Sarah Brown

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• Sarah Brown

Enhancing Womens Breastfeeding Own Skills Sarah
Brown IBCLC
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Acknowledgement

• Hearing women describing their experiences was
  the starting point
• I would like to thank Bournemouth University for
  funding the DIPEx study on breastfeeding, the
  DIPEx Group at Oxford and especially the women
  who took part in the study.

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Breastfeeding

• In a European survey the United Kingdom was 16/17
  for breastfeeding continuation (EC 2004)
• Nine out of ten women who stopped breastfeeding
  in the UK within the first six months stated that
  they wanted to have breastfed for longer (Bolling
  et al 2007)
• At one week 35 of babies are exclusively
  breastfed, at six weeks it is 21, at four months
  7 and at five months 3 (Bolling et al 2007)

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Decline in Breastfeeding

• In 1957, 80 of women breastfed until midwifery
  discharge. By 1970 the breastfeeding rate had
  dropped to 17 in the same working-class
  community (Allison 1996)
• In the 1950s women started self-help groups to
  share and develop their breastfeeding knowledge
  and skills.

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Women who Breastfeed
Many mothers selected childbirth and
breastfeeding as the most important learning
experience they ever had (Belenky et al 1997)
My physical connection with my baby is
established. Ten to twelve times a day and into
the night we become one again (Steingraber 2001
p.62).
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Reflections

• Its the most natural thing in the world to
  breastfeed but this story is agonising.
• Does this reflect practice today?
• How much do health professionals know and what
  are they seeing

• How much do the supportive family and friends
  know
• Wanting to keep on going but is it possible?

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Knowing Breastfeeding

• Almost never do they know that they, too, know
  things (Friere 1970 p.45).

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Right Side/Left Side Learning
Memory for languagelogical and rational
Memory for visual imagery, prominence over
emotions
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Our Touchstone

• Knowledge about breastfeeding generated through
  scientific methods should not be disregarded . .
  . . However, such knowledge should not be
  considered as more legitimate than womens
  embodied knowledge (Dykes 2006 p.177).

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The Breastfeeding Dyad
Observation is a skill of perceptive watching, an
informed way of looking that raises awareness and
sharpens understanding
Describing what we see is the first step
Whole person learning, in which both hemispheres
of the brain engages
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Positioning

• This word was coined by women in the 1970s to
  help other women understand the optimal position
  to enable a baby to breastfeed.
• Such a word was not previously needed

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Mothering/Breastfeeding

• Mothering is communicated by words as never
  before.
• So few people say Well Done, when youre a
  mother. It makes all the difference.
• Stadlen 2004 p.23.

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Woman to Woman

• We need to recognise and support skilled
  practitioners.
• Women should be able to access appropriate
  skilled support if needed

• We need time and space to explore our own
  breastfeeding experiences
• We need time to develop and regain our
  breastfeeding knowledge and skills

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Womens Ways of Knowing

• Silence-seen but never heard
• Listening to others-listening as a way of knowing
• The inner voice the emergence of knowing
• The quest for self concepts of self

• The voice of reason knowing how
• Separated and connected knowledge searching for
  a single voice
• Integrating the knowledge the passionate knower.

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Stages of Change (WHO 2003 )
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Health Professionals

• We carry the social legacy of an experience which
  has hurt and dismayed women
• (Palmer 2004 p.87)
• Whether or not a mother will suckle her child
  depends almost entirely on the care and trouble
  the midwife takes - -
• Artificial feeding entails less trouble and
  disturbance to the midwife.
• (Berkley 1946 p.328).

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My Grandmother told me that was what she used to
do
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References

• Allison, J. 1996. Delivered at Home.
  LondonChapman Hall p.103.
• Belenky, M. Clinchy, B. Goldberger, N. Tarule, J.
  1986. Womens ways of knowing the development of
  self, voice and mind. New YorkBasic Books.
• Berkeley, C. 1946. A Handbook of Midwifery.
  LondonCassel Company p.328.
• Bolling, K. Grant, C. Hamlyn, B. Thornton, A.
  2007. Infant Feeding Survau 2005. LondonThe
  Information Centre.
• DIPEx available at http//www.dipex.org/breastfeed
  ing.
• Dykes, F. 2006. Breastfeeding in hospital.
  LondonRoutledge.
• European Commission., 2004. Promoting, protecting
  and supporting breastfeeding an action plan for
  Europe. Available fromhttp//europa.eu.int/comm.
  /health/ph_projects/2002/promotion/promotion_2002_
  18_en.htm (Accessed 8 January 2007).
• Friere, P. 1970. Pedagogy of the oppressed.
  LondonPenguin.
• Palmer, G. Feminism and breastfeeding. In
  M.Stewart, Pregnancy, Birth and maternity Care.
  London Elsevier
• Stanlen, N., 2004. What mothers do.London
  Piatkus.
• Steingraber, S.2001. Having Faith.USA Perseus
  Press.
• WHO.2003. Community-based strategies for
  breastfeeding promotion and support in developing
  countries. GenevaWHO.