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Fit for a prince?

Watching the Duchess of Cambridge outside The Lindo Wing made me feel very grateful and very envious in equal measure. Displaying her post partum tummy with grace put her in stark contrast to others in the public eye who seem to hide away until they are back to a size six when they appear sprawled on a yacht somewhere in a tiny bikini. Her immaculate hair, however, made me wish that I had a team available to ‘work’ on me immediately after I’d had my son, there is no doubt I needed it. Nonetheless, despite all the media coverage one burning question remains…will she or will she not be breastfeeding?

We’ve all heard the slogan ‘breast is best’. There is strong evidence to support the fact that breastfeeding prevents gastroenteritis, otitis media, necrotising enterocolitis, and LRTI in the infant along with maternal breast cancer. There is also good evidence to suggest that breastfeeding is protective against SIDS and childhood obesity as well as boosting the child’s IQ, not to mention many other conditions that breastfeeding is suspected to play a preventative part in (e.g. diabetes and leukaemia). A UNICEF study entitled ‘Preventing disease and saving resources’ suggested that a modest increase in UK breastfeeding rates could save the NHS upwards of £40 million a year through reduced GP consultations, hospital admissions, etc.

It seems like a no brainer, so why are the figures so dire? The NHS Information Centre publishes the figures from its Infant Feeding Survey every five years and the 2010 data makes for interesting reading. The proportion of babies breastfed at birth in the UK was 81% however at three months this had fallen to 17% and by six months the rate of exclusive breastfeeding was just 1%. I certainly don’t profess to have the solution to this steep drop-off but I can’t help but look at these two sets of data and feel as though we might be missing an opportunity here.

Breastfeeding is without doubt one of the hardest things I have ever done. I did not find it to be the wonderfully natural, straightforward process that I was promised in my antenatal classes, in fact it was extremely painful at times (even before the mastitis episode). That together with the uncertainty of how much baby is getting, the seemingly relentless schedule of demand feeding, not to mention the nightmarish practicalities of breastfeeding in public, all combine to make it an enormous challenge for the hormone riddled, sleep deprived new Mum.

I have spoken to many people who did not breastfeed and the reasons they give for this are many and varied but they all share one common theme - it wasn’t their choice. The baby couldn’t latch, they didn’t produce enough milk, the baby was too hungry. Surely if that percentage of babies were unable to breastfeed worldwide we would have a serious problem on our hands. Support for breastfeeding mums is undoubtedly patchy but I think women need to take some responsibility for their choices too. If you find it too hard, too painful, too uncertain, then admit that and move on. Having said that Doctors need to play their part alongside midwives and health visitors in ensuring that decision to breast or bottle feed is a well-informed, well supported one.

So the question remains: what will Katie do next?

 Dr Laura O’Loghlen is a GPST1 who lives in Cheltenham and works in Gloucestershire