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.

Re Government Policy - I had major problems with my first child and received v little support from NHS, the NCT helpline sorted me out. There is a lot of misinformation about BF - folklore - sadly I've even heard Midwives utter nonsense on the subject. I am now a trained helper for the Breastfeeding Network and work with our lovely local midwives running a cafe. The basic problems from my personal perspective are:
Midwives just do not have time to sit and help and encourage when required they are too stretched and many will admit do not have sufficient training in this area. BF Mums leave hospital having had little or no help - many don't need it, but if you do the first 2 weeks particularly are critical. When milk comes in a previously successful Bf Mum can encounter problems that can escalate fast. Again Healthvisitors often lack sufficient specific training on positioning but can recommend BF cafes and helplines etc. In our area though these lists are hideously out of date. Mums need to be told to seek help asap and given access to the right info if they are in pain. Midwives, Healthvisitors and GP's need to know where to get the specialist help in their area if they don't have the time or expertise themselves. Mums often fall between the MW and the HV and are not sure who to call on.

I don't think re-stating the benefits of breastfeeding to mums sitting on the fence about BF/FF is going to make any difference. I'm fed up of all the politically-correct pro-choice faffing that goes on. Babies are designed to breastfeed, full stop. They are significantly compromised in terms of immunity, brain development and mental/emotional health, by not doing (look it up - the studies are all there). There is a place for formula (and I believe that anyone who NEEDS formula should get it free on prescription) but the bottom line is that many women no longer trust their own body's ability to birth naturally or fully breastfeed a baby. I (like most first-timers) was paranoid about getting DS1 weighed every week, despite him clearly being healthy.

Breastfeeding is the last stage in the reproductive cycle. Why does the NHS think it's OK to stitch us up and largely ignore that bit? I'm now a volunteer BF counsellor and run a weekly local drop-in group (which the lead HV has admitted is the only way the UK can actually reach baby-friendly status in BF!!). The problems women come with are usually simple to fix. Positioning is the main one, yet they've struggled on for weeks with pain, bleeding, poor weight gain, colic etc. These women have all been seen by HVs, and say their attachment has been checked. Thrush in the breasts doesn't exist according to many GPs. Today, I have phone consults with 2 mums from miles away that their (unusually BF friendly) HV has referred because there's no help there. Both have a falling milk supply and are simply being told to supplement. It's appalling!

A note on swine flu: I have heard many stories (including my own) of breastfed children sailing through in a day or two, but the formula-fed ones are in hospital. Why is the government not doing everything they can to help women BF their babies? Oh, yeah... no money in it (unlike the vaccine).

Well done MN for promoting Gabrielle Palmer's book: The Politics of Breastfeeding.

This might be a bit tangential but I'm just having some thoughts around how marketeers are so good at their job that brand awareness is very high in all aspects of our lives.

Baby milks (newborn and follow-ons) and foods are part of this of course.

I feel that these brands are so strong that, along with poor education regarding cooking and healthy eating (although I think this is improving), have undermined many people's confidence to feel that we are able to feed our babies both as infants and then as older children.

Along the lines of points others have made here, I think all these brands should have a much reduced presence in 'vulnerable' settings and I believe that even follow-on milks should be removed from television advertising.

I WAS TOLD TO GIVE MY BABY EVIAN!

I have just been told by the practice nurse who gave my 2 month old daughter her injections that I have to give my baby water in addition to exclusive breatsfeeding! Out of an Evian bottle I was carrying! This happened only half an hour ago so I'm still fuming!

My baby is perfectly healthy with no problems and has been feeding very well for 2 month and gaining weight. I'm appalled as this nurse said that my way of doing things ie; exclusive BF is "just your opinion". I'm quite well read on the subject, have a sister who's a midwife, and not least, I have 2 months practical BF experience! Less experienced mothers or people who were considering BF might really suffer at the hands of this woman. What do you suggest I do? I'm going to write to the head of the practice. I'm furious about the harm people like this could be doing in the NHS, and shocked that she's a health professional at all!

It's no wonder there's such a huge number of women giving up on BF if we are getting this sort of advice.

It's all a question of resource of course, but there needs to be much more training and support given to GPs, midwives and health visitors so that they can help with breast feeding problems - yes it's natural, but I don't know a single first time mother who hasn't struggled with it, and five minutes spent shoving your nipple into the baby's mouth doesn't equate to 'teaching latch-on'. Pressure on labour and post-natal wards also means that women don't get the support that they need right from the outset. Maybe some of the NCT breastfeeding counsellors should be allowed to hang out and trouble shoot in hospitals?

