Is breastfeeding a form of state sponsored sexism?

The following is a guest post from Mairi Campbell-Jack, who blogs about poetry at www.alumpinthethroat.wordpress.com and spews out whatever thoughts randomly come into her mind on Twitter @lumpinthethroat .  All comments and views, especially differing ones, welcome!

There is one area of life, I have discovered, in which you will find women driving themselves to masochistic extremes to achieve an ideal which other people (mainly women) are pushing them to. It’s not the catwalk, or any magazine. It’s breast feeding.
 
I can’t actually believe I was stupid enough to swallow all the hype myself. I’m middle class and I have always been terribly middle class in my tastes, so when I became pregnant with my daughter there was no question about how I would feed her. “Breast is best” is the mantra drummed into women, and so I believed.
 
Until I came across a catalogue of mothers and friends who had the most terrible time feeding their first children. The mother who couldn’t breast feed because of the antidepressants she is on due to terrible postnatal depression. Every time she was told that breast is best, and encountered the army of people intent on persuading her so, her already low self esteem took another blow.
 
Then there was the mother who had low milk supply (not calorific enough) and so her baby fed every hour and a half– that’s every hour and a half of the whole twenty four – right through the night. Exhausted, she asked her midwife if she could use a bottle, the midwife advised no, and the baby ended up in hospital on a drip because she was so dehydrated.
 
Another mother who had a biopsy due to a lump, whose baby refused a bottle, had to feed her on a freshly biopsied breast. Midwives and health visitors tell you not to give a baby a bottle until four weeks because of nipple confusion, (stop sniggering at the back – and read this Daily Mail article by a midwife casting serious doubt on nipple confusion and other tactics used to increase breast-feeding) by which point many babies will refuse a bottle because they know it’s not mum. Delaying mothers from trying a bottle aims to extend the time during which a baby is exclusively breast feed.
 
That biopsied woman was me. It was utterly excruciating. At the time I said I would rather give birth than go through those feeds again – and I gave birth without any drugs. 

It got me thinking, talking to other mums, doing a bit of research. Why would health professionals tell women to breast feed no matter what, even when not good for the mental or physical wellbeing of the mother and in some circumstances, downright dangerous for the child?
 
The reasons, as I see them, are complex and political. There are breast feeding targets set by the Government. To measure these targets, how a baby is fed is recorded, health visitors’ statistics are collated and then trotted out to prove how hard government is working to give every child the best start in life.
 
Why the targets? Scotland has a very low breastfeeding rate, although breastfeeding rates in many western countries are also low. Breastfeeding provides health benefits for the mother and the infant, well into adult life. Breastfeeding is regularly touted as a “silver bullet” for all manner of problems, such as being a bit thick, being allergic to stuff, obesity, diabetes, cancer… the list is endless, almost as impressive as all the stuff you can make out of a whale. Not only should every mother breast feed their child, but any mother who does not might actually be in dereliction of duty! The attitude towards women’s ownership of their own bodies has shifted from lie back and think of England to sit down and squirt for Scotland.
 
However, there is disquiet among many medical professionals about breastfeeding being promoted as some kind of cure all, and some, such as Michael Kramer, professor of paediatrics at McGill University, Montreal and Sydney Spiesel, clinical professor of paediatrics at Yale University School of Medicine, have started to question the evidence.
 
Joan B. Wolf, a mother and academic – who did breast feed – has also conducted research into publicly funded campaigns to promote breast feeding. Woolf’s study covered Northern America, but here in Scotland there is public money being pushed into breast feeding campaigns which are very similar to those she studied.  Wolf casts serious doubt on the ethics behind these campaigns, and the way they treat mothers.  Some of the claims for breast feeding that we see in America, Scotland and Europe were described by Michael Kramer, professor of pediatrics at McGill University, in the article above as “false information” – a polite euphemism for lie. To me, the current approach to breastfeeding amounts to little more than state sponsored sexism.
 
Current guidelines issued to pregnant women on breastfeeding don’t just propagate the “false information”, but they also ignore the difficulties that can be faced when breastfeeding. They give women even less of an accurate picture.
 
Benefits for babies touted by NHS Scotland include protection against illnesses such as “diabetes in childhood” and “obesity”, while breastfeeding helps the mother “return to your pre-pregnancy weight” and protects her from “hip fracture in later life, caused by the bone disease osteoporosis.” Research has shown all these effects to be “negligible” or “there was no relationship”.   Apparently, “Breastmilk is always best”, ignoring when it is clearly not always best, due to recurring infections, mental ill-health, drug addiction or very low milk supply. This begs the question, best for whom? Best for meeting your targets?
 
The same NHS Scotland publication quotes happily from the World Health Organisation, conveniently ignoring the fact that its recommendations are global and are most pertinent for mothers who live in areas where good available diet and clean water can not be relied on.
 
The chapter on Expressing your Milk fails to mention that not every woman is able to store expressed milk due to an excess of the digestive enzyme lipase – a problem, incidentally, that no medical effort has been made to research and resolve.
 
