Webchat on breastfeeding with UNICEF's Sue Ashmore and Carmel Duffy on Monday 8th November 1 - 2pm

[RachelMumsnet]

Sue Ashmore and Carmel Duffy from UNICEF will be joining us at MNHQ on Monday 8th November at 1pm to answer all your questions on infant feeding, support for breastfeeding in the NHS and anything else related.

Sue Ashmore is the Programme Director of the UNICEF UK Baby Friendly Initiative, which works with the health-care system to ensure a high standard of care for pregnant women and breastfeeding mothers and babies. Sue?s background is in midwifery and, as an infant feeding adviser; she supported her hospital in Sheffield to become one of the first Baby Friendly accredited hospitals in the country. Carmel Duffy is a Deputy Programme Director for the UNICEF UK Baby Friendly Initiative, where she is responsible for the development and monitoring of education and training. Carmel has recently been involved with the development of a specialised course for health professionals working in neonatal units that emphasises the importance of breastmilk as part of a family-centred approach to care for this vulnerable group.

Add the date to your diary and if you're unable to join us, please post your questions to Carmel and Sue on this thread.

Hi Ladies

What do you think is needed to change the perception of women who think bf'ing is gross and that the highly processed milk from another animal is 'normal'?

(I am aware that for lots of people ff is something they dont have a choice about, this is certainly not directed at them)

Hi Sue and Carmel

How do I persuade the trust I doula at to get rid of the Nestlé stuffed vending machines in the AN clinics and by the cafe? I don't think it sits well with Baby friendly? I've brought it up at the MSLC but nothing happened. I've spoken to the HoM and Consulant MW but nothing happened.. How further up the trust should I take it and is there any pro forma info I can use?

How can a unit be baby friendly and line the pockets of Nestlé?

thankyou

As the mother of a very premature baby how can we help the NHS balance the need for BF mothers of babies in neonatal units, nicu, scbu etc to be able to spend time with their babies in order to BF with the needs of hospitals and their staff to follow some routines with babies, ensure privacy during ward rounds and also just deal with the fact that there is not the space to allow premature babies mothers to stay in hospitals.

How can we encourage more hospitals to have milk banks and loan pumps for those with a plentiful supply of milk to become milk donors rather than spend the money on formula.

Many many premature baby mothers want to breastfeed but end up using formula as it is easier to get the babies home (by proving that they can feed) if they will take a bottle of formula given it is not possible to visit 24-7 for several weeks. How can the NHS staff be encouraged to let the mothers take their babies home to really give BF a chance to get established.

Thanks

HI Sue and Carmel - Thank you for coming to speak to us. I'm really interested in the BFI as a BFing peer supporter, as breastfeeding mother how has been a in-patient at a hospital recently and as a breastfeeding mother of an recent in-patient.

My local hospital is aiming for Baby Friendly Status and by all accounts the Maternity team is on board but the rest of the hospital seems at best unaware or at worst obstructional and hostile to bfing mothers and babies.

The in-patient wards seem bemused by mothers bfing past about 6 weeks and unwilling/unable to allow dyads to remain together or provide support for mothers that are separated from their bfing baby to maintain their milk supply.

The Children's ward is better and allow parents to stay but most staff are woefully under-informed about bfing. I had a consultant paed. today ask me how a child could self wean from bfing and why doesn't my 3 y/o eat solids yet (I'd just explained she only has one bfeed a day).

Can it be emphasised that Baby Friendly Initiative should apply to the whole hospital not just Maternity/SCBU. Or am I misinformed and is this not the case and BFI is only for the neo-natal period on the Maternity wards?

Are there plans to have as a requirement for BFI status 'pool' breast pumps that could be used by any ward, bfing trained staff that could visit other wards than Maternity ones, rooming-in with bfing babies/children where the mother is the patient (where clinically appropriate), etc?

Hello both. I have given birth in two hospitals, one in England and one in Scotland, both of which have baby friendly status. In both hospitals I have received pretty poor breastfeeding support, which basically amounted to shoving the baby onto the breast and leaving me to it, and both times I have left hospital with cracked nipples. I am sure you will agree that those first few days are absolutely key to establishing successful b/f and leaving hospital with cracked nipples makes the subsequent days and weeks so much harder than they need to be.

What is UNICEF doing to ensure that hospital staff in Baby Friendly hospitals actually take on board the training they receive and provide decent support and advice to the mothers in their care, so far as resources permit?

Hello, I won't be able to join the chat on Monday as I go to the nursery to feed my DS at that time!

