Hannah Lynes

Complaint about The One Show breastfeeding feature

Hannah Lynes

by

Mother, Chair of Bromley Maternity Voices and Activist.

Share: Share on FacebookTweet about this on TwitterShare on LinkedInEmail this to someone

I complained to the BBC about the breastfeeding feature on The One Show, broadcast on 5 October 2016. The BBC’s response did not address the specific issues I had raised, so I wrote back to them. Their second response did address the issues I raised, but did not accept that the comments I complained about were inaccurate and misleading. I escalated my complaint further and have now received a response from the BBC’s Editorial Complaints Unit. On this page, you can read:

my original complaint, sent on 11 October 2016,

the BBC’s response, received on 18 October 2016

my 2nd complaint, sent on 18 October 2016

the BBC’s 2nd response, received on 29 November 2016

my 3rd complaint, sent on 17th January 2017

Response from BBC’s Editorial Complaints Unit, received on 14th February 2017

Original complaint sent on 11 October 2016

Information given in the feature on breastfeeding was inaccurate and misleading. The statement “It really will do the babies no harm to be given formula” does not reflect the available evidence. On a population-wide level we know that formula feeding affects health outcomes. This open letter highlights the relevant section from the recent Lancet review  which considered the evidence for differing health outcomes in breastfed or formula fed babies, including in high income countries.

It was further stated on the programme that: “Lots of mothers don’t (have enough milk) even though they’re doing everything right: eating, drinking, resting.” The suggestion that the main things a mother can do to ensure she has enough milk are to eat, drink and rest is inaccurate and misleading. In fact, for most mothers the most effective way to maintain milk supply is to regularly remove enough milk from their breasts – for example, by ensuring the baby is feeding effectively, by feeding more frequently, offering both breasts at a feed or expressing between feeds. Here are some pages that give evidence-based information on how mothers can increase their milk supply:

http://kellymom.com/hot-topics/low-supply/

http://www.lowmilksupply.org/increasingmilk.shtml

http://www.babycentre.co.uk/a8487/low-milk-supply

 

BBC response, received on 18 October 2016

Dear Ms Lynes

Reference CAS-4045115-KTCH6Q

Thank you for contacting us about The One Show, broadcast on 5 October 2016 on BBC One.

We appreciate you are concerned that the item on breast feeding was inaccurate or biased against breast feeding.

We flagged this up with senior editorial staff at The One Show. They responded as follows:

“We first interviewed the women in the film before their babies were born. First time mums, they both said that they were keen to breastfeed their babies for at least the first six to eight months and were happy to keep video diaries for us to see how they got on. While as programme makers, we might have hoped one would take to it easily and the other might find it more difficult, we couldn’t know what would happen in advance.

In the event, contrary to what they’d anticipated during pregnancy, neither found it plain sailing. As was shown in the film, one of the babies was admitted to hospital within days of her birth having lost 14% of her birth weight. Her mum discussed the feelings of failure she felt in not being able to nurse successfully.

Both mums persevered with breastfeeding however and only discussed stopping in terms of whether they planned to continue to breastfeed beyond a year. They agreed they would not, both saying similarly that they each wanted their lives back.

While the comment from each of them could of itself be seen as negative about breastfeeding beyond a year, the programme team don’t believe this amounted to them being negative about their experience of breastfeeding their babies. As their video diaries showed, they were simply experiencing first hand that breastfeeding was something both they and their babies had had to learn to do successfully.

The expert in the film, Clare Byam-Cook, is a former midwife and now a breastfeeding specialist who gives one to one advice and training to women who are struggling. We feel therefore that she cannot be described as anti-breastfeeding. Her opinion, as she stated in the film, is that there should be less emphasis on telling mums breast is best, and more emphasis on researching the reasons why some find it difficult. She also sought to reassure those mums who can’t breastfeed successfully, that a formula fed baby will develop healthily.

We feel that The One Show, rather than being negative about breastfeeding, merely allowed two new mums to record their experiences. By sharing them, we hopefully provided some insight, reassurance and encouragement to other new mums watching who might be finding breastfeeding trickier than they’d expected.”

