What better way to mark the end of World Breastfeeding Week 2017 than a Q&A with the brilliant Dr Amy Brown, Associate Professor at Swansea University, specialising in breastfeeding and infant nutrition. You may have read one of her fantastic books, seen her brilliant videos about the needs of babies, or read one of her many HuffPost articles… we are so pleased to welcome her to TFTMS.
Today marks the end of WBW2017. What have you been up to? And what’s the most promising thing you’ve heard about/seen during the week?
“It’s been an interesting week. As always there have been a mix of articles in the press – some great ones supporting breastfeeding and some not so great ones where formula companies try to hijack the week. I’ve seen a lot of emotion around this and its understandable and frustrating. Even though we encourage breastfeeding, every week is formula promotion week when they spend over £6 billion a year in promoting it. Can they not let us have this one week to try and better support mums who want to breastfeed?
“There have also been a lot of articles where women have been let down and these are heart breaking. A main reason I do what I do is to try and create an environment where fewer women end up feeling this way. It’s not about criticising women who can’t breastfeed or pressurising women to do so when they don’t want to – but supporting the literally millions and millions of women out there who have been let down. Over 80% of mums who stop breastfeeding in the first six weeks weren’t ready to do so. In the UK that equates to around 25% of mums who give birth in the UK each year – around 200,000 mums feeling unhappy about their breastfeeding experience year on year upon year. That’s what we’re trying to change.
“I have however also seen lots of positive things happening this year. Lots of successful Big Latch On events, projects being launched, great blogs to read. It reminds us that this is something worth fighting for. Myself, I’ve been blogging via the Huff Post and sharing older articles that are unfortunately still relevant. I shared an article around the ‘breastfeeding jigsaw’ which contained some beautiful illustrations the cartoonist Kate Evans (AKA Cartoon Kate) drew for me. Check them out – they are free to share and use.”
Tell us about how you ended up with such an interest in breastfeeding. Was it a long term ambition or a more organic process?
“It was accidental really! I didn’t know anything about breastfeeding and thought it was a simple equal choice between that and formula milk – you picked you preferred method and got on with it! Then I became pregnant with my first baby – 12 years ago now – and that completely changed my life in the usual way, but also the less usual way in that it ended up also becoming my career. I was fascinated by the sheer number of women I met who wanted to breastfeed but couldn’t do so. It seemed so strange – what was going on? Were British breasts broken?! So I started researching women’s experiences of breastfeeding and found that they experienced so many challenges that were not their fault – yet they were blaming themselves. This has to change – and hopefully by the time I retire, together we will have made a difference.”
What is your favourite part of your job at Swansea University? What makes Amy tick?
“I love being able to research, work with mums and share my writing and ideas and call it work and be paid for it! I’m very fortunate. I also love being able to share all my accumulated knowledge with my students – many of whom can take that back into their work as health visitors and midwives. I love being able to support my PhD students to explore their passions too – I have students working on baby-led weaning research and lots around birth and breastfeeding. Ultimately, I do what I do because I hope it can change things for the next generation of news mothers. I want to play a role in changing the society and culture in which women breastfeed and I hope my work can do that.”
We love the videos you’ve produced – do you have any more in the pipeline?
“We do! We have another coming out very shortly on how normal and important it is to feed your baby responsively and how to check your baby is hydrated and getting enough milk in ways other than worrying about how much they feed.”
Editor’s note: Not seen any of these videos? They’re fantastic! Here’s one of our favourites…
Obviously, there are lots of factors that make the UK’s breastfeeding rates some of the worst in the world. What do you think is the biggest barrier that women face?
“I think lots of barriers play a big role but my current focus is on thinking more widely than the obvious cuts to support services and public attitudes. We don’t care for our new mothers very well in the UK – many are isolated and doing it all alone. Rather than cherishing them we put pressure on them to ‘get their lives back’ and get back to their pre baby lives, even though they have a brand new human being to care for. We have far too many mums suffering from postnatal depression when in fact for some, I think it is exhaustion and a lack of support and care that makes them feel so terrible.
“No wonder in this case many find breastfeeding – especially responsive breastfeeding – too much and think (hope) formula might be the solution. Unfortunately, it rarely is. Mums still end up doing most of the feeds and, contrary to popular opinion, it doesn’t help babies sleep. Breastfeeding mums actually get more sleep overall as its quicker to breastfeed than it is to get up and make a bottle or try and soothe a baby back to sleep without the wonderful parenting tool of the magical breast. Other research has shown breastfeeding mums actually spend less time feeding over the course of the day if you take into account the time it takes to make up and clean bottles. So – the solution should be to support new mums better – care for them in ways that protects them to care for their baby. Mother the mother and she can mother her baby.”
And the biggest myth about breastfeeding that you wish could be permanently busted?
“That if a baby feeds frequently there is something wrong with your milk. This one drives me insane. We have such a poor understanding of what breastfeeding is really like – and the importance of responsive feeding (feeding whenever your baby wants) – that sometimes this can lead to breastfeeding problems. We think babies should feed at set intervals and not very often when this really isn’t the case for breastfed babies. Breastmilk is digested really quickly and its perfectly normal for breastfed babies to feed every two hours or more – including through the night. Breastmilk changes over the course of the day so your baby doesn’t get exactly the same milk either. They also have natural fluctuations in how hungry they are just like us – which together means they don’t feed in a set pattern. Do you just eat or drink every 4 hours?!