I just wanted to ask if there is a similar initiative for workplaces, given that many women stop breastfeeding to return to work, and in the current economic climate, many more will be trying to get back into the workplace than they used to. I've been incredibly lucky to work at an institute which is very supportive of breastfeeding mothers - they have a 'lactation suite' (a room with comfy chair, table, sink, lockable door, and stack of trashy magazines - the only thing missing was a fridge for storage of expressed milk), a nursery on-site which encourages mothers to come and feed their babies when it's needed (the waiting list is shocking though), and great flexible working policies. I am very aware that most workplaces do not offer anything like this level of support, and wondered if there was a mother-friendly initiative which could encourage work places to improve their support (obviously not just for breastfeeding mothers).

thank you :)

Hi Sue,

Do you have any tips to help us distinguish the midwives who think they know something about breastfeeding from the midwives who actually know something about breastfeeding?

That's not meant to be a facetious question, btw, but I've been badly letdown on the breastfeeding front by midwives who are absolutely confident that they know what they're talking about, even though they are wrong!

flyingzebra hear hear.

Can midwives be made to complete a "breastfeeding" diploma as part of their training to gain an official symbol on their hospital I.D. badge! IMHO though, it is the older midwives (and health visitors) who are set in their ways.

Then we as new mums would know who to trust, believe - and call on.

Am posting now as may miss the chat if off for a walk with DD2 (almost 7 mths) trying to get her to sleep! Will the Iniative have some effect on the sudden change of emphasis that comes when your baby hits 6 mths -from "no food / just breast milk" to " why aren't you putting more effort into weaning / stuffing 3 meals a day into them"? This has happened to me in the last month when taking DD2 to be weighed. I was shocked by this sudden change in emphasis & it must surely encourage many women to give up bf-ing soon after 6 mths, when continued feeding would benefit both mother & child for months to come.

Also as someone with v inverted nipples, can I just mention that neither the nhs or Nct mentioned nipple shields to me. Luckily my mother forewarned me & a lovel nurse in Special Care (for DD1) got me one so that she could latch. We then fed happily with them for 22 mths. Why does no one look at your nipples in ante natal care even if you raise such concerns? Leaving it til you have a hungry baby & engorged breasts is no help to anyone.

Apologies for posting two issues. Hope you have a chance to consider both issues even if you can't answer both within the time of the chat

Looking forward to this webshat, hoping I can get my lunch break to co-incide with it (must remember not to go shopping!)

My question is, since most women do start breastfeeding but then the figures fall off at 6 weeks. What do you think the main reason for that is - lack of support to people who want to bf, or people placing more emphasis on the first couple of feeds, either because they are in hospital with expectations to fulfil, or because they believe the benefits of colostrum are worth it, but then don't want to continue? What can be done about it?

Also, what can I do, as a breastfeeding mum, to help?? I have trained as a peer supporter, don't think I would be much good as a counsellor, but would love to get involved somehow?

sorry, contravened the 1 question rule, so please ignore my second one :)

Without wishing to stomp all over Lenin's point...

"Do you think UNICEF could be more explicit about the bf recommendations being at least two years for developed countries?"

So many people believe that the two years minimum advice is only for poor developing countries without our nutritional opportunities and it would be really helpful to point them to a clear recommendation from UNICEF that applies specifically to the UK too, with the benefits that even babies from developed countries gain from bf for so long.

Thanks

Hello again. I'm thinking that my question about the quality of support and advice available in hospital could be usefully looked at long with CountessVonKnackerstein and flyingzebra's. They are absolutely right that half the problem is that you have no clue who anyone is, who to ask, who has and has not been trained, and who to believe. One of the ladies who helped me first time around, probably the most helpful actually in terms of taking the time, turned out to be a nursing auxiliary. I doubt she'd been on the breastfeeding management course.

Yes, I agree gaelicsheep, the person who helped me start breastfeeding successfully most of all was a friend who is a midwife, but she wasn't on duty.
She came to my hospital to see us and stayed for hours.
Do you know, she got stick from her manager for that?
Why should she have got negative vibes and "oh she thinks she knows everything" comments, jealousy perhaps?

I gave birth in a Baby Friendly hospital and the midwives were very supportive of bf - really they were. However, midwives were few and far between and trying to support many women and babies. The consistent people on the ward were HCAs and they weren't supportive (it wasn't explicit - but you could tell that their attitude was "just give a bottle and us all a break").

