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Breaking the breastfeeding barrier
Mags Gargan examines why breastfeeding levels are so low in Ireland

The World Health Organisation recommends that babies should be exclusively breastfed for the first six months.

I was at an anti-natal class where the mid-wife was discussing breastfeeding. She asked the room of expectant parents why they thought breastfeeding levels are so low in Ireland. Immediately one of the dads piped up with “because of the Catholic Church”. The midwife replied, “Ah now, the Catholic Church has its faults but we can’t blame it for everything”.

This exchange came to my mind when a recent study found a negative correlation between the proportion of Catholics and breastfeeding initiation rates in western countries. 

While Ireland’s breastfeeding rates are indeed one of the lowest in Europe, with just 46% of babies being exclusively breastfed on discharge from hospital, this dropping to 14% at two months, it is difficult to see how this can be blamed on the Church.

“I think levels are low because of the lack of support in hospital at the critical time (first day or two). Most wards don’t have nurses with the capacity to assist everyone. There is also a lack of services providing support after hospital,” says Hazel, a mother of two from Dublin. “I do think there is an element of shyness and embarrassment about breastfeeding in public. As a society I don’t think Irish people are fully supportive.”

Kerry, a mother of two from Mayo, says part of the reason is that we are more used to seeing bottle-fed babies in Ireland. “Women are so used to seeing bottles, whether it’s from their mother, aunt or sister. And it’s a natural thing. If you’ve grown up seeing it, that’s what you’re going to do. But I also think there is nowhere near enough support.”

Support

Sue Jameson, President of the Association of Lactation Consultants, agrees that it is “the support element that is lagging way behind”. “There is help available in the hospital but women are there for such a short time, and the help isn’t necessarily there when they really need it, which is day three to five. And so that is where the private and voluntary sector pop up to sort of fill the gap between what should be there.”

A lactation consultant is a paid health professional who specialises in the clinical management of breastfeeding. They come out to the home and offer advice and assistance to a mother who is finding breast feeding challenging. There are also voluntary organisations such as Cuidiu and La Leche League, who have support groups across the country where women meet to get advice and exchange ideas.

Kerry suggests that expectant mothers should go along to these meetings while they are pregnant, to find out about the reality of breastfeeding so they know what to expect.

“Everybody says it’s the most natural thing in the world and you really should do it,” says Kerry, “but they’re not told how hard it is. I think that’s a massive mistake. You need to know. I went into it without the information and that’s why I found it so difficult.”

The World Health Organisation recommends that babies should be exclusively breastfed for the first six months, and for mothers to continue to breastfeed along with solid food until the child is two years of age and beyond. According to the HSE, breastmilk contains essential enzymes, hormones and immunoglobulins vital for a baby’s normal growth, development and good health.

Bonding

Breastfeeding is an incredible bonding experience for mother and child, which can begin immediately after birth with the child instinctively latching on. It is very convenient (no need to make up bottles at night and you will always have a food supply with you wherever you go) and low cost (no formula, bottles or steriliser needed).

However, breastfeeding is a skill that a mother and baby must learn together and like any other skill, it takes time to master. In the early days babies can cluster feed, bunching feeds close together, and it sometimes feel like they will never stop. There is a possibility of cracked nipples, blocked ducts or even mastitis (painful inflammation of the breast).   

Kerry says if women are not informed about this, they may think they are doing something wrong and turn to bottle feeding.

“You might not get the latch right at first, it can be painful, babies can breastfeed for hours. People don’t know this,” she says. “And then they also expect that babies are going to sleep for four hours at a time, then five hours at a time, then six hours at a time during the night and that doesn’t happen either, especially with breastfed babies. So I do think information and support is key.”

Hazel says she struggled to breastfeed her first baby and stopped after two months. “I decided to try to breastfeeding again as I know of the benefits for baby - and mum - and really wanted it to the work this time,” she says.

Normalisation

Louise, a mother of two from Dublin, says she had “nobody on my side of my immediate family to gain support from so I did as much reading as I could from the internet and books”. As well as more support in hospital and aftercare, she thinks there needs to be more normalisation of breastfeeding in Irish society.

“I guess it could start with more posters, stories in the press, more coverage on TV, people seen breastfeeding in TV shows and more facilities in shops or shopping centres. Get the message out that it’s not disgusting and it’s as normal as feeding a baby any other way,” she says.

Sue Jameson agrees. “Yeah, that is exactly where we would be going, trying to stop using the bottle as being a symbol for all infant feeding. Even if you go to buy a birth greetings card, it’s really hard to find one that doesn’t have a pink or blue bottle on it. Even if you pick up a kids story book. I saw one the other day where the mommy teddy was feeding her baby teddy a bottle.

“The imagery is all set up in a way so that you’re first thought won’t be to breastfeed, because the images culturally are not there. Whereas in other countries you see billboards with breastfeeding mothers on it, you see normal cultural imagery featuring breastfeeding.”

Support from fathers is also essential to encourage mothers to continue to breastfeed when it becomes challenging and the two weeks paid paternity leave for fathers, which came into effect last year, may make a difference in those early days when breastfeeding can take over a new mother’s life. When you are feeding for seven hours a day you need someone to do everything else – cook healthy meals, bring you water when you are literally stuck to the chair, change the nappies, wash the clothes and let you nap.

Rollover

Sue feels that Irish mothers have already started to turn the corner on improving breastfeeding rates. “My generation is about to have a rollover, because we’re becoming the grannies. So all of our children are having babies and we all breastfed. So there is a generation now of breastfeeding grannies coming on stream,” she says.

“I have been working in a paid and professional capacity at this level for 28 years and we have seen breastfeeding rates rise from under 20% to well over 45% and way up higher than that in certain areas. So there is a big change.

“I’m seeing more women having second, third, fourth babies who are considering breastfeeding who never did on their first one. We’re seeing a huge amount of people getting online support, which is a big change. There is now the ability for people in the middle of the night to talk online and just hang out with people who think like you and who are going through the same situation as you are.”

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Feeding tips for new mums

Breastfeeding pillow: You could surround yourself with pillows and cushions to a make a little nest, or a good breastfeeding pillow can provide great support for your arms when cradling a baby during feeding.

Entertainment: Once you are comfortable in your ‘nest’ make sure the TV remote control, a water bottle and your mobile phone are within easy reach. There is not a lot else you can do while breastfeeding, except read and binge watch on something like Netflix.

Clothing:Get sized for a few nursing bras. It’s good to have a few breastfeeding tops for when you are out and about, but layers are also your friend.

Good diet:Just like during pregnancy you need to eat well while breastfeeding and take a vitamin supplement. Drink plenty of fluids and rest as much as possible.

Pain relief: Soothe and protect sore nipples with Lansinoh lanolin cream (€14.99). It is safe for baby and does not have to be removed before a feed. Multi-Mam Compresses (12pk €15.99), can be used after a feed to ease any discomfort. In severe cases silicone nipple shields (2pk €10.49) are also an option.

Expressing:The Medela Swing and Ardo Calypso are both hospital grade electronic breast pumps for expressing large quanities of milk as your baby gets older. The Haakaa Silicone Breast Pump, (€19.99), is a one-piece pump that uses the power of suction (no manual pumping needed) for expressing milk for relief if engorged.

 

For invaluable questions and answers on all issues related to breastfeeding, check the HSE’s website www.breastfeeding.ie