I Hate Pregnancy – There, I Said It!

My thanks to Sarah Baker for sharing her experiences with HeartMummy Musings.

Sarah B6

Recently I have had the chance to chat with the most amazing Health Visitor and it got me thinking on how my life has changed since I became a mummy and also to reflect on my experiences of pregnancy and childbirth.

Looking back, I knew my journey into motherhood would never be an easy one, my husband is in the British Armed Forces and in the last few years we have lived in two different countries, 5 different houses and have been forced to live separately twice. This combined with the fact that I was told I was infertile and could not conceive made things challenging to say the least, but against all the odds, after over 4 years of trying and 5 days before my husband deployed to Afghanistan for 6 months I found out I was pregnant. This was one of the happiest moments of my life! I was ecstatic, shocked, scared and above all amazed!

After my husband deployed I spent a lot of those first few weeks looking through pregnancy and new baby magazines, I even remember commenting to my mum on how good I felt and how lucky I was not to be experiencing any symptoms. This did not last! When I looked at all those magazines one thing in particular struck me, how happy and vibrant all the women looked, how their partners gazed at them in love and wonder and how relaxed they always seemed. I guess in my head, this was what I then came to expect; I knew it wouldn’t all be rosy, but I wanted that pregnancy glow, that loving and bonding feeling between me, my hubby and my growing bump. In reality what I experienced was a far cry from those picture perfect moments.  Looking back now I can be honest and say being pregnant was one of the worst times of my life. I don’t mean in any way shape or form that I regretted being pregnant, or that I don’t love and cherish both my children, but I genuinely hated the actual physical state of being pregnant. I hate being pregnant! There, I finally said it out loud!

With no family history of problems in pregnancy or getting pregnant I assumed I wouldn’t either, but mother nature had other plans. For the first 4 weeks of both my pregnancies I was fine, no symptoms, nothing……but once I moved past that point the dreaded Hyperemesis Gavidarum raised its head. Most people, myself included, had never even heard of HG: there was a bit of interest in it after Princess Katherine’s pregnancies, but on the whole most people I met either knew nothing of it or assumed it was ‘just morning sickness’. That was one of the biggest battles to overcome, lack of knowledge, shortly followed by lack of support and lack of understanding, not just from friends and family, but from professionals too.

HG is more than just sickness! For me it started around the 5th/6th week of pregnancies and by week 7 with my first and week 6 with my second I was on my first stint in hospital. I could be sick over 20 times a day, everything and anything could trigger it. Being sick so often left me with crippling acid reflux, but I couldn’t take Gaviscon as that made me sick. It also left me with no energy, feeling drained, my hair started falling out and it caused me to lose massive amounts of weight very quickly. I’m not the smallest person in the world, so luckily I had some weight to lose, but in my second pregnancy I lost nearly 4 stone in weight. The emotional drain of all this was horrible. I was still working when I became pregnant the first time and was left trying to explain to my employer why I needed such extreme amounts of time off work for ‘just being pregnant’ as they saw it. I lost touch with friends because I couldn’t leave the house. After a while people stopped asking after me because they either didn’t understand what was wrong, didn’t want to know the details of sickness or simply believed it was ‘only morning sickness’ and everyone gets that so I should just suck it up and get on with it.

I struggled to eat, but that made the sickness worse, which meant eating became impossible….it was a vicious cycle to be stuck in. With my first I knew no difference so thought everyone went through this. When I spoke to the practise nurse the first time I was told that morning sickness just meant baby was healthy and growing……in reality that is not always true and definitely not necessarily true for HG. I had to push and push to be seen by a doctor and even then they were reluctant to prescribe me anything. By the time I finally got hold of some anti-emetics I was being sick so often that I couldn’t keep the tablets down, so their benefits were non existent. Even with my second pregnancy I was faced with misinformation and delays in treatment. I remember going to see the nurse and saying I thought I was pregnant again. Once she had done the urine test the first thing I asked was about HG, only to be told that the chances of it happening again were slim…..another piece of misinformation: chances of suffering HG in subsequent pregnancies are high and increase with the number of further pregnancies. Again this meant a delay in getting access to medication, and again I was left at home without support until it was too late and I needed to be hospitalised.

If anything could change with the diagnosis and care of HG suffers I think the biggest thing would be to change knowledge around this condition so to allow care to become proactive rather than reactive.

Sarah B5
There is nothing worse than someone asking you if you have tried ginger/seasickness bands/grapefruit/sucking a mint or whatever other old wives’ tale they think might help when all you can think about is where the nearest bin is to be sick in. Being sick is horrendous, but almost worse than that is the feeling and knowledge that you are going to be sick. Even now, that feeling of impending sickness brings me out in a cold sweat and leaves me panicking and shaking.

In the space of a few weeks I went from a happy mum-to-be who was working, running the family home and generally in control to a scared, emotionally and physically drained shell of the person I was, hiding in my house, restricted to the ground floor as I was too weak to climb the stairs.

Most of the information I had about HG was from good old Dr Google, not the most reliable of sources, but I assumed that once in hospital I would at least be able to find help and support. Again this was not the case. I still remember a Nurse speaking to me and saying “You have to eat, think of your baby” as if I was choosing not to eat, as if anyone would choose HG?!?! I never chose any of it, I wouldn’t even wish it on my worst enemy.

With my HG I often found the severity of it would peak a bit and then drop a little, only to peak again. Every time it dipped a bit and things started to look a little better doctors and professionals were far too quick to sign me off, send me home and generally wash their hands of me. This meant when it peaked again, as it always did, I was back to the beginning and struggling for the support/recognition. A lot of my hospital admissions were through out of hours doctors or A&E because there were no other options available to me at that stage. Again, it was made so much harder for me to gain the support I desperately needed.

As I’ve said before though, the HG is more than just sickness. I began to dread anyone coming to the house because I was unable to clean or look after myself. During my first pregnancy I struggled to walk our dog and remember one time getting half way round the airfield only to be faced with that sickening feeling. There was nowhere to hide, nowhere to run so I crouched on the side of the airfield and threw up. My poor dog was so concerned she came running over to me….and I was promptly sick on her too. It’s degrading, it’s humiliating, it strips you of who you are and leaves you a frail shell of the person you once were. With my second I was unable to care for my daughter at home, I couldn’t cook her meals or play with her. She stayed at home with Daddy for a bit, before going into full time childcare, but I will still always worry about the effect all of this had on her and will forever remember how scared she was to see me in hospital with the central lines. It made me cry that she didn’t want to come near me or hug me, I felt I was not only missing out on my pregnancy, but now I was missing out on her childhood as well.