Also, I think some of the pro-breast feeding lobby need to tone down their rhetoric. Platitudes like 'it doesn't hurt if you are doing it right' are of no use to a woman in agony! And in the days before formula, I am sure plenty of women either gave up and relied on wet nurses or shared nursing
or were just prepared to put up with infections like mastitis. I am sure having problems with breast-feeding is nothing new.

I breastfed three kids who are now 21,19 and 11. I fed for the totally selfish reason that I NEED my sleep and the notion of getting up in the dead of night, listening to the baby scream, heating up a bottle, feeding the upset baby, getting it off to sleep again and then going off to drop the bottle in the steriliser, all at some expense, didn't weigh in well against picking the baby up, latching it on and drifting back off to sleep while it cosied in and fed. I think it contributed hugely to all three becoming calm, confident people. The no fuss, warm welcome from a well-slept mum was probably a factor.

AND everyone in the health arena approved and congratulated me and told me about all the other benefits for the baby, My point is that maybe we just need lots of success stories and a few older mums around. I wasn't taught by a health professional. I was taught by my babies, my mother and half a dozen aunts who all had that good experience.

I watched Breastfeeding without tears by Clare Byam-Cook which I found
incredibly helpful. Although if it was not for the midwives at the
midwife led unit I don't think I would have carried on. One Health
care assistant spent the best part of 6 hours with me trying to sort
breast feeding, I was determined to win. I think the whole approach
to ante-natal care is shocking. We should take more of a lead from
the Netherlands who offer a midwife every day for first 10 days/2
weeks in your own home or we need more midwife led units so mothers
can feel confident to go home. I spent 4 days in a midwife led unit,
after a very natural birth and felt confident (as much as you can be)
to go home. After care is as important if not more important than
pre-natal care. Especially if you want to learn the art of breast feeding. My second daughter latched on immediately and we didn't have any problems. Not sure if she was easy baby or perhaps I was more confident. I am now expecting number 3 so hoping that goes as good as number 2

Oh sorry - hit send before i had finished. It took me about 2 weeks to get through the pain barrier with my first I had horrendous cracked nipples (lost half of one!) one side was better than the other. My sister in laws who had breastfed all of theirs, just kept promising it would be fine after 2 weeks and to keep putting on the Lansinoh. The pain I went through in those first 2 weeks made me yealp and had tears streaming down my face, but after that was a doddle. I really wanted to feed as took me so long to conceive wanted to give baby best fighting chance also I had heard good stories about dropping the weight and it certainly worked for me.

The thing is that often families in our society are not around for the first few weeks after having a baby, my mum lived a few hours away, I don't see any of my aunties and my sister doesn't have children. I should imagine there are lots of new mothers in a similar situation. Surely in that case the best thing to hope for is that the women that are around in the first few weeks of being a new mother (ie the MWs and HV) can provide practical and consistent help and advice.

Also, I think it is really important to get women that have wanted, but failed to b'feed to be involved in the discussion of how to improve b'feeding rates. I know that a lot of it is down to some being more determined than others, but I don't think this is always the case. I was hugely determined and of course wanted the best for my baby, but couldn't get over the hurdles that were in front of me. I then failed to b'feed dd2, and am terrified that if I have a dc3 I will fail again, it is not easy to have confidence that your body and your baby will know what it is doing, when it has failed so miserably to do it in the past.

Better diagnosis and treatment of nipple thrush in new mothers. It's excruciatingly painful, and impossible to continue with b/feeding unless it's treated. I suspected it for 2 weeks but was only given a prescription for medication by the midwife after crying in agony throughout the entirety of several 1-hr feeds. Agony is not the same as discomfort. Being told that dabbing milk on them would help was insulting and utter idiocy. And it encourages further thrush growth. I finally told the m/wife I just couldn't go on and would quit b/feeding. She then finally gave me a prescription and things improved within 2 days.

Nipple shields also helped. Different advice from every midwife I met didn't.

Neither did the hospital midwife who yanked my 2-hr-old newborn on and off my increasingly sore nipples for half an hour without even breaking the suction, while supposedly "teaching" me how to recognize a good latch. She never actually achieved one, though I did later when left alone by the !*@.

More honest upfront admission of the potential problems, so parents-to-be can read up on how to overcome them BEFORE the baby arrives.

Finally, as I eventually ended up with mixed b/feeding and bottle feeding, I personally would have liked the chance to research the pros and cons of different formulas before DH had to run out in a panic at 4pm on a Sunday to get a random brand because I was in too much agony to b/feed, and so decided to succumb to the health visitor's order to top up my baby, who was gaining weight v. slowly.

How about a bit less pressure to get up and at'em, and more encouragement for new mum to stay on the sofa scoffing cake just feeding their babies?

