Why do medical staff know so little about breastfeeding issues?

[pastabakewithcheese]

I've seen two GPS, a HV, and a midwife. I've told them I'm in pain and my nipples are raw and discoloured. None of them picked up on the poor latch that caused my nipples to tear, which caused a open wound at the base of my nipples - that got fobbed off and I was told it will clear up - it didn't and then got infected and now I've had to tell my GP I have thrush so prescribe me something because the infection is oozing pus and my DD has white patches on her inner lip and a scaly nappy rash!!

Im in so much pain now and I still don't think I'm getting the right support. Short of hiring a private Lactation consultant just feel really let down that the symptoms have been missed by so many professionals or not investigated or haven't been taken seriously and it could have been prevented earlier. Genuinely don't think anyone knows what to look out for

I agree with you OP, it's shocking. I had all sorts of problems bf- TT, CMPA etc but no-one offered much help and just kept saying it would get easier.

There was that idea recently about incentivising women to bf with vouchers. I told my HV investing in lactation consultants would be far more useful in helping women to bf.

Have you looked at La Lech League? They often have local support volunteers who could help you, and regular group meet ups. In my experience they have been much more experienced in bf than the health professionals in my area.
I'm sorry you're going through this. The beginning can be so hard.

Second vote for La Leche here. My 19 week old still doesn't breastfeed so I exclusively express but we had more progress and support from La Leche League than the NHS was able to provide. (And I say that as an NHS employee!)

In some areas the NHS has invested in programs to provide training to healthcare professionals, unfortunately its not been fully utilised as, ime, the staff need to have an interest to find the time in their schedules to access.

Ultimately in a bottle feeding culture staff don't value the time to prioritise breastfeeding support 😮😥

So sorry. This is a story that’s repeated again and again and it’s appalling. Look for a local b/f support group, although most of them will be volunteers there may be a proper b/f consultant who drops in every now and then. We used to have one at ours until fairly recently (when the nhs cut her funding) but you might be lucky in your area. LLL also good.

I was shocked at a recent antenatal class how the 'breastfeeding expert' didn't once mention problems experienced in breastfeeding, reasons why it might not always work etc.

If seemed like they were setting nil very unrealistic expectations and wouldn't even mention formula feeding. I did wonder what support would be like if it wasn't there so I'm sorry to hear that it isn't.

Is there a local breastfeeding group at a surestart centre or similar by you?

I hear you :( I also had bleeding and pain (though yours sounds worse, and I'm sorry nobody thought to find a proper way to help you). I feel like I saw endless people, and at 6 weeks tongue tie was discovered.

I also found that nobody had any knowledge of D-MER, which I suffered from badly with my first, and am hoping won't return this time round. I mentioned it to a few HCPs, and they all just kind of went "oh! That's odd!" Not really the support I was looking for!

It is just not part of their standard training, so they are reliant on anything they happen to know personally, which can include old wives' tales. They are also marketed to by formula companies quite incessantly even though this is technically illegal, so some will have inadvertently taken false information on board via these means.

I think midwives do get a short amount of training on normal breastfeeding but this is a very small part of the training, doesn't go very in depth, and isn't required to be updated. So a midwife who has been working several decades may have done her required breastfeeding training all of those years ago. If you're lucky, midwives and/or health visitors might have been sent on a half day course as this happens in some areas but not all, GPs it's extremely unlikely will have had any BF related training. The half day course usually does not cover how to identify a good latch, although might go through some red flags. If you have an infant feeding co-ordinator attached to your local area they may not be trained in BF specifically either even though they are supposed to be the BF specialist!

Generally your best bet for breastfeeding advice is an IBCLC but they do tend to be private. If you are lucky you might find one who runs an inexpensive breastfeeding support group or clinic.

Indeed if you have any significantly unusual problems (D-MER would be one) then you absolutely need to seek out a specialist who has had proper training.

A large part of the problem is that we have low bf rates and the rates in hcp themselves reflect that. So there is a huge lack of lived experience which is what bf counsellors have.

It took me a few months to realise that my hv hadn’t actually bf herself and that her advice was a small amount of info she’d read in a textbook and was very therefore pretty limited.

I called lll helpline and national bf helpline and found both v good

Ps did you know there is a very good infant feeding section
On here too? Quite a few bf counsellors hang out there

I agree, only reason I managed to bf my oldest (and hence my others) was as we admitted for a few days post birth and the auxiliary who was on night shift and doing my observations every few hours would help me. Her skills as a mum (not trained and not part of her job) and being there in the night were amazing. Bf advisors, not so much

YY to lack of experience too, it's a disgrace really, a self perpetuating cycle.

If public health england want to increase BF rates they need to cut the money going into pointless promotion and instead put the money into more specialised training for a smaller number of midwives/HVs (cheaper) - not everyone needs to be a BF expert, and by allocating one or a small number per area (population dependent) that would actually increase effectiveness as the BF specialist HV would get to see all of the BF mothers with questions/issues, and so gain experience too, rather than all receiving a small amount of training and then their experience being diluted with other cases.

I agree with you, it's shocking. And I am one of the professions that you mentioned!

I recently met a woman who had seen various professionals and "experts" as her baby had not been gaining weight. She had been set up by one of the experts with a complex feeding plan involving pumping, feeding 2 hourly etc etc etc.

Straight away I noticed the poor latch which literally took 30 seconds to correct. I couldn't believe nobody had picked up on that already and saved all the horrible stress and angst the poor family had been through. It's "lucky" that she had decided to persevere and not just began FF instead.

I found the same. Poor weight gain, constipation etc and even with me asking the doctors in the children’s day unit to check for a tongue tie they didn’t find it. It took a private appt for a posterior tongue tie to be found (and then cut£ for my baby to be able to feed effectively. Everyone else was suggesting I just switch to formula.

I’m a GP, I have rotated through both paediatrics and o&g departments and have had precisely zero training about breastfeeding. Which is frankly ridiculous.
I have looked to try and get some but there are very few options that are appropriate for my role - I’ve done a WHO online module but it wasn’t very helpful. Most available courses are aimed at training breast feeding counsellors and are more time and money than I can spare. I’ve recently joined a Facebook group for health professionals so I’m hoping to get some knowledge from there but it’s crazy that it’s not part of our routine training.

Can’t good on you!!

I totally agree. My DS had a tongue tie and I saw several midwives, health visitors, BF peer supporters and was still bleeding and crying with every feed. In the end the person who really helped me was an nct breastfeeding counsellor. She came to my house on a Saturday night after I cried down the phone to her and her help made all the difference.