Hansard

The benefits of breastfeeding are well known, but the difficulties in establishing and sustaining it for mother and baby are not widely recognised. For many new mothers, breastfeeding can feel like an unexpected battle, especially after childbirth. Mothers are overjoyed but on their knees from exhaustion. There can be a poor latch, not enough milk, too much milk, thrush, blocked milk ducts, tongue-tie, mastitis, cluster feeding or infant weight loss. Something that is supposed to be natural can feel like anything but.

A mother shared with me that the problems that she experienced as she tried to breastfeed felt like her

“first failure as a mum”.

Another mum told me that she cried every time feed times came around, as she was told by hospital staff that “Breast is best.” She felt that she was failing when her baby did not latch or feed properly.

I worry that an unintended consequence of promoting and celebrating breastfeeding is that new mothers who cannot or do not want to breastfeed can feel a sense of shame. Policy makers and health practitioners need to be sensitive to that, because feeding a baby means so much more than policy guidance and Government targets.

Most new mothers will require some level of support to successfully establish breastfeeding. That support will often come from midwives, following the baby’s birth. They can advise on attachment and position, and assess the baby for a tongue-tie. However, midwives are increasingly called away from essential time supporting infant feeding to cover acute care.

Community midwives are also very important in supporting maternal and infant physical and mental health in the crucial first days. Postnatal care is often called “the Cinderella service”—something that midwifery services strive to provide but often struggle to deliver because the capacity simply is not in place.

The Royal College of Midwives is clear that midwifery services in Scotland face some real challenges. That is why the Scottish Conservatives’ amendment emphasises the importance of staffing. Demographic and societal changes are putting increasing pressure on workforce demand, and the Scottish National Party Government is failing to step up to the challenge. Meanwhile, the retention of experienced midwifery staff continues to be an issue. Many want to leave the profession altogether because they worry that they cannot deliver the required quality of care.

The figures are striking. Globally, if almost all mothers breastfed, 823,000 infant deaths and 20,000 maternal deaths from breast cancer could be prevented. If Scotland is to realise the ambition to support women with their feeding journeys, it is vital that the resources are in place. Without those resources, the risk is that new mothers will feel the pressure to breastfeed without the interventions to succeed. That will impact not only on breastfeeding rates; it can have a damaging impact on maternal mental health.

Although midwives are a crucial source of support for mothers who want to breastfeed, peer support services have done much to help new mums as they establish breastfeeding, which can take several weeks. Breast buddies Angus is an amazing peer support group that provides weekly support sessions, local WhatsApp group chats, antenatal classes, one-to-one support by text and phone, and a private Facebook group. It provides the targeted support and community spirit that so many mothers miss during the isolation of early motherhood. It is in those initial days and weeks that it helps so much to have someone else say, “Me too” or “That’s completely normal”.

Cara Jamieson is one of the group’s wonderful volunteers who help countless mothers across Forfar, Montrose, Carnoustie, Arbroath, Brechin and Monifeith to navigate their feeding journeys. She says that the support network struggles to secure reliable funding from year to year. Like so many other third sector organisations that work alongside public services, it is desperate for long-term funding to help it to survive.

Cara has also shared her concerns about the centralisation of specialist infant feeding support services in Dundee. A new mum in Montrose who has a baby with a suspected tongue-tie must travel an hour each way to be seen at Ninewells hospital. Mothers who are recovering from caesarean sections must not drive, but accessing such specialist support by public transport takes up to two hours each way. I have regularly raised with the SNP-led Scottish Government the geographical disparities in specialist healthcare services, especially those supporting maternal mental health. Such postcode lotteries can act as a barrier to accessing care. Services must be delivered as locally as possible if we are to ensure that no mum is left behind.

There are other obstacles, too. For babies who require tongue-tie divisions, waiting list times can vary. Even a few days can feel like an eternity for parents whose baby is struggling to feed and is losing weight. Interventions to support feeding in the interim, including cycles of breastfeeding, pumping and combination bottle feeding, can be physically and emotionally exhausting for a mother who is in postpartum recovery.

Scottish Labour’s amendment is right to highlight the massive concern that

“health visits for mothers and babies are being reduced due to staffing pressures”.

That is happening in Angus, in my region, where health officials contacted parents to say that there would be no scheduled reviews between the three-month check-up and when children are aged between 13 and 15 months. There are very real concerns for the wellbeing of babies and families there, who will be left without support for a year.

We must recognise that breastfeeding is usually established in the first month to six weeks after the baby’s birth, so resources need to be available in that crucial window to support mothers who want to try it. So many mums want to persevere, but they find that they just cannot. That is why it is so interesting that, at the time of a health visitor’s first visit, when the baby is around 10 to 14 days of age, fewer than half of babies—37 per cent—were exclusively breastfed.

The drop-off rate for some mums can stem from embarrassment or anxiety about feeding in public. I share the aspiration that feeding should become normalised so that no one is worried about being judged. One mum shared with me that she was so nervous about feeding her baby in public that she sat on the floor of a nearby women’s toilet—another reason, I add, why preserving women’s spaces is so important.

Important, too, is the language used by health practitioners and by wider society. Women are not “chest feeders”—a term that I note has been incorporated into the NHS’s own guidance for managers and employees on breastfeeding in the workplace. That is wrong.

Breastfeeding can contribute to a beautiful bond between mother and baby. Its health and economic benefits are proven, but breastfeeding can be difficult, painful and exhausting. Pregnant women and new mums need to know that they are not alone, that it is not always a smooth journey and that support is in place to help them to navigate it. It is also important that we support midwives. The Scottish Government must ensure that support continues and that it meets the rising complexities in care and increased levels of demand.