Gathering information, making the decision & preparing for breastfeeding
During pregnancy, the women we spoke to gathered information about breastfeeding from a wide variety of sources and had a lot to say about the quality and practical use of that information. They spoke to family and friends about birth and breastfeeding, they read leaflets and books and watched videos about the subject and some of them searched the internet for suitable websites. The women found a lot of these sources very helpful. However, some women felt that too much information could be a “bad thing”. One woman read so much that she felt confused by all the different advice while another thought that written information made breastfeeding sound “incredibly complicated”.
- Age at interview:
- At the time of interview, this 34 year old, White British woman was breastfeeding her 7 month old son. Previously a mortgage administrator, now stay-at-home mum, she was married to an energy assessor.
I was very lucky when I was first pregnant I stumbled upon a parenting website with an enormous forum, and there's some fantastic advice on that for breastfeeding and I was reading that maybe the last four or six weeks before the baby was due, and that gave me a good idea of some of the things that could go wrong and some of the things that might happen during the early days.
So you just happened to put something in Google and come up with that site?
It was when I was first pregnant, so I started posting on the, the forum they have a thread for each month that the babies are due in and I, I started posting on that, I think I was like ten weeks pregnant, so everybody all followed each other through the, through the processes but there's a whole wealth of other information on that site as well.
And you could share your experiences with other women'
'and vice versa?
Was there any technical expertise or help on that?
Well that's one thing that I felt that I really needed to be careful of because it was just people posting, you know, everyday people, some who thought they knew it but didn't, but there are, now that I've increased my knowledge about breastfeeding I know that there are some people on there who talk brilliant advice, really good sense, and very sensible stuff, but, there's some rubbish on it as well, so it's knowing how to sift through it and take, take what you want from it.
So how do you do that?
Well I just did it by reading and reading as much as I could, mostly on the internet but reading websites from breastfeeding support groups who, you know, are, know what they're talking about, like La Leche League and there's another website called KellyMom.com, I don't know if you.
Is that a Scottish website?
No I think it's American.
KellyMom.com, and once you start looking at these websites you see these recurring themes coming up and coming up and coming up, you go well if all these breastfeeding experts are saying that this must be how it is, so from that I could then sift through the, the posts on the forum and, and work out what was what.
Okay so that was one criteria for reputability?
Anything else that you look at in a website?
I just had to bear in mind that if people were posting what they said they had experienced that's what they've experienced you can't, you can't argue with that at all, but it's when people are stating facts, just to me if something didn't sound right I would go off myself, and would read up on one of these other websites, that I knew was giving the correct information.
Most women went to antenatal classes and specific breastfeeding sessions offered by a variety of providers, such as the government or NHS (local hospital, Primary Care Trust, or Sure Start), voluntary groups (National Childbirth Trust, La Leche League) and private providers (independent midwives, obstetrics/gynaecology and lactation consultants, breast pump manufacturers). Opinions of the classes covered the whole range from “very, very good” to “limited”.
- Age at interview:
- At the time of interview, this 37 year old, White British woman was breastfeeding her 11 month old son. A pharmacist/university lecturer, she was married to a pharmacist.
I went to a series of ante-natal classes with the National Childbirth Trust and again they are very big proponents of breastfeeding and they'd talk to us about, you know, the importance of trying to get the baby onto the breast as soon as possible, even to the mums who knew they were going to have caesareans because they were particularly concerned.
What else did you learn at those classes in terms of breastfeeding? Was it just talking? Did you have demonstrations?
We did actually have a demonstration, one of the classes was held at the teacher's house, every other class was held at a GP's surgery and she had a video about breastfeeding, so it was very much things about positioning the baby, you know, so that, you know they're sort of looking up at the nipple and so it did give you some confidence, it just went through the basics. She also had a baby doll there and so, you know, she let us all have a go at, you know, just trying to get the baby into the right position, because she was trying to dispel one of the myths that people said about not having enough milk and was saying that often it's because the positioning is wrong, you know, it's, it would very, very rarely be that you don't have enough milk, it's just, you know, having yourself and baby in a very comfortable position.
- Age at interview:
- At the time of interview, this 19 year old, White British woman was breastfeeding her 4 week old daughter. An activities coordinator (elderly), she was living with her partner (mechanic) and extended family.
Well, I wanted to bottle feed before I knew how to breastfeed I didn't know about anything about breastfeeding really, it wasn't until my friend then took me to Bosom Buddies at [local] Sure Start that the people there slowly introduced me to it I started doing workshops on breastfeeding and speaking to other parents about their breastfeeding and things like that.
So while you were pregnant you had a friend'
'who took you to Bosom Buddies?
Can you tell me what Bosom Buddies is?
