How Kent County Council’s new money saving proposal could put thousands of Mothers and babies at risk

As well as being a breastfeeding Mum, and a vocal advocate for other breastfeeding parents, I also volunteer my time (and Quinn’s) to get down to business and help others “on the front line” of breastfeeding support – in my local breastfeeding drop-in clinic.

For those who aren’t familiar with the work that a clinic like this does – we see many women with their babies every week, who are concerned about elements of their breastfeeding experience, and are seeking specialist advice. The reasons that a family might come along to the clinic vary significantly – in a single session we can see women who are finding breastfeeding incredibly painful, as well as babies who, for whatever reason, refuse to latch to the breast – or try, but are unable to maintain a latch to feed. We see babies who are not putting on weight at the expected rate, and also parents who want advice on how to safely wean their babies from breastfeeding. We see Mothers who’ve suffered infections such as thrush in their nipples and/or mastitis, and we see babies who are worrying their parents with fussiness or constant crying. It’s a challenging environment to volunteer in sometimes, but my goodness it’s rewarding.

I am a breastfeeding peer supporter, and I trained in 2016 with PSBreastfeeding, who are a Community Interest Company dedicated entirely to providing a range of services that all aim to support breastfeeding families.

In their own words:

“We aim to provide a centre of excellence in the field of lactation and have a team of highly skilled professionals who bring a variety of backgrounds and valuable knowledge to this agenda.”

PSBreastfeeding not only trained me as a breastfeeding peer supporter over a year ago, but they continue to provide me with ongoing training so that I can pass on knowledge, and a deep understanding of breastfeeding and early parenthood, to the families who come to our clinic.

PSBreastfeeding provide services to run three breastfeeding groups in the Thanet district, where I live. Two of these groups are staffed solely by voluntary peer supporters like me, and the third, my Tuesday clinic, offers the opportunity to see a lactation consultant, for no fee, as well as me and at least one other breastfeeding peer supporter each week.

Kent County Council has now put forward a proposal to cease their relationship with PSBreastfeeding, in an attempt to save just over £400,000 each year. The proposal is to encourage women to go along to a “Baby Hub” group, which will not be breastfeeding support specific, but rather a Health Visitor drop-in session for parents to gain information on any area of their baby’s care. It is suggested, in the proposal, that the Health Visiting Service will train volunteers as voluntary Infant Feeding Peer Supporters to attend these clinics alongside the health visitors.

Now, this is absolutely not an attack on health visitors. I see a lot of parents attack the health visiting service in one swoop, often off the back of a single disappointing experience. Let me say now, my local health visiting team are a bunch of total babes, who really know their stuff, and work hard to support the parents in our community. I definitely have no beef with them, and every health visitor that I have seen has been entirely on board with the way that I choose to raise Quinn, including my on going breastfeeding relationship. However – I’ve also never needed to seek breastfeeding advice from the health visiting team, because I’ve had access to a fantastic specialised service, where I’ve been able to approach people who are trained in breastfeeding support to a much higher level than my health visitor.

Kentish parents will still be able to see a lactation consultant without paying a fee, however, they will need a referral from the health visiting team in order to get an appointment (where at the moment they’re free to self refer), and will probably need to travel as the number of clinics operating will be reduced to just four county wide.

When experiencing breastfeeding difficulties, women feel incredibly vulnerable. Their emotional state is already delicate, and whilst they’re often strong, determined, dare I say – pig headed, in their desire to find a breastfeeding solution – they’re also scared, disappointed, frustrated, sometimes they are feeling shame or guilt about the struggles they’re experiencing. What those women want, what they fundamentally require, is the opportunity to see someone focussed entirely on supporting breastfeeding women. This isn’t an exclusive club, it isn’t a case of breastfeeding women “not wanting to mix with” non-breastfeeding women, but it’s about recognising that breastfeeding women, and especially breastfeeding women who are having a hard time, present a set of unique needs that are best addressed in a specialised environment.

