How to support breastfeeding

The Labour government in New Zealand has proposed legislation to support breastfeeding. Specifically, employers will be required to provide private space for breastfeeding mothers to feed their babies, or to express milk. There will be flexibility for small employers, but workplaces with more than a few female staff will be expected to provide space. For anyone who is getting grumpy about this ‘extra cost’ imposed on employers, I’m guessing that it could be as simple as providing a screened off area in the lunchroom, or even just access to an office with a door that can be closed a couple of times a day.

I can’t help thinking that this is tinkering around the edges, and that the government is still refusing to follow through on its alleged commitment to supporting breastfeeding. As I have written before, when commenting on the Baby Friendly Hospital initiative, it takes time and effort to establish breastfeeding. For the first day or two or three after giving birth, a mother’s breasts produce colostrum, and the milk only comes in at day two or three. That can be a painful and difficult experience, but it’s also exactly when you need to learn to get the baby latched on and drinking. You need lots of support and help, and ideally, you need to be able to do nothing except concentrate on your baby. But what do we do with new mothers at that time? We ask them to leave hospital.

There are plenty of women who find breastfeeding easy, who have support at home, who don’t have other children to run around after, who don’t need to get up and prepare meals and wash clothes and clean the house. For them, leaving hospital at day one or two or three may not be a big deal, and may even be highly desirable. I know that all I wanted to do when my eldest daughter was born was to get out the door and take her home, especially after the other bed in the room I was in was filled, with a mother who had the telly permanently on the soaps. But many, many women need to have support and help with establishing breastfeeding, and that support and help is most readily available in maternity wards and units.

If the government is really committed to supporting breastfeeding, then it needs to fund maternity wards properly, so that women can stay in hospital for more than a day or two if they need to, in order to establish breastfeeding. Alternatively, they need to fund out-patient services properly, so that new mothers can access help with a phone call, twenty-four hours a day.

10 responses to “How to support breastfeeding

  1. There are plenty of women who find breastfeeding easy, who have support at home, who don’t have other children to run around after, who don’t need to get up and prepare meals and wash clothes and clean the house. For them, leaving hospital at day one or two or three may not be a big deal…

    I have a post percolating on this subject myself, but just to quickly say I ticked three of your four boxes in this extract and I still found breastfeeding incredibly painful and difficult. I got a lot of support in the hospital from incredible midwives, and was able to stay five days (one of the few benefits of a caesarean). But it was still tough.

    Thanks for writing about this :-)

  2. I think supportive employers and an improved public perception are going to help breastfeeding more than a longer hospital stay.

  3. As commented at The Hand Mirror, I think in-home support is probably the better alternative. Sadly the Plunket service has been eroded.

    I discharged myself 2 days after my 3rd child was born by c-section. The hospital rung up and told me off, but I just hate the hospital environment.

  4. I really, really doubt extended hospital stays are the answer. Hospital stays are very costly, and the support available for breastfeeding therein isn’t always ideal anyway. Women breastfed for thousands of years without needing to be segregated into a supergerm-infested institution.

    I am inclined to believe a better answer lies in better education. Breastfeeding is not instinctual; it is learned and does not come naturally. Women need to be encouraged to seek out that education. They need to read, they need to watch, they need to ask questions. The NZ government wants to help? They should give every mother-to-be a copy of The Womanly Art of Breastfeeding, a good educational breastfeeding video, a list of La Leche League meetings, and the services of a postpartum doula for the days after mom and baby return home from the hospital.

  5. I’m not suggesting compulsory hospital stays – just that new mothers should be able to stay if they want to. It’s an important distinction. If a woman has no support at home, not such an uncommon thing now that we all remove ourselves around the country and around the world, then a few days rest before going home may be just what she needs. At the moment, she doesn’t have that choice.