It's at a Sure Start Centre which is a local centre for mums-to-be and things like that. they do Bumps and Babies, things for children and it just generally to help the local community mums, single mums, working mums, everything like that. They do it every Thursday, they have the parents that are breastfeeding or want to breastfeed go there for a couple of hours, have a chat, cup of coffee, other mums there, children are there, it's nice, it is nice.
So prior to that you wanted to bottle feed your baby?
Yeah but well [laughs] I didn't really think anything of breastfeeding I didn't think, you know that was something I wanted to do, I didn't know anything about it really.
So you've had no experience with it, you'd not seen sisters or aunts or friends?
No there's not any of my family that have breastfeeding, that have been breast, have breastfed.
And none of your friends?
No, no apart from this one, yeah.
So how did that change your mind?
I, well, I got to weigh up the pros and cons of it really, I got to find out, you know, that breastfeeding's better for the baby and better for you as well you get to lose the weight that you do really quickly, and you know it's, much better because it's on the go if you [laughs] see what I mean, I don't have to worry about making up bottles and things, which I am I'm quite a, got quite a hectic life I'm afraid so it's just up and go, I don't have to worry about making up bottles and things, it's all there [laughs].
And you saw other mothers there feeding their babies?
Yeah, yeah everyone was quite open, it was mainly no there were women, all women, men are invited but I think that, you know, because women are there quite openly feeding that they don't tend to come.
How did you feel about that when you first saw it?
When I first saw it I was a bit, I don't know, I didn't think they should be doing it in front of me sort of thing, it's quite openly, you know, they would quite openly just feed their baby. But then after a while and going there every Thursday like I was it just become natural to me, you know, that they were feeding their babies and it's natural so there's nothing to be afraid of, if you see what I mean?
So at first it was off putting'
'but you got used to it?
Yeah I got used to it yeah.
How many of those sessions do you think you did before you got to the birth?
I started going when I was about twenty weeks I think, it may hav
- Age at interview:
- This 36 year old, White British woman was breastfeeding her 19 month old daughter. She also had sons aged 9 & 7 and a 4 year old daughter, all breastfed. A nanny prior to having her own children, she was married to a self-employed plumber.
I was really lucky I had a friend who had her daughter the year before I had my son and she found out about La Leche League from somebody that she worked for and she went to meetings when she was pregnant with her daughter and then when I became pregnant with my son she invited me to go along to meetings with her, so it's her that I thank really for introducing me to La Leche League.
Did you find that useful?
Very, very I think, I do often wonder whether I would have had problems with breastfeeding if I hadn't gone to La Leche League meetings. I think I probably attended three meetings before I had my son and I can't really remember a lot about them, but I think what I gained from them was that breastfeeding shouldn't hurt and that all the previous information that I'd kind of gathered in my head from other mums and friends that had breastfed, was that breastfeeding hurts and it's painful and you have to go through all the problems of sore nipples, but I think the one thing I gained from La Leche League meetings before I had my son was that it shouldn't hurt, breastfeeding doesn't have to hurt, you haven't got to harden your nipples off to breastfeed and that's my ultimate thing I think I got from those meetings, not only that I also had the support of my friend who had breastfed and I knew that if I was having problems that she was there and also that I'd got the information from the Leaders that I met when I went to the meetings, so yeah that's that was my experience with him.
Did you go to any antenatal classes or anything like that?
I did, I went to some at my local hospital. I didn't go to my local ones and I went to some at my local hospital and we had a breastfeeding video. I remember it being a breastfeeding video and I remember not being impressed at all with what they did about breastfeeding because I'd been to my La Leche League meeting.
So what was it about this breastfeeding video at the antenatal class that you think you didn't like?
I think it was, it's a long time ago so it's difficult to remember, but I vaguely remember it being very prescriptive about this is what you should do and, and lots of information about how good it was to breastfeed but not actually any of the real realities of breastfeeding. What to expect when you have a baby because I think that is more important. You can't show anyone how to breastfeed or tell anyone how to breastfeed and they weren't seeing it from the perspective of the baby, and what the baby expects when it's born and other things as well, how the birth, because breastfeeding can be influenced by the kind of birth that you have as well and I don't remember it being, it was just very prescriptive about this is what you do, and I, I vaguely remember it being kind of coupled with some talk about bottle feeding as well and maybe a video, then something to do with bottle feeding which I don't think they are allowed to do now I think that's probably not allowed, you're not allowed to promote bottle feeding at all.
So this was in contrast to what you were getting from the La Leche League meetings?
Yeah, see my first experience of a La Leche League meeting, I can remember there was one mum there who actually went to my antenatal classes as well, she was there. There was a mum who'd got a baby who was probably about three or four months old and just seeing her, she was responding to her babies needs every time her baby needed her and, her baby didn't cry to be fed, she just, the baby would just fidget and then the mum would feed her and I think just seeing mums, seeing mums happy, babies happy, mums happy.
