World Breastfeeding Week (WBW) celebrates its 25th year in 2017 by calling on all those involved in breastfeeding support to work together for the common good, to attract backing and draw attention to the need for breastfeeding to be better supported in all areas.
With eight out of ten women stopping breastfeeding before they wanted to,[1] and the UK having one of the lowest breastfeeding rates in the world,[2] what will help women to breastfeed for as long as they intend to?
Breastfeeding Support Organisations
Establishing a support network before a baby is born can be really helpful. Going along to a support group gives a mother the opportunity to see other women breastfeed and hear their experiences. It can be reassuring to realise that there is no right or wrong way to do it; what suits one mother may not feel right for another. After the birth, a new mother has someone she knows to turn to for immediate help to if questions arise.[3]
La Leche League GB (LLLGB) is one of the lay breastfeeding support organisations in the UK. Others include the Association of Breastfeeding Mothers (ABM), Breastfeeding Network (BfN) and the NCT. LLL Leaders are all volunteers and provide mother-to-mother support in a variety of ways, including meetings and via social media groups. We run a Helpline and an online Helpforms system. There is no charge for accessing our information and support.
Maternity and neonatal care, hospitals and midwives
The support women get in hospital after giving birth can have a direct impact on breastfeeding outcomes. The UNICEF UK Baby Friendly Initiative was introduced to ensure a basic standard of care and support for new mothers and their babies. Many hospitals are now BFI accredited, which means they abide by the Ten Steps to Successful Breastfeeding.[4] Hospitals may have an Infant Feeding Lead for mothers to speak to if they feel they need more support.
UNICEF wants to remove the barriers that stop women breastfeeding and “change the conversation”, ensuring that mothers don’t feel they are to blame if they don’t breastfeed for as long as they intended. They are making progress with educating midwives before they qualify and have six neo-natal units working towards BF accreditation, so future mothers will hopefully have more consistent information.
Health visitors and children’s centres
The BFI introduced new standards in 2012, incorporating the Ten Steps to Successful Breastfeeding with a Seven Point Plan for Sustaining Breastfeeding in the Community[5] which includes health visiting and children’s centres or equivalent early years’ community settings. As women often find inconsistent information confusing, something to aim for is standard training which will provide accurate, evidence based support. UNICEF is committed to continually evaluate its Plan to provide the best standards possible.
Once at home, women can feel overwhelmed and don’t always get enough time with healthcare professionals, so small initial difficulties can grow instead of being managed. It’s really helpful for hospitals to make sure mothers know about the breastfeeding support that is available.
Doulas, Lactation Consultants, Peer Supporters and Baby Cafes
In addition to breastfeeding support organisations such as LLLGB, some mothers find that having a Doula with them during birth and just after can offer important one-to-one support. Lactation Consultants (LCs) certified by the International Board of Lactation Consultant Examiners (IBCLC) are able to offer excellent support, particularly in complicated or challenging situations. However, both Doulas and LCs usually charge for their services.
Some NHS Trusts provide funding for peer support training, breastfeeding buddies, and other groups like Baby Café. Baby cafes are often run by peer supporters and volunteers from breastfeeding support organisations; mothers don’t have to pay to attend. Unfortunately though, cuts in funding mean some of these valuable resources are no longer unavailable.
Some peer supporters work privately and make a charge. If a mother decides she would like to pay for a private visit, it’s important to check qualifications and training. It can be helpful to have a one-to-one home visit, but it doesn’t follow that paying for breastfeeding support means better support. LLL Leaders undergo intensive accreditation training and can draw on their knowledge and experience to support mothers without charge.
The Lactation Consultants of GB have produced a chart which shows all the different areas of support.[6]
Family, friends and community
Today many of us live far away from family and may not know anyone who has happily breastfed, and it can be really hard to deal with early difficulties if we don’t have people around us who understand.
Research shows that if women receive support – whether it be from a friend or family member, a health professional, or volunteer breastfeeding supporter – they are likely to breastfeed for longer.[7] Having someone to turn to for support, to offer words of encouragement, and to help deflect negative comments can make all the difference.
