14 Apr

National Breastfeeding Helpline Update

We are always super busy on the National Breastfeeding Helpline but 2020 has been unlike anything we’ve seen before! In January and February we were already answering more calls than usual and then March hit us….

Our amazing volunteers (all trained and supported by BfN and the Association of Breastfeeding Mothers) had already upped their game in 2019 – we answered nearly 10% more calls last year than we did in 2018. 2019 was a record-breaking year in many ways – receiving more calls, answering more web chats and supporting more families via social media messages than in any other year before. 

Our fabulous volunteers listened and supported on the phone for 2798 hours during the year – that’s the equivalent of more than 116 full days! (and that doesn’t include all the time given on web chats and social media, or while waiting for calls to come through either)  More than 12,000 families were directly supported across the helplines, language lines, web chat and social media. Such an amazing achievement.

So to 2020, and after our record breaking January and February, as March approached, we thought maybe, just maybe, March 2020 could be the month where we got every single volunteer to log on and take a call, and we gave ourselves an ambitious but achievable calls answered target to reach. It would require all our volunteers to give a little bit extra.

The beginning of March was busy, but not that out of the ordinary.  Volunteers were doing a brilliant job as always and we were answering more calls than usual. Then suddenly everything changed when Coronavirus hit the UK – people started isolating at home, healthcare professionals more overstretched than ever, breastfeeding drop in and antenatal groups forced to close, new mums being discharged from hospitals even more quickly than before…. And the NBH volunteers really stepped up! 

Since around the 12th March, there’s hardly been a day when the service hasn’t had 100% coverage on the helpline – 5 or 6 volunteers are often logged in at once. The team have answered almost every single call first time, and for the first time ever a voicemail option for callers has been introduced, so even if they can’t get through, they can leave a message and one of the newly recruited NBH Voicemail team will return their call as soon as possible. The service has also increased our web chat availability, social media responses and increased the amount of remote supervision that’s available. 

Needless to say, the team SMASHED target we set ourselves and answered more calls in a month than we ever have before. They also spent longer on the phone listening and supporting.  And all of this amazing support for the helpline has happened at the same time as (like everyone) volunteers have faced challenges – unknowns about their paid work, worries about relatives and family and their own health, have had to fit in home education for their kids alongside their jobs….  

We are completely in awe of and humbled by what the volunteers are doing on the helpline at the moment and cannot thank them enough for their hard work. They are providing such a vital service to families all over the UK, and they are just quietly getting on with it. 

A huge and heartfelt thank you to each and every one of them. 

Felicity Lambert, NBH Manager and Caroline Bolton, ABM Helpline Manager 

The National Breastfeeding Helpline is run in partnership between the BfN and the ABM. The initiative is funded by PHE and the Scottish Government. All calls are answered by trained volunteers, working in their own homes, using a virtual call centre. The helpline offers evidence based, non judgmental, friendly information, reassurance and support and is open every day of the year from 9.30am-9.30pm on 0300 100 0212. Support is available in Welsh and Polish on the same number.

www.facebook.com/nationalbreastfeedinghelpline

www.twitter.com/NBHelpline 

www.instagram.com/nationalbreastfeedinghelpline 

11 Apr

What BfN means to me.

By Kirstin Worsley – Scottish PfG Project Manager

To be honest, until about 4 years ago, when asked what BfN was, I would have said it was where you went to print resources about thrush and mastitis to use in training new mums to become Peer Supporters (oh and I knew there was a helpline, because I had called it once).

Going back a bit, about 20 years ago and after the birth of my third child, I realised that breastfeeding was NOT easy, it wasn’t something babies just did and it definitely could hurt to the point of feeling that my nipples were about to fall off.

In that moment, when someone suggested I train as a Peer Supporter I thought, like many of us do, that if I could just help one other mum to feel better about feeding, to reduce her pain and help her to find a way to give her baby what she had thought about hen she was pregnant, then that would be fine. 

Move on 15 years from that point and a house move and I was training with UNICEF Baby Friendly and helping more women in my part of the world to continue their feeding journey.

Then, one day about 9 years ago, someone actually offered me a job where I would get money to train mums to be peer supporters (my husband’s words were “you can actually get paid to do this sort of thing??!!”) and since then it has become the biggest passion of my life, filling every day with something breastfeeding related, although of course my family are still my total world.

So, when my manager received a call from Sarah Edwards, 4 years ago, asking if there was anyone who would be interested in training to take calls on the National Helpline, I did a bit of real research about the organisation, discovered it had become so much more than a leaflet about mastitis and decided to “give it a go”.

Roll on 4 years, and I am now taking calls and answering webchat and social media messages to my heart’s content. I love listening to a woman, sometimes with tears in her eyes and helping her to work through her thoughts and fears and come to a point where she feels able to move forward with her feeding (or have a plan to stop, if that was her reason for calling).

In the meantime, I carried on with my “day job” training peer supporters and looking after a troop of volunteers in the Scottish Borders. ( I don’t manage volunteers, they tend to be the ones keeping me on the right track!).

But then…..the Scottish Government decided to fund the implementation of breastfeeding support as a national project and this is when BfN became an even bigger part of my life as I became the Scottish Project Lead. So, now, not only do I still talk and message wonderful families on the Helpline but I also get to see support appearing in new areas across Scotland and meet lots of wonderful mums who are training to become new supporters of mums in their communities. BfN are giving me so many new opportunities.