Low milk supply? Not addressed. Instead, the focus is on Poor Weight Gain with the language used implying blame rather than offering manageable solutions.  The prevailing feeling that is given to new mums is that if they haven’t breast fed their child they have somehow failed, failed as a mother, at the beginning of what is a very long process. We take these kinds of things to heart, they are upsetting.
 
One reason why we have woefully low breastfeeding rates is to do with the sexual objectification of women’s bodies. I’m sure I don’t need to explain this. This low rate combined with the “benefits” of breast feeding is why we now have government set targets to increase the number of mothers who breast feed and why we have such a push to get mothers to breast feed their children exclusively. This push is why women are not being given the whole picture on the benefits or the difficulties of breast feeding and being supported in making a choice which is best for them, and their family’s individual circumstances. It amounts to sexism: either we choose not to breastfeed and give into cultural sexism or breastfeed and give into state sponsored sexism.
 
To not give women full or proper information is to infantilise them and fails to recognise that in most cases, given full information, the best person to make a decision on how a baby should be fed is the mother herself. Sometimes, when mothers are not able to make what is seen as “good” decisions for her child, there may well be under-lying issues more substantial than a decision between bottle and breast. She should be supported rather than chastised. Anything less is treating us like cows.
 
So what do I want? I want to see the Scottish Government (whomever that may be after May) revaluate all the scientific evidence on breast feeding, completely. I want to see arbitrary targets, which pressurise women at a very vulnerable time in their lives, scrapped. I want to see midwives and health visitors not puritanically preach whatever the latest approved message is, but to genuinely help individual women to understand information, without propaganda, and to treat their decision in a holistic manner. I don’t think it’s a lot to ask, that we be treated as people and not statistics on a chart.
 
Mairi Campbell-Jack

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About burdzeyeview

A Scottish burd casting a beady eye over political, topical, economic and social issues that ruffle my feathers.

Posted on March 29, 2011, in All things policy related and tagged , , , , , . Bookmark the permalink. 39 Comments.

  1. According to Anderson and Johnstone (1999), in a metareview, breastfeeding is indeed associated with (among other things) significantly higher cognitive achievement in children, after controlling for other factors. My wife, who is from the Middle East, simply cannot understand what all the fuss is about breastfeeding in Scotland. It is largely unheard of for women not to be able to breastfeed where she comes from (although of course it happens sometimes). There is generally a fairly significant social stigma associated with bottlefeeding – one which I don’t encounter here in Scotland, where everybody seems to do it (although the government does its best to stop them). Realistically, social stigma does sometimes work. For example, I think that the strong stigma we now have against expressing racist views has helped to make racism less prevalent. Of course, since only women can breastfeed, only women are subject to this kind of stigma, where it exists. So inevitably it risks being seen as sexist.

    I think that what is important, though, is that we live in a society which pressures women people into doing things without also supporting them at the same time. And this is really the problem. Stigma works in close, well integrated societies where people feel otherwise valued, and where they are supported to change their behaviour. In societies where people are simply made to feel worthless I suspect it tends to have the reverse effect.

  2. Sorry, I said ‘just keep feeding’ three times there as if it is the answer to all breastfeeding problems… it is not, of course. Poor latch, tongue-tie, mastitis, thrush… there are many other problems women encounter. That is why good support is so vital! So you can be assured that the problem is normal, it can be overcome, and you can ‘carry on feeding’ :-)

  3. Hi, I can absolutely believe what you say about some cows being good milkers and others not so good – women are the same! My sister in law had milk pouring out of her from the off, whereas for me it took about three months first time around to feel like I always had enough milk (I was breastfeeding twins and felt that they were on one continuous growth spurt for weeks on end – the answer was to just keep feeding them!). The problem with HCPs in the NHS is that they may have been trained in breastfeeding but many have never breastfed themselves or may have even tried and not succeeded (due to poor support they themselves received) so they may not even believe that breastfeeding is something that is as easy as ‘just keep feeding’ or even that it is that beneficial to health. And when you factor in the obsession with weight gain then many are happy to see women formula feeding because they understand that and they are familiar with that. And they know most babies will be ‘ok’ on formula.

    A review of the evidence would be great but there have been many many many peer-reviewed studies on breastfeeding and they all show the same thing. Around the world 3,000 babies a day die because they are not breastfed. OK, that is not in the West but a small number of babies in the West do die when they would have lived had they been breastfed (i think the figure was 12 in a year in the US the last year data were available). That is why the WHO puts so much time and energy into the baby-friendly initiative and why formula companies are not allowed to promote their products. Breastfeeding should not be difficult, although I accept lots of women do have lots of difficulties – it’s interesting that a previous poster said the fact the 90% of Norwegian women breastfeed spurred her on. I was the same – I just used to think ‘if I lived in the Amazon, I would just have to breastfeed!’. That belief came from my mother and sisters who all breastfed, who all said the key to breastfeeding is ‘just keep feeding’. Obviously there is a small percentage of women (around 1%) who cannot feed – probably the same proportion as of cows and dogs who have trouble feeding – but we know there is many more that 1% who claim to be unable. The shame of it is that those women are being badly let down by the system which pushes them to breastfeed and then is the reason why they fail. You list some other problems which make breastfeeding difficult eg mental health issues, but I believe these are few also, and in fact breastfeeding has been shown to help women with postnatal depression (and there are actually very few drugs which would mean a woman had to stop breastfeeding)

