10 Apr

Guest post: Breastfeeding through pregnancy and beyond

Emma Pickett is the chair of the Association of Breastfeeding Mothers, and also works as a lactation consultant. Here we share her article on breastfeeding through pregnancy, and potentially continuing to breastfeed two (or more!) children, known as tandem nursing.

Let’s imagine you are breastfeeding your toddler and you discover you’re pregnant. It’s a much wanted pregnancy but perhaps you weren’t expecting that positive test quite so quickly. And now here you are, pregnancy test still drying, teeny tiny new person inside you and less teeny person on the outside, very much still in love with breastfeeding.

By still feeding your toddler, you’ve already been up against it in terms of what most modern cultures find comfortable and acceptable. Now you’re ticking the box for another misunderstood area of breastfeeding: one full of myths and nonsense and one lots of uneducated people claim to be experts about.

A useful starting point is finding a group online of mothers who have breastfed through pregnancy and beyond. That can be reassuring and immensely helpful but it’s worth remembering that every woman’s experience is different and it’s very hard to make predictions about how things will go for you.

I’m going to guess that when many people are looking at the drying pregnancy test, their thoughts shift to the consequences for their current nursling. Then soon, you wonder about the baby-to-be. Is breastfeeding during pregnancy ‘safe’?

What does the research say?

Let’s look at this study from 2012: A comparative study of breastfeeding during pregnancy: impact on maternal and newborn outcomes. Madarshahian F, Hassanabadi M. The study looked at 320 women in Iran, some breastfed during pregnancy and some did not. It showed that, “Results found no significant difference in full-term or non-full-term births rates and mean newborn birth weight between the two groups. We further found no significant difference between full-term or non-full-term births and mean newborn birth weight for those who continued and discontinued breastfeeding during pregnancy in the overlap group.”

So, breastfeeding during pregnancy didn’t ‘take nutrition away from the baby’ and it did not cause prematurity.

Another study of 57 Californian women from 1993: Breastfeeding during pregnancy. Moscone SR, Moore MJ. Just under half continued to breastfeed through pregnancy and after the new baby arrived. The new babies were healthy and appropriately sized.

However, it’s not all clearly positive. Another research study on 133 women in Peru found a link between breastfeeding through pregnancy and 125g on average less weight gain for the new baby in the first month. (Postpartum consequences of an overlap of breastfeeding and pregnancy: reduced breast milk intake and growth during early infancy. Marquis GS, Penny ME, Diaz JM, Marín RM. 2002)

Another study looked at 540 women in Egypt with sub-standard nutrition. Effect of pregnancy-lactation overlap on the current pregnancy outcome in women with substandard nutrition: a prospective cohort study. Shaaban OM, Abbas AM, Abdel Hafiz HA, Abdelrahman AS, Rashwan M, Othman ER (2015). This was not all positive news with increased risk of maternal anaemia and issues with infant growth. BUT there was NOT an increase in miscarriage risk when women breastfed through pregnancy.

How’s your nutrition and how are your iron levels? If you are a mother with access to good nutrition, it appears you have less reason to be concerned.

Does breastfeeding trigger early labour? Even for those women who were struggling with other issues, it doesn’t appear so.

Hilary Flower is the go-to person on the subject of breastfeeding during pregnancy. Her book, “Adventures in Tandem Nursing” is considered the bible on this subject. It was first written in 2003 and is now out-of-print but a second edition is currently being worked on. Her focus was on bringing the facts to pregnant mothers and she looked at this idea of triggering contractions or early labour in detail. She reminds us that we need oxytocin to trigger a milk ejection reflex (the letdown reflex) and this is also the hormone that can trigger uterine contractions. However, this doesn’t mean that breastfeeding in pregnancy triggers risky contractions and there are several safeguards in place. We need hormone receptor sites to exist before hormones get acted on by the uterus and they remain small in number until around 38 weeks of pregnancy. And even the hormone receptors that are in place can’t really do their job of causing contractions as there are oxytocin blockers in place like progesterone (made by the placenta) and proteins missing which would act as special agents to help the oxytocin do their job. Triple protection! So, oxytocin can carry on doing its breastfeeding jobs while baby remains protected in the uterus.

I think we can say science is on our side. Which makes sense when you think that throughout history women have been breastfeeding older babies and having sex and getting pregnant.

Do you know anything about the history of pregnancy testing? Today, we might know we are pregnant days after conception. For generations, it was based on guess work, someone examining your urine’s appearance and something about rabbits (early 20th century pregnancy tests involved injecting urine into a rabbit and observing a change in their ovaries). A lot of breastfeeding women couldn’t rely on whether they had missed a period as periods may only just be settling in or may not have even appeared yet. Some breastfeeding mums get pregnant without yet having a period. They ‘catch the first egg’. Then they go and see their doctor and the doctor brings out the chart that predicts due date based on last menstrual period, “errr…2015?”

Nature isn’t daft. If breastfeeding during pregnancy was hazardous, I doubt you nor I would be here. Hilary Flower mentions that if you have a high-risk pregnancy, you should talk to your health care providers about your specific situation but if you are safe to continue sexual intercourse, breastfeeding is very very likely to be fine too.

Science might say that breastfeeding during pregnancy is safe but that doesn’t mean you have to do it, or that it’s super easy for everyone. There is a wide range of experience and you need to reflect on what feels right for you.

The age of your current nursling might be a factor in your decision. If they are 7 months, you might feel differently than if they were 4 years old and you were getting a bit tired of breastfeeding a plastic truck several times a day.

If your baby is 7 months, or at any age where milk is still a significant proportion of their nutrition, you’ll need to do some thinking. It’s likely they will need an alternative source of milk (still doesn’t mean breastfeeding needs to end). Most women who are breastfeeding when they are pregnant do notice a decrease in milk supply – often a very significant one. This can start as early as the first few weeks after that positive pregnancy test. Whatever you do, your body will be resetting in its lactation story and you will go back to making colostrum during your pregnancy. It happens at different times and some mums might go through a period of feeling like they have virtually nothing and their child is ‘dry nursing’ before colostrum then appears and quantities seem to increase again.
Nurslings behave differently during the changes of pregnancy. Some self-wean as the quantities drop. Some self-wean when things seem to taste a bit different. Some care not a jot that changes are happening and would carry on breastfeeding whatever was coming out or if nothing was.  Word of warning: colostrum has a laxative effect. That’s one of the reasons it’s so great for newborns as it helps them to pass meconium. Potty training a toddler? Brace yourself.

What else can you expect? For some women, not much else. Pregnant and breastfeeding felt a lot like not pregnant and breastfeeding. You’ve just got to worry about the bump being in the way towards the end. (This was my experience).

