Infant feeding: respecting reality

By Clare Livingstone on 03 September 2018 Midwives Magazine Infant Feeding

Many mums continue to struggle with breastfeeding. Clare Livingstone explains how the new RCM position statement empowers all mothers making decisions on infant feeding. 

Breastfeeding in accordance with recommended guidelines brings clear health benefits to both mother and baby. Wonderful work is taking place in maternity units throughout the UK, where dedicated and highly skilled staff support women along their journey to successfully breastfeed their babies.

However, at the RCM we were unable to ignore negative reports from some women who have felt under pressure to breastfeed when this was not their choice, or judged when they opted to give their baby formula milk.

We are aware of cases where some mothers have not been adequately educated on the preparation and feeding of formula milk, and even been denied supplies of formula milk while in hospital. This is in breach of UK guidance, such as the NHS constitution in England, which guarantees patients’ rights ‘to receive suitable and nutritious food and hydration to sustain good health and wellbeing’ (NHS, 2015).

Thus, in June, the RCM launched a new, refreshed position statement on infant feeding.

A mother’s choice 

We felt that there were new aspects to the infant-feeding debate worthy of inclusion that would be relevant in practice. Midwives and MSWs are supporting women’s choices and decisions every day with evidence-based information and advice, and our position statement needed to reflect the reality and context of their work.

RCM chief executive Gill Walton says: ‘Evidence clearly shows that breastfeeding in line with WHO guidance brings optimum benefits for the health of both mother and baby. However, the reality is that often some women for a variety of reasons struggle to start or sustain breastfeeding.’

We are all aware that today’s mothers and their families often have significant challenges to overcome. Many are trying to cope with financial difficulties, workplace insecurity, physical and mental health needs, and societal pressures, which can all impact on their decision-making.

Our role is to empower, inform and enable that decision-making. As registered midwives, we have a duty of care to treat people with ‘kindness, respect and compassion’ (NMC, 2015). Sometimes this will find us caring for women who make decisions we may not agree with, personally and professionally, but we are required to respect and support them nonetheless.

Gill says: ‘We recognise that some women cannot or do not wish to breastfeed, and rely on formula milk. They must be given all the advice and support they need on safe preparation of bottles and responsive feeding to develop a close and loving bond with their baby.’

We know this cannot happen without proper resourcing, and our position statement explicitly calls for sufficient investment to be made in maternity units, staff and postnatal care to ensure this is the supportive, respectful service received by every woman. The RCM is maintaining its current position of not accepting advertising from infant food manufacturers or allowing them to exhibit at RCM events.

While our position statement has been overwhelmingly well received by members, professional bodies – including the Royal College of Paediatrics and Child Health, the Institute of Health Visiting and the RCN – and other stakeholder organisations such as the NCT, we are aware of the concerns and confusion, especially around some of the media coverage. Sensationalised tabloid headlines created much heat, but little light, around the message and we can only learn from this.

Infant feeding, like many other issues connected to women’s health, generates strong feelings and sometimes disagreement, but the RCM stands by the content of this position statement, confident that nailing our colours to the mast in this way was the right thing to do.

Clare Livingstone is RCM professional policy advisor 

Position statement key points

  • Exclusive breastfeeding for the first six months is the most appropriate method of infant feeding
  • If, after being given appropriate information, advice and support on breastfeeding, a woman chooses not to do so, her choice must be respected
  • Parents who formula-feed infants should be provided with the information to do so safely and be given support to encourage bonding
  • More investment in maternity units and postnatal care to enable each woman to make informed choices about feeding her baby
  • Breastfeeding mothers should feel supported and respected by the wider society
  • Access the full position statement here