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??

"It's not hospital per se that's the problem/solution"

Not sure about that. There's a really interesting section in "The Politics of Breastfeeding" where GP discusses the impact of trying to establish lactation while among strangers in a large institution. She argues that simply being in a busy, public place where you are exposed to lots of bottlefeeding can inhibit oxytocin production and hamper breastfeeding.

Thought it was an interesting point!

Agree about the weight loss of newborn baby and pressure to switch away from bf. Hard enough without the implication that you are failing your baby and possibly starving it. Coming at the exact time where you are a bit low, tearful, feeling like a bf failure and worried about harming your child, the temptation to give up bf for the "safe" method of bottle feeding is very real.

Just to let you know that we've been in touch with the BMJ and they're going to include this thread in their blog this week. Also, we've got a meeting with Alan Johnson's communications adviser tomorrow, so we'll make sure to raise your ideas then

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How about starting by actually implementing the NICE guidance in all areas.

Sorry, but at the 'breastfeeding wing'...all mothers need calm, peace, quiet, and restful support, and we want all mothers to feel free to breastfeed or to change their minds when they wanted to formula feed! This does happen.

Slotting people into a different part of the ward depending on feeding options - no thanks!

In any case, how on earth will this accomodate the increasing nos. of bf women? I would like mothers who formula feed to see the breastfeeding mothers - not to remove the ff mothers from the bf mothers' gaze

Grendle, absolutely!

This is one of the reasons I am very at the idea of passing this thread on to the BMJ. We know what's worked and what needs to work in breastfeeding support - NICE guidelines are a review of the research, and recommends tried and tested interventions.

Some of what has been suggested on this thread has been shown not to work...or else they are ideas which sound good, but which contradict interventions which have been shown not to work (like the idea mothers should have longer postnatal stays....NO!).

It is pretty well known what needs to be done. The political will, the money and the professional determination to put it all into practice is lacking

Am in a rush so cant find who said it, but someone earlier suggested a DVD of mums talking about breast feeding, things like cluster feeding etc other issues and solutions to common problems. Possibly a section on how to spot thrush and mastitis early etc

Also second time round when I was forewarned and had looked up every support going, a friend directed me to a website with lots of clips of mums bfeeding, close up of good latches, different positions etc. It meant in the very early days at 2am when I really couldnt call anyone I could watch the clips over and over and reassure myself. It might be that a DVD given to all new mums to take home could go some way to addressing the problem we have this minute, as all the training that clearly does need to be done is going to take time to work through the system, and is always going to be dependent on local resources.

Shoot Bounty pack distributors on sight

"HiPP were also keen to drive traffic to the HiPP website in order to increase awareness and understanding of the full product range, including the HiPP Organic milks range."

Course they were.

Oh, and don't let Hipp et al sponsor the birth certificate packs.

DVD is available - supposed to be given to all new mothers.

www.bestbeginnings.info/

No-one has mentioned yet, I don't think (although I have skim read some of the thread) the Scandinavian country (Norway perhaps?) where formula is only available on prescription (although fairly easily obtained I believe, as it should be). I'm guessing that's several steps too far in a country at the stage the UK is at with bfing, but it certainly has had a dramatic effect on bfing rates in around one generation, coupled with the right of women to bfed anywhere they want at any time.

It's one way of doing it, anyway!

I've got that DVD, although haven't watched it yet. Think it's called From Bump To Breastfeeding.

I would agree that longer postnatal stays are not always a great idea. At my hospital, I was supposed to stay until feeding had been established, but it was so horrendous there that I discharged myself, after 3 nights. I think that huge damage had been done in those 3 nights.

I think the funding is there, it's just focused in the wrong areas.

I fear that a b'feeding wing might end up a bit like the MWled birth units; fantastic for the few who manage to get in, but leaving less funding for everyone else. Also, the best halp I found after having dd1 was sat amongst a group of women b'feeding, seeing how they were doing it, and being able to ask questions was fantastic. Maybe it should be encouraged for groups of women to feed together when they are on the wards, with a bfeeding councillor, there to help. (This might also make it easier for them to reach more women, for a longer time)?

Been reading thread and definitely agree it is about seeing it more in friends and relatives and on TV.
Myth busting would be useful - I met a friend today who stopped bfing at 4 months as someone had told her she had to be tee-total throughout duration of bf-ing and she really fancied the odd glass of wine.
She would have carried on if she had been told differently

there needs to be programmes on telly about the benefits and normality of breast feeding.

and also people should know that many babies don't sleep and that is normal and natural

and that looking after a baby is a difficult and important job.

I'm sorry Christina but your BF wing sounds like a version of hell for me...when I had my DDs all I wanted was to be in my own space with my things and with people who cared for me. Also poor DH would have missed those early days. And DD1 would have been even more unsettled by her mummy being away for so long. Is it too much to ask for support in the community? And actually I got pretty good support and would like to see this across the country.

Message withdrawn

The point was made earlier by Tiktok and others, but can I just say that this thread is conflating the two issues of initial breastfeeding rates and support to continue. Do we know exactly which angle the BMJ was taking in its rhetorical question?

Its not MY space though its a small hotel like room. I've stayed in far too many of them and don't like them that much. If you and the baby are well then why would you want to stay in any institution? Obviously we're all different so accept that it might be great for some people but far from all.

Resources are scarce and I feel much better to put them into the community where they can support BF establishment and problems that arise as you go along. I think I mentioned in my earlier post the support groups in my area which have been invaluable to me in helping with the latch and presently dealing with Thrush (very painful and a reason women do stop BF). Run by a mix of HCPs who have been fully trained and BFN. I'd like to see these available across the country.

BTW more problems feeding DD2 than DD1...I guess while I have an idea this time round DD2 isn't as "good" at it as DD1 was or we've been unlucky.

Anyone mentioned growth charts for exclusively breastfed babies?

Rather than more time in hospital (God forbid), what we need is a return to the "lying-in" period for a new mother, with plenty of help and support available at home - be it their own mothers, sisters, mother's helps, whatever. That kind of help is very hard for many mothers to come by, and the feeling of guilt for not simply bouncing back can be quite overwhelming. That guilt is in itself very tied to the attitude that IS commonly held by health professionals, and other mothers, that it's all normal and you should just get on with it. The fact that many millions of mothers have been through it all before doesn't make it a single jot easier for an individual going through it themselves.

I can see where you're coming from christiana, but I think putting the priority on support in the community would be more effective, cost-effective and help with the normalisation of bf.
I think some (many?) women decide to ff in order to get out of the hospital quicker.
I hated it in hospital and was desperate to leave. Never been so lonely yet without any privacy.

Advertising/marketing is a major problem. I bought a baby magazine today (free cd) and was overwhelmed by the amount of formula advertising in it.

As well as normalising bf, I think a de-normalisation of ff is needed. I don't mean in that ffers to be made to feel bad, but that formula should be a 'medicine'.
Nobody makes people with diabetes feel guilty for their non-functioning pancreas, but noone would choose to inject themselves with insulin everyday. Formula should be seen in the same light. I don't know how though.

How about TV ads promoting bf with Ulrika/Charlotte Church and any other celebs who have bf - can't think of any others but there must be some.

Sorry if this already suggested.

DVD exists? Marvellous! Where is it?? Has it gone national? Do they give it out after baby arrives?

There are a lot of myths around about Scandanavian coutries, e.g. how their bf rates have actually changed and evidence on which interventions have had what impact there. Norway's bf rates never plummeted like the UK, so it's not a fair comparison.