When the ‘Baby-Friendly Initiative’ is not baby-friendly at all{2}

In Britain a quarter of all babies will never have breastmilk touch their lips.  By the time a British baby is two months old, she is more likely than not to be exclusively formula-fed.  Yet there is a conspiracy of silence around formula feeding, that means most of the mothers of these babies will never receive critical information from the people they trust – nurses, midwives and health visitors, about how best to bottle-feed.

They’re not taught by a trusted health professional the best bottle-feeding position to reduce the chance of ear infection, nor  are they encouraged to bottle-feed skin-to-skin to promote bonding, nor are they told it’s important they throw away all unfinished bottles after an hour.

For the most part, they get basic information on how to make up a bottle from the side of a tin, and pick up other tips through crowdsourcing on the internet.  Because those are really great ways to learn about one of the most important things you’ll be doing for your baby in the first few months of her life.

This state of affairs is shameful, and negligent, and a large part of the blame must go to Unicef and its Baby-Friendly Initiative.

The Baby-Friendly Initiative is Unicef’s hospital breastfeeding program.  Its aim is to make hospitals more breastfeeding-friendly places – an admirable goal.  It does this by giving accreditation to hospitals and other health services which implement its policies.  At the moment, around half of the UK’s maternity services and health visiting services are certified ‘Baby-Friendly’.

Unfortunately, this well-intentioned effort to make institutions more breastfeeding friendly has led to bottle-feeding mothers being ignored, their babies missing out on crucial health information, and promoted feelings of guilt and inadequacy because of its ‘breastfeed at all costs’ mentality.

Last year the BFI changed some of its guidelines to supposedly better support bottle-feeding parents.

This week, the lip-service nature of this change has been on full display at the University of Bradford.

The story goes back a couple of months when myself and my co-author of Guilt-Free Bottle-Feeding, Dr Sasha Howard, were invited to take part in a debate about bottle-feeding by the University of Bradford’s Midwifery Society.

Fantastic!  We were over the moon.  Student midwives who actually want to learn more about how they can help the 25% of mothers who will never breastfeed in hospital!

This was a bigger deal than you might think – education about bottle-feeding in university midwifery courses is patchy or non-existent (a result of that ole’ conspiracy of silence again), leaving newly-minted midwives largely ignorant about formula and formula-feeding.

So, Sasha and the lovely student representative were going back and forth about logistics, when suddenly, she received this email:

“Unfortunately we have had to put the debate on hold as the university won’t support the event. This is due to the university going through accreditation for BFI and being unable to show support for anything to do with artificial feeding.”

Yes, you read that right – in order to gain ‘baby-friendly’ accreditation, simply talking about the way the majority of British babies is fed is taboo.

It beggars belief and logic, and I would suggest the ethics of a caring profession.

Any mother bottle-feeding mother who has felt let down by health professionals (and that’s most of them) should feel angry that Unicef’s BFI is encouraging a deliberate denial of information to young health professionals who want that knowledge, because they know they are going to need it in order to give the best care they can, to the most women they can.

How is it baby-friendly to leave mothers with little to no knowledge about how they will, more likely than not, be feeding their baby in two months time?   This ‘promotion’ of breastfeeding through denying the very existence of formula has to stop.  It’s not ‘baby-friendly’, it hurts babies and their mothers.

And the crazy thing is, the BFI doesn’t even really make that much of a difference to long-term breastfeeding rates.  It has increased the initial uptake of breastfeeding, but a large study of low income British mums found women who gave birth at a BFI-accreditated hospital were no more likely to be breastfeeding at one month than women who had given birth in an unaccredited hospital.

In Australia, there are far fewer BFI-accredited hospitals, but more women breastfeed, and for longer.  There are many cultural reasons for this, but it shows that the big stick of the BFI is not the answer to improving breastfeeding rates.

If the Baby-Friendly Initiative were really baby-friendly, it would recognise that the best thing it can do is support all babies’ mothers, regardless of how they feed their babies.  The conspiracy of silence around formula, and the risk that lack of information creates to babies’ health, has to stop