25 Aug

Black Breastfeeding Week 2020 – thoughts from a mum, midwife and BfN volunteer

Andrea is a trained BfN Helper volunteer based in Wolverhampton. She is a mum of three (now grown up!) children. She worked as an NHS nurse and midwife for 18 years and now works as a Clinical Reflexologist and runs her own holistic therapy business. In this personal account, she shares some of her own views on Black Breastfeeding week, and experiences both as a mum and as a midwife.

I must be honest when I saw the title Black Breastfeeding week. I thought ‘Interesting! Why would we need a separate week looking at black breastfeeding? Isn’t all breastfeeding the same? Lol!’.  I then had a look at some of the links and listened to a talk by Ruth Dennison on YouTube.
 
I must admit my personal experience of breastfeeding with regards to my family and community has been a very positive one. I come from a family of nine children, two boys and seven girls. I am the baby of the bunch.
 
I watched all my sisters breastfeeding, and skin to skin was always important. My great Auntie would come and do the first bath for the newborn following by her famous stretch massage with olive oil. The baby would sleep for half the day after that.
 
Preparing a nursery for the baby was unheard of because baby was going to stay in the room with parent/s until he/she could sleep in a bed.
Co-sleeping was also a common thing, although this would only tend to be for the convenience of breastfeeding, or if the child was unwell and wouldn’t settle unless close to their mother.
 
One true thing about the black community is they do like to feed! The thought of someone going hungry, or not getting enough nourishment does not go down well.
 
This is where I think the point Ruth makes in her talk suggesting that black people having the tendency to mix feed comes into play. I believe formula milk was sold to us as ‘good for your baby’. And we still knew deep down that breast was also good, so we would think ‘well why not do a bit of both!’
 
When I had my children, even though I was only 19 when I had my son, I knew I was going to breastfeed. Establishing breastfeeding was not all plain sailing though! I found my mother and sisters were very encouraging, although having said that, if I was given any advice from healthcare professionals that may well have gone against what we had culturally inherited from our African ancestors, I was encouraged to listen to what the healthcare professionals told me.
 
For example, I was told to give my baby some formula as he was described as ‘a hungry baby’. I know now that it was probably down to just needing a slight adjustment to the latch. Because of this I did mix feed my son and stopped breastfeeding after 6 months.
 
Then when I had my twin daughters at the age of 28, and now a qualified Nurse. I was determined they would have no formula. This time I was confronted with a lot of pressure from healthcare professionals to give some formula. I was told “you can’t feed twins”, “they are small they need something more than breast milk” “they are losing weight you need to top them up”.
   
This time though, I was a little older, a little wiser and was even confident enough to reassure my mother when she thought maybe I should listen to the healthcare professionals. Don’t get me wrong – I would never encourage a women not to listen to the healthcare professionals, as I am one myself. But we do know at times we can give out conflicting advice, therefore I always encourage women to seek evidence based research for themselves enabling them to make informed decisions. 
 
I breastfed my twin daughters exclusively for 6 months until I introduced other foods, whilst continuing with breastfeeding up until 18 months old.
During my time as a midwife I was always an advocate for breastfeeding if this was the women’s choice and I would try to support her and the rest of the family to the best of my ability.
 
With regards to supporting women from the black community, I found because I had a full understanding of the cultural background, it would help me to better understand the woman’s needs.
 
In relation to the recent Black Lives Matter campaign that has been highlighted after the unfortunate death of George Floyd, I would like to share with you two personal experiences that may help to explain some of the inequalities in health related to Black people.
 
When my twins were born in 1990, a few days after their birth I was approached by a white midwife who had two little injections all drawn up and ready to go! When I asked what it was for she said she was going to give my babies a BCG injection.
 
She went on to explain the reason I was being offered this was because (in her words) ‘Asian people come to England and they live all together under one roof, they bring TB with them from India and that’s why we offer it to all black and Asian babies’.
 
Her reply made no sense to me. I was not Asian and I did not live in their houses with them. I lived in a community that consisted of Black, white, and Asian people, yet the injection was not being offered to white babies.
 
