We need to change the conversation around breastfeeding

[pisces5891]

I am writing this post knowing that it will potentially kick off a bit of hornet's nest. I'm just really fed up with how much pressure there is on women to breastfeed, when all the evidence suggests that a significant number of women simply cannot exclusively breastfeed. I would even hazaard a guess that more than 50% of women cannot exclusively breastfeed. Its making women miserable and is the number one cause of post natal depression. Enough!!!

When I tried to breastfeed, I had real trouble providing enough supply for my baby. I was told that with the right support, almost every woman can breastfeed. I received help from 3 different lactation consultants. the first told me, less than 5% of women have actual low supply, and if low supply was really true of a lot of women, then the human race would have died out. This is objectively speaking totally false. Historically, women would share feeding of babies with other lactating women, and even then, lots of babies died. So the fact that the human race still exists is absolutely not evidence that the majority of women have enough supply. the second lactation consultant told me that if there was no formula, I would have found a way to exclusively breastfeed. this is also not true. My mother grew up in a tiny village overseast, where there was no access to formula. And she told me that it was rare that one woman would exclusively feed their own child, it was normal that it would be shared amongst the group and in the case that there were not enough other lactating women, they would put the baby at the teet of a goat in order to feed it because it was understood that it would be rare that a mother could exclusively feed her child from her breast. In my nct group, there are 10 women. One chose to formula feed from birth. The other 9 all wanted to exclusively breastfeed. only 2 of them are. and every single one of those 9 had the support of private lactation consultants, so we cannot say they are unsupported. A variety of issues from latch to supply to mastitis- so many problems that we all tried desperately to resolve, and we couldnt.

The third lactation consultant actually watched and listened to me breastfeeding and told me that my baby was not transferring enough milk. She was the only one of the 3 lactation consultants who had actually worked in a nicu ward and was able to recognise the signs of hunger. my baby thankfully was not starving but had I listened to the first 2 Lactation consultants, I think she would have been . This lactation consultant told me that it is very common on the Nicu ward to find very thin very hungry babies of mother's who are desperate to exclusively breastfeed, the babies are literally starving, drawn, crying and lethargic, because they are not being fed enough.

mixed feeding needs to be a system that is properly introduced to mothers. Mother's need to also be shown what an actual wet nappy looks like. I was told 6 to 8 wet nappies were a sign that my baby was getting enough food. Now that she is getting enough food because she's mixed fed, I can see what an actual wet nappy looks like, and it's really heavy compared to what it looked like when I was breastfeeding her.

I think this is a real issue and mumsnet is partly to blame for it, because the amount of threads I see where someone posts that they're struggling with breastfeeding, and they're told to keep going even when their baby is dropping centiles. It's the latch! It's tongue tie! Try an osteopath! Breastfed babies always lose weight! Its ok to drop centiles! You'll get there! It gets easier! Please PLEASE stop advising women to keep going no matter what, because in some instances, those women and there babies will end up in emergency care. Of course, many breastfeeding problems can be overcome with the right support, but in my experience, it sometimes never resolves, and the absolutely right and moral thing to do is to introduce the bottle.

I'm not blaming women here; the fault is in the system. Breastfeeding needs to be properly researched, but like all womens health, it's ignored.

I am still breastfeeding my baby girl, we mix feed very successfully. For anyone reading this struggling with breastfeeding, know that you're not alone.

It is a valid point and one of the things that contributes to the problem imo. My mum formula fed me. I wanted to breastfeed and EBF both my daughters; it was really, really hard at first with DD1, but I got through it, partly because of my own professional training which gave me technical knowledge to work out what to do, and partly obviously due to luck that nothing was a total dealbreaker. Professionals weren't that helpful and obviously my mum wasn't either.

DD1 now has her own baby and has EBF; baby is now a year and she's still BF. We live 10 minutes apart and I gave her a huge amount of support at first. She would not have got through the tricky first few weeks successfully without it, partly because all the professionals were giving different advice, she saw each of them once, became confused and demoralised, whereas I could see her every day and sit with her and give the same advice again and again. Yet when she mentioned to professionals that her mum could help, they apparently were hugely sceptical and dismissive. Of course many women don't have a nearby relative or friend who BF successfully and they trust to support them, but for those who do, surely it's exactly how support is meant to be in human society?

