.

dc2 was a nightmare to feed she had undiagnosed tongue tie plus when she was born she was completely disinterested in feeding (had grade 3 meconium in waters so perhaps had a very full up tummy) and I got no support in hospital as they were panicking about her blood sugars (she was very heavy) and were just too busy (June 02 baby boom) - I lived at the clinic and at the bf counsellors etc!

So IME to be well informed about it before the birth if you want to bf and also women who want to feed should be given a hand out on discharge from hospital with all the phone numbers, local clinics etc etc et - 1st visit at home - check they still have it and encourage them to use it if they need help.

that should read ff my 1st had not trid bf at all.

I am 37 weeks pregnant

I have no yet been asked ANYTHING with regards to feeding

I am seeing my MW on Wednesday and I will be asking her what support and advice she can give wrt BF as I have failed twice before but as you know I am determined this time.

I would like to be advised on what is available locally in this area in terms of support, how she intends to help and support me post birth and i think this should all come as standard.

I think MW's should come up with BF meetings so that those who are pg around the same time can meet and get to know each other prior to birth so there is a support network there too.

I know Im probably waffling, but I am petrified of BF this time and not getting any support the same way i did with the girls.

One thing which was a great help to me was the M/W firmly making the point that when we were in hospital, if we were having any problems, with ltach on, or anything else, we were to ring the bell. And that someone would come and help us out.

Regardless of the time of day or night.

and lots of women would come, at different times to help out....so you got a whole range of styles of help and advice, which I thought was a good thing. I rememebr one smashing woman, who was old enough to be my mum, placing her hands on my hunched shoulders, and making me relax! In a nice, normal way.

recognition that it is hard

Not trotting out well meaning advice that is nigh on impossible to follow, ie 'get lots of rest' 'HOW????'

one of the problems I had in hospital was that I rang the bell and my the time anyone had come (usually healthcare) the baby had screamed herself back to sleep basically complete insufficient MW support in hospital and presumably not all MWs are as well trained/experienced in BF anyway

I think an idea of what support to expect post-birth would be good. In antenatal classes my MW waffled on and on about how we would get support postnatally, reassuring us that the mw's and hcp's in the hospital would know what they were talking about, how the hv's were all pro-bfing, yadadada.

had she been a bit more realistic i think i would've sought out my own help (LLL, NCT etc) a lot sooner. i was totally unprepared for the mw in hospital to thrust ds at me and say, "He needs feeding," then walk off, or for the HCA's help to consist of her wrestling ds' head onto my boob and jamming my nipple in his mouth!!

MW's and HCP's know that there's fuck all support in the NHS, and they also know why - lack of funding. i think making mothers-to-be more aware of the alternative support, and telling them that a MW is not the same as a BFC, and that often a voluntary BFC will know far more about bf-ing than a MW, would be very helpful. the trouble is, we're told from an early age that healthcare professionals know best, and i think wrt bf-ing, they usually dont (IME, anyway)

TUD - thought you might like to know that I'm going to a LLL meeting on Wednesday with the Beds lot that you suggested. Discussion topic is 'Why breastfeeding is good for you and your baby.'

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CSWS - i'm glad, they're a fab bunch!! let me know how you get on!!

I genuinely didn't realise that the toe-curling pain didn't have to happen until I came on MN. The MW told me to slap on Lansinoh and use nipple guards, the HV said that, as DS was gaining 1lb per week from birth, I must be doing it right. No one ever checked my latch which must in retrospect have been wrong given the pain I was in.

recognition, support in the early days as has been mentioned, some sort of support in the face of mixed messages from hospital staff would also be uesful...having had no info beforehand other than my own reading on the matter, I had my twins at 35 weeks and was ordered to 'top them up' with formula by the paed to ensure weight gain. I had no idea what this really meant adn couldn't answer the MW's question when she asked which formula I wanted to give them as I hadn't even considered I'd use it! The MWs on the post natal ward where I had to stay for a week (until discharging myself and DTs in disgust ) were extremely critical of 'my' decision to top-up and of my apparent inability to express 8oz within 12 hours of giving birth so I felt crap about the whole thing - purely down to the hospital staff's attitude. Will stop now or this will turn into a major rant

I think that pregnant women should be told that it is normal to feed for most of the day when you are bf. I felt that ds wasn't getting enough because it seemed that he wanted to feed constantly. One of my lovely midwives reassured me though that was perfectly normal and was the best thing to establish bf well.

I've found that most of the women I know who have tried bf but gave up quite quickly stopped because they felt they were permantly feeding. I do try and warn people that is all you do for the first few weeks, but I think that it should be stressed in ante-natal classes.

practical information antenatally - not just running through the benefits of bfing and ticking that box on the sheet - but advice about organisations etc that can help/books that might be useful, and an acknowledgement that not everyone will find bfing straightforward

tutu I'd second that point about the time consuming nature of it, esp with multiples...

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hunkermunker is thread helpful or are we not giving you what you need - because I'd like to see things change so that woman get the support they need.