The supporters, supervisor and tutor courses have given me the chance to make connections with other BfN people across the country and at this point I send a big ‘HI!’ to you all!

If I had to put it into words, what BfN means to me, it is “family, team effort and determination”. I know it can be hard, funding is always an issue, mums always seem to be receiving less care than they deserve or the staff around them are able to give, despite their best efforts, and we sometimes feel that we are only a tiny fish in a big puddle. However, if a younger me had told me I would one day be working for the organisation that I had called 20 years ago, I am not entirely sure I would have believed them and yet, here I am.

So, believe in yourselves, you can do this, you are doing it and you are all absolutely fantastic!

07 Apr

Coronavirus update from BfN’s CEO

I was heartened to receive a tweet in the last week which read ‘the rest of the world has finally caught up with the way @NBHelpline and @BfN_Uk volunteers have been working for years! #Remoteworking’

BfN_CEO

It was in response to an image shared of our volunteers’ home work stations – places they shared where they take calls from mothers calling the National Breastfeeding Helpline. While I know not all of our volunteering and commissioned work is provided remotely, never more than now have I been thankful for BfN’s strong helpline and telephony skills, our vibrant online community of peer supporters, our established working from home culture and broad volunteer base that branches out across the whole of the UK – just the strength we have needed to call on during this pandemic.

It’s now more important than ever that we stay connected to each other, not only because sharing knowledge will help us plan and learn but because while stabilising immediate support for women and families we can also stay in touch about how we navigate the future.

All our lives have been turned upside down by the Coronavirus crisis – some of us may be finding ourselves closer to loved ones in our isolation, others may feel lost without the routine of social interaction. Without a doubt mothers looking for breastfeeding support will find their usual services drastically cut back or gone, they will find their feelings of worry and of being overwhelmed heightened as health care professionals struggle to meet demand. This is why at the Breastfeeding Network our immediate priority has been to stabilise our offer of remote support across our helplines and in communities by offering digital alternatives. In tandem we have been working with partners including – Scottish Government, Public Health England, NHS and with other third sector partners on sharing resources that will be a vital support line for women and families for many months to come.   

Responding to the crisis

I want to highlight a few things we have done to respond to the crisis – for mothers and families, for peer supporters – volunteers and paid staff, for our tutors and supervisors and for healthcare professionals in the front line or responding to the virus.

For mothers and families – we have strengthened the National Breastfeeding Helpline offer and secured additional resourcing in England. Against the usual opening hours, we have appealed to volunteers to help us respond to all calls, added in a voicemail option so any missed calls can be returned and we are doubling our remote supervision for volunteers. There is dedicated social media support that extends to enquiries on BfN’s Drugs in Breastmilk Information Service. At time of writing we are answering close to 100% of all calls to the helpline. I am so inspired and proud of what our volunteers on NBH have been able to achieve working with our sister organisation – Association of Breastfeeding Mothers, the strength of this long held partnership has been a rock of support.

With a lack of consistent reliable information being an often quoted issue from Mothers we knew that we had to develop our online resources for women and families in response to the crisis. A small team of writers mobilised quickly to develop FAQ’s that can be found here.  Content evolves in response to enquiries from the helpline and on social media and is quickly updated online.

In addition, third sector organisations working in infant feeding have come together to highlight the support that women and families can access during this time. The collaboration and generous offer of the third sector has been impressive, our combined effort can be found here.

When the Government moved from ‘manage’ to ‘contain’, it was with a heavy heart that we suspended our face to face support services including community drop-ins, training, events and home visits. Only exceptionally is face to face work continuing under the strictest of arrangements, only at the request of the local authority area or health board. It’s absolutely the right thing to do as the safety of our staff and volunteers comes first. Some of our volunteers are pregnant and with few exceptions have dependents on whom good health will be relied upon so we take this very seriously. Areas supported by a small central team are stabilising services locally through offering digital support and the charity has purchased Zoom licences to enable this to happen. Project areas are reporting that they are trialling helper training, supervision get-togethers, local team meetings and even 1-1 support with Mothers. We are learning fast and will look to test our digital capacity even further as we plan to hold our May BfN Directors’ Meeting by Zoom – strengthening our digital service offer is going to be an item of strategic importance.

We have a big network of volunteers and staff and communicating well, under pressure and accurately has called for a lot of focus. We are a small central team with contracted support on law and finance. We have managed to achieve a series of well-timed and high quality briefings that have included guidance on HR, IT, safeguarding, upskilling tools and tips on coping in isolation and remote working.  We are working hard to fast-track our online training offer and support our tutors and supervisors to feel able to offer tutoring over online means.

How we are supporting our healthcare professionals

Within a week of the social distancing measures coming in, BfN were invited to be part of the conversation with Government about what the voluntary sector can do to support the NHS. This conversation was held in the very real context that up to 30% of the NHS workforce will be undermined by the Coronavirus. Today with other organisations we submitted our collective response with the honest hope that third sector might get recognised as a vital part of society.

We are asking Governments in Scotland and England to help us raise even more awareness of the NBH, our online resources and of BfN’s Drugs in Breastmilk Information Service. These services directly support midwives and health visitors on the frontline of the healthcare response and many of these services do not rely on NHS staff. In project areas peer supporters are offering support remotely in their communities – maintaining a vital presence that health care professionals can call upon.

