Posted by Madeleine Speed, the Pelvic Partnership, August 2017
About the campaign
August has seen the promotion of World Breastfeeding Week and various renowned organisations have been involved. The aim is to encourage strong partnerships of people and organisations to combine their efforts to promote breastfeeding globally and to work together to combat the barriers preventing it.
Not everyone is able to breastfeed and some women choose not to do so. There's no intention in this blog to make those women feel uncomfortable who cannot or choose not to breastfeed. However, for those who would like to breastfeed, most can do so successfully if given the right encouragement and support. Many women with Pelvic Girdle Pain (PGP) question breastfeeding but as PGP is not a hormonal problem, stopping breastfeeding will not speed up recovery. New research from a large study in Norway (2014) shows that breastfeeding can, in fact, improve recovery and advises that women with PGP should be encouraged to breastfeed.
Sadly, in many countries and including the UK, there are still many cultural, social and practical barriers that can prevent new mothers from breastfeeding.
Very few of us are 'naturals'
When my daughter was born, I had assumed that breastfeeding would come naturally. It didn't and I found it bitterly frustrating as did the unsympathetic young midwife who was assigned to help me. Luckily, with a more experienced and kind midwife, I stopped blaming myself and found that many women initially find it tricky while learning and that it's rarely instinctive. I don't know how true it is, but I was told that when my daughter was very tiny, her mouth was too small to 'latch on 'and it was only as her mouth grew that the all important 'latching on' was possible. Over time and with support, it became easier until I could manage to do it in any position and anywhere.
Although my experience may be reflected by many other women around the world, there must be a good many different barriers to breastfeeding as this is the 25th year of the campaign to promote World Breastfeeding Week. No doubt there have been real breakthroughs over this period. There are also some very large and influential organisations behind this movement such as United Nations Children Fund (Unicef), World Health Organisation (WHO), International Baby Food Action Network(IBFAN) and World Alliance for Breastfeeding (WABA) which suggests that there are some very big and resistant obstacles impeding progress.
An obvious barrier to breastfeeding
Looking at the campaign website, it is obvious that some of the challenge is with large multi-national companies which may overwhelm communities in developing countries (and developed ones for that matter) by persuading them to part with money they can't afford to buy powered milk they don't need, which can often be made up with unclean water and so causes serious health risks to the baby. Although there may be a place for formula for those who cannot breastfeed, it seems unethical to persuade women that it is in some way quicker, more acceptable, appropriate and nutritious than breast milk when there are so many evidence-based studies that prove that breast feeding is better for both the mother and the baby’s health and well-being.
There's no room for complacency within the UK, where breastfeeding also seems to be a challenge. Although just under three quarters of women start breastfeeding when their baby is born, this drops significantly to just 44% within 6 to 8 weeks. These figures come from a report published in March this year by Public Health England (PHE), with data from both the PHE and NHS England, and suggests that even when women are sufficiently motivated to start breastfeeding, it is often a real challenge for them to continue. There are health benefits from breastfeeding for both babies and mothers; among many other things, for babies there's an increased ability to fight illness and infection while for mothers, there's less of a risk of ovarian and breast cancer and osteoporosis. So it is worth women breastfeeding for as long as possible for the first two years (some organisations suggest these continue if breastfeeding is sustained for longer than 12 months). PHE recommends exclusive breastfeeding for the first six months and commissioned a survey of 500 women of small children to find out what influences prevented them from continuing to breastfeed.
The survey found that there were a number of barriers to continuing and many were linked to very real concerns for babies’ welfare. For example, more than half of those surveyed believed that breastfeeding could mean that there was no way to measure if their baby was getting too little or too much milk. A similar number of women surveyed thought that people might assume they need a special diet in order to breastfeed. Just under 3 in 10 were concerned that their babies might not get the right nutrients from breastfeeding. A large number of women (71%) were concerned that breastfeeding might prevent them from taking medication and (37%) mentioned that they wouldn't be able to use a birth control pill.
Targeted information and support could help address some of these concerns by providing information to schools via personal, health and social education. Healthcare services can provide knowledge during pregnancy and practical support for first mums, so that women are encouraged to start breastfeeding and have help to continue if they encounter setbacks (74% of the women surveyed feared that breastfeeding could be painful).
If there were more work places, cafes, restaurants and social venues that encouraged breastfeeding areas for mums, it would help offset some of the negative social attitudes where breastfeeding in public is discouraged. Government could take a stronger role in ensuring that employment law does not include terms that deter women from breastfeeding.
Start4life and ChatBot
PHE has already taken steps to promote a healthy start to beginning a family with its Start4life initiative. It also confronts some of the barriers to starting and sustaining breastfeeding by launching a new interactive Breastfeeding Friend known as 'ChatBot'. This Breastfeeding Friend is easy to reach via Facebook and can help to make breastfeeding a more relaxed and happier experience as it is available quickly and easily at any time of the day and night. As well as dispelling some of the more common breastfeeding myths, this facility can help to clear up any concerns that new mums may have. The ChatBot operates as a live chat tool which is able to respond immediately to questions about breastfeeding asked by the user.
ChatBot can certainly play a very useful role in encouraging new mums to continue with their breastfeeding. It helps increase dramatically the number of new mums who can access help with breastfeeding when they need it. I would also encourage new mums to take advantage of voluntary groups and NHS services that offer breastfeeding support. In my opinion, nothing beats the support of another person to reassure you and show you some tried and tested techniques to help you get the hang of breastfeeding.
When I was battling with breastfeeding, I was lucky to have the support of a mum who could guide me through the first few weeks. She was part of the National Childbirth Trust (NCT). Like so many new activities, achievement comes from learning by doing. I was also impressed by a breastfeeding clinic in my local hospital where staff similarly helped to share knowledge and practical tips to get me breastfeeding with confidence. We also need to support local breastfeeding clinics in hospitals and those run on a voluntary basis in public spaces such as cafes where practical help and support can be provided. Sadly, these facilities can fold when local services and funding are cut.
The survey also showed that celebrities and household names can provide positive role models for new mums. For example, Fearne Cotton and Blake Lively have raised awareness of the benefits for breastfeeding via social media. Their influence inspired 49% of mums surveyed to breastfeed their own babies. As a result, 64% felt more confident about breastfeeding in public because they knew celebrity mums did so. This use of social media can reach so many people instantly and such positive role models can be extremely valuable in raising awareness to women of childbearing age.
In addition, we need to instigate a wider culture of encouragement for breastfeeding so women feel happier about doing so in public places. This can be done through creating partnerships and organisations aimed at promoting breastfeeding as a natural and very positive part of family life. The organisers of World Breastfeeding Week this year call on advocates, activists, decision-makers and celebrities to forge new and purposeful partnerships. "Together, let's attract political support, media attention; let’s improve the participation of young people and widen the pool of celebrants and supporters."
It's clear that in the UK, we cannot rest on our laurels; there's still much to do and we all need to do our bit.
For more information, advice and tips on breastfeeding visit:
- NHS Start4Life programme including their Start4Life Breastfeeding Friend Facebook page or visit m.me/Start4LifeBreastFeedingFriend
- Breastfeeding Network and their helpline
- La Leche
- List of breastfeeding support groups in Scotland
- Practical suggestions for women with PGP who have chosen to breastfeed