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"the scientific evidence for breastfeeding's health benefits is weak"(31 Posts)
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Interesting article. I have to say that from a personal point of view, the nhs is almost anti breastfeeding. My dd lost more than 10% of her birth weight at 3 days old and I was told I'd "have to give a bottle" by the midwife as I wasn't able to express the colostrum (who can?), then a few days later, when I asked the HV a question about BFing the reply was "I don't know the answer may be on this leaflet but if not, here's another leaflet on bottle feeding". It's really down to this forum and the NCT that I'm still going (and loving it) at 17 weeks!
I didn't have any professionals extolling the virtues of BFing but found a profound lack of knowledge and understanding on their part. Perhaps the tide is changing or the nhs is now unable to fund the teaching required.
I chose to bfeed as it was what I wanted and what I felt was best, can't say the advice I got given reflected this!
I would have bf if I could. I'll rephase that, if ds could and I and we'd been given the time and support we both needed. as it was we had rushed visits on the ward with 'well keep trying' until three days later hed still not eaten and was jaundiced. I expressed a bit and he was syringe fed until he eventually learnt to suck. It's still a poor reflex.
It took 10 days post discharge to see the bf specialist so two weeks total. The whole experience was traumatic for both of us.
I hope if I have another dc I will get more support but I know better now who to speak to. I do feel it's something I missed out on.
I just wish that the NHS would walk the walk and not just talk the talk when it comes to BF. Until we resolve this disconnect, IMO BF rates will remain low.
I had to FF DS initially due to major problems with latch etc. Turns out he had a tongue tie, which I'd not even heard of! Zero interest and support in the hospital or from the HV, despite posters and leaflets absolutely everywhere. I was able to BF DS after 12 weeks, but only after I'd hired a lactation consultant, pumped every 4 hours round the clock, bought domperidone etc. Not every mother would be in a position to do that. (At least when DD was born, I knew to ignore the NHS and use my own LC to get her tongue tie diagnosed and snipped...)
Obviously i meant some feel that way and not all. I was referencing the population wolf and others suggest are feeling 'guilty' because they have been hoodwinked into thinking bf is essential to good mothering. I suggest their feelings are more complex.
Some mothers are sad or disappointed or angry -- not all, surely?
I think these emotional aspects of BF are highly individualised and you can't generalise whether they fall on the positive or negative side of the equation.
My friend with the cluster feeds -- she has actually indefinitely delayed having another child because she would feel too guilty not to BF but she cannot emotionally deal with going through it again, it was extremely hard for her.
Obviously the emotional aspects can also be extremely positive, I just think we have to acknowledge it can go either way really.
I agree that the economic value of breastfeeding is ignored unfairly. The baby cannot pay for his mother's time and labour, but society should do, by extended maternity leave, nursing breaks, free pumps, flexible working, and whatever else is needed. There is research which calculates the cost of mothers' breastfeeding and makes it a part of a nation's GDP.
Having said that, we make a mistake if we view breastfeeding/breastmilk solely in economic, quantifiable terms.
I welcome social science and other non-biomedical research into breastfeeding, because it's only with this sort of research that we can learn more about the psychology, at an individual and societal level, of the whole issue.
It's a real shame, in my view, that Joan Wolf, a political scientist, has looked at breastfeeding research and concluded (wrongly, as it happens) that the health impact is not so great, and that mothers are somehow duped into thinking that what they are doing makes a difference. Breastfeeding is also an act of bodily autonomy - mothers enjoy the fact that their body makes their baby grow, they enjoy the role breastfeeding plays in their growing and loving relationship with their baby, and when this does not work out they are sad and disappointed and angry....not always because they worry that their baby will become ill, but because they recognise they would have liked to share that experience with their babies and now cannot.
showtunes -- that's what I mean though, it's been brilliant for you and so it was a great decision for you.
All I'm saying is that there are potential problems that can occur, that can make BF a less ideal choice for some. And I think we should be realistic about what those potential problems are and, as Holey says, not minimise them.
My one friend, for example, had to do 3-hour cluster feeds every night for weeks. She managed because she was on ML and it was her only child, but if she had had to work and had other children she probably would not have persevered, and I think that's a totally reasonable decision. There's a whole context to feeding that I think gets overlooked when we only focus on the health benefits.