Seriously, the number of mums who I have heard saying that they "just couldn't keep up" with their baby's demands for feeds makes me sad. I was lucky enough to have family support, a wonderful DH and great midwife, and NCT bf counsellors/peer supporters, but not everyone is that lucky. Someone should be telling more mums that it is ok to sit and feed ALL DAY when the baby is hungry and that eventually milk supply will balance demand and all will be well!

Many times I was feeding for an hour or more with only 45 minute breaks, but we kept on at it and were lucky enough, as i said, to be encouraged to do so. There is too much emphasis in our culture on recovering quickly from the birth when those first weeks and months should be about getting to know the baby's needs.

Oh, and proper protection in legislation for hungry babies feeding in public, as they have in Scotland, would help!

It needs to be seen as normal.

I had fantastic breastfeeding one day workshop at Queen Charlottes - taught by a very inspirational woman called Aunty Vickie - there should be such a wise aunty available for every woman.

I see comments that it should be legal to breastfeed in public in England - its come as something of a shock to me that it might not be. Is this really something that requires legislation. I fed my baby everywhere up to 12 months without harrassement. A friend commented in a cafe once that people where looking/whispering -but actually I think that was a problem for her. I never noticed such behaviour - I certainly was never interested in other peoples issues with it.

It did hurtfor a while and it was normal. I had several MW's say that we were doing it right (and therefore it musn't be hurting). It was only when I saw my step-Mum (a MW of 30 years) that she told me baby was slightly tounge tighed - hence the painful feeding. Pain lasted about 6 weeks.

How about breast feeding mentors? I was lucky enough to be supported by many women who had previously breastfed - both my age and older women. They were the best sort of support and encouragement for me. Nothing militant - just encouragement, support & pride.

How about mummy mentors, I know many other mums who would be happy to help and be on call in the scary early days.
Also an added awareness all round, people are so naive to the advantages of breast milk over formula, not always mums, but the public as a whole.

Oooh coming back to this.

I do think that the main resources should be concentrated on support for women who have initiated BF - as has been said numerous times already the best way to increase initiation is to normalise bf.

However I have recently been party to some research among young parents and was astonished that the majority of them could not think of ONE SINGLE advantage of BF over FF.

I honestly think that for a lot of people if BF crosses their mind at all it seems like a "parenting choice" in the same way that babywearing or cloth nappies is - ie fine for the hippy weirdos but not what normal people do.

So I do think information regarding the true risks of FF should be more widely available in the same way that risks of smoking and drinking are.

..thinking something along the lines of "every week in this country 20 babies are admitted to hospital because they were not breastfed."
(Disclaimer: I have made that figure up)
(but it's probably higher then that)

I have to say that my hospital came up trumps with this aspect of my care (well done Northampton!) as they encouraged me to stay in an extra night (so 3 in all) because I had trouble feeding from one boob!
I found it really hard and was tearful but I needed the support. Perhaps there should be this kind of support guaranteed? I know mothers who are ready to run out the door after the birth of their first baby and if they have trouble feeding, this is when they will need the support, just like I did.

Having exclusively breastfed my baby despite a whole load of problems (unable to latch on, milk blisters, bleeding nipples, mastitis etc) as formula wasn't even an option for me (why so many women choose to give their child formula is something I find really difficult to understand) I believe there are two main issues:

1. NHS needs to be consistent in its advice to breastfeeding mothers and needs to be honest about how difficult it can be.
2. Society as a whole needs to be less accepting of formula as the 'norm'. (It makes me wince when I see friends of mine who have had no problems breastfeeding happily switching their 6 mth old baby to formula just because 'that's what everyone seems to do' - and it's 'easier' for them. Formula should be seen as something when there is no other option - not as a choice (and whose choice is it anyway? Not the baby's).

Better use of volunteers..

In our PCT there are around 30 volunteers with CRB checks, some training (3 hours a week over 12 weeks)who are very keen to help other women as much as possible.

However, due to beaurocracy... and it taking 6 months [6 months!!!] to make up ID cards etc. Its been 18 months since I did the training and weve just not been used. The midwifes and health visitors training us have been going spare!

I personally think support groups are sooooo helpful. Feels very natural to sit chatting with other women, some of whom are experience, a few of whome are really well trained and have up to date knowledge. Was supporting at a group on Monday and a lady came in with a blockage. We sat and had coffee, reassured her, showed her a differnet position to help her have a hand free for her 3 year old, chatted about expressing and going back to work. WHat was really lovey was I then asked her stuff about toddlers and she helped me too with other issues.

