Our Response to a Government Consultation on Preventative Healthcare

We responded to two questions in the recent government consultation Advancing our health: prevention in the 2020s. The consultation sought the public’s views on government proposals to ‘tackle the causes of preventable ill health in England’.

This is what we said:

Question: How can we do more to support mothers to breastfeed?

Infant Feeding Alliance is a parent-led UK movement. We fed our babies in different ways. While some of us enjoyed breastfeeding, others experienced adverse effects, including mastitis, breast abscess, excessive sleep deprivation and babies hospitalised with jaundice and hypernatremia.

Infant readmissions for feeding related complications are increasing. A recent randomised trial demonstrated that formula supplementation prevents readmissions without interfering with subsequent breastfeeding. We urge consideration of whether the emphasis on exclusive breastfeeding is contributing to this trend.

We have found that negative attitudes towards formula from breastfeeding support providers are common and that advice about combination feeding is difficult to acquire. We urge breastfeeding support to include families who find combination feeding more sustainable or desirable.

Many of us felt distressed by pressure to breastfeed from healthcare services. For some this contributed to mental illness. A recent UK review of the Baby Friendly Initiative highlights that such experiences are common. This review also showed that BFI’s efficacy in increasing breastfeeding duration is poor. We ask the government to consider alternatives. We call for a flexible and personalised approach to infant feeding support such as that envisaged by Dr Mathew.

The Infant Feeding Survey 2010 identified that pain, latching difficulties and low supply lead women to stop breastfeeding. A Cochrane review found insufficient evidence to make treatment recommendations for breastfeeding pain. We can find no review or recommendations for latching problems or low supply. We call for research to identify strategies to resolve these issues.

Question: There are many factors affecting people’s mental health. How can we support the things that are good for mental health and prevent the things that are bad for mental health, in addition to the mental health actions in the green paper?

Infant Feeding Alliance is a movement of parents, many of whom experienced psychological distress resulting from pressure to breastfeed. Negative experiences like ours are borne out in research.

Government policy requires all hospitals to be accredited by The Baby Friendly Initiative (BFI). BFI guidelines prevent information about infant formula being on public display. They require that images of bottle-feeding should not be ‘idealised’ and only used to ‘reinforce technical instructions’.

In our view, this presents bottle-feeding in a cold, clinical way and as something to be ashamed of and hidden from view. Some of us found breastfeeding to be far from the idealised image presented by breastfeeding promotion materials, making our lived experiences invisible in public services. We found negative attitudes to formula common in breastfeeding support groups and among healthcare professionals, leaving us feeling judged, unwelcome and isolated.

Some of us were pushed to continue breastfeeding, despite pain, stress and sleep deprivation that were having a detrimental effect on our mental health. Some were advised to express milk between breastfeeds to build supply as per NICE guidelines, with no consideration of our need to sleep, eat or attend to personal needs. For a small number of us, this contributed to the development of postnatal mental illness, including postpartum psychosis.

We call for a flexible and personalised approach to infant feeding that considers the psychological wellbeing of all family members, particularly mothers. We believe this is likely to support good mental health outcomes in the perinatal period.

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