GOLD Learning Speakers

The majority of women should be able to breastfeed, but elements of their experience are ultimately stopping them from doing so. Breastfeeding works best when done responsively but many psychological, social and cultural factors work directly or more subtly against responsive feeding, meaning that many mothers experience difficulties with breastfeeding which can lead to premature weaning. These factors can include separation of mother and baby, a lack of understanding of breast milk production, public attitudes and wider pressures of motherhood to name a few. If we want to support mothers to breastfeed we must understand and target these wider factors to create a supportive breastfeeding environment. It is important however that our approaches to breastfeeding promotion and education are perceived positively by mothers in order for them to be effective. In this presentation I’ll be addressing the common barriers to breastfeeding and their impact, along with new research that looks at how mothers perceive common breastfeeding education messaging and what this research tells us about how we can change our approach to ensure our messages have the intended impact.

It is recognised that women can experience feelings of guilt, unhappiness and anger when they cannot meet their breastfeeding goals. Breastfeeding difficulties leading to early cessation are a risk factor for postnatal depression. However, research has not previously examined these feelings of loss and distress in relation to clinical models of trauma. From a research study exploring the experiences of over 3000 women who stopped breastfeeding before they were ready and held negative emotions around this decision, I argue that a subset of these women are displaying symptoms of clinical trauma in relation to their experience. The trauma stems from physical experiences of a difficult breastfeeding experience, but also the loss of a much-desired breastfeeding relationship. The combination of these events leaves the individual traumatised and understandably reactive to the topic of breastfeeding. Trauma models identify numerous emotions and behaviours that individuals typically display when they have been traumatised by an event. These include recurrent distressing recollections of the events, intense psychological distress at exposure to reminders of the event and efforts to avoid thoughts, feelings or activities that remind one of the event.

We know that responsive feeding gets breastfeeding off to the best start. New parents are told that breastfed babies often feed 8 – 12 times a day, but in practice many new mothers will find themselves breastfeeding more frequently than this. Research exploring breastfeeding frequency is however conducted primarily with younger infants, focuses simply on breast versus bottle, or was funded by industry. This presentation reports novel findings from a research study of 18,000+ mothers with a baby or child aged 0 – 5 years old. It examines how often babies feed during the day and night for each age range by milk feeding type, mode, and approach (e.g. schedule versus responsive) and how frequent day and night feedings remain the norm for breastfed babies into the preschool years. The data also explores differences in maternal perceptions of infant variations in hunger e.g. in response to growth spurts, variations over different days, and cluster feeding, highlighting how breastfeeding mothers describe a more varied pattern of infant feeding compared to those formula feeding. Together the findings challenge notions that most babies breastfeed between 8 – 12 times per 24 hour and that irregular patterns or varied numbers of feeds are normal for breastfed infants. Although many breastfeeding practitioners will recognise this pattern, these findings will provide both an addition and challenge to the scarce existing research literature on infant feeding patterns.

Promoting breastfeeding as protective of both maternal and infant health is a central role or governments, health professionals and breastfeeding advocates. Talking about breastfeeding difficulties and why ingrained barriers must be tackled is essential to ensuring the situation changes for future mothers. However, sometimes it feels as if we are caught in a vicious circle; we must talk about breastfeeding as our rates are low and many women wish they had breastfed for longer, yet discussing these issues is often criticized as causing pain. This talk will present findings from a large research study which explored the experiences of over 2000 women who could not breastfeed for as long as they wanted, presenting their lasting emotions from their experience alongside their ideas for how we could promote breastfeeding in ways that cause them the least pain. The concept of negative breastfeeding emotions displaying as psychological grief or trauma for a subgroup of women will be discussed, alongside the factors that they felt made their experience or feelings worse.