Women also need support from the wider community. In the early days new mothers often worry about going out with their baby in case s/he needs to feed. Knowing that there are places to go where she will be welcomed and that people will not make negative comments really boosts a new mother’s confidence.
The World Health Organization has stated that “The key to best breastfeeding practices is continued day-to-day support for the breastfeeding mother within her home and community”.[8]
Medical Profession
Having a supportive and knowledgeable doctor can be a key resource for breastfeeding mothers. Unfortunately, while some are really supportive, not all doctors have an extensive knowledge of breastfeeding, and some have opinions which are not in line with new research. It can undermine a mother’s confidence if she goes to her doctor with a breastfeeding problem and receives the wrong information or is told that she needs to stop. Providing more training on breastfeeding would help to prevent women from stopping breastfeeding unnecessarily.
Education and society
A whole sea-change is needed in the way society regards breastfeeding – a society which uses a bottle as a symbol for babies and in which many accept that breasts can be used to sell goods, yet find it shocking when they are used for breastfeeding.
Raising future generations to see breastfeeding as the normal way of feeding a baby starts early. Even in nursery school, picture books show bottle fed babies and animals so children learn to associate bottles with babies. This may create a feeling that breastfeeding is something which isn’t seen, instead of promoting its acceptance as something natural. Education could play a big part in changing this perception. Back in 2008 the Charity Best Beginnings[9] launched “Get Britain Breastfeeding” and aimed to make school-age children more aware of the normality of it.
Legal profession
One of the areas which can make a really positive change to breastfeeding mothers is the legal profession. Women returning to work still need much better protection and provision to enable them to continue breastfeeding. There is still no legal obligation for employers to provide breastfeeding or expressing breaks for lactating women.[10]
Women also need the law to protect their breastfeeding relationship with their child in legal disputes, shared contact cases, and in any interaction with social services or the police.Politicians can play their part by drawing attention to the need for better legal protection. An All-Party Parliamentary Group on Infant Feeding Inequalities was formed in 2016 and is working to protect all babies.[11]
Working Together
This is a long list of organisations and people who can work together to support breastfeeding women. Mothers do not breastfeed in isolation. Their individual relationship with their child spills out into society, improving the health and wellbeing of both present and future generations,[12] [13] and potentially saving money as well as lives.[14]
Working together to create a society which both accepts and supports breastfeeding and doesn’t see it as something which causes division and negativity will benefit us all.
Click here to Get support from LLLGB
[1] http://content.digital.nhs.uk/catalogue/PUB08694/ifs-uk-2010-chap4-bir-post-nat-earl-wks.pdf
[2] The Lancet Breastfeeding Series, January 2016 (http://www.thelancet.com/series/breastfeeding)
[3] A significant factor in improving breastfeeding rates has been shown to be mother-to-mother support (Battersby 2005; Renfrew, Dyson et al., 2005)
[4] UNICEF: “Ten Steps to Successful Breastfeeding” (https://www.unicef.org/newsline/tenstps.htm)
[5] https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/guidance-for-health-professionals/implementing-the-baby-friendly-standards/guide-to-the-baby-friendly-initiative-standards/
[6] Lactation Consultants of Great Britain: “Who’s Who in Breastfeeding Support and Lactation in the UK” (http://www.lcgb.org/why-ibclc/whos-who-in-breastfeeding-support-and-lactation-in-the-uk/)
[7] Dr. Sue Battersby, An Evaluation of La Leche League GB’s Breastfeeding Peer Counsellor Programme, 2007.
[8] Saadeh RJ, editor. “Breast-feeding: the Technical Basis and Recommendations for Action.” Geneva, World Health Organization, pp. 62-74, 1993.
[9] https://www.bestbeginnings.org.uk/
[10] https://www.maternityaction.org.uk/advice-2/mums-dads-scenarios/6-breastfeeding-rights/
[11] http://infantfeedingappg.co.uk/
[12] https://laleche.org.uk/breastfeeding-new-study-looks-significance-mothers-health/
[13] https://www.unicef.org.uk/wp-content/uploads/sites/2/2012/11/Preventing_disease_saving_resources.pdf?epslanguage=en
[14] http://www.nhs.uk/news/2014/12December/Pages/More-breastfeeding-would-save-NHS-millions.aspx