Other women struggle with sore nipples from increased sensitivity that probably has something to do with hormonal changes and sometimes aversion to breastfeeding can be a problem.

The reduction in milk supply can also be upsetting for some. It can come at a time when we might already have mixed feelings about giving birth to another child. We know what positives a new sibling can bring for your toddler but there’s sometimes a feeling of loss or even guilt as we’re concerned how their life is going to change – especially in the first few months. And when milk seems to be going too – that can feel doubly hard. Unfortunately, there isn’t much you can do to increase milk supply in pregnancy when changes are starting. All the usual stuff doesn’t work: pumping, herbs, just feeding more frequently. Many herbs that we might consider when we want to increase production are not thought to be safe in pregnancy. It appears that milk storage is affected for almost all women (only a small minority don’t feel their supply has diminished). You might want to consider using a supplementary feeding system at the breast, so baby can remain attached and get other milk through a lightweight tube.

It’s important to remember though (and this is engraved on the heart of many of us in breastfeeding support) that BREASTFEEDING IS NOT JUST ABOUT MILK. Your little bloke with the plastic truck might not care a jot if supply diminished and milk tastes different because this is only partially about milk. It’s also about connecting to you, relaxation, safety and contentment. That big world out there is only getting bigger and breastfeeding is home.

If you are happy to continue with that, breastfeeding is still working.

You might also be wondering what life is going to be like when the new baby arrives. How does breastfeeding work when there is a newborn and a toddler? Pretty much like it did the last time there was a newborn – nature gets on with it. While breastfeeding during pregnancy doesn’t ‘use up’ colostrum, during in the first few days after the birth, it’s sensible to let the newborn do their thing first before the older nursling gets a turn. And once your mature milk transitions, you can make decisions based on how your newborn’s nappies and weight gain are getting on. Sometimes there is talk of restricting a baby to one breast and a toddler to another. Most lactation consultants agree that’s not sensible. Ideally you want the newborn to have the option of both and continue to have the option of both fully lactating as their breastfeeding experience continues. Toddlers feeding after newborns are very effective at helping a milk supply to develop and tipping into oversupply is more of a worry than running out of milk. A toddler is also fabulous at relieving engorgement in the early days post-partum. Flashback to my 3-year-old son announcing proudly to his grandmother (not entirely on board with natural term breastfeeding) that he ‘helped mummy because her milkies were really full’!

Does the toddler feel jealous of the baby having ‘their milk’? I have yet to meet a mother who feels that’s been a problem. In fact, many feel that it can help in the arrival of a new member of the family. Toddlers are likely to need some extra support, but breastfeeding is still there for them. The thing that has always provided comfort and reassurance. And good news! It’s changing back to regular milk and there’s lots more of it! What might not be sensible is weaning a toddler in the last few weeks of pregnancy so if you are thinking tandem breastfeeding really isn’t for you, it might be wiser to wean sooner rather than just prior to baby arriving. If that’s you, I wrote an article on weaning an older child which you might find helpful:
http://www.emmapickettbreastfeedingsupport.com/twitter-and-blog/weaning-toddler-bob-and-pre-schooler-billie-how-do-you-stop-breastfeeding-an-older-child

It sometimes happens that an older child who hasn’t breastfed for a while asks to do so again when a new baby is on the scene. That might be because they weren’t a fan of the colostrum. Or there might be some other things going on in their head. Are they ‘testing’ whether they still get to be your baby? Are they just curious? Some resume breastfeeding at this point. Some are happy to have a taste of expressed milk in a cup. Some ask and run away giggling and don’t mention it again. There’s no right or wrong answer on how to deal with this but ideally, we’re looking for ways to minimise rejection and any refusal is done so as gently as possible.

Still think it’s a bit hippy and ‘risky’? This is the American Academy of Family Physicians (folks on the opposite end of the spectrum from hippy and risky):
“Breastfeeding during a subsequent pregnancy is not unusual. If the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman’s personal decision. If the child is younger than two years, the child is at increased risk of illness if weaned.
Breastfeeding the nursing child during pregnancy and after delivery of the next child (tandem nursing) may help provide a smooth transition psychologically for the older child.”

We can’t guarantee it’s all smooth but breastfeeding through pregnancy and beyond is something mothers have been doing for millennia and there’s very little to fear and lots to embrace. Those of us who do it are often those who have taken the path of child-led weaning and it instinctively feels right to let the nursling make the call. But you’ll make the decision that’s right for you.

02 Apr

“A lifeline when no one else gives you an answer”: Evaluation of drugs in breastmilk service launched today

2nd April 2019

A new report is published today evaluating the impact of the Breastfeeding Network’s Drugs in Breastmilk Information Service. This service provides evidence based factsheets and one to one support about taking medications or having medical procedures while breastfeeding to over 10,000 parents and professionals each year.

The Drugs in Breastmilk information service was set up more than 20 years ago by the Breastfeeding Network and has been funded by the charity ever since. It was established in response to reports of many breastfeeding women receiving inconsistent or inaccurate advice from some health professionals when they were prescribed a medication or procedure. This service enables them to access the latest evidence-based information on risk, from an experienced pharmacist.

The research, led by Professor Amy Brown in the Department of Public Health, Policy and Social Sciences at Swansea University, will be presented at the All-Party Parliamentary Group for Infant Feeding and Inequalities in Westminster today. It explored the experiences of mothers, health professionals and mother supporters who had used the service.

The evaluation found that the majority of mothers who contacted the service were enquiring about every day medications and procedures, such as antidepressants or antihistamines, where there is an established evidence base that continuing to breastfeed whilst taking these medications is not harmful. Yet women had been told by their GP or pharmacist that they could not continue breastfeeding whilst taking it. On contacting the service, mothers were given the information that they could continue meaning that many had the confidence and reassurance to continue breastfeeding for longer.

Professor Amy Brown explained ‘The findings are a concern as we do not know how many women did not contact the service and stopped breastfeeding through incorrect advice from medical professionals. This service is clearly plugging a gap in the knowledge of some GPs which should urgently be tackled by considering how medical professionals are trained not only in the risks of medications and breastfeeding but also in the value of breastfeeding for many mothers. Mothers highly valued the information they were given by the service as it enabled them to continue breastfeeding and take the treatment they needed. But they also particularly valued the support and reassurance given by the service around making any decision. Mothers described how before contacting the service they often felt dismissed and that their desire to breastfeed did not matter, but after contacting the service they felt reassured and listened to for the first time, describing the service as ‘a lifeline’.

Indeed, the evaluation examined how mothers felt before and after contacting the service, highlighting a highly significant improvement in maternal wellbeing, Mothers reported they felt more informed, confident, reassured, supported and listened to after contacting the service, even if they were given the advice that they couldn’t breastfeed whilst taking a prescribed medication.  