I think our system is terrible at supporting BF. Fair enough that it's not for everyone for various reasons, but the issues of well meaning but unhelpful advice don't seem to have improved in 30 years. It often is really painful at first, even if the latch is good, for example. Advice that overlooks this means women think they're doing it wrong when they aren't and they start fiddling with the latch and losing confidence for no reason. It's a shame.

When I had my first (23 years ago) on a ward of about ten women I was surprised how several never tried to breastfeed. One even said her breasts were for her boyfriend not her baby!
I think it’s good to encourage women to try, but I found it was me insisting I wanted to rather than the midwives insisting. Maybe it was the general population of mothers at the hospital? I was definitely the odd one out being middle income and older. The woman next to me was 20 and just had her second baby. She didn’t even think of breast feeding.
But totally agree that generally there should be less pressure when things just aren’t working out. And what’s with the pumping? Seems to be an essential piece of kit now. I never did and I went back to work when my child was five months old.
And I’d also advocate for not shaming women who have to have a c-section. My DH’s ex even said it wasn’t a real birth!

I never even considered trying to seriously collect colostrum in my third trimester, and it would've been pointless as my body made it one tiny droplet at a time. If I'd thought I was supposed to pre-collect colostrum, I would've probably got stressed and worried over the fact that I wasn't able to - and yet your body's not supposed to make more than that as the baby hasn't been born.

Honestly, I don't think my babies got more than a couple of mouthfuls (if that!) at each very frequent feed (hourly, pretty much) in their first two and a half days of life, but I wasn't overly worried as I knew it takes about three days on average for your milk to come in. That's why most babies lose weight in the first week - it's normal. (As soon as my milk did come in though, they put on weight in record time.)

I feel like a lot of women expect to be giving their newborn noticeable quantities of fluids (colostrum or milk) immediately after birth, and can get really stressed and uptight when they don't, but that's just not generally the way it works.

Interesting what you say about NICU, I had zero choice and they formula fed dc despite knowing I wanted to breastfeed. I was asked what milk to give him, said breast, and they said no what choice of formula. Then the breast pump on the ward was shared between women, was rinsed and put in sterilising fluids but with no way of knowing who used it last or when.

@MrsPapillon “Would feed for five minutes, fall asleep for 25 minutes and wake up for another 5 minute feed.”

Feeding multiple times in an hour is completely normal. Modern life makes breastfeeding on demand very hard.

I carried my babies in a sling and co slept, which made breastfeeding easier for me.

I sympathise with that.

After my first baby was born (c-section) I had huge difficulties breastfeeding him as can be the case after sections and I had the midwives hand expressing je like a cow to try and get some colostrum. They got about 0.3mls and they said that was enough and fed it to him via a syringe.

He did still have to have some small volumes of formula to take alongside my colostrum as the 1ml volumes weren’t just enough in order to keep his blood sugars high enough.

We had to do this numerous times over his first 24 hours and I would usually only get about 0-5-1ml of colostrum and it would take so, so, long. Ultimately, hand expressing or using any kind of pump is never as effective at milk removal as a baby directly feeding from the breast is. Mind you, it’s still hard work for babies too as for most newborns it will still take 20-30 minutes of active feeding to get the small volume of colostrum they need.

When I was pregnant with my second baby I knew I would need another c-section so in order to hopefully avoid what happened with my forth I thought I would give antenatal expression a go, and what a nightmare that was. I would spend half an hour with a syringe and again, I would only ever get about 0.2-0.3mls each time.

I was told I could only hand express antenatally three times a day for 15-20 minutes at a time so I would get about anywhere between 0.5mls-1ml a day as an average which the midwife said was normal. I stopped doing it though as I found it uncomfortable and I didn’t really see the point as like you said, it isn’t anywhere near enough for an actual “feed” so it just made me feel stressed doing it. I felt like I was failing before the baby was even born.

I don’t know for sure as I don’t work with midwives, but from talking to new mothers it seems that antenatal expression isn’t routinely recommended anymore unless there is a very specific reason for it due to the anxiety it can cause pregnant women.

Well done to you. I had 2 other children (one of whom is disabled) so I wasn’t able to dedicate 24/7 to feeding DD once she was past the newborn phase. It’s not sensible to restrain a disabled 10 year old when you’ve got a baby in a sling.

Even when she was on bottles, she never took more than 2oz at a time, but very frequently. As I said, she’s always been a grazer. Even as an adult, she only eats a tiny amount at mealtimes.

And here we are 22 years later, and I’m still being told that if I’d done things differently, I could have ‘succeeded’.

I think a big problem is lots of people assume it should happen ‘naturally’ and no effort is needed, a bodily function like doing a wee, and when it ain’t so, get disillusioned, dispirited and discouraged - and when you’re knackered and feel dreadful from having given birth that’s turned up to eleven and the whole “fed is best” turns into having formula
pretty sure most women do have enough milk, it’s just a question of getting it out - and obviously the more the baby takes the more you produce
A friend did say that she had heard somewhere that an increase in tongue tie was due to excess folic acid - the opposite end of spina bifida
id also heard from a retired midwife that they just used to pinch out tongue and lip ties with a thumb nail

The pain is a very real aspect of it. Having your nipples sucked on vigorously for what amounts to hours every day wreaks havoc on them initially - they aren't used to it, so of course they need to toughen up, and until they do it can really hurt (and bleed), and that's actually entirely normal. I'm not sure every woman realises that. Luckily, if baby has a good latch then it doesn't take long for them to toughen up!

I had pressure from midwife to use formula as apparently baby wasn’t getting enough milk from me. So I did mixed feeding which of course affected supply negatively.
second baby I exclusively breastfed and he was a massive chunky baby. I doubt there was ever a problem with my first but I was pressured to move away from the breast so I’m afraid I disagree op. I suspect many women doubt their supply when they don’t need to

they would put the baby at the teet of a goat in order to feed it
No they didn’t.

Thanks for all your responses, and although i can't respond to everyone, i would say the following;

Thanks to those who expressed support and empathy, the first 6 weeks were terrible because of bresstfeeding struggles! and i think that's my point. If the message is: "everyone or nearly everyone can breastfeed" then you'll feel like shit when you can't. I feel much better now because i can see im in the majority for having struggled, but i had no idea when it was actually happening.

For anyone wandering, my mother was born in 1947, was ebf, her 2 younger sisters were mixed fed by there mother and aunty, and the youngest sister had formula because she wouldnt latch, and by that point formula had become available in there village. My grandmother, like many of you, had diffrrent breastfeeding experiences with each child. I think its fascinating that can happen to one woman;

supply is related to hormones;womens hormones are not understood well at all. We know this by how shit menopause support is, or period issues. Its crazy that we still give women the coil or the pill for period pain (i.e. the same things women were offered in the 80s). If men had period pain, you can bet thered be new advances everyday.

Fully agree with this. It is painful at first and I suspect some women don’t realise this and feel it’s not working for them when they experience pain

@Soontobe60 https://www.theguardian.com/lifeandstyle/2007/nov/17/familyandrelationships.family2 this link describes orphans being fed goats milk in the uk

That's the 18th century, was your mum a time traveller from the 18th century?

Absolutely.

I went to a really interesting study day recently that said by the time a baby has reached age of 6 weeks, 80% of women have introduced formula and the main reason for that is because they believed they didn’t have enough milk.

And so formula is introduced which in turn reduces a woman’s breast milk supply and the cycle worsens.

I think when women are told by health professionals to introduce formula the mothers aren’t told about the impact this will have on their milk supply which again goes back to women receiving inappropriate advice from people who aren’t knowledgable/skilled enough in lactation and women feeling forced into feeling like they have no other option.

Formula absolutely has its place when a baby isn’t gaining weight, but if the question isn’t being asked of “Why is the baby losing weight?” and plans being put in place to investigate that and address it so the mother can return to exclusive breastfeeding (if that’s what the mother wants), then the mother is being let down by the professionals around her.

It is not good enough to leave a mother thinking she isn’t making enough milk, especially if weight loss or signs of the baby not getting enough milk show in the early weeks when things can be turned around.

Ideally mothers would receive realistic information antenatally about what to expect in terms of colostrum volumes and what a baby actually needs in the first few days of life, and what a newborn baby’s feeding pattern looks like… i.e that feeding every 1-2 hours can be normal. That some weight loss can be normal. Ideally a woman would be observed in the hospital feeding their baby (as in a full feed being watched) on more than one occasion by a skilled practitioner and in-depth discussions had with the mother about how to identify a correct latch and all the signs to look out for that show that the baby is removing milk efficiently and effectively. Ideally mothers would continue to have skilled breastfeeding support once they’re home to ensure things are going well and to give new mums much needed reassurance. Sadly none of this happens and results in the UK having the worst breast feeding rates in the world.

The breasts of women born in the UK are no different to the breasts of all the other women across the world so there is a reason that our breastfeeding rates are so low in comparison, and it’s not because we don’t produce enough milk (as lots of professionals would have us believe because giving formula is easier and quicker than providing education and support).

While I totally accept that not all mothers can breastfeed and this has always been the case, I view this ‘inability to breastfeed’ the way I view the very high c section/IVF rate. Something is going wrong with women’s reproductive health and ability because the figures are much more concerning than 30/40 years ago, and even 100 years ago.

100 years ago, 1.5% of women died in childbirth. Thats a shockingly high figure compared to today, but today half of all births are caesareans. Half! Even with a reasonable margin of caution, I would expect it to be 10%, not 50%.

Women’s bodies just aren’t doing what they could do more easily years ago and nobody seems to know why.

I was going to say, in NICU there’s a pumping room. Loads of mums were using it when I was in with my first. They had a lactation and feeding expert who would check the amount pumped to see how much milk you were producing was sufficient. It was really useful having this check in from a professional on volume, because it felt more acute that he get the amount of milk needed while poorly.

Among my friends and family, most of us EBF. I was probably an outlier going to 18 months ish, but most did six to twelve months. I think what isn’t emphasised enough is taking some colostrum into hospital with you. If your milk isn’t coming in quickly, you can top up with this. The syringes are small as they need so little, so it’s a great backup plan

My mum was born in a village in the middle East. In 1947. They didn't have access to formula until much later.

I have never judged any women on breastfeeding other than the two I know who shuddered at the very idea and didn't even attempt once. Ignorant, selfish women who failed at the first hurdle in motherhood IMO.

Anyone else, breastfeeding can be incredibly hard, is rarely easy and can be such a different experience for everyone. I don't judge any woman for anything about their breastfeeding journey. Even giving your baby just a few days colostrom makes a world of difference.

There should be more support, I think a lot of mothers and grandmothers have let us down in this respect as well as the NHS which wastes so much money on nonsense.

Agreed, OP. Fed is best. I've not breastfed, entirely by choice (and I will say that I'm not the kind of person that looks like they would welcome unsolicited feedback, so nobody questioned it).

Surprise, surprise - kid is healthy, happy, and we have a great relationship.

I had the same experience as you. I tried LLL and consultants. I took medication and supplements. I woke every two hours to pump. I bought 4 different pumps. I cried every day.
I was very angry that I felt under so much pressure- I won’t write all the things that were said to me by HVs but it nearly broke me.
One lovely breastfeeding advisor told me to get formula. I think she might have saved my life.

I think there is a lot of pressure beforehand to breastfeed but not great support afterwards (either isn’t enough or is there is some but it’s not all very good - as you experienced).

To play devils advocate though, of those 50%, I wonder how many of them are elective?

I imagine a lot of them are chosen by the women because of the crappy state Maternity Care is these days as opposed to them being an emergency CS because an attempted vaginal birth didn’t occur.
Or they choose to to have a planned section because their previous vaginal birth was so traumatic because of the poor maternity care they received.

A lot of women choose to have planned c-sections now because they believe them to be the safer option rather than risk theirs and their baby’s life by turning up in labour at the local understaffed maternity ward.

Please ignore this comment though if your statistic was specific to unsuccessful attempted vaginal births.

I actually think there’s a lot of support, it’s just a lot of women aren’t interested and we can’t force them to be. Their choice.

But we have so many helpful aids now. Breastfeeding groups, hotlines, the internet, breast pumps, nipple shields, lactation consultants… etc

If, with all the above, you cannot breastfeed to the extent your baby loses weight, that’s a body problem (sorry, I know that sounds harsh). So we need to be asking ourselves why.

I wonder if the very high caesarean rate has something to do with it. The cascade of hormones never really get going properly.