I decided I would try to investigate the matter further by asking other midwives and a doctor why it was so important for my babies to have this injection so soon after their birth. I understood the point being made with regards to some Asian communities, but I did not come under that category.
 
I could not get an answer that I was satisfied with. I decided not to give my babies the injection at that stage and they proceeded to have the injection in year 6 of school alongside the majority of children.
 
The moral of this story is that sometimes people of colour are just grouped together without any real consideration or thought. We have white and then BAME!
 
Secondly, when I worked as a midwife on the ward in the mid 1990’s we were provided with little bottles of ready-made formula milk that mothers could help themselves to whilst they were inpatients. Theses bottles of milk were supplied in such vast amounts that quite often they would go past their expiry date before they could be used.
 
Being a person that does not like waste I decided to investigate what happens to all this out of date formula milk. My discovery was shocking. It was being sent to places in Africa and given to nursing moms there!
 
What was even more shocking is that a lot of my colleagues did not see a problem with this, with some suggesting ‘well it’s better than nothing! Because they don’t have much food do they?’
 
We all know there are deeper conversations to be had surroundings this but I think I have ranted enough. With that said I’m still a little unsure about the title ‘black breastfeeding’.
 
Breastfeeding has been sold to us all (whatever colour we are) as something that is unnatural, inconvenient, embarrassing and difficult. I believe our biggest challenge is a reconditioning of our minds. Some of the challenges may well differ depending on our cultural backgrounds, but we all face similar challenges when it comes to breastfeeding our babies, irrespective of our colour.
 
We all have a common interest to make this a better world with less unnecessary discrimination and prejudices that just hold us back. 
 
It’s worth noting that this was some time ago and I know things have changed on maternity units now but it does demonstrate the attitudes that people had then and others have grown up with.
 

Thank you for sharing your story and thoughts with us Andrea.

07 Aug

Breastfeeding Support in Your Language

As World Breastfeeding Week 2020 draws to a close, we are delighted to showcase our wonderful Volunteer Peer Supporters speaking in some of the different languages that they offer breastfeeding support .

We hope that you enjoy hearing from them. 

 

Get in touch to find out if we speak your language.

 

#WBW2020 

06 Aug

Breastfeeding support during COVID-19 – A summary report in collaboration with Professor Amy Brown (Swansea University) and Dr Natalie Shenker (Imperial College & Human Milk Foundation)   

In May 2020, researchers from Swansea University and Imperial College conducted research in collaboration with the Breastfeeding Network to explore families’ experiences of breastfeeding support during COVID-19. 

 

Click the image to read the full report:

Covid Report Thumbnail

 

The following summary has been taken from the report, the full findings will be published in a journal later this year.

COVID-19 and lockdown has been a challenging time for breastfeeding families. Many have stopped sooner than they planned. Although this is unfortunately a common issue even outside of the pandemic3, many blamed a lack of support and lockdown experiences upon their decision to stop. 

We know that breastfeeding works best when women receive high quality practical and emotional support from professionals and peers including in the community1. This support had to change once lockdown was in place, with breastfeeding charity organisations making rapid alterations to the way they delivered their service.  

Some women were fortunate to be able to access this, evidenced by the multiple, varied queries they had answered during this time, covering both practical and emotional support needs. The majority of those who accessed this support found it useful and wanted it to stay, albeit alongside the benefits of face to face support once possible. For these women, their experience was positive, giving them easy and rapid access to support from the comfort of their homes. Notably, some women accessed this support over and above health professional support during the pandemic. It is clear that breastfeeding organisations provided a valued and needed service at this time – a finding reflected in similar previous research exploring the impact of the Australian Breastfeeding Association during this time4

Unfortunately, two further groups of women did not have the benefit of this support including those who did not realise it was available, and those who accessed it but either struggled or had a strong preference for face to face provision. These women found a lack of in person care challenging, struggling to convey issues or with technology, or simply wanted the reassurance of someone in the room. It is likely these experiences are not equal; those with more resources and fewer challenges at home will find accessing different sources of support in during difficult times easier.  

