This baby needs my milk, not your approval.

By Anne Gibson

Maternal and Infant Nutrition Dietitian, NHS Fife

As a student Dietitian, many years ago, we were always told “breast is best” yet there was little said about why. We needed to know the basics but it was not a field for Dietitians to be involved in. It was just a phrase thrown about but I took it to heart and decided that, if I ever had a baby I would breastfeed, although none of my family ever had.

Several years later, my daughter was born. We did not have an easy time with breastfeeding but I was determined that my baby was going to be breastfed, so we struggled on.

At the time, all babies had to be wheeled along to the nursery in the hospital to be fed. There was I with a crying baby, sore nipples, exhausted and hormonal and struggling to feed my baby. I was the only Mum breastfeeding at this point so had to watch as everyone else toddled in, popped a bottle in the baby’s mouth and all went quiet. I wonder how many mothers saw this as the easy option at a time when things were not going well but then regretted their decision later on. It was at this point in my life when I decided there must be a better way to support more women to breastfeed and why should a Dietitian not be involved, it is the best possible food after all.

It has not been an easy career path to follow. Breastfeeding is seen as the domain of Midwives and Health Visitors and it took years of perseverance to become accepted in the field. I have now been working in breastfeeding promotion and protection for 27 years, and believe passionately in the benefits and of giving support to women to help them succeed.

We now have a huge amount of research evidence to back up the advice we give. Support is available from NHS help lines and those of voluntary organisations such as Breastfeeding Network, NCT, La Leche League, from NHS breastfeeding support/buddy systems, support groups and of course the midwives and health visitors. All NHS Boards in Scotland are required to be working towards UNICEF UK Baby Friendly (BFI) accreditation for all maternity units and community services. This ensures that we are all using evidence based standards of care and are being assessed by external auditors.

When mothers want to breastfeed, we need to support them to do so, not bombard them with negativity. Living with the regret of not doing what they planned to do and know is best for their baby is not something we should force on our mothers. Support what they have been able to do and help them to overcome continuing problems. Seeing your baby thrive on nothing but your own breastmilk is something all mothers are justly very proud of, a huge confidence booster. Nothing is easier than breastfeeding once you and your baby get the hang of it. Don’t be afraid to ask for help to do so.

I have been running a breastfeeding support group for 15 years now – support really works. Here are a few of the comments sent to me by the mums attending.

I just wanted to drop you a line to say thank you for your ongoing support at the breastfeeding group. Before I came along my main source of information was through the internet. I’ve come to realise how much bad advice is available for breastfeeding mums, which makes me even more grateful for the knowledge and experience you bring to the group. It gives me great comfort to know I can save up all of my questions (for there are many!) for a Wednesday afternoon and I know you will be there with the answers!

I know many mums who have attended (the breastfeeding support group) say the support and friendliness has helped them to feed their children for a lot longer than they anticipated they would. I found the confidence to feed my son in public and shrug off family disapproval at my choice. So just to say thanks Anne and keep up the good work. Your hard work doesn’t go unnoticed and i am sure i am just one of many mums whom appreciate this wonderful service you provide.

I started the group when my son was one week old. There were many times in the middle of the night, with a crying baby to feed, I was stressed enough to give up. Going to group was, at these times, the only thing that gave me the strength to carry on with breastfeeding; knowing that there was someone I could talk to about my lengthy list of worries and anxieties. After each session I felt empowered to continue with breastfeeding with new knowledge and confidence.  I am proud to say that I am still breastfeeding after 9 months and plan to continue for as long as it is right for both me and my son.

I just wanted to let you know that ………..has been gaining just under half a pound of weight a week and she is now nearly 10lbs, after following your advice with BF. I’m so pleased. I’m not supplementing any feeds and only giving her one bottle of formula or expressed milk an hour after her last feed. Your advice has been brilliant and so glad I stuck with BF. I was so anxious about the weigh ins but with the consistent increase, I’m so much more confident with my milk and BF. Thank you!

Breastfeeding brings out the militant in everyone. Everyone has an opinion and people are very quick to jump to the defence of formula feeding as being “just as good”. We are very fortunate in this country that we have access to infant formulae which must, by law, contain all of the nutrients research shows are essential for the growth of the baby. We also have clean water so anyone who chooses to formula feed will be supported to do so as safely as possible. The BFI standards include formula feeding as well as breastfeeding. Although our infant formulae have improved significantly in recent years, breastmilk contains at least 34 ingredients not found in formula and which cannot be replicated anywhere other than by breasts.

To help women accept why they did not or could not breastfeed when they had wanted to and could have succeeded if they had received the appropriate support is not the responsibility of any woman or of one health professional, it requires our whole society to get behind breastfeeding and support our mothers. I would encourage all of you to get behind UNICEF UK’s Call to Action www.unicef.org.uk/babyfriendly

There is no question that breastfeeding is best for mother and for baby. It is well researched internationally and documented by bodies such as World Health Organisation, NICE, all four Departments of Health, Royal Colleges and professional bodies.

Amongst the many benefits of breastfeeding are promoting immunity, protecting against infection, improved gut function, digestion and absorption, reduced incidence of long term chronic disease in baby and reduced incidence of breast and ovarian cancers and osteoporosis in mum. The boost of oxytocin at every feed is good for baby’s brain development and reduces the incidence of post-natal depression.

I am glad to say that things have changed since I had my children. Babies are no longer taken to a nursery but stay with Mum to begin the bonding process. Adopting the BFI standards as a minimum level of care for all of our Mums and babies has resulted in much more support being available.

Sadly however, the attitude of society continues to be problematic. We hear stories about breastfeeding mothers being made to feel very uncomfortable feeding in public places, some stories even reach the media. We have legal protection to feed our babies in Scotland. The Breastfeeding etc. (Scotland) Act 2005 states “…..should be able to feed a child when required and in the most appropriate place for them, without the fear of interruption or criticism”. Anyone raising a complaint should be asked to move or leave, not the mother and baby, nor can they be asked to move to the toilet. None of us would eat our meals in a toilet.

Tom Sheldon, Senior Press Officer at the Science Media Centre wrote “We do controversy at the SMC.  If views are polarised on a subject, if the advocates and the opposition have dug their trenches and the views of scientists risk getting caught in the crossfire, we get involved…….  But nothing had prepared me for the most polarising, knee-jerking subject of all: breastfeeding.”

The benefits of breastfeeding continue throughout life. My daughter (age 27) called me the other day to tell me she could be a poster girl for breastfed babies. Her GP had told her that she must have a very robust immune system as her blood tests revealed she had been fighting a severe viral infection. He was quite taken aback that she was feeling well and had not had any symptoms at all.

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