Are you breastfeeding properly, doctors ask

Fears that babies are failing to take in enough milk prompt investigation

Doctors have launched an investigation into the skill with which mothers breastfeed after evidence has emerged that some babies are falling dangerously ill by failing to take in enough milk.

Researchers will record the number of babies admitted to hospitals in the UK and Ireland with severe hypernatraemic dehydration, a rare but potentially fatal condition caused by a lack of fluid and a rise in the salt level in the blood. The condition has been recognised for years but no study has been done to determine its extent. Experts say they expect the result to show that between one in 100 and one in 1,000 babies is affected.

Other countries have avoided doing the research because of fears that it could damage confidence in breast- feeding, which is known to give babies the best start in life when done effectively. In Britain, the proposed study worried doctors at the British Paediatric Surveillance Unit (BPSU), which is to carry it out, over its likely impact on perceptions of breast-feeding.

Colin Michie, consultant paediatrician at Ealing Hospital, London and a spokesman for the BPSU, said: “It is a biological process that some mothers have problems with. In the end we decided we had to do the study because we need the information. The benefits outweigh the harms.”

Successful breastfeeding depends on correctly positioning the baby, helping it attach to the breast and starting as early as possible after birth. Support from midwives is key to getting it right but the availability of support varies around the country, Dr Michie said. “Breastfeeding is not as easy as it looks. It is easier to get milk out of a bottle than a breast and that is why giving a bottle is a mistake. A lot of mothers give up,” he said.

“If mothers know how to breast-feed this condition [dehydration] is much less common. What the research may point up is where mothers are not getting good advice. The problem seems to be worse in the inner cities and among first-time mothers.”

Dr Michie denied that the problem had been played down because of the need to promote breastfeeding: “There is an anxiety not to give conflicting messages. The college [Royal College of Paediatrics] wants to promote breastfeeding because breast-feeding rates are quite poor in the UK but there has been no attempt to suppress the issue.”

Sam Oddie, consultant neonatologist at Bradford Royal Infirmary, who is leading the study, said: “There is discomfort about [the condition] among paediatricians because it is preventable. When you look back at individual cases it is always possible to identify clues – difficulties with feeding that have been missed.”

The study will run for 13 months and collect details of all babies less than 28 days old admitted to hospital with the condition.