What do you think is the biggest barrier to breastfeeding In Australia?

[BellyBelly]

As you may know, I am presenting in the Parliamentary Inquiry Into Breastfeeding in the coming weeks. I would like to hear your thoughts and for you to vote in this poll as to the things which you think are barriers to breastfeeding in Australia. While I know there are many things contributing to this, I would like to know what your #1 thought is as to the most pressing reason why our breastfeeding rates are lower than other countries.

Please feel free to list all the options above which you think are of big concern for you, or perhaps in order... all help and comments appreciated!

Here is the list to help:

Conflicting advice after birth
Interventions at birth
Lack of continuity of care
Accessibility of artificial milk
Marketing of artificial milk
Lack of education
Health professional influence e.g. MCHN, Paed
Family &/ friends ideals/advice/expectation
Going back to work with lack of bf support
Lack of availablility/affordability of support

EDITED TO ADD: I will be submitting this discussion to parliament as a submission as per their encouragement, so please let me know if you do not want your comments included and I can edit them for the submission. Thank-you!

You might also like to consider making your own submission, lots of organisations have put in their research etc so now they want to hear from mums. Its as simple as sending an email with your personal story and they will keep accepting submissions from mothers until everyone has had their say (despite the expiry date for submissions being in February - they didn't realise how big this would be!). You can read all the details here: http://www.aph.gov.au/house/committe...breastfeeding/

[Rouge]

Lack of education not only for mothers to be, but also for professionals (midwives, obs, GP's, MCHN's (ESPECIALLY), Paed's). There are currently too many trains of thought...

The ABA should have government funding to help support them in supporting us.

Laction Consultants should have to have certain qualifications and possibly even tested by a main body. As I've had some great ones but also cr@p ones.

I think Teenagers should be taught about the benefits of breastfeeding in sexual education to eradicate the taboo of breastfeeding.

There should be breastfeeding facilities on site in the workplace (fridges/pumps etc) and workplaces that support and encourage new mothers to breastfeed.

Totally get rid of "its natural" I think this slogan is so misleading and its half the reason people stop breastfeeding because they think their body has failed them, when in reality establishing breastfeeding in some cases is harder work than for others but that hard work is worth the effort and nutrients your baby receives.

There's more in my head...

ETA: Oops there's a poll now (I'll just go do the poll)... LOL!

*hugs*
Cailin

I breastfed for 3 weeks. battled bad cracks for most of that time. i went home the day of my birth, and had a midwife (same lady throughout pregnancy) visit me at home. she was helpful but after just 2 weeks, handed me over to the early childhood health centre. so i had no help with breastfeeding. when the cracks got unbelievably painful and i was full to bursting, i just gave dd formula. never bothered to call midwife. she then loaned me an electric pump but i got only a small amount of milk. it turns out i wasn't having let downs. cracks were healing and back onto boobs (i felt it was too soon, but she had all the experience). no more care, no more pump and cracks came back within 3 days. got myself a pump (hired) and got 40ml of milk total in 3 days. so i just gave up. later on at mother's group, one mum had a feeding line and was on milk production meds. wish i had more support and could have done that. my family were all supportive of me giving dd formula. she plumped up and put on a heck of weight within a few weeks. there is a definite lack of support for those who are struggling. and there are advertisements for formula but only for toddlers i have seen. i had no idea which one was right for her, i just got whatever the chemist had.
ps sorry for long post, my first

[Lady Zaidie]

Although I can't comment for Australia, the best advice I had was the day before I gave birth, and that was "expect to have problems". I had never thought that I'd have a problem, and when I did that advice kept me from feeling even worse (although a midwife did try to make me feel as bad as possible about it).

I would say, for me, a midwife pushing formula milk very, very hard on day 2 would have stopped me breastfeeding if I weren't so bloody minded about it (and knew I'd have the backup of the girls here once I got out of that... well, NHS hospital says it all really - oh and the constant reminders from my family that I'd previously said I'd wanted to BF for at least a year just to make me feel extra crap). Telling me to FF until I could see a LC (which would be on day six if I were lucky) was not helpful at all, especially when all she did was say that DS was doing well now so no need for her to be around after all.

And pictures of babies who decide to come off the nipple early so are sprayed with milk over their face and hair would help, I think it looks so cute, shame I never took a pic of Liebling like that! Oh well, I bet he'll be like that soon enough as he's just having a growth spurt now. But it just shows you that breastfeeding can be fun too.

