All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

Women 'pressured' to breastfeed babies - Independent Today

Screamed The Independent headline today.

It said that women have been "cajoled" with slogans such as "breast is best." But researchers have decided the  approach  is "idealistic" and "sets parents up to fail", furthermore:
"That greater recognition of the multiple demands new parents face would reap greater dividends."
OK so we agree its time to ditch the "breast is best message",  but the interesting bit is recognising the multiple demands new parents face. We'll come back to this in a moment.

The Independent goes on to say:
"Breastfeeding boosts the baby's immune system and protects against infections, reduces the risk of asthma and eczema in childhood, and of diabetes, high blood pressure and obesity in adulthood."
Well to be fair breastfeeding doesn't "boost" anything - it's the normal food a human infant is intended to consume. Infants produce some antibodies, ie they produce IgE well - IgE seems to be involved in fighting parasites, rather than pathogens. However other antibodies they don't produce in large levels for example sIgA. This antibody protects mucosal surfaces that line the oral, respiratory, gastro-intestinal and genito-urinary tracts against infectious organisms and toxins

Instead mum makes this and breastmilk has high levels, so together baby ends up with a full arsenal - it's a dyad just like before birth that work together to create the whole picture.  Not breastfeeding cuts half of this team away and leaves a baby without the antibodies expected from mum - the results show babies have lower levels of these antibodies (1).

The Independent goes on to say:
"The researchers contrast the idealism of the professionals with the realism of the women and their families.
A mother who feeds her baby on demand is the ideal, but in reality sharing responsibility for feeding allows partners, grandparents and others an opportunity to bond with the baby."
All this confirms to me is we have a society still swamped by the myth that because breastfeeding is considered "bonding", any method of feeding must be and thus it is essential for all family members to be involved in order to bond.  The "realism" is based on lack of education and perpetuation of this myth - with no consideration to the fact there are lots of ways family can bond without feeding.  Before bottles did nobody bond?  Were we all dysfunctional?
"Some parents reported feeling pressured to breastfeed and even regarded its promotion as propaganda. They felt the culture was "all or nothing" rather than "try it and see" and did not want to be "set up to fail."
This is interesting - do we hear parents reporting feeling pressured to provide a healthy balanced diet or use a carseat?  Why does this only apply to infant feeding?  When we talk about benefits of a normal function it does feel like propaganda.

For years breastfeeding wasn't promoted and bottle feeding rates were higher   "Try it and see" is an interesting concept, but also potentially doesn't convey the significance of feeding method as discussed here.

Unfortunately with the support systems in place, I'm struggling to argue against the "setup to fail" comment....
"Many new parents spoke about "getting the baby into a routine" and "getting back in control of their lives" which often conflicted with the time needed to breastfeed."
And here we have it, the root of the issue -  yet more myths pedalled by certain "baby experts" <snort> who sell parents unrealistic expectations, and indeed play their part in "setup to fail".
"Gail Johnson, education and professional development adviser at the Royal College of Midwives, said a shortage of midwives left some women feeling unsupported with breastfeeding."
Strange the "shortage" of Lactation Consultants (IBCLC) and those appropriately trained and qualified in the field of lactation within the NHS don't get a mention no?    I mean, wood - trees?  Why haven't they asked a Lactation Consultant, those working day in and out with mothers for a quote on this?
"The authors suggest changing the message from "breastfeed exclusively for six months" to "breastfeed as long as you can and introduce solid foods as close to six months as possible."
So despite the fact we know not breastfeeding exclusively for 6 months carries risks, we don't tell mothers this?   OK. I'm clearly in a minority in that I would kinda like to know and make my choices accordingly.  What do others think?

1. FOLIA MICROBIOLOGICA Volume 48, Number 2, 281-287, DOI: 10.1007/BF02930970


  1. I so agree AA, particularly with that last paragraph. Women are NOT being told all the risks of not breastfeeding, and therefore they are NOT making informed choices. Yes, if they are told all the risks of bottle-feeding and then go on to fail to breastfeed, there may be an element of guilt, but for me I know that motherhood is pretty much a lesson in feeling guilty. About everything! I don't think the risk of mothers feeling guilty about not breastfeeding is any excuse not to tell them what is more likely to happen to their babies if they don't breastfeed. When buying medicine you expect to be told the side-effects, and I think it is the responsibility of the formula companies to make sure women know exactly what they are getting when they buy formula. Thanks for another great blog AA. xx

  2. oh my goodness. well where to start? seriously?? let me see so the pressure to breastfeed is being given the facts but there is no pressure to bottle feed??? i am not sure if this happens in the UK but here in the states even those little "goodie" bags given to mamas when they leave a hospital and are planning on breastfeeding are full of formula.
    and honestly i am getting sick to death of the guilt card being pulled and the "bonding" card being pulled. you are right, did no one bond before bottles? what i don't get is so many don't see the stupidness of this. they just eat it up and don't nurse.

  3. Next headline ... 'Women pressured to carry their babies to term in the womb' It's the biological norm for Pete's sake!!!

  4. The ideal, I am told, is for me to eat two serves of fruit and five of vegetables each day, for optimal health. Well, some days that is a really big challenge and I just feel guilty when I can't meet that ideal, so they should change it to "try to eat some fruit and vegetables if you can, but don't feel bad if you rely on vitamin supplements instead".

    Of course, not every mother manages to reach the ideal but that doesn't mean we should alter the facts! Of course we should reassure the individual who has not personally reached the "goal" to exclusively breastfeed for six months but that doesn't mean we alter the global message.

    Actually, I feel really bad that I introduced solids to my first at 4 months (alright, she was almost four months ... well, sort of three and a half months...) so could you change the recommendation back to that so I don't feel bad? And that formula they gave her without my consent in hospital, well, I feel bad about that too, so lets just cut the word exclusive out to make me feel better? See, then I wouldn't have tried so hard (and successfully) to feed her two siblings exclusively for six months (or bothered to continue to feed til they self-weaned between 2 and 3 years).

