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.
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.”