It was nearly 10 years ago when I had my first child, put her to the breast and discovered it wasn’t going to be as easy as I thought. I asked 12 midwives for advice. They all gave me wildly conflicting suggestions and failed to diagnose a faulty latch, which caused terrible pain and meant my daughter wasn’t feeding efficiently.
I mix-fed. I stopped breastfeeding for two weeks. I expressed. I re-lactated. At one point one of my best friends breastfed my daughter for me, with my permission. Eventually I did what most women with breastfeeding problems do: I found collective wisdom on the internet and was told to get myself to a trained breastfeeding counsellor.
Within 10 seconds the La Leche League leader diagnosed the problem: my daughter was curling her bottom lip in. She was 10 weeks old. I had been in pain for 10 weeks. Everything changed from then and I got back to what I had always wanted to do: just breastfeed. The moment I did, my hormones normalised and my depression vanished (breastfeeding raises levels of oxytocin, which is a mood enhancer, and prolactin, which has a soothing effect). But why had my journey been so hard?
The breastfeeding training health professionals get in the UK is varied and patchy. Some health professionals really know their stuff and do care, but in the 10 years I’ve been involved in this – eight years co-running a parenting board and four years as lay rep in a large maternity hospital – I’ve found them to be in the minority.
The only internationally recognised qualification is that of the IBCLC (International Board Certified Lactation Consultant). They study nothing but breastfeeding for years: two to five is the norm. It’s only when you talk to someone who’s been properly trained that you realise how lacking in breastfeeding knowledge the average health professional is. Some hospitals have funding for a lactation consultant. Many don’t. You can see one privately but you have to pay.
In many hospitals women with a breastfeeding problem are seen by a midwife who may or may not give correct information. As I said, 12 of mine didn’t, and even more damagingly, none admitted ignorance, or told me to ring an outside organisation.
Even in those hospitals where there is breastfeeding support, that support is not standardised. There are various titles with varying degrees of training behind them: peer supporter (typically a mum who undergoes a 10-week training course), breastfeeding counsellor (two to three years of part-time training), or the aforementioned lactation consultant – but be careful here because anyone could call themselves this; it’s the IBCLC bit that counts. Confusing, isn’t it?
Shouldn’t all hospitals have a board-certified lactation consultant? How would it be acceptable in any other area of mother/baby care to not have this specialised care? A Unicef report last year showed that, even at conservative estimates, increasing breastfeeding rates could save the NHS £40m a year.
When breastfeeding doesn’t go to plan many women get angry with each other, when the people we should be really venting to are those who make the policies that decree we are not worthy of specialised, uniform, qualified support. Don’t write to me about your breastfeeding journey; write to Jeremy Hunt (firstname.lastname@example.org).
First published in the Guardian news pages, on 20 March 2013.