That said, I appreciate your concerns on this matter, and I have placed your complaint onto our Audience Feedback Report. This is compiled overnight and is among the most widely read sources of feedback in the BBC. Your complaint will be seen by senior management and ‘The One Show’ production team.

Thanks again for taking the time to contact us.

Kind regards
Chantelle Frampton
BBC Complaints Team

 

My 2nd complaint, sent on 18th October 2016

Your response to my complaint does not address the issues I raised. My concern was that the information given in the programme was inaccurate and misleading in that it did not reflect the available evidence, whereas your response focuses on whether the programme was negative and on the qualifications of your expert. I raised two specific points which were serious factual errors and I would be very grateful if you could respond to these. These sections of your editorial guidelines require you to give accurate information and to not mislead your audience:

3.2.1 We must do all we can to ensure due accuracy in all our output.

3.2.2 All BBC output, as appropriate to its subject and nature, must be well sourced, based on sound evidence, thoroughly tested and presented in clear, precise language.

3.2.3 The BBC must not knowingly and materially mislead its audiences.  We should not distort known facts, present invented material as fact or otherwise undermine our audiences’ trust in our content.

3.2.4 We should normally acknowledge serious factual errors and correct them quickly, clearly and appropriately.

3.4.2 In all our content we must check and verify information, facts and documents, where required to achieve due accuracy.

3.4.11 We must not knowingly and materially mislead our audiences with our content.  We may need to clarify the nature of some content by labeling (for example, verbally, in text or with visual or audio cues) to avoid being misleading.

3.4.26 We should normally acknowledge serious factual errors and correct such mistakes quickly, clearly and appropriately.  Inaccuracy may lead to a complaint of unfairness.  An effective way of correcting a mistake is saying what was wrong as well as putting it right.

 

BBC’s 2nd response, received on 29 November 2016

Dear Ms Lynes

Reference CAS-4054611-K313HR

Thank you for your correspondence about the item on breastfeeding in a recent edition of The One Show.

We’d like to apologise that the previous response didn’t address your specific concerns and for the delay in replying to your further email.

In your original complaint, you raised concerns about two specific comments made by contributor, Clare Byam-Cook.

1.

Clare-Byam Cook: “I think in recent years we’ve concentrated far too much on telling mothers why they should breastfeed and not nearly enough on examining why they’re finding it so difficult. They all know it’s best and it is best (contributor’s emphasis), but only if it is working well. It really will do the babies no harm to be given formula. They will still grow up healthy and happy.”

This comment should be viewed in the context of the surrounding discussion; which began with presenter Alex Jones saying “we’re always told that breast is best”. Clare echoed this.

We feel it was clear from the programme that formula was presented as a secondary alternative in the event that, for whatever reason, a mother has trouble breastfeeding. We’re aware that health experts agree that breastfeeding is the preferred and healthiest option for mother and infant. However, both the NHS and Department of Health support mothers who wish to or need to formula feed and both provide guidance on how to do so. Clare’s comment was with the aim of reducing impact on mothers who do need to use formula instead of breastfeeding and we feel it was a fair for her to say that a mother will not harm her baby by giving them formula.

2.

Clare-Byam Cook: “The two main problems that I come across that can’t always be sorted, are mothers not having enough milk; so lots of mothers don’t, even though they’re doing everything right: eating, drinking, resting. And some babies genuinely can’t suck properly.”

I note you feel that there is a suggestion here that ‘the main things a mother can do to ensure she has enough milk are to eat, drink and rest’ and that this ‘is inaccurate and misleading’.

This comment also needs to be viewed in context of the live discussion. Prior to the comment, the contributor had just explained how, in her view, she feels women in this county are told why they should breastfeed without being prepared well enough and told how (my emphasis) to breastfeed. She then discussed what she believes some of the problems are.

Anne Robinson then asked; “what if you simply can’t breastfeed for some reason”.