When I finally got the needed medication it was accompanied by lots of “only take this if you have to” style comments. Not the helpful message anyone suffering HG needs. If you are suffering HG you NEED to take the meds BEFORE you desperately need them otherwise you can’t keep them down and they are non effective, but the guilt ladled on with the prescriptions often left me waiting till it was too late to take them. To a certain extent, when my HG was at its worst, non of the combination of drugs I was on worked, none of them took me back to how I was before HG took its grip. It didn’t matter if “this drug is usually only used for people suffering sickness as a side effect from chemo” it still wasn’t enough to control the crippling nausea and sickness.

I also found the constant throwing up affected my teeth and in my second pregnancy I ended up having to have 3 teeth removed as they were so badly damaged, another lasting memory of the horrible HG. With my son the sickness was even worse and left me in hospital almost bed ridden for 4 months. My veins collapsed so much that they fitted me with a central line. In total I had 3 central lines, each one was a horrible experience and left me with both mental and physical scars. The 3rd central line became infected and then I ended up in ICU with septicaemia blood poisoning, septic shock and suspected multiple organ failure. My body was basically shutting down around me and this was one of the scariest times of my life.  I was left with on going liver issues as well as anaemia and problems with my blood count.

Sarah B3

My daughter who had jaundice after birth

I will admit, there was a point in both pregnancies where I thought “Enough is enough, I want out”. Its a horrible thing to admit, but one of the biggest things HG robbed me of was the ability to love my growing bump. When your in the midst of the grip of HG people say “think of your baby”, but I couldn’t, I could barely think of myself, all I could focus on was trying not to throw up or pass out for the next few minutes. I felt distant and removed from pregnancy. Pregnancy was meant to be this wonderful positive experience and it wasn’t. How could this nightmare of a situation be linked to a baby? My head couldn’t cope with it, so it was easier to just ignore the ‘baby’ element and try to survive the HG. No one ever spoke to me about how it made me feel, or if I was able to feel bonding or love for my bump. It made me feel empty, it made me feel angry, it made me feel sad and confused and above all scared. I love my children beyond measure, but at its worst it made me question my pregnancy and wonder if I would ever live through it.

Imagine going through all of that, both the physical and the emotional elements and still having to fight for treatment, fight people’s ignorance and fight their inability to see the wider effects HG has.

Sarah B2

My son

The assumption from all the professionals, my consultant and midwife was “it will all be worth it in the end” “ it will all go away once you have baby” That’s rubbish! It doesn’t just magically stop as soon as you give birth. Yes the physical sickness stopped for me, but I still had issues with my weight, my relationship with food, my mental health, my liver function and blood count and above all else I struggled to bond with my son. This was so hard and something I never talked about. How could I admit that having gone through all of that I couldn’t find the love for this tiny innocent baby? But I couldn’t and it was hard. I had become so detached from the pregnancy as a creation of a baby, I had become so consumed by HG that it was almost strange to be presented with this screaming small person at the end of it. We got there in the end, but again without the support of the professionals. Not once did anyone allow me to speak about HG after the birth or ask me how it was effecting me still. The consensus was it was now behind me, I had my healthy baby and I should be content with that. But even now, nearly 2 years after having my second, I am left with horrifying nightmares, flashbacks and panic attacks at the mention of a sickness bug. It’s left me fearing another pregnancy and even fearing sex itself and has put barriers between me and my husband.

We had always said we would have three children, three was our magic number. HG has robbed me of that too.

Sarah B1

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Perinatal Mental Health Perspectives

A couple of months ago I put together a survey for women on my private Facebook group regarding their experiences of perinatal mental health support.  This was never supposed to be a rigorous analysis of the issue, but I wanted to pull together a lot of the stories I was seeing on the group in terms of different mental health issues and the support available.

If this is a subject that interests you I would recommend Rachel Ellie Gardner’s work with Forging Families, a summary of which is provided by this infographic:

Forging Families

Membership of my group is just under 1,700 although I would say active members probably number around 500.  Of those, 72 women responded to the survey, having self selected on the basis of having something to say about the subject.  So I would anticipate the vast majority, if not all of the respondents, having had a mental health issue whilst pregnant and/or postnatally.  The respondents are from all over the UK, and all have given birth within the last 7 years.

Having asked about their geographical area and age of their children, I asked about potential additional stressers that had affected their maternity experience:

Q3 capture

I then asked about mental health conditions that they had experienced since having children.

Q4 capture

I can then break down those two questions to show which conditions women identified as having after having experienced specific circumstances.  So for example, women who have had premature babies identify as having experienced mental health conditions as follows:

Q4 premature baby

It is important to recognise that not all respondents who identify as having experienced a mental health issue have had a formal diagnosis of such, and there will be a number of reasons for that.  Formal diagnoses amongst respondents were as follows:

Q5

Amongst those who have had a diagnosis, the vast majority were diagnosed by their GP.

Q6

I asked about the treatment and support women had been offered, and the results of that question are obviously of more interest if broken down into those who have or have not had a formal diagnosis.  So, of those women who have had a formal diagnosis, the treatment and support offered has been:

DIAGNOSED ANXIETY

Anxiety treatment

DIAGNOSED DEPRESSION

Depression treatment

DIAGNOSED OBSESSIVE COMPULSIVE DISORDER

OCD treatment

DIAGNOSED POST PARTUM PSYCHOSIS

PPP treatment

DIAGNOSED POST TRAUMATIC STRESS DISORDER

PTSD treatment

All respondents were asked how helpful they had found the treatment or support offered to them:

Helpful

I then asked a couple of questions about support specifically from health visitors:

HV knowledge

HV awareness

And I was also interested in to what other services women had been signposted:

Homestart

Doula

So from where else are women accessing support?  Well not surprisingly a lot of these women report finding support online, as they are of course all members of a social media forum.

