Saturday 11 June 2011

Breast is Best

This is a rant. It's informed by my experience and some other mothers that I know, but it is, essentially, a rant. And actually its not about breast milk being better than formula, so don't worry if you formula fed your baby either out of choice or necessity, I'm not slating you at all, and in fact my own baby was predominately formula fed, apart from his first weeks of life.

In January I ran a "controversy week" and on my facebook page I asked for some topic suggestions, and one of them was the "lip service" paid by special care baby units to breast feeding. I didn't know where to start with this, so didn't run with it. But something happened last night that made my blood boil. And brought back a lot of painful memories. A friend of mine with a baby in a special care baby unit is not being supported in breast feeding her baby. Just like I wasn't either, nearly 2 years ago. It is a completely different hospital in another part of the country, but the practice seems the same.

I don't think anyone, no doctor or nurse or midwife, would debate that breast milk is best for premature babies. Usually from the outset you are asked to express for your baby, and are given a pump. This is confronting for many women, but it is essential to commence pumping quickly, to maximise the window of opportunity so that your body knows it has to do this, and also to ensure there is a supply of milk from early on. Expressing, as well as being pretty tough physically, is emotionally draining for many mothers of premature babies. You are told to look at pictures. Well, what if the picture of your baby is distressing, as mine was? He didn't look like a baby. He was covered in wires and machines. It hurt.

As time went on and I wanted to feed directly, that's where the opposition started, suprisingly (or perhaps not so) from Joseph's consultant. They claimed he was too frail and small (he was six weeks old by this point with no major problems apart from the usual prematurity issues). I perservered, and Joseph was getting the hang of it.

However, once in step down care, the "nursery" section of the ward, the attitude changed. It was bottle feeding all the way. I was prevented from demand feeding or even picking Joseph up except to change his nappy. I was actively encouraged to introduce bottles and formula. My milk supply rapidly dwindling (medication or stress I will never fully know) I caved.

After discharge, the neonatal outreach midwife (who was also a sister on the ward) asked me why I hadn't continued breastfeeding. When I ran through the above with her she was horrified. She had no idea that the practice of the staff in this bottom room was so different than her practice, and she said if I had only come to her and the nurse unit manager, they would have come up with a strategy, possibly lengthy rooming in, and they would have supported me. That made me feel even worse. They had both been on two weeks leave at the time this occurred.

Our unit had a really poor track record of breastfeeding. When I was battling the nurses about bottle introduction one of the consultants said "all our babies are mixed fed, its fine". I could have grabbed her by the throat and shaken her. None of them were "mixed fed" the ones who were scared lied about the breastfeeding. I only know two babies out of the twenty or so who came out fully breastfeeding their babies, and their babies were a lot later gestation than my baby, and their stays were shorter. Now whether the low numbers indicated a lack of will on behalf of the mothers, or lack of support, who knows, but surely with good support, women would be more keen to breastfeed.

I am of the opinion in that some areas of the country in some units, breastfeeding is seen as a pain in the neck, by some special care nurses and staff. It disrupts routine, its difficult to manage. And ultimately, and I know this is controversial, but it delays discharge. And I think really, this is at the heart of it. Far easier to get baby on a bottle, whether that be expressed breast milk (EBM) or formula, than on the breast. And I honestly feel that in some units they are under so much pressure to free up bed space, that they do not support mothers who want to breast feed their premature babies.

And this has got to change.

What no one tells you is that formula for premature babies is on prescription. Yep. It's free. We got free formula til Joseph was one. So that was around 9 months at £20 a tin and a tin lasted a week and a half. Do the maths. Governments are paying companies like Cow & Gate to provide formula for premature babies rather than paying for mothers and babies to stay together in units for a week or two to get breastfeeding established. And I am not sure this is right.


  1. such a good post.

    breast feeding is such a tender topic but i am not sure that the NHS are always best equipped. i was given formula on day one for the twins and as a nervous new mum I took it because the nurse said I should. My children were completly bottle fed by week 3 - I never remember conciously making the decision

    As an old timer with my third I refused to leave hospital until someone taught me to feed - I stayed in four days I have been breastfeeding now for over a year.

    j x

  2. I had the same experience so I sympathise totally. Something really needs to be done about the lack of support for mums of premmies to breastfeed.

  3. I totally agree. A fantastic post.

  4. That absolutely chimes with what happened to me. My son was sent home within 24 hrs of having the tube taken out of his nose even though I'd been expressing for six weeks and was nowhere near establishing proper feeding. He was equivalent of 35 wks gestation when coming home, so only a week after would have got the suck reflex anyway. Little wonder he never managed to do it. He was on formula within 3 weeks of coming home.

  5. That's terrible. Like you say, there is nothing wrong with formula feeding providing it is your choice. To have someone actively prevent you from doing something you feel is right for your baby is just wrong.