by Dr Clare Macdonald, General Practitioner
Feeding is the most strenuous activity undertaken by a newborn, and the activity it will undertake most frequently. For the mother, however she is feeding her baby, feeding will be a huge part of her life for the neonatal period. Healthcare professionals should be mindful that while they are seeing the mother for a brief snapshot in time, the issue of feeding will almost certainly be amongst her most frequent thoughts. Discussions around feeding should be respectful, supportive and evidence based; assumptions should not be made, nor judgements voiced about feeding choices. The intense sense of protectiveness felt by many mothers will extend to the choices she makes for her child.
Feeding provides a time for building and developing relationships. Many women have known of their child for around 36 weeks by the time they meet them, having single-handedly provided them with a nurturing environment and all the nutrition they need during pregnancy. Breastfeeding can provide the next stage in this journey and its potential physiological and psychological benefits to the mother should not be underestimated. Access to specialist breastfeeding support should be made available to all mothers who need or want it. Regardless of feeding method, skin-to-skin contact and responsive feeding promote secure infant attachment and should be valued. Mothers who are expressing breast milk have additional challenges in preparation of equipment and storing of breast milk. Parents who are using formula will need to invest time preparing the milk, cleaning and sterilising bottles. All of these can be key parts of early parenthood and require some sense of understanding from healthcare professionals who are caring for families. Above all, parents and carers should have access to safe and impartial information about feeding their baby.
The 6-8 Week Postnatal Check
The GP 6-8 week postnatal check is an ideal opportunity to enquire about infant feeding issues. Acknowledging the time constraints of this contact, and that there is a lot to cover, discussing infant feeding is important and the attitude of the GP towards it can be key. It may be sensitive to start with an open question, for example:
How’s feeding going?
This is likely to uncover feeding method, and any current problems which can then be addressed. Infant feeding experts suggest congratulating the mother on any breastfeeding she has achieved to date even if she is no longer breastfeeding (personal communication in GPIFN Online Forum).
Breastfeeding problems can be addressed, local support groups signposted and if needed, up to date information on formula feeding given. If there is a sense that the mother has stopped breastfeeding and has regret about this, as well as assessing the impact on her mental wellbeing, relactation could be discussed (see our information on the ‘Breastfeeding‘ and ‘Maternal Mental Health‘ pages) .
NICE Guidelines CG37: Postnatal Care up to 8 Weeks after Birth Last Updated February 2015
Further Information on Issues Relating to the Mother
This sub-section of the website includes information on the following topics and their links to infant feeding: