Transcript Breastfeeding Promotion

‘Breast is not best – it's
normal!’
Challenges of breastfeeding
promotion
Dr. Amy Brown
Reproductive
cancers
Osteoporosis
Allergies
IQ
Weight
Heart
disease
Ear
infections
Infections
Obesity
Breastfeeding rates
100
90
80
70
60
WHO
Norway
UK
Exc UK
50
40
30
20
10
0
Birth
2 weeks
6 weeks
6 months
Differs by age, education, income, employment, country...
Physical difficulties
Knowledge
Beliefs
Confidence
Social networks
Support
Current study

Pregnant women and mothers
with baby up to two years old.


Questionnaire based
Closed and open items




Importance of breastfeeding promotion message
Critique of information and support given
Experiences of breastfeeding
Ideas for supporting new mothers
Group
Method
N
%
Pregnant
BF only
269
73.9
N = 364
FF only
20
5.49
Mixed feed
45
13.2
Unsure
30
8.24
Birth
BF
970
84.7
N = 1145
FF
175
15.3
Current
BF only
355
31.04
FF only
309
26.9
BF partial
163
14.2
Cows milk
227
19.8
No milk
91
7.9
Promotion in the UK
86.3% agreed that it is important to
promote breastfeeding
 78.9% believed breastfeeding promotion
affects decision to breastfeed.

However only...
24.7% of mothers agreed that methods of promotion are
currently excellent
 27.3% of mothers disagreed that the commonly used ‘breast
is best’ message is a good one
 23.5% felt that the information they received from NHS
resources was useful and adequate

‘We definitely need to be telling new mums
about why breastfeeding is so good. It is
important that they learn about the
differences between breast and formula and
make an informed choice. I think this should
play a larger role in antenatal education but
also be extended to everyone else. Everyone
needs to know why breastfeeding is so
important for mums to stand a chance of
making this work’
Breast is not best, it is the
normal way to feed a baby
Recognise that every feed makes
a difference
Tell us the truth – it can be
difficult
Don’t just focus on the health
reasons
If you want us to breastfeed give
us support
‘Breast is not best, it is the normal way to
feed a baby...’
‘Breast is best but this puts
breastfeeding on an unobtainable
pedestal for some people. This then
makes infant formula seem to be
reachable, normal and something that
has all the stuff needed for babies.
Instead breastfeeding should be
marketed as normal and perfect.’
‘Breast is promoted as being best. So if you
breastfeed you are the ‘best’ mother and doing the
‘best’ for your baby and making the ‘best’ choices.
If you can’t breastfeed where does that leave you?
A not good enough mother? A bad mother?’
Recognise that every feed makes a
difference...
‘If you really want to boost breastfeeding, you
have to abandon this black or white stance. I
know exclusive breastfeeding is best but there
are so many rules now. No bottles before six
weeks, no formula ever - no wonder people
give up. It's a spectrum, with exclusive breast
at one end, and exclusive formula at the other.
But it's promoted as a black or white choice
and most end up failing to keep all the rules
and giving up the whole thing’
Although we do need to tell mums that it’s important,
give them some credibility. Tell them the guidelines
but explain how all breastfeeding counts. You might
have a mum who baulks at the idea of six months, but
six weeks or even 6 days seems achievable for her.
That is better than not at all.
Tell us the truth – it can be difficult...
‘It would have helped to have been
honestly told that it's not a piece of cake
and that you have to learn it and that it's
normal to hurt/feel uncomfortable for
the first few weeks; that "it's natural"
doesn't mean "it's easy and will just
happen’.
‘It was all so positive. Breast is best for your baby.
Breastfeeding will help you lose weight. Breastfeeding is
a wonderful experience. Perhaps all true but in no way
the whole picture. When I then found it difficult, at times
demanding and my baby appeared to want to scream
rather than feed serenely I felt like a complete failure
and embarrassed and guilty that I felt that way to boot.’
Don’t just focus on the health reasons...
‘Although there are health differences
between breast and formula fed babies they
are not guarantees. Breastfed babies can still
get ill so if mothers are sold the idea of
breastfeeding on health benefits alone and
then their baby gets sick it can make them
feel like they did it wrong or that it wasn’t
actually that good and they might as well
formula feed as their friend who did have
really healthy kids’.
‘Breastfeeding is about so much more than health.
It is about cuddles, and closeness and bonding. It
saves time, costs nothing and you can never
forget to take it out with you. Why don’t we
emphasise these things more?’
If you want us to breastfeed give
us support...
‘Saying breast is best to a woman who
is desperate to feed but struggling to
do so is like telling someone how great
this bus is, how fabulous and cheap the
journey, how much better it is allround…but not telling them where the
bus stop is’.
‘They seem to spend so much effort telling everyone to
breastfeed, how important it is, how they must do it etc
etc. Then once you actually have the baby they just leave
you to get on with it! Of course mums then struggle, give
up and feel guilty…guiltier than they would have if they
hadn't been told just how good it was.’
‘You can tell women that
breast is best til the cows
come home. But if their
partner believes differently
and the mother in law is trying
to give the baby a bottle, who
do you think is going to win?
Tell mums by all means but
also tell their wider family’
‘The only thing you can do is
make it more normal and
accepted. If everyone grows
up seeing pictures of it, seeing
it on tv etc and seeing people
doing it, it will be a normal
natural thing to do’
‘Maybe have breastfeeding
mothers go into schools and
talk about it. I’m rather
horrified by the number of
small children who see me
breastfeeding and have
absolutely no idea what I’m
doing.’
‘Formula companies
advertise by showing
bouncy, happy babies rather
than just them sucking on a
bottle. Maybe we need to
see how we can promote
breastfeeding in other ways
than the more traditional.’
‘You have the ideal behaviour, the gold standard that we should be
aiming for. But we have to realise that not everyone can do that.
Yes we want them to do it (they want to do it) but we want
them to do lots of other things like not smoke or drink too
much. Realise that just feeding for a few days is an achievement
for some, or some will want to give formula too. Understand
some mothers need to go back to work. Support, understand,
enable. Nagging never works. Make breastfeeding seem normal
bit by bit and by taking a step back we might actually just get
where we want to be.’