The surprising fact about breastfeeding in the UK vs USA

I wrote this a while ago, but for some reason it didn’t publish!!!! Breastfeeding week was 1-7 Aug! Whoops. Better late than never!

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Did you know last week was breastfeeding week?  The week is dedicated to the celebration of breastfeeding and marks the anniversary of the signing of the innocenti declaration where governments pledge to protect, promote and support breastfeeding.  So this reminded me about a surprising fact I read recently:

Only one in 200 British women (0.5 per cent) are still breastfeeding a year after becoming mothers. The figure is 23 per cent in Germany and 27 per cent in the United States. *

I am British, but live in Virginia, USA and so it is interesting to see these kind of statistics.   I was surprised because I believed it would actually be the other way around.

Why is it that the UK figures are so much lower than the US? It surely can’t be because of returning back to work because maternity leave in the UK is far more generous than the US.  It has to be other cultural factors??  Seeing as I get to see two sides of the coin it got me thinking….

I have breastfed my daughter for the past 7 months and I’ve never had a bad experience with our choice to breastfeed in either country.  However, that doesn’t mean that others haven’t.  Having said that, I have experienced the ‘unsaid’.  Those ‘looks’ of disgust or staring.  Sometimes it’s other people’s actions, not necessarily words that make our experiences as breastfeeding parents challenging.

Breastfeeding in public.  Although there are horror stories of women being harassed for breastfeeding in public in both countries, I have never been harrassed personally.  In fact, in my local mall I regularly nursed in whilst on maternity leavegained media attention over a woman wrongly told by a security guard to go and feed her baby in the family room.  I don’t cover up when I nurse, the only times I have used a cover was when Aviana was in her distracted phase of nursing, but this was in an act of desperation to get my baby to feed, not because I felt uncomfortable nursing in public.  Some babies just won’t nurse covered up, Aviana is one of them.  Breastfeeding mothers should feel comfortable nursing however they wish and wherever they need to feed, covered or not.

In the US I have had the looks of disgust as I nurse.  In the UK I have also had those looks…however, they are far more ‘polite’ in their overtness of disgust, it’s hard to explain the difference, but I can see it!  Mostly, people don’t see me nursing and so just carry on with their day.  That’s the way it should be. Everyone just gets on with their day.

This was the fact that stunned me the most: “More people in the UK believe that smacking is acceptable than believe that breastfeeding in public is okay.” wow! I am going back to the UK in October and taking Aviana with me. She will be 10 months old, very different to a newborn baby. I wonder what reactions I will get there if I nurse her in public compared to when she was just 6 months old, the last time we were there?

Perhaps it’s just an awareness issue or misperceptions? I don’t know….but it sure is interesting. what are your thoughts? What have you experienced as a nursing mother? Or as an observer? Are you surprised by these statistics?

(By the way I respect however you choose to feed your babies and in by no means intend this to be a criticism for formula feeding…I am also fully aware this is a tough subject for women who wanted to breastfeed, but can’t for whatever reason. I have to supplement Aviana with formula as well as breastfeed)

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Here is what international breastfeeding week promotes…
Breastfeeding is vital to the healthy growth and development of infants.
It also has important implications for the health of mothers.
WHO and UNICEF recommend:
∙ Initiation of breastfeeding within the first hour of life
∙ Exclusive breastfeeding for 6 months is the optimal way of feeding
infants. Exclusive breastfeeding – the infant only receives breastmilk
without any additional food or drink, not even water
∙ Breastfeeding on demand
∙ No use of boles, teats or pacifiers
∙ After 6 months, infants should receive
complementary foods with continued
breastfeeding up to 2 years of age or beyond

*According to a study published in the Lancet in January 2016

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Never give up on a bad day

They say you should never give up on a bad day. Well today was not a bad day, but yesterday, it felt like it was. So should I give up breastfeeding? Here’s what is running through my mind…

What would I’d do with the 2.5hrs a day I currently spend attached to a pump? I could exercise in the morning because I wouldn’t be engorged when I wake up. I could help get Aviana ready for daycare in the morning.