The longer term impact of the Coronavirus is still to be calculated but while it takes its toll on our relationships and erodes our traditional ways of communicating, social distancing is also offering us a choice, a choice to be curtailed by the measures or to be connected differently. There are concerns in the dash for digital – real concerns about inequalities and inclusion as well as our human rights like privacy. For now, our priority is to stabilise support and ensure that our combined efforts support mothers as well as possible while also looking after ourselves.

Heartfelt thanks to you all for your courage and commitment to supporting women and families and breastfeeding. You are a true inspiration!

Best Wishes

Shereen

19 Feb

Help and Support on Tongue Tie

There’s been a bit of conversation about tongue tie on social media after the Loose Women episode that highlighted the challenges experienced by Stacey Solomon

We’ve heard from a lot of women that the feedback that Stacey received on air didn’t match their understanding of tongue tie. So we wanted to help clear up any confusion and point mums in the right direction if they need support.

A tongue tie can restrict normal tongue movement in babies and can lead to breastfeeding difficulties. This can include being unable to attach to the breast, or staying attached, pain while feeding and slow weight gain. Some babies can feed without difficulties, others may find feeding easier after a frenotomy.

The key to identifying and dealing with tongue tie is accessing support from somebody appropriately skilled and well informed as soon as possible – such as your local infant feeding team.

Another good place to start is National Breastfeeding Helpline on 0300 100 0212, which is open 9.30am – 9.30pm every single day of the year. Your call will be answered by highly trained volunteers, who are also mums with personal breastfeeding experience.

For more information on tongue tie:

https://www.nhs.uk/conditions/tongue-tie/

https://www.laleche.org.uk/tongue-tie/

https://www.breastfeedingnetwork.org.uk/sams-story-and-ton…/

https://www.tongue-tie.org.uk/

https://www.unicef.org.uk/babyfriend…/support-for-parents/…/

https://gpifn.org.uk/tongue-tie/

27 Nov

#MakingItWork – how shared parental leave worked for us

In this blog, Kirsty and Geraint Davies explain how they used shared parental leave so Kirsty could return to work while continuing to breastfeed their son, Evan.

Kirsty writes:

My son Evan was born in May 2015. I went back to work January 2016 as a deputy headteacher when he was 8 months old. 

My husband is in the military (he was actually featured in Baby London a couple of years ago talking about SPL [shared parental leave]!) We confused everyone I think within our work places as we were one of the first to use SPL, as it came in for babies born from April 2015, however it was very easy to sort.

Evan was exclusively breastfed from birth and he never took a bottle or drank milk from any other source. To be honest, I did worry when I returned to work but I needn’t have. I use to breastfeed him before work (sometimes waking him up – much to my husband’s annoyance!), I would feed as soon as I got home and overnight as he normally would, whenever he woke up. On the days I didn’t work, weekends and holidays, I fed as ‘normal’ and responded to his and my own needs. Although Evan did not drink the milk, I did pump at work for my own comfort and as it could be used for food etc.

Evan breastfed until he was 22 months old, tandem feeding with his brother for a couple of months. We have since had two more children, both exclusively breastfed and I am now only feeding my youngest (8 months old). We have not done SPL again, not because we didn’t enjoy it or it didn’t work out, but just because of how timings of various things panned out. My husband loved having the opportunity to be at home with Evan. He says, “With SPL we got time to bond. It brought me and my wife closer; I saw things from her perspective and, similarly, it showed her life from my perspective. It made us more rounded parents.”

It’s great to hear of a family who have been able to continue their breastfeeding journey, and have used shared parental leave to their advantage.

Unfortunately there are no additional obligations for employers to make allowances for breastfeeding mothers returning to work as part of shared parental leave – breastfeeding employees are entitled to have somewhere to rest, and the HSE suggests it’s best practice to provide a private room for expressing breastmilk, but this is not a requirement. For more information on shared parental leave and breastfeeding from Maternity Action, click here:
https://maternityaction.org.uk/2018/06/shared-parental-leave-and-the-right-to-breastfeed-on-return-to-work/

For more information on how to arrange shared parental leave, click here:
https://www.gov.uk/shared-parental-leave-and-pay

For our guest blog by Dr Ernestine Gheyoh Ndzi on shared parental leave and breastfeeding, click here:
https://www.breastfeedingnetwork.org.uk/guest-blog-shared-parental-leave-breastfeeding/

To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below:

25 Nov

Joint Statement on Protecting Breastfeeding

Statement issued by:


We want the new government to invest in the health of women and children by supporting and protecting breastfeeding.


The new government needs to prioritise the first 1001 days of a child’s life, from conception to age two, to enable children to survive and thrive. How an infant is fed and nurtured strongly influences a child’s future life chances and emotional health. Importantly, if a woman breastfeeds there are substantial health benefits for her – having impacts on her future long after breastfeeding has stopped.


Independent, practical, evidence-based information and support is essential for every family. Supporting women with breastfeeding can go a long way to protecting children and mothers from a wide range of preventable ill health, including obesity and mental health problems.


This window of opportunity cannot be missed for the future health outcomes of mothers and the next generation. In addition to well documented health outcomes, supporting breastfeeding will also contribute to a stronger economy – potential annual savings to the NHS are estimated at about £40 million per year from just a moderate increase in breastfeeding rates.