Other Support

Respondents were invited to make general comments about provision of mental health services, and nearly half of respondents (35) chose to do so.  Whilst I am not able to quote directly from the comments made I can identify certain themes in what the women were all saying:

  • Please talk about mental health issues more, both in wider society to reduce stigma, and specifically antenatally to better prepare people
  • More awareness in antenatal education about emotional wellbeing and what signs new mums should look out for in themselves and their friends, particularly with first baby
  • There is a lot of focus on postnatal depression, but other conditions need to be talked about antenatally as well
  • A healthy baby is not all that matters
  • More access to therapies required, not just medications
  • Using the telephone is difficult for those with mental health problems, text or email contact with services would be appreciated
  • Waiting lists for therapies for perinatal women vary widely around the country
  • The trauma of having a child on NICU/SCBU and undergoing procedures needs to be recognised – there is a lack of services and awareness of that, particularly after discharge
  • There is a lack of services for bereaved parents, or a lack of signposting to existing services
  • Services don’t work together
  • Support and care is inconsistent – a change of diagnosis for one mum has meant a marked drop in services
  • Much worry centres around being judged, feeling ashamed, being seen as a “bad mum”; stigma felt particularly keenly by young mothers; fear of being judged by professionals such as health visitors
  • Women are afraid to admit what is happening to them as what happens next is out of their control
  • More breastfeeding support would be appreciated
  • More consistent involvement is required from health visitors to more easily identify problems

This is not a robust enough survey to produce a usable data set, but it does provide a snapshot that confirms the picture I felt was coming out of the group.  A huge amount of anxiety, ranging from everyday worries to Generalised Anxiety Disorder – anxiety seems to be a constant companion of most new mothers, along with “The Guilt”.  Women not reaching out to health visitors as much as we would hope, but also there are not enough services available for professionals to signpost to when women DO reach out.  Homestart not being publicised enough, Doula care not being publicised enough.

Mothers are desperate for empathic emotional support, as well as specialist therapies and medications. Yet they are reluctant to be open and honest with their health visitors as they are so anxious about being judged to be incapable of caring for their children.  There is work to be done here by the health visiting profession in making clear how they can help and what will happen if a mother admits to mental health concerns.  There is also work to be done on seeing the person rather than the answers to a questionnaire.  Kat Grant has something to say about this in her presentation on her experience of post partum psychosis.  Women report lying on mental health questionnaires but being in clear distress during visits and being signed off on the basis of their answers with no recognition of their behaviour.

nausea

Those mothers who have turned to their health visitors for support do report some positive outcomes, including HVs coming round for “listening appointments” in the period until a referral to mental health support resulted in an appointment.  Yet there seems to be such variation in services.  Some bereaved mothers were seen regularly by their health visitors, others were not contacted at all.  Some mothers struggling with their mental health broke down in tears in front of their health visitor and got immediate support, others were still essentially ignored.  But again, a lot of mothers simply do not feel comfortable admitting how much they are struggling to a health visitor who is, essentially, a stranger.

A small number of respondents had received support or sought support from voluntary (or non-NHS) organisations, and of those the most common sources of support were Bliss, The Samaritans, Anxiety UK and PND&Me.

There are concerning comments in a lot of the responses about the way professionals sometimes handle issues of mental health, or the way that families struggling with very difficult circumstances are often not supported in the way that we would expect.  But there is a responsibility on all of us here as well.  It is not for the professionals to remove the stigma attached to mental health problems, that is for all of us as a society to manage.  It is not only for local services to wrap a family in love after the death or serious illness of a child – that is the responsibility of all of us as family, friends and neighbours.  In the conversations we have with each other about pregnancy, birth and parenting we need to be mindful of the messages we are circulating and perpetuating, and think about what those messages could mean to a distressed new mother who does not realise that the way she is feeling is all too common.

Look after yourselves everybody.  And look after each other.  Starting a family, extending your family or facing illness with your family is an incredibly difficult time.  It is also a part of life.  The more we embrace life, and discuss life, with all of its realities and messy bits, the more we will feel able to reach out to each other and live life together, warts and all.  The life you think everyone else is living is actually a fabricated life you have seen put together by soap operas and magazines.  The life everyone else is actually living is one that you know well.  It is very similar to yours.

 

 

 

 

 

 

 

 

 

 

 

 

A Time For Compassion

There’s no getting away from it.  These are pretty dark times.  I steer clear of the mainstream media and its petty, daily calamities, but there is a tide that is rising and it should be causing you concern.  It affects us all, you cannot turn a blind eye and assume someone else is dealing with it.

I am not immersed in politics, but I can start by telling you what I can see in the world that I am involved in, which is maternity and families.

The National Maternity Review has published a report that calls for many things that the #MatExp campaign and others have been campaigning for.  I am not going to critique the report here, many others have done that admirably and their thoughts can be found under National Maternity Review Report in the #MatExp Links Library.  What I want to look at is what is happening right now in maternity and family services, whilst campaigners and leaders call for change and improvement.

FilmCapture1

“Sweeping, widespread changes to whole areas of midwifery regulation”

The Royal College of Midwives is very concerned about changes proposed by the Department of Health and is urging members and supporters to contact their MPs to challenge the proposals.  Stuart Bonar of the RCM explains “The Nursing and Midwifery Council’s proposals would abolish much of the rules and architecture governing the role and scope of a professional midwife. This potentially opens up the provision of women’s care during and after pregnancy to anyone, regardless of training or qualification. This would undermine midwives’ ability to provide women and their newborn babies with the care and support they need and represents a real danger to mothers and babies. We can see no rationale for this.

We are told by the NMC that “protection of title as a midwife” is not under threat. However, the fact remains that a midwife’s role, scope and function are all due to be eroded. The reason given – regulatory simplicity – is unconvincing. Our advice is that proceeding with the existing NMC proposals would present a risk to maternity patient safety.”

You can read more here in Stuart’s blog post of 9 February.  Regardless of your views on the subject, this is a potentially huge change to maternity care that is not currently in the public spotlight.

Midwives are struggling enormously……

“I have shed too many tears over a career I could not love more because there is nothing I can do.”

This is a quote from a blog post by a midwife from University Hospital South Manchester, published on Sheena Byrom’s platform back in October.  She reports that “5 maternity units in the North West of England have been closed over the weekend. These women need our care. We are literally being worked to the ground. I am watching amazing midwives leave a profession they love because the workload and stress is too high.”

Hayley’s is not a lone voice.  The same issues are highlighted time and again on social media, in books and at conferences.  Newly qualified midwife Dawn Stone wrote for the #MatExp campaign’s Women’s Voices series (“Your Midwife”) and explained that “Working on a busy 50 bed AN/PN ward can feel like being on a carousel that’s spinning and spinning; there is no slowing down, only jumping on, and trying to stay upright and facing the right way.”

Much has been written in the press about midwives, their failings and limitations, issues of safety and issues of culture.  Again, the answers to these issues are above my paygrade if you like, but what I can tell you is that we will not see safe maternity care in this country until we face the current workplace reality for our midwives.  For more discussion of what is happening and what can be done please see “Time to Act for Midwives” from #MatExp.

