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Guest blog: 'Breast is Best' - has breastfeeding been oversold?

(327 Posts)
KateMumsnet (MNHQ) Thu 14-Feb-13 14:15:47

Prof Joan B Wolf is the author of 'Breast Is Best?', which argues that mothers are being pressured to breastfeed for reasons that aren't, in fact, based on good evidence.

In our guest blog debate, she explains why she thinks that the science behind the 'breast is best' health claims might be fundamentally flawed. On the same page Anna Burbidge, Chair of the La Leche League, responds to some of her arguments.

Do read both, and let us know what you think. Is breastfeeding being promoted as part of "an ideology of total motherhood that stipulates that a mother can and should eliminate any risk to her children, regardless of how small or likely the risk or what the cost is to her own wellbeing in the process"? Or do you feel that, far from breastfeeding being an orthodoxy, society still feels awkward and uncomfortable about it? If you blog, don't forget to post your URLs here.

We know the breastfeeding/formula feeding thing is a hugely emotive subject on MN, as in real life, so please do remember that Mumsnet supports parents' personal choices on this issue - we're all about making lives easier. Please be kind and respectful towards those whose views or experiences differ from your own.

dragonflymama Mon 18-Feb-13 08:54:04

I think the best comparison would be to see how 2 children turn out when born to the same parents....1 bf 1 ff with all other surrounding factors the same (birth health, place of residence, working situation, etc). I bf my first child with ease and am therefore pro-bf, however I know plenty of well educated, excellent parents who ff through choice or necessity. I salute anyone who pumps breast milk as hard work! I am currently pregnant with my 2nd child and wlt bf again for 3 reasons (1-it's natural and 2-I find it easier than preparing bottles, which also daunts me and 3-we co-sleep for 6m and therefore get more sleep), but i try to be open minded in case it doesn't work. After all every parent-child bf-eeding relationship is different. I agree bf support should be increased, but ultimately the feeding (amongst other things e.g. co-sleeping) is a personal choice, cut the social pressure and leave women to decide themselves and be the best they can be under their individual circumstances.

13Iggis Mon 18-Feb-13 09:45:49

Dragonfly my dm bf her two eldest, then ff me and my db. Same family etc. One noticeable difference is the weight of me and db, compared to the two skinny oldest! But that is one family, can't draw anything from that. Anecdote, etc.

Springdiva Wed 20-Feb-13 15:46:38

My DM bfed me and bottle fed my DSis, who is slimmer (and better looking than) me. Doesn't prove anything.

I'm glad Yavi has come back to clarify her views.

I wan't to say that when someone you know is pregnant you don't lecture her on when her labour should start, how often the contractions should be and when she should push or not. Everyone's delivery is different and driven by hormones mainly.

So surely breast milk is the same and largely hormone driven. When, how quickly it comes in, how much there is of it etc. So why do the bf proponents browbeat others on what they must do?

Other factors do come into play, as they do with labour and delivery of baby, but hormones must be the main controller.

Breast feeders do seem unable to accept any comment against it. (though I am not saying BF isn't best just making this other point)

easterbaby Wed 20-Feb-13 22:15:49

Well said, Springdiva. Although I have a foot in both feeding camps, I find myself identifying more as a bottle feeding mum, for the simple reason that a vocal minority of breastfeeding mums are just AWFUL. Smug, condescending, self-centred and completely unwilling to see things from someone else's perspective. (You can normally spot them when they describe themselves as 'exclusive' breastfeeders.)

However, those who donate milk or volunteer their time to sit with new mums who are struggling are wonderful women. Their actions speak louder than any words.

