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Breast really is best

“If anything else woke up every 45 minutes during the night demanding to see my wife’s breasts, you kill it.” Ryan Reynolds.

“Breastfeeding should not be attempted by fathers with hairy chests, since they can make the baby sneeze and give it wind.” Mike Harding, The Armchair Anarchist’s Almanac, 1981.

Having had a new baby in the house for the last few weeks, the Sloane household resembles a bomb site. Unwashed dishes, a full laundry basket, ironing to be done, vacuuming on the long finger, and an empty fridge. Life revolves around a hungry six-week-old monster who constantly demands the nipple, and then, when he has sucked his mother dry, guzzles an extra 4-5oz of infant formula. You’d think he was going to die from starvation the way he goes on!

With my older two children being 16 and almost 15, I had forgotten the demands that a new baby places on parents, and particularly first-time parents. Especially for breastfeeding mums, the incessant demands of their darling baby to be fed can, at times, become overwhelming.

As a GP, I am a strong promoter of breastfeeding, taking time during almost every antenatal consultation to talk about it, gently encouraging women who are either ambivalent or have already decided it’s not for them. In our societal culture, all too often the default position starts from bottle feeding and this, to me, seems completely wrong, given the incontrovertible health benefits of breastfeeding. How did we end up in a situation where ‘as nature intended’ was not simply the done thing, or that I have yet to come across a woman from the Traveller community who will even think about it?

I am not sure why Traveller women in particular don’t breastfeed, but in my experience over the years, even raising the topic generates a look of near panic. I got very excited when last year I persuaded a young Traveller woman in early pregnancy to discuss it for a couple of minutes, but I fear that as soon as she went home, the notion went right out of her head. Despite my experience, I have a deeply-held ambition as a GP — before I retire, I hope to persuade a Traveller woman to breastfeed.

When looking at international figures, Ireland unfortunately lags close to the bottom of the breastfeeding league. Interestingly, bottom of the list is the UK. Only one in 200 women in the UK, or 0.5 per cent, continue breastfeeding until their child reaches one. In the US, 27 per cent of woman are still breastfeeding at one year, with this figure at 35 per cent and 44 per cent in Norway and Mexico respectively.

At the other end of the scale are many countries in the developing world. Take, for example, Rwanda. Despite having huge rates of HIV, with approximately 100,000 women carrying the virus, (breastfeeding with HIV infection is only recommended where there is access to, and compliance with, antiretroviral therapy), 90 per cent of mums in Rwanda exclusively breastfeed and most continue for at least 18 months. Rates at 12 months are even higher in other developing countries, with Senegal (99.4 per cent), Gambia (98.7 per cent) and Malawi (98.3 per cent) topping the league table. I am sure the fact that in Rwanda, breastfeeding mums have paid daily time off work to allow them to feed acts as a major incentive to keep them breastfeeding for as long as possible. Perhaps Minister for Health Simon Harris might consider such a measure in order to increase Irish breastfeeding rates?

As a nation, I believe we need to have a pretty frank conversation with ourselves about our low rates of breastfeeding. In a recent Growing Up in Ireland study, only 56 per cent of respondents reported that their child had ever been breastfed. Contrast that with the European norm of around 90 per cent. By six months, the number of Irish mothers still exclusively breastfeeding had fallen to only 6 per cent. Perhaps when we consider that, as a State, reportedly less than €100,000 per year is spent on promoting breastfeeding, and there is just one breastfeeding co-ordinator employed on a national basis, the persistence of our cultural lack of breastfeeding is no surprise.

GPs have a big role in this national conversation, considering that virtually every pregnant woman in the country will see us on multiple occasions during her pregnancy.

Perhaps we could also look outside to try and grasp simple measures that could help. Take Turkey, for example. It is a legal requirement that all healthcare facilities, including GP surgeries, have a breastfeeding room. And what about financially incentivising breastfeeding, like in Rwanda? We could also start by disincentivising bottle feeding. In our maternity wards, pre-prepared bottles of infant formula are provided to postpartum mums. How can this be a strong promoter of breastfeeding?

As for the Sloane household, breastfeeding continues apace. Having hit the 99th centile at his six-week check, all evidence suggests our little monster is doing okay, at least in the feeding stakes. Perhaps the fact that he is getting top-ups has helped, although we were both keen initially that he was exclusively breastfed. He did, however, come perilously close to hospital admission with dehydration and hypernatraemia at the upper limit of acceptability, and bottles genuinely did get us out of a difficult situation. So they aren’t all bad. Including the fact that, as a dad, I unfortunately (or perhaps very fortunately) am unable to breastfeed, but do derive great satisfaction and bonding while bottle feeding my wee man!

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