They are common issues - more support might make them less common, but they would still be risks of choosing to breastfeed.
Most formula fed babies don't get gastroenteritis but it is still a risk asscociated with formula feeding. Better support might also reduce the incidence.
I very much agree Holey
And I have to differ with you Eau on the issue of time. I had to FF my DS and even as a newborn, this took no more than an hour a day total, for all feeds, which I split equally with DH. (It takes 5 minutes a day to do the bottles and the actual feeds went very quickly.) Contrasted with my friends who were BF and spending hours and hours a day, having to do all the night wakings, etc. (at least in the early days)
So of course time can be an issue -- not for everyone, but for some, yes. And it's not unreasonable for women to look at the opportunity costs of devoting that much time to BF and deciding that it's not the best choice for them.
BF mother of 14 month old here.
Sleep depravation - no more than anyone else. In fact DD is now a pretty good sleeper.
Mastitis - never had it.
Thrush - not had it.
Poor infant weight gain - DD has always tracked the 50 percentile line bang on.
And in some ways, even if you take away the debate about which is healthier, I would still prob BF unless someone could prove to me that it was actively damaging my DD because the convenience has been brilliant.
But if there was proper breastfeeding support available then this kind of thing would happen very rarely. Of course women need to be told how to get help if things do go wrong but I would say they are 'real risks'.
They are not anecdotal they are real risks of choosing to breastfeed.
The tendency to trivialise these common issues is part of the problem.
But time is also used making up formula and sterilising etc, so I don't know why that is being considered an issue. Of course, other people can help with formula feeding but in reality it is almost always the mother that does it.
It will help to give mothers the facts about the pros and cons of both (the main cons of breastfeeding being lack of support and accurate information, which really needs addressing) and then ask them how they feel about the choice and what they think.
Mastitis and thrush are not inevitabilities of breastfeeding, neither is sleep deprivation (there is a study that showed this, I will find it later), poor infant weight gain is also not an inevitability. So these are not usually counted as cons because they are anecdotal.
The assumption seems to be that women who choose not to breastfeed are doing the wrong thing, rather than making a decision on what is best for their family circumstances.
Choosing formula to avoid sleep deprivation, recurrring mastitis and thrush, poor infant weight gain etc is a perfectly reasonable decision. It is also reasonable if the mother is simply not enjoying breastfeeding. I think that honesty about the pros and cons would make the topic less fraught, and would leave fewer new mothers feeling like failures for not being able to establish breastfeeding. The risks of choosing formula are tiny. There are also risks with persisting with breastfeeding when it is not going well.
I agree that the time and labour is not wasted, and we should focus on removing barriers.... But I do think this aspect of feeding does not get enough attention, and that helps account for the steep dropoff in BF.
What I find strange is that it's okay to list the pros and cons of most aspects of parenting, but with BF the focus is so relentlessly positive. As a social scientist myself I think we should address all the positives and negatives of choosing to BF, and not neglect the (potential) negatives because they're inconvenient for long-term aims.
It comes down to no one except baby (and usually mum) profiting from, and therefore valuing breastfeeding. dreaming of course a woman's time and labour is valuable, I agree, but it is not wasted on feeding and caring for an infant just because that infant cannot pay her for her time and milk.
Of course we need to look at the socioecnomic reasons why mothers don't breastfeed, but I think we should look at removing those barriers, not throw up our hands and say 'well breastfeeding isn't important then, we'll stop asking mums to consider doing it'.
It doesn't surprise me that this is coming from America where maternity rights are so poor. But money and time would be better spent on improving those rights than complaining about breastfeeding.
It is terrible that some women are forced back to work by economic necessity or aren't given the practical support they need to breastfeed. These need to be addressed as barriers to breastfeeding, and it is totally understandable that women facing these barriers 'choose' to not breastfeed, they shouldn't be made to feel guilty for giving them the best alternative - formula. But that doesn't mean breastfeeding isn't best/normal and shouldn't be encouraged. Its just finding more effective ways to do that than the slogan 'breast is best'.
Very interesting article.
I do like the questioning of the 'BF is free' line, because I agree that this holds an inherent assumption that a woman's time is not valuable, and that there are no opportunity costs (lost sleep, problems at work, etc.)