“This is complicated by comparisons with formula fed babies – who tend to feed in a longer set pattern as the milk is the same, its more difficult to digest so it takes longer and they take in more milk per feed. You can see the appeal of this sometimes but we must remember the breastfed pattern is normal – and that feeding little and often like this, whenever the baby wants, helps them to learn to regulate their appetite and just eat as much as they want. I wrote a review on this for KellyMom recently which you might find useful if you want to know more!”
Now, a few questions from our readers…
Why are so many GPs so unsupportive of breastfeeding? Especially when it would save the NHS such a huge amount of money each year if more women were supported to continue their journey for as long as possible?
“I think often its not a deliberate case of being unsupportive but more a lack of training around solving breastfeeding problems. Research has shown that when GPs get good training, breastfeeding rates in their practice go up! But it is often missing – or not detailed enough – in GP training. I think as well, that sometimes GPs only get to see the problems. In the UK we don’t tend to see our GP unless there is an issue, so they only get to see the difficulties and think breastfeeding is often more difficult and problematic than it is. Without the understanding of why breastfeeding is so important, and seeing a mum distressed in front of them, its easy to say to just stop breastfeeding. Raising the awareness and knowledge of GPs is vital and the GP Infant Feeding Network is doing a fantastic job of this – check out their webpage.”
Why is tongue tie so readily dismissed? And why are so many health professionals unable to spot them? One of our readers was told by no less than 10 NHS professionals that her baby did not have tongue tie but eventually had it diagnosed by an IBCLC…
“I think again it is a case of more training. Good, accurate diagnosis – not under diagnosis nor over diagnosis is so important. Spotting them is vital to ensuring the baby can get the right care, but equally not over diagnosing when better practical support with positioning etc is needed. So, again, a case of good quality training for professionals is needed – investment, which unfortunately our government seem to be avoiding at the moment.”
What is your opinion on extended / natural-term weaning and the nutritional and mental health benefits for child and mother?
“I think it’s fantastic and mothers should be supported to breastfeed their baby for as long as they and their baby wish. As the American Academy of Pediatrics state – there is no upper limit and mothers should be encouraged and supported to do so. In a case of here’s one I prepared earlier, check this article out.”
Do you know of any plans for formula companies to be regulated in their advertising so that they actually comply with the WHO advertising code?
“I wish!!! They have been getting away with it for far too long and unfortunately, although sometimes lip service is paid to stopping this, I worry that the profits these companies generates for the government sways their decision. Alison Thewliss and the All Parliamentary Group for Infant Feeding and Inequalities – and Baby Milk Action – are doing a fantastic job in trying to pass stricter regulations and I hope in time they will be successful.”
And, along the same lines – how are companies still able to get away with marketing infant food, ‘from 4 months’ despite the guidelines being ‘from 6 months’ (unless under medical supervision)?
“This also drives me insane and I wish that the government would crack down on it. It makes no sense given they promote guidelines saying from 6 months! This also comes under the WHO code because promoting solid foods to babies under 6 months can count as promoting a breastmilk substitute because those solids will substitute exclusive breastfeeding. Manufacturers are however allowed to continue labelling their product as from 4 months in Europe as the WHO code is merely advisory rather than the law.
“Unfortunately though, when many parents read ‘from 4-6 months’ they go for the lower end, introducing at 4 months or even sooner because ‘it’s almost 4 months’. One of the benefits of changing the recommendations to 6 months was not that everyone started at 6 months, but that the average age of introducing solids rose because although some parents introduce solids when their baby is almost at the recommend age, this meant they were now doing so at 4 months rather than 3 months or earlier.
“There is also some interesting research that shows that unfortunately many of those jars labelled from 4 – 6 months are really high in sugar compared to other foods. Babies who eat too many sugary commercial baby foods are at more risk of having a sweet tooth – and being overweight – as school children. So if you do choose to introduce solids at 4 months its important to give your baby a range of tastes rather than just sweet, fruit based products.”
Finally, your specialism is in infant feeding – tell us more about your other book (and FB group) ‘Why Starting Solids Matters’.
“It’s brilliant of course! And very sweet looking as it’s compact and fits right into your handbag or changing bag. Why Starting Solids Matters explores all the evidence around how and when to introduce solids to your baby and I think its main messages are:
- Take your baby’s lead and don’t rush them – be responsive.
- Don’t worry too much about how much they are eating – solids are meant to compliment a mainly milk-based diet in the early months.
- Think of weaning as an experience for your baby, rather than just about food. Offer lots of tastes and textures and let them explore them!
“I think lots of parents worry about introducing solids and that they need to get their baby onto solid foods as quickly as possible but that’s not the case. It’s a learning experience for both of you and taking your time is fine – and important. I wrote an article bringing the key messages of the book together and emphasising the idea of being as laid back as possible about it. There is no rush.”
Dr Amy Brown, writing for The Mother Side.
Thank you, Amy, for joining us to close WBW2017, for sharing some important messages and for busting some of those insidious myths that we find SO frustrating when trying to support other breastfeeding mamas!
We’ll be giving away a copy of Amy’s book ‘Breastfeeding Uncovered’ during World Breastfeeding Week (8th-15th August 2017), why not join us over on Facebook to enter our competition.