One woman in particular acted almost as a gatekeeper to the midwives. She answered your buzzer and only got a midwife if she felt your request merited it. My requests for help with latching did not merit disturbing the "very busy" midwives and I left hospital with my nipples in shreds and what turned out to be the start of a very nasty infection. Thankfully I had an amazing Community Midwife who turned things around for me.

I have other friends who have found midwives very supportive but doctors dismissive of the worth of bf.

So (sorry - long preamble ), how much emphasis is put on getting all staff on board when Baby Friendly status is awarded? And how is this checked up on to ensure it's not all lipservice?

don't know how to word this but....

it seems as if there are women who want to bf and will do it hell or high water, then there are women who don't want to, no matter what but in the middle there are women who are open to giving it a go but when they have problems bf they seem to be let down by mv/hv when they should be referrred/signposted to specialist support. it seems like telling the mother that 'oh its ok, you gave it a try, never mind, time for formula' is acceptable when i think that bf professional help should be recommended and be accessable to all mothers who want it.

i think what i'm getting at is do you think bf support (counsellors, latch on groups, peer supporters) should be explained and promoted to all new mothers?

Hi Sue and Carmel, very much looking forward to the webchat.

My question is- do you think if the NHS changed their 'just don't do it' policy on co-sleeping and instead gave advice on safe co-sleeping it would make a significant difference to BF rates?

Hi Ladies

I fed my youngest until his 8th year - of course only occasionally and he was enjoying a 'normal' diet the rest of the time. All well and good - and that was a few years ago. But at work the other day talking to none other than a social worker, heard her saying that she thought feeding an older child was unnatural and wouldn't hesitate to confront a parent who was doing so. Wow! She acknowledged it isn't against the law but saw nothing wrong with getting heavy about it, including interviewing the child in question. Hope this problem isn't endemic in a profession that yields so much power in many families' lives. What do you think about all this?

Sorry, I know it's only one question each but I've just thought of another. Perhaps someone else might want to ask it, otherwise just ignore.

A number of NHS areas are training groups of peer supporters. Is there any evidence as to how effective these peer supporters are wrt improving breastfeeding rates/success in those areas?

Increasingly maternity units are discharging postnatal women within very short timescales, sometimes just 6 hours after delivery. And in many areas the days of daily midwife visits until day ten are a thing of the past, with some women seeing a midwife only once or twice within that period.

How can this possibly be compatible with the BFI, and what are your thoughts on NHS-funded breastfeeding counsellors visiting daily instead, for those mothers who wish support?

Hi, I work as a breastfeeding peer supporter within a city that is working towards Baby Friendly accreditation. In the past few months I have worked with 8 women whose babies have been diagnosed by midwives as tongue-tied and yet there is no provision locally to rectify this. I am aware that frenulotomy is not always the answer and that good bf support on attachment and positioning is vital. However, when the bf support has been provided, and women are still struggling there is nowhere for them to go other than exclusively expressing or moving to formula milk. The HCPs Local Infant Feeding Guidelines state that NICE recommends snipping tongue tie as an option but this is contradicted by local clinical policy which is not to perform the procedure. It all seems pretty-unBaby Friendly to me. Does Unicef have a view on tongue-tie and its potential treatment?

Where to start with this?

Most of the issues I wanted to raise have been done already

I especially agree with the post re the advice on feeding until 2 years old

I have had to justify myself on 2 recent occasions to friends about why I am "still" feeding

I think the key to successful breastfeeding is expectations ... So for a MW or HV to be able to reassure a mum that a baby feeding very frequently, and cluster feeding is ok for example and doesn't mean your milk isn't enough or you need to top up

I think we need to temper the idea that babies should go 3 hours between feeds and then drift off to sleep in their Moses baskets

Co-sleeping was the key for me to successfully feeding in the early days so can this be encouraged? My Baby friendly hospital rooms babies with mums but not in their beds ...

Ditto ruby. I was talking with DH about the co-sleeping in hospital thing just last night. I suppose the worry is exhausted mothers, possibly still under the influence of drugs etc. But if there are no contra indications I think it should be encouraged. With bigger beds.

Hi, I'd be really interested in your views on the role of peer supporters.

Myself and many of the other mums from our local group recently completed training and are now active peer supporters at our weekly support group. We now outnumber the non-peer supporters attending the group and w're really struggling to recruit new members. We are working hard to publicise the group but we seem to be finding it very hard to overcome the breastfeeding=boob wielding nutter myth.

Do you have any ideas that might kick start our recruitment drive?