As some of you may know from reading this blog, I work quite a lot on a voluntary basis; answering helplines, the blog, another website etc. I do this probably obviously because I'm passionate about trying to help mums who want to breastfeed do so.
At the moment NHS care is a postcode lottery (going to cover this in a blog post very soon!) and many women are left with inadequate support to have a chance. Unfortunately there's only so much we can do in a voluntary capacity - for example I can't regularly offer 1 2 1 home visits. Why? Here's an example: It was Sunday and a mum got in touch who was desperate, she didn't think she could get through to Monday and I could hear her baby screaming in the background. Mum was very distraught because she really wanted to breastfeed but just didn't know what to do. So, on a Sunday - the only day I have with my children and family, I set off to make the 40 min journey to her house, was there over an hour and then did the 40 minute journey back. I don't even get petrol money covered.....
Over the past year or so, more and more mums have been contacting me asking if they can pay for support - but on a National level things are still sadly lacking (as the comments on many of my articles here will testify!) and so we hope Milk Matters can help with this.
We are independent - which means parents can pay for a range of services depending upon their situation. Mums who want can take a full bump to breast 1 2 1 package, but we also offer this as a group option to reduce costs. We offer a second time mum "debrief" to help establish why breastfeeding didn't work with a previous child, stand alone antenatal sessions, plus a "need help now" emergency option!
We have launched in North & West Yorkshire, but we hope to extend this to other parts of the country over coming months. Only those who are qualified as a breastfeeding counsellor with one of the main organisations or IBCLC lactation consultant will be able to offer this service; ensuring quality of care.
We are also in the process of becoming a social enterprise, as we plan to donate any profits back in to the voluntary organisations that are training counsellors (proportional to which organisations our specialists are trained by) and back to those working to develop support, resources and research.
There will of course be strict ethics and guidelines in place, to ensure mums who take a voluntary call do not self refer for payment - which is why we call ourselves "breastfeeding specialists" to try and separate the two roles. But we hope our services can help to go some way to filling the gap that currently exists in the system - where Health Visitors are referring to volunteers, no continuity of care is offered, and as per one mum I spoke to today - left paying £70 for a breastpump (for the last 6 weeks!) because they can't find anyone to help transition baby back to the breast. Mum had NO support and couldn't find anyone - hence why she ended up expressing and supplementing.
There's lots more information on our website, and I will also of course be happy to answer any questions anyone has :)
A word from Annalisa
“Breastmilk provides the very cornerstones on which a human’s health is built. There are too many myths surrounding breastfeeding, myths that sometimes stop women continuing, even though they want to.
When I had my first child, I got so much conflicting advice from people, my head was spinning. Some of that advice I later found out was factually incorrect and hugely damaging. One friend told me her GP had told her that there was “no benefit to breastfeeding past seven weeks”. Well! This is just codswollop. Luckily I got proper help just in time and was able to salvage my breastfeeding relationship which had got into a right old mess: I gave formula within 24 hours of my daughter’s birth, I stopped breastfeeding for a while, I was mix feeding, pumping, I re-lactated…With the launch of Milk Matters, we hope that with qualified, specialist support the women who want to breastfeed will get the best help possible. Jamie Oliver has campaigned very effectively to raise awareness regarding wholesome school dinners, but good child nutrition starts way before solids are even introduced.”
I am currently about half way through the training to become a peer support trainer. I agree with you that we are only taught the very basics and able to assist with the more straight forward problems.
ReplyDeleteSaying that, I wouldn't dismiss us all together. In a area where the art of breastfeeding is mostly forgotten sometimes a friend on your side can be a massive support.
Hi Anon
ReplyDeleteI've never dismissed peer supporters - I think they have an extremely important role to play within their remit :)
I'm sure AA isn't dismissing Peer Supporters! Just that when things veer out of the realms of normal, as Annalisa describes, a little more in depth training can be needed to support mums through the challenges that can sometimes occur. But of course we need you - Peer Supporters are an integral part of the joined up thinking we need to effect change and provide the emotional and practical support all mothers need.
ReplyDeleteCongratulations AA! What a wonderfully apt (albeit sad) day to launch Milk Matters. Let's talk soon as I might well consider being your first recruit in E. Anglia.
Mxxx
What Maddie said ** :)
ReplyDeleteI know Maddie, I got home and read the email and thought how weird a day can be so happy/sad at the same time.
Absolutely let's talk :D :D I'm sure I can send bribes of cake and chocolate to help you're considering ;)
BIG amazing thank you to Chris at www.verysimplesites.co.uk for creating such a fab webspace for us - not easy given I'm a picky perfectionist lol
YOUR considering, not you're obviously! sorry rather a large glass at wine o clock today to celebrate ;)
ReplyDeleteOoh I LOVE that you can be so picky over apostrophes even at wine o'clock - girl after my own heart :-)
ReplyDeleteCake and chocolate sounds very tempting ;-) xxx
I SOOO agree with you about being a volunteer,I have been doing it on ad hoc basis for 4 years but had to give up my counsellor training due to family illness,then when it came to picking it up again needed to get back to work .Am now trying to bit by bit study for the LC exam(finances allowing)I truly wish you success as there is clearly a huge need for more breastfeeding support.
ReplyDeleteHi AA,
ReplyDeleteI am really pleased to have found your site. I just wanted to say I totally agree with you about the postcode lottery of NHS care. I am a midwife and IBCLC and don't currently practice privately as a LC. I did do, for a month and found it just felt wrong to charge people for care they should have received anyway within the NHS. However, by not practising privately it leaves an even bigger gap in accessing proper quality BF support for many women. I am now being asked for help and suport outside of my NHS work by increasing numbers of friends of friends etc. It's really hard balancing the guilt of charging for private BF support against working at a loss (considering petrol and considerable miles etc) when that is time I should be with my young family. I'm in E Anglia. Any gems of wisdom for me in my quandry?
Hi Anon
ReplyDeleteIt IS a tough one isn't it. I've never worked within the NHS, but I have felt the voluntary orgs are "propping up" the breastfeeding arm for quite some time - because the NHS is under delivering in SO many areas for women, which are ultimately all linked to breastfeeding ie antenatal/delivery and postpartum care. If someone wants a birth with continuity of care, respect, and evidence based practice - the only way to currently guarantee this is to pay for an independent midwife. I say guarantee because I think it is down to chance - you can get an AMAZING NHS midwife or you can get an utterly terrible one who knows nothing about "normal" birth (perhaps always practiced on a consultant led unit?) or breastfeeding.
I don't see things changing anytime soon - in fact with cuts I've heard already about things getting worse, meaning as you say all the happens is women have even less chance; but after the 9 months of "breast is best" they are then the ones left feeling crappy!
Ultimately I feel the NHS spends 9 months pushing mums to breastfeed - then when mothers do, they get diddly squat support. I remember with my first when struggling getting allsorts of advice from health visitor. Eventually I hunted and hunted online and discovered what were then called "growth spurts" - I remember feeling STUNNED nobody had mentioned any of this stuff, and wondering why my health visitor hadn't given me this information when I mentioned the very frequent feeding (her advice was give a bottle)
The NHS doesn't value breastfeeding beyond the lipservice it uses to promote it. If it did it wouldn't be employing people with no training to deliver huge chunks of the care. Imagine going to hospital with something serious and instead of seeing someone trained and qualified, they sent you off to someone who had suffered from a similar condition last year! Or perhaps instead of a midwife - just suggested you made do with a doula if she's had a baby herself. Those qualified often can't afford to work for the salary the NHS is offering (the last one was less than 14k) and the only job criteria was "IT skills and passionate about breastfeeding". Another popular one seems to be "maternity assistant" ie no skills but plugging a hole.
So if parents want guaranteed effective support in a duff postcode lottery area - I think the reality is that leaves either parents or volunteers paying for it. Now for the volunteer to pay - this adds up week on week, visit on visit, month on month. For the mums it's a one off thing, and as one mum pointed out - ultimately how much will formula cost if she doesn't get the problem sorted? Isn't it about £800 for a year? plus of course all the other stuff required - all lining the breastmilk substitute machine's pocket, giving them more customers and ultimately power....
So - I reconcile it by also doing as much voluntary stuff as I've ever done ie I'm not taking anything away from the voluntary sector, but adding something on top. I also hope if enough other counsellors are interested, it could be financially beneficial for the voluntary orgs (rather than the formula companies!) plus perhaps allow us to offer some free group sessions for those not able to pay - covered by the 1 2 1 care for those that want to.
Lastly there will always be people who want private care rather than NHS ie a friend I mentioned it to (private hospital lover etc) said it was SUCH a good idea as no way was she trekking to some local support group - if she could have had a home visit she would rather have paid.
The more women we can help to breastfeed, the more normal it becomes again in society and the more skills can be shared between mothers. But as I can't afford to fund that, I think a reasonable charge to keep our good counsellors counselling makes for less of an ethical quandary...
Hi, Love the blog but I need to point out something that you probably know....If a mum has the money to pay for BF support or even if you have to reduce the rates for her then is is probably not in the lowest social sector and is probably able to find/drive to/ look online to access the support she needs. The women who REALLY need the help are at the lowest end of the social spectrum and bf will make the most difference to the health outcomes of their babies.
ReplyDeleteThere is one organisation (there may be more) that will not take payment from mums for support so will you be contributing towards any of their training costs? The reasons behind this are to be seen to be independent and on the mums side.
Peer Supporters in many areas have supervision so that although they have only had 12 weeks training they are able to deal with normal breastfeeding problems so there is no need to be scared about these women supporting their peers as they are usually very aware of the babies and the mother's safety and what to do if they are worried about it.
I think it is really important to keep poor mums in mind and organisations should be there to pay expenses to volunteers who are themselves on the lower end of the social scale. Middle class woman driving to the poor area of town to support a mum is no good. This is why peer support works.
From a Breastfeeding Co-ordinator
(Firstly want to say that I find your blog a marvellous resource of informed common sense, I often recommend it!)
ReplyDeleteI'm a Peer Supporter in an area which has very patchy support for Breastfeeding amongst HV's and Midwives.
The county Breastfeeding Coordinator post was lost even before the recent cuts... A Lactation Consultant is paid part-time... all the other help for Mums is voluntary - the Peer Supporters! What scares me is that this County is probably not that unusual.
We have had a growing number of mothers using our support groups over the last 3 years, but still the most disadvantaged sectors of the community rarely self-refer (e.g. young Mums). Also disheartening that we cannot organise regular antenatal classes. Funding this year is roughly zero.
I absolutely agree with all that has been said on your blog post & comments here. Bravo to you and all your future colleagues in this new venture. I'm sure it will enable many trained breastfeeding helpers to continue despite financial pressures.
Hi Erika
ReplyDeleteAs mentioned it would be great if we had the means to be able to offer services to all. I'm of course aware of the social issues you describe, two areas locally had rates of 3 & 4% 12 months ago - but funding has to come from somewhere. None of the voluntary orgs accept payment and nor do I for work done with that "hat on" :)
I really have to disagree with this point though:
QUOTE Peer Supporters in many areas have supervision so that although they have only had 12 weeks training they are able to deal with normal breastfeeding problems so there is no need to be scared about these women supporting their peers as they are usually very aware of the babies and the mother's safety and what to do if they are worried about it. END
But it's my experience that makes me worried lol 12 weeks training isn't designed to equipt women to then deal with problems?!? When working for a voluntary org the limitations and remit of this role are very specific - but this is totally ignored a lot of the time when trained externally or when the NHS etc buy a package from the voluntary orgs; as your post clarifies.
In some areas peer supporters are "supervised" by a "breast feeding champion" health visitor or feeding co-ordinating who herself has only done the exact same very basic training! Myself and others have all picked up the pieces when mums have got in touch thinking they have seen qualified help, which turns out to be from someone who actually has a fancy title, but who without the skills to unpick the history and establish why a problem is occuring has given incorrect "stock advice". I saw a mum several months ago who had a very slow gaining baby, unsettled, frequently feeding. The baby displayed green stools and so was told by the peer supporter (calling herself a counsellor!) this meant too much foremilk and to feed only one side for a several hour period. This technique reduced the mothers supply even further!! which was where she was at when I met her.
I've spoken to those working in a peer supporter role who FEEL way out of their depth, have nobody to refer to and are under a lot of pressure to support with things they are simply not qualified to help with.
In fact to be fair - Lisa's post pretty much makes m point!
Time for a blog post on the subject I think :)
Lisa - how worrying they have cut the breastfeeding co-ordinator! who is then there to support you?
Hello again and thank you for your reply, AA.
ReplyDeleteI think you're totally correct in your feeling that the voluntary organisations 'prop up' the breastfeeding 'service' of the NHS. And the more that voluntary organisations do, and the better they do it, the LESS need, incentive and demand there is for the NHS to buck up it's ideas and start proving a proper service in ALL AREAS. I find myself pondering if we would be allowed to qualify and practice as midwives if we had such an inadequate level of training and knowledge around blood pressure measurement or abdominal palpation?!
The double standards really wind me up. We give advice in pregnancy about the (relatively small)risks of eating pate, brie, unwahed salads, tuna etc etc, yet we dare not mention any of the risks of formula milk. Instead we do ourselves and our clients a disservice and talk about the benefits of breastfeeding, a biologically normal activity. But it is no wonder midwives and other health professionals do not tell women about the risks of formula- many of them don't even know themselves. How can they if they were never educated about it? I look back to my own knowledge of breastfeeding and it's management and I am embarassed at what little I knew before I undertook further post registration study.
As midwives, we are all too aware of the chronic under-investment and under-appreciation for biologically normal birth and biologically normal infant feeding. That is not to say that some mothers and babies do not need higher tech care and support, or that every woman can have a normal birth or breastfeed. But when we get to a point where normal physiological birth rates are sometimes 30% and exclusive breastfeeding rates are around 20% at 6 weeks (let alone 1% at 6 months!), we need to ask ourselves what an earth is going on.
I can't tell you how depressing it is to see substandard breastfeeding care and support every single shift, week after week, month after month, year after year. Hearing and see poor advice given to vulnerable mothers and babies. And that poor advice coming from everywhere a woman turns- midwives health visitors, paediatricians, GP's.....
It is really sad seeing a woman discharged from a maternity ward knowing full well that she is unequipped to deal with normal feeding behaviour because she doesn't know what to expect. Add onto that watching the good midwives leave or become ill because they can't stand to work in a system that is so inadequate, and at times unsasfe. The NHS maternity service, in my opinion and experience, often runs on good will, and on midwives foregoing meal breaks and leaving late. It can suck the energy and passion out of even the most dedicated staff.
I am personally at a turning point where I have two options- leave and do something else, or try (again) and effect some small change in 'the system'. (Right, I'll get off me soap box now, rant over!).
I admire and wholeheartedly support properly trained breastfeeding cousellors. I think you are fantastic. I would dearly love to do more 'couselling' training as I think that aspect of lactation support is so important. I too, share your worries about peer supporters, unprotected titles and patchy supervision of breastfeeding supporters.
I am inspried by the posters here and hope we can all learn from each other's expertise and experiences- and find a way forward for the voluntary sector, for the NHS and ultimately for women and their babies.
I look forward to reading more of your blog and comments from others, too.
P.S. I choose to keep myself anonymous as I know how those who speak out against the NHS are sometimes treated.
Oh my goodness, I've just realised I've written an essay- sorry. Maybe I should have pre-fixed it with "Get a cuppa and a biscuit before you attempt to read this"....
ReplyDeleteYears of frustration, can you tell? ;-)
No I absolutely welcome your essay!! It sums everything up SO well. I wont bore everyone with details of the "support" *cough* I received when my preemie - and I didn't even need practical help!! just someone NOT trying to shove formula and/or a bottle down his throat at every opportunity. When I refused to let this happen (it was NOT needed and we got out EBF!) I was literally bullied - my life for the time I was in there was made utterly horrific. I of course complained afterwards but supporting mums locally nothing has changed :(
ReplyDeleteI totally agree about the NHS not seeing an urgency because of the voluntary orgs - hell when health visitors earning 40k plus are referring to unpaid volunteers, you've got to question the state of play...We do have an AMAZING IBCLC locally - but only 2 days part time and also based within the hospital. Half the time staff don't make her aware there is a problem mum on the wards - let alone once they are out in the community.
I also can totally understand (given my preemie experience!) how the hands and mouths of truly passionate midwives and health visitors are tied. On another forum one health visitor replied she would be sacked if she told parents "the truth". Because they would complain!
I can imagine how utterly destroying it is to see this crap care day in day out - I considered options to work within the NHS at one point, before realising I couldn't be part of that system ie I wouldn't be able to handle it. It's bad enough the small amounts I have to witness - let alone as a fulltime job.
As you say it means the most dedicated staff are burning out and leaving the system :(
I do understand what you are saying about unregulated peer supporters and I suppose what I was trying to say is that they need regulating and that the titles do need to be clear. Plus the fact that when peer supporters are used by the health professionals they are nearly always given the 'difficult' cases where they have come to the edge of their own knowledge. Mostly these cases are inappropriate for peer supporters to deal with and need more specialist help.
ReplyDeleteI guess I'm defending peer supporters because I am just about to start training funded by the PCT. We are desperately trying to set up volunteers before the money runs out. It was a choice between paying ourselves or training some new women and we choose the most sustainable way.
I'm fairly new to this blog and it has become a wonderful resource for me - thank you. It seems to be a really interesting place to hear the voices of breastfeeding supporters from around the uk.
Hi Bast - sorry am getting all confused now by who posted what with all the anon postings lol What is your position again? are you an IBCLC?
ReplyDeleteBut there is really no need to defend peer supporters - because nobody has attacked them? my issue is with peer supporters acting beyond remit ie Health Professionals refering to them when there's a problem. Helping women with problems beyond the very very basics is not what the peer support programme was ever designed to do?
IME peer support programmes only work when there is proper structure - someone capable to refer problems to. So PS can work in the role they are designed to - as a well informed friend ie yes xyz is normal or information about when to start solids, "fussy spells" etc, Otherwise PS become demotivated,the service disjointed and isn't sustainable.
What I do struggle with is why the NHS doesn't recognise the BFC qualification at all - to my mind this would be the perfect missing link between PS and IBCLC. Many hospitals only have part time LC cover - which could be used for the most clinical cases, because there would be another layer of competency....BUT it all goes back to how little the NHS values breastfeeding -that they expect unpaid workers to be motivated, longstanding and in effect doing the job of a properly trained/qualified person.
I think this matter so use full. I like this New Independent Breastfeeding Support ideas so interesting topic. Many hospitals only have part time LC cover - which could be used for the most clinical cases, I saw in this many time so I said in this is good collection in this post. I like well in your choice Thanks this use full post.
ReplyDelete