Dr Gretel Finch, Research officer for the project noted ‘We expected to see that the service would be rated positively by those who used it but were struck by just how significant the impact was for maternal wellbeing. Even when mothers were told that they could not breastfeed and take a medication they reported feeling listened to and cared for, rather than simply being told they couldn’t breastfeed. Given what we know about the devastating impact not being able to breastfeed can have for maternal mental health, this service is playing a key role in helping alleviate that by providing women with answers and support, rather than a simple ‘no’.

The report found that for many mothers, if they had not received information from the service, they would have made the decision not to take their prescribed medication, rather than stop breastfeeding. GPs often assumed mothers would stop, but in reality, they valued breastfeeding so strongly that they would put their own health at risk in order to continue doing so.

Dr Heather Trickey, Research Fellow at the University of Cardiff School of Social Sciences explained ‘It is clear that breastfeeding women who are given incorrect information when prescribed a medication face a difficult choice. Many stated that they would decide to continue breastfeeding over taking the medication, putting their own health at risk when in fact there was usually evidence that it would not be harmful to continue breastfeeding. This is a common theme for new mothers when it comes to information about caring for their baby. Many are not given accurate information by health professionals about the real risks to them and their baby putting their physical and psychological wellbeing at risk. Women deserve the level of accurate information and support this service brings.’

The evaluation clearly shows the impact the service has and the gap that it is filling. As a result of the report the Breastfeeding Network are calling on the government to ensure that this gap is not left to a charity organisation to fund.

Shereen Fisher, Chief Executive of the Breastfeeding Network, who commissioned the evaluation, said ‘Many of the mothers who contacted the service stated that they were only able to continue to breastfeed because of the support and information they received. The service is vital for women yet we rely on funding from the charity, goodwill and fundraising appeals to provide it. Given the impact of the service upon maternal and infant health and wellbeing we are calling for the Government to reverse cuts to the Public Health Grant and to provide funding to support the continued work and expansion of the service’.

The BfN Drugs in Breastmilk Service can only continue with sufficient funding.  To donate to help keep the Drugs in Breastmilk Information service running, text BFNDIBM to 70085 to donate £3. This costs £3 plus a standard rate message. Alternatively, you can opt to give any whole amount up to £20 by texting BFNDIBM 5 to donate £5, BFNDIBM 15 to give £15.

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For more information:
Felicity Lambert, BFN Comms Officer felicity.lambert@breastfeedingnetwork.org.uk / 07979872301

www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk
www.facebook.com/BfNDrugsinBreastmilkinformation

21 Mar

Press release: The Breastfeeding Network’s Pharmacist, Dr Wendy Jones to receive MBE at Windsor Castle on Friday 22nd March

Wendy Jones MBE, BSc, MSc, PhD, MRPharmS

One of the founding members of the Breastfeeding Network (BfN), and their resident pharmacist for over 20 years, Dr Wendy Jones, will receive an MBE at Windsor Castle this Friday.

Wendy set up the BfN Drugs in Breastmilk information service in 1997 after being asked to update a basic information pack about the safety of drugs in breast milk. Gradually the service grew and now she now leads a small team of volunteers who offer individual support to more than 10,000 families and healthcare professionals each year via email and social media. 

Commenting on the award which Wendy receives for services to mothers and babies, Shereen Fisher, CEO of the Breastfeeding Network, said:

“We are delighted with the news that Wendy is receiving this award in recognition of her work. Wendy is an inspiration to us all.  She has dedicated the last twenty years to supporting mothers and families through the drugs in breastmilk service she founded.  Day in day out, she responds to phone calls, emails and now social media messages from parents and healthcare professionals who need reliable, evidence based information about the safety of medications and treatments while breastfeeding.  The work she does allows parents to make their own informed decisions, undoubtedly saving breastfeeding journeys.”

A soon to be published evaluation of the drugs in breastmilk information service was overwhelmed by responses from mums and healthcare professionals when they were asked for their thoughts on the service. A mum of four said: “Wendy has saved me and my daughters many times over. I can honestly say I would have committed suicide after my second baby was born had it not been for her support to keep taking my meds and to keep breastfeeding.”

A consultant paediatrician in the same evaluation said: “Wendy’s information is presented in a way which is accessible to non-medical mothers to understand, but also written in a way that doctors who know little about breastfeeding will take seriously.”

On hearing about the award, Wendy said: “I couldn’t be more proud that I have been awarded an MBE as Founder of the Breastfeeding Network Drugs in Breastmilk Service for services to Mothers and Babies.  In 1995 when I wrote the first information on drugs in breastmilk I could never in a million years have imagined this happening. I followed my dreams and the opportunities given, massively supported by my family and particularly my husband Mike who gave me the opportunity to leave paid work and develop my passion.

Nothing I can do would be possible if breastfeeding advocates didn’t spread the word that you can breastfeed as normal when you take most medication or there are ways around it. So, this MBE is for all of you too for all the hard work you do in groups, on the helplines, face to face, via social media and just at the school gate or supermarket checkout. You are all amazing.

Thank you everyone for your wonderful comments. I’m treasuring them in my heart and taking inspiration from them to keep challenging and to carry on supporting mums, dads, grandmas, peer supporters and everyone to keep breastfeeding these special precious babies. I’m hoping that this is the beginning of a year when breastfeeding and its support gets the recognition it deserves and just maybe some funding as a public health issue.”

Earlier this year Wendy was also awarded a Points of Light award by the Prime Minister.

The BfN Drugs in Breastmilk Service can only continue with sufficient funding.  To donate to help keep the Drugs in Breastmilk Information service running, text BFNDIBM to 70085 to donate £3. This costs £3 plus a standard rate msg. Alternatively, you can opt to give any whole amount up to £20 by texting BFNDIBM 5 to donate £5, BFNDIBM 15 to give £15, etc.

Wendy’s story

Over the past 40 years, Community Pharmacist Dr Wendy Jones has made a huge impact on the lives of thousands of families across the UK. In this time she has helped people manage issues such as weight loss, cardiovascular disease and smoking cessation alongside her general pharmaceutical duties, but her real impact has been felt by new mothers. Wendy has dedicated her life to researching the effects of medication and medical treatments on breastfeeding mothers and their babies.

In 1997 she was one of the founder members of national charity The Breastfeeding Network, and in 1999 she set up the Drugs in Breastmilk helpline. This telephone helpline was set up in response to the number of questions the charity was receiving from breastfeeding mums about prescribed medications. At that time there was no easily accessible, reliable information for mums who had been told to stop breastfeeding in order to take certain forms of medication. Wendy has singlehandedly filled this gap.

In many cases where a mum is told to stop breastfeeding, there is no evidence to support the need for this. The mum can be left feeling she has no choice but to stop breastfeeding (even if she wants to continue), or she may choose not to take the medication prescribed. The impact of having to make a decision like this can be far reaching for some mums. In a very few cases, evidence shows the mum does need to stop breastfeeding, and then, being able to understand the reasons behind this may help the mum with this process. In most cases, the evidence shows the mum can continue breastfeeding safely and for many, to know this is possible is a huge relief.

Over the years, the service Wendy provides has grown – she now leads a small team of volunteers who offer individual support to more than 10,000 families each year via email and social media.  She is contacted by mums and families, as well as health care professionals.

She has also written more than 50 information sheets about the most common medications breastfeeding mums ask about – these infosheets cover everything from postnatal depression and anxiety to cold and cough remedies, to contraception, hayfever, headlice and norovirus.

She was awarded a PhD in 2000 and has written several books on this topic, as well as speaking at numerous national and international conferences, study days and other events.

She is extremely well known and highly regarded by breastfeeding supporters across the world. Her knowledge, patience, understanding and support has been felt and appreciated by thousands of families.

With her unending, selfless commitment and passion Wendy is an inspiration to many. Her work is so far reaching, it is impossible to measure the difference she has made.

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Notes to editors:

For more information:
Contact Felicity Lambert, BFN Comms Officer
felicity.lambert@breastfeedingnetwork.org.uk / 07979872301

https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk
https://www.facebook.com/BfNDrugsinBreastmilkinformation

11 Mar

Guest blog: Who says young mums can’t breastfeed?

BfN recently attended an event in Edinburgh run by Family Nurse Partnership, an organisation that provides dedicated support for young mums. At this event, BfN Supporter Melanie met a young mum called Susan (pictured above with her daughter Maisie). Melanie was so inspired by Susan that she asked her to share her story. Susan agreed, and has written this guest blog for us.

I fell pregnant with my daughter at the age of 19 and gave birth at 20. I have always felt very maternal and knew that my one real dream in life was to become a mother.

Sadly I lost my mum 4 months before I fell pregnant, this is a pain that never fades. However my little girl has brought so much joy back in to my life and I really believe she was sent to me by my mum.

I said from the very start that I was going to try and breastfeed as I wanted to do what was best for my baby. I told my midwife I was not going to put pressure on myself or my newborn and if it was too stressful or we had problems then I would change to bottle feeding.

On 4th November 2017, I gave birth to the most precious gift I’ve ever received. My daughter Maisie. I had a horrendous pregnancy and suffered with hyperemesis gravidarum and was in and out of hospital constantly. After a traumatic birth, I was very weak and I was kept in the labour suite longer to be monitored. During this time I had Maisie laid on my chest, skin to skin. The best feeling in the world. Within a few hours of her birth she became hungry and knew exactly what she wanted and how to do it. I was in total awe of this magical feeling and bond I was sharing with my baby and I knew in that moment that I wanted to give this “breastfeeding journey” a real go.

For the first few weeks it was quite a blur and some days were tough as she cluster fed. I worried that she was hungry and wasn’t getting enough, but with the support of my health visitor and support groups I soon realised this was all normal behaviour. I planned to breast feed until 6 weeks.

By 6 weeks we were doing so well, I wasn’t willing to give up. Maisie was very unsettled and colicky and so people would come out with retorts such as “its cause your breastfeeding” or “she will sleep better on formula”. I tried not to take any of these comments to heart but in the end I was exhausted and I decided what harm would it cause if she just took 1 formula bottle a night from daddy so I could rest?

Well if only I had known! She broke out in a horrible rash and I freaked. We rushed her straight to the hospital who ran tests and then came back to us with “its just baby acne”. So off we went home, I felt awful for over reacting and wasting hospital time.

However over the next few weeks this rash persisted and she became so unsettled and I knew something wasn’t right. It took a lot of trips to the hospital and GP to get an answer. When she started to have blood in her nappies I was adamant that there was something wrong so pushed for a diagnosis.

This is when we finally discovered she had CMPA. This is an allergy to the protein in cows milk. We cut out the added formula top ups straight away. I felt so ashamed and upset that I had been feeding my daughter something that was causing her so much pain.

At this point, I had two choices. Stop breastfeeding and feed special prescription formula, or change my diet to exclude cows milk and continue our breastfeeding journey.

I wasn’t ready to stop and wanted to give my daughter the best again after what she had gone through. So that’s what I did.

It was very hard and on some occasions I was so ready to give up but watching her feed and seeing the comfort and love she got from it I powered on through.

We did trial some special formula to which she couldn’t tolerate either so it became clear that breastfeeding was our only option.

None of my friends really understood, a few did but not all. I often got comments like “just put her on the formula it will be easier for everyone” or “well you can’t breastfeed her forever can you!?”

These comments really got to me, and I tried my hardest not to let them eat away at me.

I was part of online support groups and these really helped me through the darkest of days.

Watching my daughter grow and learn boosted me though and helped me to keep going with our breastfeeding journey.

I returned back to study when Maisie was 9 months old. I was worried how I was going to manage to feed her and keep my supply up.

Thankfully my college have been so supportive and have gave me my own private room with fridge to express in. Everything went smoother than expected with this transition.

My daughter has just turned 1 year old and I always thought I would definitely want to stop by this stage but, after everything that we have both been through to get to where we are, I’m now in no hurry to stop.

I will continue to feed my daughter for as long as I see fit and as long as she wants to, I have learned to ignore the negative comments and focus on how far we have come.

Never let anyone tell you that you can’t, and if they do, use it to fuel your fire to keep going. Mothers have hidden strength inside and you will find it. So when any of you new mummies are having a bad day please remember you are not alone and that it does get better.

The good days will always outshine the bad ones.

If you need breastfeeding support, please contact the National Breastfeeding Helpline, or reach out to the BfN through our website or social media channels (click here for our Facebook, Instagram & Twitter). We will always strive to give evidence-based, mother-centred support and information to help you make the right decisions for your family.

05 Feb

A new year’s revolution: take time to enjoy the stillness.

Kirsty Cummins is one of our National Breastfeeding Helpline Link Workers. She has written this post about changing the perception of new year as a time to make huge changes or rush to achieve unrealistic goals. Instead, she’s championing a more laid back approach, taking cues from nature to rest, reflect and prepare for the excitement of warmer months ahead – a near-perfect analogy for the sometimes intense experience of new parenthood.

