So another study has found Ireland has one of the world’s lowest breastfeeding rates. It didn’t surprise Andrea Mara as hospital midwives are run off their feet and there is little HSE help when you return home.
Don’t let anyone bully you into breastfeeding” – it was one of many comments I saw on Twitter last week, in light of the publication of a Lancet report showing low breastfeeding rates worldwide and how just 55% of Irish mums have ever breastfed compared to 81% in the UK.
It reminded me of the time a work colleague gave me precisely the same advice. I was expecting my first child and planning to breastfeed. The notion of being bullied had never crossed my mind, but as soon as I believed that I’d be pushed into breastfeeding, my back was up.
Because of course, most of us don’t like being told what to do, and that’s just one of the problems with getting the breastfeeding message out there. Another huge issue is that this message is not followed up with practical support. All the “breast is best” posters in the world make no sense if women are abandoned to figure it out for themselves once the baby is born.
And indeed, that was my experience, when I had my first baby.
There were eleven of us in a six-bed-ward, two per cubicle. It was Grand Central on Oxytocin – exhausted, inexperienced mothers being looked after by overstretched midwives. All night long, beds were wheeled in an out, staff were called by ringing bells, babies cried, mothers cried too. I rang the bell and asked a nurse for help latching my baby. She said she could give me a half a minute but that she wouldn’t have time to give me her full attention. Twenty-four hours later, my newborn hadn’t fed at all.
I was moved to a quieter ward, where the midwives had more time. A wonderful nurse latched my baby on, then told me to ring the bell before every feed so that she could help. I wasn’t to worry if it was the middle of the night or how often I needed help – it was exactly what I needed to hear, and it worked. Three days later I went home, confident that I could feed my baby. I was a long way from figuring out motherhood, but I was breastfeeding like a pro.
Unfortunately, for every woman like me who (eventually) gets the help she needs, there’s another who rings the bell to no avail. Maybe it’s because she doesn’t know to keep asking even when the midwives are too busy to help, or maybe it’s because she is never moved to the quieter ward, or maybe it’s because she’s exhausted, and too worried about her crying baby to keep going.
Which is why every time a report comes out about low breastfeeding rates, there are women who feel misplaced guilt. “I tried to breastfeed and I couldn’t,” they say, “I feel so guilty.” And of course, they shouldn’t feel guilty – they didn’t fail, they were failed by lack of support.
“We need actual action from government level that doesn’t just pay lip service to breastfeeding,” says Nicola O’Byrne, vice president of the Association of Lactation Consultants in Ireland.
“There are lots of mothers out there who want to breastfeed but are just not getting the time and expert help they deserve. Then they feel guilty. We could turn this around in Ireland, I know we could, but it has to come from the top down and they have to believe it. Remember when the smoking ban came in? The government at the time was adamant that it was the right thing to do. Some of that passion needs to go into breastfeeding at that level. Mothers are telling me every day that they can’t understand why breastfeeding is promoted so much in pregnancy then once they have their baby they are told it’s not that important.”
Four years ago, I had my third baby, and found that breastfeeding was unexpectedly difficult compared to the two times previous. One week of horrific pain later, my public health nurse suggested my son might have tongue tie, a common condition whereby the frenulum under a baby’s tongue is too tight, meaning the baby can’t efficiently get at the milk. It’s painful for the mother and exhausting for the baby, and unfortunately, at least four years ago, it wasn’t being routinely checked in newborns.
I went back in to my maternity hospital and saw a lactation consultant – she was helpful, but I couldn’t help wondering why nobody had told me about her a week earlier, when breastfeeding was so difficult due to undiagnosed tongue tie, or indeed four years earlier, when I was a new mum with a baby who wouldn’t feed at all.
The Maternity Strategy for Ireland launched last month recommends 24/7 access to lactation consultants in hospitals, but that’s not currently the case. As part of its research, it stated: “[Irish} women reported receiving inconsistent, sometimes contradictory and poor quality information, and limited support on postnatal wards, with little or no access to lactation consultants.”
“Do you know that some maternity units in Ireland have no lactation consultant’s post?” says O’Byrne, founder of BreastfeedingSupport.ie. “I’ve heard the argument that midwives are trained to help with breastfeeding and that lactation consultants should only be called if there’s a problem, but I think if every mother who expresses a wish to breastfeed could have even one full session with an international board certified lactation consultant (IBCLC), it would raise our rates.”
I was lucky – I had great family support, and could pay for help from a private lactation consultant. But many women in Ireland have grown up without seeing breastfeeding around them and don’t necessarily have family encouraging them.
The age-old practice of mothers helping daughters to figure it out has diminished considerably, meaning outside resources are needed. But many mothers also don’t have the means to pay for a private service and can be overly reliant on the graciousness of volunteer organisations who have sprung up to fill the gap. So is breastfeeding only for those who can afford to pay?
“We need breastfeeding preparation classes prior to birth. Mothers who attend my class rave about the knowledge and confidence they feel afterwards. Mothers prepare for labour; breastfeeding needs the same prep’,” says O’Byrne. “We need 24 /7 lactation consultants in every hospital. Then once home, a 24-hour phoneline and daily house-calls from community nurses, or IBCLCs. All of this should be state funded. If we help the mothers who want to breastfeed, that will raise our rates.”
“Women don’t need to hear ‘you must breastfeed’– they need to hear “we’ll be there to support you” and to know that when they ring the bell, it will be answered.”
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