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.

I like Starlight's answer and agree with everyone calling for docs, nurses, mws and HVs to have TRAINING in b/f, to understand how it works, what not to do or say, how they can support women and to encourage them to say 'I don't know' and suggest other sources of help where appropriate.

Oh, and make sure ALL prescribers know about Dr Hales so they don't just assume women 'have' to stop b/f if they need to take medicines.

FREE breastpads for everyone (or at least free if you are on benefits). Likewise breastfeeding bras tops etc.

One of the arguments I have used to shut up my mother when she moans about breastfeeding is that it is a lot cheaper than formula feeding. She watches every penny so this usually shuts her up. Then I got to thinking about how much money I spend on pads and bras and night feeding tops and all the money on washing as I leak like a mad leaky thing. Still cheaper but it is not as cheap as I initially thought.

If free is too much in this economic climate then how about pads etc not attracting VAT i.e.zero rated

Sadly, women who try BF but end up FF are often angry with the people who promote BF, but grateful to the HV or whoever it is who recommended formula in their darkest hour, thus rescuing them from the pain and agony of BF that is going wrong.

Equally sadly, often it was actually the HV or whoever being badly trained that meant that a solvable BF problem wasn't solved. It's the NHS that the mums who've switched should be feeling angry with. But how can they when they may never find out that their breastfeeding problem could have been solved? It's natural for the HV or MW or GP who suggested formula to end up being seen as some kind of saviour, while the 'breast is best' message is then hated and resented ("don't they realise not everyone can breastfeed?!"). It's completely twisted.

Better training for healthcare professionals and lots more detail in some of the standard leaflets mums get - explaining how milk production works with diagrams! So it's understood that feeding on an empty breast is OK.

And for formula to be seen as second-best not breastmilk as ideal - so mums who don't get good BF help feel ripped off by the NHS, so they get angry, so they complain and are not happy - it's always an unpopular thing to suggest but it would definitely help more babies to get more breastmilk.

How about a TV advertising campaign with lots of breasts and babies? Fun and informative.

Agree agree agree re introducing routine tongue tie check for all babies at birth/in the first week or so. It's not good finding out that your baby has a severe tongue tie at 10 weeks, even if it does explain her steep and worrying tumble down the weight centiles. Once top up bottles of ebm are introduced to guard against further weight loss it really does put breastfeeding in jeopardy, especially for babies who can't use their tongues properly and so relish the ease of a flowing bottle perhaps even more than the average baby. I think we might just about make it through still breastfeeding now that her tongue has been released but it's been touch and go, really stressful and it's only luck and stubborness that have seen us through really. Oh, and a really good hired breast pump that has kept my milk supply up while we were waiting for the snip appointment. Might be good to provide those free to anyone on a low income.

Starlight - generic formula will never happen. Too much money invested from various companies.

I suggested that dissolving all formula companies, banning all advertising and just having one, cheaper, generic formula to a (childless) friend. He was horrified, and suggested that it was one step on the way to socialism. Can't quite remember what his argument was now, but certainly I don't think people would be very happy if you got rid of SMA, C&G, Farleys and the rest. He didn't believe me when I told him that they were all pretty much the same!

What about the NHS?

Although am not sure that this would increase or improve b/fing rates.

Haven't read thread so apologies if this has already been said.

Make sure all HCPs (students) who might come in contact with under 4s have Baby Friendly breastfeeding training.

Ensure all healthcare settings have a breastfeeding room.

Offer all pregnant women/new mothers a step by step (inc troubleshooting) breastfeeding DVD.

Promote father's role in supporting women to breastfeed.

i dont think there will ever be a generic formula for under 6 months or for all ages, there is just too much money being made on them. but i would definitely put forward the suggestion for govt to go to tender and to put a tax on it, and expect it to be taken seriously.

I think there should be a policy to tell women that breastfeeding can be hard, you might well struggle, it does hurt - its NOT just the latch you have to get right, but that there is support if you need it.
Stop treating us like children and telling us its all easy and lovely. Because then, when it isn't, we feel like failures and give up!

Hear, hear, BumptiousandBustly!!

But the trouble is that the NHS claims (in antenatal info) to provide support, and then doesn't.

Suggesting we use the excellent voluntary helplines, means acknowledging the lack of professional support available. So I don't see it happening,

Sorry not read thread so probably repeating, repeating, repeating.

