Breastfeeding is not a choice!
As my pregnancy continues, my thoughts are naturally drifting back to when Little Man was born. I find myself especially thinking about the difficulties I had getting breastfeeding established. Looking back, I was just so naive and so uninformed starting out with it. I assumed that because it’s natural, breastfeeding would be easy. But unfortunately that wasn’t my experience at all in those first few weeks. I didn’t understand that breastfeeding may be natural, but it is still a “learned” skill.
Last week, I read two very different articles about breastfeeding. The first was a UK-based report commissioned by UNICEF, which found that 90% of mothers who stopped breastfeeding and switched to formula, didn’t want to switch. 90 per cent! I know those are UK figures and not Irish figures, but I think it’s likely the figures here are similar.
The second article was published on TheJournal.ie, and was called “Breastfeeding? Nobody tells you about the bleeding nipples.” Written by Siobhan Corcoran, a junior doctor in Obstetrics and Gynaecology, it’s a personal account of switching to formula feeding following breastfeeding difficulties including bleeding nipples. Siobhan recounts with regret the type of support that her pre-baby self used to offer to mothers experiencing breastfeeding difficulties in hospital:
When I rounded on tearful mums asking for a bottle for their baby in the postnatal ward I rebuffed their complaints and questions about breast feeding with the stock answers we’d been given by the lactation consultants: “You need to feed on demand”; “Sleep when your baby sleeps”; “Your breasts will make as much milk as your baby needs”; “ It’s not sore if you do it right, if your attachment is right”.
And she concludes that it’s important to let mums for whom breastfeeding just doesn’t work know that it’s okay, because the guilt heaped on “deserters” is unfair and unnecessary in a country where excellent sanitation means that formula-feeding won’t scar your child for life.
But Siobhan is looking at the problem in the wrong way. In fact she’s looking at the wrong problem. She’s feeling guilty and trying to find ways to ensure that other mothers don’t feel the same guilt. But the real problem is that she wanted to breastfeed and didn’t receive enough support and help to resolve any breastfeeding difficulties that she encountered, so she was forced to switch to formula before she intended to. She didn’t get to choose.
I made the following comment on Siobhan’s article:
I remember that pain all too well. But I also remember the unhelpful platitudes being passed off as advice in the hospital. My son was eight weeks old before we figured out latching without pain or damage. And in the end, I had to resort to the internet to find the solutions I needed to the breastfeeding issues I encountered. That to me is the real problem when it comes to the breastfeeding debate in Ireland. Plenty of enforced guilt, and no real educated medical support when you need help.
I couldn’t care less whether someone chooses to breastfeed or to bottlefeed their child. But what I do care about is that if someone chooses to breastfeed, she gets the help she needs to make that happen. As I learned the hard way, there are lots of potential causes, and plenty of solutions for bleeding nipples. And if our medical professionals who are so keen to hand out breastfeeding “advice” were properly educated about feeding issues, then they could actually help the women who come to them for help, instead of doing as you say you did, and piling on the guilt without any real understanding or practical solutions to go with it.
I don’t care whether someone chooses to formula-feed or breastfeed their child, but I do care about those who aren’t getting a choice. Because switching to formula before you want to isn’t a choice. So why do we persist in framing it as such? Why does the media persist in framing the discussion in terms of “breastfeeders vs. formula-feeders”, as though there are two distinct camps both determined in their feeding preferences? Framing the discussion in that way is failing all of the women who really didn’t get a choice. But of course, it’s far easier to rile up your readers and generate interest by painting a picture of “bullying breastfeeding hippies vs. regular people who just want to feed their babies” rather than discussing the real issue, which to my mind is “Why are so many women – maybe as many as 90% of those who want to breastfeed – switching to formula before they want to?”
And I think that many of the answers lie in Siobhan Corcoran’s article. Generations of Irish women bottle-fed rather than breast-fed their babies, so a significant amount of breastfeeding knowledge has been lost, or replaced by myths about breastfeeding. So many Irish women turn to their medical professionals rather than their mothers or grandmothers for advice when they run into problems. And as Siobhan readily admits, those professionals respond with stock answers – but no real knowledge or understanding of the issues they’re supposed to resolve.
I believe it’s time we stopped focusing so much on breastfeeding campaigns to encourage women to try breastfeeding, and instead put our efforts into helping those who have chosen to breastfeed to achieve their feeding goals. If a woman switches to formula-feeding, it should be because she chooses to do so, and not because she has encountered a breastfeeding problem she can’t overcome.
When covering breastfeeding in antenatal classes, spend a bit less time extolling the virtues of breastfeeding, and a bit more time teaching women about the key stumbling blocks that they may need to be aware of. How many women sit crying in their hospital beds on their baby’s second night, crying because their milk hasn’t come in and they think their baby is starving? Would it be so difficult to explain that constant feeding on the second night is normal, and will help their milk come in?
What about giving practical advice on how to deal with bleeding nipples – or how to prevent them in the first place, rather than trying to pretend they don’t happen in case it puts people off?
Yes, the numbers initiating breastfeeding in hospitals may drop at first, which would of course reflect badly on the hospitals. But if the women who still choose to breastfeed receive the support they need to continue and to establish feeding, I suspect that slowly, slowly, the body of knowledge held by society about breastfeeding would start to grow again, countering the established myths. And if more women are helped to continue feeding for longer, then inevitably more women will be seen in society feeding, more women will share positive stories with their friends, and maybe when those friends come to choose whether to breastfeed or formula feed, they will have a real choice to make. And then we might see some real growth in the numbers who breastfeed in Ireland.