Birth Issues Journal > Reviews

BREASTFEEDING: COPING WITH THE FIRST WEEK
Mark-It Television, UK 1997 30mts

Review by Virginia Thorley OAM IBCLC

This is the fourth video of a series recently made in Britain and while it addresses the questions and concerns of mothers during the first week of breastfeeding, it has wider uses. For instance, it would be useful for showing to antenatal groups as part of breastfeeding preparation, and it also has a use, beyond the first week, with mothers who are still having difficulties attaching their babies at the breast.

The narrator suggests that viewers who have not yet had their babies run through the video, replaying the how-to-sections to gain a clear idea of how to get breastfeeding off to a good start. Some of this video's appeal for antenatal use is because the mothers, and one father, have been involved in answering the question 'Why breastfeed?' They cover what they each see as the benefits to them and their babies in a natural, realistic way, without hyperbole. The mothers are also involved in describing what is happening in the 'how-to' segments, where the photography is clear and unambiguous, while Caroline Flint, the midwife featured, speaks authoritatively, but with infectious enthusiasm.

Flint points out that breastfeeding is a learnt behaviour, and the narrator then explains the value of 'a good first feed', that is, comfortable and painfree, in giving the new mother a standard against which to measure subsequent feeds. As the mothers breastfeed their babies they describe the feeling as comfortable', in contrast to when the attachment is not quite right. One brief segment, however, mars this otherwise excellent section when the senior midwife's hands intrude and take over the attachment, where it may be more appropriate to stand back and assist the mother to do it herself, as happens elsewhere in the video. Mothers with less post-discharge support than these
mothers seem to have, may fail to achieve good attachment and abandon breastfeeding if they become dependent on the 'expert' to attach the baby.

The second section of the video presents a well-designed checklist, orally first, and then repeated with the printed text on the screen to support the narrator's voice. While the easy-to-read checklist simplifies the stages towards achieving good attachment, one point at a time, a pleasing degree of flexibility in achieving these basics is evident in the narration, in the advice given by Caroline Flint and in what the mothers are seen to be doing. For instance, the mothers in this video, all of whom are sitting up to feed, use different holds when attaching the baby, including the madonna (or cradle) hold across the mother's body and the underarm (or football) hold, instead of relying solely on the modified clutch hold widely taught as standard at the present time. Mothers use what is comfortable for them.

Later sections, where the babies are no longer newborn, involve a discussion of the mothers' recollections of their experiences during the first week of breastfeeding. Topics include:

• the coming in of the milk
• the baby's stools
• maternal food and drink
• the learning process
• the fact that women and babies have to learn, and that 'babies all feed differently'.

Finding new words and phrases to present new information or describe actions unfamiliar to new mothers is always a challenge to the lactation professional. An example from this video is its description of the tongue and its 'rhythmic, roller-like action'. Later, the mothers share their experiences of expressing or pumping when separated from the baby, and feeding away from home. All the mothers in the video presented a positive viewpoint on breastfeeding in public places, and how to do it. The question of whether to offer one breast or two is addressed in a commonsense way by Caroline Flint.

The narrator recaps the 'how-to' points towards the end of the video. The wording of the instructions is again clear and spoken at an acceptable pace. Once again, the choice of words and images aids clarity: for instance, 'the chin should reach the breast before the nose does'. The video ends with more comments from the mothers and a charming contribution by Caroline Flint that appeals to the viewer's emotions. Several times during the video, the video is told 'Ask your midwife for help'. One minor quibble is that this recommendation is relevant for a longer hospital stay, but may not be possible with the increasing trend towards early discharge in Australia. When this video is shown to new mothers in Australia, it would be better to provide a card or handout with appropriate local telephone numbers for breastfeeding help after discharge, in accordance with the tenth of the Ten Steps to Successful Breastfeeding.

When used post-discharge for mothers of babies who have never attached properly, the video can usefully be set to begin at specific sections to illustrate specific points. A segment which may be particularly useful, when used this way, involves a mother and baby who make several attempts to latch, the midwife and the mother together describing what is happening with each attempt and explaining the steps taken to improve it. This can be reassuring to the mother who feels she is the only person in the world who needs to detach and re-attach several times to get the attachment right, while she and the baby are learning.

This video has a good feel about it, the information is accurate and presented in a mother-friendly way, whether through the narration or the comments of the midwife and the mothers themselves. The technical advisors for the production were Chloe Fisher and Sally Inch. This beautiful video is thoroughly recommended. 

Virginia Thorley OAM IBCLC
Author and lactation consultant
from Birth Issues Vol 7 No 2 July-August 1998