Support for breastfeeding is also an environmental imperative and recognition of the contribution breastfeeding can make to avoiding environmental degradation should be a matter of increasing global and political attention.

In the UK, the majority of women start to breastfeed but breastfeeding rates drop rapidly – our continuation rates are some of the lowest in the world and are even lower amongst women living in deprived areas, where increasing rates could make a real difference to health inequalities. Support for all women, parents and families with breastfeeding falls short of what is wanted and needed.

Women tell us they encounter difficulties with the public perceptions of breastfeeding out of the home. Families tell us they are still regularly exposed to conflicting messaging and marketing for formula milks that drowns out advice from healthcare professionals. Women tell us they receive little to no help with infant feeding and that their health visitors, midwives and doctors often have little training or knowledge about breastfeeding and limited time to support them. Recent cuts in health visitor numbers and breastfeeding peer support services mean many women may be left without the support they need however they choose to feed their infants.

Despite robust evidence showing that investment in breastfeeding support and protection makes sense, politically breastfeeding has been viewed by governments as a lifestyle choice and so left to parents to work out for themselves. For too many women, trying to breastfeed without support, or stopping before they want to, is deeply upsetting and the situation is made worse by fragmented care, and poor and often conflicting advice from those they are seeking to support them. To ensure an increase in breastfeeding rates, to help reverse obesity rates and to reduce widening health inequalities will require significant investment in breastfeeding.


It is essential that our new government prioritises breastfeeding and invests in its support and protection.


We call on all political parties to commit to the following actions, if elected:-

  • To appoint a permanent, multi-sectoral infant and young child feeding strategy group and develop, fund and implement a national strategy to improve infant and young child feeding practices.
  • To include actions to promote, protect and support breastfeeding in all policy areas where breastfeeding has an impact.
  • To implement the Unicef UK Baby Friendly Initiative across community and paediatric services, building on the recommendation for maternity services in the NHS Long Term Plan.
  • To protect babies from harmful commercial interests by bringing the full International Code of Marketing of Breastmilk Substitutes into UK law and enforcing this law.
  • To commission, and sustainably fund, universal breastfeeding support programmes delivered by specialist/lead midwives and health visitors or suitably qualified breastfeeding specialists, such as IBCLC lactation consultants and breastfeeding counsellors, alongside trained peer supporters with accredited qualifications.
  • To maintain and expand universal, accessible, affordable and confidential breastfeeding support through the National Breastfeeding Helpline and sustaining the Drugs in Breastmilk Service.
  • To deliver universal health visiting services and the Healthy Child Programme by linking in with local specialist and support services.
  • To establish/re-establish universal Children’s Centres with a focus on areas of deprivation, offering breastfeeding peer support.
  • To make it a statutory right of working mothers and those in education to work flexibly as required and to access a private space and paid breaks to breastfeed and/or express breastmilk and manage its safe storage.
  • To commit to resourcing for charitable organisations who play a key role within the health agenda working at a national and local level to support families and communities with infant feeding.
  • To support the commitment to undertake an Infant Feeding Survey which builds on the data previously collected in the Infant Feeding Survey 2010 (now discontinued). To implement the recommendations of the Becoming Breastfeeding Friendly (BBF) study.

Case for Action

  1. Breastfeeding benefits all babies, and studies have shown that just a small increase in breastfeeding rates could cut NHS expenditure considerably. It is vital to invest in breastfeeding support in the early months and this will reap rewards in the future that are likely to exceed the initial cash flows associated with putting proper support in place.
  2. A UNICEF report states that “no other health behaviour has such a broad-spectrum and long-lasting impact on public health. The good foundations and strong emotional bonds provided in the early postnatal period and through breastfeeding can affect a child’s subsequent life chances”.
  3. Evidence has also demonstrated that a child from a low-income background who is breastfed is likely to have better health outcomes than a child from a more affluent background who is formula-fed. Breastfeeding provides one solution to the long-standing problem of health inequality.
  4. Research into the extent of the burden of disease associated with low breastfeeding rates is hampered by data collection methods. This can be addressed by investment in good quality research.

References

  1. Laurence M. Grummer‐Strawn Nigel Rollins, (2015), Impact of Breastfeeding on Maternal and Child Health. https://onlinelibrary.wiley.com/toc/16512227/2015/104/S467
  2. Borra C, Iacovou M, Sevilla A (2015) Maternal Child Health Journal(4): 897-907. New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions.
  3. Brown, A, Rance J, Bennett, P (2015) Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties.  Journal of Advanced Nursing72 (2): 273-282
  4. https://www.brunel.ac.uk/research/News-and-events/news/Breastfeeding-for-longer-could-save-the-NHS-40-million-a-year
  5. Li R, Fein SB, Chen J, Grummer-Strawn LM, (2008) Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics 122: S60-S76
  6. Joffe, N., Webster, F., & Shenker, N. (2019). Support for breastfeeding is an environmental imperative. BMJ 2019;367:l5646 https://www.bmj.com/content/367/bmj.l5646
  7. McAndrew F et al (2012) Infant Feeding Survey 2010
  8. NHS (2019) NHS Long term Plan https://www.longtermplan.nhs.uk/
  9. National Institute for Health and Care Excellence (2013) Postnatal Guideline NICE, London https://www.nice.org.uk/guidance/cg37
  10. National Institute for Health and Care Excellence (2012) Improved access to peersupport NICE, London
  11. Rollins N, Bhandari N, Hajeebhoy N, et al (2016) Why invest, and what it will take to improve breastfeeding practices? The Lancet387 491-504
  12. Wilson AC, Forsyth JS, Greene SA, Irvine L, Hau C, Howie PW. 1998 Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study. BMJ. Jan 3;316(7124):21-5.
  13. Brown, A, Finch, G, Trickey, H, Hopkins, R (2019) ‘A lifeline when no one else wants to give you an answer’ – An Evaluation of the BFN’s Drugs in Breastmilk service. https://breastfeedingnetwork.org.uk/wp-content/pdfs/BfN%20Final%20report%20.pdf

