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

So many good arguments. i have to say lack of continuity of care. i had the 'problem' of having way too much milk and aside from that i couldnt understand why, after being told that evie was attached perfectly, had a good strong suck and was positioned well that it was so incredibly painful. i had massive blisters on my nipples, they were cracked and bleeding so badly that i couldnt wear any clothes over top of them. when i rang the hospital at 9 at night for help in tears i was told the next available appointment was 3 days away. So there i was crying in pain and distress that my baby was vomiting up my blood just when i am trying to feed her, my toes curled the second she attached from the pain and i am being told my only option was to wait to see a LC in 3 days and then dismissed with 'have a good night'.
I was totally ready to give up until someone said 'it hurts because your nipples need to get used to it' and that was all i needed. why couldnt someone have told me that from the beginning. it took 10 days for the pain to stop and my nipples to heal but i kept feeding and still am but i was really disappointed that help wasnt really there when i needed it.
So i support LC checkups every week for the first 6 weeks, in the home if necessary and i agree that women (mostly 1st time mums) not be discharged until the milk has come in and b/f'ing is established to the point where the mother is capable to do it on her own with total confidence.

These are my top three:

Interventions at birth
Lack of continuity of care
Conflicting advice after birth

This is what I think impacts the establishment of breastfeeding initially:

- high rates of intervention which undermine women's self confidence and
instinct

- failure to protect the initial bonding time after a baby is born - during
the first 15 minutes.

We should promote and respect:
* undisturbed skin to skin contact
* delay routine measuring and examination, except for life-saving measures.
* keep as quiet as possible
* leave the couple and baby alone, don't talk to them unless absolutely
necessary
* quiet, soft lighting, warmth

I don't see the bonding window really respected in many institutions. Sometimes they leave parents & babe for an hour or two to 'bond', which is good - but it's the first 15 minutes when the oxytocin helpers are there, that needs special regard - as well.

I think we need to look at another way to handle third stage. Directed pushing leads to lots of chatter during (often) a managed third stage, then comes clean-up and suturing .... somewhere in the bustle, the critical bonding moments are just lost.

Undisturbed birth leads to undisturbed bonding, which paves the ways for successful breastfeeding.

Undermining confidence in our bodies' ability to breastfeed I think is a
continuum of undermining our bodies' ability to birth.

Sweeping generalisations I know - but them's my thoughts.

I think as a society we don't have that much respect for and confidence in
womanly knowledge, intuition and arts. Because it is not a precise science.
But powerful and valid, nevertheless.

I really like the idea of an introduction to birth & breastfeeding education as part of reproductive health education in high schools - for BOTH genders!

Good point, Amy&rafi, there is definitely a level of responsibility that a lot of women abdicate. Others just don't have the exposure to BFing, though - how do you find out about something no-one around you values? Some women don't have basic research skills to seek out resources. I often get frustrated when a woman tells me she didn't know about such and such, because if they had just asked around they would have known sooner. It's easy to say it is their fault for not investigating it themselves, but women have become so disempowered in this society of advertising saturation, images of babies=bottles, hospitals comp feeding babies etc, that it is no wonder that, realistically, women just don't know better. Ideally, they should be more instinctive and questioning, but it's just not as simple as that anymore.

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.

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Ideally, (women) should be more instinctive and questioning, but it's just not as simple as that anymore.

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I agree totally.

I'm also with rayray and after reading all these brilliant comments I could almost change my vote. I still don't know whether education is a "cure all" but it certainly would help more than silencing the formula companies I guess. I like the comment about getting a script for formula, maybe for babies younger than 6 months so that some professional counselling could be provided.

I also really agree with the comments about being discharged from hospital before your milk comes in... infact it almost seems like they want you out of there before that happens because all of a sudden you will become too demanding/needy at that point...well that's just how I felt when I had my 2nd child. I knew that I would want extra help when my milk came in but they kept saying to me "Oh it'd be much more comfortable for you at home wouldn't you think?" A total fob off! But it was only because I was a 2nd time mum that I new what was coming...

I also enjoyed reading Jennifer's comments about countries that have paid maternity leave usually have high BF rates... fortunately I've never had to juggle work and BFing but I can't imagine that it would be easy!

Really enjoying reading all the comments... it's interesting how my initial ideas have changed a bit since reading the entire thread too.

