This post is inspired by my conversations with mums who for various reasons were not able to breastfeed at all, or were not able to do so for as long as they would like to. It is also inspired by my experience of breastfeeding and attitude of NHS staff towards it. Officially NHS is promoting breastfeeding over bottle feeding, but are they really offering enough support?
Official NHS attitude to breastfeeding
NHS has a website dedicated to giving information and support to breastfeeding mums, and mums-to-be who want to breastfeed. The first things that pops up into your view is a big blue slogan:
”Breastfeeding is a vital part of looking after your new baby”
So far, so good.
The website is full of useful advice on breastfeeding, expressing, feeding in public and other issues surrounding breastfeeding. It was interesting to find out that:
”according to the Equality Act 2010, it is illegal for anyone to ask a breastfeeding woman to leave a public place such as a cafe, shop or public transport”
Officially the NHS clearly wants to be seen as promoters of breastfeeding and all their websites are full of information about the overwhelming benefits of breastfeeding both for mum and the baby.
I also came across a study, which calculated that increased rates of breastfeeding would save NHS millions of pounds, because of reduced rates of certain childhood infections (like inner ear infection and bowel infection) and breast cancer (yes, breastfeeding can help to protect mum from cancer).
So why is the uptake of breastfeeding so low in UK (the lowest in the world)? And what is the day to day reality on birth wards?
Breast is not the best for NHS staff
Here’s a few real life stories, which help to illustrate how the overworked NHS staff ‘supports’ breastfeeding.
My sister in law had a baby just a few weeks after I gave birth to Little S. Her first pregnancy was a twin one and she decided not to breastfeed, as she felt it would be too much of a challenge (hats off to anyone who breastfed twins!). Her second pregnancy was single and she really wanted to breastfeed the baby. Unfortunately due to issues with her placenta the baby was small and had to be born via planned c-section at 36 weeks. He weighed around 2 kg at birth (about 4.5 pounds).
My first thought was that for such a small and premature baby breast milk will do the world of good and my sister-in-law will receive lots of breastfeeding advice and encouragement before she leaves the hospital. It turns out things were quite the opposite. She was told that the baby is too small and too weak to suckle, which is fair enough. She asked to be given some help with expressing to feed the baby breast milk in the bottle. She was told that her breast are probably not ready and that the baby will be given formula, so that the nurses can record how much milk he had.
Because of her insistence she was given a breast-pump, but no real support. Or advice. And certainly no encouragement. The nurses were too busy, but they also did not seem to have the knowledge.
The woman in bed next to her experienced a similar situation. Her baby was in intensive care and she really wanted to express to offer her baby breast milk in a bottle, to help him get better. She was very upset to learn that without asking her the nurses fed her baby with formula. I am not sure what was the end of that breastfeeding story.
I have shared my experiences of feeding my second baby and mentioned that when Little S was in hospital fighting septicaemia she was also nearly offered formula. I was there with her and the breastfeeding was established (at two weeks), but one afternoon she did not want to feed. She was too tired after crying, while doctors tried to put a cannula into her tiny vain. I was worried she was getting dehydrated, as her fontanel was a little sunken. When I asked the senior nurse what is the course of action if she does not want to feed within the next hour, I was told that she would be offered a bottle of formula. Expressing breast milk and offering it in the bottle was not mentioned, although the only reason for using the bottle would be to make it easier for baby to drink and to see how much liquid she took.
We also had a second encounter with NHS staff for whom breastfeeding was a bit of a nuisance. This was during a heart scan Little S was sent on to make sure there is no bacteria lodged in her heart.
To conduct the scan Little S had to lay calmly on her back for about 20 minutes. She got a bit restless 5 minutes into the scan and the lady asked if she had a dummy. I sad that she didn’t, but that she might be getting hungry. The lady asked if Little S is bottle fed, of course then she could eat and be scanned at the same time… As it was I fed Little S and she had to wait. Of course I appreciate that the hospital is busy and things like this cause delays, but I certainly did not feel like my choice to breastfeed my child was supported during this encounter. It did not bother me, as I know I’m doing the best for my child.
How to make breastfeeding number one choice
Forgive me if this sounds harsh, but I think public message has to be clear, that breastfeeding is not really a choice. There is no choice. Breastfeeding is the only way to feed a baby. Formula was originally developed for the small percentage of babies, who for some reason could not feed. It was on the same shelf as medicine. It’s the marketing efforts of formula makers and their need to make more money, and so sell more products, which has created the perception of choice between formula and breast milk.
I know that government keeps on cutting NHS budgets and staff is overworked, but surely it makes more sense to invest in real breastfeeding support. Create more jobs for lactation consultants or employ more specially trained midwives to give them time to support new mums. After all it could save NHS millions of pounds.
Or put warnings on boxes of formula, like the ones on boxes of cigarettes:
Feeding your child formula significantly increases his/her risk of infections.
Not breastfeeding increases your risk of breast and ovarian cancer
Feeding your baby formula increases the risk of child obesity and type 2 diabetes (which can lead to premature death)
I am not writing all this to criticise and aggravate mums who don’t breastfeed. I am sure they are good mums and they try to do what is best for their babies. I am writing this, as I think it’s important to change the general perception of ‘choice’ between formula and breastfeeding. This is something, which will require a great public campaign to undo the damage done by decades of formula advertising.
Offering mums a year on maternity leave on full pay, could certainly help, as a big reason for using formula is mum’s return to work. Countries like Poland, with smaller GDP than UK, can afford to offer 6 months on full pay or 12 months on 80% pay, which is much better than statutory maternity pay in UK.
Social media does not help
One of the questions my sister-in-law asked me before she gave birth was if anyone ever said something to me about breastfeeding in public. No, I have never been made to feel bad when I fed Big F, or Little S. And I fed them both in many public places. The reason she asked the question was things she saw on Facebook, indignant mums venting their frustration. This certainly does not help to change the image of breastfeeding. Women who do it are seeking public support, but what they are unwittingly doing is scare of mums-to-be from breastfeeding.
What has been your experience of breastfeeding support offered by NHS? If you started out breastfeeding, but moved on to formula, what was the reason for it? I would love to hear from you, so do leave me a comment or get in touch on Twitter (@mumbalance)