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

[MantaRay]

Wow, so many response. Obviously I'm not the only one passionate about this topic! I have made my own submission to the enquiry so I'll try not to be too detailed here as well, but I also think there are many factors.

From the list, I think the main factors are conflicting advice, lack of continuity of care, lack of education (for the public and health professionals)and the availability of artifical milk. I experienced lots of problems when Jack was born - he had a tongue-tie and couldn't attach, I had engorgement beyond belief (and again with Thomas - I expressed over 440ml in one sitting and was still not empty!), sore nipples and mastitis twice in the first 3 weeks. Despite seeking help from mws and lc in the hossy, and the MCHN after discharge, I did not receive useful help until joining the ABA. In fact, not one health professional (until I found a gp who specialised in tongue-tie snips) believed that the tongue-tie was the problem. I was instead told I had flat nipples, and that it was this and not the tongue-tie that was preventing attachment. Then after Tom was born the mw told me I had great nipples for bfing - these are the same nipples, which is it??? Well, seeing as I was able to successfully feed Jack without nipple shields once his tongue-tie had been snipped, and was able to successfully feed Thomas without nipples shields from birth, I'm guessing the problem really was the tongue-tie.

In my submission I also list other reasons that I feel contribute to the low breastfeeding rates, including mis-information from health professionals (one gp told me that bm is as effective as water in preventing illness), the view in society that ff is the norm, especially after 6 months and even more so after 1 year, and the inability to get products and support for bfing easily - eg breast pads, breast milk bags, info on expressing and bfing after returning to work etc. I am sure there were more things I mentioned too (I think my submission is no 108 or 109 on the inquiry submissions website if you are interested).

Whoops, I think I did get too detailed. Better stop now!!

[Bathsheba]

I thought long and hard about this one.... almost chose "lack of education" but in the end, like Tanby who I agree with %100, I think it's the accessibility and marketing of artifical milk. I specifically chose the "marketing" because I think this is the worse of the two situations that the govt. should actually tighten up on and do something about.

The way I came to this decision is because, going back to 'lack of education', sometimes you can educate people until you are blue in the face but at the end of the day people will do what is easiest if they think the outcome will be pretty much the same.

I don't want to offend all the poor mums who have tired desperately to BF their babies because my heart goes out to them... but I believe there are many mums in the broader community (not so much here in BB) who try to kid themselves that artifical milk is "just as good" so that their lives are easier. I draw an analogy with the Healthy Food/Diet campaigns: everyone KNOWS that you should eat from all 5 food groups (2 fruit and 5 vegetable serves per day etc) but how many people honestly do??? Most of us consume things that we know are of very little nutritional benefit but we eat them anyway because it's convenient and/or it tastes good and we don't think it will do that much harm.

So I think, at the end of the day, it's human nature to do what comes easiest and I honestly don't know what can be done about this. I'm not saying either that ALL mothers take the easiest option! There are hundreds of wonderful stories of womens' journeys to breast feed their babies despite difficulties both here in BB and on the ABA forum. I have the deepst admiration for these women

So I just want to restate that my main point is that artificial milk companies should not be allowed to convince the public that their product is comparable to breast milk. Not just because it is swaying the choice of parents... but because it is infuencing everyone and minimising the importance of breast feeding in general and impeding the BFing 'friendliness' of society as a whole, workplaces/shopping malls etc.

ETA: I also think that a few "warm and fuzzy 'Huggies-Style' Breastfeeding "Ads" (Govt education campaign) on TV would help... I'm sure a clever marketer could beat the formula companies at their own game

[MantaRay]

Off topic, but Karina, I continued to feed after returning to work. It was actually easier than I expected. I hope you give it a shot!