    And you can knock off with all that stuff about natural birth, cause I had three caesareans and I feel guilty when I hear how much better vaginal birth is ... oh, no - wait - no, I read something recently about the risks of vaginal delivery, so caesareans are probably better after all.

    (shakes head, wonders of we have made any progress in the past 28 years of motherhood, seeks brick wall to bang head against)

  5. You are, as always AA, spot on with all the problems of this 'too much pressure' argument – but, however daft it is, people *do* feel pressured to bf, and *do* see 6 months as 'unrealistic'... (and yes, we know it's other expectations that are the real problem, but many new parents don't – and it's their attitude to their ability to bf that we need to change here.)

    I've heard that we are told to 'eat 5 portions of fruit or veg a day' because the real target – 9 a day IIRC – is considered unrealistic. I can see the psychology of that - people who maybe eat 3 a day might push themselves to 5, but would know they couldn't make it to 9, so wouldn't bother to try and would just stick at 3.

    I suppose it might be worthwhile to tell people something along the lines of 'the first 2 months are the most important', as soooo many people seem to give up at the 6 week growth spurt – and if they only feel they have to stick it out for 2 more weeks (as opposed to 4 and a half months), they might keep it up and get through to the point where bf is easy! Of course, the risk is that people would then take it that they only need to do 2 months (and start believing that human milk turns to water after 2 months, instead of at 6 months – or is it a year?)

    Still, I don't think there are many people who would normally have eaten 9 portions of fruit and veg who have cut back to 5..

    I guess we'd need a 2 tier approach – 5 is good, and if you can do 5, can you do 9? 9 is better. 2 months EBM is good, 6 months is better. We certainly can't stop telling people about the ideals/norms just because some people think it's too hard or too much pressure. But we do need to think about how to get as many breastfeeds as possible for the children of those who see it that way.

  6. QUOTE I've heard that we are told to 'eat 5 portions of fruit or veg a day' because the real target – 9 a day IIRC – is considered unrealistic. I can see the psychology of that - people who maybe eat 3 a day might push themselves to 5, but would know they couldn't make it to 9, so wouldn't bother to try and would just stick at 3.

    My understanding is that it is through further research 8/9 rather than 5 has developed, rather than this being a deliberate misholding of information - it was in the news Jan 2011 that newer evidence suggested more than 5. But regardless here is what the news also said:
    "Britons missing 'five-a-day' fruit and veg target, study claims. According to a study of the consumer habits of the nation, just 12 per cent of the population manages to hit the target recommended by experts.
    A further 12 per cent do not eat any fruit and vegetables at all, the research found.
    On average, people in Britain eat two-and-a-half portions a day, but the study, titled 'Health of Britain - Perspective on Nutrition 2008', found significant differences between age groups, gender and social class."

    One could also argue from a psychological POV that if the target is 5, people eating 3 think they're "not far off" the optimum and so will be "fine". Whereas if the target was 9, they may eat a few more than 3 to try and get closer.

    QUOTE I suppose it might be worthwhile to tell people something along the lines of 'the first 2 months are the most important'

    But is this true? Do we have evidence for this? Or are we just making something up? Exactly as you say years ago I remember many mothers being told the first few days were the most important due to colostrum, a few years ago a social enterprise in our area decided it would work to tell mothers to do it for just 3 weeks - as a "more realistic target", more may have got to three weeks, then when 3 week fussy spell started figured they had done enough. I overheard one mum saying if you only had to do it for 3 weeks it could hardly be that important!

    I just can't get my head around the language used for a 2 tier approach - re bfing 6 months is better? But it's not, it's just normal! As Watch Your Language found, people don't aspire to best or optimum, just normal/ok....

    1. "One could also argue from a psychological POV that if the target is 5, people eating 3 think they're "not far off" the optimum and so will be "fine". Whereas if the target was 9, they may eat a few more than 3 to try and get closer."

      Yup - good point - I suppose different people will always react in different ways to whatever info they get - if only we could just tailor the info to be given to the different personality types (target driven vs close enough)! And you're right, the language doesn't really work for the 2 tier approach. Although, it is perfectly true that 6 months IS better than 2 months AS WELL AS being normal. I know the implications of using best/better instead of normal - but in this instance saying '6 months is normal' is equating 2 months with 'not good enough' - which is what is being suggested is the problem in the first place - that if you aren't going to make it to 6 months, you may as well not bother to do it at all - you are doomed to be 'not good enough' no matter what, so why give yourself the stress?

      My point was meant to be more about moving from 'formula is normal' to '2 months bf is normal', almost as a stepping stone to the true normal, IYSWIM. And your 3 week target anecdote is exactly why you NEED those 2 tiers, to stop people thinking reaching the first target is the ultimate aim - and why I choose 2 months - after the early fussy stages!

      As I understood it, basically the younger the child, the more important the bf is - so *technically* the first (insert ANY amount of time... 2 hours, 2 days, 2 weeks, 2 months, 2 years...) is the most important. But yeah, 2 months is blatantly plucking a figure out of the air to try to persuade people to get past the tough stage and onto the point where it is so much easier than preparing bottles that switching would be counterproductive.

      I guess 'every bf counts' is a better way to promote it - alongside the minimum recommendations. That would hopefully remove the 'all or nothing' culture. Still, that has drawbacks too - it practically encourages supplementation to 'give mum a break' -y'know, the idea that if dad gives a bottle at night, mum'll have more energy and so will be able to keep bfing longer - resulting in more bfing overall. Which might be true – *if * her supply survives supplementation, and you don't worry about the virgin gut.