Support plays a vital role in enabling women to breastfeed for longer. It helps solve many different challenges, stops physical and emotional pain, and helps women feel accepted as part of a community. Yet across the UK, many breastfeeding support services have been cut. Austerity is usually cited, with policymakers failing to see that such support could save the NHS many millions, even billions, further down the line.
So who picks up the slack? Volunteers. Charities. Women who have breastfed their own babies (often through difficulties) who can’t bear to see women sold a dream of “breast is best” then failed with an absence of actual support. Imagine that for any other area of health – sorry your hip is broken, can’t help with any medical treatment, but if you pop along to the association for broken hips, they’ll help you.
Breastfeeding might be “natural” but just like many physical skills, it can take time to learn. In previous generations, when breastfeeding rates were much higher, we would have learnt about breastfeeding as we grew up. We would have seen it happening more often in our families and communities, directly and indirectly learning how it worked. There would have been little need for promotion of breastfeeding or organised support because the community would have picked up and supported any issues.
Fast forward to today and we just don’t see breastfeeding in the same way in our day to day lives – unsurprising given less than half of babies are receiving any breastmilk at all by six weeks, and only half of women who breastfeed ever do so in public.
In one study in Scotland, less than half of pregnant women reported having seen someone breastfed in the last 12 months. More astonishing than that, a study of teenagers in Ireland found only half had ever seen a baby breastfed in their lives.
In the absence of this everyday learning, coupled with cuts to formal support, women are turning to a different type of community in the form of online support groups and social media pages. Typically run on a voluntary basis, these groups are designed to help women with breastfeeding challenges and provide a circle of support particularly for those in “real life” communities where breastfeeding rates are very low.
Our new research shows just what a lifeline these online groups can be. In a series of interviews with mothers who had recently turned to online breastfeeding support, the findings highlighted just what a service gap these groups were plugging for new mothers.
When the local group closes down, and a mother can’t reach her overstretched health visitor fast enough to solve the pain she is experiencing, these groups are her answer. And given the global nature of some pages, and the regularity of babies waking at night, someone, somewhere, is always there, bleary-eyed or otherwise.
Online groups also provide a layer of support that face-to-face provision cannot bring. They don’t require you to be out of the door at a certain time, or even dressed. They don’t even require you to make actual conversation. You can listen to others’ stories when anything more than clicking “like” feels too much. This means that these groups play a vital role in supporting mothers who may be struggling with new motherhood, with local online groups helping mothers feel confident in building up to attending their face-to-face version (if they still exist).
The women we spoke to attributed the support they received in these groups to enabling them to continue breastfeeding. Which means that these groups are essentially propping up services that should be centrally funded. After all, although women value breastfeeding, by doing so they are benefiting the government by reducing the need for GP appointments, hospital treatment and days off work. So why, in an era where so much we do is now online, can the work of these groups not be recognised, valued and supported through funding?
The lack of funding can mean that some experience a dark side to online support. Groups that are led by those who are not trained to support breastfeeding, or do not have qualifications to manage complications, may be giving inconsistent, misleading or downright dangerous advice. The internet allows anyone to set themselves up as an expert, with no requirement that the advice that they give is accurate.
A lack of moderation by someone trained to do so can also mean that some online groups may do more harm that good. Women in our study reported online fights breaking out, polarised debates, and judgements being made (particularly against women who had decided for whatever reason that they needed to introduce formula milk).
Some level of regulation is needed to ensure women get the best possible information and support, yet many that do have these structures in place are still relying on volunteers, placing significant demands on their time and even well-being.
When breastfeeding mothers need help, women and communities will come to support them. But this major public health responsibility should not be laid in the lap of unpaid volunteers.
Amy Brown has previously received funding from the ESRC, NIHR and Public Health Wales. She is author of three books published by Pinter and Martin Ltd - 'Breastfeeding Uncovered: who really decides how we feed our babies', 'Why starting solids matters' and the 'The Positive Breastfeeding Book'. With many thanks to Sian Regan who led the research as part of her MSc in Child Public Health at Swansea University.