- Breastfeeding in the UK today

Breastfeeding in the UK today

I felt a need to share this Breastfeeding report by Welelda so well put.

Breastfeeding in the UK today: do we need to create a virtual village?

An honest look at breastfeeding today

Breastfeeding is a crucial chapter in the lives of many families, and one you may be about to start yourself. It’s a truly special time, when a mother and baby are together laying the foundations of their relationship. But it isn’t always plain sailing! Today’s new mums are caught between a shiny, social media perspective on breastfeeding on one hand, and overblown tabloid taboo on the other. At Weleda, we felt it was time to shine some sunlight on such an important and divided subject. We wanted to cut through all this noise
and take an honest look at breastfeeding in the UK today. We wanted to listen to the experts. And by doing this provide useful
advice and information on what new mums need, and how they can find support during this important time. Weleda is the Ancient Celtic name for the revered ‘wise woman of the
village’, a counselor and healer, and so it felt entirely appropriate for us to bring together an expert panel of accomplished women to share
their wisdom.
Ranging from a professor of neonatal medicine to midwives, doulas, and journalists, they each bring their own unique perspective.
If you’re a new mother, we hope you find something in here that helps
you find your own path, whichever way feels right for you. Jayn Sterland, director Weleda UK & Ireland
Jayn Sterland is managing director of natural
phyto-medicine and natural babycare pioneer Weleda (UK & Ireland). A passionate advocate of all things green
and natural, Jayn speaks regularly about the
important link between health, wellbeing and lifestyle choices. Jayn has topped the Who’s Who in Natural
Beauty list for the past two years.

Meet our experts
Neena Modi is Professor of
Neonatal Medicine at Imperial
College London, a consultant
at Chelsea & Westminster
Hospital, and former president
of the UK Royal College of
Paediatrics and Child Health.
She is dedicated to identifying
novel approaches to improving
breastfeeding rates in the UK.
Neena’s team developed the
widely-used National Neonatal
Research Database and she
leads a multidisciplinary
neonatal research programme
on nutritional and other
perinatal determinants of lifelong
health.

Amy Brown is a professor at
Swansea University, where she
leads the MSc programme in
Child Public Health.
She is an advocate of responsive
feeding and hopes to change
the way we view breastfeeding,
mothering and caring for our
babies in the UK.
A psychologist by background,
Amy has published more than
60 papers and two books
exploring the psychosocial,
cultural and political factors
affecting decisions around
feeding.

Dee Bell is an International
Board Certified Lactation
Consultant (IBCLC), tongue tie
practitioner and a midwife of
15 years.
Dee is experienced in resolving
a wide range of breastfeeding
challenges, and has delivered
breastfeeding training to
hospital staff for many
years. She has also helped
establish several community
breastfeeding drop-in services.

Jil Wild Manning is a
reflexologist and birth doula
with a special interest in
breastfeeding education
and support.
Five years ago, she trained as a
La Leche League International
breastfeeding peer supporter.
 She volunteers in her
community and hospital dropin
clinics and on the postnatal
ward for her local trust.
She is the mother of “five
lovely people” and grandmother
to two little ones.
Mia Scotland is a clinical
psychologist, birth doula,
hypnobirthing instructor and
author of Why Perinatal
Depression Matters.
She has a special interest
in understanding postnatal
distress from a sociological
perspective, with a view to
helping mothers, babies and
fathers adapt to life as a
family.
She runs a private clinic
helping people with birth
trauma, birth fear and
postnatal depression, as well
as workshops for midwives and
birth workers.

Beverley Turner is a
journalist, TV presenter and
host of a radio phone-in
current affairs show. She is a
mother of three, and founded
The Happy Birth Club which
offers fun and informative
antenatal classes.
Beverley sits on the Royal
College of Midwives’ Better
Births Initiative team and
chairs events for Independent
Midwifery UK, Birthrights and
Doula UK.
She is also a trained psychotherapist
and hypnotherapist.

Angie Barrett has been
working in breastfeeding
support for more than 20
years, formerly as a postnatal
nurse and more recently as a
midwife. Her ward experience
spans antenatal, labour,
postnatal and community care.
Angie has also worked with
mothers in rural, poorly resourced
countries such as
Cambodia, where she provided
antenatal, intrapartum and
postnatal care.
She has also worked as a
lecturer in public health and
co-wrote a degree programme
on the subject.

Sally J Hall is a journalist and
editor with two decades of
experience working on leading
parenting titles including
Mother & Baby, Emma’s Diary
and Pregnancy & Birth.
She is managing editor of B
magazine and website, which
brings pregnant women and
new parents the latest news
and research on pregnancy,
birth, and baby health.
Sally is also author of Eco
Baby, A Guide to Green
Parenting and contributing
editor to Dorling Kindersley’s
Watch My Baby Grow.

Emma Pickett is a
breastfeeding counsellor,
International Board-Certified
lactation consultant (IBCLC)
and chair of a national
breastfeeding charity that
offers mother to mother
support.
She has a special interest in
breastfeeding support and
writes a popular blog about
the issue.
Emma combines private
practice with volunteering
her time to provide telephone
support to people in
Haringey, North London and
is author of You’ve Got it
in You: a Positive Guide to
Breastfeeding. She also spoke
about responsive feeding at
the 2017 Unicef Baby Friendly
conference.

Jo Gould is a Registered
Midwife, Lecturer in Midwifery
and a module leader on
the BSc (Hons) Midwifery
Programme at the University
of Brighton.
Jo qualified as a midwife in
1999 and worked in clinical
practice in hospital and
community settings for several
years before moving into an
educational role in the NHS,
followed by her move into
higher education in 2014.
Jo is founder of The
HypnoBirthing Clinic, a
specialist parent education
service focused on the use
of self-hypnosis techniques
for use in labour and birth. Jo
is a passionate advocate of
supporting and facilitating
women’s choice in relation
to pregnancy, birth and the
postnatal period.

What information and when?

Few mothers will tell you breastfeeding is as effortless as it appears in perfect social media moments. But nor
is it something that should be hidden away, as some sections of the media would have us believe. Here, we
explore the deluge of conflicting messages new mums receive, and how to navigate your way through them.

In a world in which everyone has an online soapbox, and
we’re bombarded with thousands of messages a day, it’s easy
to see why a new mum might feel overwhelmed … as if she
doesn’t already have enough going on!
 At one extreme, she may have been exposed to an overly
optimistic view of breastfeeding that’s tough to live up to,
and at the other, the kind of finger-wagging that can leave
women feeling stigmatised if feeding doesn’t work out.
Journalist and broadcaster Beverley Turner’s response was
to set up The Happy Birth Club antenatal classes to provide
informative antenatal courses to couples.
“I felt really strongly that women were getting mixed
messages and being terrified.” she explains.
Perhaps part of the problem is in not being able to talk
frankly and honestly about the sometimes difficult reality of
breastfeeding. Professor of Neonatal Medicine Neena Modi
believes perspectives on breastfeeding are often very limited.
“The truth of the matter is that for some women it’s great,
and for others it’s not. Let people have information about the
entire range of possibilities,” she says.
 It’s a theme picked up by midwife Angie Barrett.
 There are many factors that can make it easier to give up
rather than to continue, and many of these are because of
lack of support and guidance in the early stages.”
But these messages don’t make great headlines. Beverley
Turner believes the media’s natural tendency to seek out bad
news has distorted our view of birth and early motherhood.
“I’m one of the very few voices in the media who tries to
speak positively about pregnancy, birth, and breastfeeding,
so it doesn’t always sound like something to be dreaded,”
she says.
“I get told it’s a very niche area, and I think that’s one of the
problems that breastfeeding has … [the media] loves to write
a negative breastfeeding story,” she explains.
Despite this, many women in the UK still want to breastfeed.
Initiation rates of around 75 percent suggest the intention
is there, but drop-off rates point to some challenges in
continuing beyond three months.
Perhaps mixed messages around the length of time babies
should be feeding for are part of the problem. While The
World Health Organization (WHO) recommends two years
as a benchmark, the Department of Health recommends
exclusive breastfeeding for the first six months, followed by a
period of continued breastfeeding alongside the introduction
of solid food for as long as mother and baby wish.
For lactation consultant Dee Bell, the focus should be on
helping those who initiate breastfeeding continue to do so.
“I think whoever wants to breastfeed should have the
support they need. If initiation is 75 percent that should
mean that by four months, 75 percent are still breastfeeding.
 So let’s have that as a rough goal,” she says.
Fathers and partners play a vital role in providing this
support, and they too are looking for a more realistic picture 
of breastfeeding.

