Almost 6 in every 10 babies (60%) born in Ireland are breastfed in the first week of life but only 6 in every 100 (6%) are still being breastfed at six months of age. This is way below European and global averages of 25% and 38% respectively.
Margaret Hawkins talks to mum of four, paediatric and public health nurse and certified lactation consultant Katie Mugan of nursingmama.ie about why women choose to breastfeed and why they don’t - and about the benefits.
Starting well but dropping off very rapidly – that’s the story with breastfeeding figures in this country.
“It tapers off quite quickly unfortunately, three or four days after the birth,” Katie Mugan, a mother of four, “and we have to look at why they drop off so dramatically and so quickly.”
She believes that it can come down to lack of education about breastfeeding or unrealistic expectations of what breastfeeding entails.
“Even if we have educated ourselves about it before the birth when babies arrive there is a critical period when we need a good support network around us,” she says.
“Breastfeeding takes time to get the hang of and with hospitals under extreme pressure and under-resourced with midwives and public health nurses that sort of support often just isn’t available to new parents in that critical period,” she says.
Spending time working in Australia as a paediatric nurse showed Katie how different things could be.
“Breastfeeding was the norm there,” she says. “Most mothers breastfed in hospital, even in neonates where I worked, almost all expressed (milk) and went on to breastfeed on discharge. This was rare in Ireland from my experience. The support (mothers got there) was amazing from the start and when I returned to Ireland, I knew that helping and advising mothers about breastfeeding was something that I wanted to do.”
She went on to qualify as a public health nurse (PHN) and later as an International Board Certified Lactation Consultant. Based in Naas, County Kildare, she is currently on career break running nursingmama.ie and providing online classes and postnatal lactation consultations for mothers online and offline.
Why women say no
There are many reasons why women choose not to breastfeed, she says.
“For some it’s just not for them and we have to respect that choice. For some it’s down to them not wanting that contact of the baby on the breast.”
For others it may be that they’ve never seen it before and they don’t understand how it works, that they would feel very embarrassed to breastfeed in front of others.
“Sometimes they just want the other partner to be able to help them and feed the baby via the bottle. Some women feel that their life is going to change, that they can’t eat what they want, can’t drink what they want, can’t go out but breastfeeding should be part of our lives.”
Confidence is key
Building the mother’s confidence is key, she believes.
“It’s about building up the mother’s confidence, seeing that they understand when things are going really well and maybe when things aren’t also. It’s about being able to manage that situation and get past it. No support (or not enough support) can lead to them maybe moving down towards a more combined (feeding) route before they had ever thought that they would.”
Part of our lives
The more we expose our communities to it the more we accept it as normal, as part of family life, she believes.
“Every time we feed our younger kids in front of our older kids it has a very good impact because they see it as a normal thing so that hopefully when they grow up they will consider it themselves or support their partners if they choose to do it. If we see more moms out there living their lives and breastfeeding then it will make it easier for new mothers who have never been exposed to this culture before and it makes it more normal.”
Breastfeeding should be discussed and the benefits learned about in class
While the sexual emphasis on breasts in society may put some women off breastfeeding, as a country we can change this thinking through our education system, she maintains.
“Breastfeeding should be discussed and the benefits learned about in class. Then we can talk about improving our breastfeeding rates. We need to educate our medical teams too. If we have all our healthcare staff singing from the same hymn sheet then we can protect our breastfeeding. It’s about educating women about why they are doing it, giving them a plan and follow up care, not just sending mothers out of the hospital with little knowledge of what they are doing and no plan in place if issues arise.”
The National Women’s Council (NWC) and the Baby Feeding Law Group (BFLGI) are seeking stricter legislation related to formula milk.
“Aggressive advertising and marketing of breast milk substitutes by industry influences and positively promotes infant formula to parents, health workers and policy makers without acknowledging or explaining the health risks, economic burden and environmental impact of their use,” they say.
“Implementing stricter legislation can protect society from these marketing messages allowing families to get their information about how to feed their children from unbiased public health resources.”
Benefits for mum
For information related to breastfeeding support the following websites may be useful: www.cuidiu.ie/supports_breastfeeding
Health Service Benefits
Breastfeeding also impacts the health service because it reduces the demand put on it by people in later life by reducing cardiovascular incidents and diabetes incidence.
“Breastfeeding may not be the choice for everyone but a lot of parents will go in with an open mind and say ‘I’m going to give it a go and see how we get on’ and they will do the preparation classes.”
The reality can be very different to what people expect, however.
“They think that it’s going to be very easy. People talk of breastfeeding as natural and natural, for some people, equates to it being very easy but that’s not always the case.
While, for many parents, breastfeeding will just work and the baby latches on and there are no issues with milk supply, for other mothers they will hit a few bumps along the way.”
Some simple instruction in altering latching on or attachment techniques will help resolve problems for many but a small number of mothers can hit substantial hurdles.
“Unless you’ve got the support for mothers they won’t have a positive journey with breastfeeding. In the first two or three days most moms if they are struggling and at rock bottom and don’t have enough support and are offered a top-up (of formula milk) or a supplement the mom will go for it.”
The theme of the HSE National Breastfeeding Week which took place from 1-8 October 2022 was Expert Help for Every Step of the Way. The HSE has recruited 20 additional infant feeding and lactation posts within nursing and midwifery services to support breastfeeding parents, they say. All 19 maternity hospitals now have a specialist lactation support service available. More infant feeding/lactation posts are being recruited to ensure nationwide availability within primary care services. Practical breastfeeding advice is available from the HSE at mychild.ie as well as at ‘Ask Our Expert’ live chat. An e-mail breastfeeding support service is also available 7 days a week.