    As for the body ‘catching up’ after induction and c-section, this may well have been the case, but the problem would have been low supply, not low calorie. For what it’s worth my twins were born 3.2 weeks early after induction and I was able to breastfeed them exclusively (but not entirely easily). The answer is to keep on feeding!!

    Mairi it sounds like you had a terrible time and were very poorly supported. La Leche League is a charity which began in the US decades ago when 8 women felt a lot of their peers were having problems breastfeeding and they felt having breastfed themselves that they could help. It’s just mothers helping mothers… they have a helpline you can call in the UK. Free breastfeeding support is also available from the Breastfeeding Network, The Association of Breastfeeding Mothers and the National Childbirth Trust. La Leche League do a wonderful book called The Womanly Art Of Breastfeeding which I would really recommend. Also The Politics Of Breastfeeding by Gabrielle Palmer is a great book. I only hope that one day you can see breastfeeding as a wonderful thing for mothers and babies rather than something forced on us by a patriarchal society.

    • Nina – thanks for your long and full reply. I’m sorry to not get back to you sooner, but I’m afraid I had a heavy week of family visits to attend to.

      I am quite shocked by your statistic that 12 babies died in the US becuase they were not breast feed and 3,000 in the World. The death of any child is horrific and shocking. I have to ask, how did bottle feeding kill them, or was it just a contributing factor? Were autopsies done, were there other underlying health problems, problems in the family etc?

      In the same vein I mentioned the woman in my post who was told by her midwife to “just keep feeding” and her baby had to go back into hospital on a drip becuase it was so dehydrated. Dehydration in such a small baby can quickly kill – so I’m afriad I do find the “just keep feeding” mantra just not suitable for every case – I think in some cases this could be dangerous. You will point out that this is a small percentage, and you will be right to do so, but even a small percentage is too big if babies have to be readmitted. If women were fully informed about all the risks and problems and how to deal with them, this wouldn’t have to happen.

      I can tell from your writing that you are coming from a very person centred place, and obviously doing a lot of good work supporting women. I have never been and will never be anti-breast feeding, I am just pro-informed choice. Although you say there have been a lot of peer reviews which all show the benefits of breast feeding I have never said that there are no benefits. My concern is that the benefits are being over stated and women are not being properly informed. If it was a financial product I’d be complaining to the FSA.

      The doctors who are saying that breast feeding is being over sold are highly respected professionals who are leaders in their fields. They are people who are used to evaluating scientific medical studies, so when they are being cautious about the way breast feeding is promoted I think they deserve to be listened to.

      I have been very concerned by comments by some pro-breastfeeder that women on anti-depressents should just switch meds. Anti-depresants are highly complex medicines, with vast and scary side effects. A woman may be able to switch meds, but some anti-depressants (including the newer types) can actully make depression worse in some cases. The use of anti-depressents is like sending in a bomb to crack a nut. There may be multiple and complex reasons why a woman is on anti-depressants, not just post-natal depression, and these all have to be taken into account. I’m sure, again, that you will point out that that this is a small proportion of women – and you would be right to do so. However, the reactions of some (I’m not including you in this) to what is highly complex area, appears to put their need to push their own agenda’s before the mothers.

      I’m gald you had such a positive experience, especially with twins, which must have been exhausting. However not all women will, and for the vast majority thinking about what they would be doing if they were in the Amazon or being compared to household pets will not be helpfull analogy, and I fear may put women off, which I know is the opposite of your aim.

      I think women are being horribly failed when it comes to breast feeding, and recieving a very judgemental attitude from medical professionals and also other mothers. From the comments from many other women on this thread, and also who I have spoken to it appears that this exists both for those who chose to breast feed and those who don’t. This is horrendous as far as I am concerned, and I believe more strongly than ever that having government set targets for breast feeding should be scraped. In fact, I’m begining to think that these targets are not only sexist but are actully doing the opposite of what they intend. I’m afriad I would still like to see the whole promotion of breast feeding by NHS Scotland reassessed and overhauled.

      Thank you for contibuting to this discussion – it’s been a really interesting expereince.

      • And thanks again Mairi for writing this post. It has provoked a really interesting discussion and is clearly of the moment. I see the BBC are following our lead (ha!) with a programme on this very issue next week!

  4. Thanks Jacq – one of the sad things to come out of this post has been the amount of women, both online and in person, who have shared horrible stories with me about the day’s and weeks after their child’s birth, and how badly supported they were. This is not dependent on if they chose to breast feed or not.