To this Clare replied; “I think lots of mothers genuinely can’t”.

Rather than saying that the main things a mother can do to ensure she produces milk is to eat, drink and rest; it seems that Clare was saying that sometimes, no matter what, it simply doesn’t happen for some mothers. And if that does occur, a mother should not be made to feel like a failure.

I hope this has helped to allay your concerns, and thanks again for taking the time to contact us.

Kind regards

Brian Morgan

BBC Complaints Team

 

My 3rd complaint, sent on 17th January 2017:

Dear Editorial Complaints Unit

Reference CAS-4137997-07TG9G

I would like to escalate this complaint about the breastfeeding feature on BBC1 The One Show, broadcast on 5th October 2016. Having completed stage 1 of the complaints process, I stand by my original complaint which is as follows:

Information given in the feature on breastfeeding was inaccurate and misleading.  The statement “It really will do the babies no harm to be given formula” does not reflect the available evidence. On a population-wide level we know that formula feeding affects health outcomes. This open letter – https://ukbreastfeeding.org/open-letter/ – highlights the relevant section from the recent Lancet review – http://www.thelancet.com/series/breastfeeding – which considered the evidence for differing health outcomes in breastfed or formula fed babies, including in high income countries.

It was further stated on the programme that: “Lots of mothers don’t (have enough milk) even though they’re doing everything right: eating, drinking, resting.” The suggestion that the main things a mother can do to ensure she has enough milk are to eat, drink and rest is inaccurate and misleading. In fact, for most mothers the most effective way to maintain milk supply is to regularly remove enough milk from their breasts – for example, by ensuring the baby is feeding effectively, by feeding more frequently, offering both breasts at a feed or expressing between feeds. Here are some pages that give evidence-based information on how mothers can increase their milk supply:

Increasing Low Milk Supply


http://www.lowmilksupply.org/increasingmilk.shtml
http://www.babycentre.co.uk/a8487/low-milk-supply

In response to the comments I received from Brian Morgan in the BBC Complaints Team, I would like to add the following:

1. You say that because “it was clear from the programme that formula was presented as a secondary alternative,” it is “fair” for Clare Byam-Cook to say that a mother will not harm her baby by giving them formula. I appreciate that you want to be respectful of mothers’ feelings, but I don’t think this can justify giving inaccurate information and I think there are better ways of reducing the impact on formula feeding mothers. For example, I would suggest not using the phrase “breast is best” – even as a straw man to knock down. As a breastfeeding counsellor myself, I would never use that phrase, because I have been trained, as most UK breastfeeding supporters have, to adopt a non-judgemental approach to supporting mothers. On a population level, we know that more breastfeeding results in better health outcomes for mothers and babies, but this does not mean we can say that breast is best for any individual mother. Health is just one factor that a mother will take into account in deciding how to feed her baby. In our society, mothers face a wide range of barriers to breastfeeding including (but not limited to) unrealistic expectations of mothers and babies, the medicalisation of birth, inadequate postnatal breastfeeding support and the sexualisation of breasts. In this context, “breast” may well not be “best” for every mother and baby; some mothers make a valid decision not to breastfeed and many more feel they have to stop before they wanted to. We need to shift the conversation from one about the responsibility of individual mothers to one about how we as a society can break down the barriers to breastfeeding so that women’s decisions are less constrained. Sue Ashmore, from UNICEF UK, has made this case well here: https://www.unicef.org.uk/babyfriendly/changing-conversation-around-breastfeeding/ .