For further info, contact CEO@breastfeedingnetwork.org.uk
November 2019

22 Nov

#MakingItWork – breastfeeding as a student.

What’s it like being a student and a new parent at the same time? In this #MakingItWork real life story, Jenni tells us how she juggled study, part time work and breastfeeding.

“I was 20 when I got pregnant, 21 when I had my little girl and began our breastfeeding journey!  I was in the middle of my foundation degree which I was going to night classes to finish – I was also working full time in Burger King while doing placements for my course, and moving house! I found that there wasn’t much support on breastfeeding and I went into it pretty blind. When my baby was 2 months old I returned to night classes, I had a bottle refuser so was actually bringing my little girl to class with me and then leaving her with my mum when possible and running over every 3 hours to feed her so I ended up missing out on a lot of course content. Then when she was 7 months I went back to work in Burger King, returning home on my lunch break to fill my little one with her favourite drink! I passed my course however! I was able to graduate from Stranmillis and get myself a new job in a day nursery, little one is now able to take a cup, however still nurses to sleep every night.”

It’s brilliant that Jenni was able to complete her course, and that she was sometimes able to bring her daughter to class in order to continue breastfeeding. But it may not always be a straightforward process – many student parents feel that they are, at best, overlooked by their college or university, and that more adjustments and allowances could be made. This article in the Guardian states that “Sixty per cent of student parents have considered leaving their course, a number which rises to 65% for single parents.”

Education institutions should make the same types of provisions as employers for women who are returning to study and wish to continue breastfeeding. A good first step is to talk to your place of study as soon as possible, telling them that you intend to continue breastfeeding after your return. For more information on the types of allowances that should be made, check out this blog post: https://www.breastfeedingnetwork.org.uk/breastfeeding-mothers-returning-to-work-top-5-tips/

It’s worth taking maternity and/or sex discrimination legislation into account too. The NHS/UNICEF Start4Life booklet, “Breastfeeding After Returning to Work or Study” states:

“The law protects students against maternity discrimination. This means that you are protected against unfavourable treatment because you have given birth in the last 26 weeks or are breastfeeding a baby under 26 weeks. Your course provider must not treat you unfavourably because you are breastfeeding. Unfavourable treatment could include refusing to allow you to take part in the course, refusing certain benefits or services or treating you differently. If your baby is over 26 weeks old it is likely to be direct sex discrimination if you are treated less favourably than you would have been treated if you were not breastfeeding.”

You can find more information on this subject here (breastfeeding information starts on p.17): http://www.ecu.ac.uk/wp-content/uploads/external/student-pregnancy-and-maternity-implications-for-heis.pdf

In summary, returning to study shouldn’t be a barrier to breastfeeding, and vice versa. As one student stated in the article quoted above, “Student parents make fantastic students. You can’t balance a degree and the overwhelming job of parenting without being hardworking and resilient. I’m even more determined to succeed now I’m studying for my daughter’s future, as well as my own.”

To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below:

20 Nov

#MakingItWork – what adjustments can I expect to be made?

In this #MakingItWork case study, Emma tells us how she went about discussing adjustments to her work pattern with her employer.

“My company weren’t really informed regarding my rights however they were so accommodating about whatever my needs would be that I initially didn’t have to think about what my rights were. I’m now into my sixth month of being back at work full time and still exclusively breastfeeding (baby is 14 months old). My employer makes time for me to pump through the day however the nature of my job requires me to be away from home. This is where I have had to do my own research regarding my rights whilst breastfeeding in full time employment as my company was expecting me to be away quite a few consecutive overnights which I couldn’t accommodate due to breastfeeding.”

It is down to each individual employer to decide what adjustments they will make for breastfeeding mums returning to the workplace, though there is guidance in place from the Health and Safety Executive (HSE) and European Commission, as well as organisations such as ACAS.

The HSE states:

Employers have certain obligations towards their employees once they have been notified in writing that she is a new or expectant mother. When an employee provides written notification (regulation 18 of MHSW) to her employer stating that she is pregnant, or that she has given birth within the past six months or that she is breastfeeding, the employer should immediately take into account any risks identified in their workplace risk assessment. If that risk assessment has identified any risks to the health and safety of a new or expectant mother, or that of her baby, and these risks cannot be avoided by taking any necessary preventive and protective measures under other relevant health and safety legislation, then employers must take action to remove, reduce or control the risk.

If the risk cannot be removed employers must take the following actions:

  • Action 1 – Temporarily adjust her working conditions and/or hours of work; or if that is not possible
  • Action 2 – Offer her suitable alternative work (at the same rate of pay) if available, or if that is not feasible;
  • Action 3 – Suspend her from work on paid leave for as long as necessary, to protect her health and safety, and that of her child.