[ashsmum]

Hi Kelly,

I think a lot of people just generally think breastfeeding is 'weird' and feel uncomfortable around us. Especially if you breastfed past 6 months. I am still breastfeeding my son 15 months and a lot of people are telling me it's time to wean him cause he's a toddler. Perhaps they see it as sexual?? I can't get my head around it. I asked my husband and he said it's just 'weird' when a woman breastfeeds a toddler... what ever that means! It's a real shame as it's not sexual or weird, actually very natural and the best thing for them. The world Health Organisation recommends 6 months of exclusive breastfeeding and feeding them for two years as well as solids. It's not fair of other people to judge or comment, I think they should just keep their comments to themselves and live their own lives! They are our breasts and our children! That felt good to get off my chest actually So this might come under Family &/ friends ideals/advice/expectation???

Kind Regards,
Charmaine

[Smoke Jaguar]

It's an intractable situation, the way I see it. Whilst, yes, formula and wet-nursing should be for when breastfeeding really does not work out (not for want of trying), it's hard then to, simultaneously, remove the stigma from those feeding methods so that mothers who CAN'T BF don't feel like failures. Again, education can help with this one. It is not helpful to have a 'breastfeed or die' attitude, and neither is it helpful to espouse 'if it's too hard, just use formula'. There IS an inbetween, but we get caught up with the extremes instead.
I knew I COULD bf, and yes, perseverance is a huge part of it. But, why do we persevere? Because we know the substantial benefits of it. Those who persevere do it because they KNOW what they're working towards.
It is too simplistic to say that the problem is that people don't persevere. Perseverance has an aim - those who don't know the aims, i.e. those who don't have that education, are far less likely to persevere when they hit the speed humps. The education (knowledge, experience, exposure) has to be there for perseverance to happen.
Lack of family support, to me, points to lack of education of the family and support systems. I really do think it comes back to education and knowledge.
ETA:
Katiepie - there SHOULD be facilities for you to express or bf at uni - get yourself in contact with your Women's Contact Officer person, facilities manager or student association and look into this. Please don't take it for granted that you have to wean. If you start making noises now, by the time you go back there should be something set up, if nothing is now. Find out if staff have expressing facilities. If they don't, get them on board, too! I've started to make noises at my uni about this. QUT has got excellent facilities for families and bfing students. It is not good enough to have students assume they have to wean! Please don't take this one lying down. It's your child's human right to have access to breastmilk and your right to keep feeding your child. I am only studying part time, but I also do volunteering, and I have to palm DS off to MIL to get some study in. It's heart-wrenching for me, but I express when he's not here and that provides milk for him for when MIL has him. I freeze it into cubes and grab a few, pop them into a sippy cup along with some food and off he goes. If he's going for more than a few hours then he gets a container of frozen EBM. It CAN be done. During a recent weekend school, when I wasn't able to use the psychology dept's sleep labs, I expressed in my car and brought an insulated lunch bag with frozen packs to store the milk till I got home. If your BFing means a lot to you, you'll find a way...I did
This is part of making BFing normal in our society. If it were normalised, there would be far more facilities available for expressing and BFing, because more workplaces, uni spaces, social spaces etc would be aware of what lactating women need access to. It's definitely a bee in my bonnet!

[totalfrog]

I am new around here but I thought I would throw in my opinion. Back in the day a woman's mother/sisters/aunts who had children of their own would help her with the new baby and give advice on breastfeeding and the like. They knew what they were talking about because they had been there and done it.
Today women are expected to listen to health professionals that not only haven't had children but also haven't been educated themselves. I had a midwife in hospital who tried to convince me I held my daughter wrong and constantly tried to move her around while I was trying to feed her!! My mother caught her doing it and told her where to go.
Luckily I had a mum who had breastfed us and a sister who breastfed my niece and they were willing to offer advice and listen to me whinge about being the only one who could feed the baby at 3am! My husband was also very supportive of whatever I chose.
I think we need more support to BF our babies. IT IS HARD!! but just like labour nobody tells you the truth before you try and do it, leaving women with unrealistic expectations and feeling like failures when they really shouldn't.

