There was much to-do last year when world breastfeeding rates were published in the media and the UK ranked as the lowest in the world.
Here are some of the figures released:
- As of 2010, 81% of babies in the UK were breastfed at birth
- At three months, the number of mothers in the UK breastfeeding exclusively was 17% and at four months, it was 12%
- Exclusive breastfeeding at six months remains at around 1%
- After one year, 0.5% of UK women is still doing any degree of breastfeeding. This compares with 23% in Germany, 56% in Brazil and 99% in Senegal
As you can see, it seems that the issue is not that women don’t want or try to breastfeed – there is a huge percentage starting off with breast. But the continuation rate for breastfeeding is shockingly low.
I’m currently on an extended trip to Taiwan – I’m here for about three months here in total where my baby will be 4-7 months – and I was amazed to learn how good the breastfeeding rates are here.
Rates in Taiwan:
- In 2016, the rate of exclusive breastfeeding in the first six months was 45.5%
- This is above the global average of 38% and just short of the WHO’s 2025 goal of 50%.
What has driven this high breastfeeding rate?
Education, no doubt, on the benefits of breastfeeding, but also public support and encouragement. Since 2010, Taiwan has put in place breast-feeding rooms at 17 MRT (subway) stations, at motorway service stations and other public places such as banks, libraries and department stores. Trains even have a private room onboard for private feeding, too! This means that pretty much anywhere you go, they’ll be a private space available for you to feed or pump – and if there’s not an officially designated space, you can ask at any establishment if you can use a private room to nurse. Since being here I’ve fed at the back of a massage parlour, in a private room in a temple, in a hotel’s “VIP” room and on the empty second floor of a restaurant.
Support from the government
There’s even an app developed by the Taiwanese government that shows you where the nearest feeding room is located: here’s a screenshot from when I was out and about in Taipei and looking for a room.
Why is there a need for feeding rooms?
At first, I felt that the feeding rooms were sending out the wrong message – that breastfeeding was something we should be doing in private and in hiding. I had got quite used to nursing in Costas and Starbucks back in the UK, and even did my fair share of park bench feeding in the summer. But I still found it awkward on occasion, and there was more than one instance when I felt really uncomfortable (an old man’s pub in the middle of nowhere England springs to mind).
Plus, it was really annoying having to stop and buy a coffee every time the little one got hungry – up to three times per short trip into town. And then the wearing of nursing tops all the time – I was eager to get back into my old wardrobe but always had to consider wearing something that I could discretely nurse in.
Aside from these minor inconveniences, though, there are three main reasons why I think nursing rooms are an absolute must if we have any chance at increasing breastfeeding rates in the UK above 1% at 6 months:
1. Nursing rooms don’t allow baby to get distracted.
Once, on a very busy day in Cambridge city centre, I tried to feed my 3 month old in a bustling Bill’s restaurant; it was the only place we could get a table. The trouble was the table next to us were a little bit in love with my little one, and so every time I tried to latch him on, he’d pop right off and try to get their attention again.
When a baby’s peripheral vision kicks in at around 3 months, trying to nurse in a public place gets really really hard. Noise and an interesting world means they don’t want to focus on food; life’s far too exciting for that!
I attended a breastfeeding clinic at 12 weeks post natal because he was too distracted to eat during the day and so made up for it by feeding every hour or so at night – I was absolutely shattered at this point. I was told that I should stay home and feed him in a quiet, dark room. This was the worst news to hear when I was just getting comfortable getting out and about – the last thing my mental health needed was to stay home all day long.
Nursing rooms give Mum the best of both worlds – the chance to get out and about in the fresh air, sunlight and for some exercise – but also enable them to nurse in the “quiet, dark room” that lactation consultants recommend.
2. Nursing rooms mean a Mum can pump and keep her supply up. If a mum is not able to feed her baby regularly, her milk supply diminishes very quickly. So for the first few months there are two choices: Mum stays close to baby so that she can nurse frequently, or if she needs (or wants) to be away from baby for longer than an hour, she can pump to express her milk and keep up her production. The trouble is, pumping makes you feel like a dairy cow at best, and I’ve never seen anyone do it in public – for good reason.
So what happens if you want to attend a wedding or work Christmas party without your baby? I’ve known friends to pump in a freezing cold, dark car. Or if you need to take a professional exam on the other end of the country? Another friend pumped in a smelly train toilet when she had to go cross country for the day.
