…and not enough actual support.
Almost 5 months ago I gave birth to a tiny human. To me she is just perfect, but when she was born we didn’t know that she had a minor issue with her tongue that would make it incredibly hard for her to breastfeed.
This week is world breastfeeding week and I thought it would be a good opportunity to share my experiences and thoughts on why the UK has some of lowest rates of breastfeeding in Europe. I should be clear that this is not my area of research, so this post really is based on my personal experience.
I spent 9 months barely even contemplating the idea that I wouldn’t breastfeed my daughter. In my undergrad degree in biological anthropology and to some extent, my masters in public health, I learnt how beneficial breastfeeding is to an infant’s current and future health. I ignored my mother when she suggested having some formula in the house ‘just in case’ (sorry mum) and nodded along with the NCT leader and midwives talking about the benefits of breastfeeding. I was aware that some people choose to formula feed, or just struggle with breastfeeding, but I had decided that that wouldn’t be me. I heard many times that ‘breastfeeding is hard’ so I learnt about latching and skin to skin contact. I thought I had all the information.
Then on the 5 day weight check up (the baby, not me thank god) we discovered that she had lost too much weight and we found ourselves back in hospital. There had been warning signs in the days before, that quite honestly, were not taken seriously by the midwife. She was very stressed out and according to my husband, I probably gave the impression of being ‘too competent’ (oh how things change). This was my first thought that things are not quite as they should be on the breastfeeding support front. The midwife clearly had too much work to do and was stressed to the point where I was a little concerned for her wellbeing. The Royal College of Midwifery recently announced there is a shortage of midwives in the UK, which could perhaps explain why my midwife was so overworked.
Another problem we consistently faced was the sheer amount of conflicting, and sometimes, wrong information we received. The maternity support worker who weighed our baby and started the process of admitting her to hospital had begun by telling me that an hour was too long for a feed (correct) but that 15 minutes was not enough (incorrect).
On admission to A&E, we were told to get 60ml of milk into the baby every 3 hours – the presumption was that this would be formula. Fair enough, it’s much easier to assess whether the baby is getting the right amount with a bottle, which at this point was clearly more important. Much later, I discovered I could have asked for donated breastmilk, but this was never offered to me.
The A&E nurse was kind and tried her absolute best to support me to continue with breastfeeding, but I got the impression that this was of her own accord as she was clearly drawing on her own experiences when discussing feeding with me. I now know that she didn’t quite have all the information she needed to support me. “It’s only 5 days in so if you don’t continue breastfeeding overnight, you won’t be able to feed anymore” (so, so wrong). Given that I had just discovered that my breastfeeding currently wasn’t working, this was quite a stressful statement. After much pushing from me and clueless looks from paediatric nurses (but I must stress, they really tried to help) I managed to see a lactation consultant. This person had been mentioned in A&E as someone I should see, but once admitted to the paediatric ward no one seemed to know who or what I was talking about.
Talking to the lactation consultant after 24 hours of being in an infant feeding wilderness was like finding an oasis in the desert – she just knew everything about infant feeding, breast and bottle. It was this person that provided us with a feeding plan that simultaneously took account of the baby’s weight issues and establishing breastfeeding. A few weeks later, it would also be this person who would diagnose the tongue tie and latching issue our daughter had – something missed during the initial assessment in A&E. If the A&E doctor had been able to do the same simple assessment as the lactation consultant had done (I can only assume he didn’t know of it) we might have saved weeks of stress and many hours of expressing.
As my husband said at the time, “I can’t see how a single mum would be able to do this”. My husband might be on to something here, with breastfeeding rates lowest in deprived areas and in women with lower socio-economic positions – often people with little time and a lot on their plate, like single parents. I can’t even describe how much support I needed from my family to be able to establish a milk supply when my baby could not do that for herself.
While I’ve found breastfeeding itself is fine once you get the hang of it, establishing breastfeeding ended up being harder than I had ever imagined. Granted, I had some extra barriers, but anecdotally, almost every mother I know has had some struggle or another with breastfeeding – be it supply issues, pain or illness after the delivery. Some persevere, some don’t want to, some just don’t have the support or capacity.
In Oxford there is a wonderful community breastfeeding support service – they were invaluable when one day my husband and I were at the end of our tether with the expressing/breastfeeding/formula merry-go-round, but they are incredibly underfunded – council funding was withdrawn a couple of years ago (as has happened across the country) . At the hospital, when chatting to the lactation consultant, we discovered that a) there aren’t enough of them and b) the links between them and the hospital staff are just not good enough. Again, this points to a lack of funding.
When pregnant, you spend months being told that ‘breast is best’. There is postnatal support to teach you how to latch, but breastfeeding is more than just latching and there is a lot of misinformation being handed out by all sorts of people that we think know better. In that haze of sleep deprivation and recovery from giving birth, you need the people giving you information to be clear, consistent and most importantly, correct. Sadly, that wasn’t my experience and I don’t think it is the experience of many other women.
We have managed to create a culture of shame for women that don’t (for whatever reason) breastfeed their babies. We emphasise all the risks of not breastfeeding while at the same time not providing enough support to help establish it. From my personal experience, if we want to increase breastfeeding rates in the UK we need to:
- train all paediatric nurses and doctors in the basics of breastfeeding and establishing a supply
- have more lactation consultants trained and employed
- fund community breastfeeding support services properly
- train enough midwives
I think this would get everyone on the same page. Only because we had problems did I discover that not only are some people reading from different pages, but there are missing words and mis-translations. So we need to stop talking about breastfeeding and start putting our money (and efforts) where our mouth is.