Many described the information that they gained from antenatal classes as theoretical rather than practical. Many said that they were too focused on the forthcoming birth to think about breastfeeding. Some pregnant women valued informal opportunities to chat and learn about breastfeeding from breastfeeding mothers whom they met at groups. Some women believed that there was no substitute for experience in learning how to breastfeed. Some said that they needed the breastfeeding information more after the baby was born.
- Age at interview:
- At the time of interview, this 33 year old, White British woman was breastfeeding her 6 month old daughter. She also had a 3 year old daughter whom she had breastfed. She was a married, full-time mum.
While I was pregnant, there was a little bit of help from the antenatal classes it was really a series of, I just did four classes, so they did a little section on breastfeeding and I think they put, I think they showed us a video clip of someone. Again I think I just, seeing the video clip I think I just assumed that it would come very, very naturally and didn't really, as they wouldn't, they wouldn't, they didn't really highlight the fact that a lot of people get soreness and that it's to do with the position and, again until you've actually experienced it you don't really sort of fully comprehend what they're talking about. And also I think in the ante-natal classes they were so focused towards the actual birth and I think my mind is probably more thinking about labour and the hospital and that side of things that, yeah I, I didn't really, probably give enough thought to breastfeeding.
- Age at interview:
- At the time of interview, this 38 year old woman was breastfeeding her 9 month old daughter.
What did you know about breastfeeding at that stage?
It was just a, a theory in a book to be quite honest, I hadn't really given it much thought we were encouraged when I went to the antenatal classes to breastfeed. Oh I went to one of the workshops on breastfeeding as well where, we had a doll and we mimicked the doll breastfeeding and it was nothing like I expected it to be because I mean a doll and a natural baby are very different. But it was quite good because they did things, tried to give examples like, the sucking motion by using balloons and things like that and also told us about breast pumps. So it was a lot more real than the theory but I was probably still only around five months pregnant with [daughter] so it didn't seem, it's, it, thank you, it still didn't seem as if it still didn't seem as if, it was that real to me until she was born.
Who ran those antenatal classes?
I think they were run by midwives'
'but I can't remember their names.
You don't know whether it was an NHS Trust or the hospital or?
It was the hospital.
It was the hospital yeah, and they also, they also had specialist midwives who came in to do the breastfeeding classes.
In fact one woman she said that, I mean her daughter was nine, and she said if she could she would've continued to breastfeed because she loved it so much, she was, they were basically people who were very, very enthusiastic about breastfeeding and that enthusiasm carries through to all of the people there, it was a really big class as well they were around, it must have been seventy or eighty of us, it was a big class.
Several women found the advice and information they got from antenatal and other classes not that useful when faced with breastfeeding difficulties. Lizzie said that the class she attended didn’t discuss what to do if you have very low milk supply. Jessy found that the courses she attended provided no information about medical conditions or medications that could affect breastfeeding. (See ‘When breastfeeding doesn’t work out’ and ‘Medical conditions that could affect breastfeeding’).
- Age at interview:
- On maternity leave, works full-time for an international charity organisation. Married with a one eight-month-old baby son.
I think the, before I had my baby, I went to the, I think they’re called “parenting skills classes” at the hospital. And I went to the one on breastfeeding. And actually what was quite interesting at that point is that there was the implication that you would kind of, as soon as you had that baby, you would be gushing buckets of milk. And it was sort of, you know, you wouldn’t be able to hold back the tide. And it was, and the focus of these parenting classes were more around, “Should you breastfeed or not?” rather than, “Actually, this is how you do it.” So yeah, but the implication was that milk would just come and you’ve actually almost got to stop it, you know. There was sort of, advise you on nipple pads and, actually, if you need to express because there’s too much. And so I think in my head I was expecting there to be loads - of milk. And then in the hospital there just didn’t seem to be anything coming out.
Some women did not attend antenatal classes because they either didn't get around to it, hadn't planned to breastfeed specifically or the baby arrived before they had begun or completed the classes. Others talked about barriers to attendance such as language difficulties, the lack of classes in their locality or their husband's/partner's refusal to attend.
- Age at interview:
- At the time of interview, this 24 year old, Pakistani woman was breastfeeding her 18 month old son. A housewife, she was married to a social worker.
So we were talking about when you were pregnant and how much you knew, did you go to ante-natal classes?
I came from Pakistan when I was pregnant I was very new here, and I couldn't go, I had got a leaflet and I couldn't understand, I couldn't see the street the names and I was very like I can see the I hadn't confidence to go outside, that's why I didn't go.
Did you speak English at that stage?
Yeah I learned from Pakistan but here accent is very different from Pakistan, very different and I've taken two years to learn here the accent, talking with people, my husband, my in-laws, brothers and sisters.
Right, so you didn't attend antenatal classes did you do any reading?
Yeah reading, yeah, books my health visitor gave me a lot of books, leaflets, I been reading all every week, like after two or three days when I was pregnant.