If I was spending public money on improving health and nutrition, I wouldn't choose to promote breastfeeding awareness. Instead, I would make sure every schoolchild has a proper breakfast in the morning, with outdoor playtime each day to soak up vitamin D for strong, healthy bones. In an age when Victorian diseases such as rickets are making a comeback, we need a more encompassing public response than 'breast is best'.

issynoko Thu 21-Feb-13 14:27:42

I wanted to bf all my children but have only really achieved it with number 4 who is still breastfed at 15 months and has never had any other kind of milk. He still feeds frequently, including during the night. Mostly I am delighted it has finally been a success and it is hugely convenient, cheap, massively comforting and lovely for him. Most of the time I also enjoy the times we feed. However it is also true that there are times - at least once a day when I feel frustrated, trapped and restricted by the fact that he is still bf. Not enough to feel ready to stop, and largely this is due to how much I love him, how much it comforts him and that I am one of those mums willing to sacrifice a lot of my own well being for the children - not sure this is always wise though. I am completely knackered and often feel drained by still breastfeeding too.

All my children are healthy, slim and well above average achievers at school with fewer than average illnesses but the bf baby has had far more colds and snotty noses than the others. He has also been the slowest to walk and is hardly speaking although his ff sister was speaking in sentences by his age. I'm sure it will all level out but in my little world, bf had not achieved significant health or development benefits over ff. My bf baby is very firmly bonded and clearly derives great pleasure and security from breastfeeding - sometimes at my expense. I consider the fact that they have a healthy diet and lots of exercise the main reason for their well being and I am no less attached to the ff babies than to the bf one. In short I agree with breastfeeding being 'oversold', although think ff is only safe in cultures where we have the facilities and environment to prepare it cleanly and accurately. Re the fact that formula was only intended to feed foundlings and orphans - this is completely irrelevant. If it was found to work and sustain the healthy development of babies the initial reason for manufacturing it doesn't matter. After all, babies without mothers were fed on cows' or sheep's milk or given to wet nurses before formula existed - some of them thrived and some didn't so all in all formula is an improvement for such circumstances. It is not poison. In fact my bf baby has consumed plenty of diluted wine in his feeds - not something the others have ever been exposed to.

Also I have found the only smug, judgemental women to be breastfeeders who felt permitted to comment, uninvited on my ff. It happened over and over again. But then I was in a very smug middle class area of London. Now I live in rural England, surrounded by a much more mixed demographic. I bf everywhere - including on holiday in Italy, Czech Republic and have never had a single negative comment - not even an unpleasant glance. For me, bf has been very positive, if sometime restrictive. FF was fraught with guilt - because I believed that breast is best and felt I failed my children - and nastiness on the part of other mothers - a minority but a vocal, confident and damaging minority. Support is needed, whatever we choose.

Hizzle Thu 21-Feb-13 18:50:20

Having watched my partner desperately try and fail to breast feed following an emergency c section and 9 hours of surgery (including a hysterectomy to save her life), I have felt angered by the constant pressure to breast feed. She feels a failure and blames herself for not 'doing the best for our son' because she has heard so many times that breast is best. She even ended up with wasted muscles from sitting for hours trying to breast feed as her milk had mostly dried up following her time in intensive care. An extreme example maybe, but even the most intelligent woman can feel undermined by constant messages of how breast feeding, no matter what, is better for baby. I always have and always will believe happy mum = happy baby and I will not be beating myself up if for whatever reason I can't breast feed when I have our second child. This is the first article that I have read that in any way reflects the real reasons some babies are healthier, happier, more intelligent than others - a number if factors and not just because they were breast fed!

jojo72 Thu 21-Feb-13 20:20:26

I was a breastfed baby yet I suffered from hayfever, allergies etc.I breastfed my 3 children then bottle fed them as I found it exhausting.I think breasfeeding for the first few days is good for mums as your womb cotracts back to a healthy level.its personal choice.I believe mums are bullied into breast feeding. As long as baby is healthy I do not think it should matter. I would never judge anyone if they decided breast or bottle.mums should do what is right for them & their family

jojo72 Thu 21-Feb-13 20:26:27

I had my eldest by emer c section on the same ward A younger mum & her baby were so distressed as the midwives insisted she should express milk on a spoon & pipette feed baby.why put mum through all that stress, creating any anxious was horrendous listening.better if the baby was given formula

ExBrightonBell Thu 21-Feb-13 21:21:26

No one should be bullied, pressurised or harangued into breastfeeding. Clearly that is wrong and counterproductive as mums will hardly feel positive towards breastfeeding as a result.

