Why are BF rates so low in the UK?

[LastNerve1]

Compared to other parts of the world, e.g the Scandinavian countries. And why is the level of BF knowledge sometimes so low/inadequate amongst HVs/midwives? Just curious.

I've had a baby in the UK and in a Scandinavian country and to me, it all comes down to support. In the UK I was out of the hospital within 24 hours and left to get on with it. In Sweden I stayed in the hospital until they were happy I was able to feed my baby.

And also, I don’t think it’s compatible with how “modern mums are supposed to be”

By that I mean social expectations to be back in nice clothes, glossy hair, back at work and socialising with friends.

BF is pretty much all consuming for the first few months and you often feel like a scruffy mess.

Believe me I am still like that now!

@lavenderandwisteria

I find formula much harder too, but it depends on your baby I suppose. I think breastfeeding is possibly harder at first but then gets easier.

I agree bf is much less faff

I don’t know about other cultures but in the UK there’s a lot of pressure on women to work and go back to work after having a baby. It’s just easier if you know you haven’t got the time to use formula. You’ve got more options for childcare and people think babies will sleep better on formula. Having a baby glued to your boob all night and then having to get up at 6 am for work is not great. My own experience was I had tons of support with my first to breastfeed but I had hypoplasia so it was a five month struggle before everything dried up completely and no amount of pumping, skin to skin or anything else was bringing it in. With my second I had a new partner and although I had no desire to breastfeed again I don’t think he would have been that supportive of it. Don’t underestimate how many women will be pressured by men to give them formula

Lack of support must be an issue in why people start but then stop quite early. Plenty of encouragement to try BFing, but if things are difficult, it is so hard to get help. I was committed to breastfeeding, it never occurred to me not to as am from a BFing family and hadn't really considered formula, yet I came close to stopping because it was so hard and I became quite upset about it. I couldn't have done it without lots of help from DP, who had been able to take extra time off work, and hours spent reading and posting on MN threads and Kelly Mom. It did all click eventually, at around the 6-8 week mark, but if I had been less determined or had less time, I would have moved on to formula.

Cultural expectations. Lots of people do what their families and peers do. And in the wider community, although people are generally fine with newborns being fed, some shift seems to happen around 4 to 5 months.

Some of the information you are given around feeding isn't helpful. Makes it seem easier than it is. I would like alternative leaflets to be printed, "it might hurt, it can be really hard, you may want to give up a million times, but if you do get through that, you have free food for as long as you want it, and no need to sterilise stuff, so on balance it might work out for you".

@AllTheUsernamesAreAlreadyTaken so true - body odour increases due to hormones, crusty milk all over your top, faffing with breast pads, cluster feeding making it difficult to find time to shower in the evenings...it was only at about 6 months that I sort of felt like me again (just with a baby attached to my boob).

Where I live (in the UK) there is a HUGE amount if bf support available. What that can't do,is help at 4am, when you've been up for 5 hours already and are exhausted. Sometimes when women say they want support, what they mean is they are exhausted and it's too hard, rather than there being anything anyone can really do about it.

I've seen lots of babies being fed out and about, and I'm still bf my 2 year old (though not in the day these days, so not in public). I've not seen it heard of any negativity around this.

I think rates are 'low' because:

1. there is too much pressure to bf, which turns some women off

2. it's portrayed as all or nothing, which puts a huge amount of pressure on women. If there was more encouragement if mix feeding, I think more work would do that.

3. scaremongering messages, such as if you give some formula at the begining you are doomed, if you don't get enough skin to skin, you are doomed, so much scaremongering about avoiding any bottles because of nipple confusion that it means women reach breaking point.

4. because bf runs contrary to how a lot of us now like to share parenting more between parents. It creates an unequal burden, and whilst that's nature for you, its tough, and I thin some people start to resent that.

5. ridiculously strict criteria for counting a baby as being EBF for the first 6m, so that even a single formula top means you don't count in that statistic. Or if you decide to wean a day before they are 6m,or pinch a slice of toast early, you also don't count. I think a lot of other countries take a less strict and more pragmatic view instead.

Given its a choice, then perhaps we need to make sure all parents feel as supported as possible, and then just let them make their decision. Much better a mum that happily chooses to FF, than one that grudgingly BF and hates it, because of peer pressure.

I would have loved to breastfeed DS but after a 46 hour labour and an emergency section I was too knackered to even want to hold him after he was born. He then absolutely refused to feed for the first day and I had to express milk and dropper feed him. I wasn’t allowed home until he’d fed and he wouldn’t feed. By day 6 I was fed up, exhausted and hungry and he was screaming constantly so I gave him a bottle of formula and packed my bag.

Tried repeatedly to feed him myself once home but he was having none of it. Eventually it all got too much and I trotted off to the all night supermarket at 3am and stocked up on everything I needed to bottle feed. Life got much easier then.

@musthavebeenlove

Because taking care of a newborn is hard and using formula is much easier then BF’ing.

^This

It's easier and the feeding can be shared between parents and wider family if needed

People are caught between a rock and a hard place.

I think as others said visibility of breast feeding, it isn’t something that’s happening regularly so people don’t see it. With my first it didn’t work out and honestly it was like my daughter didn’t have a clue either! My 2nd it just clicked straight away!

Support & honesty- breast feeding is hard and at times it’s bloody painful - those first 6 weeks are bumpy lack of sleep cluster feeding etc etc but for me it did get easier and life was ok - even with teething!!

My mum flapped a lot when she realised I was going to breastfeed - she was very uncomfortable and when I would discreetly feed - trying to get me to hide away!!

The right thing is feed is best.

