Breastfeeding in the UK and the USA

Before I moved back to the UK I was excited that there is such a great maternity leave allowance in the UK and I imagined a breastfeeding heaven of sorts, women being able to breastfeed for as long as they wanted because they had no need to go back to work at 12 weeks or less like so many women have to in the US.  In the United States full time workers are entitled to a maximum of 12 weeks leave for a number of reasons (including the birth or adoption of a child).  There is no pay involved, and the company has to hold your position for up to twelve weeks if you have completed a minimum number of hours at your job in the last twelve months.  I was lucky that when I gave birth to William in the US I had accrued enough annual leave so that I did not have to lose any pay during my twelve weeks leave.

There are a number of benefits for going back to work so quickly after the birth of a child and I'll go through them in a minute, but I was definitely concerned that I wouldn't be ready, and that I wouldn't have established our breastfeeding relationship  enough to withstand the time I would be spending at work away from William.  Many women that I met through my work were not in the same position as me and had to return to work as early as two weeks after birth due to financial reasons or because they had not been working at thier job for long enough to request any more time away.

I definitely belief that parents should have the option to be able to build a relationship with their newborn, and that a Mother should have the opportunity to build a strong breastfeeding relationship and be given the time to establish a plentiful milk supply, but after seeing the differences in both countries it's hard to say exactly who has the correct policy.

Breastfeeding in the US

From the time you first visit a maternity store or visit your physician to start your maternity care you are bombarded with formula advertising.  The formula companies even provide a breastfeeding kit for the Doctors to give to everyone who is pregnant, and many companies will sell your details to formula companies so that a couple of cans of formula are waiting on your doorstep when you get home from the hospital, along with the free diaper bag from the hospital containing ready to use formula and pre-sterilised teats.

If you get past the first few days and the bombardment of coupons from the three biggest formula companies (in the US) coming through your door, then there were a lot of places to go for help in the State that I lived in.  Many hospitals, although none of them Baby Friendly, had lots of resources including lactation consultants on the wards and breastfeeding support groups for out patients.  Most hospitals rent out pumps, and there are lots of private practise lactation consultants for those that can afford them.  The WIC program also provides a lot of services for those on a lower income, support groups, free lactation consultant consultations, free pumps and even free nursing bras.  You may even be assigned to a peer supporter who will call you periodically to see how you are doing and then in turn you can call her with any questions you might have.

Going back to work after having a baby will probably be one of the toughest things you will ever have to do, but I think that there is more of a pumping culture in the US because so many women go back to work so soon and choose to provide their babies with breast milk.  Daycare is much more flexible and open much longer hours.  It costs a lot more to have a baby in daycare, so working full time is a must to take full advantage of all the hours you are paying for anyway.  When I returned to work I worked four days, each of ten hours.  I paid for a full time spot which William did not use on Mondays, but he spent a total of 44 hours a week at the centre.  I fed him on drop off, pick up and during my lunch break.  I was welcomed into the centre to nurse at any time, and staff were happy to wait for me if I told them I was on my way to feed.  Spending so much time at the daycare centre also allowed me to get to know the staff really well and learn all the gossip.

I said before that there is more of a pumping culture in the US, and this is shown in a number of ways, one being the new federal guidelines that make sure that employes are entitled to take unpaid breaks in a suitable location to pump their milk regularly.  Many large companies have lactation programs that provide all sorts of benefits from merely a space to pump to a full service of lactation consultant home visits and free pumps to use at work.  I have heard a rumour that the Pentagon has two lactation rooms.  You will also find a pump more easily in the US, available from many chain stores, and as I mentioned before many hospitals and stores rent pumps.  On a visit to the UK in 2008 my pump broke and I found it almost impossible to find a replacement on the high street, I had to call the company and ask for one to be shipped out.  Many high street stores only carry manual or single electric pumps, or those manufactured by bottle companies (ones that I wouldn't consider the best choice).  I've come to think that this is becasue there is less of a need, less of a pump culture.

So, let me summarize.  Women return to work much sooner in the US and pumping is more widespread I believe because of this.  Pumps are more readily available to buy and rent, and the workplace is required to provide adequate space and time for pumping or feeding throughout the day.

Breastfeeding in the UK

I know a little less about breastfeeding and working in the UK, mostly because I was pregnant when I moved here and didn't think anyone would hire me in such a state.  I would not have been eligible for paid maternity leave, and childcare for two children would have been very difficult to justify.  I have spent a lot of time in the company of women who work and who have taken time off after having a baby.  I've made the following observations -

1. women start their maternity leave really early, I think because they get so long there is no real need in their eyes to work up to the final moment saving precious leave to spend every minute with the new baby.  I've known quite a few women in the US start labour while at work because they needed to save as much time as possible to spend with the baby, so from that point of view it does seem a little wasteful.
2. I thought that a longer maternity leave would mean that more women would breastfeed longer, but that hasn't been the case as far as I can tell.  The majority of women that I have met so far consider three months as the time to stop, six months at the most.  I guess I had this romantic idea that if a woman was given the time to breastfeed then she would do it as long as she possibly could.
3. When talking to women about their return to work, I have yet to meet one that has even considered pumping, and when I ask them, they say that there is no way that their employer would ever allow it and there would be no point in asking.  It does bother me that they haven't even tried, but I do wonder if people went back to work earlier whether pumping would seem more of a priority.
4. Access to breastfeeding help can really depend on where you live and how much money you have.  Being able to afford an NCT antenatal class in my area can really open doors for you because you do get "assigned" a breastfeeding counselor who will, in some cases even come to your home to help after the baby is born, but at a minimum will answer the phone if you call for help.  The NCT also provides hospital grade pumps for hire.  We are lucky that more and more support groups are being made available and that some Surestart centres have decided to loan pumps at a reduced rate.  We even have a local tongue-tie service which is something of a breakthrough in my opinion.

I guess I am trying to determine in my mind whether extended maternity leave in the UK has benefited babies by leading to higher rates of breastfeeding and longer durations of breastfeeding.  I don't have any statistics to go by, but in my observations in my own local area I'm not seeing the breastfeeding Utopia that I expected to see when dreaming about longer maternity leave in the US.  Higher rates of breastfeeding have been seen in Scandinavian countries where maternity leave is pretty long and pretty highly paid, so maybe we need to look at why the rates in Britain are not higher.  Could it be that breastfeeding is a more acceptable way to feed in Scandinavia, nursing in public is such a contravercial subject in the UK and US.  Could it be that hospital policies are more baby friendly so that women leave the hospital breastfeeding well and supported throughout to reduce the need for supplementation?

I don't know the answer, but I think it's interesting to think about these things and consider the reasons behind them.  What do you think?

If you have enjoyed reading this post, you may want to check out these other bloggers who are writing about breastfeeding during the month of June.  You may also want to check out The Lactivist for some amazing Keep Britain Breastfeeding Goodies.  Lisa, the owner designed the logo for this scavenger hunt and has some really cute mugs, hats and infant t-shirts for sale with many cute and funny breastfeeding slogans.  Lisa is also running an additional competition here today so that you can win your very own infant T-shirt wth the slogan of your choice.  Enter below using the rafflecopter.

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