Would I miss escaping to my ice box ‘lactation station’ private room at work? They can’t do anything about the temperature in the room. I am wrapped in a fleece blanket and still cold. I hate it. I want to work from home so I can pump quicker, but it’s not so easy with some of my projects.

I would probably need to stop sending formula coupons to a lovely lady I met through my local infertility support group who has twins just a few weeks younger than Aviana.

What would I use my giant work pumping bag for if it wasn’t carrying my pump?

Will Aviana get sick more often? Chris is ill at the moment and Aviana and I have both stayed well…this has happened before but when he caught the flu which would potentially have been serious.

Will my nipples stop hurting after Aviana has recently learned how to bite me? 

I wouldn’t need to lug my pump everywhere and figure out how to get my milk back from different foreign countries when traveling with work, navigating different customs rules.

I might feel sexy again and not feel like a human milk machine? I could wear bras that I like!! 

BUT…..

I would miss those nursing moments with Aviana that are so precious to me. And it’s not for long. She will only be this young once and this will be my only chance to nurse her before she decides she doesn’t need me anymore. She likes to be an independent girl so I fear it would be sooner than later, and makes it even more precious. 

The past couple of days at work I felt like quitting. And yesterday as I sat nursing Aviana in the middle of the botanical gardens behind a random bush because she still gets easily distracted, as I batted away the mosquitos and tried not to shout in pain when Aviana clenched her gums around my nipple, I wanted to stop there and then. But today? Today was a good day, even though she bit me, even though she got easily distracted, even though I’m sat here pumping late at night in bed whilst Chris is asleep next to me. Because Aviana looked up at me with a cheeky smile as I nursed her and my heart melted. Still, 7 months later and she gets me right there in the heart.

It’s all about my perspective on the day. Today I don’t want to quit. And this, this is why they say ‘don’t quit on a bad day’.

3 month weight check & distracted nursing

After some issues with Aviana taking the bottle when I went back to work (High lipase issue) and Aviana becoming more and more distracted at the breast I was worried that she was not putting on enough weight.  When I took her for her weight check at 3 months I was fully prepared to be told to supplement her again.

Aviana weighed in at 10lbs 12oz (4th percentile) at 3 months and 13 days old and 23″ tall (14th percentile).  Although she is still off the charts for her height/weight ratio, the pediatrician was pleased at her continued weight gain along the curve so told me she wasn’t concerned.  Looking at Aviana she is getting some nice little fat rolls on her thighs which the pediatrician was happy with.  We count her rolls of fat!  So no more weight checks until her 4 month wellness visit!

Aviana has become distracted and fussy at the breast noticeably since she has learned how to grab things…it was like she has become awake to the world.  Sometimes she latches and pulls off quickly to look up at me, then re-latches, pulls off, smiles at me, re-latches etc.  Which is actually sometimes so darn cute, I’m trying really hard not to encourage this behaviour!  But of course she pulls off hard sometimes and that hurts!!! Then she gets frustrated she can’t re-latch quick enough and cries. Also I have not been able to feed her in public because she gets distracted and pissed at noise.  I have resorted to feeding her in the car or under a nursing cover (which she HATES and I equally hate!).

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Aviana’s weight progress  – she is following her own curve nicely 🙂

I went to my local la leche league breastfeeding support group to ask about all of this.  Apparently this is very common at this age – it’s called distracted nursing.  There is no telling how long this will last for, but many of the women in the group have experienced this!  Phew…so it’s kind of normal! Their tips included: nursing in quiet places (ok i got that one!!), using a comfort toy or blanket at the breast to distract them from the distractions, singing to her and rocking. Yesterday I was out and about and needed to nurse in public, I sat outside in the shade and I tried rocking/bouncing, that seemed to work quite well.  I really hope this is just a quick phase because I want her to be able to feed anywhere! I feel soooooooo guilty and bad when she won’t nurse properly.  She is not the kind of baby to make up for it at other times, she will easily skip a meal if she isn’t happy.

It is good news that the doctor is happy with Aviana just following her own weight curve.   I enjoy breastfeeding Aviana (when she isn’t distracted) and I hope I can keep it up for at least 6 months is my goal – my stretch goal is 12 months.  But this distracted nursing issue and having her low weight on my conscience has made me feel like giving up at times.  They say to never give up on a bad day…and I’ve kept that in mind, it’s helped me to keep going. Plus going to the support group meetings and being a member of a facebook breastfeeding group has also kept me on the path to my goal.  Breastfeeding is not easy, and I have had a pretty easy time of it compared to some people I know.