I am trained specifically in breastfeeding support, by a company who specialise specifically in providing breastfeeding support services. My colleagues have all breastfed for a minimum of 6 months (this is a requirement to study as a breastfeeding peer supporter), and our groups run only to address breastfeeding queries (including those raised by parents who are combination feeding breastmilk and infant formula, women who are exclusively expressing their breastmilk and bottle feeding, and women who are formula feeding exclusively but want to get back to breastfeeding). As a vulnerable, agitated, breastfeeding parent, this environment provides a safe place for you to seek help, surrounded only by like minded individuals who’ll do everything that they can to ensure you’re able to meet your breastfeeding goals. That is important. That is a vital service.

Tell me, Kent County Council, what your saving of £400,000 will be spent on, that is so much more important than giving women the support that they need to feed their babies?

If the proposed changes to Kent’s breastfeeding support services go ahead, then we will almost certainly see a fall in local breastfeeding rates.

An increased number of tongue ties will go undiagnosed, resulting in women stopping breastfeeding before they’d like to, due to common symptoms such as: pain when breastfeeding, increased symptoms of trapped wind and colic, repeated maternal infections such as mastitis, slow infant weight gain or infant weight loss and failure to thrive. This will predominantly be as a result of families not being able to travel to see a lactation consultant, or the need to see a lactation consultant not being acknowledged by other health care professionals.

Women may go without vital information about normal newborn behaviour, such as expected feeding intervals, night time feeds, fussiness at the breast, craving maternal contact etc. and may worry that breastfeeding is “to blame” for the perceived distress of their babies, switching to formula feeding on anecdotal advice from friends and family. Exclusively breastfeeding groups create an environment in which these topics are openly discussed – but are much less likely to be touched upon in a mixed-service group where breastfeeding Mothers will be in a minority.

Women are less likely to make friendship connections with other breastfeeding families at a general “Baby Hub” group, and we know that having other breastfeeding parents within your social circle is often key to being able to breastfeed for as long as possible.

Families are likely to turn to other sources of advice when experiencing struggles in their breastfeeding journey. With the “Baby Hub” not providing any form of specialised breastfeeding support, parents are unlikely to see the benefit of attending with their queries, compared to making a convenient appointment with their GP, or, taking their questions to the internet. This poses two different sets of problems.

Advice provided by GP’s seems to differ significantly, whereas breastfeeding peer supporters receive ongoing training in up to date breastfeeding knowledge from a dedicated source. As a peer supporter I am required to attend a course every 12 weeks (roughly) – four courses per year, otherwise I’m unable to continue in my role.

I asked a group of breastfeeding Mums to share their stories about information provided by their GP’s (in my local area) regarding breastfeeding, and the responses were rather shocking;

“When I went to the doctors to tell them that I was pregnant with my third baby, it came up that I was still breastfeeding my toddler. The (female) doctor told me that it isn’t possible to breastfeed whilst pregnant and just seemed really confused. She’s not a young woman, I’d say probably in her late 50’s, and told me it’s not something she’s ever come across in her career!”

I went to the doctor whilst I was pregnant because I was suffering with really bad constipation (sorry, TMI!), and when I told him that I needed a breastfeeding friendly laxative because I was breastfeeding my 11 month old, he told me that I had to stop breastfeeding IMMEDIATELY, because my breastfeeding baby would be taking away all of the goodness and nutrients from my body so the baby in my belly wouldn’t get any!”

I took my 6 week old baby to the GP because she really obviously had oral thrush. The GP was totally cool about prescribing her the gel (to be fair it was really obvious what was wrong – her tongue looked like cottage cheese!), but when I asked about a treatment for my nipples (which were really f***ing painful) he told me that you couldn’t get thrush in your nipples and that sore nipples was just “part and parcel” of breastfeeding.”

I could only get a telephone appointment with my doctor when I had mastitis because the receptionist refused to give me an emergency appointment because it was something that could wait until the next day, apparently. When I spoke to the doctor I told him that I was certain I had mastitis (hot red patch on my breast, really painful deep bruised feeling, flu like symptoms) and he told me to pump my milk but not to feed my baby because I would pass the mastitis on to him?!?!?!?”

