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WHEN I was pregnant with my second child some years ago, a lactation consultant offered me a brochure on how to express milk for an older child while in labour with the next one.
Because what anybody going through one of the most arduous experiences known to humanity needs is to try to simultaneously manage a painful and clumsy suction device attached to their nipples. Right?
My memory is that I responded politely to the consultant’s offer of assistance, though I suspect that was mostly because I was too gobsmacked to say anything much at all.
I’m by no means antibreastfeeding. I was committed to the practice with both my children, was fortunate to be able to do it relatively easily (once we got through the cracked nipple stage, anyway), and found it rewarding and convenient.
But I’ve always been disturbed by a certain kind of breastfeeding fundamentalism that seeks to shame women who, for whatever reason, don’t breastfeed their babies.
As a society, we have mostly, if belatedly, accepted that women have the right to decide what they should do with their bodies. When it comes to breastfeeding, not so much.
Sometimes, the rhetoric is beyond extreme. A Brisbane breastfeeding counsellor told an antenatal class that formula was “a little bit like AIDS” back in 2012, prompting widespread condemnation, including from medical organisations.
According to the Courier Mail, the counsellor told the class: “Every 30 seconds a baby dies from infections due to a lack of breastfeeding and the use of bottles, artificial milks and other risky products. Every 30 seconds”.
That’s an unusually hardline approach, but journalist and medical student Amy Corderoy has been taken aback by the stigma attached to formula after having her first child earlier this year.
“As a health writer and medical student, I was very pro-breastfeeding,” she wrote recently in the Sydney Morning Herald.
“I’d done classes before birth and read the long lists of everything breastfeeding had and could do compared with formula. I had also naively accepted maternity care’s new dogma: that people who didn’t breastfeed weren’t really educated, interested, or, worse, had been tricked by the marketing of wicked formula companies.”
The reality was something of a shock.
Corderoy’s newborn daughter just couldn’t get enough milk. Distressed and hungry, the baby lost 13% of her birth weight in the first 3 days.
Australian guidelines say that weight loss of up to 10% is normal in the first week.
When a midwife suggested supplementing with formula, Corderoy felt sick: “She may as well have been suggesting I give my baby Coca-Cola”.
Corderoy still hates having to reveal her “dirty formula secret” to new health care professionals and is left distraught when the response is a raised eyebrow or disapproving tone.
She wrote her article in the hope it would help other women struggling with breastfeeding and help to promote “evidence-based, non-judgmental health care”.
With that in mind, she tried to share a link to the article with a feminist Facebook parenting group she belonged to.
The response from the site’s moderators was a surprise.
They refused to allow the link to be shared, saying the article came across as “deliberately provocative” and might pit women against each other as happened in other “anti-women” media.
It’s beyond me how it could be considered “pro-women” to censor discussion of an important topic in this way.
The moderators did offer Corderoy the opportunity to resubmit her article with more justification or clarification, but she chose at that point to leave the group.
Breastfeeding is clearly a good thing, but more important is the welfare of mothers and babies. A fixed focus on breastfeeding as the only acceptable option will not always deliver that.
We need to be able to discuss such complex issues in more nuanced ways, without trying to shame or silence those whose experiences may not fit the mould.
Jane McCredie is a Sydney-based health and science writer.
To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.
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Bottle feeding is such a very good second best to breast feeding that no mother should be shamed or ashamed when she uses it.
Breastfeeding is a learned art. Mum learns how to hold babe for optimal attachment and check babe’s mouth and breast are in the correct position. Babe has to learn to open mouth widely and grasp breast, not just nipple. Where can a mum learn? With smaller families there is little chance the new mum saw either young siblings or nephews/nieces being breastfed. Few women breastfeed in public because of public attitudes and when they do, they cover up. It wasn’t taught at my antenatal classes, and you are out of hospital by the time your milk comes in. The health system must provide breastfeeding lessons or continued support after baby is born. Yes, in Australia there may be little difference in outcomes, but there is some difference and if a mum wants to breastfeed for that tiny difference or any other reason, the health system must provide practical support.
Performance anxiety never helps breast-feeding.
Susan Ieraci says it all. Public health is not advanced by idealogues. As the author of a book on postnatal anxiety and depression, I agree that a mother’s mental health is paramount to a child’s well-being. If a woman is made to feel guilty by her apparent ‘failure’ to breastfeed this can contribute to mental health problems at this emotionally vulnerable time.
Interesting set of comments – which confirms that the author is right; the ideology of infant feeding far exceeds the evidence.
This argument was very important in the days when formula was being heavily promoted in impoverished communities. Due to lack of reliably clean water, and the risk of dilution due to poverty, the method of infant feeding can make a huge difference in some communities.
In modern Australia, however, the difference in outcomes is marginal. We have cheap access to good quality formula and clean water, and we also have access to lactation consultants and midwife home-visits to support breast-feeding, if it suits the family.
We know from studies like PROBIT that, in wealthy societies, the health outcomes of infants are not much different between the breast- and bottle-fed infant – the difference amounts to a small increase in respiratory and gastro infections in the first year, for babies who are not exclusively breast fed for a six months. We also know that there are many other factors affecting respiratory and gastro infections in the first year, notably exposure to other siblings, or shared child care.
Infant welfare depends, first and foremost, on growing up in a stable, loving family. A good breastfeeding relationship can confer a small, temporary health benefit, all other things being equal. Infant starvation and maternal anxiety/depression weigh the odds in the other direction.
We would do better as a society to ensure that all our children grow up in a stable, loving environment and receive good education rather than judging parents over infant feeding.
I formula fed my children from the start. I knew it was best for my family. I have 5 incredibly healthy and intelligent kids. I really don’t care what anyone else thinks. It’s not really their business.
“It doesn’t matter as long as baby is well nourished and Mum is happy”? Seriously? It does matter. Public health does matter. Breastfeeding is a public health issue. Our health system is groaning under the weight of chronic and acute health conditions that would be reduced if the exclusive breastfeeding rate was increased marginally. Women want to breastfeed and it is the maternity care system that is failing them when they are not able to. Of course Amy Corderoy was upset. She should be angry that our maternity care did not provide the support she needed. Rather than railing against advocates we should be lobbying for better education for health professionals and improved services to support women adequately.
I find it disturbing that medical professionals do not support breastfeeding as a health behaviour in the same way as other issues that can provoke guilt, such as smoking, diet, use of car restraints for children, vaccination, etc. In addition, infant feeding is an issue that has life-long health effects on another person (the baby) who has no say.
The vast majority of mothers forced to formula-feed their babies should be angry, not guilty, as the health system failed to provide correct information and support.
It is no matter of chance that formula-fed infants are over-represented in our children’s hospitals.
Articles and polls like these send the message that medical professionals don’t take infant feeding as a health issue seriously. The public will follow suit, to the detriment of the community at large.
This is simplistic poll and the results will be meaningless
V disappointing that a medical journal would support such a poorly designed survey
Garbage in = garbage out
a well known research truism!