Your thoughts on breastfeeding policy and what could be done to improve it/ increase breastfeeding rates

[JustScreamMumsnet]

Hello Mumsnetters, we've managed to get a meeting with the person running the Government's breastfeeding initiative and would like to pass on Mumsnet's top suggestions for improving breastfeeding policy and to outline the key issues.

So let rip! But do bear in mind that there's probably bugger all in the pot, so, much as we'd all love to have a one to one breastfeeding counsellor for the first 48 hours for all type thing - that's probably not a realistic suggestion at this point.

And whilst we're on the subject of hv's not having training they may want to take a look at the NHS NoHelp Line, I was told that my exclusively bf'd (at the time) son needed to be given boiled cooled water for a cold and that the reason for this was to give him something warm to drink and increase his fluid intake. Last time I checked the milk coming out of the old norks was body temp and bf changes to reflect your babies needs.

StillVeryAnnoyedAtThatTiggaxx

basically all the points mentioned above.

Also, as part of the making breastfeeding more acceptable within the community I would like to add a plea to give breastfeeding mothers who return to work more protection. The current situation is vague, unhelpful and offers naff all protection for those with unsympathetic employers. So many women feel that they have to either stop bfing or mix feed if they are returning to work because they don't feel able to raise the issue with their employers. It doesn't help boost take up at the start but it might just stop people weaning their child onto formula a couple of months before they go back.

Good practice should be identified and spread across the NHS. My local hospital automatically sets up a cot attached to the side of the mother's bed on the postnatal ward to make feeding easier. This should be standard practice.

A long prologue I am afraid but....When the MW did my 1st antenatal visit for dd2, the one where they fill in your Antenatal booklet, I mentioned I was still bfing dd1. She dutifully wrote it down. Since we had met before when dd1 was a tiny baby - me in the HDU unit and at home on a Community MW visit we got chatting about different things. She asked me why I was still bfing a toddler. Not in a bossy, negative way, but in a curious and confidential way. She knew already that I was a peer supporter with the ABM.

So I ran upstairs and printed off the Jack Newman leaflet 'why on earth' and another one called 'comfort vs nutrition' and gave it to her as reading material. I was thrilled that she asked and I could help but I also had a wistful sadness that a woman who was the head of the team of community midwives did not realise that breastfeeding a toddler was normal and a good idea.

So yes, training, training, training.

JetLi that link is fantastic - have had a look at the booklet, what a brilliant, well-written piece of literature.

Some wonderful ideas on here. Lots of good ideas about working in the community. Having read through a bit it seems the hospital is a particularly tricky place with sabotage by poorly trained staff and resources stretched to the limit. I am particularly shocked by the lack of control families have on the ward, how their choices are ignored because it doesn't fit with policy or the staff are not well trained enough or too busy to deliver the support where it's needed.

I didn't have my baby in hospital so may be really wide of the mark, but would having a family advocate in every maternity hospital help? (family as opposed to mother & baby or just mother because it covers both of those and includes partners who are obviously very important too)

Their mission would be to be a contact point between patients and staff to raise issues on behalf of the family, provide an ear (and kindness) for women and partners, ensure support is delivered by clinical staff and barriers to bonding and breastfeeding are removed.

Amongst their duties would be...

To ask the mother if she wants to breastfeed, check her progress and be responsible for ensuring the clinical staff deliver the necessary support.

S/he would report in to the Clinical director (or whatever the head clinic honcho is called) so they have a bit of clout and respect to effect the changes needed.

To indentify and implement changes that need to be made to improve the experience for families on the wards (whether that be changing restrictions on vistors/changing meal policies etc)

To take phone calls from mothers requesting support when they are not on the ward and act on those calls.

I don't think this person should be a clinican because I believe all that will happen is this that person will become the breastfeeding support counsellor and I am strongly of the opinion that all clinical staff working in maternity care should be properly trained in breastfeeding support. The role should be worked flexibly because 9-5 Mon-Fri just does not cut it when someone needs support at 8pm on a Friday evening.

what a lovely cleaner gingertoo.

btw, there is a sidecar cot in production now that can be attached to hospital beds. there was a big trial at the RVI (Newcastle) by a team led by Dr Helen Ball of Durham Uni. It seemed a big success and another study is just getting underway looking more in depth I suppose. I don't have all the details tho.

The more I think about it, the more I think the whole culture of what happens when women have to stay on post-natal wards is part of the problem...