She said she was really pleased as we had cheered her up and she didn;t feel patronised.

There was a health visitor who was mega booby trained there for an hour. The rest of the time (4 supporters for 3 hours) was 'worked' for free... our kids all had fun playing together too.

I have absolutely no qualms about breastfeeding being a good thing but I absolutely do not think that breastfeeding should be promoted to the point of ramming it down new mothers' throats as it presently is in hospitals and by many midwives/health visitors.

For those of us that are not producing enough milk or cannot breastfeed for other reasons, it is upsetting enough without being made to feel like you've failed wherever you turn. Emotions are up in the air after birth anyway and adding another pressure is not needed and can indeed be dangerous both to the mother's mental health and the baby's developmental health not to mention the bonding between mother and baby.

My father-in-law is a paediatrician and at 5wks quietly told my husband that we were starving our first-born (she didn't put on her birthweight until 5wks rather than the expected 2wks). Thank goodness for honesty on his part and also on the part of the hospital consultant who, whilst I was in hospital, quietly told me that, contrary to what else I might be indoctrinated with, breastfeeding was not the be all and end all and that I should do what works for the comfort and health of me and my baby. I thought it was an odd, out-of-the-blue comment at the time but it all made sense later on when I realised I was struggling to feed my baby enough.

I breastfed my 2nd child until 5wks too but with him I realised that topping-up with formula was the way forward.

I forcefully believe that mother's should be told the honest truth - breastfeeding is wonderful etc etc but not all can/should feed their babies in this way and that that is equally fine. No-one should be made to feel guilty/a failure. Take those posters in hospitals/sugeries etc down!

I am an experienced Breastfeeding and Parenting Counsellor with 8 years of experience in the West Indies. The most common reason given for not breastfeeding there is "Not Enough Milk". I know that the statistics are similar here. This misconception needs to be addressed, and women need specific information about how breastfeeding more increases milk supply.

I often find that classes become enthusiastic about the idea of breastfeeding when I explain that breastfeeding doesn't make your boobs sag, going braless does! And they love the idea that breastfeeding helps you to slim down, and sucks your uterus back into shape. These are good marketing ploys: Breastfeeding makes you slim and sexy! Yay! We have to sell breastfeeding, in the same way other companies sell their products.

www.thingsivefoundinpockets.blogspot.com

I breastfed my twins until they were one, supplementing with formula when I went back to work when they were 5 months old.
I felt there really wasn't enough information about coping with feeding on demand in that situation and seemed to be a full time milking machine, mudddling through in the early days.
It was exhausting and sometimes tear inducing but I felt and still feel very strongly that it was a very precious time and I believed that I did my best for them although my own life was, by necessity, put on hold for a few months.

Wonderful idea! - thanks so much, MN.

Mothball Breastfeeding Awareness Week - thereby saving cash and preventing the grimly inevitable tide of negative press we get every single year.

Most people who talk to their midwife/health visitor/GP about BF have no idea that said professional may never have had even a single day of BF training.

Change the dim-witted referrals system whereby feeding problems are referred by midwives and health visitors to GPs with even less expertise in BF. Enable and encourage HCPs to refer such problems to BF counsellors instead (who should be paid to provide this service). It's simply indefensible that the people with the highest expertise and training in BF are outside the official system.

By the way, the govt person will probably tell you that they are taking steps in this direction - in fact they are mainly interested in involving peer supporters (better than nothing, but they still only have 10 weeks training).

beccar917 - Why should you wince when your friends switch to formula at 6 months? For an average baby at that age the risks of ff are so tiny compared to ff a newborn. If they are switching because they ff easier I think that is a perfectly valid reason.

Silly Sounthern Mum - 10 weeks training and often lots of breastfeeding experience.

Chain David Walliams to a rock for all eternity, to have his liver pecked out by eagles, while crying, "I'm sorry about the bitty sketch! I support mothers' rights to bf in a comfortable and supportive environment! I would never have let it be broadcast if I'd known that it would become the rallying cry of teenagers/dodgy bils/Radio friggin' 4 everywhere!"

I echo those who have said breastfeeding mothers to come along to antenatal classes. When DD was a couple of months old I went to a baby massage class (a SureStart thing); the midwife asked if a couple of us would go to her antenatal session to talk about BF - so I went along with another woman.

Like to think it was useful for the pregnant women there - this was in a 'deprived' borough of London and the midwife wanted to show a couple of women who were just getting on with BF, to normalise it I suppose. We discussed any problems we'd had (thrush, in my case), how we'd got round them and how we were finding feeding. Probably just having us there feeding our DDs was useful, I think. Hope so anyway.

Anyway, hoorah for that midwife!