In the absence of a clear national message, it’s the job
of a multitude of bloggers, journalists and healthcare
professionals to provide information. But what kind of
information do new mums want and need to get started
and to continue? 
“Our readers want every bit of information they can get
their hands on,” explains Sally Hall.
“There’s a general rule that online features are no more
than 500 words, but we ignore that in the baby world
because people want to know stuff!”
Neena Modi, professor of neonatal medicine at Imperial
College London, says new parents are asking for information
early, but acknowledges that new mums and their partners
are often a little shell-shocked in those early days. Beverley
Turner agrees.
“We will do a breastfeeding session as part of our antenatal
classes with women who 100 percent want to breastfeed,
but then they go into hospital where they might get told:
‘You don’t have enough milk, here’s a bottle’,” she explains.
“And then we’ll remind them that their milk doesn’t come in
until day two or three and they say ‘Oh, I’d kind of forgotten
that’.”
Midwife Jo Gould feels it’s a delicate balance for her profession.
“I feel that the situation we have at the moment is that there
is too much information and not enough support. One
hundred percent of women are using the internet for their
information because they don’t know where else to turn.”
Emma Pickett feels there’s a very meaningful message
getting lost amongst all this information.
“If there’s one important message that needs to get through,
it’s that breastfeeding is so much more than a milk delivery
system. It’s a way to meet a baby’s needs, and you may not
know what those needs are.
“It might be that they’re tired, or hungry, or that they’re cold
and uncomfortable. Mums don’t have to ask themselves if
their baby is hungry to know if they’re allowed to put them
on the breast. It’s multi-purpose!”
Neena believes perceptions around the mechanics of
breastfeeding can shape our perspectives very early,
highlighting some research conducted by her team.
“Some young people said to us that breastfeeding is terribly
‘yucky’,” she explains.
“That was the word they used. And we thought that if young
men and women believe breastfeeding is yucky, then clearly
we, as a society, have got our messaging wrong.
“Children need opportunities to actually see their mums and
their parents’ friends breastfeeding, so they can take it in
their stride and think nothing of it.”
Amy Brown says other research suggests young women have
made the decision about whether or not they will breastfeed
at just 14 years old, underlining how important those early
influences are in shaping our views.
“The peer example isn’t there,” she says.
“And so a lot of our education is obtained through the media,
where anything to do with early motherhood and birth isn’t
at all true to life.”
Many of our panellists shared stories of their own children,
highlighting how a child playing at breastfeeding is
somehow considered taboo – and why is it that toy babies
always have bottles?
The hysteria that surrounds breastfeeding in public hardly
helps; recent positive news like the scheme in Newport –
in which breastfeeding mums are encouraged in cafes and
restaurants with a ‘breastfeeding welcome’ sign – is still
outweighed by more negative stories.
The solution for some has been the adoption of a ‘hooter
hider’ or nursing cover, a kind of shawl/curtain hybrid
that makes feeding more discreet by hiding both breast
and baby. But they don’t always have the desired effect.
Beverley Turner shares a fantastic ‘out of the mouths of
babes’ anecdote.
“My son was six or seven and saw a lady using one in the
park,” she says.
“And he was asking the lady what she was doing. When she
replied she was feeding the baby, he said: ‘Why have you got
that thing on – is your baby really ugly?’. To this day I don’t
know if he was being deliberately hilarious or whether it was
said in total innocence!”

