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Infant feeding

Get advice and support with infant feeding from other users here.

Why are BF rates so low in the UK?

139 replies

LastNerve1 · 09/06/2021 13:56

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.

OP posts:
Feelinghothothottoday · 09/06/2021 20:03

My baby was in special care. There was no room for me to stay with him. So I had to “visit” everyday. There was no support to breast feed either in hospital or afterwards. Without the support of female friends I think I would have had a breakdown over the guilt of not (being able to) breastfeed. 18 years later with two boys 6ft tall I now wonder why I didn’t just enjoy my time bottle feeding instead of beating myself up.

GalesThisMorning · 09/06/2021 20:06

Also the shame of it is that after the initial few, difficult weeks breastfeeding does become so much easier! No sterilising, no worrying about temperature, nothing to bring out with you... you can do it in your sleep, you can do it wherever you are, and it solves 99% of your babies problems. It's so worth persevering with. To me anyway

Parker231 · 09/06/2021 20:06

Are people really bothered by how other people feed their babies? I knew that formula was right for our family but can’t remember how friends and family fed theirs. All I was wanted was healthy babies with an excellent start in life. It made me happy so never thought anymore about it until I discovered Mn.

Soupforoneplease · 09/06/2021 20:12

With all respect to mums that have had this choice taken away (babies in NICU, illness etc) there is no biological reason why breastfeeding rates are lower here. It must be down to the system (NHS, for whom I work so I do understand the pressure it's under) and/or culture.

My friends who formula fed largely did it through choice. One had anxiety about not being able to measure how much her baby had drunk, one had a long labour and post labour complications, one had PND and didn't bond immediately, one found it really painful and thought it would be that painful everytime! Nearly all of these could have breastfed with better support and more discussion. A lot of the peer support out there is only aimed at women who are really determined to breastfeed and tbh can be a little intimidating. If you are 20 and not MC, dare I say not white either, there's no way I would have felt comfortable in my local BF peer support group where the mums were all vegan, late 30's with good jobs and a borderline obsession with sourdough. I was 25, worked in a shop and lived in a scummy area and I found it hard to get support for my tongue tied DD and ended up pumping for 4 months before giving up. I wasn't confident enough to go for help and ask for support and just nodded when the MW's came round and asked if everything was going ok. I feel a lot are in similar boats.

Sunshinegirl82 · 09/06/2021 20:14

@Parker231

Are people really bothered by how other people feed their babies? I knew that formula was right for our family but can’t remember how friends and family fed theirs. All I was wanted was healthy babies with an excellent start in life. It made me happy so never thought anymore about it until I discovered Mn.
The way I feel is not so much that I am "bothered" by how other women feed their babies more that I feel we should support women to be able to make actual choices and I'm not convinced we do that with bf at the moment.

It's a bit like how I feel about whether or not someone is married, I don't actually care if they are married or not, but I think people should be given more information and guidance to understand and appreciate what the pros/cons are of marriage depending on your situation.

I'm not sure if I'm making sense! It's about empowerment I suppose, empowering women to be able to make genuine choices that work for them.

BertieBotts · 09/06/2021 20:16

YY - in Germany here and DH took 2 full months off with DS2, then went back part time for 3 months, and is planning to take 4 full months off with DS3. It's paid at 66% of his salary so while we will need to make up the difference, it's affordable.

But - I do sometimes think people say "There is loads of support for BF in the UK" and what they mean is that midwives/HVs etc are told to tell you to breastfeed a lot or look disapproving at the mention of formula. When I/others say there isn't a lot of support for BF in the UK we do not mean support as in cheerleading, we mean practical, helpful, useful knowledge. This is what is generally lacking. Not always, but the general level of support is not good. I don't think it's only true that more people speak out when they have had a bad time. I think more people get bad advice/nonexistant advice than get good advice. We know from stats that around 2/3 of mums who start breastfeeding (which is about 75% I think at the last count) experience problems. Then around half of those (so 1/3 each or 25% of mums overall) are able to overcome those problems and get to a point they are happy with, and the other 25% are not and end up stopping earlier than they would have liked to. So that's probably 50% not needing support (because they didn't BF at all or because they BF without problems) and of people who did need support, at least half of them did not receive enough. I say at least half - because within the group of "I had problems but was able to overcome them" some will have simply overcome them despite poor support, or through luck.