[Mayaness]

Definitely lack of education all round, IMO and in my experiences/conversations with other women.
For instance, many women do not realise that stress about BFing difficulties (including pain, cracked nipples etc) can and will affect letdown. I was lucky that I was subscribed to the ABA by a relative. I received my free book and read it before DS was born. The book told me about stress affecting letdown. The book helped me diagnose vasospasm that I had instead of hindered letdown (oversupply meant I had major letdown!) - that was my manifestation of the stress of attachment problems caused by undiagnosed tongue-tie. The book was my first education, then I went to meetings and have been reading Essence religiously for their research updates etc and began educating myself.
Lack of education lets down far too many women in this country. I am not saying that women who give up are ignorant. I'm saying that many are being failed by our 'health system', that could do with a goodly bit of breastfeeding education because that would then alleviate the burden on the health system in so many, indirect ways.
I have said it before and will say it again, instead of trying to scare the bejesus out of me when I was pregnant, those women with their birth story badges (the worse the birth, the better the story) should have told me about breastfeeding. One of them had the nerve to tel me, after finding out that I was having attachment problems, "yeah, it looks easy, but it's not, is it?"...you tell me NOW? When you could have prepared me for this two months ago???
Anyway, I digress. I totally support the idea of breastfeeding education for our school children - boys and girls. Muslim women must be taught about it, as it is enshrined in the Quran - anyone care to educate me? The Quran and that fat man, Buddha, have got some great teachings to live by! Again, I digress... it's late and I should be in bed, or writing an assignment...

[Edensmumma]

Accessability of artificial milk is definately right up there... i have had a friend say to me... "im sorry to say Gill(when i was having a blubber about no sleep) FF fed babies are just so much easier, you have chosen the tough road for yourself"?!?!... that statement made me angry. Eden is a bad sleeper and everyone, wants to put it down to her being bb fed. I also think its lack of support, families often dont "get it", and my mum and hubby's mum didnt booby feed....
Lack of education- but this too is the womans responsibility and it is out there!!! i was a little library worm while i was pregnant, i read everything about birth and then when i thought i was ready there i moved onto breast feeding... you have to learn about breast feeding, esp(going back to above) if its not around you, i mean lots of us had never seen anyone breast feed before having our bubs... You need to go in search of information... I also think how amazing would it be to be taught these things at school- i mean crikey you get taught to feed yourself in Home Economics, why not be taught how to feed your children too?

[christy]

oh there are just soo many to choose from IMO though I've had too many "health" professionals telling me to FF. MCHN's telling me over the phone that I don't have enough milk and should FF (even without seeing our feeding relationship...)

[Berry]

Hi Kelly,

Interesting thread and quite a topical issue to me personally.

I have always been very pro-breastfeeding and always intended to be a breastfeeding mama, and so (having easily breastfed my first baby for 14 months) it was hard having a hospitalised 27-weeker and having all sorts of obstacles which led me to abandon breastfeeding attempts when she was 4.5months old. I am now a consumer rep. on a hospital Committee (mainly comprised of neonatal medical staff) which is forming extensive guidelines for establishing feeding of hospitalised babies. I have been advocating to my best ability for the hospital to encourage every possible avenue, within funding constraints, to support breastfeeding of prem babies.

So for me the first barrier to breastfeeding has been baby's early hospitalisation which caused unavoidable maternal separation (would have LOVED to room in with my baby at the hospital for the 3 month stay but unfortunately that just doesn't happen with NICU/Sepcial Care), and baby's immature development causing physical difficulty latching on and sustaining the energy to feed.

From your list, I would say Conflicting advice after birth has been a significant barrier following both my birth experiences - particularly nurses differing in their beliefs / patience / assessment of mum's breastfeeding success and baby's sucking ability. Can't generalise as I have had some absolutely amazing nurses assist me with breastfeeding. However, after my firstborn arrived and I felt I was doing a great job with him latching on and feeding well from the start, my mum overheard a particular nurse say to another nurse that I "still hadn't learnt to breastfeed my baby". The same nurse insisted that I return to the hospital after discharge to have my baby weighed, as she felt he couldn't be getting enough milk. He had put on well more than expected and as his mum I always knew he was a content, great breastfeeder. That is one example of an experience where a first-time mum could have been put off by the unfortunate attitude of a nurse. All the other nurses were great with my firstborn though.

