why don't the NHS provide breast feeding counsellors ?

[gokwancarr]

I mean really experienced ones like the NCT or LLL have? why don't they come out for a standard visit, to mothers who have expresed the desire to bf, within the first week after birth (when it is most common for mothers to stop bfing through pain/thinking baby not getting enough/etc)?
i was just reading another thread on why people thought they didn't succeed with bfing. i can honestly say that i would not have continued to bf dd without the information i recieved from other mums on mumsnet....and one MW who came on the wrong day (but thank god she did i was sobbing on the sofa wondering why i could only express 40mls of milk on day 3 poor naive me)i really struggled to bf dd and every health professional i saw had a different opinion, looking back now i can even tell which ones must never have bf in their lives. i just think that during my pregnancy i was bombarded with so much written info on WHY i should bf but very little practical help on HOW. also it was never mentioned in any of the info that some babies suckle for hours and hours in the first days, as dd did, and this is why i nearly gave up cos i thought she wasn't getting any milk.

I am training with the ABM and cant wait to be able to give mums more support (am currently a mother supporter with them). However I know it will also be incredibly tough as there is no way I will be able to help every mum who needs it!

I would love to see a postnatal visit by a BFC to mums after the birth and as a researcher am actually thinking of doing a study on the effects of this on breastfeeding duration. However to do that I would need breastfeeding counsellors!

My existing research shows that women who have support from a BFC go on to breastfeed longer but I have no idea whether those mums who choose to see one or fight to get one or who know about them etc etc are more determined to breastfeed in the first place - or have more existing support (ie a mum who breastfed and told them to see a bfc).

I would love to do a random design where mums are visited after the birth and to see what effect this has matching them. In my little fantasy world this would also change government ideas and all hospitals would then get a bfc or two lol.

Have a feeling I can keep dreaming unfortunately.

I'm a breastfeeding counsellor, i do groups and twins home visits, others do just home visits and others go to the hospital once a week on several different days. We are, however, all volunteers!!

expat - I think we'd all support you and wish you masses of good will after a really difficult experience...it's just not true that there are 'lots of threads' on mumsnet bashing mothers who stop breastfeeding. It's a pretty supportive place and if the occasional insensitive person does anything that remotely resembles 'bashing' she is usually jumped on pretty quickly

PS I'm saying that so other people who are lurking do not worry about posting in the future if they stop bf...that's all

Our pct has a breastfeeding counsellor but she's one person who works a 4 day week in quite a big area. Her office is very close to home though, but I found out about her existence after things had gone quite badly wrong. That's a point, I must find out whether she's still around before dc2 arrives.

i've noticed a couple of posts which detail some really poor advice given by health professionals ie cc for 4 day old, and use of nipple shields without proper expalnation of how they should be used. makes me feel so sad. when i look back on my hospital stay, i feel like i managed to bf dd DESPITE the advice given to me.....the worst being don't let your baby suckle for more then 30 mins at a time: cue very sore nipples, very unhappy baby and milk not coming in properly until day 5, and adequate supply not being established until she was 4 weeks.

just to clarify, i'm not criticising anyone who can't/chooses not to bf, just commenting on the lack of support for some people who really want it.

TheInvisibleMan - 'Community mothers' still exists! Not sure where you are but we have recently expanded so there are CMs in Stirling, Clacks, Polmont and Falkirk now. (Well, there's ME in Falkirk. but it's a start!!)

I have to say though that I disagree with LackaDAISYcal who said that she thought "the level of hospital support is down to whether the individual hospital has signed up to the Unicef baby friendly initiative and also what the local trust policies are."

Our local hospital is at the second stage of getting baby friendly. the support there is still hit and miss. Sadly the training the 'professionals' get is varied. for every one MW who knows her stuff you get 5 more who advocate nipple sheilds or timed feeds or says that baby's starving give him a bottle.

Unicef Baby Friendly doesn't ensure the hospital has got itself sorted - but it does mean that at management level they recognise the importance of breastfeeding support and the fact that extra training and supervision is needed to make it happen.

The other aspect I think is important is that mothers can alert Baby Friendly UK to shortcomings if they experience them (and it would be good if the same mothers would alert the maternity unit, too). Baby Frienldly UK has a form on their website (or did, last time I looked) that allows you to do this, and they apparently follow it up.

You can't keep Baby Friendly certification for ever, either - some places have lost theirs. And there is research that shows BF units do make at least a short term difference to breastfeeding.

Not a perfect system, but a step forward, I reckon

It is very wrong that it totally depends on where you live - where I am in south london there are several drop-in breastfeeding clinics attached to surestart centres.

I used one of them when my dd was 2 weeks old and it was really helpful. Sadly lots of people I talk to don't know about it or won't go because they think the staff there will be as useless as their hv. I must admit that I had the same reservations but was completely wrong.

The saddest thing is that if the services that exist arent used then these will be cut as well.

Purplemonkey, I'm in North Lanarkshire,

Good to hear it's still running.

some areas have no drop in clinics, too..

maybe they did in the past, maybe they never did.

i'm sure it's a matter of funding.

but you can say about a lot of things.

Drop-in clinics are better than nothing, but the real help you need is either in hospital - with very unhurried midwives - or at home, with MW making it a priority to come round when a feed is due and sit with you.