…..and so is everyone else

It is far from only midwives who are struggling in this way.  Health Visitors have long been under pressure from all sides, and commissioning for these services have now moved to local authorities as of October 2015.  Inevitably we have seen reports that some authorities are considering cutting services or not commissioning them altogether.  If you are unsure of what that means, Health Visitors are currently tasked with caring for 100% of families with children under 5.  That’s the first five years of children’s lives, in every single family.  Interacting with health visiting services is a choice, families are not legally obliged to do so, but the vast majority choose to turn to their HVs for support and advice, and the service focuses on transition to parenthood, maternal mental health, infant feeding, healthy weight for children, accident prevention and school readiness.  Important stuff yes?  The things that we constantly see people calling for more action on correct?  This is what HVs do.  And they are understaffed, under-supported, over-stressed and now potentially not commissioned everywhere.

Again, whilst you might not have had a fantastic experience with your HV I hope you would agree that there is no other service that can pick up the slack if health visiting disappears up a local authority flue.

junior doctor

And what of junior doctors?  It is reported that two thirds of the general public currently support the continued action of junior doctors in the face of Jeremy Hunt’s determination to crush them.  This post from 23WeekSocks back in November explains the issues at stake on the eve of the first strike.  Events have now moved on to the point where a contract they bitterly reject is about to be imposed on junior doctors.  Are these the conditions under which we want our vital NHS staff working?  Conditions which they reject as unsafe?

The pressures under which obstetricians and sonographers work can be glimpsed through another two entries in the #MatExp Women’s Voices series.  You will see common themes in all of this, including the threat to the mental health of the very people we rely on to keep us well.

Which brings us to mental health services.

This article from The Guardian describes the postcode lottery of mental health services for new mothers.  “More than one in 10 women develop a mental illness while expecting a child or in the first year after giving birth. For about 40,000 women it is severe and in extreme cases necessitates admitting mother and baby to a specialist unit.”

“Mental health problems are the biggest single preventable killer of women in the “late” postpartum period, between six weeks and a year after giving birth, accounting for almost a quarter of maternal deaths in this period, according to University of Oxford researchers. One in seven maternal deaths in this period are by suicide.”

“There are 111 beds across the 15 MBUs, but that is not enough with large areas of south-west, eastern and north-west England without a facility.”  There is currently no Mother and Baby Unit in Wales.  “Of the 40,000 who have antenatal or postnatal problems, or both, only a quarter get access to specialist perinatal mental health services.”

Another piece in the same newspaper describes the personal experience of a junior doctor confronted with a struggling new mother.  “I called social services and relayed the story. It was 4.55pm. “Is she going to kill the baby and then herself?” was the business like question I was asked. I replied no. “Ok then, we can see her tomorrow.” I was left literally holding the baby.”

PNMH

Anyone who has engaged with mental health services, or who has tried to get support for a friend or loved one, knows that there are staggering gaps.  Like many of you I have a store of anecdotes of people in crisis left to struggle alone.  Of services not joined up.  Of professionals not communicating effectively with one another.  Of mothers falling through gaps because they don’t fit a particular model.  Of families who have gone through dreadful tragedies being left to fend for themselves.  At the most vulnerable time in many people’s lives they are left to try to advocate for themselves, to fight for the services they need, to get their voices heard.  When they are in no position to do so.

Where can go to?  Where can we find support?

Well the answer used to be Children’s Centres.  And in fact I still see this answer given regularly. People suggest new services could be based in Children’s Centres.  That is where support could be based, where professionals can come together, where services can be centred.  Yet where are these fabled centres?  In my area, Trafford, we have lost 14 out of 16 Children’s Centres since 2011.  When my eldest son was born I had a centre within walking distance of my house.  I volunteered there.  I received support there.  I gave support there.  I got information from there.  I met professionals there.  So did many other families.  By the time my youngest son was born two and a half years later my nearest Children’s Centre was across town.  Fine for me, I can drive there.  But is that what we want, for crucial services to only be available to those with access to a car?  Do we really believe that vulnerable new mothers are going to struggle with public transport to access services?  If you believe that you know nothing of early parenthood.

And of course many centres are based in libraries.  Which are also under threat.  Who need community hubs eh?  It’s only where joined up services for families can be based.  Let’s close ’em.

Support for Infant Feeding

I have written enormous amounts about infant feeding which I am not going to revisit here.  This open letter from the World Breastfeeding Trends Initiatives team signed by a huge number of eminent professionals outlines what needs to be done.  Suffice to say that as the evidence mounts for the importance of breastfeeding support and the improved health outcomes of optimum infant feeding, funding for breastfeeding support groups is being consistently cut across the country.  Statistics tell us that the vast majority of mothers choose to breastfeed.  Yet an enormous number of those women give up breastfeeding early in a baby’s life.  Anyone involved in infant feeding or who has tried to breastfeed a baby will tell you that access to good quality support is the pivotal issue.  So let’s close down breastfeeding support groups too eh?

Use Your Voice – If You Can

For women and families who have suffered due to any or all of the issues above, when it comes to maternity there is an option for them to provide feedback to their local services.  That option is their local Maternity Services Liaison Committee (MSLC).  Not every area has one in place, but where an MSLC is available it can be a vital way for services users to come together with staff and commissioners to work for improvements.  This blog post from the Chair of Bromley MSLC discusses the importance of these organisations in more detail.

So guess what?  I bet you can!  Yes, funding for MSLCs is under threat.  If we are going to limit the provision of services and support for families we should make sure we limit their ability to talk about that too right?

You can sign this petition to call for better funding for these important services.

What is happening in your world?

The above is a snapshot of the issues happening in the world I inhabit.  I know that there are huge struggles in the worlds of other vulnerable people, those with disabilities being a prime example.  We all know of the shameful issues surround the “Bedroom Tax”.  The Independent has reported the names of the MPs who have recently voted to force through the ESA disability benefit cut.  Referrals to food banks are rising by enormous percentages.  This is skimming the surface.  What of refugees and those fleeing unimaginable horror?  What is happening in your world?  Please do comment to share your experiences.

independent

Time to cut the budget.

Good news then on the BBC today that George Osborne is warning of further budget cuts.  I mean, there’s just so much surplus!  So much fat in the system.  So many areas where cuts can be made with little impact to families and vulnerable people!  Oh…. wait…….