First baby I suffered with really bad post natal [depression] and I finally managed to pluck up the courage to ask for help. I went to my GP who told me that it was probably because of breastfeeding hormones and if I stopped and switched to formula I might start to feel better. But he also told me he wasn’t sure that I was depressed because I smiled when I came in, and seemed ‘OK to him'”

My doctor told me I needed to drink cows milk in order to make milk to feed my baby. Enough said?”

When breastfeeding support moves away from a dedicated source, we risk information becoming inconsistent. Some GP’s are totally clued up on the boobs (I’ve seen two in particular who have been fabulous!), but GPs are not required to attend ongoing training on supporting breastfeeding Mothers and providing them with current evidence based information. They could have been working for a long long time and not be up to date on current understanding of breastfeeding and supporting breastfeeding families at difficult times.

The internet poses a different threat. I am part of the admin team on a very large breastfeeding support group on Facebook, we have well over 30,000 members from all over the world, but take a pretty hard line on keeping advice evidence based (referencing the NHS, WHO, ISIS for sleep info etc.) There are some great sources of breastfeeding support and information on social media platforms. There are also some shockingly bad sources of breastfeeding information on social media platforms. And it is only getting worse with aggressive campaigns from the likes of the “Fed Is Best Foundation” undermining women all over the shop. Parenting support groups that are not breastfeeding specific, for example, tend to allow for non breastfeeding parents to share advice based on their own anecdotal experience, with breastfeeding Mums who go to the group seeking information. This can lead to comments such as

“My baby was exactly like this and it was because I didn’t make enough milk for him so I had to change to formula otherwise he would of starved.”

to

“Have you thought about giving formula at night and just breastfeeding during the day? That way he might sleep better. I did that and my baby started sleeping through the night.”

to

don’t put yourself through it and beat yourself up. Formula is just as good as breastfeeding anyway, all that is important is that Mum is happy.”

In these general parenting communities online, the administrators will rarely step in when poor advice is given, because they themselves aren’t aware of the correct information concerning breastfeeding and breastfed infants. Within the group that I admin, administrators are all required to be trained to breastfeeding peer supporter or a higher qualification. This isn’t because we act within these roles as a member of the group – but our training allows us to recognise and remove non-evidence based breastfeeding advice from the page as soon as we spot it.

If we see more Mother’s taking breastfeeding advice based on such anecdotal experience as the above, we will absolutely see a steep drop in breastfeeding rates.

So, what are the real risks of a drop in breastfeeding rates? As long as the babies are being fed, is that not all that matters?

Short answers: A hell of a lot, and no.

Babies who are not breastfed, or whose Mothers stop breastfeeding early on in their feeding journey, are at an increased risk of:

  • infections, such as ear infections, which are typically treated with antibiotics. The use of antibiotics can often lead to secondary infections, such as thrush. These infections make life less pleasant for the suffering baby, a lot more stressful for their worried parents, and cost our NHS money in treatment. Parents of children who are more prone to these types of infection have to take more time off of work if applicable, and the children themselves are more likely to miss out on a full education. The reason that non-breastfed babies are at a greater risk of these types of infection is that breastmilk contains specific live ingredients which support the child’s immune system, because of the common behaviours of bottle feeding parents (such as the way they hold their child when delivering a feed) and the bacteria present in infant formulas. Formula milk contains ingredients which fail to support a child’s immune system, and can negatively impact on natural immunity. When breastfed children do contract these types of infection (which they do, breastfeeding isn’t complete protection from illness) they tend to have less severe symptoms and recover in a shorter period of time.
  • obesity, formula fed children are at an increased risk of obesity, this is because formula alters the natural behaviours and characteristics of the human digestive system very early in life. Not breastfeeding can interfere with the development of natural hunger and satisfaction cues, and over-feeding is common in bottle fed infants, leading non breastfed children to be at a greater risk of over eating in later childhood, teenage years and even adulthood.
  • asthma – not breastfeeding increases your child’s likelihood of suffering from asthma, which again, costs the NHS a lot of money, as well as impacting upon the life of both child and parents.
  • allergies – non-breastfed children are more likely to suffer from allergies which, like asthma, costs NHS funds and impacts on the lives of all effected. Severe allergies can be life threatening.
  • Accute respiratory disease – ARD is significantly more common in non breastfed children.
  • Cancer – non breastfed children are at a greater risk of developing certain types of childhood cancer, such as acute lymphoblastic leukaemia, as well as carrying their increased cancer risk into adulthood. Cancer claims many lives, involves unpleasant and expensive treatment, and could be significantly diminished in our population with increased breastfeeding.
  • Chronic Diseases – not having adequate access to breastmilk as an infant/toddler is recognised as a leading cause of chronic diseases such as irritable bowel syndrome, ulcerative colitis, Crohn’s disease and celiac disease.
  • Diabetes – non-breastfed children are significantly more likely to develop type 1 diabetes, either in childhood, or as an adult.
  • Cardiovascular Disease – studies have found that where infants were not able to access breastmilk, they had much higher cholesterol, and much higher blood pressure, in later life. Putting them at significant risk of cardiovascular disease, strokes and heart attacks.