A New year makes me uneasy. I dread all the slimming programmes on TV, the ‘how to get yourself in shape’ articles, whether physically or mentally. I struggle in January and February and the last thing I need is more media making me feel I am doing a bad job of it. That the left over 12 boxes of mince pies (yes I DO bulk buy my favourite winter treat) cannot be touched because I should no longer be indulging, and that I should be making health choices (whatever they are) or else I am failing. I feel it unfair that it is the end of January that heralds the release of the small chocolate gooey filled eggs that are my favourite treat, when the guilt of having done nothing still lingers. Why is it now that I feel I am being told to don a stretchy outfit and be physical when I would much rather do that when the nights are lighter and I feel more alive? My head, if I let it, can be so full of what I am not achieving in this murky, dank, cold time that I forget what IS actually going on.

I have always dreaded that certain time in September when you know the summer is over. I would feel bereft that the summer was all but lost to me and all I had ahead was winter and cold and having to pretend that I love Christmas and New Year, when I would much rather carry on enjoying the warmth and the hope that truly fills my soul in summer. I would ignore the beauty of autumn because it heralded the coming of the cold.  I would tell anyone that would listen about my woes in winter. I did exactly this to a lovely lady who was treating me with acupuncture last January. And her reply has turned things upside down. She mentioned the Chinese, as she often does with little snippets of Chinese beliefs and said quite simply that January really should be a time to slow down and make things as simple as possible and really enjoy the stillness before the spring slowly starts to sneak its way in. In that pause you might think about what it is you wish to achieve over the whole of the coming year.

Thinking about it now I am guessing this would be connected to Chinese New Year which is sometime between 21st January and 20th February, depending on the New moon and building up to the New Year in the quiet, sleepy weeks gives you time to reflect. Perhaps it was her own ideas and not Chinese beliefs but either way I listened and remembered what she said to me.  It seemed important to remove the need to take quick, drastic action in January and the guilt that I hadn’t done that sulking away to itself in the corner in February.

She was suggesting that if I stopped hating the supposed emptiness of this time of year I might start to find the time to reflect and truly listen to what I do want and what I do appreciate.

Whilst simple and glaringly obvious somehow it was a jolt to my own beliefs and I decided to really try very hard to do just that. To find the beauty in the weather and the land and the lack of much to do. I decided to remove things from my life that made me unhappy and to think what would really make my life feel better all year round.

 I really took time to ponder that the earth beneath my feet and all around me is resting. That the trees and other such magical beings are sleeping, conserving their energy for greater moments when the Sun begins to linger for a little longer each day in the sky. This whole hemisphere is on a well-earned break from the busy busy of ‘getting it on’ except it would seem us humans.

Over the coming months I acted upon those things I had fully absorbed and appreciated during my rest and reflection.

 I am doing the same again this year without the feelings of dread and despair I have suffered in the past. I am enjoying the dark evenings while I can so I can prepare myself for an energy boost and throwing some shapes in the warmer months, when I don’t mind leaving the house after the kids are tucked up because it is still warm and light out there. I always aim for the clocks changing because then I know things are really on the move – including me!

I am using this time to think about what I would like to give to others. I am not failing if I am not giving now – I am preparing myself to do it the right way for me. Volunteering has a huge part to play in our lives but it has to ebb and flow like the seasons and we should never beat ourselves up when our own lives get too full to support others. Perhaps for you this quiet time IS your time to support. When the busy of the world slows, is it that you have more space to hear the thoughts of others. In the stillness of these months can you can give others the wisdom of the benefits of slowing down, listening to themselves and what their instinct is telling them, that it is ok to take time to make decisions or to practice rather than be immediately perfect?

Winter (especially that January panic) sounds a bit like a new mother doesn’t it? In that scary time when all is new and we are expected to do so much in the right way when actually perhaps what a new mum needs to hear is bed down, listen, reflect and trust that life as you knew it will return in some recognisable form at some point in the future but it doesn’t have to be now. That the early unfurlings of motherhood is a time to slow and snuggle and make choices without all the background noise of life.

The comfort of knowing things are ever changing, like the seasons, can bring comfort to us whether we are new parents or volunteers choosing our next adventure or women going about our ever changing lives from maiden to mother to grandmother. Sometimes the still bits are just what we need.

And now we are in February and every snowdrop lifts my heart.

31 Jan

BfN in the news: Shereen Fisher appears on BBC Woman’s Hour

Shereen Fisher, our CEO, featured in a panel discussion on BBC Woman’s Hour this week, on infant feeding experiences and how they made women feel. Shereen was joined by GP Dr Ellie Cannon and maternity matron Gill Diskin. The discussion covered all aspects of infant feeding, and addressed some of the challenges faced by new mums, as well as the health care professionals and organisations who aim to support them. Here’s what Shereen had to say about the experience.

I was thrilled to be invited to be part of the panel for BBC Radio 4’s Woman’s Hour this week, representing BfN. The opportunity was unique and the feature would be part of a 3 day-long focus on infant feeding – no flash in the pan for women’s stories about breastfeeding this time, but 3-plus hours of national radio air time devoted to getting the triumphs and heartache across – and for me – the injustice of women who don’t get the support they so deserve.

Invitation accepted then the worry began, as the facts of the show and angle the producers were aiming for were slow to emerge, along with details of the other panel members. I liken the experience of preparation to that of ‘getting a genie into a bottle’ – I am not a doctor or Public Health specialist, so a fair amount of reading and revising ensued (taking me back to my Law degree finals, when I promised myself that I’d never put myself through it again), as did heartfelt conversations with some sound, strong and sensible minds – you know who you are.

The challenge was, when the cork was taken off the bottle, to make sure that at least five clear messages were unleashed and not just a mist of vapour … The preparation, guidance from others and commitment I have held to this issue for over six years came good in the end and I was calm and relaxed in the studio (broom cupboard!), waiting to hear Jenni Murray say my name and invite me to speak.

Predictably the slant has been somewhat focused on the problems and the negatives of breastfeeding, but the presence that BfN was afforded has given me hope that all voices are valid and with a concerted effort we will be able to improve support for all women to pursue their choices and reach their own individual goals. That, I am certain, will be the secret to happy mums and babies.

To hear the full podcast featuring Shereen Fisher, Chief Executive, visit:
https://www.bbc.co.uk/programmes/m00027ml

09 Jan

Dr Wendy Jones, The Breastfeeding Network’s pharmacist, awarded MBE in Queen’s New Year’s Honours List

One of the founding members of the Breastfeeding Network (BfN), and our resident Pharmacist for over 20 years, Dr Wendy Jones, has been awarded MBE in Queen’s New Year’s Honours List for 2019.

Wendy set up the BfN drugs in breastmilk information service in 1997 after being asked to update an information pack about the safety of drugs in breast milk. Gradually the service grew and now she now leads a small team of volunteers who offer individual support to more than 10,000 families and healthcare professionals each year via email and social media.