Another conflicting advice vote here - the midwives in the private hospital I was at ALL had different views. You'd think in a ward they would have a uniform policy. Can you push for that Kelly?

I was really lucky to have a fantastic MCHN who got me onto an equally fantastic LC - and we're still going today. I battled with cracks, mastitis, huge flow, non sucking, bad latching, PND, a MIL who told me I was undernourishing my baby (WTF?!?!) but I kept going with my DH, LCs and Mum's support. However I do believe that inital consistent education would have been a better start.

JMO, but if there was more education I think conflicting advice wouldn't be as much of an issue. I had lots of conflicting advice but saw it all as a variety of options to choose that were right for me and my bub, rather than the right vs the wrong way to do something, IYKWIM....

But Kim I know what you mean about the need for a uniform policy

i voted lack of education, cos though all the other factors are totally significant, with enough education (and then support) one can trump them all

I think that uniform policy is a great idea.
At Westmead the midwives who had extra training in lactation (and other issues) had it on thier badges under thier names so they were easy to identify.
I think hospitals need more LCs on staff and I think that a LC should visit each Mum and Bub the same way that the paed, physio and hearing people do. It's silly that the pead comes to you but the LC doesn't.
Maybe if they did this they could identify the women who genuinly can't BF quickly so that they can move onto plan B (expressing &/or formula) ASAP with a minimum of pain, fuss and guilt.

I'm a bit of a lurker.. and haven't read this post through but I just wanted to put my 2-cents in. I hope that I'm not too bold in saying this.

But other than the lack of knowledge and the publics view of public breastfeeding.. I think a huge part is how every tries to be PC... so as not to offend anyone we don't always push the benefits of breastfeeding. We *know* that Breast is Best but often when said in a group of mothers, we're met with scowls, or "you're only saying that because you can do it" etc. It sucks that, in our efforts to keep everyone happy, we have to keep quiet all the benefits because people who didn't breastfeed get upset. :rolleyes:
Lest we remind people that breastfeeding is what the boobs were made for.

I hear so many women saying they wanted their babies to sleep through the night so they switched to formula :( It's such a myth too as my fully breastfed baby slept 12 hours a niight from 2 months old. The problem is that there are a lot of well meaning family and friends out there spreading this myth further and further.

Please don't be afraid of being honest, I am specifically after everyone's personal opinions of their own experiences not a debate or discussion over what someone else has said, and that will be removed if it happens.

I would love to be able to go to parliament and say, 'this is what is happening, this is how they feel, this is what they want.'

There is no right or wrong, what you feel is the key thing here because they want to know what they can do to help, so they need to know the problems you are facing. I really appreciate your open honesty and I will protect that.

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When I mention that Oscar can feed for as long as he likes, some people say "what if you fall pregnant again?", and they are confused when I reiterate "for as long as he likes", because they are under the impression that feeding must cease when pregnant. That's an education issue.

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Not to mention that people are shocked that you CAN fall pregnant whilst breastfeeding! When will people learn that it's not an effective contraceptive?? LOL

But I completely agree. I'm facing this almost every day, and it's tiring :( Everyone is expecting me to wean, and are shocked when I say he can feed until he doesn't want it anymore. Mum is slowly putting the pressure on, I think she can't fathom the whole tandem feeding thing. Personally, I'd love Tallon to keep feeding beyond the pregnancy, I'd love for the both of them to share feeding together. If anything I think it would REDUCE jealousy issues, coz he CAN have booby as well as the baby!

Education and just general awareness of these things is crucial. I don't want to sound like I'm blowing my own trumpet, but sometimes I feel like a bit of a pioneer amongst our peers, because I was determined not to have pain relief in labour (nobody believed that was possible and thought I was kidding myself), I KNEW I was going to breastfeed come hell or highwater (but received the "but don't worry if you can't, formula is ok" comments) I even got scoffed at for wanting to use cloth nappies! However, I have achieved each of these things, and seeing our friends and family realise oh, it CAN be done is just a great feeling. Now of course I'm copping it for feeding during a pregnancy. I must admit I put pressure on myself not to fail at these things, coz I know that my doing these things is "educating" my friends, and hopefully they'll stop blurting things out like "oh you can't feed through pregnancy" coz they'll now know someone who has and that it's possible iykwim. Of course if Tallon weans during the pg well, nothing I can do about that! LOL. But I feel like I'm doing my bit by making things work, and helping my friends see that it's possible.