With my second baby (prem), when she finally began graduating from tube-feeding to suck-feeding, me and some of the wonderful nurses were delighted and rated the initial attempts as successful and despite what this 27-week-born-baby was up against, she sustained some pretty good sucking (and was then topped up with EBM each time). I desperately wanted to hear that me and my baby were doing a good job and that there could be hope for successful ongoing breastfeeding. I felt really deflated that one nurse had to say "your baby is a poor sucker", and pointed out that other babies in the room were doing a lot better. That broke my heart and I wish all prem mums could be told that they are doing an amazing job just getting anywhere with breastfeeding.

[Tobily]

Gosh can we only pick one?

I would say lack of support after leaving hospital (the last option?).
I was lucky enough to have a champion feeder this last time and not need any help with him. But I had alot of problems with Emily and I found it very hard to get help. I am a well educated, capable woman as many mothers are, yet I found it pretty much impossible to access the help I needed in my community to help me breastfeed successfully. The ABA were no help to me at all despite contacting them repeatedly. What I needed was a lactation consultant who could come to my house and work with us face to face - but at the time I didn't know such a thing existed, let alone how to access it. I think that's really appalling.

Further compounding my problems (in fact probably one of the root causes) was the fact that Emily was born 4 weeks early, so was jaundiced and sleepy. I was booted out of hospital on day 3 before my milk had come in so I was left to work it all out for myself at home - with a premature, sleepy baby who couldn't stay awake to feed properly for nearly two weeks. So many mums have similar stories of having to go home before they've got milk so no one is around when they actually start feeding "for real".

Running a close second is the return to work issue. I had to go back to work when DD was four months old so when I decided to wean her at two months with all the problems we were having it was an "easier" decision because I knew I would have to do so in another few weeks anyway. Like many mums the practicalities of trying to express and store milk at work were seriously prohibitive.

Interestingly, I have a full year of maternity leave this time and DS is still breastfeeding and I expect he will be until after I go back to work, and probably longer since by the time he's one, expressing won't be such a drama as he won't need as much milk as a three month old.

[Fee]

I think definitely lack of education and then followed by the accessibility and marketing of ABM.

[rayray]

I voted for Health Professional influence, but I think its really a combination of things, probably these 4 would be the main ones in my experience.

Lack of education
Health professional influence e.g. MCHN, Paed

Lack of education, both on the part of the mum and contributing to the health professionals "advice".

I know of one OB who frequently tells mums to stop breastfeeding at their 6 month check if he decides their weight gain is not up to scratch, when often its fine for a b/f baby.

A lot of mums have no idea. Most in my mothers group did not know that the charts (until recently) in the baby books were based on white, middle class American FF babies.

I have also met a lot who are scared of the ABA. I mean it, the term "breastfeeding nazi" was used, and they thought that they'd be frowned on for having problems.

I was very, very lucky that all of the midwives when my son was born were supportive of me breasfeeding, and that he was a big baby.
My milk did not come in until day 5, and until then we were hand expressing and catching it in syringes to feed DS. He didn't attach properly, breastfeeding DS was extrememly painful for me and frustratig for him.

The oncall paed wrote him up for comp feeds.
The midwife and the LC discussed it with me, and we decided that he didn't need them just yet, he was getting enough, albeit barely.

I stayed in an extra day at the Breastfeeding day stay (not enough of these available IMO. I have been 2 two different hospitals for them, it was great) and had another 5 or so visits after we went home.

I was lucky to have a supportive MCHN, who could recommend a pro-b/f paed. for me to see.

Unfortunately not everyone else is as lucky as I was.
I think all mums and babies deserve to have this care and these opportunities.
It shouldn't come down to the luck of the draw.

[Eugenia]

I can't pick just one! I think they're all very important. ANyway, here is my list in order of what I think affected me the most.

Health professional influence e.g. MCHN, Paed
Family &/ friends ideals/advice/expectation
Lack of continuity of care
Conflicting advice after birth
Lack of availablility/affordability of support
Lack of education
Interventions at birth
Accessibility of artificial milk
Marketing of artificial milk

I probably should have put lack of education higher as I really didn't bother to educate myself about breastfeeding as much as I did about pregnancy and birth, I just assumed it would be easy because it's the natural thing to do. I also wasn't the only one amongst my friends who thought that. I know others who stopped breastfeeding because they had an unsettled 5 day old baby and just assumed they didn't have enough milk and that was the reason for the crying. One friend even told me that I too would give up bf just like she did once I had to be up at 3 am with a crying baby.

Which brings me to family/friends/society expectations. I found that in our society ff is seen as the norm by just about everyone and as soon as you have any trouble the advice is, "switch to formula". People think you're crazy to choose to persevere with bf despite having massive problems. Even a so-called LC told me that. There should be some sort of standard to make people have real qualifications to work as LCs, and not have just anyone do it.

Enough of my ranting. Good luck, Kelly. I hope you can make them see some sense!

[Trillian]

I can't choose one to vote for in the poll as every single one of them influences what a mother choses to do. Several may apply to one womans journey, and for others it may only be one thing on that list. Sadly, the list is just too long to start with and it shouldn't be kwim? I really do think that everything needs to be addressed as all of them relate to one another - i.e. lack of education can be compounded by conflicting advice and then the availability of formula when the advice doesn't work.

[dee73]

I had supply issues with my milk, as did my mum. I would have tried to increase the supply but felt I was being bullied by the nurses at CYH who told me Dylan was feeding well but was just "difficult" when actually they had weighted him incorrectly and he was losing weight! By the time this was discovered by a Paed, it was too late to build my supply back up so he was weaned at 8 weeks. I felt awful that this happened and was then very cross when the same nurse scoffed that "of course a paed won't support breastfeeding" when it had been HER mistake in the first place that caused my son to be starving!

Next time I will listen to my own instincts instead.

[bigbird2girls]

For me personally it was conflicting advise after birth. I was told one thing then another. I basically self taught myself and read books. I was lucky though that my DD new how to do it and i had no problems. I only got mastitis once which i had no idea about either no one told me anything, it was like they thought i had already had about 4 babies and it was not my first!

I also found that not one of the midwives were trained the same way and i found that the older midwives obviously did not go to regular updates in training to be in line with the now times, it was always back in the old days etc etc. The new young midwives were trained well though and were helpful no negative advice was given from any of the younger girls at all it was the older girls who gave negatives and did not support you.

HTH

Jen

[chocolatecatty]

I voted lack of education, specifically about artificial milk. For one, formula should be know as just that..artificial milk. Does it say that on the tin?

I HATE going to the supermarket/chemist and seeing tins and tins on this stuff in the baby section. It totally normalises artificial milk. It makes mothers-to-be think there's two options for feeding thier unborn babies, an either/or, a simple choice. Like they're both good choices and you must pick one!

I had one young mum tell my mums group she tried bfeeding for a day or so with her 'fantastic milk supply' but then switched to, get this, 'normal milk' as it was too hard. I would have ripped her head off but I hardly knew her and so held my tongue.

The fact that formula is in our faces, and breastfeeding women and ads aren't, leads a lot of young mums to think that it's absolutely fine to use, IMO.

And a close second would be all the different opinions of midwives. I think even if they were trained up in the same way, they'd still pull you aside and give you thier own differing opinions. It was never pointed out to me that I had flat nipples (yeah, I didn't know either!) and I was sent home before my milk came in......lucky for me I scored a very pro-bfeeding visiting health nurse who sorted me out with shields and advice.

[Suzyanneau]

I spent months reading about pregnancy and birth. I didn't realise that breastfeeding could be so complicated. I had such a lot of milk and a baby that was too sleepy to suck. I battled constant bouts of mastitis, cracked nipples and leaked badly all the time. I'm pleased I perservered because I ended up enjoying breast feeding very much. I do think there needs to be more education on breast feeding.

Suz

[cathybutterfly]

I voted for conflicting advice, but these are my 3 biggest reasons I struggled (however did stick with it):

Conflicting advice after birth
Lack of education
Lack of continuity of care


I found each midwife/nurse on duty in hospital had different advice, none of which actually helped anyway.

It wasn't until my daughter was 5 days old and I was home, and my birthing centre midwife came to visit that I finally got some advice which actually helped.

However, I'd also like to comment on the ABA. I found 2 piece of their advice in literature etc totally inaccurate, not just for me but for several people I know:

1. that letdown "tingles". For me it really really hurt, and for several months.
2. that if you introduce some formula your breastmilk will suffer. I have successfully breastfed and formula fed my daughter from 2 weeks old until 12months old, and will continue with this.


Cathy