Don't panic

You have to assume health professionals truly don't realise the impact on parents of being told that breastfeeding is failing to meet their baby's needs. There is 100% focus on getting more milk into the baby - pumping, topping-up, introducing formula.

It seems goals around exclusive breastfeeding are ignored or dismissed in so many cases. There is no space for grief, no suggestion of speaking to a breastfeeding counsellor to work through those emotions and rarely any referral to an IBCLC to diagnose why the baby isn't effectively removing milk from the breast. The default blame is the mother has insufficient supply.

A baby who has not met anticipated weight gain on one occasion is not cause for panic. There are many reasons why this might be the case and these should all be explored. Rather than pumping and topping up, skilled assistance to improve the baby's intake with increased feeding and better attachment should be suggested. A follow-up weighing session scheduled within a week will lessen anxiety. Sending breastfeeding parents home with vague suggestions and instructions to top up after every feed and not offering to check before the next scheduled visit in two months condemns the baby to mixed feeding.

When health professionals don't follow their own guidelines, parents lose faith in their advice. When parents feel unsupported in their goals to meet recommendations to exclusively breastfeed for six months, they feel anger and frustration.

"Growth reference charts are monitoring or screening tools, not diagnostic instruments.

The pattern of the infant's growth, in particular whether the pattern crosses the centile channels, as well as the position on the growth chart, are used in conjunction with clinical assessment in determining if there is a problem"

AS A RESULT, A DECISION THAT MAY AFFECT THE INFANT'S FEEDING PATTERN SHOULD NEVER BE BASED ON GROWTH MONITORING ALONE."

Infant Feeding Guidelines Information for health workers