Gosh I hope that didn't all just come across wrong. I'd like to make it clear that none of it has been that easy, and that I'm continually learning.. but I'm proud that we've fed as successfully as we have, and that my being open about it with friends is helping them too. My biggest hope is that all the horrible discouraging comments that they made to me during my pregnancy, won't be in their vocab anymore when it's time for their daughters to have babies.

I think it is the fact that women think it will all happen within the first couple of days...(i actually thought the first couple of hours ) and when it doesnt they feel as though they have failed (i know i did).
I got so stressed that i couldnt breastfeed i was a hysterical mess and gave up after 2 weeks because DS wasnt latching on correctly and i had terribly cracked nipples.
Having only 4 weeks to go with DD i have done alot more research and asked for refferals to breastfeed clinics and lactation consultants.

My daughter(baby #3) turns 2 months old today. And I am a membe of another online community which isgrouped by birth month, so I am presently privy to several "new mums" and their journeys with breastfeeding experiences, plus myown experiences and general awareness since I became a Mum in 1999. With the "other forum" I participate in (March 2007) I am surprised/saddened at the number of Mums giving/given up feeding already.

I had various signicant early feeding difficulties with my 1st baby (recently turned 8) and despite the advice of midwives to bottle feed (while still in hospital) I refused to supplement with formula and went on to breastfeed him for 2.5 years, and he gained weight beautifully too. I think what got me through the early weeks of difficuly was my absolute desire to breastfeed because I knew if was best - by far. I had had a difficult birth, and there was no way I was going to muck up breastfeeding as well.

So I would have to nominate lack of education, purely because I think just about all women are aware "breast is best", but despite this awareness many, many women also believe that artificial feeding is also 'fine'/'almost as good'/'better for their sanity'/'beats sleeplessness'/'okay to do when breastfeeding is hard'. We often hear "I was bottlefed and I'm fine" etc. And, "He had three days/weeks/months of breastmilk, so that's better than nothing." And while it is better than nothing, it would be great if mothers were highly motivated to breastfeed long term.

I also think that health professionals, when faced with a tired, tearful, sick (mastitis the third time) mothers often 'take pity' despite their training. Goodness only knows I probably would too. It must be hard to say "Yes, I know, but in three more weeks everything will be fine, these days of cracked nipples/poor weight gain/bouts of mastitis will be a fading memory" to a woman presenting sick/tearful/afraid/exhuasted.

Here's my list of reasons in order...

Lack of education (inspiration)
Health professionals
Accessibility of artificial milk
Family and friends advice (esp grandmothers and partners)
Conficting Advice/Lack of continuity of care (though this may be a blessing depending on care)
Lack of availability/affordabiilty of support
Interventions at birth
Going back to work bf support
Marketing fo artificial milk

Thanks for the opportunity to contribute.

Regards - Jo
Mother of three, long-term breastfeeder and since March '07, a homebirther too!

It's hard to single out just one - I eventually settled for lack of support going back to work, because that's where a lot of people I know have come unstuck. I think education is important too, and on reflection it's probably the crux of the problem.

For me it's a no-brainer and worth the effort, but some people seem to think it is all too hard.

Oooh no, the night midwives were better - the day midwife was a b*tch though. It was a nighttime midwife who spend a couple of hours sat with me helping to get DS on where everyone else ignored the issue and pushed formula. Everyone told me I was holding DS wrong, so tried to adjust him - he feeds best the way I instinctivly held him, still feeds like that now. He doesn't do the latch-on mouth either, taking him off because he didn't do the mouth was unhelpful - we just needed to trust each other that I'd not mess around with his feeds and he'd feed fine.

I'm very lucky that our special care until were fab too - they promoted expressed milk when DS needed an NG tube and encouraged me to not have him in the nursery when the tube came out - not that I needed encouragement!

I agree with a lot of PPs - why do FF mummies tell BF mummies pre-baby that BF is too hard and discourage us? What if BF mummies told off and mocked FF mummies?

Yep - night time staff were awful. Ringing the buzzer was a waste of time - it was always the temp nurses, not even midwives and lc's! I reported it to my OB who has a large stake in the hospital, dunno if he's done anything about it. Admittedly I could walk down to the nursery and see an LC (well, that's if she was there), but it's much more private to be helped in your own room!