No one should be spoken to rudely, patronisingly or harshly by midwives or other health care professionals when in the vulnerable position of having just given birth. In fact it's blindingly obvious that no patient in a hospital should be spoken to like this at all.

Anyone to whom this has happened should complain formally to the hospital, starting by contacting the hospital's Patient Liaison Service (PALS) who will be able to explain what to do. Hospitals will have details of PALS on their website.

If women don't complain about poor treatment it will never improve for the next person. As far as I understand it you can contact the hospital many months after giving birth if you want to. It may well be a positive and empowering experience to go through this process. I am aware of women who have had health care professionals personally apologise to them about the way they were spoken to when in hospital.

BUT - poor midwife care as described above doesn't mean that it isn't right to encourage women to breastfeed. It needs to be done properly and sensitively of course, and using formula should not be judged if that is what is necessary.

There are many studies that show the various benefits of breastfeeding for mums and babies, I think they have been linked to previously in this thread. However, there will always be examples of babies who don't appear to have experienced these benefits, but that doesn't invalidate the research! To think so is to misunderstand what scientific research is all about. If you disagree with the evidence about the benefits of breastfeeding, find some research that backs this up. With the widespread availability of the Internet and search engines this is surely possible. Anyway, this is almost beside the point....

....I feel very sad that so many women as it seems from this thread have been treated so badly by midwives and hospital staff when they should have been supported. The first few weeks of breastfeeding can be really tough, and women need all the sympathy they can get to help them through it. Or if it doesn't fit their personal circumstances, to find a way of feeding their baby that works for them without abusing them as a result.

[apologies btw for the lengthy post - I have realised I feel quite strongly about this!]

Bukkie Thu 21-Feb-13 21:44:58

Exclusive breastfeeding, in my own view is the best. However, there are some mothers who for genuine reasons are unable to breastfeed. So, does that mean that such children will not be healthy or that their brain will not develop properly?

ExBrightonBell Thu 21-Feb-13 22:24:34

No. They will be healthy and their brains will develop normally (assuming no other medical or lifestyle problems). However, within the normal spectrum, they will not have had the absolutely optimum food source, and so may miss out on the most optimal development possible for them. How that manifests in individual babies may differ widely. The research into breastfeeding shows that on average there are discernible benefits for babies that are breastfed.

The vast majority of mums want to do their best for their baby (I sincerely hope). Breastfeeding is the logical choice to try and give your baby as much chance of optimal development as possible. Formula milk is a perfectly adequate substitute if for whatever reason you discover you cannot breastfeed, or decide that it doesn't fit your personal circumstances.

JumpHerWho Thu 21-Feb-13 22:33:25

ExBrighton - I would complain if I thought it would help me lay my awful feelings to rest, but I don't think it would. There's simply no money in NHS trusts and no political will to put money towards postnatal care, despite it coming up again and again on MN.

It was SO awful, so traumatic, that I don't wish to revisit it tbh and have to defend myself, to revisit 'was it my fault?' again. I want it to be better for other first time mums, for other c section mums, but I'm not willing to address my own experience.

ExBrightonBell Thu 21-Feb-13 22:51:16

JumpHerWho - I agree with you about the lack of funding and matching lack of political will, sadly.

But I do think that if complaints are received by a hospital and are fed back to staff then their attitudes might change. It doesn't cost much to do that. If one midwife is told that patients have complained about her manner then this must surely be taken on board as part of their professional development? Midwives must surely have performance reviews at some point? If the complaint is very serious then the Nursing and Midwifery Council can take action to suspend or strike off a midwife.

I completely understand that for you personally to go over your birth experience in order to complain would be too traumatic. But there most be lots of women who are able to, and should do so in order to try and improve patient care.

ExBrightonBell Thu 21-Feb-13 22:55:22

And for what it's worth, JumpHerWhi - it was not your fault. We are all left to deal with the turn of events that are dealt to us during childbirth, which we have zero control over.

