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.

Sorry, not able to read the whole thread so probably remaking points that others have already made but here are my thoughts.

• A single set of guidance to be rolled out throughout the NHS so that women get consistent advice from MW, HV, docs etc.
• That guidance to translate into education programmes in schools, antenatal classes, postnatal classes etc
• identification and education of areas where there is low uptake and bf - additional resources in education in schools and antenatal classes
• bf support to be part of postnatal home visits. I found that they were keen to make sure baby was gaining weight and feeding well but were not actually able to support me in doing that. I did not feel ready to leave the house to go to the breastfeeding clinic for a couple of weeks.

Agree with Spiggy about bedside cots on postnatal wards.

I got a lot of bf support in hospital when I had ds (NHS but paid for amenity room) but every single person that came to see me gave me different advice. I discharged myself after 24 hours solely because I felt I needed to get home and work out the bf for myself i.e. there seemed to be the resources there to support me but they were not consistent and frequently conflicting.

The high point was the NHS breastfeeding clinic where I got the support I needed to finally be able to breastfeed.

five lines is a bit nuts, i think. i also distinctly remember not getting an answer from the abm line.

getting on this thread for later

Thank you Aitch I am so happy that we survived it had a very long lovely bf relationship despite the stupid american way me having to go back to work early. I was lucky in that DS was at my best friend's house. I'm a teacher, so just 8.30am-3.30pm, I got to go and bf him every day at lunch and had holidays very very often.

maremj - it's sad, isn't it? I don't understand why they don't seem to really value bf at all . Are you in the UK?

I just reread my initial post. I forgot to put in the express that I did as soon as I got to work at 8am as well. Without that expressing session it just makes it seem simple.
I did seek help from a lovely bf counsellor.
A friend of mine kept telling me "don't kill youself for it, star. there's no reward for bf. No one will care in the long run, there's no prize"
But I knew differently. I am so happy I was able to do it . People who didn't bf should not be able to give advice to those who choose to bf.

Haven't read all the thread as it's 11 pages so this may have been said but, I think HCPs should be better trained and GPs should refer to (free?) LCs rather than dishing out outdare nonsense.
Also support should be well publicised and in place.

Just thought of something else. I noticed (13 months ago now though) that there was a disconnect between the recommendations of bf counsellors made re treatment for thrush for mother and baby (off-label fluconazole) and what the GP would/could prescribe. There was a leaflet that recommended fluconazole (sorry a bit rubbish here because I can't remember which organisation, maybe LLL?) that has now been withdrawn - probably for that very reason.

I know that there is an issue because of the therapeutic indications that a given treatment may or may not have been granted but the main issue is the inconsistency in the advice and, as someone else mentioned, the ability of HCPs to recognise the symptoms.

star6, yes I live in the UK and work for a Canadian company. Maternity leave is 12 months in both the UK and Canadian offices. Sometimes I do wonder what the policy is in their US offices since they take liberties when possible

I think it would be safer to say the women working isn't valued in the US. Everyone I know breastfeeds, every single one. Not only my mother, but all my aunts, cousins, and friends breastfeed. We had a whole thread about it earlier and that seems to be very different than the East Coast (I am from California). There would have been really intense pressure to breastfeed there, and huge pressure to NEVER put a child in daycare.

Like I said, my friends felt that they would be substandard mothers if they carried on working.

My MIL just doesn't understand when I say they DH and I wouldn't have had children if we were still living in California.

Star6, I've just been reading your posts. I have a 14 month old and work for an American company - I only went back to work in September. I'm sorry that your situation has been so different.

FullMoon- I am American as well... so that made a difference.

We all know that Breast is Best - stop wasting money on telling us that and instead focus on policy that enables this.

BFing does need to be normalised and I'm afraid money needs to be invested in this.

1. Make it mandatory for undergraduate courses for all HCP to have even a small amount of training regarding the importance of BFing.

2)Better training and in depth training for HCP in contact with new mothers. My HVer doesn't have the first clue about BFing and thinks I should be cutting down on feeding my 8month old.

3. Paid mat leave for 12 months - Once BFing is established you can't just turn it off like a switch. It is a fundamental part of your relationship with your child.

4. Laws to support breast feeding mothers so they can work very reduced hours up to the child being two years. Paid breaks so a BFing mother can express.

5. Give tax breaks to companies that provide BFing areas that are of a certain standard.

6. Laws to protect BFing mothers in public up to age 5.

7. Why not incentivise it? If you're BFing at 6 months then you get a lump sum / voucher? The government does it to encourage healthy eating. Or even pay a higher rate of mat pay if you BF . I realise this may offend some people but I'm trying to think outside the box. This would only work if BFing was properly supported by HCP.