We found that women who did access charity support when they needed it were more likely to still be breastfeeding at the time of completing the survey compared to those who did not. To some extent their ability and willingness to seek support will in itself have supported these mothers’ ability to continue breastfeeding, most likely reflecting high motivation. However, given what we know about the impact of breastfeeding support for new families1, the range of queries posed to teams, and the positive experiences from some women in this survey, it is evidence that charity breastfeeding organisations have played an important role in ensuring mothers could continue breastfeeding through lockdown.  

In terms of where we go from here, the good news is that online breastfeeding support services are working well for many women, helping them to breastfeed for longer. However, many challenges and questions have been set, with some of the answers likely outside the control or remit of organisations offering support. Namely: 

  • How do we ensure better promotion of availability of online breastfeeding support so that more families know they can access it? 
  • How do we ensure these organisations are well funded to be able to meet the needs of more women? 
  • How to we enable all populations to access online support, including those who may not be able to afford technology or high-speed internet connections? 
  • What is needed to recommence face to face breastfeeding support, given other public spaces such as restaurants and public spaces are open?  

Given the known impact of breastfeeding upon population health5 and maternal wellbeing6, the government urgently needs to review its provision of care for new families, considering how it can ensure that more are protected in similar circumstances in the future. Although almost all mothers valued the option to receive online or phone support during lockdown, many expressed a wish for face to face support to continue. Recent press reports have stated that Health Secretary Matt Hancock wishes to encourage future virtual GP appointments unless clinical need, but caution must be urged in relying too heavily on a lack of in person support. It was clear mothers valued both the information they were being given, but also the warmth and connection from face to face support, and engagement with other mothers.  

Finally, the impact of breastfeeding charities in supporting mothers practically and emotionally through this stressful period should be celebrated. They have served a community of new mothers, whom without their support may have had a much more challenging breastfeeding experience and likely a premature end to breastfeeding altogether. Their value and contribution must be recognised.  

 

References 

1.     McFadden, A., Gavine, A., Renfrew, M. J., Wade, A., Buchanan, P., Taylor, J. L., … & MacGillivray, S. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, (2). 

2.     Unicef UK (2020) Unicef UK Baby Friendly Initiative statement on infant feeding during the coronavirus (COVID-19) outbreak.  

3.     McAndrew, F., Thompson, J., Fellows, L., Large, A., Speed, M., & Renfrew, M. J. (2012). Infant feeding survey 2010. Leeds: health and social care information Centre2(1). 

4.     Hull, N., Kam, R. L., & Gribble, K. D. (2020). Providing breastfeeding support during the COVID-19 pandemic: Concerns of mothers who contacted the Australian Breastfeeding Association. medRxiv. [preprint] – doi 10.1101/2020.07.18.20152256  

5.     Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., … & Group, T. L. B. S. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490. 

6.     Brown, A. (2018). What do women lose if they are prevented from meeting their breastfeeding goals? Clinical Lactation9(4), 200-207. 

7.     BBC (2020) ‘More Zoom medicine needed’ in NHS says Hancock https://www.bbc.co.uk/news/health-53592678

 

Download the Summary Report in PDF

05 Aug

No experience needed, but prior knowledge advantageous: What I learned about breastfeeding second time around – by Alyson Spicer

“Mmm, you’re feeding him like a multip.”

The midwife preparing to discharge me gave a satisfied nod. I wasn’t sure what she’d said. “Like a what?”

“A multip. You’ve had a baby before, haven’t you?”

Oh Christ, was it that obvious? Had parenting a toddler really left me looking so noticeably haggard? Did I have Weetabix in my hair? But then I looked down. I was (slightly wonkily) cradling my not-quite-a-day-old son in one arm, while making notes with the other hand and occasionally pausing to guzzle more peppermint tea or tweak my top out of the way. He was doggedly cracking on and doing his thing.