There are free support groups, but they are not clearly signposted and so people don't always know about them. It's also a bit of a postcode lottery as to whether or not you have access to these. They are also generally volunteer run which is different to other countries - most countries either employ lactation consultants directly in their health service, or it's something health insurance will pay towards. In the UK it's left up to charities! Often these charities have their own agenda as well which can make them off-putting or mean that the message is blended with something else (for example, La Leche League are excellent for BF advice but are also extremely pro attachment parenting and explicitly do not support combi feeding by choice, sleep training, weaning before a certain age or various other decisions that parents may wish to make).

There are IBCLCs in most areas of the UK but these are private health services and so they cost. People in the UK obviously aren't used to paying for healthcare, and so can be a bit suspicious of these kinds of services. Because it's not really mentioned on the NHS, people often don't know they exist. If they have heard that they exist then it can be a bit of a minefield trying to work out what's a real qualification and what's just a made up term. Many people cannot afford to pay for help or are (understandably) unwilling to pay for something which they can't guarantee will definitely help, especially if they haven't heard of it before and nobody they know has ever used one.

Sometimes people get advice from their midwife or health visitor and assume that is the best info they can get and don't realise that there are other things that could have been done. That's the kind of thing I class as poor support, although the person might say or feel that they have had good support. It's hugely frustrating to see this kind of narrative play out time and time again.

Dingleydel · 09/06/2021 20:18

I think there’s several reasons. I don’t think our figures accurately represent the true amount of breastfed infants by 6 months because they focus on exclusive rates. Neither of my babies would fall under that despite being fed majority breast milk for 6m. Many have supplemented by 6 weeks or had some solids by 6 months and it’s not necessarily the be all and end all to exclusively breastfed for 6 months. That’s the WHO and it’s the world wide recommendation. There’s lots of strong evidence to support feeding babies some solids before 6 months to prevent allergies, and there is an epidemic of childhood allergy in the U.K.

I think with aggressive formula marketing in previous generations we have lost the culture and skills to support mothers. There will be lots of families where no one has been breastfed for generations now. Cue well meaning ‘advice’ from granny/HV/midwives many of whom have never breastfed themselves. This is why peer support is so important.

It’s an issue that only affects women and babies so poor funding for support. Lots of NHS trusts break the WHO code and receive indirect (or direct) funding from the formula industry, so it’s unsurprising that even HCPs can be very misinformed. Couple this with no funding for breastfeeding support it doesn’t take a rocket scientist to see why rates might be low.

Ultimately we can bang on about personal choice until the cows come home but it’s clear many more women would like to breastfeed than end up doing so for the length of time they want. So that’s a problem.

BertieBotts · 09/06/2021 20:22

Sorry DS was taking ages to get to bed so I crossposted loads.

I did find DH being home helped me with breastfeeding because it meant we could take shifts to sleep and didn't really matter about trying to keep one of us on a normal schedule. I also wasn't totally isolated on my own at home stuck to the sofa feeding - I had another adult there to hand the baby to between feeds so I could get a snack or shower or just do something else. He could also make me food on demand!

It is exactly about empowering mothers and giving them information to make a choice. Which is also why there shouldn't be endless "You must BF!" at every single appointment, although it's difficult because you do want to inform people about the benefits of breastfeeding, and it's hard to do that without making it sound like breastfeeding is some kind of "superior option". It won't always be, because the full picture needs to be taken into account.

Charley50 · 09/06/2021 20:23

Tbh 17 years ago when I had DS, I had no 'peer support' (Although I've already mentioned that the amazing new mum's group set up by the health visitors, which ended for the next lot of new Mum’s after me) but it was generally accepted that it was best for baby if you breastfed (if you were able to), even if just for the first couple of months, as it was positive in terms of bonding and also with building up babies natural immunity. It was ok to breastfeed in public, women would just wear something that meant not much flesh would be on show. It's really sad that it seems it's not being promoted anymore as the healthy, easy (for most), free option.

Justgettingbye · 09/06/2021 20:24

@dopeyduck

Because support is so utterly shit in the early days.

Because people think it's more acceptable to shove a bottle in a baby's face and are disgusted by a mother feeding her baby at the breast.

DS is 18 months now and I am asked constantly is he STILL breastfeeding - um yeah because he has a nutritional need for milk until he's atleast 2 if not older and he is in face a baby human not a baby cow so I don't give him baby cow feed.

