The UK has a breastfeeding rate at 12 months of 0.5% apparently - worst in the world.

[minifingerz]

Whereas 99.4% of women in Senegal, where there is widespread poverty, double the UK average family size, no maternity leave and minimal medical or midwifery support for postnatal mothers, are still going.

Those statistics are mind-boggling, given that most of the 82% of women who start off breastfeeding in the UK state medical reasons for not being able to continue breastfeeding.

Does beg the question - how is this possible?

here

[HairyToity]

I breastfed for 2 years 8 months, after pressure from DH to stop. Also I knew I wanted to start trying for another child, and didn’t want to be tandem feeding or having to go through weaning when pregnant. My husband felt uncomfortable that our daughter would ask for a feed when we were out (I stopped feeding her in public at a year old, as it was so frowned upon to feed a toddler), and also she would keep trying to put her hand down my top for comfort. I felt embarrassed when she did this too. When DH told my MIL, her response was about time. She formula fed her three children, and encouraged her daughters to do likewise.

My mum and her two sisters extended breastfed. My maternal granny breastfed, and in 1950s I understand there was enormous pressure to formula feed. My granny felt that human milk had to be better. I digress. To breastfeed felt normal, it was what I grew up with seeing my younger siblings and cousins breastfed. I didn’t realise people preferred to formula feed and it was an option, until I was an adult.

Despite all the pain for the first 16 weeks, and I also had mastitis when my daughter was 22 months, I carried on. I wanted to feed her for two years as WHO recommended.

I went back to work part-time when DD was a year old. I would feed her the minute we walked through the door, and before we left. It was fine.

I think the problem is two fold – lots of women find it embarrassing getting their boobs out, and it’s generational. When you have a baby the new mum tends to turn to female family members, if all they know is formula this is what will be advised on you, especially if mum has any problems.

I assume in Senegal the mothers are led by generations who breastfeed and consider this normal and acceptable. Formula is ingrained in our society. Extended breastfeeding is looked down upon. I was an undercover breastfeeder to my toddler. If I admitted it, a disgusted look would appear on certain peoples faces.

[FurryGiraffe]

Also upfront costs for long term gain is never been something the NHS really do. They need a lot of convincing, but the evidence has been there for years on this one. Someone is sitting on it.

I suspect the NHS internal market is also a big issue here. All the 'breast is best' literature is funded (I think) by the public health budget: it's a national campaign. On the ground breastfeeding support would need to be funded by local commissioners, but the savings would come in a variety of areas: fewer GP visits, fewer hospital admissions. So not only would there be upfront cost for long term gain in a system which commissions services in quite a short term basis, but the upfront cost would be coming from one pot of money, but the reductions in cost will be coming (at least in part) from other budgets. There would be an overall saving to the NHS, but that saving wouldn't necessarily be going to the people who would be paying for the support, so there's a lack of direct financial incentive.

[MigGril]

If you want to see what breastfeeding stats are like more in your area the infant feeding servay linked further up thread will give more local data.

The fact is a large number of women in the UK already want to and initiate breastfeeding. What is still lacking and what I believe they put in place in Norway is some seriously good postnatal breastfeeding support. Implementing the WHO code (which means banning advertising on formula) works as well, they did that to. This doesn't take away anyone's choice it just puts in place the support needed for mums to achieve the Breastfeeding that they want. Anyone experiencing pain with feeding please seek more help this isn't normal.

As many have said on hear already once breastfeeding is already established they often find it easy then bottle feeding.

Although recent article published reckoned the NHS would save money if more babies where breastfed. There's no need to force anyone to do anything. These measures have been shown to work but take upfront investment. Unfortunately we've got formala companies lobby in the government to prevent these things. Also upfront costs for long term gain is never been something the NHS really do. They need a lot of convincing, but the evidence has been there for years on this one. Someone is sitting on it.

[tiktok]

Just to emphasise this point - Mistigri, the Lancet is a journal where playing 'fast and loose' with the stats would be unlikely. The paper itself - available, free, online here:



and if you register (again, free) you can read the whole thing - does not use emotive language. It is sober, referenced, and shows you its workings-out, IYSWIM.

By looking at a wide range of research, it calculates what the health impact and public finance impact might be, if more babies, in general, were breastfed, and were breastfed for longer.

This is not an instruction to individual women, but useful information for governments, agencies, HCP training organisations, demonstrating the evidence that support and enablement of breastfeeding is worthwhile.

Support and enablement does not mean pressurising women; it does not mean saying how great breastfeeding is, and then letting women struggle in pain and confusion with it when it doesn't work well. It doesn't mean being evasive about information related to formula feeding, either, making women worry about feeling marginalised and judged.

It means making sure maternity and paternity leave is generous and paid for; that workplaces enable continued breastfeeding (by making it easy to express and store at work); that public places make it easy and comfortable to breastfeed; that HCPs are trained in resolving problems; that hospital maternity units are well-staffed with knowledgable people; that community HCPs are well-trained; that unethical marketing of formula is stopped and false claims about formula are banned.

[tiktok]

Anyone can register and see the actual paper for free. If you do so you will see where the stats come from. The authors acknowledge that some of the stats are more reliable than others but they haven't made them up :)

In many countries, BF stats are not the same in every area. In the uk, for example, BF stats in London are very high both in initiation and maintenance compared to Northern Ireland. The same may well be true of France - high in some areas ( perhaps especially in the DOM?) and low in others.

The paper does not talk about 'worst' and 'best' stats. I can see how ppl might be sensitive to headlines using these words but honestly, it's not about you. It really isn't. The paper makes a convincing case that overall, the health of mothers and children would be improved in all settings if there was more BF. So, if BF rates are low, then this is not as 'good' as having higher rates. So somewhere with low BF rates can be said to have 'worse' rates.

It really does not mean that individual baby A who was not BF is somehow 'worse' than individual B who was BF.

[StitchesInTime]

Yes, I agree that sort of thing can get very irritating very quickly.

[TheCatsMeow]

Stitches that's really uncalled for and like you said doesn't even make sense!

The people I'm on about are the ones who give birth without pain relief and so insist everyone should because "well what did you think it would be like?", insist everyone should bf, insist that parental sleep is a luxury. I'm sure you know the type

[StitchesInTime]

Okay TheCats, perhaps I was being a little touchy.

I've heard that sort of line uttered in all seriousness about all women who BF past a certain point too many times before.

[TheCatsMeow]

Stitches I don't think everyone who bf martyrs themselves but adele said in response to me saying formula was easier for some people "well having a baby is hard" and implied you shouldn't "take the easy option".

It's that thinking I'm talking about. Not just bf because it suits you

[FurryGiraffe]

I think it's very easy for people to generalise from their own experience (in relation to many things- not just breastfeeding!). If you found it tough, then you imagine that continuing to breastfeed beyond the first few weeks is an act of sacrifice. I'm know some women do persevere for a long time through huge problems and for them there is sacrifice involved. But personally, once I got past the first couple of weeks it was easy and formula would have been much more work. For lots of people breastfeeding is the lazy choice

Whether it's easy or difficult of course depends to a large extent on your body (breast size, supply, underlying health conditions), baby (prematurity, tongue tie, general tendency to faff about etc) and birth. Obviously those things we have no control over. But it also depends on factors we (as a society) do have control over: quality of post-natal breastfeeding support, education (about how it works, not whether it's a good thing) and cultural norms and expectations surrounding breastfeeding. I think the case for working very hard on those things is overwhelming, not least because we know that there is a large number of women who want to breastfeed and either can't do so or give up sooner than they'd like to. Given the evidence on health outcomes at a population level, it seems very shortsighted as a society not to attempt to do something about these. At the moment, we seem to have the worst of all possible worlds: a culture where we are all indoctrinated with the idea that 'breast is best' so that women who can't/don't breastfeed often feel enormously guilty for FF, but where we not only don't provide adequate support for mothers who want to breastfeed, but actively sabotage it a lot of the time (from the HCP who advise 'topping up' after every feed when a perfectly healthy baby has lost a few grams more than the flowchart says it 'should', to the well meaning relatives who dispense 'advice' about 'not getting enough').

[StitchesInTime]

I hate it when people use terms like some women like to martyr themselves in relation to breastfeeding.

Yes, I know it doesn't work out for everyone. I know establishing breastfeeding can be very tough or impossible. I didn't manage to get it established with DS1, so he was bottlefed.

But when breastfeeding works well, the choice to continue breastfeeding to 6 months or a year or more is not equivalent to "liking to martyr" yourself.

DS2 is breastfed. DS2 took very well to breastfeeding. Breastfeeding DS2 has been easier and more convenient than bottle feeding DS1 ever was, even when we were using the UHT bottles of formula for convenience. Choosing to stop breastfeeding DS2 and switch to formula would have made me feel like far more of a martyr than breastfeeding him ever has.

I would guess that most women who breastfeed longer term are also women who are are finding breastfeeding works well for them, rather than women who hate breastfeeding and are having to force themselves to continue.