ExBrightonBell Thu 21-Feb-13 22:56:14

Oops, I meant JumpHerWho not Whi, sorry.

inthewildernessbuild Fri 22-Feb-13 00:18:54

I feel really puzzled by this argument. Breastfeeding is what nature intended for babies. There is no reason why it shouldn't work 90 per cent of the time. If it doesn't work, well, formula is a wonderful alternative, which we are lucky to have IF WE NEED IT. But in the majority of cases, it is NOT NEEDED. Why does anyone need to choose formula over breastmilk? It is not a choice, it is a solution to a problem. An excellent solution, but surely not a choice.
I have formula fed and breastfed babies. And I know which method I preferred. The formula was a solution to a problem, and it worked brilliantly, but I would never in a million years not have wanted to breastfeed. Which I did, when problems resolved, for 2 years. I loved it, it was part of my relationship with my babies. It nearly killed me at the beginning, but relationships can be hard sometimes, and looking after babies is hard too, at first whether you are breastfeeding or not. Because some women have terrible experiences is not a reason to say that breastfeeding is outdated or bad for us. We don't live in a breastfeeding culture which makes those terrible experiences a lot more likely. Misinformation, doubt and isolation,and lack of postnatal support, peculiar to this inimical culture which tells us babies should sleep through, or eat at long intervals or not tie mums down, is what makes breastfeeding difficult, NOT breastfeeding itself. Other mammals do it, why should we be SOOO bad at it then?

inthewildernessbuild Fri 22-Feb-13 00:28:17

What I find odd is all those who ebf for first four months and then move onto bottles completely? It is as you have to choose your armed camp. Why not continue to breast feed for some feeds. It is all part of this rubbish idea that breastmilk is this powerful elixir that does its magic for first four months,but really this elixir is far too expensive (timewise) and taxing for anyone sensible to continue with. It treats bfng like a scientific process, a course of action that only needs to be continued for x months to have the desired effect on child's brain etc. I feel like screaming, no, there is more to it than that. It is a bit like saying procreation was only designed for making babies.

inthewildernessbuild Fri 22-Feb-13 00:34:17

Hizzle I am horrified at your poor wife's experiences. Sorry, didn't read thatfar back up thread. I know what it is like to try and feed after traumatic birth experience when milk won't come in. I just want to send her best wishes, and say she is the baby's best gift, a living mum. Hope you can give her lots of love and support over next few weeks and that she gets so much happiness from your new baby - she will...

dekari Fri 22-Feb-13 07:33:58

I think more research/info needs to be available on combination feeding as a, dare i say it, compromise.

I had to introduce a formula top up at 6 weeks when my LO dropped to the .4 centile. That was despite a good supply, ebm top ups and spending over half the day feeding (still feel the need to justify - argh!) That 60ml made all the difference (and surely improved DD's life chances as it helped her thrive).

The all or nothing approach just reinforces the dichotomy of bf v ff. Although, saying that, it's good practice... TW v BLW, back to work v stay at home, childminder v nursery... It's neverending! wink

Maebe Fri 22-Feb-13 09:53:40

I definitely agree there should be more discussion on combination feeding. I didn't hear anything about it, I wasn't really aware that combination feeding was an option. As I said earlier in the thread, I was one of those who circumstances made me feel ff was for us - but I know that was because I believed that if I was bf, it would be me doing all the feeds and then expressing so that anyone else could help out, which just seemed an awful thought. If someone had talked me to about combination feeding from the start, about your milk regulating itself to your needs, I probably would have given bf a chance.

inthewildernessbuild Fri 22-Feb-13 10:43:22

but Maebe why did it seem such an awful thought that you would be doing all the feeds? After all, most mothers who formula feed end up doing most of the feeds anyway (that is why formula feeding is as good a way to bond with your baby) AND doing all the extra work of sterilizing and making up bottles.
There is so much that needs doing with a baby, feeding is a large part, but there is always other ways people can help if they want to support a mother who IS finding breastfeeding time consuming. Why is the answer just to say change to formula, when it creates more work for that mother in the long run?