Breastfeeding my IUGR newborn baby: The first two weeks

I had no expectations when it came to breastfeeding my newborn. Yes, it would be good to breastfeed, but if for some reason it didn’t work out, I wouldn’t be overly upset. Formula milk is perfectly fine for a baby. Well…that’s what I thought I would feel anyway!

Not long after Aviana came into our world, in the golden hour skin to skin, I attempted to breast feed her. Chris and my Doula helped me with Aviana’s first latch. Wait – help from Chris?? Although Chris isn’t an expert in all things breastfeeding related, he did attend the Breastfeeding class with me, and he was able to recollect our learnings far better than I could at that moment of time. My head was a bit foggy after being awake for so long and laboring hard! He was my walking breastfeeding text book (well the fundamentals at the least).  I am so glad we went to this class – one of the most beneficial films we watched was how to visually tell the difference between a good latch and a bad latch.

Fortunately, after a bit of fussing, Aviana latched quite quickly and easily, I was pleasantly surprised. Getting the position right as I held her was awkward. I had never held a baby so tiny in my life. I was afraid to break her!!! And here in her first waking hours I was planting her onto my bosom. It was so innate and natural for her to suckle.

This first feed was rather magical. Yes, it was weird having something tug at my nipple constantly, but it made me feel connected to her. She was mine, she was our responsibility to feed, nourish and love.  It also felt onerous at the same time.  I was worried before hand that I wouldn’t fall in love with her, but this experience banished that worry.

Aviana is a ‘IUGR’ (Intra Uterine Growth Restricted) baby, born 5lbs 1oz, weighing in the less than 1 percentile, but very long at 19.5″ in the 50th percentile! Because she was so teeny we had to stuff her up and feed her every 2 hrs round the clock. Whilst in the hospital, just before each feed she had to have her blood sugar levels checked. She wasn’t keen on this – I mean who would want their heel pricked and a cold thermometer shoved between your armpits every single time you were about to eat some food??  It was a tough first 24 hours, recovering from labour, the first several hours I was surviving on adrenaline, but later I don’t know how I was staying awake as I fed her.  Each feed was lasting at least 30 minutes as she kept falling asleep.  After changing her she slept for an hour or so and then it was time to feed again!

She was 4lbs 15oz 36hrs later when she left the hospital and 4lbs 8oz 60hrs later when we visited our pediatrician. When I heard this weight I was shocked!  She  had lost just over 10% of her birth weight. For most other babies losing this amount of weight was on the edge of normal and to be expected- for her low weight it was a concern. My milk had yet to come in yet, so we were told we should try supplementing the breast with 1 oz of formula with every feed.

Now, I said before Aviana had arrived that I had no expectations for breastfeeding and I would be totally cool with formula.  But in that moment when the pediatrician recommended supplementing, my tear bucket was almost full and I felt a huge level of guilt wash over me.  My brain blamed my body for not providing the sufficient nutrients for her.  What if after the ease of the first few days and my baby latching so well she decided to pack it all in and replace me with the bottle?  I had fallen in love with the idea of breastfeeding, and now it all suddenly felt to be at risk.

DANI-don’t be ridiculous.  Your baby needs the nutrients, supplementing is critical to her thriving.  Buck up – I told myself.

Then the pediatrician asked me how I felt about the supplementing?  I responded – “she needs to thrive and that’s the most important thing.  We can supplement, no problem”.  I don’t know if I had hid my initial reaction of disappointment well.  We didn’t have any formula at home, and with it being Christmas eve and getting late, the pediatrician gave us a tub of formula for newborns to go home with.