[CoteDAzur]

I agree with Mistigri. Breastfeeding rates among French mothers are surprisingly low around where we live. I would be very surprised at even a 1% claimed rate of extended breastfeeding.

[Mistigri]

I'm very dubious about the stats on which this claim is based ... Not the UK stats necessarily, but some of the others seem very inflated. I just did a poll on the Parents in France group that I help run (1000 members most of whom have raised small children here), and we are in unanimous agreement that 9% is a massive overestimate of extended bf in France. It is likely that this figure includes France's poor and relatively undeveloped overseas territories (which is a bit like Britain including former colonies in national statistics) - but even so we're at a loss to understand it. One member described her French doctor's reaction to the news that she was still bf at 12 months as "actively disbelieving".

I agree with bunloaf's comment about emotive language, which if used in the study (and not just in the reporting on the study), might suggest researchers who are not above playing fast and loose with the stats.

[tiredandhungryalways]

I nursed my eldest till just over 2 and currently nursing my baby. This time I am much more confident but when nursing for the first time I avoided all my family as I constantly had horrible undermining and negative comments. Breastfeeding was seen as being not really worth the hassle when formula is so easily available. However my eldest was a preemie and the fantastic nurses in special care really explained the valueof breast milk and it being like medicine for the baby. It was the only thing I felt I could alone do for my children. So to conclude, the issue is I think breast milk and formula are perceived to be similar which is why rates are so low

[Stepawayfromthezebras]

What's the 'optimum' time for bf'ing then. Most people I know have bf for 6 months but if that's not enough what should we be aiming for?

I'm currently bf'ing my 10 day old baby. She'd lost nearly 11% of her body weight at her 5 day checkup so the midwives have put us on a feeding plan which fingers crossed seems to be working, hopefully when she's weighed today she'll have put more on. I'm quite relaxed about the whole thing mainly because I know that if all else fails I can change to formula so my baby isn't going to be malnourished if I have an inadequate milk supply. I really want bf'ing to be successful but would find this time incredibly stressful if there was a taboo around ff and I was going to feel a failure for having to resort to it

Another thing, I wonder how much of the UK'S lower bf'ing rates have to do with our drinking culture. I really hope I don't offend anyone by bringing it up - but there must be some people who go onto ff because they want to enjoy more than the occasional glass of wine

[TheCatsMeow]

I agree the language is not appropriate. Why not say lowest or smallest?

[BunloafAndCrumpets]

Yes I understand that it's a population study but the implications of the language resonate at an individual level for me. It's an emotive subject.

If it is the case that survival of babies in Senegal is in fact confounded by breastfeeding then the language is even less appropriate.

[CultureSucksDownWords]

I think the judgement element comes from the fact that at a population level outcomes are improved with higher breastfeeding rates. It is a judgement being made by that headline as its been reported, but not a judgement about any individual, rather about the UK as a whole. So, the lack of effectiveness of public health campaigns and similar.

[BunloafAndCrumpets]

*breastfeeding

[BunloafAndCrumpets]

It was a headline on the bbc website I think?

Isn't the Lancet paper actually titled 'reastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect'?

Anyway, whatever the source I still don't like the use of the word 'worst'. 'Lowest' would've been equally descriptive, and implied no judgement.

[CultureSucksDownWords]

The headline in the Lancet is just saying that our rate of breastfeeding at 12 months is the worst rate of the countries they looked at. It's not making a judgement about anyone's individual feeding choice. National and international health organisations recognise that increased rates of breastfeeding across whole populations produces better health outcomes at a population level. Again it's not about any one individual's situation.

[BunloafAndCrumpets]

Tiktok my baby is allergic to cows milk and we get formula on prescription. I'm so, so grateful, as it would cost £20/tin otherwise (2-3 tins a week)

[BunloafAndCrumpets]

I haven't read the article so apologies if this is stated in the discussion or whatever, but just wondering: could it be that babies in Senegal who are not breastfed /cannot breastfeed actually do not survive, for reasons mentioned by pp (lack of clean water etc)?

I don't much like the title of this post saying that we in the UK are the 'worst' for not bf at 1 year. I was very sick after giving birth and my milk never came in. Despite weeks and months of trying (feeding and expressing every 2h etc etc), I never made milk and I would say this is a medical reason for not bf. I don't consider that my baby's experience is 'worst' though.

[tiktok]

:) at ovaries :)

[Out2pasture]

late to the party and I did not read all the posts but what do people put in bottles if not formula?? well I've seen people use; goats milk, powered milk, condensed milk, and recently in the news nut milk, watered down pablum (rice cereal) and more.