Becoming a mother is visceral and humbling, and it’s rarely the experience you were expecting.
After the awesome feat of pregnancy and childbirth, in the thick of exhaustion and overwhelmed by the reality of a newborn, mothers then have to learn how to breastfeed. And it is something you have to learn, while simultaneously teaching your baby how to do it.
Mothers bring important instincts and skills to the dynamic, which will be honed over the coming months, and the first few days are crucial. But this is often when support and understanding is despairingly lacking.
Postnatal wards are often stressful and breastfeeding support is a time-consuming task for swamped midwives, while women simultaneously jump through hoops to be discharged home. The news that at least 44% of local authority areas in England have been affected by cuts or closures to breastfeeding services in recent year is not a surprise. Postnatal care is haphazard, and many women don’t get a visit within the first 48 hours of being discharged, which can be make or break for the breastfeeding experience.
Many of the women we see at our specialist drop-in sessions are highly educated professionals who are determined to breastfeed because they know about the benefits. But it seems very little else is really understood about breastfeeding.
Ina May Gaskin, a pioneering midwife and natural birth advocate, explained that when we do not place enough cultural value on breastfeeding, “knowledge about the very capacities of women’s bodies to lactate gets lost to a surprising extent to women themselves and to medical professionals”.
We see some women as early as one or two days after giving birth, while some arrive two months down the line, lost as to how to continue with an unrealistic feeding plan that is taking them further and further from their hopes to breastfeed.
Fourteen women arrived to be seen within a two-hour window at a session I ran alone last week. Most of them were battling self-doubt, fear, guilt and confusion in the face of well-meaning but conflicting advice and input from healthcare professionals, family and friends.
Many had no previous experience with newborns and lacked confidence to handle them with the assertiveness that can be needed. Many had at some point been told unhelpful things about the apparent shortcomings of their anatomy, or their ability to sustain their infants.
The work we do is only partly about the physiology of lactation. It takes weeks and months of unpicking myths, teaching knowledge and building confidence to get women to a positive and self-assured mindset to enable joyful feeding and mothering of their babies.
The NHS is increasingly like a business on the brink of liquidation. When you’re in survival mode, it can be difficult to adopt a creative approach to services.
Money is being shifted towards acute care and pulled from less obviously critical areas such as antenatal and postnatal care. But the dearth is felt, and the impact on breastfeeding has wide-ranging, complex and long-lasting physical and mental health implications for families.
NHS antenatal education sessions seem rarely to have the capacity to provide women with fundamental knowledge about the normal physiological behaviour and basic nutritional needs of a neonate in its first days of life, and a practical understanding of what to do if and when challenges arise.
People live in increasing isolation from family and friends, and healthcare professionals must try to cut through this. Those who are already parents should reflect on and share their experiences – don’t spread fear, show support to your expectant friends and neighbours.
Let them hold your babies, sit together, talk, breastfeed before them, teach them what you know. If it takes a village to raise a child, it also takes a village to breastfeed one – a mother needs a support network to help her.