[*charmalea*]

i had issues with bf since day one ...
every few hours or so a midwife would hold my boob in one hand a bub in the other and i just sat there i had no idea what was happening at all .. ds didnt latch on in hosp and i went home and hired a pump... each feed i tried to get him to latch on but it was tricky... after 2 months of pumping he finally latched on ... i was relieved .... when he was 5 months my supply dropped and i tried everytihg to get it back.. nothing worked... i feel like i havent tried hard enough even tho theres nothing left for me to try.... people and nurses shame you when you whip out a bottle and everytime in public... i mourn for my milk and die of shame when ppl look at me ... i even went back to the lc who helped me in the beginning and she said if i was happy to give some feeds and formula at other it was ok... she didnt help me when i said i wanted each feed to be a bf... it was a sad day that day, she was a professional and didnt even help.. pfft!!

[Bathsheba]

Edited my post.

Loved your comments Totalfrog: "IT IS HARD!! but just like labour nobody tells you the truth before you try and do it, leaving women with unrealistic expectations and feeling like failures when they really shouldn't."
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[Smoke Jaguar]

Jelvie - I was talking about attitudes and that there can be an in-between attitude. I mean an attitude of "well, you have tried and tried because you know that the benefits are plentiful, but now we need to look at plan B". The WHO has this sort of attitude - Plan A is to BF, plan B is wet-nurse, plan c is EBM (have I got that mixed up?), plan D is formula, or something to that effect. Whilst 'last resort' is the best term I can think of, when other people use it, it tends to have a slightly negative connotation. Maybe that's just me. It concerns me that the term infuses a mother, who is already feeling guilty, with feelings of ineptitude.
So, Jelvie, I'm not sticking my head in the sand, I realise that in our society it's a BM or formula dichotomy (not always, though - as someone else said, they comp feed, and that's possible for many women, too), it's the ATTITUDE I'm referring to. We don't have to be 'nipple nazis' and we don't have to be the women who say 'look, it's just easier to FF'. We can be women who are empowered with knowledge, and then act according to our own circumstances, or advise with consideration for someone else's circumstances. Even the ABA is curerntly trying to tackle the false image that is out there portraying a bunch of women saying 'you HAVE to BF, no matter what'. Both extremes concern me.
KWIM?
ETA I'm probably not explaining myself well, but let me stress that my post was referring to attitudes, not actual feeding practices
Nixonsmama - your lactation consultant did the right thing by you! She can't control the fact that you will want to beat yourself up about it - she recognised that the best thing for your baby was to comp feed and was helping you to accept that. It's not a reflection of her professionalism or skill that you didn't want to accept her acceptance. All I can say is that I hope you feel better about it now or very soon - there is plenty more about your baby's life that you will beat yourself up about, let go of something you really tried hard to 'fix' :hugs:

[YummyMummy]

I feel the continuity of care for new mothers albeit 1st or subsequent births in Australia is dire considering all pregnancies and babies are different!! As a new mum - to my 3rd - in the UK, the midwife visited me at home everyday for 10 consecutive days enabling me to ascertain a routine, heal, milk come in, deal with my emotions and other issues thrown at me and have the support of a team of midwife's to answer innumerable questions, weigh my baby and HELP with breastfeeding. With my 4th baby born in Australia I was on my own. On day 5 having to make my way to the community centre for her heal ***** test whilst dealing with terrible problems feeding thus amounting in 3 courses of antibiotics and visits to the dr. and Ob.whilst dragging a 20month with me between feeds and sleeps.....not to mention the soreness of giving birth, um the last thing i wanted to do!

I think that makes a small point -

Good luck!!

YummyMummuy xx

[jimssteph21]

I really think that intervention at birth has a huge impact on the breast feeding relationship. DS1 was not given to me until 24 hours after his birth, because of emergency c/sec. I only bf for 4 months, his attachment was poor so I started to dry up. A scheduled c/sec with DS2 and he was not given to me to feed for 48+ hours due to being put in to a humidycrib. I bf him for 8 months but he also had poor attachment and was a lazy sucker. But I made specfic requests to feed my 3rd son very soon after birth, and within 2 hours of my 3rd c/sec I was feeding him. He had a great suck and excellent attachment. I think the time between birth and the 1st breastfeed has a significant effect on how well the breastfeeding will go for you. Granted breastfeeding is usually introduced quickly with natural births but c/secs are a different matter. The faster a baby and mother are reunited after the surgery really helps in my experience.

[Rach80]

For me I also had supply issues. My Bubs was 8 weeks prem so i expressed for 7 weeks as bubs had to be tube feed she also had alot of trouble attaching to me while in the hospital.I bf untill she was close to 5mths (3mths corrected), and at that stage she was bf every 1.5 -2hrs apart,including nights. For me complications at birth,affordability/availabilty of support and education were what i think were my main concerns.

[Jennifer13]

This is a hard one for me, since I didn't have too many problems and had access to an abundance of education, etc.

I chose Going back to work with a lack of bf support. I think many of the comments on here relate to why women don't bf soon after the birth, in the first few months, which I think is hard pin down (society?). But from the figures I've read, Australia also has a shocking record of bfing to 6 mths and as for getting to 12 mths...! IMO the reason for that is that so many Mums have to go back to work. There aren't a lot of expressing facilities in most workplaces, it's considered a bit 'odd' and childcare centres don't seem to be geared around using expressed bm. While I didn't have to go back to work, since I work from home, I had to organise times to be at clients' offices around Lucy's feeding times (certainly can't whip out a pump in the middle of a meeting!), and OMG that's a challenge! In countries where there is paid maternity leave the bf rate is much higher.

My second choice would be a lack of good education. Some of the stories I've heard from others and what they've been told (by health professionals, which is scary) is totally contradictory to what I read from reliable sources and found to be true.

[bon]

I haven't voted. I can't really say what is the single biggest barrier for breastfeeding in this country is...they are all very valid reasons.

A big one I think is women being discharged too early from hospital, before their milk has come in and without any real knowledge of what to expect, and how to deal with difficulties. So I suppose that could be classed as lack of eduction.

I don't think that getting rid of formula is the answer. That is like saying because we have an obesity problem in this country we should get rid of all takeway shops, or get rid of all high fat foods in supermarkets. Or because cars contribute to pollution that we should ban them. It implies that we are not smart enough or too ignorant of the issues to be able to make our own decision.

I think at the heart of it is lack of support - in the home, in society and at work. Not just for breastfeeding either but for parenting in general.

Then there is the fact that, no matter what you are told or taught about breastfeeding, no matter if you have all the support in the world - there are those who just don't want to do it. Purely and simply, they don't want to do it, and there is nothing that will change that. In the past, those women who didn't want to breastfeed (usually those in a higher socio-economic class) got a wet nurse. That is not an option these days, at least in this country, so those who don't want to breastfeed use formula.

[Smoke Jaguar]

Yep, Jennifer - good education, the right kind of education, helpful education! Good point
ETA - but Bon, why don't they want to breastfeed? I really do believe that if many of these women who 'don't want to breastfeed' were given a sound, balanced education about the ups and downs of BFing, that many would then give it a go.
It IS a lot like labour and birth - you know that the benefits far outweigh the hassles of it. With me when I first started BFing, I had the education about why I was persevering with it, because I knew that once I'd gotten past the initial period of learning to BF, I would be richly rewarded. I can now say that I had no idea just HOW richly rewarding my BFing experience would be, so I am especially glad that I had the support from friends and, most of all, DP. Yes, non-BFing mothers DO miss out on the unique aspects of an infant-mother bond that come with BFing - for the ones who needn't miss out on that (that is, the ones who don't have physiological or medication issues), this should be a reason to persevere, the rewards are great and very much worth the initial attachment period, because it DOES get better

[Pandora]

OK, I wanna change my vote to whichever category this comes under:

A big one I think is women being discharged too early from hospital... before their milk has come in and without any real knowledge of what to expect, and how to deal with difficulties.

Bon reminded me of the other thing the midwives when I had DS told me Women should have the choice to stay in hospital until their milk comes in and b/f is established. I guess a budget surplus is more important.

[amy&rafi]

hello kelly and fellow mums!

i voted for 'interventions at birth'...

if policy-makers want to know why there is big barriers to breastfeeding they MUST first recognise the great disadvantage most mothers begin with... many women are captive consumers to a health care system that does not make it easy for their bodies to transition into motherhood...

hospital protocol calls for a cascade of interventions that severly hinder the mother- infant bond as well as a mothers body's ability to provide the necessary hormone triggers that make breastfeeding 'natural' and enjoyable

even a 'natural' birth comes with sintocin injected after the head crowns, premature clamping and cutting of the cord and a vitamin K injection (and hep B vaccination) for bub... and that's if everything 'goes well'!... our health care system needs to re-think its policies regarding birth and care for all mum's and bubs.

i strongly believe by simply letting women be during and immediatly following the birth of their babies (rather then the unnessesary poking and prodding and injections that often go on) the rate of breastfeeding would increase! the transition into motherhood and also breastfeeding would be smoother and more rewarding for thousands of mothers in the australian system...

i also think the other options mentioned are definately contributing factors, however many of these could be avoided with some preparation and information gathering on behalf of the mother. i hate to sound cold but each of us as parents are responsible for our choices and experiences in regard to our babies. at the end of the day, it's not the midwife (with his/her discouraging words) whose baby gets formula over breastmilk- it's yours- so if it's not what you want for your child- then dismiss their negativity and get a second opinion.

*food for thought*: a lactation consultant is going to work out to be alot cheaper then infant formula in the long run; and also going to cost you alot less emotionally knowing your giving your baby the best...

there is a plethora of positive information out there (in the form of books, pamphlets, mothers groups and on the web) that can both educate and inspire mums to commence and persist with breastfeeding- but you have to get out there and look for it (and honestly- you don't have to dig deep to find it).

after arming myself with a range of positive information there was not a single advertisment or negative comment from health care workers that could deter me from breastfeeding after the birth of my son. i had sourced mothers groups toward the end of my pregnancy that supported my ideas and was ready to turn to them for support if needed. i began planning soon after i found out i was pregnant how to adjust my work and financial situation because i knew i would not be returning to work for 6 years after having a baby so we downsized to make that possible.

it is so important that every parent set goals and then place ourselves in a position that gives us the best chance to succeed :angel2:

[hannahfroodoo]

I chose conflicting advice after the birth but I also think lack of education is a big factor. I am still BF my 11 month old - only because I was absolutely determined to do it. I had the bleeding, pus-oozing, infected, cracked nipples until DD was over 3 months old. I have large, gaping scars in my nipples where the cracks were.

I put my problems down to a few things:
1 - DD was attaching incorrectly from the start. I asked a midwife at hospital if I was 'doing it right' since it was hurting a LOT. She said - without even looking - 'Oh yes, it's normal for it to hurt.' When I saw a LC about a week later she told me 'If it hurts, you're doing it wrong - take her off and reposition.' So much conflicting advice. There should be LCs there at the hospital who can talk you through it and give you strategies for coping.
2 - I saw the LC at my child health clinic every couple of days for the first 6 weeks. It was just getting worse and worse. It was only when I went to the doctor for my post-partum check up and was prescribed antibiotics for the infection that things finally started to improve. The LC was wonderful - BUT she should have known that it was infected and sent me to a doctor earlier. Better training/standards for LCs would definitely help.
3 - I knew that people got 'cracked nipples' from breastfeeding. I had NO IDEA it could last 3-4 months like mine did or that it would be so very excruciatingly painful. In my antenatal classes cracked nipples were talked about as though it was a problem that lasted a day or 2. You just lathered on some lanolin and gritted your teeth and it would go away.

sorry - hugely long!