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 true that formula is only on prescrip. in Norway and elsewhere - and this would be disastrous anywhere. Who on earth wants doctors (or nurse practitioners) to decide whether a baby needs formula or not....we know full well one of the reasons why we are in this position in the first place is that healthcare professionals do not know enough about infant feeding

The decision to use formula is and should be the mother's - informed, when necessary, by health concerns, but not dictated by HCPs.

Lemontart - I so agree with what you said further down - that FF is often presented as the 'safe', foolproof option, whereas BFing is much more 'risky' as you 'may not have enough milk', or 'baby might not be latched properly' etc etc. When of course in actual fact FF is more 'risky'. Its a dreadful thing to use the fear mothers naturally feel for their newborns to 'trick' them into FFing (I'm not really saying Midwives and others are doing anything quite so sinister, but I think that this is, in effect, what is happening).

Does anybody know if Health professionals are actually help to account foe the advice they give?

I was given advice on at least 5 occasions that I'm fairly sure would be against the guidelines for GPs, MWs and HVs. I did not make any complaints (I should have done), but what would have happened if I did complain?

It would be no good to see HVs being penalised for helping women to FF, or to see them bullying women into BFing against their will, but, in the case where a woman has expressed both verbally and in writing her wish to BF (as I had), I do think Health Professionals should have to account for why they advised or encouraged said woman to use formula. I should add that in my case, there was no medical problem, nor any significant issues with BFing (nothing that couldn't be solved with a little help from Tiktok anyway )

sorry, I meant "held to account for the advice they give"

I'm sorry if this is repeating what has been said elsewhere on the thread, but it has just occurred to me reading other posts from new mothers recently.

I think it would be useful if the NHS had a good, pragmatic think about co-sleeping and new bf mothers. I'd like to see some evidence-based guidelines and recommendations that acknowledge the risks/benefits and allow midwives/health visitors to advise women.

There are risks to cosleeping but there are also risks to ff. It would be interesting to see some research which quantified these risks, including the risk that women will stop bf due to lack of rest/feeling their baby won't settle.

I know there's a lot of stuff out there already on reducing the risks when you cosleep, and studies on bf mother's and their instinctive reactions when sleeping with their baby, but certainly my NHS Board officially do not recommend it.

Make breastfeeding fashionable and admirable.

In Portugal (where my hubby is from) I always feel way more comfortable and proud to breastfeed in public. My husband shows off proudly that his wife feeds his baby with her own milk still, especially to his Portugese friends. People never give you shocked looks if you feed your baby the natural way.

The reasons that women stop bf is often linked to selfish needs. It might help women to be reminded that bf does help us to by protecting against illness such as breast cancer and by giving us calm, happy more easily contented and confident children!

It would be great if the gov could give an extra weekly cash benefit for bf mothers but unfortunately they like the revenue from formula sales and nursery costs ect.

Ladies. I love all the suggestions on this thread but one way I think we can really help is by PROUDLY BREASTFEEDING IN PUBLIC. I know it's hard as a minority. Minorities often feel stronger in groups so gather your fellow bf freinds and go to a cafe together. Other minorities have faced prejudice. I feel there is a prejudice against bf fashionable at the moment. I myself need to take my own advice as I often bf my 15 month old baby in a public loo
I even felt a bit embarassed in a store feeding room the other day as 2 women looked shocked as they fed their newborns and asked me 20 questions. But realised that it was chance to educate/provoke thought on the subject and one of these women might one day change their mind. Immediately afterwards another women entered and felt comfortable to bf her toddler next to me which made me happy
Go for it girls
xx

I have to say every time I get out my norks to bf I do it in the knowledge that it is paving the way for other more shy women to do so. It is a matter of pride to me that I am brave enough to do this, and if anyone challenged me I would just ignore them and carry on. Only once have I given in and that was when my own mother was having a go at me, but even she couldn't stand in my way now.

Part of the problem is having to return to work before baby has self-weaned at the natural time... pressure to get baby sleeping and mum rested enough to dash out to earn £££... expressing milk for a baby left with someone else is a complete pain... and so on.

If mums were respected and valued as bringing up the nation's next generation on the best food ever, they should be encouraged i.e. PAID to take as much time off work as necessary (assuming they want to of course!)

As an aside - this is extremely interesting and may make some sit up and take notice of what breast milk can do!!!

Breast Milk Contains Stem Cells

The Office for National Statistics performs its Infant Feeding Survey every five years. The figures from the 2005 survey were published in March 2008.

Overall, only 35 per cent of UK babies are being exclusively breastfed at one week, 21 per cent at six weeks, 7 per cent at four months and 3 per cent at five months.

Does this surprise anyone?

Millbill - I had heard those statistics before, but interestingly tiktok posted some further down which were quite different....I'm not arguing with either of you, but wondering why the difference? Are they measuring different things?

There the same stats - I quoted from the UK Infant Feeding survey in my post. The stats in my post are 'prevalence' of any breastfeeding. MillBill is quoting exclusive breastfeeding ie with no formula, solids or anything else.

There = They're

Thanks tiktok - I can't find where you posted them further down, so couldn't read and compare

That's fine, Astrophe - it's good to draw attention to the difference. I find the very first figures very telling: 76 per cent of UK mothers start breastfeeding, and by the time the baby is aged one week (one week!!), the rate of exclusive breastfeeding is only 35 per cent.

More than half the mothers are using formula by that stage

Some babies need formula because breastfeeding is not going well. But not over half of them....

Early formula makes breastfeeding a lot harder.

Many (most?) of these babies get formula in hospital. Hospitals are not good places for supporting breastfeeding. That's one of the reasons why I have posted in disagreement with people who say 'women are discharged too soon' and 'they need to stay in hospital until bf is established'.