  6. I left hospital after one night, on a public holiday (Christmas Day) completely by choice. I hate hospital.

    Breastfeeding was hard, the midwives were trying, but unable to help (“You seem to be doing everything right, I don’t know why it hurts”). Fortunately my local Council provides a free lactation consultant, just one suburb away from my home. The only thing that could have made it better would have been a home visit. To really support breastfeeding we need to upskill our midwives and maternal and child health nurses, support them and pay them to become lactation consultants, so that women in hospital and at home actually get care from people who are qualified to help.

    My mother was horrified at how early I came home, she always stayed in hospital as long as possible. But she never gave birth in a hospital on a public holiday when the cafeteria was closed, there was no real coffee available, and the Bloke was starving. As was I, someone took my brekkie from the kitchen so I missed out.

  7. Breastfeeding was hard, the midwives were trying, but unable to help (”You seem to be doing everything right, I don’t know why it hurts”).

    Snap! I kept getting stuck in this very circular discussion that went:

    Me – it really hurts, what am I doing wrong?
    Them – well it shouldn’t hurt so you must be doing something wrong.
    Me – so please show me what I am doing wrong.
    Them – well you don’t seem to be doing anything wrong.

    Argh!

    I was also in hospital during a low staffing period (one of the two maternity wards was closed entirely) although not as bad as Christmas Day by the sound of it. I can’t believe you missed out on brekkie, that is awful!

    The main reason I appreciated the relatively long hospital stay (5 days) was that it gave all three of us (me, partner, baby) a chance to just learn how to feed, change, bath, hold etc, without the stress of also cooking, cleaning, washing, answering the endless phone calls, and so on. I got a lot of sleep in the hospital, which really helped. After I got home I quickly started to try being superwoman and got quite sick as a result. I can’t imagine how I would possibly cope, if I have another child, without a decent hospital stay. But I have no problem with those who want to leave early going when they want to.

  8. I wouldn’t/don’t hold with the idea that women should be sent home to do the cooking/cleaning/care of several children. Women going home from hospital should have:

    a) a responsible, capable grown up partner/mother/friend living or staying with them to make sure the mother eats, has plenty of water, doesn’t throw the baby out the window and gets a shower and so forth. I can’t imagine how people cope getting home from hospital after a couple of days and then being all alone or with only one of the less useful variety of partners.
    b) someone whose job it is to provide food and/or tidy and clean up.
    c) someone whose job it is to support mothers and fathers learning to hold/breastfeed/bathe their baby.

    In some cultures all of those jobs would be done by grandmothers. Here we used to have an extended hospital stay to make up for the shortage of grandmothers, now we’ve got very little support at all. I think mothers need lots of support in the first few weeks, and through the first year, but that we should look at the ways we can provide that at home.

    Far cheaper than providing 24 hospital for a week, would be a cleaner, lactation consultant, and meals on wheels. I was thinking the other night that we should have a registry of families expecting babies: you sign up when you’re pregnant for your family to provide a meal or two to someone who’s just had a baby, and then someone provides meals for you when you’re pregnant.

  9. This is where I think increasing the amount of partner leave is essential, and in particular making at least some of it paid. Currently the legal minimum is 2 weeks, unpaid. For many families I imagine it’s a stretch to afford to take that time, especially if you have just lost the income of the mother. Some workplaces will pay for more leave (I was lucky my partner got 6 weeks paid) but I’ve also heard that there are many employers who pressure the partner not to take their full leave.

    Some grandmothers do fulfill the roles you have mentioned – my mum was absolutely great. But then she is semi-retired, my parents are financially secure (and still together), and her health is good. My partner’s mum works full time and although I know she’d love to help more she just doesn’t have the time. Perhaps it’s a feature of the shift to women working more, that they are less available to fill these unpaid roles of the past?

    I really like your idea of registering to support parents with newborns by cooking them meals. That was one of the most useful things people did for us when Wriggly arrived, and I’ve got two lots of meals in the freezer for my friend who just had a baby, to take around to her when she is ok with me popping in. To be honest it never would have occured to me before my own experience.

  10. I should say that my comment about partner’s leave is the situation in NZ, sorry I don’t know what it is in Australia (or elsewhere), although I suspect it is the same or worse.