Right and what language were those in?
In English? You were reading in English?
Did you get any material in your own languages?
Materials? No, I had a no need of it.
You didn't need it?
Do you know if there are breastfeeding information leaflets and things available in Urdu for example?
I know, I know but, I wanted to read in English yeah, 'cause I.
Yeah good practice I wanted to read in English and 'cause for knowledge or for my child or for, what d'you call it? For in, living in England, 'cause here's everywhere English. You can read the books, a lot of books they are very helpful, very helpful, every experience I had I read before doing my experience, I read in books and leaflets and I been watching videos.
Oh yeah, yeah?
Yeah I've got by my health visitor about breastfeeding and that was, that's why I was very excited, I couldn't wait to give my breastfeed to my son.
So you were looking forward to it you were very excited about it?
Yeah, very much, yeah very excited, I was very excited.
Yeah and it's lived up to expectations?
You've enjoyed it?
The decision to breastfeed was made by different women at different points' before pregnancy, during pregnancy or after the birth. Several women said that it seemed like the “natural” way to feed a baby but some felt uncomfortable about the idea at first. Most women were asked by their health professionals how they planned to feed their babies and that was recorded in their medical notes. Several of the women decided to breastfeed because their religion recommended it.
- Age at interview:
- At the time of interview, this 25 year old, British Bangladeshi woman was breastfeeding her 14 month old son. A Breastfeeding Support Worker, she was married.
In, how you have the Holy Bible we've got a Koran and it says in the Koran, because breastfeeding is natural, Mum has all the antibodies, all the vitamins, all the protection that you can give to a baby especially when the baby just come, come to this world where there so many illnesses and so many disease and so many bacteria's about. So baby to suck on you and, for baby to take that benefit from you is wonderful thing. It's says specifically in our Koran to breastfeed your child for up to two years.
Which is very, very important, because in our religion we for, we're so, not we're supposed to it's, it's a guidance of what to do in life, how to go about it and it does say that to breastfeed, to suckle your, suckle your baby for two years. If you can't do that that's absolutely fine, but we recommend you do, it's very, very highly recommended. And obviously when I was pregnant I had so many books, I borrowed so many books from my colleagues, from the library, I got on the internet, breastfeeding networking to do a lot of research.
What language were those books and things in?
Oh English, English and I read Bengali literature also but which I've read them to also myself but I think.
Was there much available in Bengali?
There is, there is especially if you look at it in Islamic, Islamically because Is-Islam says to breastfeed your child that's why he has got be, there, I've got a this book it's called the 'Ideal Muslim Woman' and it says there like step by step ante-natally, post-natally, breastfeeding, make sure you have a good diet, step by step everything and it says how important it is benefit for the baby and for the mother.
As well as ensuring that they were well informed in preparation for breastfeeding some women purchased bras, breast pads, nipple creams and breast pumps while others said that there was no need to purchase anything except perhaps for bras and breast pads (see 'Advice for pregnant women and new mothers'). Some women attempted to express colostrum prior to the birth, usually as reassurance that they would have milk afterwards. One woman spoke of moisturising and stretching her nipples prior to birth in an attempt to strengthen them and prevent sore nipples*. Others ensured that their partners knew of their desire to breastfeed in case there were complications during the birth. One woman used pregnancy yoga and swimming to help her withdraw from using drugs by the time that her baby was born.
- Age at interview:
- At the time of interview, this 29 year old, White British woman was breastfeeding her 14 week old son. A Retail Assistant, she was married to a Military Policeman (SIB).
I don't know because he was quite a, because I got quite a lot of help actually in my antenatal class from, and not just from the, the lady that run it but from the mothers who was breastfeeding at, you know, for their other children that they'd breastfed, so I was quite fortunate in that respect, the fact that I'd got quite lot of advice beforehand and also I've read a lot of the breastfeeding leaflets that you get given. In fact to a point where before he was born I was dreaming I was breastfeeding, and only on the last sort of few dreams of me breastfeeding I would actually leak in, in the bed, and I would, my breasts would leak whilst I was dreaming [laughs] so I found that really quite odd, but it was like my brain was, obviously taking in all the leaflets that I'd read and all the information I'd been given and was processing into like a training programme in my mind, it was really quite special [laughs]. So I was quite fortunate in that respect, because I would literally wake up thinking 'have I had my baby? No, no it's still inside me' and my pillow, my bed would be all wet where my boobs were been [laughs], so they would just leak just to reinforce the fact that it could happen [laughs] I think [laughs], quite strange.
Footnote' For discussion about leaking see 'Talking about' Getting started with breastfeeding' Early experiences' Sensation of breastfeeding'.
* Footnote: Nipple preparation used to be recommended but recent research has shown it to be unnecessary and ineffective.
Last updated September 2015.