Across the pond……

In some ways this all pales in comparison to the terrifying things happening over the Atlantic in the United States.  It is becoming increasingly likely that a vicious, uniformed racist is going to become the Republican nominee for president of the United States.  He has called down hatred upon specific religious and racial groups.  He is whipping up support by speaking to people’s fears and prejudices.  His rallies have been the site of violent clashes.  Does any of this sound familiar at all?  Have we perhaps seen charismatic leaders whipping up hatred at times in our global history?

Has it ended well?

Like I say, these are dark times.

What is the point?

So what is my point in listing all of this to you?  Why start your Sunday on such a note?

My point is that there are different ways that we can respond to all of this.  There is less money, less to go around, less for you and less for me.  So very tempting then to give in to the rhetoric and believe that there are groups who are not deserving of compassion.  Groups whose suffering should be ignored.  Groups who are not as compassionate as they say they are.  Professions whose funding should be cut.  Groups who should be rejected.  Because then we can claw back some more for ourselves, because those other people shouldn’t have it.

And even if we do not buy in to the rhetoric of hate it would be easy, so very very easy, to simply despair and do nothing.

Well guess what?  This is not the way forward.  It never was, it never has been, it never will be.  You have heard the phrase “The only thing necessary for the triumph of evil is that good men do nothing.”  Perhaps like me you assumed that it referred to apathy?  Perhaps it does.  But it also refers to despair.  When there is so much suffering around us, it feels overwhelming, and being overwhelmed leads to inaction.  And inaction lets in those things we fear.

The answer is to do SOMETHING.  Anything.  Start in your home with what you teach your children.  Start on your street with how you care for your neighbours.  Start in your community with what you campaign for.  Start in your workplace with the compassion you show to your colleagues.  Start in your conversations with the rhetoric that you challenge.  These are not small things.  These are the things that turn the tide.

We all imagine that in dark times in history we would have stood up to be counted.  We would not have allowed these things to happen.  How could people have stood by?  How could they ignore their neighbour’s suffering?

Are you standing up right now?  RIGHT NOW?  Or are you standing by?

Let’s stand together.

starfish story

 

Infant Feeding – what is your experience?

Before the National Maternity Review claimed everyone’s attention, we had The Lancet Breastfeeding Series which was big news in the infant feeding world.  The WBTi team put together this wonderful Open Letter in response and many productive discussions were had.

Inevitably, social media being what it is, there were also unproductive discussions between people who found it hard to see each other’s point of view.  I have discussed acknowledging each other’s truths before when I wrote about Infant Feeding for the #MatExp campaign, but what occurred to me this time around was that when we discuss these things we all have a different person in mind.  We think that we’re discussing things in general terms, for the benefit of all readers or listeners, but in truth we are discussing our own experience, or the situation of a close friend or family member, and we are speaking to that person who annoyed us hugely at the coffee shop, or our parent who doesn’t support our feeding choices.  This colours a great deal of our discussion and goes some way to explain why emotions can run high.  There are real people behind the generalisations, real experiences, and sometimes real pain.

So I thought I would take a leaf out of the #MatExp book and try to gather some differing voices.  This blog post is a snapshot of feeding experiences, it would take a far wider study to truly hear “all voices” in this regard.  But I hope I can present some alternative people, so that the next time we all come together to discuss feeding choices we can perhaps bear in mind the experiences of people different from us.  Stepping into other people’s shoes can help to bring us together.

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Lucy – “I feel good that he’s alive and thriving”

Lucy Richards

Lucy chose to breastfeed her baby, as most women do, but had to switch to formula at 5 days old when baby was admitted to special care with 16% weight loss and severe jaundice.  “I had no positive support at all on the maternity ward or at home from feeding support workers.  No one picked up on the fact that my son wasn’t latching on at all and one midwife squeezed my nipple into his mouth – it was very painful.  I had no support for formula feeding at all either, apart from the nurses in special care who were amazing in helping us get to grips with bottle feeding.  Most of my information about my feeding choice came from them.”

How did friends and family support your feeding choices? “My husband and mum were amazing, but my brothers and sisters-in-law didn’t really understand why I wasn’t breastfeeding.  My brother would make constant comments like ‘bottle fed babies throw up more’ and ‘bottle fed babies are much easier’.  My mum didn’t really understand the importance of sterilising.”

“I had one mother come up to me at a family centre as I was preparing a bottle when my son was a couple of months old and she told me ‘It’s a shame you’re not breastfeeding as that’s best for baby’.  To which I replied that I preferred an alive baby to a dead one.  I feel bad about my feeding choice most of the time.  I feel less guilty now though as he’s thrived so much.  I do feel like I’ve let him down but I feel good that he’s alive and thriving.”

Liz and Alan – “happy that the grandchildren are happy and fed”

Liz and Alan

Liz and Alan’s daughter Sarah breastfed her eldest son for about six weeks before switching to formula.  She then breastfed her middle son exclusively for ten months, and is four months into breastfeeding her youngest.

Liz breastfed Sarah for 10 months “which was full term for her, she decided she didn’t want it so just stopped herself.  My son who was a very small baby had trouble latching so after three weeks of breastfeeding I switched to formula.  The midwives helped me with both of my children. They were on hand to answer questions and were supportive of my choices with regard to feeding.  I had a special care midwife for my son because he was premature and so small (5lb) and she was great.”

Liz is pleased that Sarah is able to breastfeed “but I was also supportive when she decided to switch to formula with her first child.  I fully support Sarah however she chooses to feed.”  Liz explained that she had not seen any infant feeding information aimed at grandparents, but that “I personally don’t feel the need for it as I know the benefits having breastfed and formula fed my own, so I know the pros and cons.  I am happy that the children are happy and fed.”

Liz did feel that it could be useful for there to be information available to grandparents about expressing breastmilk, the importance of sterilising bottles and so on with regard to looking after the grandchildren whilst their parents are at work.

Alan feels that it is great that Sarah is breastfeeding her son as “it’s the natural way to do it.”  He feels that the way his daughter has fed the grandchildren gives them the best, and he has no concerns whatsoever.  When it comes to infant feeding information for grandparents, he also commented that perhaps “grandparents who look after young children (as childcare for working parents) might like up to date information about how best to feed them.”

Sarah said of her parents “I feel very blessed to have them, they support me completely and would no matter how I chose to feed.”

Sarah-Jane – “it was the norm in my family, it was what I wanted to do”

Sarah-Jane

Sarah-Jane breastfed her daughter until she was twelve months old.  “From the moment I found out I was pregnant I wanted to breastfeed.  It was the norm in my family, my mother breastfed me, my sister breastfed, it was what I wanted to do.  I also researched the benefits of breastfeeding which confirmed that I was making the right choice for me and my family.  As I returned to work when my daughter was nearly ten months old I would express each day at work to ensure she had enough milk for her time at the childminder’s.  This worked well for us and she was happy to take a bottle of expressed milk when I was not around.