I also think it's important to have social scientists and sociologists involved in the debates, because feeding doesn't happen in a vacuum. As long as the emphasis is on medical research then we will be stuck at 'breast is best' with not much insight into the very real impact of policies on women's lives.
The article seems pretty confused tbh, we shouldn't encourage women to breastfeed because they don't currently and because women who work can express?
I think basically she's describing the current situation but I don't think it supports the conclusion that breastfeeding is overrated. Just because randomised trials would be unethical, does not mean there is no worth in the only ethical studies that can be done. It wouldn't be ethical to have a 'scientific' experiment where randomised groups were told they couldn't cuddle or kiss their babies, but that doesn't mean that cuddling and kissing babies is not beneficial and that it shouldn't be done.
This can be added to the large pile of opinion pieces about breastfeeding, that are under the mistaken impression that mothers who breastfeed for six months and over are martyrs, over enthusiastic or cautious mothers. This stems from the myth that breastfeeding is hard, overly onerous etc. This is particuarly clear in the attitude against expressing at work.
The myth that breastfeeding is hard/onerous etc stems from so many people stopping doing it so early. Yes, some people find it hard in the beginning, it is a new skill to learn, and a new baby does need to be fed often. But once mother and baby have got the hang of it, it is easier than bottle feeding. No preparation, no cleaning up etc. If my only experience of breastfeeding was the first bit, the hard bit, I'd think those who carry on are superhuman/ridiculous massocists too, but it does get easier, for most women it does, honest.
It also values the economic value of a woman in the workplace, more than her value to her infant as carer, and source of nutrition. Presumably because the baby has no money to pay its mother for meeting its needs. Its an old argument. If some women are forced to give up breastfeeding or otherwise caring for their extremely young infant in order to work due to economic necessity, the problem is not the promotion of breastfeeding making the women feel guilty, it is poverty and high living costs forcing them back to work before they and their infant are ready to be parted.
It is not an onerous economic burden for a woman to be allowed breaks to express for her baby. And its a hell of a lot healthier for the nation than taking a cigarette break as used to be so common.
I do agree that women should be given more support to bf if that is their choice, because many women give up ebf before they'd wish to because of problems bfing. Most bfing problems have solutions that would allow either ebf or mix feeding and it is a shame that women are not given the support to do so.
Yes, it would be helpful to have more research from other areas. I think there should be more emphasis on informed choice.
Wolf is a social scientist. It is a shame that more interdisciplinary work has not been done on this subject.
Understanding the social context is key to identifying confounding variables.
She's not a medical professor then.
I don't think she is wrong to debate, it never does to just accept things and not question them, but I wouldn't agree that the evidence for breastfeeding's health benefits is 'weak' at all
I wonder what her angle on this is. I completely agree that there's too much pressure on mothers from all sides (not just BF/FF, but every aspect of parenting). The way that breastfeeding is viewed in this country and the way it is encouraged by the NHS is all wrong- there needs to be more support and more acceptance of the mother's feelings. Not enough time is spent discussing feeding methods and the emotions of the mother surrounding them. Simply telling mothers what the benefits are without really talking about it does not help.
All this 'breast is best' stuff is all well and good but once your baby is born there is almost no support from the NHS or from society in general. No wonder so many women struggle and end up feeling guilty. That is what needs to change- not the information on breastfeeding, which is sound as far as I'm concerned.
It is also harder to establish breastfeeding when the baby - or the mother - is not in perfect health.
That might be due to a traumatic birth, a complicated pregnancy, or as yet undiagnosed SN.
Separating those issues out from the stats is very difficult.
We're going to move this to the Breastfeeding topic in just a mo, at the request of the OP.
I remember the Zoe Williams article - or maybe an even earlier one than that - do we all seek to justify what we personally did? I was lucky enough to breastfeed (ebf to 6 months) - its simple and lovely when it goes right.
But I read up a lot of the WHO stuff and bought into the sealed gut theory, and the scientifically based reasoning behind their recommendations (this meant I expressed and stressed about being back in time in case DD had to have - (gasp!) formula before I got back! After 6 months when she started eating - I didn't worry so much about formula cos other stuff was already going in.
Breastfeeding would be optimal for most babies and mothers in most cases - but this doesn't include everyone.
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