"Generally good care overall but some significant…"

Our experience of the antenatal, maternity and postnatal units at Frimley was generally positive - however, there are some significant areas of concern that we would like to feedback on regarding our experience with an early term infant induction birth.

1) Re Information given regarding recommendation of induction at term due to sga. No information was provided on the known risk that birth at term can lead to significant challenges establishing bf and likely jaundice and readmission (as did indeed happen). Had we been given this information ahead of induction we would have prepared for the potential scenario (for example, by bringing a breast pump into hospital). There needs to be fuller and more honest conversations with parents regarding the risks of induction at term, or at least a readiness to have such conversations.

2) Re Lack of awareness and care in postnatal for early term infants struggling with Bf. We received some Bf support, but not enough - priority should be given to early term infants on the postnatal ward, who are falling through the cracks. This would save resources in the long term by avoiding tcu readmissions due to weight loss and jaundice when Bf does not establish. Ideally mothers of late preterm and early term babies should be offered access to breast pumps in the postnatal ward to allow for double pumping between feeds.

3) More specialist lactation support should be given in Tcu for breastfeeding. Offering formula by bottle does not do this, as a baby will take the bottle more easily, which fails to promote mothers' own supply by encouraging time at the breast. We were not offered cup or syringe feeding for our 5 day old, and new parents cannot be expected to ask for this. We were the only family on the ward, so it was not busy.

In conclusion, all midwives, doctors, consultants and paediatricians must be trained in lactation, or at least provided with information on signposting parents to professional Ibclc support. Failure to do so only creates problems and costs down the line. We were never able to fully establish Bf, and what we were able to establish we do not attribute to the care we received in either antenatal, maternity or postnatal, where Bf is not sufficiently supported.