Tuesday, February 17, 2009

Proper support for breastfeeding best prevention for rare condition

I do wish the BBC would get a sense of perspective sometimes and be a bit more responsible about how it reports things. They are running this story about a potentially serious condition that can rarely affect breastfed babies who don't take in enough milk in the first few days of life. They could easily have chosen a less scare-mongering headline than "Breastfed Baby Risk Investigated" which is bound to strike fear into the hearts of anxious new parents or parents to be.

It goes without saying that there are going to be problems if a baby doesn't get enough milk.

It's important that we know how prevalent this condition is and whether its incidence is increasing so that aopropriate action is taken to wipe it out.

The doctor who is running the study into this condition is clear that the answer is not to reach for the formula:

""Once we understand the scale of the problem we can work out what to do about it - how to spot it, and how to act on it," he said.

"But as far as I'm concerned the answer isn't more formula feeding, but increased support for breastfeeding from the outset in the form of counsellors.

"Women who are having difficulties should be monitored and helped - this is something society really needs to invest in."

Ante-natal breastfeeding classes can be very helpful - they allow mothers to create their network of support before the baby is born and also to recognise the signs that their baby is getting enough milk - and when to seek help.

The easiest way to tell is, logically, by what comes out. I wonder if Simpson's Memorial Pavilion (the maternity bit of Edinburgh Royal Infirmary) still produces the very useful, if graphic, leaflet which leaves parents in no doubt that their baby's output is sufficient. There is picture evidence of amount and colour of the bowel movements which indicate that all is well. I used to put about 3 tbsps of water into a newborn nappy and let mums in the support groups I ran feel the weight so they would have some idea of what a wet nappy should feel like.

The trouble is that we throw new parents out of hospital with an hours old baby and then fail to provide them with sufficient support in the community. A busy midwife with 10 minutes to spare once a day if the mum is lucky can't possibly give the time to either identify or advise if there are problems. That's no criticism of the midwives themselves, but of the managers who think that their workloads are realistic.

It's important that new parents have access to a breastfeeding specialist every day if they need it. This doesn't need to be a health professional - drop in baby cafes where there are other mothers there are great, as are breastfeeding support groups. Chances are, you will meet someone there who has been where you are and can give you the information to help. Telephone counselling, and even help by e-mail is provided by organisations like La Leche League and the NCT.

The Government still invests signficantly more money in supporting formula feeding than breastfeeding even in maternity hospitals, and if you take into account free milk tokens to low income households, then that imbalance is even greater. If this study teaches us anything, it's that it's time for that imbalance to be rectified. I always worry about the relentless promotion of breastfeeding without the support to back it up - it's like giving someone a bowl of very thin soup which they say will cure them and a fork to eat it with.

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Anonymous said...

You hear a lot about women who failed at breastfeeding and I agree that support is needed!
But I was wondering if there was any data on the numbers of mother's who failed at bottle feeding?

Caron said...

Women don't fail at breastfeeding -they encounter problems which they don't get accurate information to resolve. If anyone fails, it's the health servicde for not giving them the information and help that they need.

I don't think that we do anyone any favours by concealing the fact that human milk is way superior to any alternative - the World Health Organisation says that formula is 4th best after human milk fed at the breast, expressed human milk of the mother and milk of another woman.

Of all the women who give up breastfeeding in the first 6 weeks, 90% don't want to and regret it. We have to be better at making sure they have the answers to whatever is wrong.


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