BREAST FEEDING - How can we increase rates?

[HPNC]

This is the question writ large (very large, in fact) on the front cover of last week's British Medical Journal.

The BMJ is delivered to the home or work place of practically every doctor in the UK. It is read by many other health professionals.

I assume that the editor of the BMJ did not intend this as a rhetorical question. (It actually refers to an article in the magazine, which I thought was interesting).

I would like to offer 2 (humble) suggestions:-

1. Mumsnetters post their (constructive) comments/ideas/suggestions here.

1. Mumsnet Towers write to the aforementioned editor, and suggest that the BMJ readership log onto mumsnet and read the thread.

I think there is a real opportunity here to make the voices of consumers heard.

What do you think??

And a blanket ban on all formula milks; first stage, follow-on and toddler milks. They are all breastmilk sustitutes, and all the adverts are misleading.

(Thanks GreenMonkies I have been dairy-free since ds was 4 weeks but his reflux got worse at 8 weeks hence the Gavi. I like to think that being dairy free might be helping too though.)

I think this thread is a really good idea.

Five - can you give an example of bullying? Not being inflammatory, just genuinely interested. Have not ever encountered that myself, but have been given lots of grief for BF in real life. Including from a GP.

Pixsix are you drinking caffiene (tea, coffee, coke, irn bru, lucozade, red bull etc) and what about wheat, tomatoes and citrus fruits? Does he just have reflux or does he do nasty green slimey poos and have dry skin/excema too? It might be worth keeping a food diary to see if you can spot a pattern. Hats off to you, DD2 was a dairy refluxer, I was dairy free for 18 months,and it was hard..... (she is still intolerant but I can eat it now without her being effected)

GreenMonkies my only caffeine is from dairy-free dark choc (2 squares a day). I tried cutting it out for a week before the Gaviscon and he was worse if anything so am still having it now. I didn't have any citrus fruits until recently as my mum told me they were bad when bfing so i don't think they are to blame. I am having wheat, tomatoes and also soya which I've heard can be a problem. I will try a food diary and see if i can spot any patterns. Thanks for your advice.

Been looking can't find as search doesn't work for me.

I do remember suggesting on another thread that a one to one session with a breastfeeding counsellor in your own home pre birth and then there if youneed help afterwards actually explaining how to do it would help.

LeninGrad, bf stats are here :

www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/infant-feeding-s urvey/infant-feeding-survey-2005

You are w....a.....y out.

"Initial breastfeeding rates in 2005 were 78 per cent in England, 70 per cent in Scotland, 67 per cent in Wales, and 63 per cent in Northern Ireland. In England and Wales, Scotland and Northern Ireland the incidence of breastfeeding increased between 2000 and 2005.

"In 2005, 48 per cent of all mothers in the United Kingdom were breastfeeding at six weeks, while 25 per cent were still breastfeeding at six months. Between 2000 and 2005 there was an increase in the prevalence of breastfeeding at all ages up to nine months in both England and Wales and Northern Ireland. The pattern of fall out was broadly similar across all countries."

The vast majority of women initiate breastfeeding. If you read the rest of the full survey you will see that of those who stop before 6 weeks, nine out of 10 of them wanted to continue.

1. Make it a criminal offence to stop a woman from bf in public.
2. Put posters of people bf all over the place, to habituate the population into seeing breasts used for their natural purpose.
3. Discourage hooter hiders and that ilk.
4. Have lovely cuddly 24 hour drop in bf advice centres attached to every maternity unit in the country, where bf people new and old can mingle, get advice and generally be encouraged to persevere.
5. Give women extra child benefit if their babies are bf (more controversial, but they used to subsidise formula via baby clinics, which amounts to the same thing for ff).
6. Teach bf techniques in schools via the National Curriculum, including info for males on how to support bf mothers.

Last one is actually most important, I reckon.

Some HVs, GPs and midwives have a lot to answer for.