What I liked about the woman who helped me is that she wasn't in a hurry. She helped me get DS on, and then sat and chatted for an hour, and talked everything through with me, and then came back the next day, and debriefed on all the feeds and did the same thing again. Because I felt under no pressure, I relaxed and felt much more confident.

That kind of help is incredibly time-consuming and therefore expensive, but hopefully you would only need it for a generation, and then older women who breastfed themselves could help.

Gokcannwar - all I can say is that I totally agree with you

BF is a lost skill IMO and if we had experienced women around us who could offer support and informed advice then I feel heps more women would suceed in BFing in the UK

dinny - yes St George's does have a lactation consultant. One. And you get offered appts for a month's time - what use is that with a newborn?
(I've got one for 9 Dec, in case I still have thrush then).

There's a few drop-in clinics in south London but they're hard to find out about - I asked one HV about breastfeeding cafes/clinics and she said 'I never heard of any such thing'. Fortunately I decided to venture an hour's bus ride and found one that day - although went the next Monday to find it shut, because the NCT website hasn't been updated in over a year.
Another one I phoned had the wrong phone no and got me a fed up elderly lady. There apperars to be only one volunteer bfc for the nct, lll etc in the area - all other numbers are defunct.

The bfc at the baby group today told me my best bet would be a drop-in clinic in Croydon which happens to have a lactation consultant - hopefully they'll let me in as both Merton and Lambeth ones are restricted to residents. bloody nhs bureaucracy...

notcitrus - where are you - theres a good drop-in opposite st helier at the tweedale centre in rose hill on thursday mornings - if you're around st georges then not too hard to get to - the 280 stops really close-by - merton is indeed rubbish but sutton has got a few...

I had brilliant support - late in the day and after lots of rubbish support - by someone from our Surestart. I never really understood who was who or how the system worked but what happened was that she came round to the house when DS was about 2 weeks old, and spend nearly 2 hours with me, really calming me down as I had got myself into a state about Bfeeding, convinced myself that he would only take one breast, was expressing the other...She showed me various different holds, helped me find the position most comfortable for me (everyone else I had seen had completely poo pooed the fact that I was desperately uncomfortable and stressed with the "proper" way) and waited for DS to wake up properly so that she could sit through the feed.

It was fantastic. We never looked back. I never saw her again, but did pass on my thanks via my HV when I was next there. DS was bfed until he was 14 months and was no longer interested, and I still believe it was down to that one visit.

We were very, very lucky.
(her name was Lynette, from Roehampton Surestart - certainly worth another mention!)

notcitrus - the clapham nct now has a bfc drop in cafe on weir rd link

kate - i'm between streatham and norbury. Thing is, the bf is now fine (thanks to 5 of the 6 postnatal midwives at Georges, a NCT bf counsellor who I visited, and the midwife bfcs at Brixton and the new Streatham drop-in, no thanks at all to the bonkers postnatal midwife and 2 GPs who told me my cracked nipple was 'normal'). I can even feed on the uncomfortable chairs in the clinics! Ironic that the main advice to new mums is sit comfortably and use pillows to position your baby, but the clinics have neither pillows or sofas...

What I've got is thrush in the ducts, which hasn't responded to a second week of flucanazole and impeccable hygiene (boiling all pump and bottle parts, changing breast pads + boiling bras, etc). I've gone back on an anti-yeast diet, but combining low sugar and low fat (other med needs) and getting enough calories is tricky! At least my cooker now works again...

So probably need a specialist - who will probably prescribe a metric shedload of flucanazole.

The b/fing support in hospital is infinitely better - wonder if it's the UNICEF Baby Friendly standard? I asked to stay in hospital an extra day with DS as I needed the help with his latch and had horrible blisters.

notcitrus, mmmmm, I know - she was on holiday when I had dd and I had a bloody nightmare feeding her (prem)

What I don't understand is why HVs and Midwives are not better trained as standard? Surely supporting mothers to breastfeed is an obvious part of their job?

Couldn't agree more, dramas - it seems basic good sense to me as they are the ones on the frontline helping mothers.

One thing I do think is that when breastfeeding rates are so low, many HVs/MWs have had little or no experience in overcoming many breastfeeding problems because so many women FF before or as soon as difficulties show themselves. This might contribute to the 'some women can and some women can't' mentality which I have met in a number of them (of course I realise there are a very few women who physically can't). We need higher breastfeeding rates so that more difficulties can be encountered and successfully solved, which will in turn one hopes encourage even more women to BF.

you'd think that dramas, but they just don't have the time to sit with new mums, to watch a whole feed could take an hour and they are too busy to do it. Even if they do have the right training.

My first HV had a trainee with her, who until I started feeding A, had never seen anyone bf at all, ever.
Given HVs only have one year's training and that part-time, it's amazing there's as many good ones as there are (and they admit half their knowledge is what they came in with).

Someone said on another thread that HVs have to be reg nurses, but they certainly aren't round my way.

I did feel very supported in hospital - possibly because they didn't have anyone else to support, judging by the fact that I never saw anyone else in the bf room, and spent most of 2 nights there watching Bollywood movies.

theblonde thanks for that link. A friend went there a couple weeks ago only to find it was shut for half-term...

purplemonkey, that's a good point about having the time. That would make a huge difference.