I know I was extremely lucky in that my midwife was very pro breastfeeding and was very knowledgeable about it.  She prepared me for all scenarios on what to expect, what I can do and linked me into the local breastfeeding groups.  Following this my health visitor was also a massive support in my decision to continue to breastfeed beyond six months – she enabled me to feel confident in the choice I was making and gave me information to assist me in this choice.  My local breastfeeding support group was also led by health visitors which was fantastic – meeting like-minded mums, being able to discuss things with people who were going through exactly what I was was a great support to me.

My husband was amazing, he supported me from the beginning with my decision to breastfeed our child, so were my family.  For me I think it would have been weird if I hadn’t have breastfed as it was just assumed that I would.  I was never made to feel uncomfortable, I was always encouraged to feed wherever I needed to.  My friends were also supportive and accepting of the choice I had made.  I have made some long term friends from my breastfeeding support group.

I got most of my information on infant feeding from Internet research and my family, in terms of finding the information in the lead up to having my baby. I had seen my sister feed her two babies so I knew some of what to expect.  As my due date got closer I did use my appointments with my midwife to seek further information and discuss my concerns.

I feel good about my feeding choice knowing I was giving my baby the best start in life I could, also the bond I have with my little girl is so worthwhile.  When you’re feeding your baby and they gaze up at you in that moment I know and still know now that I did the best for her, this makes me feel good.

Lisa – “my friends and family were in awe of me”

Lisa

Lisa wanted to breastfeed exclusively but her baby has feeding issues – a tongue tie, reflux and a milk allergy, so she was combi-fed.

“I breastfed in the house and expressed or gave formula – I could only feed indoors as it would take my baby hours to take a feed due to reflux.  I went to breastfeeding support groups but I found that as my baby got more unsettled due to milk allergy and reflux that I couldn’t really get the support I required. My daughter didn’t respond much to any technique and advice.

My friends and family were great, they in fact said they were in awe of me as they know how difficult it has been, but I couldn’t really have much support from them as they hadn’t been in the same position.  Healthcare professionals just pushed my daughter on my breast which obviously made her scream.  Often at times I felt that they thought I was just a new mum that couldn’t cope.

Some friends and family members told me it didn’t matter that my baby had formula as well as breastmilk.  I know they were trying to be helpful and meant well, but I didn’t find it helped at all.  I got myself really stressed and people would tell me not to be silly, but I felt it was a big deal to me.

I have got most of my information on my feeding choice from online support.

I felt bad when I was still breastfeeding and I had to give my daughter a bottle of prescription milk.  I had to cut other stuff from my diet which I found extremely difficult.  Being a tired new mum with a high needs baby was difficult enough.

I have nothing against women that choose to formula feed, but I wanted to exclusively breastfeed and I felt a failure that I couldn’t.  But despite my baby’s issues she has still continued to put on weight and is otherwise healthy and this makes me feel good.

Liam – “it’s natural, relaxing and peaceful”

Liam

Liam’s partner Gill has breastfed their two children to natural term.  Liam is very happy about this as he can see how happy it makes his children.  “Knowing that it is best for them makes me positive about it.  Natural, relaxing and peaceful.  It works for Gill because she buys into the reasons for doing it so is very keen to continue.  We don’t have to use any false breastmilk replacements which cuts costs, reduces environmental stress – it takes less thinking.  With William it was a learning curve so it is easier these days for Hattie.  I’ve learnt to understand how I can help and fit into the approach.

A few people asked questions when both Hattie and William were younger about how Gill had to be there for them most of the time – when would Gill get any time away?  But people have made positive or neutral comments on the whole.

I don’t have any other vision in mind of how this should all work, i.e. non breastfeeding, so nothing to compare it to.  I think it’s sad that so many children miss out – including myself.  Breastfeeding is very good at calming children – when managing William and Hattie at times on my own I don’t have this to depend on, so sometimes I feel a little lost when it’s not available.

I remember reading about the positives of breastfeeding for mum and baby, and the support that is needed.  I recall the good midwives showing Gill and me how to approach it, techniques and things to do.  I listened to Gill about what things she needed, and I wasn’t influenced by anyone who was negative about it.”

Gill recalls that “a different midwife came to the house every day for the first eight days post birth ‘just’ to help with breastfeeding.  I was at the point of giving up numerous times, at the time I resented Liam for his resolute determination that we would continue to breastfeed.  He was SO encouraging I could have killed him.  But I am so very grateful now.”

Sarah – “everyone pitches in and helps, no one judges”

Sarah Emily

“I formula fed Joe from day one, mainly because of the experience I had with my eldest.  I felt like I wasn’t ready to try breastfeeding again.

I didn’t have any advice or help from any health visitors or midwives.  I think because I was so confident in my decision they didn’t feel I needed any.  Luckily my family are all pretty chilled.  They would have helped no matter what my choice was.  My mum even took a week off after my other half went back to work just in case.

When I said I didn’t want to breastfeed I wish someone had asked why and had explained my experience with Grace to me.  As mad as it sounds, I had no idea that I would struggle with my milk supply with Grace after losing so much blood and having a traumatic birth.  If we’d have talked that through I would have felt better. It was only from an online forum that I knew with hindsight what had happened.

I get most of my infant feeding information from the World Health Organisation and NHS websites.

I can honestly say that all of my friends and family have been helpful.  Everyone pitches in and helps, no one judges.  But when Joe was a few days old I went to a coffee shop with Grace and my mum.  A lady in her late fifties walked past me and said “breast really is best you know dear”!

I constantly feel bad about my choice because I didn’t even try.  I know now that my experience with Grace was not my fault, and I had poor advice from horrible midwives.  I worry I have deprived Joe and I’ve not provided myself with the benefits of breastfeeding either.  But I feel good because we have an amazing bond.  He is thriving and my other half was able to help with the nights in the early days.”

Julie – “I chose to breastfeed to natural term because why would I stop?”

Julie

“I breastfed both my children: my first son until he was 3 years and 9 months when he naturally weaned and my younger son, who is currently 3 years and 3 months, is “still” breastfeeding.  I breastfed throughout pregnancy and tandem fed both boys for around one year.

I chose to breastfeed because it is natural and normal.  I chose not to formula feed because of the dangers associated with doing so.  I chose to breastfeed to natural term because why would I stop?  The benefits of breastfeeding do not decrease with the age of the child.  Through breastfeeding I have provided nutrition and protection to my children, it has been a comforter and soother, it has helped them calm down after tantrums, it has helped them sleep and it is the single most important thing I have done for both my children.

