2 August 2018
Building on her interview on Dispatches, lactation consultant Emma Pickett highlights the vast inconsistencies in infant feeding service provision across the UK, and urges readers to speak out for national leadership on infant feeding to better support health professionals, mothers, their babies and families.
This World Breastfeeding Week we’re meant to reflect on women’s experiences of infant feeding across the globe, but in the UK this is a challenging topic for me.
The last fourteen years of my life have been about breastfeeding: doing it, reading about it, qualifying as a breastfeeding counsellor and then a lactation consultant, taking helpline calls, running groups, doing home visits, writing about it, getting a breastfeeding tattoo and helping to train others.
But when it comes to breastfeeding in the UK, we’re in big trouble.
I’ve lost count of all the campaigns from local families desperately trying to save their breastfeeding support service; when I get another text from someone in a hospital bed; when I hear of a mother desperately trying to find a specialist who understood the complexities of her situation and being told they were on maternity leave and no one is available.
As I’m writing this, there is no infant feeding coordinator in post in my London borough. Our last specialist left several years ago and was replaced by a lovely health visitor who wasn’t a breastfeeding specialist and she has now left. The last job advert read like the job of three people combined. I’m hoping a new person will be able to cope with such a huge brief but it’s an enormous ask.
We were going to have breastfeeding champions – health visitors and health professionals trained to give some extra support in breastfeeding. That initiative disappeared with the health visitor who was trying to do the job part-time. We’ll have to wait and see as to whether it returns in the future.
A couple of miles south, mums can meet a breastfeeding peer supporter in hospital and she might then come to your home. In my borough, you don’t get home visits.
You had a c-section? You have mobility problems? Shame you don’t live just one street over, isn’t it?
You want to meet someone who understands the implications of the fact you had breast implant surgery on the NHS aged 18 and can talk to you about how to maximise the amount of breastmilk your baby will receive? You want to meet someone who can assess your baby for a tongue tie (which was mentioned briefly at the hospital but the person who mentioned it wasn’t qualified to do a referral)? That sometimes seems to be more about luck than anything else.
You might only have a breastfeeding support group in term-time. You might only have a breastfeeding support group because a group of volunteers are busting a gut to run marathons (LITERALLY run marathons) to raise money to pay for a room. You might only have access to an IBCLC because one happens to volunteer in your area OR a local midwife self-funded to get specialist training in breastfeeding.
You might have NO support groups because someone actually believes a health visiting service can simply take over a breastfeeding support service. Health visitors weren’t exactly having long coffee breaks and twiddling their thumbs waiting for things to do before, you know.
I meet a midwife who has been ‘told off’ for spending too long trying to support a mum to breastfeed without pain. I meet another who tells me that when she looks at the list of women she has to see that day in the community, she finds herself hoping that not very many are breastfeeding – they are likely to be the ones who need a longer appointment slot and she’s not been given the time. I meet another who says she had half a day of Powerpoint slides as part of her training on breastfeeding.
I meet a doctor who says she is embarrassed when she realises how little she knew about breastfeeding before she had her own children. Actually, I’ve yet to meet a doctor who DOES NOT say that.
In 2018, Scotland published the results of their national feeding survey. Rates at six months are up. How does that compare to England, you ask? WE DON’T KNOW and we won’t know because it’s not considered important enough to find out. The last set of figures are from 2010.
100% of Scottish babies are born in Unicef UK Baby Friendly accredited settings. How many in England? 57%
Can we see the English national strategy on infant feeding and talk to the English national lead on infant feeding about this? Sorry, no. Because England doesn’t have those things.
When I reflect on breastfeeding in the UK, I just feel like crying.
So what can we do?
Tell our MPs to attend the All Party Parliamentary Group on Infant Feeding and Inequalities (APPGIFI). This is about supporting all babies and with Brexit approaching, formula fed babies are at risk if laws that protect the quality of formula are threatened. Write to your MP and ask them to press the government to do more about breastfeeding support, ask THEM to ask for information. Tell them about cuts in your area. If your MP doesn’t think feeding babies is important, it’s time to have a word.
Sign up to the Baby Friendly Initiative’s Call to Action campaign, urging for a national leadership on infant feeding.
Speak out about cuts. Sign this petition, ask questions in your local area, find out who your local councillors are and tweet or write to them.
Join up the dots to the areas people are talking about. The Health and Social Care committee have highlighted the links between obesity and infant feeding: https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/882/88202.htm
Don’t forget babies in conversations about obesity.
And don’t forget feeding support in conversations about maternal mental health. It is unethical to promote breastfeeding without giving mums the resources they need to be able to reach their feeding goals. When mums want to breastfeed and they are unable to reach their goals, they are at significantly greater risk of developing mental health problems.
Be a customer of the NHS. We are grateful for the NHS and like having affection for an old aunt, it can feel a bit cruel to make complaints. We are not complaining about individual staff, we are complaining about the system that is failing them too. We need to COMPLAIN when our hospital isn’t Baby Friendly accredited. COMPLAIN when you can’t speak to a breastfeeding specialist. COMPLAIN that your neighbour gets a home visit and you don’t. COMPLAIN that your midwife didn’t have time to watch your breastfeed.
And if someone offers to bring you round a lasagne post-natally, thank them for the lasagne but ask them to stay and type out the letter to your local hospital while you dictate.
We need to STOP BEING SO BRITISH AND MAKE A FUSS.
Visit our blog during World Breastfeeding Week to hear more from people interviewed on this week’s Dispatches.