So what are our experts’ takeaways for new mums?
• Think like a reporter. Choose your information sources carefully, and be wary of accepting things at face value.
Collect and check the facts, and speak to as many real-life mums and dads as possible.
• Don’t be put off by overblown media stories, and don’t feel like you’re doing something wrong if you’re not living up
to the glossy, idealised image you may find on social media platforms. It’s up to each of us to find our own way
through and make our own decisions.
• You are not a milk delivery system. Breastfeeding is about so much more; it’s an opportunity to provide warmth,
comfort and bonding time for your baby.

The confidence to continue
Lots of women believe in the benefits of breastfeeding, and lots of them start. But then many of them stop.
Are women getting the support they need to continue? And where can new mums find it?
If the experience of all new mothers across the UK was
averaged out into the story of just one woman, it might look
a bit like this.
She’s heard about the benefits of breastfeeding and is keen
to breastfeed her own baby. She starts feeding when baby
arrives, with every intention to keep it up for a year. But after
a few months, she decides she can’t do it any more…
“Initiation is high – it’s about 75 per cent,” explains professor
of neonatal medicine Neena Modi.
“But then women go home and by three months, the
number of mothers breastfeeding has fallen drastically and
by six months only about a third of babies are having any
breastfeeds at all.”
Why do we have this challenge with persistence in the UK?
For some people, it just doesn’t work out, and our expert
panel was unanimous in saying these women need as much
support as those for whom it all goes to plan.
But maybe there are bigger matters at play, too. Those
big, infrastructural issues around the kind of immediate
postnatal support women receive from professionals, like
midwives and health visitors.
“Lots of midwives are very woman-centred, and very
motivated,” says Jo Gould, a midwife herself.
“But they’re thin on the ground.”
These are hugely influential figures in a child’s first few hours
in the world. So influential that Jo left behind her career as
an architect to retrain.
“Having had a terrible birth, I had an incredibly supportive
midwife who transformed the experience and transformed
me as a person,” she explains.
“I just felt ‘I’ve got to do that’ – it’s the most important thing
in the world to work with women and help them start their
family lives.”
The sheer enormity of this work – spread over so few people
– can mean midwives are stretched; and there was concern
amongst the panel that new mums don’t always get the best
start to breastfeeding.
“I think sometimes the reality of the postnatal ward is that –
with the best will in the world, you cannot spend time giving
breastfeeding support,” Jo says

So what are our experts’ takeaways for new mums?

• Don’t be afraid to ask for support from your midwife
or the people around you if you’re struggling.
A visit, or advice from friends and family, could make
all the difference.
• Check out your local support situation. You may be lucky
enough to be in an area with drop-in classes or calls
from a friendly midwife.
• Start your own virtual village! The advice of people in
the same boat can be invaluable for new mothers –
if only so you know you’re not on your own.