The healthcare professionals I have been in contact with were generally supportive of my choice, but did not provide me with any useful or practical advice.  I received basic help from the midwives in hospital after the birth of my first child and then received some advice from a breastfeeding support worker, when after a few days I panicked that my milk had not come in.  When my second child was born the midwife was delighted that I was also breastfeeding my then 2 year old as she had fed all four of her children to natural term. She was extremely helpful in reminding me of the difference between feeding a newborn and the more experienced toddler.

Sadly I have received inaccurate advice (going against the WHO code) and even personal opinion from healthcare professionals about both breastfeeding and natural term breastfeeding.  I have been told that breastmilk causes tooth decay, that there is no benefit after six months and that I am making a rod for my own back by feeding to sleep – all of which is inaccurate.  When my second son was born, I took both children to a breastfeeding support group in Lichfield.  The other mums were very welcoming and supportive, and asked my advice as an experienced breastfeeding mummy.  The health professional however said that I would make a mockery of her statistics with a child breastfeeding at nearly 3 years old.  Another healthcare professional used to scoff at me for breastfeeding and said to me that formula didn’t do her children any harm.

I feel sorry for women who receive this advice and hear these comments and believe it.

My husband has always been very supportive.  He is very helpful in providing refreshments whilst I am breastfeeding, as well as staying awake at night to chat to me.  Our families and friends have been accepting, even though they may not agree with my choice to breastfeed to natural term.  I have met dozens of women who have breastfed their children for up to six and seven years, and they have been especially supportive of me.  Many of these have become good friends.

I have occasionally had comments about when I will stop breastfeeding from friends.  I choose not to be embarrassed and have continued to feed on demand irrespective of my child’s age.  I have never had any negative comments.  I have had many people congratulating me and offering me admiration for feeding my boys to natural term.  Many people have expressed their regret in giving up breastfeeding.

I get the majority of my infant feeding information from the Association of Breastfeeding Mothers and La Leche League.

I am very proud that I have given my boys the best start in life.”

Laura – “I am able to make anything that upsets them instantly better”

Laura

“I set out to exclusively breastfeed because I had some general understanding of the risks associated with not breastfeeding and I didn’t want to expose my babies to them.  I ended up supplementing my first baby with expressed milk and formula top up until around 13 weeks and then managed to return to exclusive breastfeeding.  My second baby has been exclusively breastfed.

I received no support from healthcare professionals with my first baby.  A support worker at the hospital helped me for about half an hour.  The midwives there were genuinely too busy to help me.  They tried but were called away within a couple of minutes every time they sat down.

The community midwives were unpleasant, treated me like an inconvenience they didn’t have time for and strongly pressured me to formula feed.  I gave into this pressure, even though it felt so wrong, because I didn’t know where else to turn for help.  I thought they would help me, not undermine me. I didn’t have the strength to fight them.

I now realise they simply didn’t have the knowledge to support me. I wish they’d been honest and directed me to some properly qualified support, instead of covering their backs by telling me I was endangering my baby by persisting with exclusively breastfeeding.  I now know she has a (fairly obvious) tongue tie but they never got close enough to check and I’ll never know if that was the problem.

My husband was (and is) wonderful.  He took over everything in our lives so that I only had to express milk and feed our daughter.  He constantly reminded me that he was on board with whatever I chose to do and told me he was proud or me.  My mum knew nothing about breastfeeding but would drop in, make me a cuppa, do the dishes, stick some laundry on and then leave us to it.  So, so helpful.  Other people who visited stayed for hours, made a mess and helped very little with practical things.  Normally I could handle that but whilst trying to recover exclusive breastfeeding it nearly tipped me over the edge.

Back then I got most of my infant feeding information from the Kellymom website and Mumsnet.  Nowadays it’s La Leche League’s The Womanly Art of Breastfeeding, and still Kellymom but also Dr Jack Newman’s site.

My Mum regularly says she thinks it’s great that I have breastfed the kids but….. A woman on a train once said ‘It’s so lovely to see a baby being fed properly.  That’ll be why he’s such a happy little chap.’  I feel good about my feeding choice because it means I am able to make pretty much anything that upsets them better instantly.  Also, knowing I’ve done my best for them, which is the least they deserve from me.”

Ruth – “a healthy mum means a mum who could care for her child”

Ruth

I began breastfeeding my second child because I had breastfed my first child as I wanted to give my babies the natural milk, and believe it should be the default position. But two things intervened that meant I formula fed him. The first of these was a tongue tie that I didn’t get support with until he was 3 ½ months old, and even then it was my own vigilance and questioning and then my own research and seeking a private appointment which resolved it. This is something that might have threatened my ability to breastfeed in any case. However, within a week of his birth I was diagnosed with postpartum psychosis and put on medication that I was told was not compatible with feeding, and I was so knocked out by the medication others had to be with my baby at night. In the end he was formula fed long term.

In the hospital the midwives kept checking his latch but could find nothing wrong so they lacked the experience to question whether tongue tie had some bearing on it. Once at home he was having some formula and the midwife gave me some support on how much to make up and some basic info on formula feeding a newborn, since I had breastfed my first child. There was no support for reinstating breastfeeds or checking the latch or for further problems. But I also managed to do some feeds as breastfeeds especially as my milk came in and the pain subsided a little. Then when the psychosis took hold the midwife ensured I got a diagnosis but once the mental health team took over the support was for me and not really my feeding choices.

I could have done with some support about the logistics of fully formula feeding. One of the female mental health nurses just shared her own anecdotal information to help me get my head around it but it wasn’t correct info on making up bottles safely. Their advice was for me not to breastfeed whilst taking quetiapine and diazepam. I do not know if this is accurate. However it has to be said that as I wasn’t able to do the nights as I was knocked out by the meds, I would have had to have combi-fed at the very least, but I could have had some support for this maybe. I am still unclear to this day whether or not my medications are compatible with feeding so I would think that accurate info on drugs and breastfeeding needs to be more readily available to health professionals.

As I moved on to formula the midwife stopped me to say that formula feeding would be a lot harder as if you had an unsettled baby and couldn’t work out if he needed feeding or not then you couldn’t just whip a breast out and see. You would have to make up a bottle and risk wasting it. It made me very anxious about bottle feeding which didn’t help my mental state.

My husband and family and friends were all supportive and realised it was something that had to be so, due to the postpartum psychosis, and I received no criticism.