With increased or, at the very least, maintained, breastfeeding support services in Kent, we could see fewer children put at the great risks involved with not breastfeeding. Sometimes, formula feeding is unavoidable, for any number of reasons – however, as someone who works every single week at the breastfeeding clinic in Ramsgate, I know just how many women want to breastfeed but are only able to do so thanks to the support they receive in our groups. The loss of the groups would mean children would be put at risk unnecessarily, when the opportunity to self refer to a specialist could give their parents the tools to protect them.

It is fundamentally incorrect to state that feeding methods don’t matter in infancy. Formula feeding, like all medical treatment, carries risks, some of them significant and a bit scary. Formula feeding parents require support, support to ensure that they lessen the risks associated with feeding their child an infant formula as much as possible. Those parents who set out intending to breastfeed but were unable to make it work, for whatever reason, not only need practical support in making formula feeding safe, but also emotional support to help them deal with the grief associated with having their feeding options taken away.

However, parents who can breastfeed, but who need to overcome certain hurdles in order to do so, must be given every scrap of assistance that they require and are willing to accept in order to make sure they’re able to do so – because when the cost is their child’s health, not just immediate, but well into adulthood, there’s no space for messing around and trying to save money.

It’s not just the risks to children that we need to acknowledge when we put forward proposals that may result in fewer women breastfeeding. The wellbeing of the women themselves is an important consideration.

Not breastfeeding negatively impacts upon women, even women who didn’t want to breastfeed. Of course women have the freedom and the fundamental right to choose whether or not to breastfeed, but we can’t shy away from the fact that the recent lancet report on breastfeeding concluded that not breastfeeding was, in fact, the leading contributing factor to non hereditary breast cancer. Simple giving women the information and the tools to breastfeed if they’re able to, could be one of the greatest things we, as a society, could do to bring breast cancer rates crashing down. Just two years accumulated breastfeeding out of a woman’s entire lifetime, was shown in studies to eliminate her risks of non hereditary breast cancer when other risk factors (such as smoking) were not present.

Breastfeeding support in cancer prevention in action.

Cancer prevention in action does not deserve to be lumped in with conversations about how to treat nappy rash, or whether you should give your baby raw or steamed carrot sticks. It deserves it’s own dedicated space that allows for breastfeeding women to feel empowered, in control, positive and informed.

Breast cancer aside, by breastfeeding, women can also lessen their risk of other cancers, including ovarian cancer, as well as osteoporosis, mental health problems including post natal depression and post partum psychosis, and type 2 diabetes.

When you consider the significant increase in health risks to every Mother and her baby who do not have a breastfeeding relationship, and you take into account the increase in the number of families that that will apply to as a result of the loss of these breastfeeding groups – a saving of £404,000 per annum is nothing in comparison to the increased costs to be swallowed by Kent & Medway NHS.

If our parenting communities in Kent lose their breastfeeding support clinics, and their easy local access to a lactation consultant, both women and their children are at risk, their day to day lives are less fulfilling as a result of a weaker support network, and our NHS is burdened with many cases from ear ache and thrush, through to advanced and life threatening disease.

 

 

 

 

 

 

 

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