So why aren't hospitals and PCTs obliged to implement NICE guidelines?

I am a bit more committed to feeding DC4 for longer since reading this thread btw, and I have asked work to buy me a little fridge for my office to store milk in (to stop my more mad colleagues attempting to put it in their tea or whatever ). But there are two obstacles I have never managed to surmount:

1. How do you stop them biting you once they have teeth?

1. When you go back to work with a 5 or 6 month old, how do you stop your norks leaking in the day when you have no baby to put on there to regulate things? I've tried pumping but never successfully got into a daily rhythm with this.

I am sure these are two big factors in other people giving up as well.

I wish there was some way of making Trusts implement guidelines.

I have posted on MN before about the fact that even letters to individual CEOs from the Chief Medical Officer don't seem to carry much weight.

That is why I thought that if even a few GPs/Obstetricians and others were to read this thread, it might make them think, and perhaps change some of the advice given to individual mothers, even if they haven't read the NICE guidelines, or the relevant research.

Everything at Trust level is about saving money and ticking boxes.

BoffinMum, those two factors don't appear anywhere in the survey-type research at all (there are questions along the lines of 'what were the reasons you stopped breastfeeding?'). Most babies don't bite at all when they get teeth, and the ones that do, bite only once or twice...the very, very few who continue to do it can be taught not to (start a thread or read archives for ideas). Anyway, it's not an issue for most people.

Leaking at work is not mentioned, either, and I don't think this is a problem that makes a major impact, either. There are ways to deal with this, though, so again, another thread

Cheers tiktok. I have to say I don't know many people who have bf after going back to work, so maybe this is why I have a knowledge gap. I will move this over to another thread.

Cheers tiktok. I have to say I don't know many people who have bf after going back to work, so maybe this is why I have a knowledge gap. I will move this over to another thread.

I got my info re: this mythical Scandinavian country from an extremely well-informed source so perhaps my pregnant brain has just rearranged it - but I now need to check cos I hate to be wrong .

I bfed after I went back to work, but I was lucky enough to work in a fairly craply paid job so I took the whole 12 months off. Consequently I was only expressing once or twice a day for the first few months and then stopped bothering as DD was fine in the day without her taste of home . But then, I was part time too. Have to admit I don't know anyone who returned full-time who didn't at the very least go to mix-feeding.

BTW, I wasn't necessarily advocating formula on prescription (myth or otherwise) and tiktok, obviously it would be a disaster with the UK health professional's current track record on help with bfing and a vast amount of updating and training would be required... although that, of course, would be of massive benefit on its own.

I feed a 2.8yr old in public - rare now but occasionally required to sort out proper injury/massive upset, and am frequently surrounded by fascinated kids and a few curious adults, who feel confident enough, will ask questions. Particularly now I'm visibly pregnant, I get the 'I didn't think you could get pg when bfing, will you have to stop when the baby's born' type of question. That's why I said earlier that feeding in front of as many children/people as possible is the grassroots action that will make a difference. But it will take a veeerrry looonnng time.

The NHS says it supports breastfeeding but, in this part of the country anyway, Health Visitors only do if you bully them. Any problems and the first suggestion is formula top-ups.

Shonaspurtle - I agree that it is important that people know how to co-sleep safely and are educated about how it can benefit breastfeeding. Prof. Helen Ball's research at Uni of Durham has shown that it can make a dramatic effect on breastfeeding success. Some PCTs are now moving forward as the FSID folks are now talking about co-sleeping more openly and have a co-sleeping leaflet with UNICEF. The 2005 government infant feeding survey found 61% of bfing mothers co-slept at some point and recommended safe co-sleeping guidelines are publicised further. I work with HVs and the infant feeding co-ordinator and the message in my PCT is that co-sleeping can have real benefits. Bf drop-ins teach lying down positions etc. I think the anti-cosleeping vibe is no longer the future. People will be respected for their choices and encouraged to co-sleep safely if they want to.

I agree with previous comments re-cluster feeding/ growth spurts. I think it would be beneficial if in the bumpf of stuff we got from the hospital there was a really decent national bf leaflet with FAQs. There is a pretty good NHS leaflet knocking around but it has gaps and it doesn't get wide distribution. People don't need bizarre photocopied scraps instead. People need to know what is NORMAL with regards to nappy output, growth spurts etc.

I think HV training and midwife training in bfing is KEY. It is pretty scary how little is currently offered. HVs are often on the front line when it comes to supporting bfing mothers and there are too many who know too little about bfing. Supplementation becomes the recommendation as they literally know no other way to support a mother who may have question marks over her baby's weight gain. Nor do they even know what weight gain is always acceptable. Hugging the curve is seen as incorrectly essential. An HV may have received only 6 hours training in bf and be considerably less informed than a peer supporter.

I am a counsellor on the NHS helpline and I am getting far too many calls from mothers with babies under 2 weeks who aren't even seeing a midwife regularly - bf knowledgeable or otherwise. In the last month I have spoken to several mothers with babies a week old who have been at home more than 48 hours and have yet to see a midwife. They sometimes have simple concerns about feeding intervals and wet nappies and a decent leaflet could help with some of this. Some have serious bf concerns and a volunteer on a helpline with a toddler running around is their best opportunity for support. Not everyone is seeing a midwife post-natally to an acceptable level. Bf levels are not going to improve without money money money towards midwife and HV training.

Sorry if I went on a bit!

BTW on the biting thing. I've been bitten once by my 15 month old as she was falling asleep. Never bitten first time round and he ended with a full set of teeth.