Jeremy Hunt has announced plans to recruit an additional
3,000 extra maternity staff over four years, and provide
women with continuity in support. But perhaps it isn’t just
about the numbers.
“I think there are a lot of mixed messages coming from
midwives too,” explains Dee Bell.
“They might be told they mustn’t use nipple shields or they
mustn’t pump yet, things like that. I think training staff can
make a real difference to women on the wards.”
British women spend less time in hospital after giving
birth than any other European country1
. Doula and peer
supporter Jil Wild Manning volunteers at her hospital
drop-in centre and says there is a real thirst for additional
postnatal support.
“Some are desperate to get home, but others choose to
stay some extra nights in our care just to get breastfeeding
established,” she explains.
And there are patches of the country where this kind of
support is continued in the community.
“If you look at somewhere like Lewisham, which has very
high breastfeeding rates, they have a drop-in every day of
the week, two a day quite often,” explains breastfeeding
counsellor and author Emma Pickett.
“You might have peer supporters who visit you at your
home and you might be able to access support through your
mobile too. But that model is increasingly rare.”
The answer for many mums is to look elsewhere. TV
presenter and campaigner Beverley Turner had been
running an antenatal course for three years in Chiswick
when she decided on a change of focus.
“We were hearing from a lot of women who’d got home and
were saying ‘I haven’t got enough milk, it’s not working’,”
she explains.
“So we dropped a session off our antenatal course and
swapped it for a postnatal home visit from the midwife, and
we now have 100 per cent breastfeeding rates across the
board. It’s been transformative for people because they have
that continuity of seeing one person.”
1https://www.telegraph.co.uk/women/mother-tongue/11319166/British-woman-I-was-told-to-leave-hospital-6-hours-post-birth.html
Midwife Jo Gould agrees wholeheartedly that continuity
is essential for a new family. She sees a more communitybased
model of care as the future.
“The Albany Midwifery Group is working in a part of London
where you have really fragmented care, but they pick women
up and look after them – this is the model we need to be
working on,” Jo believes.
These services cost money, of course. But the members of
the panel make a convincing pitch for investment.
“Someone like me can visit once and pass on the right
information and save five visits from someone else,” explains
Dee Bell, midwife and lactation consultant. She adds that
establishing good breastfeeding practice in those early days
will prevent babies being admitted for dehydration or weight
loss and protect their overall health for decades to come.
Professor of neonatal medicine Neena Modi says she doesn’t
know why this very logical argument for more breastfeeding
support isn’t cutting through.
“The evidence is all there,” she says.
“And the economic argument is there, so you’d expect every
government in the world to be falling over themselves to
increase breastfeeding rates. But tackling this on a very
evidence-based, logical way is not enough, it seems.”
In the absence of organised state care, many women are
forming their own communities of likeminded supporters.
These might be close friends and immediate family,
including dads and partners (who may need their own
support).
“There’s some new research that has looked at what’s
effective in terms of peer support,” says Dee Bell.
“We’re able to create our own little village of people who
breastfeed if we don’t have our own!”

A breastfeeding culture?

Women across the UK know about the benefits, yet we still have some of the poorest breastfeeding
rates in Europe. Here, we explore the cultural factors shaping our choices, and how women can find
like minds who share their values.
‘Is she a good baby?’ It’s a question new mothers are asked every
day – but what does it actually mean?
“I just hate that phrase,” comments author and researcher Dr Amy
Brown.
“It seems to mean a baby who doesn’t bother you too much, and
the connotation is that only good mothers have good babies.”
Her frustration is probably shared by thousands of parents who
resent the idea that a ‘good’ baby is a compliant, sleep-all-night
non-complainer. Not least because the implication is that other,
perfectly normal babies are ‘bad’.
“I think it’s about that pressure to get your life back to how it
was before you decided to have this brand new human being,”
continues Dr Brown.
“So you have to get your baby to be good, which means sleeping all
night, without needing to be picked up or interacted with.”
Our panel agreed that this pressure to get ‘back to normal’ could
mean many women are cutting short that crucial period of
postnatal ‘R and R’.
“I think we’re almost programmed to feel guilty for not being
busy,” says TV presenter and founder of The Happy Birth Club,
Beverley Turner.
“I always encourage women to see that they are actively doing
something that’s very valuable. You’re probably not going to sit
down for the next 18 years, so make the most of the opportunity!”
But where does this kind of pressure to snap back to a
pre-children existence come from? Author and lactation
consultant Emma Pickett thinks it’s a big, societal influence.
“What’s interesting about other cultures is that the rest
period is actually enforced,” she says.
“The mother doesn’t think ‘maybe I’ll sit in
bed for six weeks’, she’s told to stay there,
while family members and friends will look
after the house.”
This kind of support is far from a given in our
modern, atomised family units, where the
extended family is often an oh-so-precious
resource. When grandparents do get stuck in,
they don’t always offer the most helpful advice.
“I’ve visited women who have been taught
about positioning the baby for feeding, and
things like skin-to-skin contact,” says Jo Gould.
“But then their mother-in-law comes along and says
‘you don’t want to make a rod for your own back’.”
It’s a message that’s entirely at odds with a responsive
feeding approach – adopted by Unicef Baby Friendly
and taught across the world since 2014 – that advocates
responding to a baby’s feeding cues.
But it’s worth remembering that the advice of well-meaning
grandparents (however dated) may be a hangover from a
time when a healthy childhood was far from guaranteed.
Clinical psychologist Mia Scotland believes previous
generations treated babies more like ‘things’, simply because
of the heartache of becoming too attached.
“That’s becoming reversed now in society, which is brilliant,”
she says.
“But it’s taken a few decades to actually view the baby as a
sentient, emotive being.”
The point is picked up by Jo Gould, who adds that “we need
to stop thinking of them as babies, but as people”.