The idea of the supplementing was to give her all the time she needed at the breast, then when she was done, to offer her the formula.  Aviana wasn’t keen on the bottle at first, and I was secretly pleased she preferred my boob.  I wasn’t happy with the nipple we had, although it was a Dr Brown’s slow flow, I thought the shape of it was too different to my nipple.  So I sent Chris out to the shops to buy some new nipples.  We went with Nuk Perfect Fit Slow Flow.  This seemed to work better for Aviana and we lucked out at the second try.  We do have other nipples in the cupboard just in case.  Even with a better nipple, we were practically force feeding her the formula.  It broke my heart every time we tried to  give her the bottle.  But it was for her own good – she needed it.  Still on the two hour feeds the feeding sessions now lasted even longer with adding in the formula.  Chris and I worked as a team…he prepared the bottle whilst I breast fed her.  We took it in turns to burp her, then give her the bottle, then burp her.  It was exhausting at night because it required leaving the bedroom.

At night time, Chris and I took shifts to deal with Aviana’s fussing, change her diaper and burp her.  Chris took 9PM -2AM and I took 2AM to 7AM.  This suits us well because I’m a morning person, Chris is a night owl. Of course, I still had to be awake every 2 hours for every single feed.

Three days later we were back at the pediatricians for a weigh in.  Miraculously she had gone from 4lbs 8oz to 4lbs 15oz in 72 hours.  My milk was now in, so the doctor said we could reduce the supplementing if we wanted to but still stick with 2 hr feeds.

Another three days later we were back for a weigh in.  Incredibly, she had gone from 4lbs 15oz to 5lbs 6oz!!!!!  Chris and I high fived each other when the nurse called out her weight!  Aviana was gaining an incredible amount of weight just on my breast milk!  I was over the moon that my body had responded so well to Aviana’s needs.  The doctor said we could now extend to three hour feeds at night as long as we kept up the two hour feeds during the day. Woohoo – another high five!!!!

The prospect of an extra hours sleep in between feeds was worth celebrating!!! Except….Aviana hit her 7-10 day growth spurt and I was feeding her almost every hour.  I was on the verge of breaking down from tiredness.  I started to think that maybe my milk wasn’t sufficient for her.  But I educated myself on this kind of cluster feeding and took the advice not to give up and return to supplementing because my body would respond to the increased demand, I just had to keep up the breastfeeding.  Cluster feeding is normal.  As long as Aviana was pooping and peeing regularly she was getting enough milk.   It was a really tough few days.  But we came out of it and she returned to being an angel baby.

Another six days later (today) and we were back at the pediatricians for Aviana’s two week wellness check up. Aviana had grown from 5lbs 6oz to 6lbs 1oz!  She had moved up from the 1 percentile to the 2 percentile!  The pediatrician was impressed with her progress and said we could move to on demand breast feeding if we wanted to.  She told us that typically she would expect Aviana to be at least 5lbs 1oz (her original birth weight) – and we had exceeded that goal.

Admittedly, I have had it relatively easy with my breastfeeding experience so far.  My nipples have survived, yes they have gotten a bit sore, but the Lanolin the lactation consultant gave me to put on my nipples when I left the hospital has worked wonders.  Aviana latches well most of the time, we struggle a bit with my left boob for some unknown reason (I will go to the breastfeeding group the hospital runs with a lactation consultant every month next week to see if I can figure out why).

The only other thing I will mention is my experience of breastfeeding in public so far.  I bought a nursing cover a while ago because I thought that is how I would breastfeed in public.  My first necessity to breastfeed in semi-public was in the car after we had been shopping at the mall the day after Christmas.  That didn’t feel too public.  The next time was at the children’s health centre where my pediatrician is.  This was quite a benign environment to feed in, I felt comfortable whipping the boob out there.  This gave me a bit of confidence for my next public outing – the grocery store.  There was a starbucks in the store, so I sat with my back facing away from the public and fed Aviana there.  Again I didn’t use the nursing cover.  This all gave me the confidence for me to feed openly in Starbucks in Target and even at a restaurant when we had some lunch with a friend and his daughter.  I will still take the nursing cover with me just in case one day I don’t feel comfortable feeding so publicly, but I am surprised at my own confidence!

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Before Aviana arrived I mostly read about women’s stories of failure or problems with breastfeeding, which is why I didn’t have high expectations.  So that is why I’m sharing my breastfeeding story of success!  Here’s hoping it continues, because it is rather economical.

Dani

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