It occurred to me that I hadn’t really paused in my conversation, and that it probably looked like I wasn’t paying much attention to what he was doing. It was pretty clear how this contrasted with my first days of learning to breastfeed three years before: constantly questioning, “Am I doing this right? How do I know?”; watching like a paranoid hawk for every possible feeding cue; requiring all body parts at exactly the right angle, precisely the right arrangement of pillows, no distractions…it was all a world away from the sort of casual lolling that baby number 2 and I were currently engaged in.

So I took her point.

But, previous time served in the breastfeeding trenches aside, I also had another secret weapon that she wasn’t aware of. When my first baby was a year old, I’d trained as a breastfeeding peer supporter, with the Breastfeeding Network. I’d volunteered at drop in groups for parents and their babies, offering information and support to help establish and maintain breastfeeding – everything from explaining how milk supply works to practical tips on positioning the baby at the breast…even ideas for gently handling well-meaning but clueless family members.

So when it comes to breastfeeding I should, on paper at least, have a fair idea what I’m doing.

Working as a peer supporter and then going back for another crack at breastfeeding myself has been an interesting experience. At almost 6 months in, it feels like it’s come easily this time. In some ways that’s definitely true – no cracked nipples, no worries about supply, no issues with baby’s weight, no mastitis. But there have also been times when it is the most challenging and frustrating thing in the world (Newsflash: being a trained peer supporter does not make you immune to all breastfeeding issues. Who knew?). Oversupply. Screaming baby. Sleepy baby. Uncomfortable boobs. Always being on call. Cluster feeding. Sleepless nights. Exhausting days.

Not to mention the fact that, when my baby was just nine weeks old, lockdown was announced thanks to COVID-19. The prospect of getting out to a breastfeeding cafe to get support or meet other mums – something I was particularly looking forward to, having just moved to a new area – disappeared faster than you could sing Happy Birthday (twice).

These were all challenges to push through, with the aid of hundreds of biscuits and gallons of tea (and a few glasses of wine along the way). Not because I’m supermum/a martyr/a masochist. At one point I found my hormone-addled brain thinking I must have been blessed with some sort of brilliant talent for breastfeeding (My calling at last! Are wet nurses still a thing?) – but that’s nonsense.

Why does it feel easy this time? Because I was armed with knowledge about breastfeeding. That’s all. So when I hit those challenging and frustrating times (which are so often just a normal part of getting breastfeeding established), I usually knew what I had to do to fix them. Or at least how to push through until they fixed themselves.

I knew that babies usually feed incessantly for the first few days, and I knew it didn’t mean I didn’t have enough milk. I knew the difference between a bad latch and a good one. I knew that a sore spot was a warning sign of a blocked duct, and I knew how to clear it before it got worse. And most crucially, if I didn’t know what to do, I knew where to go for support and information.

Sure, the local group was closed, but the breastfeeding community is an incredibly committed one, and nobody was going to see parents left in the lurch if they could help it.

Within days of restrictions being imposed, virtual support groups were set up on Zoom. Lactation consultants increased their Skype support offerings. Midwives posted how-to videos on hospital Facebook pages. Breastfeeding supporters on maternity wards donned layers of uncomfortable PPE and soldiered on. I even heard of peer supporters coming out of retirement to volunteer on the National Breastfeeding Helpline, where demand rocketed. Support was out there, even if it couldn’t always be offered face to face.

But what about first-time parents – not just those raising their babies under the shadow of a global pandemic, but anyone who doesn’t know what to expect or who to ask. Who have been told “breast is best” (a truly unhelpful phrase, but that’s a whole other essay) but not offered any follow up support, and have expected everything to just naturally fall into place.

Looking from that perspective – without the knowledge that it could and would get better, and working on the assumption that if this natural process didn’t come naturally, then it just wasn’t meant to be – there were many points where I could very easily have thrown in the towel, very quickly.

Even with the knowledge that I have, there have still been days when it’s bloody hard. It has become blindingly obvious to me why many parents have a tough time breastfeeding, and why breastfeeding rates aren’t higher (only 1% of babies in the UK are being exclusively breastfed at 6 months of age, as recommended by the World Health Organisation).