[quote otterbaby]@AllTheUsernamesAreAlreadyTaken so true - body odour increases due to hormones, crusty milk all over your top, faffing with breast pads, cluster feeding making it difficult to find time to shower in the evenings...it was only at about 6 months that I sort of felt like me again (just with a baby attached to my boob). [/quote]
Yep! Your wardrobe is restricted to clothes that you can breastfeed in. Baby cries more often because breast milk gets processed so quickly so you’re feeding every two hours, when do you get a chance to wash and dry and style your hair?

I hundred percent agree with you. At six months, when they start eating solids, it suddenly becomes so much easier and, actually, much easier than formula feeding (in my perception).

@lavenderandwisteria I've found the complete opposite. I'm always surprised when people say this.

I had a hca like a rabbit in headlights constantly trying to latch baby on and it clearly wasn't working yet didn't call anyone in to help try to change anything in the end my DP said she was just give a bottle?

Then a midwife came in later and said if you want to breastfeed were gunna have to come up with a feeding plan you will have to stay overnight and pay for a room as the ward is full OR if I just write MiXED FEEDING on your note you can go home now. I had a older child at home so what was the obvious answer

I think the NHS believes in the breast is breast message in theory but not in action

Yep, my experience too.

I'd agree that if you have bf challenges it can be incredibly hard to get the right support and you have to be pretty determined and persistent (or be able to pay for it).

DS2's tongue was missed by the hospital (I specifically asked for it to be checked) and despite being readmitted with jaundice and 12% weightloss and me explaining that he couldn't latch I was offered no feeding support at all. Just given a feeding plan.

I paid for a private midwife to come to our house and assess us and she discovered and released the TT. If I hadn't been in a position to do that or had had to wait weeks for an NHS assessment I'd have had to switch to formula because I couldn't keep up with the pumping etc.

I had ebf DS1 for 18 months so I knew something wasn't right but it was still a real battle to get it sorted.

Also I don't think anyone should feel obliged to bf if they don't want to (for whatever reason) but I know so, so many people who wanted to but for one reason or another couldn't get established or had could only keep going for a few weeks and ended up turning to formula because they felt they had to rather than they wanted to. I suspect with the right support a good proportion of those people could have bf or bf for longer if they had wanted to.

Personal opinion is that it's hard, can be torturous for the first few weeks (I screamed and cried as it hurt so much), people are embarrassed and some mums don't want to cart their baby around everywhere and want to be able to leave them with other people.

I breastfed and after the first 6 hideous weeks it stopped hurting and became as easy as breathing. No bottles to wash, no feeds to time, no getting up in the night, no planning how many bottles to take, no worrying about powder contamination. I think the effort level of breastfeeding seems too steep in the beginning to most, but then it gets super easy while bottle feeding effort is the same effort level throughout.

I know doctors preferred bottles because the few times I took the children to a doctor they were exasperated that I couldn't tell them how much they drank. That wasn't very supportive and would have put me off if I hadn't made such a huge effort to get started.

I went to a BF clinic for support and the midwives were excellent. There are 3 BF clinics within walking distance of my house, although they are not all midwife led. I don’t readily accept that widwives’ / HVs’ knowledge is inadequate. Plenty of people receive brilliant care but people who received poor care are more likely to speak out about it.

When trying to choose formula as a back up I watched a documentary on your question on channel 4 by dispatches. It covered social attitudes, formula company kick backs to the NHS, poor regulation and self regulation regarding advertising, issues with lack of support in many areas of the UK, funding cuts to post natal women's services.

Where I live (in the UK) there is a HUGE amount if bf support available. What that can't do,is help at 4am, when you've been up for 5 hours already and are exhausted. Sometimes when women say they want support, what they mean is they are exhausted and it's too hard, rather than there being anything anyone can really do about it.

And that's hugely different between the UK and skandi countries too. When my DS was born in Sweden DH got 6 weeks off to begin with, then he worked 3 days a week for the first 6 months, 4 days a week for the rest of the year and then went back to work full time. He was around to support me. In the UK he got 2 weeks off and was then back to work fulltime.

My partner took extended leave both with my ff and bf baby. With my ff one it meant we could truly share the load, with my bf baby, the feeds were 100% falling on me. And yes, dad can do 'everything else', but with a young baby, the everything else is pretty small compared to the feeding.

So I very much doubt that the presence or absence of fathers/paternity leave has much of an impact on bf, except for a bit of cheerleading.

Pregnancy, early motherhood and parenting has been increasingly medicalised by society (as has childhood to some extent) and this has led to a large amount of pressure on mothers to conform to the societal norm and what society perceives the medical benefit is (rather than what it is).
Falling rates of BF is a well known phenomenon in a lot of countries. The benefits of BF (which are not in doubt here) are never fully explained to mothers and let's be honest formula feeding is easier and more convenient for most mothers (especially if there are other children).
Similar to the rise in c-sections by request (rather than medical need) which not only have an increased risk to the mother but have a cost burden to the health service - if we removed the perception of medical benefits and stopped pressuring mothers and treating pregnancy / early motherhood as something which is to be endured we may just get the rate of BF to increase naturally.

I've no idea. But all this constant feeding throughout the day and night and carrying around in a sling all day. Co-sleeping and breast feeding for years would have put me off. People let it take over their lives. So its been a bit counterproductive IMHO.

I’m a FTM (LO is six weeks old) and my experience has been the opposite to many people here so hopefully there is a cultural shift in progress - my NCT classes and the midwives were very pro-breastfeeding, my mum breastfed and my friends who’ve had babies all at least tried to breastfeed even if they weren’t successful. I was lucky that friends told me how hard it could be and so I was prepared for a struggle (signed up pre-pregnancy to colostrum expressing support, then went to a BF clinic on day 3, whereas if I hadn’t known it could be difficult I might have felt reluctant or embarrassed to seek out support). All my NCT class at least wanted to breastfeed even if they’re not now.