Midwives ‘should support informed choice’ on infant feeding says RCM

The statement, released today by the Royal College of Midwives, began with the following paragraphs:

Exclusive breastfeeding for the first six months of a baby’s life is the most appropriate method of infant feeding. Breastfeeding should continue alongside complementary foods for up to two years, in line with the World Health Organisation (WHO) and UK departments of health recommendations to promote and support breastfeeding.

As with other areas of maternity care, midwives and maternity support workers should promote informed choice. If, after
being given appropriate information, advice and support on breastfeeding, a woman chooses not to do so, or to give formula as well as breastfeeding, her choice must be respected.

Tabloids have taken the opportunity to whip up the classic ‘breast vs bottle’ debate, with front page headlines such as ‘END OF BREASTFEEDING TYRANNY (Daily Mail)’, profiting from mothers’ guilt and shame whilst simultaneously adding to it.

‘Informed choice’ is the idea that a person should have all the information prior to making a decision. Unfortunately with breastfeeding support and services being cut and breastfeeding initiation rates struggling, this is clearly something which needs to be addressed as the statistics are showing that informed choices surrounding breastfeeding are in a dire state. The statement goes on to say:

A collaborative approach to breastfeeding which promotes the benefits of peer support programmes and third sector involvement will ensure the best outcomes for women and their families. The RCM supports the WHO Global Strategy for infant and young child feeding and International Code of the Marketing of Breast Milk Substitutes and subsequent World Health Assembly resolutions..

Maternity units must be appropriately staffed and sufficient investment made in postnatal care to enable each woman to get the support and advice she needs to make informed choices about feeding her baby.

Later on in the text, the current situation is highlighted:

Successfully supporting mothers to breastfeed depends on sufficient numbers of appropriately trained and skilled staff, including midwives, maternity support workers and peer support services. The RCM continues to express concern over workforce issues that according to research findings, shows many mothers are left with inadequate support and information to enable them to breastfeed. The RCM will continue to lobby for adequate investment in tailored services and peer support programmes that will reach out to mothers with support. 

Until vital breastfeeding support services are well funded, mothers and parents will not have the tools and information required to make an ‘informed choice’. The statement also makes a good point about the data collection surrounding infant feeding:

UK-wide Infant Feeding surveys (which were discontinued in 2015) should be reinstated, in order to ensure robust monitoring and to inform commissioning strategies.

Midwives will also be making sure that parents are informed on how to make up artificial milk (formula) correctly which includes:

… instruction on cleaning and sterilising appropriate equipment and the correct method for making up formula feeds, to minimise the risks associated with artificial feeding. All midwives and maternity support workers should promote close physical contact between mother and baby when feeding.

So to summarise, what this statement is saying is not that midwives should be saying ‘it’s fine to bottle-feed’, it’s saying that midwives should support a parent’s choice on how to feed their child, as long as they have been provided with all the information beforehand to empower them to make an informed choice. Which, frankly, is the stance of most breastfeeding advocates and health professionals anyway – so the only thing that needs to change is making sure people can access that information.

Over to you, government.

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