8. Why not allow NCT/ breast feeding network / LLL to be contractors for the NHS. It would retain expertise.

Breast is Best is outdated. WE need to concentrate on the 75% of mums who start off BF, the fallout rate by 6 wks is staggering. If there is actual proper support for BF for the first 6 weeks then in 20 yrs time BF will be seen as the cultural norm and 100% of women will start off BF and 99% will continue.

I would like to see mandatory training for all HCPs. It is shocking how many stories I have heard in RL or Mumsnet about HVs who have effectively forced a mother to stop BF with crap outdated advice.

GPs and Paeds should be trained too.

most importantly MW should have extensive training on BF. There should also be a code of conduct about how they should treat BF mums.

In Scotland it is illegal to stop a woman BF he baby. This should happen in the rest of the UK but up to the age of 5yrs. We need to move away from a culture where BF is acceptable up to 6 weeks but after that they should be on bottles.

Oh and the advertising of follow on milk should be banned.

I agree with everyone else on here - there is too much emphasis on the "breast is best" and not enough practical help. Lots of women attempt breastfeeding, so the message has obviously got through, but so many women are hijacks by ignorant HCPs. MWs and HVs need up to date practical training. And they need to admit when they do not know and pass the problem on to a trained breast feeding counsellor.

I suppose that the problem is that lots of HCPs have bottle fed and refuse to accept that they didn't do the absolute best for their DCs and so shrug off the benefits, while having no practical experience. Perhaps we need a anonymous phoneline to dob in stupid HCPs who ruin any chance that a woman might have to breastfeed. They should then be targeted for more training.

Even MWs who are really into natural birth seem to struggle with breastfeeding problems, in my experience, which is all a bit depressing.

Not sure if this has already been said, but all restuarants should display the Breastfeeding welcome sign if they don't have a problem with feeding mothers. I know that legally people are not supposed to be asked to leave premises, but i have known it happen. The stickers in the window would make it easier for those mothers (like me) who still feel uncomfortable feeding in public and only do it because my DS needs to eat.

I also agree that there should be more support in hospitals for mothers that want to BF as although i had lots of MW come and watch me try and feed only two actually helped me try and get DS latched on. The NHS also has to stop making women feel like they are being bad mothers if they want to give their baby formula. More support is needed to help people understand how to make up feeds and sterilise properly, especially if mothers want to mix feed.

Sorry I haven't read the whole thread but here are thoughts. This is such a contentious issue - where do you start? I think it's right that either you do want to breastfeed or you don't. For those who do, better support in the early weeks (first 2/3/4 weeks?) is needed. I have breastfed 2 children to the age of 1 but I spent the first few weeks of feeding my first child exhausted, confused, in pain (mastitis), doubting my instinct that I wanted to breastfeed was right, and ANGRY that nobody but NOBODY had prepared me for what it involved - pain whilst you get the latch right and establish supply, anxiety that you are never sure they are getting enough because you can't see how much is going in, tiredness because you can't delegate a feed to someone else without the palaver of expressing, unable to contact NCT breastfeeding helpline because chronically understaffed (and when you need help you need it pretty much immediately because in the early days what is happening changes almost from feed to feed). And I had supportive private midwives who i could keep calling on... I have no idea how those who don't and are struggling alone find the will to carry on. Being given the phone number of a trained counsellor or a local volunteer mum with experience of breasfeeding would help. Maybe community midwives could hand these out at ante-natal appointments. Post birth is too late.

For those who don't consider breastfeeding, we need to look at why they don't and discuss pros and cons one to one at ante-natal appointments. I'm not sure it was something I ever discussed at my NHS midwife appointments. To do this I think a lot of the conflicting evidence around breastfeeding needs to be clarified and simplified. If expectant mums are to be better prepared for the realities of early feeding - how hard and stressful it can be - then who can blame them for saying "not for me thanks"? We need to be able to give clear evidence that breastfeeding is better. It doesn't seem to me that anyone can make a convincing clinical case for this at the moment. We also need to be a bit more realistic about it - is breastfeeding for 6 weeks better than not at all? Why? How about 2 weeks? Is mixing formula and breastmilk an option? Surely it's better than no breastmilk at all? So give guidance on how to do it rather than trotting out the "all or nothing" approach we seem to have at the moment. Stop pushing the "recommendation is to breastfeed for first 2 years" message. This is instantly off-putting to any first time mum and is a daunting and unrealistic target. I think that if you can keep someone going - with support and motivation - for the first few weeks then they will get through the worst and just keep going naturally because it's easier, cheaper and better for your baby (I think!).

A murkier issue is the influence the food giants have on research and funding in the NHS. How would they react to a big push on breastfeeding? My HV came to my first appointment with her Aptamil pad and pen in hand. Nice touch. But maybe that's for another day...

Sorry - not read the whole thread.

Better support for breastfeeding to keep rates up - Please ask for this

Ditto change in legislation so women can't be asked to stop feeding in public. And maybe a widening of the "baby friendly" schemes so places that are already doing well can advertise themselves as such and do better business

Proper labelling of food/milk and crackdown on advertising of follow on milk to make sure misleading ads don't run for a while (as has recently happened with 2 companies).