    I think Zoe William’s article in the guardian on women being given unscientific advice on what to eat during pregnancy illustrates your point very well.

    http://www.guardian.co.uk/society/2007/may/29/health.medicineandhealth

    And personally I remember being very stunned, when I was pregnant, at the amount of people who felt it was perfectly ok to touch me without my permission.

    I think, perhaps, what we see he is the fact that women have managed to gain control of their lives and bodies in a lot of areas, education, marriage, birth control… But as soon as you have conceived you are then again somehow public property and are subjected to every bodies opinions, even though they know nothing about you or your life circumstances.

    How taboo this area is can be seen by some of the angry and patronizing comments above. I do believe this is not helped by government targets, that I am sure put horrendous pressure on medical professionals who’s time could be better spent. It essentially demotes a person’s care to a tick box exercise, rather than the sort of person centered approach that a society could pride itself in.

  5. Interesting post Mairi – I don’t know a huge amount about the issue, but I do think there’s a worrying lack of support for women when they become mothers in many regards. The assumed public ownership of their bodies is a major part of that. I’m horrified how many people assume the right to tell pregnant women what they should be doing – often contradicting actual the evidence. They stop being seen as individuals and start being “mum” or “mummy” – even to their friends, family and the healthcare professionals who are meant to be supporting them. I do think there needs to be more support for women who are breast-feeding, but we need to stop demonising women who don’t or can’t – whatever the reason is.

    As for some of the comments, I’d advise ignoring them. i find that people are routinely abusive on the internet (especially to women) and say things they would never dream of saying to someone’s face. They deserve nothing more than your contempt.

  6. I agree that breastfeeding is pushed too hard especially after giving birth – it makes you actually want to stop as soon as possible. I was not let out of hospital for five days because staff assessed me as not being able to breastfeed my baby properly to their satisfaction. I became so anxious and scared of staff watching me breastfeed that I tried to put it off for as long as possible resulting in bigger weight loss for the baby. The staff did not help me with positioning or consistent advice as they were so busy rushing about only screaming a bit of advice like hold the nipple so the baby can still breathe during feeding or arm under baby or stuff like that whilst they were running away again to the next patient. The staff actually did not seem to care much at all until I threatened to discharge myself and the head midwife got involved. I had some nice midwives, too, but in the first three days only a student midwife seemed to have time to talk to me at all.
    I am still breastfeeding the baby who is now 7 months old. And yes, for a long time he wanted milk every one and a half hours. Saying that if money for the NHS will be cut again the care will even be worse in maternity units as there aren’t already enough midwives. And breastfeeding rates are very low in Britain and Scotland compared to other countries and contrary to World Health Organisation advice, but with the lack of care in maternity units the breastfeeding campaign seems more comparable to bullying rather than helping the new mums with feeding their newborns.
    A lot of women in my maternity ward cried a lot because they had no colostrum and were made to hand-express miniscule amounts to feed to baby with a syringe. For these mums breastfeeding must have been a really oppressing experience.

  7. Louise – what is tricky is not finding answers to your questions but working out if it is worthwhile to do so. I have been approached by several people both online and in person (who agree or disagree with me to varying degrees) since posting this, all of whom were horrified by what you have said and the way you have treated what could have been a usefull and informative deabte. Your last comment does not promise anything different. In replying to you now I have already gone much further than any of these people have (without asking) councelled me to, all of whom have thought that it is best if I ignore what is destructive negativity. If I engage any more with you then I condone the way you have addressed me, and I am not prepaired to do that.

    Nina – I am intersted in La Lech. You have obiously have a lot of knowledge and skill and have a passion for supporting other women, which is all to be comended. But I’m not sure who La Lech are, where they come from, how they are funded?

    I don’t want to sound negative about what is obviously something that helps a lot of women, but you’re telling me that health visitors and midwives don’t know what they are talking about when they are speaking about breastfeeding, but they do get trained on it and are essentially a first line of breast feeding defence in the NHS.

    I’ve stuck with the NHS through my whole life and so has my family so I find it hard to understand why suddenly I am meant to completely ignore what they say on one issue and one issue only. But please, I am open to hearing more from you on this…

    Another thing that has come through from people’s comments is that in a small country like Scotland there can be a vast variation in how women are treated depending on georaphical area. Factor in this georaphical difference, and then the fact that women are being told different things from different professionals all of whom say they promote breast feeding, but appear to not respect each other, then all that results is confusion.

    The result of confusion will be that a lot of women are turned off the idea, and perhapse this is one of the problems in the whole promotion of breast feeding, not just over strident comments about it’s nature but the fact that not everyone is singing from the same hymn sheet?

    Also my Gradfather was a dairy farmer, and yes cow’s have probelms producing milk. You get good and bad milkers in every heard. Sometimes calf’s have to be feed on the milk of a cow which isn’t it’s mother becuase she can’t produce, and they won’t take it from another cow’s teat – they have to be taught to take it out a bucket. Kind of like the idea of milk banking.