As a mum who BF my DS for 13 months I would say get mystery shopper feedback from patients to find out what sort of support they get to BF - particularly in the first few days. Midwives in particular are so , so crucial to helping people get off to a good start but I have heard loads of feedback about harrassed midwives being very quick to offer FF rather than spending the time it takes to support someone to BF and making women feel guilty for breastfeeding - that baby is losing too much weight, you will give that baby jaundice etc etc

As an NHS manager working in public health and responsible for implementing BF policy locally I would say stop with the pointless BF promotion initiatives and spend the little money you have on making sure women can access quick support from HCPs in hospital and beyond as soon as they face any problems. Oh and train GPs better so that they give more consistent support to women. The fact that there is a 6-8 week BF vital sign target now is great for putting pressure in the system so make sure this stays put and doesn't get replaced with another priority.

ime the voluntary orgs are not excellent, sadly. two babies, probably phoned the nct about ten times all in all, never got to speak to a soul. of course they're volunteers but it was very off-putting.

what about putting a REALLY GOOD bfing algorithm onto nhs direct/24 and making new mums aware that it will be treated calmy but properly if they phone up with a problem.

that could be revolutionary, tbh. there are so few things that do go wrong, really, but part of the problem is that there's so much old wives tale-ey nonsense to contend with.

an algorithm written by the nct and concluding with the tel nos of the person's local bfing cafe could be really good. it would just indicate, as much as anything else, that the nhs is treating bfing seriously.

A simple suggestion for these cash-strapped times: get all MWs and HVs to have a list of local places and phone numbers where you can get support.

I was lucky in that a bf clinic was only a few miles from me, as was a NCT counsellor and a specialist at a Baby Cafe. But the local HVs had never heard of any of them - one didn't know that there was such a thing as bf advisors! Luckily I have the internet and ran into the MW setting up the local clinic who told me about the others, but a simple sheet of A4 paper photocopied would have done so much good.

notcitrus I totally agree, that was what I was trying to say earlier in the thread - I found local bf support because I had the motivation and the means to do so and because I knew what to look for, not because the information was made universally available by HCPs. If you're a new mum struggling with bf already, no support in place and ill-informed HCPs in your ear telling you to top up with formula, finding these things out for yourself might take a back seat. Having that information to hand could make all the difference.

My experience and what could have been done to improve it:

• My labour midwife wasn't too big on the idea of skin-to-skin and I didn't try to latch ds on until he was about 6 hours old. I wish she'd got me to do it at birth rather than taking him to clean him up. I really think it would have got us off to a better start.

• The postnatal midwives were all keen on bf, albeit all having slightly different techniques which was confusing, but the HCAs were not and they are the guardians of the midwives. Hard to follow the advice to "buzz me when you're latching him on" when the HCA answers the buzz and is very scathing about you disturbing the "very busy" midwives. Train the HCAs and make them understand that this is evidence-based, not optional, not about what you think, not about what you did with your babies (that goes for all HCPs actually).

• The midwives wanted you to be comfortable with feeding before you went home. Good idea? well, the woman in the bed across from me was bfing until she asked to go home, was told she should stay another night to establish the bfing, hurried convo with husband, asked for bottle and left that afternoon. I lied because I was exhausted and wanted my own bed. Discharge when the mother is ready but better support in the community.

• I went home and my nipples were a mess. It was pretty much hell for the next 2 months and hurt for the following 2. Turns out that the bf counsellor's office was right next to my postnatal ward. No-one told me. Luckily my community midwife was on the ball but if i'd had that expert support earlier I really believe it would have stopped the original damage and saved me a lot of grief.

I totally agree with concentrating on those who want to bf. Virtually all my friends stopped within the first 6 weeks. They didn't want to and in almost every case it was due to issues which could have been prevented with better initial support. It's hard to turn things around when they go wrong. Much easier to prevent them going wrong in the first place. But that will take training so that the people who are meant to help us actually help, not hinder.

(Sorry, a bit epic. i feel quite strongly about this - can you tell?)

i have been bfing for 5 months now and i go to a weekly bfing support group. apart from that i dont know of anywhere else i can go for help or advice. now perhaps thats because i get all the advice i need from my support group and so havent needed to look elsewhere but i cant believe that one group is sufficient for all the needs of all the bfing women in my local town.

also, he group is supposed to be run by a hv but as we have had a sudden increase in hv retirements, the midwives from the local maternity unit are running it but one of them actually said "i'll just sit back and listen because i dont know anything about bfing." any advice we have received has been from two ladies who have bfed before and for extended periods. the hcp might aswell not be there for all the help they are. there really needs to be a huge focus on training HCPs to be able to support bfing mothers beyond establishing bfing in the first 48 hours.

Oh yes, and education - for everyone- about the myths. You know the ones, watery milk, frequent feeds, drink milk to make milk etc etc etc.

I saw an ad on a bus in Glasgow aimed at grandparents suggesting ways they could support their bfing daughters/dils. You could have a series of myth-busting ads.

Families and friends need informing about the myths as well - they are an absolutely massive influence.