Commenting on the award which Wendy receives for services to mothers and babies, Shereen Fisher, CEO of the Breastfeeding Network, said:

“We are delighted with the news that Wendy is receiving this award in recognition of her work. Wendy is an inspiration to us all.  She has dedicated the last twenty years to supporting mothers and families through the drugs in breastmilk service she founded.  Day in day out, she responds to phone calls, emails and now social media messages from parents and healthcare professionals who need reliable, evidence based information about the safety of medications and treatments while breastfeeding.  The work she does allows parents to make their own informed decisions and has undoubtedly saved lives.”

A soon to be published evaluation of the drugs in breastmilk information service was overwhelmed by responses from mums and healthcare professionals when they were asked for their thoughts on the service. A mum of four said: “Wendy has saved me and my daughters many times over. I can honestly say I would have committed suicide after my second baby was born had it not been for her support to keep taking my meds and to keep breastfeeding.”

A consultant paediatrician said: “Wendy’s information is presented in a way which is accessible to non-medical mothers to understand, but also written in a way that doctors who know little about breastfeeding will take seriously.”

Wendy said: “I couldn’t be more proud than I am today that I have been awarded an MBE in the New Year’s Honours List as Founder of the Breastfeeding Network Drugs in Breastmilk Service for services to Mothers and Babies.

“In 1995 when I wrote the first information on drugs in breastmilk I could never in a million years have imagined this happening. I followed my dreams and the opportunities given, massively supported by my family and particularly my husband Mike [pictured above with Wendy] who gave me the opportunity to leave paid work and develop my passion.

“Nothing I can do would be possible if breastfeeding advocates didn’t spread the word that you can breastfeed as normal when you take most medication or there are ways around it. So, this MBE is for all of you too for all the hard work you do in groups, on the helplines, face to face, via social media and just at the school gate or supermarket checkout. You are all amazing.

“Thank you everyone for your wonderful comments today. I’m treasuring them in my heart and taking inspiration from them to keep challenging and to carry on supporting mums, dads, grandmas, peer supporters and everyone to keep breastfeeding these special precious babies. I’m hoping that this is the beginning of a year when breastfeeding and its support gets the recognition it deserves and just maybe some funding as a public health issue.”

Earlier this year Wendy was also awarded a Points of Light award by the Prime Minister.

Wendy’s story

Over the past 40 years, Community Pharmacist Dr Wendy Jones has made a huge impact on the lives of thousands of families across the UK. In this time she has helped people manage issues such as weight loss, cardiovascular disease and smoking cessation alongside her general pharmaceutical duties, but her real impact has been felt by new mothers. Wendy has dedicated her life to researching the effects of medication and medical treatments on breastfeeding mothers and their babies.

In 1997 she was one of the founder members of The Breastfeeding Network, and in 1999 she set up the Drugs in Breastmilk helpline. This telephone helpline was set up in response to the number of questions the charity was receiving from breastfeeding mums about prescribed medications. At that time there was no easily accessible, reliable information for mums who had been told to stop breastfeeding in order to take certain forms of medication. Wendy has single-handedly filled this gap.

In many cases where a mum is told to stop breastfeeding, there is no evidence to support the need for this. The mum can be left feeling she has no choice but to stop breastfeeding (even if she wants to continue), or she may choose not to take the medication prescribed. The impact of having to make a decision like this can be far reaching for some mums. In a very few cases, evidence shows the mum does need to stop breastfeeding, and then, being able to understand the reasons behind this may help the mum with this process. In most cases, the evidence shows the mum can continue breastfeeding safely and for many, to know this is possible is a huge relief.

Over the years, the service Wendy provides has grown – she now leads a small team of volunteers who offer individual support to more than 10,000 families each year via email and social media.  She is contacted by mums and families, as well as health care professionals.

She has also written more than 50 information sheets about the most common medications breastfeeding mums ask about – these infosheets cover everything from postnatal depression and anxiety to cold and cough remedies, to contraception, hayfever, headlice and norovirus.

She was awarded a PhD in 2000 and has written several books on this topic, as well as speaking at numerous national and international conferences, study days and other events.

She is extremely well known and highly regarded by breastfeeding supporters across the world. Her knowledge, patience, understanding and support has been felt and appreciated by thousands of families.

With her unending, selfless commitment and passion Wendy is an inspiration to many. Her work is so far reaching, it is impossible to measure the difference she has made.

 

For more information/press enquiries:
Contact Felicity Lambert, BfN Comms Officer felicity.lambert@breastfeedingnetwork.org.uk / 07979872301

https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/

https://www.facebook.com/BfNDrugsinBreastmilkinformation/

17 Dec

Peace on Earth, goodwill to all relatives: surviving the holidays as a breastfeeding mum.

Victoria Davies, aka Mum In Make-Up, writes about how to get through the holidays even when your family’s views on breastfeeding don’t quite match up with your own.

The festive season. It means something different for everyone, but for new (and not so new) breastfeeding mums it can spell an entirely new level of stress. This year I’ll be celebrating my third Christmas as a breastfeeding mother. My little boy might not be a cluster-feeding newborn any more, but he’ll certainly be demanding boob fairly regularly nonetheless. It’s his way of reconnecting with me when things get a bit much, when he’s tired or just wants some uninterrupted time with me. If you’re new to this, unless you are spending the whole two weeks staying at home with just your little family, you’re likely to be wondering how whipping the girls out regularly is going to go down. After all, you’re going to be seeing various assorted extended family and friends and Jane-from-number-ten who always comes to the Boxing Day buffet. Here are a few things to consider before you decide to come down with a mysterious seasonal illness.

Get some boob buddies
Chances are if you’re staying somewhere for a few days there will be a few others there too. Who can you trust to have your back? If you have a partner, they should be the first person you drag onto your cheerleading team, but there are bound to be others who will get you a glass of water, plump the cushions for you and glare at anyone who dares to utter that time-honoured line “Are you still breastfeeding?” Give those people a quick message before you see them. Something like “Please help, I’m breastfeeding and Uncle Martin thinks my five-month-old should be eating steak” should do the trick. 

Dealing with nosy parkers
Chances are nobody will make a peep. After all, drawing attention to the fact your boobs are out just isn’t cricket, and most people will be polite. If, however, there are people there who haven’t seen you breastfeed yet and don’t observe the usual social boundaries, you might find yourself inundated with a barrage of questions and interest. If you feel so inclined you can discuss your choice to breastfeed, telling your audience all about current recommendations from the NHS and the World Health Organisation, and that things may have changed significantly since they had their own babies, in regard to when and how children are weaned from the breast. If someone is genuinely curious it can be nice to impart some of your gems of wisdom.