    Sheep also get mastitis – some animals have problems feeding their own offspring from their bodies, and to tell women that they don’t is to give women false information. I’m a big believer that natural does not always mean nice, enjoyable or necessarily best for every individual and their unique circumstances. Nature red in tooth and claw!

    What I have asked for is a review of all scientific evidence, given that some fairly senior medical professionals, who are leaders in their fields, have doubts about studies that are being taken as biblical by some. And a lot of anicdotal evidence that some women are having very difficult times, becuase of strident, opinionated people within the pro-breastfeeding group. Really, if breast feeding is the cure all that people promote it as, then the review will prove that, and is nothing to be afraid of.

  8. I didn’t particularly enjoy breastfeeding but persevered despite the mastitis, constantly broken nights sleep, breast engorgement, etc etc and managed to stick with it for 6 month for each of my sons. Ringing in my ears was the fact I had read that over 90% of Norweigan mothers breast feed their babies.

    Where I think we go wrong in this country is that the establishment puts most (all) of its efforts/resources into getting new mothers to consider and try breastfeeding but very little in supporting them when it gets hard or goes wrong post birth.

    Breast feeding workshops designed to encourage breastfeeding and teach the techniques are all very well but by that time (prior to my first son’s birth) I had already decided that I would breastfeed. What angered me then was the almost complete lack of acknowledgement that we might encounter difficulties. Indeed, I was astonished to discover that not all the health visitors delivering the workshop were themselves mothers who had breastfed themselves!!

    We needed emotional support post-birth when, zombified from countless nights of broken sleep and faced with a fretting baby who appeared to need feeding every 2 hours yet showing only modest weight gains – unlike a friend’s child who was putting on a pound a week.

    In Norway and other scandinavian countries, I believe, breastfeeding is ingrained in the culture and has been for many years. Female friends, mothers, aunts and grandmothers are all around as role models and their experiences shape a more realistic expection of breastfeeding for the new mother. The most important supporter that a woman needs at this time tho’ is that of her partner’s and this I think could be a crucial reason why so many British women give up on breastfeeding. They are the ones who should be attending the Breast Feeding Workshop!

    Difficulty breastfeeding is not the only reason mothers give up however – it’s the attendant problems that finally do it for her. Lack of sleep, breast soreness, pain ‘down there’, guilt, lower self esteem due to weight gain, hair loss, lack of social contact – indeed a complete lifestyle change that some women find hard to deal with.

    Breastfeeding is not easy for every mother and it wasn’t for me either. I just know I’m glad I stuck with it.

  9. Nina — by the time she visited the doctor things seemed to be improving. It was seemingly just a temporary glitch for the first few days — the GP reckoned it probably had something to do with the fact that she was induced early, but this failed and she was given an emergency c-section. She was told that her body just needed to “catch up”, basically — also false info??

  10. I applaud this discussion as it echoes my experiences to an extent.

    My overall feeling of my 2 breast feeding experiences was that there was a one-sided view of breast feeding promoted in the ante-natal classes prior to giving birth. We talked about the pain (&pain relief) of giving birth, contractions, stages of labour … and then pop baby comes out. As far as I was aware ( before son was born) you just popped baby on tour breast and off you go.

    As a first time mum I knewnothing of the difficulties of BF but soon encountered a lot of the usual difficulties which were ‘fixed’ by speaking to any one who could help – who all gave such varied opinions – and then I just muddled along my own way.

    One thing I feel that isn’t looked after is the self-esteem and mental health of new mums. Sure I did The Questionnaire at 6 weeks – but at 20weeks I was experiencing real swings of self esteem as a result of massive guilt in my ‘unsuccessful’ breast feeding attempts (2months then mixed). I think volunteer breast feeding mentors would be good – unpushy mums who have been there and just appreciate what it’s like and can show new mums it does get better. I’d sign up in a heart beat if I could help keep someone upbeat in those early months.

    Again – thought provoking writing and I hope most critics see the personal vein that runs through it.

    Katy

  11. Louise Winters

    I retract the “your writing sucks” – am here if you’d like to answer the rest of what I wrote, but will understand if it’s too tricky for you.

  12. Gosh, I really didn’t think there was a push for breastfeeding in Scotland at all. There is a lot of social pressure to not breastfeed, though. I haven’t ever seen anyone other than me breastfeed in public and I have had pretty much no support.

    I live in the greater Glasgow area and it feels like I’m the only person around here breastfeeding — the health visitors, nurses, doctors, etc. all act like my choice to breastfeed is just some cute novelty. In fact, a paediatrician suggested I stop breastfeeding my toddler (who was less than two at the time)
    and start “giving him something more appropriate.” (I assume that meant formula or cow’s milk.) I have no problems with breastfeeding and my toddler is in excellent health, I guess the paediatrician didn’t think I should be breastfeeding anymore.