The individuals that are questioning your feeding choices are the dickheads. Don't take it out people who formula feed.
Northernsoullover · 09/06/2021 20:28

I wish someone had been completely honest from the outset. No one told me how hard it would be. I guess they don't want to scare you off but I really would have appreciated a heads up. Raw nipples, cluster feeding. When I queried it I was told that it was normal and would settle down. I was so bloody miserable. I did manage to mix feed for 6 months so felt I did achieve some goodness.
That's another lie they tried to tell me. Don't introduce a bottle too soon or they will get confused. Nope. They did not. However, friends who waited to introduce a bottle until 6 weeks found that their babies wouldn't take it. I had many unhappy breastfeeding friends who felt stuck with it. Anyway I digress. Stop with romanticism of breastfeeding. I don't mean say its shit just acknowledge that for some people it can be tough and how to prepare if that happens.

woodhill · 09/06/2021 20:29

@Dingleydel

I think there’s several reasons. I don’t think our figures accurately represent the true amount of breastfed infants by 6 months because they focus on exclusive rates. Neither of my babies would fall under that despite being fed majority breast milk for 6m. Many have supplemented by 6 weeks or had some solids by 6 months and it’s not necessarily the be all and end all to exclusively breastfed for 6 months. That’s the WHO and it’s the world wide recommendation. There’s lots of strong evidence to support feeding babies some solids before 6 months to prevent allergies, and there is an epidemic of childhood allergy in the U.K.

I think with aggressive formula marketing in previous generations we have lost the culture and skills to support mothers. There will be lots of families where no one has been breastfed for generations now. Cue well meaning ‘advice’ from granny/HV/midwives many of whom have never breastfed themselves. This is why peer support is so important.

It’s an issue that only affects women and babies so poor funding for support. Lots of NHS trusts break the WHO code and receive indirect (or direct) funding from the formula industry, so it’s unsurprising that even HCPs can be very misinformed. Couple this with no funding for breastfeeding support it doesn’t take a rocket scientist to see why rates might be low.

Ultimately we can bang on about personal choice until the cows come home but it’s clear many more women would like to breastfeed than end up doing so for the length of time they want. So that’s a problem.

Yes so true. I felt pressure to formula feed by MIL but my dm was supportive as she had bf and I remember her feeding my dsis.

I think it may be possibly be a class thing to some extent with the NCT aspect

BertieBotts · 09/06/2021 20:30

There are also figures for "any breastfeeding" - I agree the EBF rates are misleading because 1% EBF at 6 months is actually what you'd expect to see when the advice is to start solids around the middle of the first year but no earlier than 4 months - I also found (medical) people started getting antsy if you wanted to leave it any longer than 6 months! So yeah, most people will have introduced solids by 6 months, regardless of formula use, as this reflects the advice generally given.

Any breastfeeding rates by age, infant feeding survey 2010:

At birth 81%
Two days 76%
Four days 72%
One week 69%
Six weeks 55%
Four months (table isn't clear - approx 42%?)
Six months 34%

That's a hugely sharp drop off in the first days and weeks.

LiJo2015 · 09/06/2021 20:30

Support is crap.

TheVolturi · 09/06/2021 20:32

My mum didn't bf any of her dc but my sister and I have both bf our children. I think I always wanted to bf but my sister did so well with hers that she inspired me. I couldn't manage with my first child and gave up while still in hospital, due to no help or support and my nipples bleeding. With my second I was absolutely determined to do it, and I did all of my own research. I battled through sore nipples and mastitis and eventually it got easier and I was glad I'd done it. With third child it was easy from the start.
I have no idea why the rates in the UK are so low, I personally think mums should at least give it a go, but obviously it's each mums individual choice. It's great that we have a choice, formula was a saviour for me with my first.

Sunshinegirl82 · 09/06/2021 20:35

@Northernsoullover

I wish someone had been completely honest from the outset. No one told me how hard it would be. I guess they don't want to scare you off but I really would have appreciated a heads up. Raw nipples, cluster feeding. When I queried it I was told that it was normal and would settle down. I was so bloody miserable. I did manage to mix feed for 6 months so felt I did achieve some goodness. That's another lie they tried to tell me. Don't introduce a bottle too soon or they will get confused. Nope. They did not. However, friends who waited to introduce a bottle until 6 weeks found that their babies wouldn't take it. I had many unhappy breastfeeding friends who felt stuck with it. Anyway I digress. Stop with romanticism of breastfeeding. I don't mean say its shit just acknowledge that for some people it can be tough and how to prepare if that happens.
I understand where you're coming from but I also think this is, in part, another example of women being told things that are demonstrably not normal, are in fact normal, because it's easier than helping women to address the problem.

