Tag: breastfeeding

I’ve stopped talking about the benefits of breastfeeding in antenatal classes.

I’ve stopped talking about the benefits of breastfeeding in antenatal classes.

Posted on by Michelle Bromley-Hesketh
Newborn breastfeeding
(C)Snowdrop Doula CIC

Bit of background here… I have been involved in infant feeding support and education for around 16 years now. I am very passionate about adequate support for breastfeeding for the whole family. 

In this time I’ve seen just about every scenario. Our model of support at Snowdrop Doula CIC triples the chance of breastfeeding at 6weeks and 6months.

In my practice I started off sharing all the benefits of breastfeeding. This felt important then as I believed parents to be were unaware of the evidence. 

I now believe this is likely to do more harm than good. Here’s some of why I now think this.

Advertising of formula and breastfeeding.

We now have a lot more advertising and campaigns for the benefits of breastfeeding. It is no where near enough or even the right way but it exists, nonetheless. 

We see formula advertising talking about how breastfeeding is best and how their milk is trying to replicate it. These ads are seen by everyone and so that message does get heard. (Yes, there’s very clever marketing in that so you buy their product but the message remains). Seeing these adverts does put a simple message in a person’s mind that breastmilk has properties that formula can’t ever replicate, because they are saying how they are trying to replicate breast milk, “over 50 years of breast milk research”, etc.

Depending upon the area you live there are various NHS campaigns as to the benefits and “breast is best”. This helps to cement what we have already seen on TV. In addition to this, midwives and antenatal information given includes the benefits too. I am not naïve to think this is consistent in areas nor optimal. It is not. Still more should and could be done.

This all contributes to a basis in messaging via advertisements of breastmilk being optimal for health of both mother and baby. It would be rare for a pregnant woman to not have seen any of this or for conversations with family and peers have happened. 

Parents are not stupid.

In this article I am concentrating on why I no longer talk about benefits in a class setting. Parents who attend antenatal classes have a tendency to have already been seeking information on birth and feeding. They have often seen the information in that breast milk has more beneficial properties than formula milk before signing up for the class. In a class setting I have usually just repeated this. In talking about specific details parents have been surprised by the amount of benefits but the basic message of breast milk having properties formula does not have is not new information.

A note here; is wise not to make assumptions here, however, not everyone attending classes has read anything else and are coming to classes for the point to learn. 

I’ve found, often, in breastfeeding support circles there’s a judgement that parents who formula feed just haven’t done their research and/or don’t care. When’re this may be true of some it is quite rare. There are many reasons a person chooses to formula feed. Rarely due to not understanding the benefits of breastfeeding.

Why talking about benefits of breastfeeding does more bad than good.

Guilt. It is a very powerful emotion that can affect anyone. I have seen this as a common theme within postnatal depression, the feeling of not being good enough and failing at what should come naturally. Very common comments when talking about these feelings include “and I couldn’t even breastfeed, I know it’s the best, and I couldn’t even do what’s best.” Everytime I hear this I become upset at what kind of messaging society is giving where a woman is feeling such despair. Surely something should change here.

What benefit is there to knowing all the benefits but then not being able to breastfeed, for whatever reason? In my experience, all it does is trigger negative feelings and beliefs on the woman’s ability to parent. That is not good. 

With some studies suggesting over 80% of women do not breastfeed as long as they want to this impacts far more woman than it should.

It doesn’t actually improve chances of breastfeeding. The problems are more to do with expectations of feeding and life with a newborn. Knowing the benefits rarely suddenly makes a woman suddenly decide to breastfeed. In some circumstances they may so, “oh I didn’t know that, I may try to give some now”, but, in my experience of working with families from all sections of society, this does not have a huge impact. 

On balancing the positives of potentially helping someone to breastfeed who may not otherwise against the guilt inducing if not breastfeeding, it does not appear to be worth it. Instead, I use the time to discuss infant feeding as a whole, how breastfeeding works, how formula feeding works, the common problems and how to help overcome, and answer questions. With this giving a caveat that it can be difficult and it’s not for all. If parents ask for the information I will give it, but I’m not discussing as a general topic. I’ve seen too much harm with very little, if any, benefit.

I am aware that in some circles this is quite a controversial viewpoint but I’d ask is it worth it? Is it improving breastfeeding rates? Does it help with wellbeing? If no, then why are we doing it?

Why breastfeeding support should be completely overhauled.

Why breastfeeding support should be completely overhauled.

Posted on by Michelle Bromley-Hesketh

I have been supporting mums in feeding for about 16  years now and nothing much has changed in that time.

Some areas in the UK have implemented things such as UNICEF Baby friendly and peer support programmes. These have increased rates of breastfeeding from where they were but still remain low and around 80% of mothers report stopping before they want to. It’s clear that more can be done and yet there seems to be a reluctance to do so. This reluctance appears to be for a few reasons that I can see.

Not enough money. Services have been hugely cut across the board in healthcare and within the COVID pandemic this has been even more drastic, many new parents groups just vanished. When there’s no money then there’s no resources to provide services. Which leads on to the next point

No one wants to admit it’s not working. This one I find huge, I’ve seen this many times over the years. I’ve asked “Why not do it this way” to be met by some really defensive responses. (Sometimes I don’t get asked back ). If money is lacking and more can be done then maybe a different way could be tried.