2. I agree with the statement that “sometimes, no matter what, it simply doesn’t happen for some mothers. And if that does occur, a mother should not be made to feel like a failure.” It is true that some women are physiologically unable to make enough milk for their babies. It is also true that the societal barriers mentioned above can make it very difficult for mothers to make enough milk (e.g. by encouraging them to schedule feeds, or not providing sufficient support to help them judge whether their baby’s feeding effectively). However, it is also true that many women doubt their milk supply when in fact they have plenty of milk or are capable of making more than enough.  My concern is that women may have concluded from this feature that if they feel they’re not making enough milk and they’re eating, drinking and resting, then it is probable that they are physiologically unable to make enough milk and their only option is to offer formula. In fact, in most cases mothers can increase their milk supply by feeding their babies, and/or expressing, more frequently. If women don’t understand this, they may decide to top up with formula “just in case,” which can lead to a downward spiral of reducing milk supply. So although those words “eating, drinking, resting” may not have seemed like the main point of the conversation, they were actually an important part of a message that may have led to more women giving up breastfeeding before they wanted to.

Your expert was right that women feel pressure to breastfeed but do not receive adequate support. Indeed, the National Maternity Review (https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf) concluded that “There needs to be much better support for breastfeeding focused on practical help that supports and empowers women, rather than pressurises them.” Unfortunately, I think your programme may have helped to perpetuate the problem by stating that “breast is best” and then offering misleading, inaccurate and incomplete information.

I would appreciate it if you could reconsider my original complaint. At the least, I would like the BBC to consider how it can ensure that any future programmes on breastfeeding reflect the available evidence. I would, however, like to think that the BBC could be more ambitious than that and actually take a lead role in helping to shift the conversation about breastfeeding – in the words of Sue Ashmore, “to stop laying the blame for a major public health issue in the laps of individual women, and acknowledge the collective responsibility of us all to remove the barriers to breastfeeding.”

Yours sincerely
Hannah Lynes

 

Response from BBC’s Editorial Complaints Unit, received on 14th February 2017

Dear Ms Lynes

The One Show, BBC1, 5 October 2016

I’ve now watched a recording of this programme and discussed your concerns about the item on breastfeeding with colleagues within the ECU. As you may be aware the remit of the Editorial Complaints Unit is to carry out independent investigations where people are dissatisfied with previous responses received from the BBC, and to assess whether the output complained of represents a serious breach of the standards set out in the BBC’s Editorial Guidelines. In this case the relevant guidelines are those on Accuracy, since you felt some of the comments made by contributor Clare Byam-Cook were misleading.

The requirement in the guidelines is for “due accuracy”, which they describe as “adequate and appropriate to the output”, and they go on to say that the requirement may vary between (and even within) genres depending on the context.

The statements you took issue with were “It really will do the babies no harm to be given formula” and “lots of mothers don’t (have enough milk) even though they’re doing everything right – eating drinking resting…” In terms of the first of these, I think there’s a distinction to be drawn between something considered best practice and something with the potential to actively cause harm. While there’s no doubting the scientific evidence of the potential health benefits of breastfeeding, it doesn’t necessarily follow that babies who are not breastfed will come to harm as a direct result. In the context of a discussion that was clearly striving to avoid causing distress to mothers who for one reason or another have not breastfed their babies, I think it was reasonable to reassure them their babies would not come to harm as result. I don’t think it could be considered materially misleading, particularly as it was prefaced by “They (mothers) all know breast is best – and it is, but only if it’s working well”. Clearly the overriding priority has to be, as evidenced in the film by Vicky’s experience with her baby, that babies get the nourishment they need to thrive.

Similarly, with regard to mothers’ milk supply, it’s clearly not inaccurate to describe eating drinking and resting as “doing the right things”. It may be an incomplete list but, as I’ve said, the guidelines talk about “due accuracy” that is “adequate and appropriate to the output”. There may be other particularly effective methods of maximising milk supply, but I don’t think a short piece of less than ten minutes – including the mothers’ video diaries, could be expected to cover all bases or go into great detail. Nor do I think their omission led to what was said being materially misleading.

I’m sorry you were disappointed by the piece, but for the reasons given I don’t believe there are grounds to uphold your complaint on the grounds of accuracy. However, ECU findings are provisional initially and we welcome comment on them for ten days following notification, so please let me know if there are points you’d like to make on this finding by 28 February and I’ll be happy to consider them before finalising it.

Yours sincerely
Alison Wilson
Complaints Manager
Editorial Complaints Unit