What mums think of the British College of Midwives new ‘fed is best’ approach to breastfeeding

Until as much emphasis is given in antenatal classes about how to feed by both formula and breast milk, women will continue to feel like they've failed if they can't make it work.

One of the first lessons you learn as a new mum is that things don’t always go to plan. Your expectation of having that drug-free natural water birth might be the first ideal to go out the window, and then you realise that breastfeeding is not as easy as it looks.

In a North and South story published on our sister site, Noted, earlier this year, writer Sarah Lang explored the emotional toll on Kiwi mothers who struggle to breastfeed in a climate where ‘breast is best’ is militantly advocated.

All new mothers want the best possible start for their babies, and they’re told again and again that breast is best. But what if breastfeeding is too great a struggle? Lang asks. Should women be bullied online, pressured by health professionals, even watch their babies suffer?

Lang explored whether a kinder and more commonsense approach was needed.

Such an approach has just been announced by Britain’s Royal College of Midwives (RCM), which has updated its official position on breastfeeding, saying mothers who choose not to breastfeed should be ‘respected’.

“This is not entirely new advice from the RCM,” College representatives explained. “The college has, for many years, insisted that women who have chosen to feed their babies by means other than breastfeeding should have their decision respected, however they are now clear that informed choice must be promoted.”

The RCM’s new position statement says: “If, after being given appropriate information, advice and support on breastfeeding, a woman chooses not to do so, or to give formula as well as breastfeeding, her choice must be respected.”

The RCM’s position statement still says that “exclusive breastfeeding for the first six months of a baby’s life is the most appropriate method of infant feeding”, in line with advice from the World Health Organization (WHO).

However, RCM’s chief executive, Gill Walton acknowledges that breastfeeding is a struggle for some new mothers, and their choice to not breastfeed should be supported.

Walton says: “Evidence clearly shows that breastfeeding in line with WHO guidance brings optimum benefits for the health of both mother and baby. However, the reality is that often some women for a variety of reasons struggle to start or sustain breastfeeding. The RCM believes that women should be at the centre of their own care and as with other areas of maternity care, midwives and maternity support workers should promote informed choice.

“If, after being given appropriate information, advice and support on breastfeeding, a woman chooses not to do so, or to give formula as well as breastfeeding, her choice must be respected.”

In New Zealand, you don’t have to search far to find a mother with a negative breastfeeding anecdote. Instances are recounted of being refused formula by hospital midwives, despite babies crying continuously in hunger. Others have felt pressure within mother’s groups, persevered through terrible bouts of mastitis for fear of being judged for ‘giving up too easily’, or women have felt frowned upon for bottle feeding in public.

Here, breastfeeding rates drop off significantly in the first four to six months. According to The University of Auckland’s longitudinal study, Growing Up in New Zealand, which tracked 6000-plus children from birth to two years, it found 97 per cent were breastfed initially, with just over half exclusively breastfed to four months. One in six was exclusively breastfed to six months, and one in eight received some breast milk up to two years. Mothers were likelier to breastfeed exclusively for longer if they were 20-plus, European, tertiary-educated, had planned the pregnancy, or had other children.

Anecdotally, women stop breastfeeding “early” for many reasons, including pain, sleep deprivation, returning to work, waning milk supply, and the baby losing interest. Also, practical breastfeeding support fluctuates in quality and, later, accessibility, Lang reported in her North and South story.

Australian midwife and mother of five Marni Tuala told our sister site Now To Love Australia that she’d observed first-time mothers who choose to bottle feed sometimes faced more judgement than those who were already mums.

“In my experience, I think first-time mums are scrutinised more when they choose not to breastfeed however, there is always a reason behind her choice.”

In the UK, mums have welcomed the RCM’s announcement. According to research by Channel Mum, a UK online community for parents, 55 per cent of mothers felt that the pressure to breastfeed was too heavy while 41 per cent of those asked had been made to feel that they had “failed as a mum and failed their child”.

However UK mum Katherine Ormerod, who documents her journey into motherhood on her @mamalovesgrey Instagram account, told Grazia Online that she questioned whether RCM’s updated policy will have much of an impact at grass roots level: “I don’t think that the language should be so black and white – breast or formula. Because there are a lot of options to combine the two in various ways.”

She added: “Until as much emphasis is given in antenatal classes about how to feed by both formula and breast milk, women will continue to feel like they’ve failed if they can’t make it work. The focus should be on what to do if breastfeeding doesn’t happen, like how to use a breast pump and nipple shields or how to retrain a baby on to the nipple if they’ve had to take a bottle for a week, instead of showing videos of babies magically latching perfectly in 10 minutes.”

UK mum Samantha Winchester-Jones is expecting her first child and in the run-up to the birth has maintained her intention to breastfeed, predominantly because it is cost-effective.

“It costs nothing at all but my time, the health benefits are a bonus,” she explains. “I’ve grown up around women who breastfed so I consider it rather normal.”

Over the course of her pregnancy Samantha’s been under two different midwifery teams in South Wales.

“When you get pregnant you are given a book called Bump, Baby and Beyond from NHS Wales and it has a whole section on feeding options. It does state that breast does have additional health benefits, but after that, the book is very unbiased,” she explained.

Samantha had a similarly balanced experience when talking through options with her first midwife. She already knew that she intended to breastfeed, however she said her midwife went though all of the preliminary advice she had been given again to make sure she understood the pros and cons of both options.

“She didn’t shy away in telling me the problems that can come with breastfeeding,” Samantha said.

“Obviously its great for health benefits and immune system but she did prepare me for how difficult it will be, especially for the first few weeks.”

While it will take a while to remove the complicated stigma around breastfeeding, the RCM’s new steer seems to be a step in the right direction for mums who are apprehensive about the pressure to conform to expectations held by the ‘breast is best’ ideal. However the importance of well-informed advice appears to be mothers’ greatest hopes.

Via Grazia and Now To Love

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