Nursing rooms give Mum the chance to be away from baby for a few hours without having to sacrifice breastfeeding. In both Hong Kong and Taiwan I regularly saw women pumping in nursing rooms, and then going to lunch with a friend or heading back to work. Sometimes Mum needs a break, and feeding rooms allow for this.
3. Clearly signposting breastfeeding rooms and making them part of a building’s infrastructure normalises breastfeeding and the conversations around it. You see signs for breastfeeding rooms everywhere in Taiwan which makes every sector of society aware of nursing mothers and their needs. It also forces the men and women who are designing the buildings to consider these needs and makes it “normal”.
4. Even though public breastfeeding should be encouraged, many women will still feel uncomfortable. The first few times I fed in public, I felt utterly embarrassed. When George was a week old, I went out to town with my Mum and sister for the first time, a much needed break from the house.
As I awkwardly tried to latch him on under a nursing scarf, my Mum and sister tried to shield me from passers by. It reminded me of trying to get into your swimming costume on the beach under a towel; the more you try to be subtle the more obvious it is. Since then I’ve grown far more comfortable nursing in public, though I did once give myself Mastitis from an awkward latch next to a table of policemen at a service station. Many Mums will never feel comfortable feeding in public, especially if they have a noisy or distracted feeder.
In a survey by Dr Amy Brown of Swansea University, of 300 women who had stopped breastfeeding in the first six months, “around 80% cited pain and difficulty as contributing, while 40% referenced public attitudes, 60% lack of support from others and 20% blamed embarrassment.”
So yes – we should work on public attitudes towards the normality of breastfeeding, but perhaps equally as an effective option would be to give Mum and baby some privacy to comfortably nurse.
Feeding rooms would likely increase breastfeeding rates.
In summary, feeding rooms give Mums the chance to continue breastfeeding for longer whilst still being able to get out of the house and have a life and identity outside of being “Mum”. In the first 3-4 months post natal, it felt like I had a new feeding challenge every week; figuring out the latch, he was noisy, he got distracted, I got Mastitis twice, he was teething and throwing himself off the boob violently, he got hungry every hour, the list goes on. Feeding in public made these challenges harder to overcome and I don’t doubt are the reason many Mums give up on breastfeeding altogether – I was certainly tempted many times for the sake of my mental health.
Having a private space to figure out feeding issues would have been amazing. I’ve seen relatives and friends here in Taiwan go into the room with new Mums – no doubt to offer advice and support on the latch and positioning of baby. If 80% of women cite pain as one of the reasons they stop breastfeeding (I certainly found it painful for weeks until I learned a better latch technique) then there needs to be more help from family and friends on showing a non painful way to feed. This isn’t easy to do in a Costa.
Moving to Taiwan when George was 4 months old is one of the reasons I believe I was able to continue breastfeeding well past the 6 month mark; the feeding rooms and public support of breastfeeding made it a doddle. The whole society is encouraging of feeding and Mum is really made to feel like she is doing the right thing (if she can – I am well aware that some Mums can’t breastfeed, and that’s a totally different story. What I’m talking about here is being able to socially breastfeed, not physically breastfeed).
SUPPORT is the key.
It’s not only the government that is encouraging and supportive of breastfeeding in Taiwan and other countries. You see men supporting women over here too – partners are often waiting outside of the feeding room looking after the older child or just waiting patiently for Mum to finish. I’ve never been embarrassed to ask a male employee where the nearest feeding room is, and no one has ever been embarrassed to help me find one. It’s just a given here that a baby needs to eat, and thus a mother needs a space to feed it. Simple.
I should point out here that feeding publicly in Taiwan is a legal right – much like in the U.K.- and there is no obligation to use a feeding room. But I’ve found that most of the Taiwanese – and foreign – mothers I’ve spoken to here prefer to use a private room.
Here are some pictures of feeding rooms in Taiwan:
So what do you think? Are we doing enough to provide breastfeeding support for new Mums in the U.K.? I think we need to work on continuation rates and this is one solution. Whilst writing this post I came across a number of initiatives and helpful folk who have curated breastfeeding friendly spots in the U.K. It’s no where near as common as it is in Asia to offer feeding rooms but it’s a good start.