My biggest gripe of them all - when I took my baby to have his birth registered I received all sorts of nice "growth and development" chart/info goodies from a well known baby food manufacturer. They also make infant formula but managed to comply with baby milk marketing legislation by not mentioning their formula - only their other products - on the chart. But surely giving this info early on is actually about brand awareness. As far as I know the registry office is a government agency. THERE IS NO WAY A GOVERNMENT AGENCY SHOULD BE IMPLICATED IN PROMOTING BRAND AWARENESS OF A FORMULA AND BABY FOOD COMPANY. IT SHOULD BE STOPPED IMMEDIATELY.

And yes, I did mean to shout. I'm a little cross about it. You are welcome to shout it on my behalf.

Make it illegal to ask a mother to leave because she's BF - up to any age (not just 6 months).

Compulsory reading of Mumsnet feeding boards for all HVs - might finally scotch once and for all this idea that's so often peddled that "many mums don't make enough milk, so you need to express so we can see how much milk your baby is getting"

Recognition that BF and FF are completely different ways of feeding your baby, and that (a) just because a baby WILL drink a bottle of formula, doesn't mean they were desperately hungry, and (b) it is not necessarily natural or desirable for BF babies to feed every 3-4 hours, the way it is for FF babies.

How about all HV's receiving some training. The 2 HV's that cover my town still tell mums to switch to formula as soon as they hint at having problems.

If there is more money, then training for GP's too please!

Mahobbit- surely that is illegal?
Truly shocking
Tell the Baby Milk Action people, they will know who to report to. doesn't quite cover it

MaHobbit Write to the registrar of births at your council and complain.

Do you still have the bumf or have you binned it.

I would like to have it if you don't mind. evil

Hello,
I don't want to upset anyone (honestly I don't) but I had real problems with breastfeeding and have 'successfully' combined-fed my 6mo(successfully in quote marks because I know many people won't see that as much of a triumph! I do, because to keep on breastfeeding for this long after the horrid time I had feels like a little victory, and I love the fact that my boy gets the benefits of breastmilk and I get the extra snuggles it brings)
Anyway. I felt a horrid pressure to breastfeed from all around when it was difficult and traumatic for all concerned and was beginning to affect our relationship. I'd like to ask that as well as all the wonderful advice on breastfeeding, you also suggest that proper guidance is given on sterilising etc if Mum really feels she needs to supplement with formula after full support is given to try and breastfeed. I hope I haven't upset anyone.

Roo, the NHS produces a sterilisation leaflet. If your MW or HV knew you were mix feeding, they had a duty of care to offer you one.

sorry you had a lot of pressure to breastfeed but as it sounds to me, very little genuine support. The NHS is big on breast feeding SOuNDbites but short on breastfeeding support, in the experience of many women who post on here.

I think the people trained to offer breastfeeding support and communication about breastfeeding should be more positive and messages more straightforward and simple.

I'm bewildered as to why everyone focuses on the potential problems. It's the most natural thing in the world to breastfeed and if it was as complicated as everyone seems to make out the human race would have died out centuries ago. It shouldn't even be an idealogical issue, it simply makes sense.

Reading this forum or indeed attending almost any antenatal class on the subject would be enough to put any unconfident mum off. Can we not hear more from those mothers who have enjoyed breastfeeding from the offset, who have not suffered pain, discomfort or stress and whose babies have thrived from day one? Surely we're not in the minority? I can't help but think that mothers set themselves up for failure by buying into to this 'breastfeeding is difficult' myth that everyone seems to peddle.

I actually believe the complete opposite, mamanpoule.

At my nhs antenatal class I asked about potential b'feeding problems (my best friend had really struggled to b'feed her ds) and was told not to be negative, that b'feeding was as natural as giving birth and what women are designed for.

Well it turns out that I was pretty crap at conceiving (took 7 years with 2 mc), had horrendous births (long with 3rd and 2nd degree tears) and was utterly crap at b'feeding (tongue tie, thrush, nipples that blistered and split, and agony throughout a feed). Just because something is natural doesn't mean it is going to be easy or pain free. I know many women who have b'fed with ease, but have met a lot more who struggled, some of whom gave up, and some of whom succeeded.

I would have liked to have known that babies can have tongueties and thrush in their mouths at birth (even though my gp said this was impossible), and that nipples can burn like fire throughout a feed (and that this is not 'just your nipples getting used to b'feeding dear', and what a good latch feels like, and that a baby can want to suck for hours and hours etc etc. Instead I felt like I was treated like a child, patted on the head and told not to make a fuss. I knew that birth could be agony (thankyou for telling me your birth story in vivid detail mum!), it didn't put me off children, but it helped me to be prepared to consider pain relief seriously and to be realistic about a birth plan.