    When I had my first baby, in a midwife-led unit in Glasgow, a new mum was in the same post-natal room as I was and had been having trouble getting her son to latch and feed well and instead of helping with the latch and encouraging her, the midwives brought her a pump and later several bottles of formula — they seemed too busy hanging out and chatting at the front desk to care. I was a new mom at the time, with no experience breastfeeding and with no friends who breastfed and I probably gave her more help and breastfeeding support than anybody else.

    I had to take my second baby to hospital for an operation and even though it said in his medical paperwork that I was breastfeeding, every time he cried, a nurse would come scuttling over asking if I needed a bottle. Everyone just assumes that you’re bottle-feeding.

    • Oh my word, CJ, I guess I hadn’t realised that the support was so dire down there! I live in the Highlands and the main maternity unit here has achieved full unicef Baby Friendly accreditation. There are trained breastfeeding peer support volunteers who make contact with every breastfeeding mother on discharge from hospital. Every member of NHS staff who comes in contact with breastfeeding mothers has to complete mandatory breastfeeding management training.These measures, along with the rest of unicef’s ‘ten steps to successful breastfeeding’ need to be implemented in every maternity unit. Perhaps then mothers won’t be left struggling unneccesarily as Mairi was.

      http://www.unicef.org/newsline/tenstps.htm

      • The UNICEF initiative has been, and is, a fantastic one but even it isn’t perfect! The advice is good on supporting mothers with special care babies or with complex health needs to breastfeed but at the time I asked them – acknowledge things might have changed since – they hadn’t thought about how they might support or advise mothers with disabilities to feed themselves.

        But hurrah for the Highlands!

  13. claire, can you explain how your friends problem with low calorie milk was solved?

  14. there is definitely no such thing as low calorie milk. I am a trained la leche league breastfeeding peer supporter and i can assure you many health care professionals do not know what they are talking about when it comes to breastfeeding, health visitors and midwives included! Do you ever hear of dogs or cows having low-calorie milk, unable to feed their offspring? No, because as mammals we make the milk our offsppring need. Low milk supply however is real and is caused by the baby not feeding enough or feeding ineffectively (eg poor latch). These things are not solved with formula. a baby feeding every 90 mins is quite normal and a woman should sleep with her baby in these circumstances (as long as she is not drunk, using drugs or a smoker). Cosleeping has been found to be safe and would benefit the bfing relationship for many. When your dog has pups she just lies in a corner sleeping and feeding her babies, if that was the expectation of western women in the early weeks of motherhood (well not sleeping on the floor of course!) then many would find it easier. As for being a feminist issue, i cannot see how feeding your baby with milk from a cow can be a positive feminist choice over feeding it with the milk that is perfectly made and always available.

  15. Sorry, I also meant to comment re: low calorie milk. A good friend of mine has a wee girl who is about to turn one. For the first few days after mum and baby came home from the hospital, my friend was alarmed by how often the baby was feeding, and after a week she was shocked to find the baby seemed to be losing, rather than gaining weight. When she went to see her doctor, she was told that her milk was low in calories which accounted for both issues. This cleared up quickly and both mum and baby were fine thereafter… but it obviously is possible.

  16. I am not a mother, but I am a feminist and read a great deal of feminist writing, often in the blogosphere — so I was very interested to come across this debate. I think Mairi should be commended for being brave enough to examine this issue, even though many of her points are contentious. I also felt the post was well written, personally, and think the “your writing sucks” comment was a little unfair.

    I am really interested in the discussion of feminism’s attitude to breast feeding — I have also read “feminists” who equate breastfeeding to ‘another form of female servitude’ etc., and encourage feminists to turn away from “traditional” female practices like breastfeeding essentially just to make a point about female choice and agency. But it’s Feminism 101 to say: no woman speaks for all women, and no feminist speaks for all feminists. Frankly, any feminist who says “all women in x position should/should not do x” is not worth their salt. As Elizabeth says, the aim is to be a good parent and a happy mother — I would say that ‘sending a message to the patriarchy’ should be much further down the list of priorities!

    Thanks Mairi and commenters for the interesting food for thought.

    Claire

  17. Lousie – I’m afraid I don’t engage in discussion with people who are just setting out to be scathing and comments such as “your writting sucks” adds nothing to what could be a useful debate for everyone. It is sad that you have missed the opporunity to engage constructively.

    Elizabeth – some interesting points, yes it is a scientific fact that we produce milk – there are also a lot of other facts about humans, but essentially when we have constructed a way of living and societies that comepletely remove us from any of our mamillion heritage. Why when we have some many amazing inventions to make life easier, better and healthier for ourselves, so why is it women are still be expected to go through a lot of needless pain (I’m also talking child birth here) purely because they have a baby?

    I’m interested that you say there is no such thing as low calorie milk – every midwife and health visitor I’ve every met, plus every mother speaks about low calorie milk or what is called low milk supply. I’ve never heard anyone say that it is not something that exists so would be interested to see your information.

    I’m afraid to say that I disagree that breast is the ONLY option, it quite clearly isn’t always appropriate.