It can be argued that stopping breastfeeding before the mother and child are ready could present a risk to their health (since breastfeeding has a number of proven health benefits – see here, here and here), so if an employee wishes to continue breastfeeding her child, her employer should take action to adjust her working conditions to allow her to do so.

The employee may also wish to consider requesting flexible working in order to accommodate breastfeeding. More details on how to do so can be found here: https://www.gov.uk/flexible-working

Employers can find more information and guidance on our website, including details of how to join BfN’s Breastfeeding Friendly Scheme. Click here: https://www.breastfeedingnetwork.org.uk/more-information-for-employers/

To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below:

15 Nov

#MakingItWork – what if expressing doesn’t work for me?

Gemma Scott is a registered midwife and health visitor, and currently works for Plymouth City Council Public Health Team. Since her work focuses on children and young peoples’ health, she was familiar with some of the challenges she might face when returning to work as a breastfeeding mum – but what happens if you find it difficult to express milk when you’re away from your child? As she discovered, it needn’t spell the end of breastfeeding.

Some of the most common questions I see mothers asking about returning to work are,

How much breastmilk should I leave with my child?

How often should I pump?

I don’t have enough expressed breast milk, do I need to switch to formula?

My own experiences of returning to work whilst both my children were still feeding (around the clock!) and both around 9 months old, suggest these issues might not matter as much as you would think

Personally, I could never pump a huge amount of milk no matter how hard I tried. I have spent a whole week pumping a measly 100 mls for my daughter! And do you know how much of that precious liquid gold she drank? ZERO, choosing instead to have cups of water, solid food and cuddles with her nanny instead. I’ve tried, pumping and hand expressing religiously in office spaces, cafes, supermarkets, the car and everywhere else in between, terrified that my supply will dwindle whilst away from child, all to no avail. So, as you can gather, none of this stuff worked for me, …but something did, as we continued through our breastfeeding journey well into their toddler years.

Instead, I’ve learned that some good questions might be,

Who or what is my support system?

How can my support system adapt to support me on my return to work?

So, who or what was my support system? Well, it was completely a team effort and it began well before the babies came along.

Preparing my employer and particularly my immediate colleagues for the fact that I would be breastfeeding on my return to work was so important. The ‘what’ of course, was an HR policy which supported me as a breastfeeding mother – so do find yours and if there isn’t one, start asking some questions! Alongside this, during pregnancies I made sure that my work mates knew how important breastfeeding was to me, and how I might need to manage that on my return.  In my case I did make it very clear that I would need to go out of the office to either express or feed my baby during regular breaks.

I kept in touch with my colleagues during maternity leave.  I took opportunities to bring baby in to work to for events and occasional meetings when I could and so, my children became part of my work identity. I believe that this made it easier for my work system to adapt around me and be empathetic to my needs as a parent. I can recall a number of corporate events where I attended with baby in a sling, who was of course then passed continuously around everyone in the room. I mean, who doesn’t love a cuddle with a baby?!

Gemma and her baby at work.

It wasn’t only my employer who was prepared for the need to adapt and support us, but my partner’s also. By asking to flex his hours around our family well before baby arrived, he was able to work a shorter week and to be at home more as needed.  By being provided with the necessary IT and diary considerations, he was supported in supporting me. On his days at home if I wasn’t able to get away from the office for some reason, he would often bring baby to me for a breastfeed. Working in a fairly male dominated sector, he was initially reluctant to request this change to his schedule presuming that it would not be approved or, that it wouldn’t be a priority; but of course it was, so do ask!  

By also having additional childcare close to work, I was able to organise my day around visits for breastfeeds, never being further than a 5 minute drive away.  There were times when I would arrive and baby would be too busy to be interested in feeding, or fast asleep, but to arrive and see that they were happy and settled that was always good enough for me. It wasn’t long before myself and baby were ready to be separated for a little longer, but the transition felt like a process that we were both very much in control of.

Of course looking back, I was very lucky! I had good relationship with my employer, as did my husband. We had childcare from someone we knew and trusted. We had choices. I know unfortunately that this is not the case for lots of families, but some of the questions we asked and the steps we put in place, might be just a bit easier than the challenges women like me face with pumping, storing milk and being physically away from baby for the day.

We know that given the right support baby and mum will adapt around each other, it’s actually up to everyone around us to make sure it happens.

To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below:

12 Nov

Guest post: Emma Pickett on returning to work as a breastfeeding mum

As part of our #MakingItWork campaign, Emma Pickett (IBCLC and chair of the Association of Breastfeeding Mothers) gives her take on the process of returning to work as a breastfeeding mum – from the practical to the more emotional aspects.

The first few weeks are often a blur for new mums. The learning curve is steep and you survive day to day – remembering to shower and put food in the fridge for yourself if you are lucky. For those mums still in the middle of that blur, the thought of the eventual return to work can be one that provokes anxiety.

You can’t imagine how it will feel to leave this new special person in your life.

How do you people cope with drop-offs to childcare and getting back to work after potentially several night-wakings?

What do you do if you don’t want to give up breastfeeding?