Maebe Fri 22-Feb-13 15:51:58

For a lot of reasons, wilderness, most of which I'm not going to go in to here, but one reason was down to the support around me and a feeling that I wouldn't cope if I wasn't in a position to allow my DP to do as much care of the baby as I was. But I can honestly say that with ff the feeding of our baby and the making of bottles etc was done pretty much 50/50.

(This is a side issue, but I do wonder how men feel about bf - unless expressing comes easily to a mum, or combination feeding is introduced, men are missing out on such a large part of their new babies life. I find it very interesting that women who have loved bf talk about the wonderful experience feeding was, occasionally in a way that suggests they feel sorry for women who missed that experience, yet there never seems to be any comments about men missing this experience.)

Personal feelings and beliefs aren't entirely the way forward in a debate such as this. I am sure that most people won't agree with my decisions to continue ff, just as people have taken issue earlier in the thread with zavi's reasons for not bf - just as women who struggle with bf or who make the decision to ff from the start can struggle to hear comments about bf being a greater bond with a baby or something similar. Personal feelings as simply that: personal.

What is needed all around is the ability to discuss feeding a baby without anyone feeling criticised or guilty or blackmailed or a failure, and to discuss the best way of achieving the way you want to feed.

drizzlecake Fri 22-Feb-13 16:32:47

but Maebe why did it seem such an awful thought that you would be doing all the feeds

Because you can't do anything else energetically whilst feeding, ie you can watch day time tv or peruse mumsnet, but you can't run down to the shops or dig the garden.

Surely it's restricting?

If breastfeeding is a wonderful fulfilling happy time then you want to do it. If you are sitting thinking 'hurry up, i have this, this and this to do'. It's frustrating.

The temperament of the mother doesn't seem to be consdidered.

No doubt I'll get the 'why have children if you can't be bothered to blah blah blah...' but I now realise (many years on) that I was and am a great mother. But felt quite a failure for not maintaining bfing. V sad that I should feel that imv and it is the insistance that only this is best that caused that.

inthewildernessbuild Fri 22-Feb-13 20:58:27

I'm sorry, I'm back again.

You do have to sit on the sofa when you are feeding a baby formula, truly you do, you can't run down to the shops or do digging then either. Quite frankly you are so tired with a new baby that I can't see many people wanting to do either activity much. You sit and you cuddle the baby, and the feed takes a while, then you burp the baby, change it. That is time consuming, whatever the milk source. Unless you have a maternity nurse a live-in MIL or a nanny. If you have other children, why would formula feeding husband help reduce workload. He can look after the other kids for goodness sake if he wants to help or bond with someone. I think this incredible tiredness that people associate with breastfeeding is an optical illusion to do with first few weeks after childbirth, which is incredibly tiring, and happens, surprise surprise to co-oincide wth first few weeks of breastfeeding.

My husband was incredibly helpful with small babies. He bonded with them. He did not need to bfd them to do that.

inthewildernessbuild Fri 22-Feb-13 21:13:41

I agree that first few weeks can be frustratingly inefficient. I do agree. Everything seems to be about getting supply going, and there is a bewildering sense of everything being out of kilter. Is baby getting enough, why are they crying, are they hungry again. I understand why it feels like a relief to see what they are getting, to know the feed is finished.

But it is such a short stage that things are all over the place. The supply settles down. Feeds take no tme at all by 4 months. The baby is satisfied in 10 mins. I think there are plenty of mothers with crying babies who don't settle or sleep through, or have colic who are fed on formula. It is not the perfect milk for some babies. My neighbour had a child with reflux who screamed on formula until he was diagnosed as being severely allergic to lactose. He has asthma. She didn't feed because she had a very traumatic birth and I completely understand why she moved to formula after a week. But I bet she regretted her decision in light of what happened next; okay another anecdote, but the point is that not all babies will do better on formula than on breastmilk. Most will be fine, but what is there any harm, if you have not had a traumatic birth or terrible problems with weight gain, or all the reasons why people are justified in feeling very reluctant to continue bfng, on just giving it a whirl, and looking beyond immediate "busy" concerns. They can wait in 90 percent of cases. There is the rest of your life to dig the flowerbed. And I love digging.

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