I’m not saying that every breastfeeding issue can be solved by reading a leaflet or spending half an hour with a peer supporter. Of course it’s never going to be that simple (and Professor Amy Brown explains the reasons for that far more eloquently than I ever could). But the right information and support can truly make the difference between having to stop breastfeeding, and being able to continue.

It allows every parent to make an informed choice about how to feed their baby (and if parents choose not to breastfeed, as is their right, at least that decision would be based on knowledge of the facts rather than an automatic adherence to prevalent bottle feeding culture). As a bonus, better breastfeeding support could save the NHS billions, through prevention of future health issues in both the child and the mother.

Information on breastfeeding isn’t a secret – but it’s not always easy to find, and not everyone has access to the same level of care. Every GP and midwife in the country will likely tell you the benefits of breastfeeding your baby and will encourage you to do so. Not all of them are able to support you to actually do it, or even point you in the direction of someone who can – usually because of cuts to local authority funding.

It’s cruel, when you think about it (Emma Pickett, chair of the Association of Breastfeeding Mothers, calls it “inhumane”): to dangle the carrot of how brilliant breastfeeding is, but then snatch it away again if you don’t live in the right postcode. This isn’t a criticism of GPs or midwives, who do a fantastic job – it’s just often the case that they don’t have enough time, resources or training to offer the support that is so badly needed.

So what can we do? If you’re about to have a baby, you’re probably (understandably) preoccupied with the matter of safely getting another human out of your body. But try to also focus a little further down the road – find out as much as you can about feeding your baby, as soon as you can. It can feel daunting, but even a little bit of knowledge of what to expect will help.

Follow the Breastfeeding Network and Association of Breastfeeding Mothers on social media, and check out their websites – they have so much amazing information available. They also jointly run the National Breastfeeding Helpline – save the number in your phone, and call them whenever you need to speak to a mum who’s been there, and has been trained to help you out.

There are some really helpful books out there – head to the library if you don’t want to buy your own copies. Ask your midwife or health visitor about support available in your area – make a note of where drop-in groups are held, which days they run and contact details for the organiser. Consider checking them out before the baby arrives – if it’s a face to face group, at least you’ll know where you’re going if you need to pop along again with a baby in tow.

As previously mentioned, under the current circumstances many groups are now online and are offering virtual support – from the comfort of your own sofa! Arm yourself with the knowledge that breastfeeding may be difficult in the beginning, but that most issues can be resolved. Perhaps most importantly, make it clear to your family and friends that breastfeeding is important to you and that you’ll need their support. Make sure everyone is on the same page.

We all have a part to play in creating a society that supports breastfeeding. Look out for your breastfeeding friends and family members. If they’re struggling, don’t reflexively tell them it doesn’t matter – ask them what support they need. You could also write to your MP, asking them to attend meetings of the APPG on Infant Feeding, to help make sure infant feeding support is on their agenda. 

You don’t need to be an all-knowing guru, or be blessed with a magical talent for feeding babies. There’s no flashy product or clever gadget to buy. Just knowledge, kindness, support, perseverance.

For most of human history, it would have been passed to you by your mother, your sister, your aunt, your friends – cultural shifts mean that this is often no longer the case, so we can all step up to fill the gaps. A little information can go a long way towards helping to achieve breastfeeding goals – whether that’s feeding for a week, a month, a year, or longer.

As I finish writing this, I’m so grateful to everyone along the way who has supported my breastfeeding journey, and allowed me to reach a point where I can type with one hand while my baby nods off during his bedtime feed.

The midwives on day 1 in hospital; my husband helping me stick to my guns through the tough bits; my breastfeeding friends who gave me tips; the peer supporter who went above and beyond to help me; the tutors and supervisors who trained me and taught me so much (not just about breastfeeding!); and, through it all, my two sons who have somehow shown me the ropes even while learning alongside me.

I obviously couldn’t have done it without them, and I’m so proud of what we’ve achieved together. Even if they do leave Weetabix in my hair.