As a breastfeeding counsellor and lactation consultant, I’ve been supporting breastfeeding mums on their return to work for the last 6 years and there are a few things that are worth bearing in mind.

Here are my SIX top tips for returning to work as a breastfeeding mum.

1.       Don’t think about it.

OK, now I don’t mean that too literally. My message is just that if you are going to take 6 months, 8 months or a year off work and you spend several months of that stressing about the return to work, you will be seriously missing out.

STOP yourself thinking about it too much. If you stare at your gorgeous three month old and think fleetingly, “How can I ever leave you?” (which is how nature very much wants you to feel), that is fair enough. But if you spend chunks of your maternity leave feeling anxious and worrying about practicalities, you will be wasting the special times you do have together.

This time is precious. Your baby now is not going to be the same person when you return back to work. They will sleep differently, feed differently, and interact differently. You will not be leaving THIS baby but an older one.  So get your childcare sorted (which you may well have thought about in pregnancy anyway) and other than that, there’s not too much more to do! If you intend to express milk at work, it’s a good idea to write to your employer about 2 months before you go back to work to talk about arrangements. And then just carry on as normal. If your 4 month old baby won’t take a bottle and that starts you panicking because you have to go back to work at 8 months, don’t think about it. An 8 month old baby can breastfeed when you are with them in the morning and evening, take a sippy cup, drink from an open cup – you will have options. And a four month old baby that refuses a bottle may not if you try again after leaving it for a few weeks. It’s very easy to set yourself into a panic when the truth is that things usually work out with the right information and the right support.

2.       As mentioned, speak to your employer.

http://www.hse.gov.uk/mothers/faqs.htm#q14

http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/breastfeeding-back-to-work.aspx

The recommendation is that you inform them that you will be returning to work as breastfeeding mum so they have a chance to assess your health and safety and what provisions you may need. Your employers are required to keep you safe. They also have a legal requirement to allow you to ‘rest’ as a breastfeeding mother. Sadly, in the UK, there is not a clearly established legal right to express breastmilk at work and it’s important you talk to your employer so they have advanced warning and you can come to an arrangement. Some women need to have break times re-organised or a room found. Although there is no ‘legal right’ the VAST majority of employers understand that it is in their interests to try and meet your needs and provide you with facilities. Your morale matters and a baby receiving breastmilk is less likely to suffer from illness meaning less time off work for you. There are health and safety executive recommendations and many employers understand the benefits of supporting you as much as possible. However, employers will be more likely to be accommodating if you give them warning and explain your needs clearly.

3.       Talk through your schedule with a breastfeeding counsellor or lactation consultant.

Drop-ins are not just for people with problems with positioning and attachment. It’s really common for a mum to come along a few weeks before their return to work to talk about how they hope to organise their feeding and pumping schedule and how to organise things practically. I’ve included some typical scenarios later on.

4.       Practise pumping.

Is the breast pump you are using a home something you are familiar with? Do you have a backup if you need to pump at work? Is it worth sourcing a double pump if time is an issue or even hiring a hospital grade electric breast pump for a few months which can just stay at work? You’d be looking at paying around £45 a month (http://www.ardobreastpumps.co.uk/breastpumps_for_hire)

There are tricks such as preparing the breast using massage and warm compresses. And we know that women who finish a pumping session using hand expression techniques can increase their output considerably.

http://lllrochester.weebly.com/uploads/7/9/5/4/795404/marmet_technique_tearoff.pdf

It’s also not a bad idea to build up a bit of a freezer stash before you go back. If you start pumping for one extra session each day and storing that in a freezer bag (store them flat and build up layers of thin flat bags which defrost more easily and take up less space), you will have some wiggle room if you need it. It’s not entirely predictable how pumping will go at work and some women find that their pumping output decreases towards the end of the week and then a weekend of normal breastfeeding boosts it back up again. If you have that freezer stash, it will take away some of their anxiety.

5.       Get your kit.

So you need a pump and some bottles and some breastmilk storage bags. What else? Surprisingly not much. You don’t need to store freshly expressed breastmilk in the fridge at work if you don’t want to. You can have a freezer block and an insulated bag and put any expressed milk in there. It is fine in that for 24 hours. So if you store it like that at work, put it in the fridge when you get home, then that milk can be given to your baby’s carer for the next day.

https://www.breastfeedingnetwork.org.uk/breastfeeding-help/expressing-storing/

It’s also really important to note, you don’t need to wash and sterilise the pump between pumping sessions. Breastmilk is fine at room temperature for up to 6 hours. So you certainly don’t need to wash a pump between your 11am pumping session and your 2pm one. Lots of working mums use a technique called ‘wet-bagging’, putting a pump in a plastic bag between sessions and then putting it back in the fridge. Then simply take it out next time and wipe any wet parts with paper kitchen towel if you don’t fancy cold drips against you! This also saves precious time.

6.       Breastfeed when you can.

Your supply is more likely to be maintained if you breastfeed when you get the chance. Is your childcare near work or home? Could you visit your baby at lunchtime?  Could you work from home for one day a week for the first few weeks? You could breastfeed early in the morning, then once more at drop-off, once more at pick-up and again at home later in the evening. Those 4 feeds would be enough breastmilk overall for a baby of 8 months or more. You may not need to be carrying bottles back and forth. And breastfeeding at the weekends and during holidays will help to boost your supply.

