Supporting breastfeeding: many mothers struggling to continue to breastfeed feel unsupported and may be given misleading advice, even by health professionals.
Nurses (Social aspects)
Maternal health services (Services)
Maternal health services (Social aspects)
|Publication:||Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2012 New Zealand Nurses' Organisation ISSN: 1173-2032|
|Issue:||Date: March, 2012 Source Volume: 18 Source Issue: 2|
|Topic:||Event Code: 200 Management dynamics; 290 Public affairs; 360 Services information Computer Subject: Company business management|
|Product:||Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners|
|Geographic:||Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand|
Until I experienced real difficulties breastfeeding my youngest
son, I had always assumed mothers who gave up breastfeeding had probably
not really tried hard enough to continue.
I had worked as a Plunket nurse in the Hutt Valley for two years before my son was born. Breastfeeding difficulties led me to a non-profit organisation called Wharekai Pepe Charitable Trust. This runs support groups in the Hutt Valley, facilitated by mothers like me, and a lactation consultant.
Before getting involved with the trust, I was rather naive about the availability of adequate breastfeeding support in the community, and the issues facing women and their families. As a Plunket nurse, many of the infants I saw for the first time were close to six weeks old, despite the ideal requirements of a visit by a Plunket nurse before a baby turns five weeks. By the time I was seeing the infants and their mothers, many of them had either discontinued breastfeeding or were well on the way to weaning. Many of them reported that it was "too hard" or "it didn't work" or they "had no milk". I used to receive this information without a second thought and considered it "normal". I assumed the mothers had decided to stop breastfeeding of their own free will and had probably not really tried hard enough to continue. After all, the World Health Organisation says: "Virtually all mothers can breastfeed.'^ Had they just asked for help, they would have been able to breastfeed, I thought. It wasn't until I had breastfeeding issues myself that I realised these mothers may have felt unsupported by health professionals and had ended up discontinuing feeding without wishing to.
After my son's birth, we had immediate skin-to-skin contact and he breastfed within an hour. The initial feed went well but, sadly, that was the last "good" feed he had for weeks. He was getting just enough milk to grow ... slowly. At five weeks, breastfeeding became painful. He was biting down on my nipple and getting very frustrated at the breast. Being able to access health care easily, I sought the advice of my Plunket nurse and nurse colleagues, none of whom could offer any specific solution to or advice for my problem. I went to my GP for help. He suggested an ear, nose and throat referral. This seemed bizarre to me, so I declined. He then admitted he didn't "know much about breastfeeding". I was incredulous! The visiting midwife did not seem to know what the problem was and suggested the pain "would get better if I just kept feeding", a line that is bandied about far too often!
Unfortunately, none of the health professionals could help me, as all had inadequate breastfeeding knowledge. Under my own steam, I sought out Wharekai Pepe. This was hard to do, as they were a small group based in a different area from where I lived. I later discovered the health professionals I had previously approached knew about the group, but failed to suggest I contact it.
Surgery for posterior tongue tie needed
I told the group my story and within minutes of the lactation consultant meeting with me, we had a diagnosis of posterior tongue tie. After a quick surgery and months of expressing and practising good latching, I am still breastfeeding my son and he is now 18 months old. It was that simple. The difference was, I felt listened to. The lactation consultant was also very knowledgeable and the other mothers in the group very supportive.
I now volunteer my new knowledge of breastfeeding to the mothers attending the support groups and I am training to become a lactation consultant. Many of the mothers who come to us are in real crisis. They, like me, have felt they have not been listened to by their nurses, their lead maternity carers and their GPs. Many of them have been given incorrect advice by their health professionals--such as introducing a bottle to encourage sucking; that the pain will improve; that because their baby can poke out its tongue, it hasn't got a tongue tie; or to feed to a schedule. These women are often on the verge of giving up breastfeeding. Wharekai Pepe is often the first place where they have felt listened to and able to share their story.
The sort of misinformation I have mentioned is all too readily available in hospitals and communities, and it is not helping our national breastfeeding statistics. The WHO code might say that every mother can breastfeed but we need to remember that it also says: "provided they have accurate information, and the support of their family, the health care system and society at large." (1)
Over the past 18 months, I have reflected on my practice as a Plunket nurse and even thought further back to when I worked on a post-natal ward. I had very little breastfeeding knowledge in those days and thought breastfeeding was easy and something mothers just did naturally. Breastfeeding is natural and it's the normal way to feed an infant. But I also know it is challenging and the challenges can vary widely. As health professionals, we can help reduce these challenges by listening to mothers, seeking further education in breastfeeding support and then sharing this new knowledge with our peers. Above all, we should know our communities and what they have to offer in terms of support. We should get to know community initiatives like Wharekai Pepe or even start our own initiatives to fill the gaping hole that exists in breastfeeding support in this country.
World Health Organisation. (2012) Health topics: breastfeeding, www.who.int/topics/breastfeeding/en/. Retrieved 09/02/12.
Kate Anderson, RN, PGCert Well Child, lives in Upper Hutt and is training to become a lactation consultant.
|Gale Copyright:||Copyright 2012 Gale, Cengage Learning. All rights reserved.|