However, you don’t actually have to do any of this. It’s not your job to be Google, and if you don’t want to be drawn into a conversation about breastfeeding, especially if you’re dealing with truculent people who feel they have the right to question your choices, you absolutely don’t have to. Being asked repeatedly “But when are you going to stop?” can get incredibly wearing after a while, especially if “when we’re ready” isn’t quite cutting it with people who want some kind of detailed timeline.  After two years of breastfeeding, I’ve found the most helpful phrase to shut down anyone who is challenging me beyond my boundaries is “It’s working for us and we’re really happy.” It lets the person know that your choices are not up for debate. After all, this is your child. Don’t feel undermined or threatened for a second.

Do what you normally do
Does your partner usually give a bottle in the evening? Go ahead and stick to that. Perhaps Granny would like to do it; after all, some of the complaints tend to be about extended family members not getting enough cuddle time. Do you usually use a cover or scarf to feed? Keep going with that, especially if it gives you the confidence to feed whenever and wherever. Do you and your partner like to curl up together on the bed for a feed with your baby? (I ask because this is our favourite thing to do). Keep on keeping on, and enjoy that little ritual together.

Take a break
Particularly when babies are very young and going through a cluster-feeding stage, having to breastfeed almost constantly in front of everyone gathered at the Christmas celebrations can feel a bit much. Smiling at your in-laws through gritted teeth as one of them pipes up “Are you feeding her again?!” is probably not what you need right now. And here is where breastfeeding gives you the perfect excuse to take a break. Take your child off to the bedroom or to another quiet space, put your feet up and enjoy the peace and quiet. You don’t have to worry about anyone else right now; this is more important. It’s also a brilliant excuse to get away from your dad’s more strident views on politics, or to avoid eating yet another slice of Granny’s horrible cake. Breathe and enjoy the time with your baby. Barricade the door if you have to.

A breastful of milk
This is the time of year when, at its heart, we’re celebrating the birth of a baby. A baby who would have been fed from his mother’s breast. Hey, it’s even mentioned in the carols we sing every year! Every time someone questions your decision or makes you feel on edge, just take a few deep calming breaths and remember that you are part of something beautiful. So many women have done what you are doing, and have experienced that magical bond created by breastfeeding. At one time, the entire community would have helped a new mother and encouraged her. If you’re struggling, remember that you’re not alone, and you will always have help and support online or on the phone from organisations like The Breastfeeding Network. If it was good enough for Mary and Jesus, it’s good enough for you and your baby.

Merry Christmas, you brilliant woman. Well done.

14 Nov

MBRRACE-UK Report, “Saving Lives, Improving Mothers’ Care” – BfN Response

Shereen Fisher, BfN CEO

MBRRACE–UK released their 5th report ‘Saving Lives, Improving Mothers’ Care’. It describes the lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity from 2014-2016. Here’s The Breastfeeding Network’s response. 

The Breastfeeding Network (BfN) welcomes the report. While the research has found that the number of women dying as a consequence of complications during or after

Wendy Jones

Wendy Jones, lead pharmacist, BfN Drugs in Breastmilk service

pregnancy remains low in the UK – with fewer than 10 out of every 100,000 pregnant women dying in pregnancy or around childbirth, the report highlights the unacceptable disparity in care for black and ethnic minority women. Shereen Fisher, Chief Executive for the Breastfeeding Network said, ‘The almost five-fold higher mortality rate amongst black women compared with white women requires urgent explanation and action. BfN welcome further exploration into this unacceptable disparity to ensure there is real change for black and ethnic minority women’.

A key concern, is the tragic case of a mother dying several weeks after her baby was born (Commencing treatment, dose and compliance page 39). There were delays in prescribing thromboprophylaxis because of concerns over  breastfeeding.

Dr Wendy Jones, lead pharmacist for the BfN Drugs in Breastmilk Information service, said ‘I have long feared such a scenario.  Physicians need to be aware how to check that a drug treatment is compatible with breastfeeding quickly, using evidence-based sources. The drugs in this case are widely used in the immediate postnatal period yet emergency medicine teams are often unable to access readily available evidence-based information on medication and breastfeeding as quickly as they need. The information should have been readily available in guidelines or a reference source including specialist information. The wording of the BNF: “Due to the relatively high molecular weight and inactivation in the gastro-intestinal tract, passage into breast-milk and absorption by the nursing infant are likely to be negligible, however manufacturers advise avoid” needs to be updated where the manufacturer is merely not taking responsibility in licensing the product. The removal of the words “manufacturer advises avoid” makes the information read very differently to a busy practitioner’.

Shereen Fisher, Chief Executive for the Breastfeeding Network said, ‘This sad case highlights the need for mothers to be able to access skilled support in their local communities, with staff alert for symptoms needing attention; the mother in question had multiple ‘fainting’ episodes postnatally that were not investigated until day 44. This emphasises the need for health care professionals in all front-line services to understand how to treat pregnant and breastfeeding mothers – until this happens women will continue to be exposed to risk and potentially loss of life. It feels that no-one listened to the mother or observed her and her baby as a dyad as closely as they should have done, possibly because breastfeeding was seen as a barrier to medication. Women should not be disadvantaged in the management of acute illness just because they are pregnant or breastfeeding, and communication needs to be improved throughout the multidisciplinary team.’

To read more you can download the full report, lay summary and the infographic here: https://www.npeu.ox.ac.uk/mbrrace-uk/reports

06 Nov

Prevention is better than cure

Shereen Fisher, BfN’s CEO, responds to Health and Social Care Secretary Matt Hancock’s vision for prevention released yesterday, and how it relates to investment in breastfeeding support.

The future of health in the UK is dependent on us all getting really serious about prevention[1]. Currently the NHS spends £1 in every £5 on health problems that are a direct result of our lifestyle such as obesity and poor diet[2]. We are told that not only will prevention help reduce the strain on the NHS but it will also improve all our health.

Getting serious about prevention must include getting serious about community level investment to enable all mothers who choose to breastfeed to do so, given the substantial evidence that links breastfeeding with improved health.

The Lancet[3] series on breastfeeding offers the most comprehensive review of all the evidence on breastfeeding to date and highlights breastfeeding’s role in the UK prevention agenda.

The authors state: “…how important breastfeeding is for all women and children, irrespective of where they live … Appropriate breastfeeding practices prevent child morbidity due to diarrhoea, respiratory infections, and otitis media [ear infections]. Where infectious diseases are common causes of death, breastfeeding provides major protection, but even in high-income populations it lowers mortality from causes such as necrotising enterocolitis and sudden infant death syndrome. It also helps nursing women by preventing breast cancer. Additionally, our review suggests likely effects on overweight and diabetes in breastfed children, and on ovarian cancers and diabetes [Type 2] in mothers.”