I would say that if your nipples are torn to shreds then that is not normal and something is going wrong somewhere. Baby is tongue tied, baby's latch is not good etc. Genuine on the ground support would help with this sort of issue and hopefully get in front of it so it didn't happen. Unfortunately instead of proper support women get told it's "normal", it's so frustrating!

gluteustothemaximus · 09/06/2021 20:38

Cluster feeding and raw nipples are normal though. And a bloody nightmare. Until your nipples toughen up, those first 8 weeks are awful.

Babyboomtastic · 09/06/2021 20:40

@Soupforoneplease

I'm not quite sure what you wanted tbh. You can't chuck the vegan sourdough eaters out of the groups, your didn't get confident asking for help and when you were asked if it was ok, you lied. I understand why, and it was a confidence trying, but I'm not sure really what else they could have done.

kowari · 09/06/2021 20:44

My youngest sibling was born when I was 10 and my mother breastfed us all for three months, after that was the bottles. They were just all this additional work, I often helped make up bottles so I got first hand experience. I couldn't be fussed with all that myself, I wanted to be free to walk out the house with a backpack already packed with nappies etc, baby in sling, no hassle. I don't know why breastfeeding rates are so low here.

kowari · 09/06/2021 20:53

@Soupforoneplease

With all respect to mums that have had this choice taken away (babies in NICU, illness etc) there is no biological reason why breastfeeding rates are lower here. It must be down to the system (NHS, for whom I work so I do understand the pressure it's under) and/or culture.

My friends who formula fed largely did it through choice. One had anxiety about not being able to measure how much her baby had drunk, one had a long labour and post labour complications, one had PND and didn't bond immediately, one found it really painful and thought it would be that painful everytime! Nearly all of these could have breastfed with better support and more discussion. A lot of the peer support out there is only aimed at women who are really determined to breastfeed and tbh can be a little intimidating. If you are 20 and not MC, dare I say not white either, there's no way I would have felt comfortable in my local BF peer support group where the mums were all vegan, late 30's with good jobs and a borderline obsession with sourdough. I was 25, worked in a shop and lived in a scummy area and I found it hard to get support for my tongue tied DD and ended up pumping for 4 months before giving up. I wasn't confident enough to go for help and ask for support and just nodded when the MW's came round and asked if everything was going ok. I feel a lot are in similar boats.

I was 22, single mother, care worker. They were mid thirties to early forties and MC. The vegan sourdough types were lovely and welcoming.
DappledThings · 09/06/2021 20:56

@gluteustothemaximus

Cluster feeding and raw nipples are normal though. And a bloody nightmare. Until your nipples toughen up, those first 8 weeks are awful.
This isn't a universal experience though. Yes it's good that women are aware of how the experience might be but definitive statements like the above aren't helpful.

I was pain free by 3-4 weeks and neither of mine cluster fed for more than a day or so. I wouldn't have described the experience as "a bloody nightmare" at any point.

MrsPsmalls · 09/06/2021 20:58

Nothing to do with support in my opinion.lots of women don't want to sacrifice their body or their life to a child anymore than necessary and I don't blame them . Much easier if dad or the GPS can feed as well. Also we don't value extended bf. We as a rule think it is weird. We do value slim women who are back in jeans six days after giving birth and back running marathons six weeks after that.

Fnib · 09/06/2021 20:59

I had my babies late 80s/early 90s. New mothers stayed in hospital until feeding was established. It meant I was in for three days with my first, but I had all the support I needed. I had one in special care unit too, and I was able to pump for him to be fed my milk through a tube. When he was strong enough to latch, I stayed on the ward with him until feeding was established. I wonder if there's less support now.

woodhill · 09/06/2021 21:00

@Fnib

I had my babies late 80s/early 90s. New mothers stayed in hospital until feeding was established. It meant I was in for three days with my first, but I had all the support I needed. I had one in special care unit too, and I was able to pump for him to be fed my milk through a tube. When he was strong enough to latch, I stayed on the ward with him until feeding was established. I wonder if there's less support now.
You were very lucky, I didn't feel supported and had my first around the same time
Fnib · 09/06/2021 21:01

You have a point @MrsPsmalls.