On maternity wards and NICUs breastfeeding is one of the most important topics, and is certainly at the forefront of postnatal care even though the support on offer varies from place to place.

But what about on children's wards? What about in children's hospitals that do not have a maternity wing? If you have a sick child who is transferred to a specialist ward within hours or days of birth, do you still receive support to breastfeed that child if you wish to?  

A nurse's personal perception of breastfeeding has a huge impact on the way it is approached on the ward. The common perception of breastfeeding throughout our society can be summed up in the odious phrase “breast is best”. The perception is this: breastfeeding is an ideal. A lifestyle choice. A wonderful thing to do if everything is fantastic and straightforward in your life. What impact does this perception have on the way that breastfeeding is viewed by many paediatric nurses if you have a sick baby? Well of course, it's the last thing you want to be worrying about isn't it? I mean, you have a very ill child. You have enough stress in your life without putting yourself under pressure to breastfeed. Far better to remove one area of stress from your life and focus on other things. When your baby is very ill them getting the “best” food is not really a top priority, as long as they're eating something. Right?

Wrong. Breastfeeding is the biological norm, the way that human beings have evolved to feed their children. Breast is not “best” it is normal. Yes, there is a place for formula feeding (and thank goodness we have that option when it is necessary) but it is not the normal way that human babies are fed, and as such it does not offer anywhere near as much to the child as does breastmilk. Why this matters for sick children becomes clear when you consider the following key information:

• Breastfeeding and breastmilk provide pain relief.  

• Breastmilk guards against infection. 

• Feeding at the breast is a huge comfort to a child, the importance of which cannot be underestimated when the child is hospitalised.

• Some hospitals class breastmilk as a “clear fluid” which means that it can be taken far closer to the time of an anaesthetic than formula can.

• Breastmilk is easy to digest and contains significant immune factors to protect a child's gut.

The evidence behind these points is listed below and can also be found on www.heartmummy.co.uk 

Breastfeeding is a vital part of the child's medical care and complements everything the medical team is trying to do.  

Parents who choose to breastfeed their sick child need specialist, professional support, especially where fluid intake and weight gain are crucial as, for example, with a cardiac patient.  

Within this #WeNurses chat we would like to consider the following quesitons:

1. Do paediatric nurses feel adequately trained to support breastfeeding?

2. What are the challenges in supporting a breastfeeding journey where the child is seriously ill?

3. What best practice have you experienced and where are the gaps?

4. Are nurses confident in where to signpost families for additional breastfeeding support, both within the NHS and outside of it?

5. Does your children's ward adhere to the Royal College of Nursing's guidelines for supporting breastfeeding? 

Evidence:

Breastfeeding during immunizations or other painful procedures - KellyMom

BREASTFEEDING RESEARCH - AN OVERVIEW - UNICEF

Breastfeeding to Sleep and Other Comfort Nursing - KellyMom

Perioperative fasting in adults and children - RCN 

Immune factors in human milk - KellyMom

Guest host bio:

Helen Calvert (@HeartMummy) says : "In 2013 I had my second son, David, who has Hypoplastic Left Heart Syndrome. My experiences breastfeeding him at Alder Hey Children's Hospital led me to start working with the hospital to improve their breastfeeding support. I then started the #hospitalbreastfeeding campaign on Twitter which led to the launch of my website, www.heartmummy.co.uk"