Whatever their origins, our parents’ views can shape our own behaviour, even
in adulthood. Our panel spoke about a ‘family culture’ of breastfeeding, and
the influence this has on a new mother.
“I’ve had clients whose mothers breastfed and so they expect to breastfeed,”
explains lactation consultant Dee Bell.
“I had a lady yesterday who was really struggling with milk supply, and pushing
herself beyond where most people give up. I turned to her mum and asked if
she breastfed. And she said, ‘Oh yes, all four’.”
It doesn’t always work this way, of course. Teenage habits die hard, and for
some of us, a parent’s instruction is an invitation to do the exact opposite.
“There’s also an interesting phenomenon out there that women don’t take their
mother’s advice,” says midwife Angie Barrett.
“So over the last 20 to 30 years, they will increasingly listen to friends, peer
groups, people on television and online.”
It’s a theme picked up by Dee Bell, who says women today create their own
community of like-minded people if they’re unable to find them amongst their
immediate friends and family.
Peer support and social media are invaluable for a generation of new mothers
who may be at odds with their parents. But what about the next generation?
“If I could change one thing to support greater take-up of breastfeeding, it
would be about normalising it for children,” explains Mia Scotland.
“When I learnt to drive, I’d seen other people doing it for years before I tried
myself. If I’d never seen anyone drive a car before I wouldn’t know where to
start. It’s exactly the same for breastfeeding – we need to normalise it for the
next generation of parents.”

So what are our experts’ takeaways for new mums?
• Try to relax into your postnatal bonding time with baby.
This time is precious, short-lived and vital for both mother
and child.
• Don’t get too hung up on the advice of the grandparents
(or anyone else). Nobody can understand your baby’s
needs like you do … even if it doesn’t always feel that way!
• Peer support programmes and social media offer
countless opportunities to find people who can support
your breastfeeding journey.

In conclusion…
You probably won’t be surprised to hear that ‘support for mums’ was
one of the phrases our panel used the most. We know the intention
to breastfeed and the awareness of its benefits is there, but many
new mums don’t find the help they need to stick with it.
At the time of writing, Government plans to recruit and
train 3,000 extra maternity staff have been announced,
along with a recognition – raised directly by our panel –
that continuity of care is essential for new families.
This is a welcome step in the right direction, as long as
they are offered effective training. Many women are still
likely to form their own ‘village of peer support’, made up
of friends, online peers and family members who share
their views.
In closing, we’d like to highlight how important partners
are to this village. Dads and partners play a vital role in a
mum’s support network.
They’re becoming increasingly active in the social
dialogue around breastfeeding and, just like mums,
they’re looking for a more truthful narrative about the
reality of breastfeeding.
This is so important because – as one of our panellists put
it – the partners are ‘the ones who are there in the middle
of the night’ when things are proving difficult. After all, it
takes two to make a baby.
Whoever and wherever your support comes from, it’s
essential you ask for it. We hope you’ve found some
ideas here to help you get just what you need. Trust your
instincts, find your own path, and share your journey.

Other sources of information and support
Association of Breastfeeding Mothers
www.abm.me.uk/support-group
Breastfeeding Network
 www.breastfeedingnetwork.org.uk
 Tel 0300 100 0212 (9.30am to 9.30pm)
NCT new parent support
www.nct.org.uk
NHS Choices pregnancy and baby guide
 www.nhs.uk/conditions/pregnancy-and-baby/benefits-breastfeeding/

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