My information about formula feeding came from the midwife who gave me information by answering some questions, and then I looked back at a book that the NHS issued with my first son of caring for baby and the info about formula was there. And a friend who formula fed her second helped me out with information, from what bottles to buy to tactics to manage making up formula in the night i.e. using the ready made stuff.

Mostly I have accepted that two things weighed heavily against me. The tongue tie and my mental health. However when I see information about the benefits of breastfeeding I do get pangs of wishing I had been able to breastfeed and feeling upset I have had to rely on formula. But as a believer that breastfeeding is the default position where possible I think it is fine to continue to share this info widely. Whilst I had pangs about it due to this info, I really think it is so important to promote breastfeeding as the norm. And I feel good knowing that I did my best for me and for baby in the circumstances, and I am proud of a relatively quick recovery from the worst ravages of post partum psychosis. On medical grounds my feeding choice seems to have been necessary, and a healthy mum means a mum who could care for her child. Formula feeding has worked very well for me.

Scott – “I found it very straightforward”

Charlotte

Scott’s wife Charlotte chose to formula feed their son.  He doesn’t have any strong feelings about that choice, but he feels that it works for them as “I have been able to help with feeds since he was a very young age.”  He doesn’t remember seeing any specific information about infant feeding, but says that he “found it very straightforward”.

Scott’s main concern is about the price of formula milk. “It’s the same price everywhere you shop and for a government obsessed with allowing market forces to dictate every other aspect of our lives, it seems a bit self-contradictory that they should be controlling this in this matter…. especially when some families are working on very tight budgets!”

Lucy – “I love knowing they’re ‘homegrown’ “

Lucy Ruddle

“My children have both had breastmilk.  I breastfed my eldest exclusively for two weeks, then I switched to formula.  I regretted this decision though and started to relactate when he was four weeks old.  He was combi-fed for around eight weeks until I established my supply again. He was then breastfed until he was eighteen months, when I decided to wean him.  My youngest is unable to breastfeed so I express exclusively for him.  It’s very important to me that my children have the milk my body makes specifically for them and their needs.

Support from healthcare professionals has been patchy.  Sometimes good, sometimes awful, but mostly just not offered. I met a very good health visitor at clinic with my eldest, who was able to encourage me with relactation, but the others I came across never seemed willing to talk about it – usually I was met with “that’s very difficult.”  One health visitor even told me to just stop giving Alfie bottles…. I had no milk at this point, and if I wasn’t in touch with a breastfeeding counsellor then that advice would have ended my attempt to breastfeed there and then.  I have found volunteer breastfeeding support workers to be much more supportive and knowledgeable.  With Oliver I have accessed the full range, from peer supporters to lactation consultants, and have found the support to be excellent.

With Alfie I had very limited support from friends and family.  I hadn’t had chance to make friends with women who had children, so no one understood what relactation actually meant in terms of time and dedication.  My husband was the only support I had at that time.  He didn’t really understand my drive but he respected my choice and enabled me to do it by simple things like washing up breast pump parts and holding the baby while I expressed.  This time round I have lots more support from friends because they have breastfed so they understand.  I have had meals brought round for us, offers of babysitting and invitations to friends’ houses for myself and my pump.  My husband is more clued up on the importance of breastmilk now too and fully supports my decision to express for Oliver.  He does the night feed so I only have to get up to express, and he’s done practical things like buying an in-car power socket so we can still have days out – I pump in the car!

Sadly I don’t have support from other family members.  I have been told “I don’t know why you’re faffing with expressing, you’re just being selfish really.”  “There’s no need to breastfeed after six months, it’s just wrong and I don’t want to see it.”  “Well all mine had formula and they’re okay.”

Most of my infant feeding information comes from International Board Certified Lactation Consultants (IBCLCs) and breastfeeding counsellors.  Also from the Kellymom website and other breastfeeding mums.

I feel good about my feeding choice because I know I’m doing the best I possibly can for my boys.  I wouldn’t be expressing full time if I didn’t feel the benefits are important.  I love knowing they’re ‘homegrown’ “.

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I asked all of the contributors to read and comment on the Open Letter from the WBTi team, as I feel it is a very important call to action with regards to infant feeding in the UK.  This was their responses:

Lucy – “I think the letter is brilliant.”

Liz & Alan – “Good if there is more encouragement and support for breastfeeding. Interesting that more mums are choosing breastfeeding but not sticking at it for very long.”

Sarah-Jane – “I agree with the letter in that mothers are not always given the best chance to breastfeed long term.  The hardest time is those first few weeks and if you haven’t got a good support network around you it could be easy to think formula is best or that your baby isn’t getting enough milk from you.  The level of support across the country is very much a postcode lottery – if you’re lucky you can get support, if you’re not you’re alone.  Not having the support of family can also play a massive part in whether you continue or even consider breastfeeding as an option for your child.

I agree that more needs to be done with regards to the advertising and marketing of formula, including the concept that formula is better or as good as breastmilk.  The marketing should be honest and open allowing people the best chance of making the right choice for them.  I also agree with the actions of what needs to happen to make the UK a more open, capable, able society for mothers to have the best available information, with the facts, benefits, advantages on each of the feeding choices.  It is only then we can be confident as mothers that we can make an informed choice.  Support has to be the key: where there is support and peers there is success.”

Lisa – “I agree with the majority of the letter as I still feel now if I was better supported I may have been able to continue breastfeeding.”

Liam – “I agree with all that is said.  It takes time to change attitudes and mindsets but it will happen.  Perhaps untapped is the father’s input, views and support.  Get blokes on side, articulate about breastfeeding, as well as supporting ongoing improvements.”

Sarah – “I think it’s really sad that there is such poor support for something that is so natural.  Encouraging support is good, but bombarding women who are probably already struggling with information (which they probably already know) isn’t helpful.  That is only my experience of how you’re told breastfeeding is the right thing to do.”

Julie – “I think that the letter should be treated with the importance it deserves and the actions it requests should be given the highest priority by the UK government.  I congratulate the contributors.  I am continually astonished that more has not been done and more is not done to ensure that breastfeeding rates improve, that the WHO Code is fully acted upon and that there is both training for healthcare professionals and more support for women.  It is time now to act and to work together, as a community and as a nation, to improve the health of our babies and of their mothers.”

Laura – “I think it’s an excellent letter and I hope it gets the attention it deserves.”

Scott – “The more education on the subject the better.”

Lucy – “The letter is important, I agree with all of it and I really hope the right people listen and take action.”