Because of the enormous pressure on staffing, and the general issues of hospital staff becoming neutralised to both the feelings of women, and the policies that are fed down, there is very little attention to the support of BF. I do believe in an open visiting policy for partners, or a key supporter but not for anyone and everyone. In fact the rather slack attention to visiting policy was one of the things I found most difficult: the woman in the bed opposite me was a hospital staff member so it was OK for her to have a constant stream of colleagues popping in

The whole routine, lights on, meals, medication etc all has to be done, I'm sure but none of it is conducive to BF. If there were enough staff, surely things could be done more flexibly?

The 'help' given by auxiliaries and assistants is well-meaning but often counter-productive, and this needs to be properly and accountably managed.

And crucially, women who have never breastfed a baby themselves, or seen it done over a period of time, need to see it, and listen and find out about what it is really like. I guess so many people just make it up, and assume if the baby is on and sucking then all is OK.

I was opposite a young women who had a very serious tear and had been in intensive care for a while. Her English was not very good and she was utterly traumatised. The HCPs and assistants basically bullied her. I listened to every word over 3 days knowing that they were destroying her attempts to BF. They started off well-meaning and tried to show and help her, but rapidly lost patience because the woman did not (or could not) realise that she needed to respond to the baby's signals/cries quickly. I did not intervene, to my lasting regret, because I was already struggling battling with them myself. By day 3, the baby was dehyrated and unable to feed. In the end, a very cross assistant (not a midwife) took the baby away with a breezy 'look, you're not going to manage this and this baby needs food' over her shoulder. The young woman sat alone crying, then stared into space, and didn't put the baby to the breast again.

Sometimes I think what new mothers need is a bit of mothering; what they don't need is bossy infantilisation.

So many good points on here.

I think there should be a total ban on formula AND follow on milk advertising. And NO free samples of the stuff from Bounty bags, stands in Supermarkets etc.

Proper compulsory training in bf support for MWs, GPs and HVs. I had a fantastic HV, I know from this board that many people are not so lucky.

Proper support on the post natal ward is really important. (Ginger's cleaner brought tears to my eyes.) Even little things like having enough pillows (literal support ), like Vulpusina, I found the staff were obsessed with only allowing you two. I had to get DH to bring in a V pillow from home.

As has been already said but will add again for emphasis;

Educations and training for HCPs who come into contact with feeding mums.

My HV told me it would be easier to treat my refluxing baby if I wasn't breast feeding (factually incorrect I now know - thank god I paid no attention)

When I got thrush in my boobs the HV didn't recognise the symptoms but the NCT BF support line did, told me to print out some info and take it with me to the Dr. Just as well, he asked me what made me think it wasn't mastitis, err completely different symptoms maybe??

I've just come back to this and agree with everything having been said, so will not repeat (you will be glad to her ).

It is shame that the more assertive/well-informed woman stands a far higher chance of initiating BFing and is more likely to stick to it longer.

Re limit of 2 pillows, restrictive visiting, general inflexibility in hospitals where a lot of HCP mistake the word "guideline" and "policy" as Law Cast In Stone. Also (which is a fact that may well drive me out of practicing medicine) political drive is to ensure more and more tick boxing rather than a common sense approach to lots of things. "BFing discussed" - tick: even if that discussion was a "Oh, is baby crying, would you like some FF?". A form will have been ticked and collectors of data for statistics are satisfied.
Having said that, I know of a lot of HCP who are very insecure and feel vulnerable between the "support BFing", "respect women's preferences", not wishing to be "BFing Nazis" - God I loathe that phrase!

By most favorite leaflet (apart from my hero Dr Jack Newman, kellymom and MN ) is "Reasons to be proud". I think it should be required reading for anybody who has anything to do with new mothers. Maybe could be added to hospital packs for new mums?

Wholeheartedly agree that BFing needs to be normalised in society in general. There's a tricky one...

That's exactly the right word, Pacific: the HCPs are insecure. And unable to simply say 'I don't know; I will find someone who does...'

I havent read the thread but just wanted to add that it would be useful if healthcare professionals all sang from the same tune!

Despite being recommended Lansinoh by midwives at breastfeeding workshop, saying it was very good for sore nipples etc, my GP refused to prescribe it for me because 'its not licenced for use' which turned out to be more about money than anything.
Im lucky enough to be able to buy a tube myself from Boots, but many women may not have £10 to spend on nipple cream.
Basically my GP's attitude was he'd rather give me a cheaper, potentially not as good cream, rather than me potentially suceed at breastfeeding!

Getting the message across to all first time mums that bf-ing is often very hard at first (by which I mean, for the first few months, not days), and that they will probably need support in some form to establish it successfully. If we want to normalise breastfeeding, we have to stop idealising it and start being honest about the difficulties lots of people face.

Reading some of these is bringing back so many memories of my first few days in hospital with both my dd's! And I totally agree with everyone who say change the way maternity wards are run, make them more conducive not just to breastfeeding but to caring for the babies in many other ways too.

But can I also add that it's all very well talking to the Government on this; is there any way you can also get these messages across to the Conservatives? Like it or not, they are more likely to be the ones making these decisions in the future?

Sadly Clara makes a good point - if any Tories likely to be MPs or part of the next government are reading, can I suggest that if you support breastfeeding, there's a lot of examples here of why closing Surestart projects and Children's Centres down in favour of more harrassment visits from health visitors isn't likely to help matters.

I am worried about what will happen to bf promotion and support under a Tory government . HCPs and anyone likely to come into contact with bf mums need more training. There is a need for bf to be on the curriculum PSHE I suppose but also biology and maybe other subjects. BF needs wider community acceptance. A total ban on all FF advertising (ITV take note!). Stop worrying about offending FF mums. You cannot base public health policy on a perceived risk of upsetting people. I FF'd #1 because of bad advice and support. I am angry that the NHS let me down and #1 has probably had recurrent acute ear infections. I do not feel less of a mother.

To be honest, and cynical, I am not especially worried about BF promotion under a Tory govt - I would be worried about support for mothers who want to BF and work at the same time.

I would imagine that BF promotion coupled with a shortened mat leave (seems likely) can be used as a way to encourage mothers out of the workforce - if formula is removed as an easy option and no support is given for working AND BFing. I know it's possible, but before, say, 7-8 months it would be really difficult and a lot of this thread is focusing on ways to make it easier for mothers to continue to BF.

I'm not very good at making the point, but I can see BF being used as another guilt stick to beat mothers who return to work.

I agree marenmj. I bf DS for a little over a year (now 13 months). I had to go back to work when he was 9 weeks (american organiziation, long story... in UK... don't ask).
I woke up at 4.30am to express milk, then fed him, brought him to my childcare provider, fed him again once I got there, left at 7.45am expressed in a tiny stuffy closet at 10.45am, left to feed him after that (11.15ish), then returned to work and expressed some more (12.45/1ish), then collected him at 3pm and fed him again and however many more times he needed until bed (and through the night as he wasn't sleeping through for a LONG time). It was bloody hard work! I did it because I was determined to do it. I was certainly not encouraged to do it by any means. I had to fight for a space to express and leave every day for lunchtime feed. He stopped taking a bottle of ebm at around 5 months in my absence and had to think of other ways then. It wasn't easy. Very little support. I had to sort it all out and fight for it myself. It def wasn't all there and easy for me. As it should have been!

I suspect I understand . I'm American and I had a whole section of my post I deleted about all my friends who quit their jobs to becomes SAHMs rather than switch at 12 weeks (and I know BF was a factor in a lot of those decisions).

DD would never take ebm without me there, so if I had left her at nursery that early she would have been switched to formula out of necessity.

I know one woman who carried on BF after she went to work - she has a nanny and works from home. The rest chose to leave their jobs. It's very sad.

Same as what lots of others have said.

Stop making people feel guilty when they are having problems with breastfeeding and be realistic that it is difficult at first and has to be learnt.

I did not know that when I had my first dd and it was a nasty shock.

Don't know about the formula advertising though- not sure it would change your mind from bf ing to ff ing more to change your mind from one brand of formula to another?

Has there been any research into why people do or don't breastfeed in the UK? I would be interested to know the reasons people opt for or avoid. Any promotion should then target the reasons why people shy away from breasfeeding.

You need different solutions to different problems. Prudishness (is there such a word) would require a shift in society and discomfort/pain would need practical suggestions.

More research should be done on why it hurts some of us so much (I breastfed for 2.5 years and it never really became totally comfortable)and now 6 months with in again it is still sensitive. I suspect we have lot of the old wives tales that would help people like me.

FARKING hell, star. that is heroic bordering on insane! well bloody done!

FARKING hell, star. that is heroic bordering on insane! well bloody done!

Aitch - there are actually 5 helplines in the UK.
The NCT
LLL
BfN (breastfeeding network)
ABM (Association of Breastfeeding Mothers)
and the National breastfeeding helpline (staffed by ABM and BfN volunteers but separate) which is the one on the site. The National helpline number doesn't go through to the NCT or LLL as they declined to be involved. Despite the national helpline the ABM and BfN have kept their separate lines.

Breastfeeding is a part of the PSHE/PDE curriculum in Yr 11 but it is delivered by who ever happens to deliver PDE in that school as the policies differ from school to school. I can only imagine it is lottery on the quality of the (one) lesson.