Thursday, 7 August 2014

The line between support and pressure: A post for World Breastfeeding Week

When I was a child I went to a childminder. I don't have many recollections about that time, but one thing which has strangely stuck in my mind was the time when, after finishing my lunch, she told me to put my knife and fork together on my plate. I didn't understand what she meant and tried several different positions, all with the tips of the knife and fork touching - because that's together, right? But every time I tried, she would say, "no, put them together," in an increasingly exasperated tone until she lost patience and put them side by side for me. Only then did I realise what she meant. I felt pretty stupid.

What has this got to do with breastfeeding? Well, the other day I was talking to a friend who said that she'd read (I don't know where) that all the pressure to breastfeed is stopping new mums from even trying because they don't want the hassle. Having not read the source I don't know how true this is, but it does point to a problem, or a perceived problem, that there is more pressure than there is support. Telling someone to do something is useless unless that someone is shown how to do it, much like my childminder repeating an instruction over and over when I needed to be shown what she meant.

It's quite hard for me to write about this topic, as actually, I didn't feel pressured to breastfeed at all. I was asked at one of my midwife appointments how I planned to feed and I said I wanted to breastfeed, and that was it. Of our three NHS antenatal classes, half of one session was devoted to watching a DVD about breastfeeding and asking some questions afterwards. And when my Health Visitor paid her first visit she gave me some leaflets and a little demonstration with a doll and a knitted breast (which I found rather comical). Personally I didn't feel that constituted pressure, but then I wanted to breastfeed, so the information was useful.

Similarly, after birth I didn't feel particularly pressured. At one point when I was really struggling my husband said he thought I was being put under a lot of pressure, but I didn't see it that way. Yes, I had a lot of midwives giving me advice, and when I mentioned feeling like giving up and using formula they would just give more advice - but that was exactly what I wanted them to do. To me it was support, it was encouragement. When I said I was thinking of giving up I expected them to agree with me, and I knew that I'd be heartbroken if they did. So their continued advice gave me the courage to just keep trying until I cracked it.

I don't doubt that there are genuine instances when mothers are actually pressured - I've read stories of women being told they were bad mothers and didn't love their child enough if they gave up. But equally, I've probably read a similar number of stories about mothers being pressured to give formula for health problems such as slow weight gain or reflux, even though in the cases where the mothers persisted in breastfeeding these problems did work themselves out in the long run.

So when does promotion become pressure? I think the big problem lies in what happens in those few weeks after birth, perhaps even in the few days after birth. I was in hospital for three days, and if I'd left sooner I'm not sure I'd have been able to carry on breastfeeding, but a lot of women are rushed out after 24 hours or sooner. When in hospital, midwives are overstretched and just don't have the time to support women who are having difficulty with feeding. Back home, one midwife visit a day (if that) is not enough to keep breastfeeding going when things are tough - mothers need access to support groups, breastfeeding counsellors, peer supporters etc. Support groups aren't always easy to get to, and counsellors and supporters are usually volunteers who, wonderful and dedicated as they often are, have their own lives and therefore may have limited time. There is the option of seeing a lactation consultant, but my understanding is that many of these charge (as they are generally not employed by the NHS) so new parents with all sorts of other money concerns may not feel able to afford this service. And besides, are new parents told that this support is available? I was given a leaflet with the numbers of local breastfeeding counsellors (of the two in my town, one had given up counselling and the other didn't seem forthcoming with help - although I may have just got her on a bad day) but it was months later that I heard the term 'lactation consultant'.

This all adds up to a situation like little me desperately trying to figure out how to place my cutlery without being properly shown, then feeling embarrassed and ashamed that I couldn't. As much as pressure may be in the eye of the beholder to some extent, promotion without proper follow-up support will lead to mothers not being able to breastfeed then feeling guilty about it. I don't know what the answer is, but I think that more funding to allow for increased midwife numbers (in the wards and in the community), more support groups and more access to professional support such as breastfeeding counsellors and lactation consultants would certainly help. That funding, however, doesn't seem forthcoming as this government just doesn't see breastfeeding as a priority.

In the meantime, we'll just have to help each other. I have huge admiration for mothers who give up their time and money to train as peer supporters and breastfeeding counsellors, whose only payment is the knowledge that they're helping other mums. But even without that training, I think we can all play a part in normalising breastfeeding, talking about the highs and lows, offering support to friends and family members (even if that is just bringing a meal round so a mum can have an extra hour to focus on feeding instead of cooking) and generally showing that it can be done, in an unpressured, non-judgmental way.

If women are being put off by all the pressure to breastfeed, that's really sad. If you feel like that, please know that support is available, you may just need to do a bit of digging to find it. You don't have to figure it out on your own. And, when it does work out, it really is a wonderful thing.