Saturday, November 16, 2013

Actually, Nick, there might be something in this vouchers for breastfeeding thing

Nick Clegg was asked yesterday, on his LBC phone in, what he thought about the plan to give women in deprived areas £200 in High Street shopping vouchers. This was one of these questions which he had to answer by instinct because he didn't know the detail and to give him credit, he said a lot of the right things. He talked about how no mum should feel pressured to breastfeed, but those who do should get the support they need. Whether he knows on a practical level what that actually means, though, is not clear.
He was unambiguous about one thing, though
Needless to say, it's not going to be Government policy to pay mothers to breastfeed.
I actually think that the benefits of breastfeeding, particularly in deprived areas, are so clear that it is worth trying anything that works.  Given Nick Clegg's commitment to tackling inequality, too, he might be very interested to find that research shows that a poor breastfed baby has better long term health chances than an affluent formula fed baby. If I had to pick just one of my many ramblings on various subjects for him to read, it would be this from last year following the UNICEF report that showed that the NHS could save £40 million a year by supporting breastfeeding and in particular this quote from research:
Breast fed children from lower socio-economic groups had better outcomes than formula fed children from more affluent families.
However, when resources are tight, I think that there are three very practical things  that come ahead of the vouchers scheme. I was on Radio Scotland's Call Kaye on Wednesday talking about them, and you can listen here to "Caron from Bathgate" at about 45 minutes in.

Good quality support

When I hit trouble early in my breastfeeding career, it was the specific support I received from La Leche League that sorted me out. I could so easily have given up because my local midwife and health visitor, lovely though they were, just didn't have the detailed information I needed to get through. Nor could they come out and sit in my house like LLL's Louise did. When I started supporting women myself, I found that some health professionals didn't know things I considered to be basic. Things are better now, but women often still can't access the help that they need.


Guilt seems to go and in hand with motherhood. When you're tired and upset and things aren't going well, you can blame yourself and think that you are the only one in the world who's going through it. You worry constantly that you are failing your baby. Attending a support group means that you meet others who are going through the same thing. Some will still be struggling with it. That group dynamic, led by someone who has some good evidence based solutions to offer in an informal and friendly environment, can do wonders.


Ante-matal breastfeeding classes are extremely useful in informing and preparing parents for what they might expect. Like all problems, the sooner you recognise it and intervene, the easier it is to resolve. If you can give people an idea of how to know if the baby is getting enough milk - and there are some very graphic leaflets around showing you exactly the size and colour of the emissions necessary to indicate that - they are more likely to call you in earlier.

I'd take it further, though. I've come across so many women whose families have undermined their breastfeeding. If their baby doesn't sleep, or cries a lot, breastfeeding gets the blame. They are told, often with the best of intentions,  that their milk isn't good enough or that the baby is hungry. I think there needs to be an ad campaign, or a class targeted at grannies to update them on current research, evidence and effective ways to support the new mother in their family.


Our culture has some very strange ideas about what breasts are for and how they should be portrayed. It equally has some very strange ideas about how babies behave and what they need. The baby that sleeps for four hours and only wakes up to be fed exists only between the wishful thinking pages of a text book. It's going to take a long time to achieve that and it will take getting many more mothers to breastfeed before we accept it as normal. That's why the vouchers scheme might be worth a shot. I'm looking forward to seeing how the pilot turns out. There is a very strong argument for putting as much money into encouraging breastfeeding as it takes to transform the health of our most disadvantaged babies.

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