In my experience of having DS in the UK, I had misleading advice from a midwife, refusal to help with BF from another midwife, encouragement to 'top up' with formula from an HV, encouragement to give up at 6 months from the same HV, and encouragement to give up^ at 12 months by a GP.

So thats one BF experience and at least 5 encounters that could so easily have meant an end to my BF. I continued because I had previously BF DD, and was resonably confident with good family support. But is it any wonder so many women quit with that kind of edvice from people they trust with their health care?

I agree that information on the risks/cons of formula feeding would help. Its a bit of a taboo subject as people don't want to offend FFeeders I think.

Also agree that normalising BF in the media would help, and making BF less of a 'middle class' thing. Also 'targeting' groups that are least likely to BF. Talking to them about why they don't BF, and then addressing those issues in a sensitive way.

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(christian - you might get lucky, but if you don't then ask to see a lactation consultant. And if one is not forthcoming, then call a BF councellor from La Leche league or somewhere. Don't keep hoping that an ignorant or unhelpful midwife will suddenly become helpful)

Tiktoks stats are right but there are huge regional variations in BFing rates. Some areas of London like Kensington and Camden have very high BFing rates (nearly 90% initate BFing), other places have extremely low BFing rates. I think in Knowsley (in Merseyside) only 30% of women initiate BFing and very few continue till 6 months.

Peppermint, am more than aware of that, and can quote places where initiation is not even in double figures

Astrophe - there are hardly any lactation consultants in the UK.

My HV was wonderful, but it seems clear from MN that there are a lot of ill-informed shockers out there. Mine was incredibly supportive, even to the point of going out and getting a prescription and fetching the drugs for me when she did a home visit and diagnosed mastitis. Wish they were all like Maisie!

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I was hugely let down when i was attempting to bf ds. I was in agony and no one woould help me. I was just told that it looked like he was latched on okay and to just carry on. This was while I was crying in pain and frustrationa nd guilt.

Encoraging women to do it is no good. There must be support to help them continue.

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Nickytwotimes

Absolutely spot on; Encoraging women to do it is no good. There must be support to help them continue.

and it needs to good, helpful, educated, honest support. not just The Chant.

Normalise it.

Make it illegal to tell a woman she 'can't bf here.'

Liaise with soaps and other popular culture media to try and include it.

Include it in sex-ed or whatever kids have these days.

Try and get local cafe's, play areas, shopping centres and other places where new mums hang out to subscribe to a 'breastfeeding friendly' scheme, showing their support by clear labelling ('we are bf friendly) and the provision of nice surroundings for feeding.

And make training and training TIME available through PLT or CPD schemes for the professionals we already have who should be giving less crap advice.

Contacting the BMJ is an excellent idea, btw. Does the article have a 'rapid response' option? You could respond there and link to this, or email the editors.

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Cristiana, where did you get your figures from? I was under the impresh that Netherlands bf stats were roughly the same as ours - not 'much' higher! I checked and I think I am right:
www.cbs.nl/en-GB/menu/themas/bevolking/publicaties/artikelen/archief/2007/2007-90051-wk.htm

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Still don't see how their stats are better than ours - our initiation is actually higher.

The table showing excl bf is best interpreted as 'any bf' as there is no differentiating column on mixed or predomoninant bf (common sense guessing here, have to say). The figures are a tad higher than ours, that's all.

Let me know if I am reading it wrong!

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No - 53 per cent after a month, 39 per cent after 2 months, which is very similar to UK stats.

"Thus, in the United Kingdom the prevalence of breastfeeding at one week was 63% in 2005
compared with 55% in 2000. At six weeks the respective prevalence levels were 48%
compared to 42%, while at six months the levels were 25% in 2005 compared to 21% in
2000. "

This is from the UK 2005 Infant feeding survey. Pretty similar to the Dutch, and actually we're rather better at 6 mths

However, the WHO tables seem confused and confusing about exclusive bf - so it maybe the Dutch do better at excl bf than us, and we do better at 'any' bf.