Importantly UK women and babies offer policy and health leaders an attractive opportunity. While breastfeeding rates in the UK are the lowest in the world the rates of initiation – women starting to breastfeed – have been increasing for the last 20 years (81%)[4].

Scotland’s infant feeding statistics[5] (November 2018) show signs of positive change – no happy accident but consequence of national leadership, strategic planning, partnership and sustained investment.

Women’s intention to breastfeed offers an important opportunity for health and wellbeing both for babies (next generation) and women themselves. However, individual will has to be met with support that effectively improves a mother’s breastfeeding experience and helps sustain her choice to breastfeed. Peer support can make a big difference here especially as over time it offers the chance for areas to recreate a culture where breastfeeding is familiar.  We also know that choice isn’t made in a vacuum but is heavily influenced by family members, hospital care, health care professional advice and societal views. Patient empowerment is an important theme in the vision of healthcare for the future yet women feel constantly disempowered in their efforts to breastfeed through the lack of support available to them.

With the NHS celebrating a landmark anniversary alongside £20 billion a year in extra cash now announced[6] NHS leaders will be putting forward a 10-year plan that will make crucial decisions about how the service will spend the money.

In the planning no doubt demands will be high, as cancer survival rates, mental health support, health inequalities and an aging population all vie for consideration, how should we use the government’s cash boost to tackle the priorities that matter most to us?

In the debate let’s remember the substantial benefits to health in breastfeeding for mother and baby as well as the sheer economic and environmental sense that breastfeeding makes.

In 2012 UNICEF UK[7] reported that just a moderate increase in breastfeeding rates could save the NHS millions. In 2016 the Lancet[8] series calculated that the overall savings would actually be in the order of billions, not millions, of pounds. Moreover, the measures required to support breastfeeding are relatively inexpensive and soon pay for themselves. Keith Hansen of the World Bank said …

“In sheer, raw bottom-line economic terms, breastfeeding may be the single best investment a country can make.[9]

The potential savings into the billions are important here because we all know that the cash boost being offered by government to the NHS and social care isn’t going to be enough. While the additional £20 billion a year (in five years) has already been welcomed, the Kings Fund has pointed out, that this does not come close to the amount required to improve services after years of underfunding[10]. On social care, the budget announcements will not be able to undo the cuts in services and underfunding of local government that has already occurred. These cuts that have caused losses to breastfeeding support services, many of which are located in areas of low breastfeeding rates and run by volunteers and supported by charities[11].

Knowing how the money works to support breastfeeding is essential and it is currently hard to know this in England. What we do know is that funding for community-led breastfeeding peer support has been cut because it sits within a shrinking public health budget devolved to local authorities. Despite excellent evidence-based commissioning guidance on infant feeding for local authorities[12] breastfeeding support services in communities is entirely optional.

This has led to mothers who choose to breastfeed being unable to access local services and leaves them failed and let down. This is just too precarious a situation for a public health priority as important as breastfeeding that if better funded and supported could serve us well in the prevention of infant mortality, obesity, type 2 diabetes, ovarian and breast cancer ….

If we are going to get serious about prevention in health then there needs to be a clear strategy and leadership for breastfeeding. Government’s role is key here in taking responsibility for building an environment that promotes, protects and supports breastfeeding[13], not just for the next year but for the next 20 years.

This should include at a minimum the following very important steps many of which are recommended by National Institute for Clinical Excellence:

  • Appoint a national multidisciplinary infant feeding board or committee with strong leadership to ensure evidence on infant feeding is understood and enshrined in policy
  • Ensure that Baby Friendly accreditation becomes a minimum requirement for all maternity settings (achieved in Scotland and Northern Ireland) (NICE recommended)
  • Ensure that all mothers regardless of where they live, receive skilled evidence-based breastfeeding support, making this provision a mandatory responsibility by protecting the public health budget that protects health visiting and breastfeeding peer support workers (NICE recommended)
  • Protect all families from aggressive marketing of formula companies by enacting into UK law the International Code of Marketing of Breastmilk Substitutes and subsequent relevant resolutions (NICE recommended).
  • Require employers to provide breaks to breastfeeding mothers to allow them to breastfeed or express milk at work.

With careful, long term thinking and action the prevention agenda offers great focus to help us plan the health and wellbeing of the UK for the future. The health of women and babies will be stronger still for joined-up planning and provision of quality breastfeeding support. Let us not forget all our responsibilities in supporting breastfeeding and ensuring that its role in the prevention agenda is fully acknowledged.

 

 Footnotes:
[1] https://publichealthmatters.blog.gov.uk/2018/11/05/matt-hancock-my-vision-for-prevention/

[2] Anita Charlesworth, Chief Economist, The Health Foundation interviewed for Healthy Visions BBC Podcast / https://www.health.org.uk/Running-to-stand-still-why-20-5bn-is-a-lot-but-not-enough

[3] Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect (30 January 2016), Victora, CG et al, The Lancet Volume 387, Issue 10017, 475-490 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01024-7/fulltext

[4] Infant Feeding Survey 2010 (2012), Fiona McAndrew et al, Health and Social Care Information Centre https://digital.nhs.uk/data-and-information/publications/statistical/infant-feeding-survey/infant-feeding-survey-uk-2010

[5] Scottish Government Infant Feeding Statistics 2017/18 http://www.isdscotland.org/Health-Topics/Child-Health/Publications/index.asp#2275

[6] NHS funding: Theresa May unveils £20bn boost https://www.bbc.co.uk/news/health-44495598 17/06/18

[7] Preventing disease and saving resources: the potential contribution of increasing breastfeeding rates in the UK (October 2012), Renfrew, M et al, Unicef UK https://www.unicef.org.uk/babyfriendly/about/preventing-disease-and-saving-resources/

[8] Why invest, and what it will take to improve breastfeeding practices/ (30 January 2016), Nigel C Rollins et al, The Lancet Volume 387, No. 10017, 491-504 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01044-2/fulltext

[9] The Power of Nutrition and the Power of Breastfeeding (2015), Keith Hansen, Breastfeeding Medicine, Volume 10, Number 8

[10] The Kings Fund, NHS Funding: What we know, what we don’t know and what comes next https://www.kingsfund.org.uk/blog/2018/06/nhs-funding-what-we-know

[11] Open Letter on the crisis in UK breastfeeding https://ukbreastfeeding.org/open-letter/

[12] https://www.gov.uk/government/publications/infant-feeding-commissioning-services

[13] https://www.unicef.org.uk/babyfriendly/about/call-to-action/