Page last updated at 00:41 GMT, Sunday, 16 August 2009 01:41 UK

Inside Medicine: Breastfeeding lead midwife

Suzanne Barber
Suzanne encourages mothers to breastfeed

In a series focusing on medical specialties, the BBC News website meets Suzanne Barber, an infant-feeding adviser midwife.

Her speciality is helping mothers breastfeed their babies and deal with any problems they have.

WHAT IS YOUR JOB?

I am the infant-feeding adviser midwife at Milton Keynes Foundation Hospital NHS Trust.

My role is to improve, protect and support breastfeeding.

WHAT IS THE MOST COMMON CONDITION?

Nipple trauma is experienced by a significant proportion of mothers.

This is directly caused by incorrect positioning of the baby at the breast, which does not allow the baby to latch on to the breast tissue sufficiently to form a natural teat shape in their mouth.

Following the birth of my second child, I was deeply affected by her puzzling inability to breastfeed
Suzanne Barber

This preventable injury occurs as the baby fixes just to the nipple itself, and the pressure of the baby's gums compressing the nipple can cause significant injuries.

Women can receive the highest standard of antenatal education and literature available to help them prepare to feed, but nothing can replace the value of observing breastfeeding, and living in a culture where breastfeeding is the norm.

WHAT IS THE MOST COMMON PROCEDURE?

There are no procedures currently performed by my specific role but I hope in the future to become clinically competent in performing simple frenulotomy for tongue-tied babies experiencing breastfeeding problems.

Frenulotomy is the division of the tongue-tie, which may restrict mobility of the tongue. Free movement of the tongue is essential for breastfeeding.

Breastfeeding baby
Some babies have problems latching on

Babies who have tongue-ties can fail to thrive due to poor feeding techniques and have excessive weight loss.

Official statistics say that about 4% of babies born are tongue-tied - but this figure appears to be very conservative.

The ability to promptly resolve feeding difficulties early in the postnatal period is essential in order to facilitate successful milk production and maintain breastfeeding.

WHAT IS THE HARDEST THING ABOUT YOUR JOB?

Midwives recognise the influence that extended family and friends have on the decisions a woman makes. This is especially true with the management of feeding a newborn infant.

My biggest challenge is when there is unintentional undermining of breastfeeding, from well-meaning others, by recommending supplementation with formula milk.

So often it is said that a baby is "starving" and "the mother hasn't got enough milk" or "the milk isn't good enough".

It takes patience and sometimes courage to re-educate those who have unintentionally been given poor advice and education when they had their babies and to convince such mothers that the baby's behaviour is normal and that the mother will be able to provide for all the baby's nutritional needs.

WHAT IS YOUR MOST SATISFYING CASE?

Mothers sometimes get off to a shaky start with breastfeeding and when there is a weight loss greater than 10% there can be pressure to "top up" the baby with formula milk. This is often justified as "being able to see exactly what the baby is getting".

I supported one mother in her choice to continue to exclusively breastfeed her baby.

We worked together to correct poor technique and stimulated her lactation by teaching hand expression. My satisfaction came when mother and baby were discharged home within a couple of days, thriving and happily breastfeeding exclusively.

WHY DID YOU CHOOSE THIS SPECIALITY?

Following the birth of my second child, I was deeply affected by her puzzling inability to breastfeed. Subsequently, I found it very hard to bond closely with her as every bottle feed brought a sense of rejection.

I have since been driven towards supporting others both in the teaching and promotion of practice, which maximises success in breastfeeding wherever possible.

IF YOU HAD YOUR TIME AGAIN WOULD YOU CHANGE YOUR SPECIALTY?

In my dream world I would have wished to have been an actor.

However, in reality, I already have my dream job of teaching, leading best practice and welcoming new life into the world. I am very glad that I chose this speciality.

HOW DO YOU SEE THE ROLE DEVELOPING IN THE FUTURE?

If we could all change the culture in this country to one which embraces and supports mothers who breastfeed, they would, in turn, influence the generations to come. This would render my role redundant.

In reality, once breastfeeding improves locally, and becomes the cultural norm nationally, there will still be a need for a clinical lead to continue to educate carers and protect informed choice for breastfeeding.

Maintaining best practice standards has, in other baby friendly trusts, proven to be the biggest challenge of all.

CV - Suzanne Barber
1989: Qualified as a Registered Nurse at Addenbrooke's Hospital, Cambridge
1992: Qualified as a Registered Midwife at Bedford Hospital NHS Trust
2002: Senior Midwife at Local SureStart Programme
2006: Successfully completed Post Graduate Certificate in Supervision of Midwives and appointed Supervisor of Midwives at Bedford Hospital NHS Trust
August 2008 : Appointed Breastfeeding Lead Midwife at Milton Keynes Foundation Hospital NHS Trust





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