    Thank you for your kind words as well but really it was a long time ago and I’m over it and on to much bigger problems. Really it was a very small problem for me, but what continues to be a difficulty for me is the way that women are not given whole or complete information. It is the fact that women are not aloud the information to make up their own minds that makes me angry.

  18. With regards to the question of how breastfeeding can be restored to being seen as the cultural norm – we can fling as much money as we like at ‘promoting’ breastfeeding, but as long as there are adverts on TV, websites and in magazines making untrue claims about artificial milk, it won’t have the desired effect.
    So, as Mairi said, “To not give women full or proper information is to infantilise them and fails to recognise that in most cases, given full information, the best person to make a decision on how a baby should be fed is the mother herself” is quite true. But in my eyes it is the formula companies, and the Government for allowing this advertising to continue, who are at fault.The World Health Organisation guidelines are for all babies, not just those in developing countries,therefore the WHO code for marketing of breastmilk substitutes needs to be fully embraced.

    It’s fact that in INDUSTRIALISED nations, formula feeding doubles infant deaths. That’s not what the laughing babies on the TV ad tell us.

    • That is too simplistic, banning the advertising would help but we need to do more. THere is a huge cultural objection to breastfeeding out there in communities – I know of three university educated young women from traditional, rural working class backgrounds who are all bottle feeding and say they “tried” but didn’t work for them. Why? What are the barriers? Why is still such hard work to persuade women from a range of backgrounds in Scotland and in the UK to feed their babies themselves – or at least make that the first choice with bottle feeding there as a back up for when it really doesn’t work out

      • I don’t feel that it’s too simplistic when it’s apparent that the countries with the highest breastfeeding rates are the ones who have fully embraced the WHO code, rather than adopting a watered down version like the UK has. It’s not just mothers who are influenced by commercials, but health professionals who are targeted through advertising in professional literature. Given that most GPs receive something like half a day’s training on breastfeeding throughout their degree, its little wonder that they find themselves turning to literature on breastfeeding which has been produced by formula companies. Which helps to exploit the ‘low calorific’ milk myth, and further undermine our culture’s faith in the ability of a woman’s body to nurture her child. Until the formula companies are prevented from these practices, there will be no cultural change. Perhaps this explains this better than I can;

        http://www.babyfeedinglawgroup.org.uk/resources/whychangelaw.html

      • This is a great resource – thanks for sharing. And yes I take your point about the impact of adverts. It would make a difference but I think is one of several steps that need to be taken. If you want to know an atypical experience in Scotland, read CJ’s comment. Then weep!

        I have a big bug bear generally about investment in women’s health, especially maternal, and also in obstetrics and paediatrics. The infant mortality rate in Scotland has only just started going down after years of increases but is now only at same level as in 2005. So many women have horror stories to tell about their care during pregnancy and then in birth, and finally through breastfeeding, it really is a scandal.

  19. A bloke's eye view

    As a bystander I found it a bit judgemental and pressurised for my liking.

  20. Louise Winters

    I find it interesting that many feminist writers berate women for wanting to breastfeed, or to make other choices that they deem to be “betraying the sisterhood”. Much of equality, for these commentators, seems to be about being identical to men in every way, but striving for this overlooks the undeniable fact that there are differences.

    For me, feminism is about celebrating “woman” – I’m not sure if you’ve seen, for example, the T-shirt that bears the slogan, “I make milk, what’s your superpower”?

    We will only truly have equality when women do as they please, without worrying whether their actions are equal to the choices men have. Men actually have fewer choices than women, after all – they can’t bear children or breastfeed them. Instead of feeling bound and constrained by our biology, ought we not seek to embrace it, celebrate it and work towards finding ways to make society value the contribution we can make by doing these things well?

    I find all the competition to be men, and calling it feminism, really quite sad.

  21. My overriding feeling having read this article is one of empathy for this woman who obviously wanted to do the best she could for her baby even though it caused her a lot of pain. Mothers who have difficulties breastfeeding and opt to discontinue are making their own choice and doing the best they can with the resources to hand. There should be no need for them to feel guilty. I think that when breastfeeding is described as being the “best” or “ideal” or “optimal” we put it up there on a pedestal. It would be great if we could be “ideal” parents all of the time but that is the kind of pressure we could do without. Most of us are happy to be normal and whilst letting go of being “the best” can be hard at first it may actually seem like such a relief in time.

    However, breastfeeding is not anything more than our biological norm. Perhaps if we stopped treating it as something more than that then a lot of the struggle to feed in that way would be released. We are likely to give up something we are struggling with much more quickly if we perceive that what we are struggling to achieve is “the best” rather than simply the norm.

    The language we use in describing breastfeeding goes a long way towards how we view it in our society. Breastfeeding is normal. The more we describe it as being so, the more we are likely to accept it as such in our society and the easier it will be for more mothers to breastfeed their babies.

    • Thanks for your post – couldn’t agree more. I’m also struggling to work out how we change the culture to the biological norm. The norm in many parts of Scotland, and the first choice for many mothers still, is to bottle feed. Yet we have spent a small fortune in recent years in trying to increase breastfeeding rates and any increase has been minimal. In some areas with very low starting points of around 20%, it has actually gone down. The current approach isn’t working -what can we do differently and more successfully?

  22. I am sorry you had a hard time. I am sorry you experience medical mismanagement – like thousands of other women who are trying to breast feed and facing many obstacles again due to medical mismanagement such as the alarming levels of interventions during labor. I wish you had better help pumping and getting ready for after the procedure. btw I hope you’re ok.
    But you are so wrong in some many ways. There can be “scientists” saying the earth is the center of the universe but that won’t change the fact that is not, we have overwhelming evidence of that. Same applies to breastfeeding. There is overwhelming scientific evidence is THE way to feed babies, not the best but the only way. It s great that we have another way to feed babies when a mother is not present and no other smothers or sources of food are available but that doesn’t make formula good. We are mammals, we produce the food of our offspring. It is not a government take over my dear, is a scientific fact. It is a political issue for sure, but not governmental one. And if you are willing to get political you should care why US is one of the last industrialized nations with no maternity leave and allows formula to advertise. We are spending too much of our tax-payer dollars on formula and health care due to complication caused by its use and for sure would save a lot of money and have a lot more babies and mother healthier if we did a better job helping with our social programs. There is no such thing as low caloric milk, as a matter of facts it takes weeks of famine to start affecting a quality of milk as you posed it has been proved in developing countries where there isn’t enough food resources. Yes, babies eat more than 8 times a day, about 12 to 20 times a day. their tummies are the size of a marble. it fills up and gets empty pretty fast. All the rest is mismanagement and lack of help and support. It is very undermining to say a woman does not or could not breastfeed and it has been shown – once again with medical research and not pre-conceived assumptions. Breast is not the best, is the ONLY option. Health care professionals are not doing a good job promoting breast milk, other wise they would tell mothers that all the miracles advertise by formula companies are not proven in any way shape of form, quite contrary. The dha and aha oils they claim build brain cells like breast milk (here we go again!) are synthetic and destroyed by the digestive enzymes and actually can cause diarrhea and constipation like proven before so they had to removed them from “organic formulas” . Formulas that advertise more and longer sleep are increasing the risk of SIDS. Babies suppose to have short shallow sleep for sometime so they wake up by themselves if they stop breathing. Perhaps you co do yourself a favor and allow to be angry because you didn’t have good help and that caused you pain and stress, then allow yourself some grieving and healing. But don’t get bitter and ignorant. It won’t change a thing and make you feel (genuinely) happy and confident as a mother. Be aware of the fact that the web is a wonderful thing, but there is a lot of “research” out there claiming the most absurd things, the holocaust didn’t exist, you name is out there.
    Most of all, be a happy mother. You are not performing to your child, you are raising a human being and that is a miracle and a privilege.

  23. Louise Winters

    Oh, I respect alternative opinions in principle.

    But I reserve my right to be absolutely scathing about the content of them when they’re so way off the mark as to be damaging.

    For instance – women on antidepressants can breastfeed. They may need to adjust which meds they take, but it’s strike one as far as your guest blogger is concerned.

    And the mum who had the baby who was feeding every one and a half hours needed to see a lactation consultant or breastfeeding counsellor, because that sort of feed frequency and a baby who’s not gaining weight/becoming dehydrated is not breastfeeding well. But it’s not breastfeeding that’s at fault.

    As I said before, relying on Clare Byam-Cook for anything like decent breastfeeding information is lunacy. She’s not recommended by anybody who knows anything about breastfeeding.

    And this “Research has shown all these effects to be “negligible” or “there was no relationship”” isn’t true. Try reading the very well-respected Cochrane Library: http://www.thecochranelibrary.com/details/collection/1018443/Breastfeeding.html

    I find it fascinating that women are harangued for not being feminist enough if they want to breastfeed – not especially in this post, though there’s more than a sniff of it about it. Is feminism about being exactly the same as men and completely denying our own biological differences even exist?

  24. Louise Winters

    Bloody awful post – really, really bad. Relying on Clare Byam-Cook for factual stuff re breastfeeding is dim at best. And the rest – it doesn’t stand any kind of scrutiny. You have your facts so seriously jumbled, your writing sucks and you lack any sort of ability to reach an intelligent conclusion.

    Ah, just seen it’s a guest post. Don’t have her back if you want to maintain any sort of credibility, eh?

    • I’ll let my guest reply to your “constructive criticism”! But on the issue of credibility, actually a surprising number of people agree with Mairi’s key points. And while I disagree with some of what she suggests, I respect Mairi’s right to have an alternative opinion and wanted to create the space for a debate on what is a huge issue. I don’t see that as potentially denting credibility at all.

  1. Pingback: Breast is best… but there’s no need to keep shouting about it | dorkymum

  2. Pingback: I’ve missed you. I’ve missed you a lot. « A lump in the throat

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