Concern of looking “militant“. I must admit this is one I’ve struggled with myself. There are those who do not quite understand the complexities within breastfeeding. I have seen the comments of “well they’ve just not tried hard enough” and I hope more training now sorts this out but I worry it’s not enough. A lot of breastfeeding training isn’t available to anyone who hasn’t breastfed 6months plus, which I still find is missing something. But I know I’m quite a lone voice there and a whole topic on its own. My 3 weeks feeding my first were far more a learning experience than my years with the 2nd and 3rd, but I digress.

So what can be done? 

I think a massive overhaul. Complete change. 

I might brag a bit now. Our service at Snowdrop Doula over the last 3-4 years has shown a significantly high rate of breastfeeding, with 97% at birth, 76% at 6 weeks and 60% at 6 months. All but the latter are exclusive breastfeeding. I had to triple check these rates as even I was surprised it could be so much difference. Now I hear some voices saying, “yeah, but you’re a doula service, you’ll have a certain type of client”, I’d agree for your regular Doulas but we work differently. We work with every family as this service did not charge and worked with other services, such as social services, mental health, health visiting etc so many other “complexities” were involved. 

So if we can achieve high rates with a range of demographics then surely there’s a chance it can be replicated in larger populations. It may not but why not try.

What did we do?

Lots of things but 2 main things I believe (and based on feedback) made the difference 

We didn’t only talk about breastfeeding.

This one will alarm some but we didn’t. We were there to support in whatever was wanted and needed. We supported in what you’d typically think a doula would do in antenatal class type support. When it came to feeding baby we would talk all options. In my years of experience “breastfeeding peer support“ can stop people from engaging. Even those who want to breastfeeding can be put off as it has the image of being only one thing and that things should be ok. I believe this needs a bit of an overhaul in imagery. 

We offered a true continuity of support.

So, there’s a lot of stuff around continuity of care and it really does make a difference to a lot of things in maternity care, (and other areas of healthcare). This does seem to rarely actually happen though, and birth support is often by someone else in most cases. By offering that 1 to 1 continuous care throughout the full journey into parenthood it seems to have made a difference. One point of contact for support. 

Unbiased support. 

This seems to be a biggy we’ve found. Because we’re an independent organisation we don’t have “red tape”, rules and lots of guidelines. (Of course we have some safety rules). We are free to give all the information and our only targets are to make mum feel healthy in mind and body. This seems to help the relationship with the parents and breaks down lots of barriers. 

All these things show how things can be different. We need to STOP alienating parents. Just STOP. The conversations around “engaging” families have been going on far too long now. Just listen. Just change. 

As my mum would say, “If you do the same thing again and again, you’ll always get the same result.” 

Newborn Feeding Cues

Posted on by Michelle Bromley-Hesketh

We are constantly told from a very young age that babies communicate by crying only. It is true that crying is their way of communicating with us. However, crying is a LATE feeding cue. This means that baby has been communicating with us for a while in another way and we have missed these cues.

(c) Snowdrop Doula Comnunity Interest Company
(c) Snowdrop Doula Comnunity Interest Company

The video on this blog shows us early newborn feeding cues. Note the following cues as you watch it.

  • Eyes open,
  • Alert
  • Fidgeting
  • Hands to mouth
  • Lip licking
  • Lip smacking
  • Making noise
  • Sticking tongue out.

Of course your baby may not display all of these and may even have a few of their own. Each bay is an individual and finding their cues may take time to learn in the early weeks. This list are the common cues that we know of.

Click here to view video

Saying things such as “If your baby is crying you’ve not listened to them.” Can be quite a difficult thing to hear. Our modern lifestyles mean that we aren’t often close/attached to our babies and perhaps we were once. As you will note from the video the baby has only communicated for a few minutes all of the cues above. That’s only the amount of time to make a cup of tea, or attend to another child. The baby here doesn’t cry in the video but by the time he was out to the breast, shortly after, he was beginning to cry. Our lifestyles mean we are often busy so may miss all these cues.

So what can we do?

It is noted in tribes where mothers carry their babies and have open access to the breast that the babies rarely cry. These mothers keep their babies extremely close whilst they go about their day to day business. They note when baby is awake and offer breast immediately. Again this may not always be practical for us to do long term but in the early days/weeks if we stay close we can learn so much from our baby and our baby learns us.

There are lots of schools of thought that having a ‘babymoon’ for a few weeks after can help with this. This is where a woman stays with her baby constantly (ok, maybe not 24/7 but mostly) for at least 2 weeks, most of it in bed. They learn so much and breastfeeding rates improve and postnatal depression rates lower. Even if this is not possible it’s important to note that being aware of your babies cues can help with breastfeeding. If you’ve ever tried to feed a crying baby (either by breast or bottle) you will know how difficult it can be. I know when I am upset and have been crying or even if I am crying, I don’t want to eat. I suppose this could be the same for a baby.

Babies do cry and if you’re baby cries you shouldn’t feel bad. Maybe think if you have missed something? How could you do things differently next time? Did they tell you before the cry they are hungry? Are they crying because they are hungry?

Here are a few phrases we often hear. Now you know the early feeding cues, what do these phrases mean to you?

 “She is so worked up she won’t latch on”

“He’s crying so he must be hungry”

“She’s not crying so she mustn’t be hungry yet”

“When they tell you they’re hungry he’s too old to be breastfed”

From birth babies tell you they are hungry. Chances are that if baby is awake, baby wants milk.

 

Video and Blog by:

Michelle Bromley – Snowdrop Doula Community Interest Company

 

References: