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

I chose conflicting advice after birth, but I'd love to say all of the above too! I was fortunate that I had done reading and research, and attended an ABA breastfeeding class, so was able to sift through the variety of advice given in hospital.. and yes.. there was a variety!!

I was able to eliminate any fears of lack of supply etc, coz I knew what to expect from my boobs. I knew about engorgment, I knew about letdown, I expected the upcoming fussy periods where he'd feed and feed and feed, I knew my boobs would lose their full feeling after a few weeks, and didn't worry about it coz it just meant they now knew what they were doing! So education is a BIG one because mums I know that have stopped breastfeeding have usually had the same reasons, thinking they have no milk, or that the baby doesn't want it because they're being fussy etc etc. Managing sore & cracked nipples is possible, but there's no real help out there.

So, second I would choose lack of education, then I would choose health professionals. Just yesterday I was told by a GP that DS is only feeding for comfort now, not for nutrition. What a load of rubbish!

I agree with the culture thing too. I know some mums formula feed, and yes that's their choice, but what upsets me is when I hear "you know, it's ok to switch to formula - it's just as good". Whilst this can be supportive of those that choose to FF, it totally undermines breastfeeding, and provides NO support for those that want to breastfeed.

THE best piece of advice I received was from the ABA breastfeeding class, and that was "only take breastfeeding advice from someone who has successfully breastfed". So I was able to basically ignore any comments on formula being ok, and only listen to those that had got through any problems. Sadly, no-one in real life around me had successfully breastfed (except SIL) longer than a few months, so majority of advice was from the lovely BB girls :) I think even the ABA counsellors have to have successfully fed for at least 9 months to qualify as counsellors. Maybe next time in hospital with this bub if I have problems I should outright ask the LC & midwives how long they fed their babies for. It would probably be a real eye opener!

I find the lack of consistency in care and the lack of information on discharge are the biggest hurdles. All 4 of my kids were special care babies. It is easy to forget that in this situation your baby is the patient and your wishes as the mother can sometimes be trivialised or given a cursory regard as the patients welfare is in the hands of the Paed. Finding a Paed with a BF lean is very difficult. I was lucky in that my Dr was, for 3 of my kids, but I had a different one for one and his lack of support was frustrating. The nursing staff in special care at the hospital I attended were very pro BF of the premmie bubs and offered me all the support and assistance I needed. They were a fountain of knowledge and were quick to assure me that I was doing the right thing and consulted me before doing anything to my baby, and allowed me to be involved in the medical care side as well as the mothering side. I was luck enough to stay in 3 weeks with my twins.

In contrast the midwives on the wards, had a vast difference in the advice and attitude towards BF. Most were not committed to establishing the BF relationship as much as the special care staff and actually told me that I had nothing to do so I could make my own bed ( twins in special care and I was pumping all their feeds 24/7)

On leaving hospital I feel there is not enough information given to mothers to let them know what’s in store. Of all the new mothers I know only a few are still BF and most cite lack of milk and I couldn’t produce enough as the reason to give up. If they had known that it takes 6-8 weeks to establish BF, that the milk has to be produced by the bond between mother and baby and its not just there for the picking then many would be prepared to stick it out, as it is the unknown and the desire to have a happy baby that drives some mothers to FF. The basics of how the breasts work and how much feeding you need to do are not realistically communicated to departing mums.

The last issue I have is the early childhood nurses. Most I have encountered seem to be “retired “from the active hospital system and working the 9-5 is the last step to retirement. They are quick to advocate solids if a baby seems to be feeding too often and they are quick to tell mothers that the baby is not thriving (even though they are on the curve and travelling forward) and that they need to supplement. Teething is another panacea for all that ails the newborn.. the list goes on. These centres are the only contact some new mothers have and they arm themselves with the knowledge given to them by these professionals and as new mothers find it hard to question the advice. The answer could be that better more stringent requirements need to be met in order to work in these environments.

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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...

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yep, In Islam it is regarded as child's right to be breastfed for 2 years (by its mother or failing that a wet-nurse). Of course it's also recognised that this isn't possible for some women so there are allowances made.
Judaism has similar perspective. Yael started a thread about it here

I think that with this in mind that to promote breastfeeding the government needs to look at culturally sensitive campains that target specific communities ie campain that suits the Muslim community would make referance to the Quranic verses as well as the modern research and another campain that targets the Jewish community would refer to the Talmud as well as modern research and so on...
Alos it would be great if the government could fund the ABA to do some sort of outreach work - visiting schools, mosques, churches, sports clubs etc.
We can't really expect that a one-size-fits-all approach is going to influnce everyone.

Also I don't understand why the government can't mount a massive tv campain - they have the funds to promote all sorts of other stuff (like thier super changes) so why not a health campain for breastfeeding? It should be shoved into people's faces during Neighbours; it would make a nice change from gangrenous toes lol.

I vote lack of education - but I would qualify that as actual lack of education in society, not just mothers to be.

My sister thinks breastfeeding is yucky and revolting and seems quite disgusted at the thought that she actually breastfed as a baby. My brother is not so bad but complains that he doesn't like seeing women breastfeeding in public. My father was too embarrassed to be in the same room as me initially when I was breastfeeding. He now inquires as to whether my DS is still feeding from the boob and while he never says anything I can tell that he is starting to think that it is getting a bit unseemly and that DS is too old to be on the boob (at 7.5 months).

My mother is very supportive but when DS was going through a growth spurt and feeding a lot she came out with the lines "maybe you're not making enough milk" and "maybe your milk isn't of very good quality". Of course, they were the lines she was given back in the 70s. The classic four-hourly feed routine that our mothers learned is a problem I think - mums are trying to help their daughters but "don't know any better" which sounds horrible but I can't think of another way of putting it.

My DH was pushing hard for me to introduce formula just so I could have a break because everyone was telling us that DS would sleep better on formula.

Breasts are regarded as primarily sexual so I think that is a problem. I am amazed at how many people seem to think breastfeeding is primitive, or a bit "animal" or that some people seem to think it is a "toilet" function and that formula feeding is so much "cleaner" and more socially acceptable. I've wound up being far more "out there" about breastfeeding than I ever planned to, just with my own family. When they inquire about me feeding in public I'm at pains to demonstrate my discretion while saying at the same time that if someone was actually close enough to get a tiny glimpse of nipple before DS clamps on and were disturbed by that glimpse, then they were the ones with the problem, not me. (Said in such a way that they cannot do anything but nod in agreement because they know I'm right and won't admit that they feel confronted by it).

The wide availability of formula is also an issue. I always thought that you HAD to introduce formula at some point, that it was a vital part of the weaning process. I had no idea that formula wasn't actually necessary until I spoke to my MCHN.

The question is how to do this without the women who have no choice but to use formula don't feel marginalised at the same time. Every now and again I read an angry opinion piece by a woman about "breastfeeding nazis" and how her baby was losing too much weight etc etc and the bad advice the woman was given by midwives etc etc (which of course points back to something lacking in education, this time on the part of the midwives and MCHNs).

Someone else suggested education of teenagers which I think is a great idea because I honestly think part of the problem is societal. I also think that women having trouble establishing breastfeeding or wanting extra help should be able to stay in hospital a bit longer if they want to. This happened to me - I was kicked out on day 4 because the hospital wanted the private room and my milk supply had not come in properly so I ended up teaching myself to breastfeed. I felt so vulnerable leaving that day, I really really needed one more day in hospital.

Although I have selected one option (lack of continuity of care), I believe it is a combination of factors which create a barrier to breastfeeding.

To put my comments into context, I had no problems with attachment and milk supply. My daughter was happily sucking within 10 minutes of being born, and I am still breastfeeding her at 8 months. However, I was struck by the following:

1) The conflicting advice given by midwives at the private hospital I attended. Is there a reason why hospitals don't have a consistent approach to breastfeeding for their staff to follow? Some midwives were great. Some were a nightmare to deal with.

2) The insistence that if you are breastfeeding 'properly' it shouldn't hurt. The video I watched in BF classes boomed (in capital letters) that BF should be "comfortable, pain-free, and pleasurable". Well, yes, eventually it is. But starting off, no it's not! To tell women they shouldn't have ANY pain is quite unrealistic. I can't see how using a body part for the first time is going to be completely pain-free... and it is unfair to imply a new mother must be doing something wrong if she reports any discomfort when BF-ing her baby.

3) Other people's attitudes. A couple of male friends laughed incredulously when I mentioned such people as lactation consultants existed. Their simultaneous response was "Women have been BF for thousands of years! What new age nonsense is this?" (One man had adult children, the other didn't have any). Which brings me to an observation that others have already made: the emphasis on the word "natural": the implication that breastfeeding should be as easy as breathing or weeing. This is just setting up new mothers to feel like failures. Walking and eating are "natural" functions too, but it takes a little initial practice before anyone can perform either well.

I can sense the dismay and almost-anger is some posters here, and I think it's important to say that I don't think anyone here is talking about women who cannot breastfeed for physiological or medication reasons. I am pretty sure we're talking about women who can otherwise breastfeed but give up for one or a combination of the reasons Kelly listed.
I find the 'nipple nazis' tend to be MCH nurses and vigilante midwives (who are notorious for conflicting advice) and the tag has somehow stuck to ABA, quite unfairly. I say unfairly because even the ABA forum, has a thread all about 'when breastfeeding doesn't work out'...how can you justifiably call ABA the 'nipple nazis' when they are real believers in 'breastfeeding is for baby, not baby is for breastfeeding'? If there is no breastfeeding, baby has to eat something else!
As someone who used the phone twice during my initial attachment problems, I have to say that you need to know that there are lactation consultants available. The second time I called someone I realised that my particular problem needed to be seen in person, because according to the 'instructions' I was doing everything right. I was right in the end - it was not my fault, it was DS's tongue tie! Definitely a visual diagnosis, unless someone has the foresight to ask 'can your child stick his or her tongue out over the gumline?'...which no-one thought to ask. But I persevered because I knew that once I did that, it would be fine. As much as I didn't have the anecdotes before DS was born, afterwards I was surrounded by women who would swear to me that 'it just clicks and gets better' (for attachment problems) and I trusted that implicitly to get me through.

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Not only did I have a bad experience with a midwife with my second baby which made me feel crap about myself for days, but I was then also excluding from the mothers group because I was a non breastfeeding mother.

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Thats awful, was this by the other mums? Its never OK to discriminate against someone becaase they either are or are not breastfeeding.

I chose lack of support, because I think it is an ongoing issue.

Breastfeeding is totally natural, but people don't realise that natural does not mean instinctive and it has to be learned.

For example, walking is the totally natural and normal way for human beings to get around. But we don't expect babies to be able to do it, we know that it is something they have to learn and develop the skills for, and we support them in that. We know that they are going to have problems and hurt themselves, and we pick them up and cuddle them. They may even get scared and refuse to do it for a while. But no-one says to them, "It's alright, you had a go and it didn't work out. Just use a wheelchair, it's practically the same."
This is what happens to so many Mums who then feel guilty because they have "failed" at breastfeeding, when in reality it was other people who failed them by not supporting them.
And just as there are some people who genuinely cannot walk, there are women who genuinely cannot breastfeed. If they were given ongoing support this may be picked up, rather than putting them through months of trying and all the worry of poor weight gains.
Deb

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A couple of male friends laughed incredulously when I mentioned such people as lactation consultants existed. Their simultaneous response was "Women have been BF for thousands of years! What new age nonsense is this?"

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Well, it's true really :) BUT in all those years, women had community and family support, mothers would educate daughters, if not, then an aunty or a neighbour in the community, or whatever. They would even feed each others babies when there were problems. These days sadly we DO need lactation consultants, because the culture of breastfeeding has slipped out the window, and big corporations have come up with an alternative which is all too readily available. So the importance of breastfeeding and encouragement to persevere have taken a back seat.

I would say all!
I have also heard that some women find it hard because they want to go out and stay social but want privacy and modesty is a concern when in public so that stops them.
Education as always is key.
I have breastfed 3 babies over 7 years and I still feel there is more to learn. Experience is important - how can you learn about something that you haven't experienced?

Hi,
I found that my sister-in-law and myself are the only one out of 14 people we knew having babies a the same time that are still BF! I am always asked when i'm going to stop and told that it would make life easier... Who's life? I don't have any problems at all with feeding my little angel and she still likes at least one night feed. I'm not sure why friends tell me to stop when they are the ones getting up at 2am to feed.
When in hospital, i also had the same problem as many others... Every different midwife would give different advise. I had a HUGE amount of milk and VERY fast letdown and one midwife thrust my daughter face into my rock hard breast and the poor little thing almost drowned in milk. They offered no help at all! One night when she was crying becasue my milk had come in and she was getting use to it, the midwifes just took her off of me and told me to go back to bed... they would sort her out. I felt totally useless and felt like a failure. I wasn't helped or told how to help her. So i ended up leaving the next day on the 3rd day after a c-section. I felt more comfortable at home to try and work through it on my own. I had mastitis quite a few time and my cracked bleeding nippels lasted for over 12 weeks. I used nipple sheilds, even though they are not recommended. I would try every 4th feed or so not to, but it was too painful. I worked through it and even with the problems i had i am SO happy i stuck with it now. She is 7 months now and a very happy and healthy child.
I also find peole telling me i don't have enough milk because she's getting hungrier... Don't babies get hungrier as they grow?... as they start to move?... as they start to crawl?...
I'm glad i did what i felt was best for HER!

I had a lot of interventions with my sons birth, as a result I needed medication to help my milk come in - during this time he has had to be supplemented with formula to satisfy him. There are always extenuating circumstances to why some babies cant be purely breastfed - it would be nice at this highly emotional time for a new mum to gain support for whatever her decisions are, as sometimes, there are external factors.
I would love to only breastfeed, I am perservering with breasfeeding as I love the connection it brings between my son and I, but I will not let him be unhappy or go hungry if this is not enough. So more support for any decision.

I would like to add that I mentioned my reason because it wasn't listed as a voting option. Not angry at all!

no need to be shot down in flames and I don't think this forum is for people who only Breastfeed or had ongoing problems. The topic does say "no matter how you feed your baby.. vote!"

I voted for lack of education, but i would have liked to of voted for intervention too. I found from the section I didn't want to eat hardly any food so there for my milk did not come in. I also hardly drank, but no one told me about that either.

There are so many things that don't help mothers continue breastfeeding. I think as a whole it is societies perception of breastfeeding that is a mothers biggest barrier. Breastfeeding while natural is not seen as normal. Mothers today rarely handle a baby before birth and most have never seen a baby being breastfed. We lack the family support networks we had decades ago. Back before formula was marketed mothers had friends and family who came around and did stuff and helped the mother so all she had to do was learn to breastfeed. The mother had on a hand a wealth of knowledge to help the mother through any problems. This is where I feel ABA fits in. Mothers are able to access groups while pregnant and observe mothers breastfeeding, once baby is born they have other mothers who can sympathise and offer advice and trained counsellors who can help out. But the ABA can't help if the mothers don't know about them and this is hard when the they receive limited funding.
Health professionals not having up to date information is a big problem. Most of them have only done a few hours of breastfeeding learning while in medical school so their knowledge is made up of past experiences with patients, our themselves/or wives and most terribly from formula companies whose only interest is getting the sales.
If you read through any of the submissions already made to the parlimentry enquiry you will see that between the mothers and the professionals that have submitted the answers are relatively the same. Lack of support, lack of education from others (lets face it most pregnant women are bombarded with BF info) and also mothers not being correctly informed of the health issues that can occur from formula.
I think also a big thing that affects BF is peoples perception of formula. I know there are women that cannot physically or even from pyscological reasons cannot breastfeed, however there are many women who choose before birth or after a few weeks to feed formula. Quite often these mothers are under the false impression that formula is the same or better then breastmilk, and a lot of time this is told to them by health professionals. Formula is too readily available for mothers in those difficult times. And despite saying on the tin to consult a HP before using many women just buy it form the grocery store without even talking it over with anyone.
There is now 300 submissions on the website and some really good suggestions (many that have been made on here) on what the government can do. Lets hope they do it ASAP. It is estimated that the cost of premature weaning of infants at 3 mths costs the government $290 million per year (source the NHMRC) imagine what could be done with that money.

I have a not been able to breastfeed either of my children for terribly long. The first was 3 weeks and the second less than a week! Both were c sections and all the ideas in the world have been thrown at me as to this being a reason for my inability to breast feed. Nos 1 son and I had huge attachment issues and I remember sitting there in a state crying as he was brought to me for a feed...every time! When I made the decision to go to the bottle with Nos 2 I was so scared of telling anyone the judgements made by friends and family were too much to handle! The second time around I still felt judged regardless of what my situatiion and feelings were. I still get upset at people bangingon about breast is best and those who are so into it and doing it successfully and good on them but spare a thought for those who do struggle! I think people need to be more aware of the effect their words can have on others even unintentionally. But hey I am sure I am guilty myself! It is all a journey of learning for ones self!

Just flying in and out - while there are many factors, I think it's mainly education, if you know why you're breastfeeding and all the benefits, then you KNOW why it's worth persevering through hard times, you KNOW whether you need to supplement with formula or not, you KNOW it's your right to breastfeed wherever you want, you KNOW it's normal and boobs are actually for a baby's nourishment, and not just simply nice looking accessories.
And other people KNOW that what you're doing is feeding a baby, big deal.

It's said that knowledge is power, and I reckon that I couldn't have been as strong and determined to persevere with many of my choices I've made for River if I hadn't looked into those topics for myself.

That said, that's not to say there's absolutely no place for formula, but if mothers can be taught FIRSTLY to give breastfeeding a really good shot, because of all the benefits, and supported and encouraged through their problems, or even to supplement with formula as opposed to making a complete switch.

I would have to say that for me, the midwife that did my second home visit would be the one that mostly stopped me from continuing to sucessfully BF. She came to see K at day 9 to find that K had lost 16% of birthweight. The MW then proceeded to go into a mad panic telling me to rush K to the hospital she needed tests as something was wrong with her. K was born 4.25kg, so she wasn't underweight at all and had been sleeping and feeding 4 hourly so I had no idea there was anything wrong. After a night in hospital and using formula to top her up after having the breast she had put on 85g so they determined I had not enough milk. Unfortunately, because of the state that panicing MW had put me into and how stressed it made me, I suddenly had even less milk and had to stop BF altogether. Because I had been discharged from the hospital midwife program and was only seeing the ECHN, I didn't have the support there to know that with help I could have got milk going again and that it wasn't my fault.