Thursday 15 November 2018

Sinead Moriarty: Overwhelmed new mothers need support whether they choose to breastfeed or not

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Sinead Moriarty

Sinead Moriarty

To breastfeed or not to breastfeed, that is the question. It is a question that, without fail, causes heated discussions.

I was at a dinner party once where a husband said he wished his wife had “tried harder” with breastfeeding their child, and not “given up so easily”. He ended up with a full glass of red wine dripping down his face and a week sleeping in the spare room.

It’s a very contentious issue and one that causes women to react very strongly, whichever side they fall on.

But, whatever your opinion, breastfeeding is not for everyone and women who don’t choose to breastfeed should not be made to feel guilty, or less of a mother, because of it. For this very reason, the Royal College of Midwives (RCM) in the UK has just taken an initiative to encourage midwives to respect the decision of women who choose not to breastfeed.

While it still contends that babies should be breastfed for the first six months of life, the RCM has told its members not to try to force any woman to breastfeed and to give all new mothers appropriate support if they make an informed decision to bottle feed.

A lot of women who choose not to breastfeed feel judged and suffer from a sense of failure and guilt for not giving their baby breast milk. But the reality is that some women really struggle to get the baby to latch on, or suffer from mastitis, or worse. After spending a week or more sobbing in pain and frustration at every feed, these women are entitled to give up.

Happy mother equals happy baby, so if the mother is suffering, the baby will too. Deciding to bottle feed your baby is not a decision anyone takes lightly and if it’s right for you, then no one should make you feel bad about it.

In 2015, the National Perinatal Reporting System recorded that only 58pc of babies in Ireland were receiving breast milk on discharge from hospital. The Health Service Executive recorded that only 35pc of babies were receiving some breast milk at three months.

Only 55.4pc of babies are being fed by their mothers by the time of the first visit by a public health nurse, a few days after discharge from hospital. This compares with 99pc in Norway.

So, why are the Norwegians all breastfeeding and not the Irish? 99pc of new mothers initiate breastfeeding at the hospital in Norway and 80pc still do it after six months. What are the Norwegians doing that we aren’t?

First of all, breastfeeding in public places in Norway is not considered awkward or even unwelcome, like it can be here. Norway also has a generous parental leave and support for new mothers. When they go back to work, mothers are given two-hour breaks at home or at the office to breastfeed or pump. That’s all wonderful for the breastfeeding women of Norway, but for those few who can’t manage breastfeeding, or just don’t want to, they feel ostracised. Not only is bottle feeding frowned upon, but access to formula is strictly limited.

As Irish women have shown recently at the polls, they want choice. And, in this case, the choice to breast or bottle feed should be up to the individual – not an overbearing midwife or society frowning upon an overwhelmed new mother.

Here in Ireland figures show significant variations in breastfeeding rates between urban and rural areas, and between wealthier and more deprived parts of Dublin. Breastfeeding rates in affluent areas of Dublin are more than three times higher than in counties Donegal and Louth, while the youngest mothers and those in lower socio-economic groups were least likely to be breastfeeding on discharge from hospital.

There are many reasons why Irish women opt out of breastfeeding – they want their partners to be equally involved in the childcare, they’re exhausted, they’re struggling with breastfeeding technique or they’re going back to work, and companies here are not offering two-hour lunch breaks so mothers can nip home and breastfeed their babies.

As Dr Laurence Grummer-Strawn, of the World Health Organisation’s Department of Nutrition for Health and Development, explains: “Many people understand the importance of breastfeeding, but too often they assume that responsibility can be placed entirely on the mother.

“They don’t give consideration to the political, social and environmental factors that actually shape breastfeeding.”

How can we, as a society, encourage women to breastfeed? ‘Breastfeeding in a Healthy Ireland’ is the current national action plan for the development of policy, practice and research on breastfeeding. It aims to improve exclusive and non-exclusive breastfeeding duration rates by 2pc per annum up to 2021.

It plans to achieve this by implementing national standards for better healthcare and better maternity care, including lactation consultants within hospitals and communities. There is a fine line between encouraging breastfeeding and breastfeeding zealotry. The most important thing is the baby is fed and the mother is not distressed or in pain. Every woman wants the best for her baby. We need to support women and help them to make decisions that are right for them and their babies, without judgment.

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