Here are the stories of three mothers I have supported (names and some details have been changed):

Carla is going back to work full-time at 6 months. Her son is an enthusiastic exclusive breastfeeder and she’d like to avoid using formula if she can. When her son is 4 months old, she writes to her boss (she is a PA in a law firm) and explains she would like to express her milk at work. Her boss explains the company procedure of having a small office set aside for pumping and there is also a fridge available. Carla explains she intends to express around 3 times in the working day and one of those times will be during her lunch break. Her boss is fine with that. She has a double electric pump which she starts using from 4 months and she gives her son a bottle every other day to get him used to it. She finds he prefers to sit a bit more upright and usually takes 3-4oz from the bottle.

She starts solids around 10 days before she goes back to work and he takes small amounts initially and Carla knows his breastfeeding schedule will remain unaffected for a while. The week before she starts work, they visit the nursery together and he has a few hours there. He then has two trial days where Carla practises her expressing schedule and the nursery workers give him a bottle and some solids.

On her working day, she breastfeeds him as normal at 6am. She drops him off at nursery at 7.45am and offers again and he takes a small feed. At work she expresses at 11am, 1.30pm and 3.30pm. She collects her son from nursery at 6pm. He is keen to breastfeed when she arrives and they breastfeed at nursery. She breastfeeds him again at home at around 10pm as a dreamfeed.  He wakes once at around 2am and she breastfeeds him again.

While he is at nursery, the carers give him bottles and offer solids and he usually takes around 12oz in total while they are separated. As he has 3 good breastfeeds in addition to that in 24 hours, Carla isn’t worried. Carla expresses more milk at work than her son takes in a bottle at the moment. Over the next few weeks, she moves to expressing only twice. Carla ends up offering exclusive breastmilk until 12 months and then she gradually introduces cow’s milk.

Phoebe is returning to work at 10 months. She is a graphic designer and works from home with some client visits necessary around London. Her daughter breastfeeds around 4 times in 24 hours and enjoys solids which she started at 6 months. Phoebe doesn’t enjoy pumping and finds it difficult so would rather avoid it if possible. She finds a child-minder who lives near her home. Phoebe breastfeeds at 8.30am and drops her daughter at the child-minder. If she is working from home she visits at lunchtime for another breastfeed. She then collects her daughter at around 4pm and takes her home to breastfeed at 6pm and around 11pm. While her daughter is at the child-minder, she eats solid food and drinks water. The child-minder doesn’t give her milk. When Phoebe has a client visit, she sometimes hand expresses for a few minutes into a plastic bag when she can grab a private moment. This is just to stay comfortable when she feels particularly engorged. This will help to reduce her risk of blocked ducts and mastitis and help to maintain her supply. She doesn’t keep the milk. Phoebe continues breastfeeding her daughter until she is 18 months old. At the end she is only breastfeeding in the morning and evening and Phoebe doesn’t feel the need to use any hand expression when they are separated.

Catherine is returning to work at 8 months. Her son breastfeeds around 6 times in 24 hours. He started solids at 6 months. He doesn’t particularly like bottles and usually only takes around 2oz max. Catherine finds that he will take more milk from an open cup called a doidy cup. He will also more likely to take it if she mixes the breastmilk with ripe banana and makes a smoothie! Catherine gets through a lot of bananas! She works 4 days a week (and at 12 months will go back to being full time). Catherine is a teacher. Her headteacher has struggled to find her a private room for pumping but has given her the key to the medical room and if that is in use, she uses a stock cupboard and she has told staff that when her scarf is on the door, please knock! Usually the medical room is empty. Her colleagues have agreed to relieve her of playground duty while she is breastfeeding. She breastfeeds her son at 5.45am and again at 7.45am at the child-minder. She arrives at school at 8.15am. She expresses at 10.45am during morning break. She expresses for 10 minutes. She expresses again at lunchtime for 15 minutes and at around 4pm for another 10 minutes. She has to use a double pump as her pumping time is restricted. She remains at school for meetings and lesson preparation and collects her son at around 6pm. She breastfeeds him at 7pm and 10pm. He wakes to feed between 1-2am and Catherine is happy for that to continue for the time being as he feeds and goes back to sleep quickly.

With the child-minder, her son takes around 3oz of breastmilk in his smoothie, 2oz mixed into a porridge and another 1-2oz from his doidy cup. She also makes sure his solids contain good sources of fats and calcium. Sometimes she struggles to pump in her breaks as she really needs to continue working. She finds herself dipping into her freezer stash and as time goes on, the child-minder sometimes uses formula to make up the porridge. On the weekends and on her day off, he breastfeeds more frequently.  

There are many women who effortlessly combine breastfeeding and working. If it sounds hard, remember that in the USA there is no statutory maternity leave and women often return to work after just a few weeks. However they have 16% of babies exclusively receiving breastmilk at 6 months and the UK manages 1% (http://www.cdc.gov/breastfeeding/pdf/2012BreastfeedingReportCard.pdf).

Working and breastmilk are not incompatible. With modern electric breast pumps and using breastfeeding support available locally and through the National Breastfeeding Helpline, it’s never been easier. However if we could get the statutory right to pump at work it would certainly help. Contact your MP if you feel the right to express at work (as exists in 92 countries throughout the world) is something UK mums should be entitled to.

This article was originally published on Emma’s blog, here, and is reproduced here with her permission.

To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below: