Any NCT teachers here?

[Libra1975]

i would like to start an AIBU thread but before I do I would like to get my facts straight. I was told that NCT teachers are not permitted to give out information about bottle-feeding unless specifically asked about it, and by specifically asked I do not mean "I would like to FF" but "I would like to FF and need some information about ". The reason apparently they are not allowed to give out information about bottle-feeding is that they have signed up to the WHO guidelines over breastfeeding.

Is this really true?

I've picked my argument a few posts back. I don't think it's rocket science. I don't think it needs teaching as such in a group. Not because it's unsafe (and you still haven't provided a good argument of how UNICEF's blanket statement - how is it wordced anyway? - would apply to the educated women attending NCT classes) but because you won't remember it. I think it is worth mentioning that guidelines have changed and that it is important to follow them and I think the perfect place would be in an antenatal class.

I approached this discussion with the complete belief that if it's not mentioned it's because of personal individual teachers' choices. Then I find it's in fact "policy" not to be mentioned in a group setting.

TBM - huh?

I think most people know what they are going to get when they pay to go to an NCT class don;t they?
Anyway, for what it's worth, I think thta despite the fact that the NCT is a strong supporter of bf, it's like the natural vs cc thing. Just because the NCT promotes natural birth doesn't mean they should ignore the fact that many women WILL have ccs. Similarly, promote bf but don't ignore the fact that many women will ff. And if you don't think they can remember everything from a group demo then do the demo and hand out the info sheet. Could save a baby's life!

I really, really don't see the point of teaching something you know people will not remember.

There is so very little teaching about breastfeeding in the UK - I mean, real teaching, that looks at people's feelings, their emotional baggage, the challenges they may face with social and cultural support.

Using up time demo'ing bottle feeding, knowing people will not remember what they see, is not good.

The 'how to's of bottle feeding are well supported with the clear DH and UNICEF leaflets, and with instructions on packs, and with midwives and HVs whose job it is to ensure parents can feed their babies safely. If people want branded info on this from NCT, they can ask for a factsheet or print one out themselves from the web.

(The rules about no group demo'ing are part of Baby Friendly, cthea)

Why do people remember the other things that NCT teaches but not info on ff?
I kind of agree with you TT on not teaching it, but the not remembering thing bothers me.

I may be wrong but I thought you added the formula to the water, not the other way around? It's a while since I had occasion to use ff (about 7.5 years) but it was drummed into me by my mw that you do it this way around as otherwise the powder absorbs some of the water which can impact on the bottle being made up correctly.

Amazing you can remember that Sally! You're right too.
I think people do remember important info especially if it is explained that it is crucial to the health of thier baby. And they remember it for years not just months. That's what makes MILs so annoying with thier words of wisdom from the 50s!

Are people really more likely to remember the info about bf than ff?

I didn't go to NCT antenatal classes, but to privately-run classes organised by a lady who works locally as a midwife and HV. A lot of the time was spent on bf, and rightly so. However, she did make a point of explaining about ff and did a demo of how to make up a bottle correctly. She also went through the various types of formula milk and bottles available, which I found very useful. In reality, do all mothers who chose to ff have their technique properly checked by the midwife or HV once they're home?

As much as I support bf, and chose to myself, I think that ff mothers do need some support and info antenatally to ensure that their babies come to no harm through incorrectly made-up milk.

As an example, my SIL (who had a baby 6 weeks prior to me) used to make up a whole day's worth of feeds using mineral water, adding the water to the milk and then heating in the microwave. Noone had asked that she was making the formula correctly, it was just assumed. It wasn't until my neice was 3 months old when I saw what she was doing that anyone had questioned it. Don't assume that people will read and follow instructions correctly- people learn far more by being shown.

No, of course people may not remember much about the breastfeeding info as well - the point of the bf class is not to drum in information to be retrieved weeks later. The class does contain some info, of course, but it's far more than that (or should be). It's to explore challenges and attitudes, to prepare for what lies ahead, and for them to know where they can get help.

NCT teachers and bfcs are not there to do the job of HCPs. HCPs are perfectly capable of checking that someone knows how to make up a bottle safely - if someone uses unboiled mineral water to make up a feed, then they have not done their job.

I do think ff parents need support and information - but the antenatal breastfeeding class is not the place for it.

Isn't part of the issue here that support for ff mums, be it from HVs, midwives, or the wider community where ffing is the norm (although of course some of the info from friends/relatives/woman at the bus stop is wrong, sometimes disastrously so) is more readily available, and that at least there are instructions on the tin, whereas breasts don't come with instructions and good, well-informed support can be harder to source? Many HVs and other HPs (although not all of course, before someone flames me) are short on bfing training and/or out of date, whereas I suspect they could all show a mum how to correctly make up a bottle.

The NCT says it supports parents however they choose to feed their baby. But it's a campaigining charity, trying to fill a gap in provision. Surely it should be allowed to do that? And as TT has said, if someone has a specific question, BFC will answer the best they can. I don't think anyone is actually refusing to provide help. I'm just not sure what would be the point of teaching a group how to make up a bottle when, if all the group attendees are as smart as pps have said, they can easily read the instructions on the tin and call their HV if they need help. Although I do take the point about inconsistency... I have no experience of formula so I'm ignorant in that respect.

Mij, good post.

I worry that there is a hidden agenda in the calls for demos of ff in NCT classes - a challenge for NCT to 'prove' it supports all parents with a demo of something (ff) which :

i) parents do not need to know at that time (while they certainly do need to know about bf as they need to think about confidence issues, support from family, and so on)

ii) they will probably not remember effectively or in sufficient detail to be useful

iii)is more effectively and easily done by people whose job it is to do it

NCT does support all parents, regardless of feeding decisions. I am sorry if people see the only proof of that in a ff demo.

I'm an NCT teacher and this is what I do: at some point during the course I ask the parents if any of them have any questions about formula feeding/bottles that they would like me to help them with.

I get them to write the questions down.

Then I work through them in the class.

There is no question I wouldn't answer other than 'can you demonstrate how we make up a feed?'

I wouldn't demonstrate how to make up a feed because it goes against our guidelines, and because I personally don't feel it's helpful or safe (parents need to do this one to one after their baby is born - they don't retain the information sufficiently if they're shown it in group demo's in antenatal classes) but I'm happy to discuss where and how to access this sort of information. I hand out factsheets on this if people ask.

I also direct all mums to this board for information about breast and bottlefeeding!

If I went to a breastfeeding class I would tune out when it came to formula feeding (if it was included) because as far as I'm concerned that doesn't apply to me. I (obviously looking a little retrospectively here) don't plan on even having a bottle in the house, so why do I need to know about it? If it comes to my breastfeeding not working I will have done everything I can with my HV/MW and then switch with their support. Most of the people I know formula feed so it can't be that hard, there are instructions on the packet, I can get ready made if I'm unsure until I can talk to someone.

I suspect that the more people know about ff BEFORE their baby is born, the less likely they are to want to do it! That's if you're giving them unbiased, evidence based information rather than a load of marketing twaddle.

One issue that arises when people say they want 'more' information about formula is exactly what do they want to know....they tend not to want to know more about risks of ff, or maybe I'm wrong? Maybe they do want to know?

I agree fabsmum! I didn't want to do it anyway but the more I know the less interested I am in it. I remember rolling my eyes at my sister (who's childless BTW) joining the boycott and now I'm there too (just wish someone would buy Buttons off of them)! I know I'm most likely going to have a premature baby and the thought that I might not be able to give her BM straight away upsets me far more than it did with Tink. I'm just hoping that tandeming will give me a head start!

With respect though cupcake - you have a two hour bf session. How much time should you devote from that class to dealing with the issue of what happens if bf fails altogether? Mothers have little enough confidence in and knowledge about bf as it is. They need to know where and how to get very speedy help if things are difficult with bf, but useful, detailed discussion about the practicalities and emotional fall-out from bf failure really are best saved for one to one sessions with a bf counsellor at the appropriate moment. If you spend even half an hour of a 2 hour class talking about bottlefeeding and bf failure that's half an hour less to help people succeed with breastfeeding. I'm not saying that women don't need a chance to talk to someone knowledgeable if this happens to them, and obviously it needs to be acknowledged that bf isn't going to work for everyone, but there's a time and a place for that and I don't think the bf class is it.

For my own education cupcake (and I'm sorry to hear you had to make rush decisions at what must have been an emotional time anyway), with hindsight do you remember why you made up bottles incorrectly to start with? Was it the sleep-deprived haze (totally understandable) or are instructions on formula tins really crap/wrong?

I think the teacher has failed badly if you come away from a lesson not knowing where to turn if there's a problem.

If parents don't intend on BFing then they wouldn't be at a BFing class, would they?

Tiktok - if all teachers started with the idea of not teaching something you know people won't remember, we'd never learn maths beyond simple sums. Going back to the current discussion, with all respect, but I think it's a bit paranoid that a simple questioning as to the rationale of deliberately avoiding talk of formula becomes some kind of hidden agenda. You couln't be more wrong in my case. I'm just curious and very mistrustful of company ruled behaviour. That's why I didn't believe the NCT would be so controlling regarding what is taught. That's why I still take it as zealous over-interpretation of something not entirely evidence based (the group based teaching rather than ff before anyone starts flaming me).

Fabsmum - your approach sounds v reasonable to me and your asking participants what they want to know in contrast to the OP's teacher who said she's not allowed to initiate discussion.

Mij - I think you've identified there the restrictions or challenges of being both a forward thinking, campaigning organisation, and one that tries to be responsive to the people paying it to be on its classes, who provide much of the income that then allows the NCT to keep on campaigning etc.

I have no problem with fab's approach at all.

I am not paranoid about agendas - I know, from a lot of experience, that when people say they want 'more information about formula' they generally do not mean 'information about why this form of feeding has risks'.

I am very sad indeed for people who find themselves having to give formula and under-informed about it - but what you are describing is inadequate postnatal care, cupcake

No class I have ever seen or done myself omits references to the fact that for some people, bf does not work out. Everyone who comes to a class knows from their own or someone else's experience that it may not be plain sailing, and for some people breastfeeding ends before they planned it, or is done in addition to formula. The whole raison d'etre of having a class is to enable the plan to bf to work...to build confidence and explore challenges and to prepare for them, but most of all, to show there is hep available.

If everyone breastfed happily and as long as they wanted to, there would be no need for classes.

I think it is fair to paying customers to let them know that there will be no demo of ff, and that the bf class is about bf.

I don't think it is 'zealous' not to demo ff. It is consistent with NCT's stance on infant feeding. If you think the 'no group demo'ing' is not evidence based, then this is something to take up with UNICEF Baby Friendly...in the meantime, I will try to find what exactly they say about it.

www.babyfriendly.org.uk/page.asp?page=74 is Baby friendly's guidance on this.

Tiktok - that is very interesting. I had no idea that UNICEF were so detailed in their guidance. I also note, however, that "this standard is not intended to deny women information or to undermine safety. Other impartial information on formula milk can be given in antenatal classes. It is also expected that all postnatal mothers who have chosen to bottle feed will be shown how to make up a bottle correctly before discharge from hospital, and that community staff will check to ensure that mothers have received and understood this information." So individual judgement is still allowed. You can give information, especially if yout think the only correct info received will be from the classes rather than the MW/HV.