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"Breastfeeding support"

About: Royal Devon & Exeter Hospital (Wonford) / Maternity

(as a parent/guardian),

I'd like to start by saying that the care we received at the RD&E (and from Maternity Services overall, including from the community midwives) was brilliant. Everyone was very nice, and we felt supported at all times.

However, there was one area that I think should be mentioned, as for me it is symptomatic of the algorithmic dumbing-down of healthcare delivery and professional services in general.

It was clear to me that the midwives we spoke to were institutionally blinkered by a top-down obsession with breastfeeding that goes far beyond the breast is best advice and crosses over into something that in my view can and does cause harm. I want to pick up on this point in particular because I have noticed this in many areas of modern life, including in other areas of the NHS, where experienced professionals are prevented from giving the best advice by corporate policies that are presumably an attempt to counteract a lack of training/experience in more junior members of staff.

In our case, when our daughter was not gaining weight fast enough, the focus was exclusively on my partner's breastfeeding technique, which while not perfect was certainly good enough. Our daughter was latching fine, and getting fed, yet we had several sessions where her breastfeeding technique was analysed. If we had all instead stopped for a moment and looked at the root cause of her weight loss, we would have realised that my attempts at cup feeding (the only other feeding method endorsed by the midwives) were failing, and that since my partner was possibly not producing enough milk yet we should be topping up with bottle-fed formula.

We eventually worked out how to deal with the situation ourselves, and helped by a brilliant and experienced midwife (whom I won't name for obvious reasons) who was prepared to take a more pragmatic approach and help us not worry about getting it wrong, we quickly got back on track.

This has been a common theme in the discussions we've had since becoming parents, from experienced midwives about to give excellent advice that begins with - I shouldn't tell you this but..., to the story of a new parent so focussed on following the advice that they wouldn't allow their partner to bottle feed, resulting in a lower quality of life for them when their baby now refuses the bottle, along with missed bonding opportunities for their partner.

I fully appreciate that all situations are different - some babies will experience nipple confusion, some won't, and some women will be able to breastfeed exclusively, and some won't - but that just makes my point stronger: You must allow experienced midwives to make their own decisions, based on their professional qualifications and experience. By all means provide guidelines for those with less experience, but they should be able to access the experience of their more senior colleagues rather than be told what to do in this clearly unsuitable one-size-fits-all approach.

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Responses

Response from Joanna Black, Transformation Midwife (Eastern Services), Maternity Services (Eastern Services), Royal Devon Healthcare University NHS Foundation Trust 3 weeks ago
Joanna Black
Transformation Midwife (Eastern Services), Maternity Services (Eastern Services),
Royal Devon Healthcare University NHS Foundation Trust
Submitted on 09/06/2025 at 09:53
Published on Care Opinion at 09:53


picture of Joanna Black

Dear rhinofj78

Thank you for your time sharing this feedback and for your kind words about the care you received from our maternity services. We’re pleased to hear you felt well supported overall. We have shared your comments with our Infant Feeding Team for their review and reflection.

Kind regards,

Jo

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Response from Lauren Ishag, Infant Feeding Specialist Midwife, Maternity, Royal Devon University Healthcare NHS Foundation Trust 3 weeks ago
We have made a change
Lauren Ishag
Infant Feeding Specialist Midwife, Maternity,
Royal Devon University Healthcare NHS Foundation Trust
Submitted on 09/06/2025 at 13:55
Published on Care Opinion at 13:58


Dear rhinofj78,

Congratulations on the birth of your daughter, it's wonderful to hear that your experience, overall, was very positive.

Please accept my apology for my delayed response, I have been on annual leave.

Thank you for sharing your story. I am however sorry to hear that you felt our policies prevented your family from receiving the right support in feeding your baby.

All of our policies are written with the intention of supporting maternal and child health, with a focus on empowering parents to make informed choices. We do not support the 'breast is best' narrative but rather we aim to provide the right support, at the right time, to help families make the choices that are right for them.

To enable this, we have recently increased our level of infant feeding training for staff, from a full day every five years to a full day every three years. We have also introduced an annual update session for all midwives and maternity support workers. This year's session focuses on our weight loss policy, with the aim to ensure consistent, evidence-based practice across our service, as well as how to escalate if things are not improving. This training includes the introduction of formula when required, or when desired by the family.

We are also offering one to one training for our new staff members on alternative feeding methods (which includes cup feeding and bottle feeding, amongst other methods) as well as group sessions on this topic at staff meetings. These sessions include discussions about personalised care and informed choice for parents, as well as the application of professional judgement. This training does not endeavour to overrule the expertise of our wonderful midwives, but we do need to ensure that our staff all practice to the same high standard.

In order to better understand whether we are meeting our goals of personalised care, we are re-introducing an audit system which includes interviewing mothers to hear their experiences of feeding support, and we are in the process of creating a Trust-wide feedback system for feeding support so we can improve further.

I recognise that you felt you experienced a 'one-size-fits-all' approach which is not what we strive to provide. I am pleased however that staff took the time to watch your partner breastfeed, whilst you have expressed you do not feel this was the issue in your case, for approximately 80- 90% of breastfeeding mothers their issue comes down to feeding technique so this represents good practice. I cannot comment on the story you shared of another baby bottle refusing.

You are very welcome to contact me if you wish to discuss your experience further, my email is lauren.ishag@nhs.net or my number is 01392 406663 and I am the Infant Feeding Specialist Midwife for the RDUH. I would be very pleased to share your feedback with the midwife you praised, as we always celebrate good practice, however there is no need to provide her name if you do not wish to.

Thank you again for your feedback.

Kind regards,

Lauren

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