Infant Feeding - Massive Straw Men with Ambivalence & Gaslights

Never thought about it as abuse from a partner point of view, my own DH was quite supportive. But I can certainly see how it could be used that way.
I was given lots of pressure to switch from both grans. One from the formula babies are more settled point of view. The other from the we could help point. I strongly suspect it was more their selfishness wanting to give a bottle rather than concern for me.

We were living with the latter of the two grans, when my eldest was 3 mths to 7 mths. So I'd at least managed to get BFing established. But constant pressure to introduce a bottle was tough going. I had visions that if I introduced a bottle it would be a fighting over fed my baby. Which actually made me more determined to keep going. I've never felt like such a rebel.

I thought the idea of preventing women from breastfeeding being a form of abuse was very interesting. I had never thought of it that way before, but I do have two very close friends whose partners effectively sabotaged their breastfeeding for different reasons.

One friend has a very controlling husband- his own friends on the whole have partners who are much younger, less well educated and easier to control. None of them have breastfed. So when my friend was pregnant she was very clear that she wanted to breastfeed, but after the birth her husband put enormous pressure on her to mix feed. The breastfeeds got fewer and the bottle feeds happened more often (given by her husband and his family) until she found herself exclusively formula feeding. This was absolutely not what she had wanted at the start. Incidentally, her husband has still never done a night feed despite giving this as one of the advantages to mixed feeding.

My other friend had a very traumatic birth and couldn't get breastfeeding started initially. Her partner was very quick to take over formula feeding. He prepares and gives most feeds. He is desperate to be involved in the whole feeding process. She meanwhile is devastated that breastfeeding didn't work out and is rather depressed. Her husband is lovely, but is so desperate to be involved in feeding that he made no attempt to support breastfeeding. I had suggested a lactation consultant, knowing that my friend wanted to breastfeed, but he was keen to point to all the adults he knew that had been formula fed and turned out fine.

Society as a whole should be more supportive of breastfeeding mothers as a matter of principle, anyway. If formula were to advance to such a level that there were no benefits even on a population level, I'd still want women to be able to breastfeed anywhere they and the baby are legally allowed to be.

I guess if the benefits of breastfeeding are on a population level it's not unreasonable to expect society as a whole to be more supportive of breastfeeding mothers. The discrimination laws are a good start but we have a long way to go to create a breastfeeding friendly society.

Additionally, the motivation for the NHS to keep pushing breastfeeding is because there are a couple of advantages on a population level, and even the best controlled research shows this. That is, fewer colds and gastro problems in babies and a reduction in breast cancer in women. Which, unlike the reduction in ovarian cancer which is also accessible through taking the combined pill, doesnt appear to be replicable.

So it's financially worth the NHS producing less evidence based information because even if women eg breastfeed because they think it'll make them bond better, if you can bullshit enough of them you'll still get a population level decrease in admissions for gastro problems.

I, however, dont regard that as a particularly feminist outcome if the women would've otherwise made a different decision.

It's politics, and wider cultural frameworks. Healthcare policy is made in that context, because all policy is. Specifically with regard to infant feeding, we're experiencing a completely understandable backlash against the behaviour of some formula companies, and an equally understandable desire from global bodies to prioritise babies in poorer countries and thus to be less willing to give any advice that might be seen to present formula feeding as Western and aspirational. There's also a general natural is better mentality, which is why the WHO came up with that nonsense 15% section recommendation and why when they withdrew it, they did so rather quietly.

And certainly the NHS has plenty of experts, but they also give out dietary advice recommending low fat foods, which is hardly evidence based. Remember the eat well plate?

But this is what I'm trying to say - stopping breastfeeding was clearly the right choice for you, but it wouldn't be for all women. Trying to insist that all women do one thing or the other is not in anyone's interest - and that's as true as trying to say that breastfeeding is pointless and formula feeding is liberating, as it is of saying that breastfeeding is always the best thing and formula feeding is inadequate. I think if we could reach a point where no one felt that how another women chooses to feed her child reflects on their own choices then we'd all be a lot happier for it.

People say a lot that the NHS pushes breastfeeding to the detriment of women, but I'm never quite sure what people think the motivation for this is? Who benefits from promoting breastfeeding unnecessarily? Unlike formula feeding, there's no clear and obvious commercial interest/profit to be made, so why do people think the NHS is involved in this huge lie? Or is it that people think that they, random people on the internet, have spotted flaws in the research that have never occurred to the NHS experts?

I agree with lisa to an extent, but I also don't think we can separate the numbers of women saying they want to breastfeed and that they stopped due to lack of support from the information and prevailing climate either.

So for example, I think it's more socially acceptable in many circles to say you stopped because you didn't get the support rather than because you tried it and decided it wasn't worth it. That's what I told my health visitor when asked, because it seemed to be what she wanted to hear. It was a lie. I don't know if that was ever recorded anywhere, but it if was, it will have misled anyone looking at it.

There's also the reality that the NHS has a party angle on this and doesn't give the most accurate picture. I don't just mean fluffy stuff like the bonding claims, but for example they don't restrict their recommendations to what's clear from the best quality research, ie PROBIT and confounding sibling studies (and heaven knows there are flaws with PROBIT, but all breastfeeding research is riddled with incredibly hard to control confounders anyway). I never saw any mention in the pregnancy literature of there being more Vitamin D in formula, or the rate of readmission being higher in exclusively breastfed neonates.

I'm passionately in favour of support for women who want it. But nor is it a particularly feminist outcome for a woman to decide to breastfeed because she accepted what the NHS told her about reduction in obesity because they based their advice on evidence that does a worse job of dealing with confounders than PROBIT, need support and get it, and meet breastfeeding goals that are based on claims that aren't necessarily accurate.

I would say both the more patchy claims and the lack of support are only able to continue because it involves women and our bodies. It's a very toxic brew and one cannot help but think men wouldn't have to put up with it.

Lisa - For me it was a feminist victory - the expectations on women to breastfeed are huge and I don't and will never buy into them. I wanted to breastfeed, it didn't work out and as someone who went through ALL the avenues to try to get breastfeeding to work it really was akin to telling someone with a broken ankle to just keep running the marathon.

If women were given more balanced information regarding feeding prior to having a baby I think more women would be happy with their outcomes. The 'resources' that are cited as being needed in my experience were essentially pressure to keep going and kept my baby hungry. The NHS needs to put out balanced information on all forms of feeding including the fact that if breastfeeding isn't working there are dangers to both mother and baby.

I just wish on this - like so many parenting issues - we could accept that people making different choices isn't an attack on our own, and we're all different. I fed for as long as I wanted to, which I think is pretty fantastic and sadly pretty rare. If the low breastfeeding rates were because women in the UK just didn't want to breastfeed then I'd think that was fine, but the statistics are clear that a lot of women want to breastfeed, initiate breastfeeding and then find it's not working, often (but not always) for reasons that could be resolved if they had the right resources and information - so that's not a positive choice. I want people to have a positive choice about how they feed their baby, and that means more support and information about all forms of feeding. Just telling women to give up and give formula isn't really a feminist victory since the statistics show that's not what most women want to do.

Oldermum - couldn't agree more.

I think it's a huge feminist issue that more specific information about the benefits of breastfeeding aren't readily available and given to you by the NHS. Blindly encouraging women to breastfeed isn't helping anyone. I really struggled and spent days researching the "benefits" before deciding it wasn't worth continuing. Alongside breasts, women also have critical facilities and should be given detailed and balanced information so they can make the choice for themselves.

Even the way the NHS page on breastfeeding is written is infantilising:
breastfeeding can build a strong emotional bond between you and your baby

• or it could do the opposite when you hate the whole parenting things because it isn't working

• mine wasn't, my baby was starving despite feeding A LOT

The pressure to breastfeed is huge and in my mind pretty unacceptable. Formula is more than adequate, and I do believe the only reason the bullying to breastfeed is allowed to continue is because it involves women.

I see so many people in here saying you should be able to hve a productive discussion, etc - you can't have a productive discussion without giving voice to the millions of women who simply don't want to breastfeed or can't, or have adopted/foster children, and admitting there is no good reason to insist on donor milk and the many reasons why women don't want to do it and shouldn't feel required. The breastfeeding cult is getting way out of hand. I was bullied horribly when my milk ran out and I'm sick of seeing it everywhere, the breast bullying squads. Babies are fine with formula. They thrive.

If you are heartbroken over not being able to nurse ask yourself why. Is it because you are being sold this weird perfect image of the perfect nursing experience? I did it for six months and it was six months of cranky baby sore breast torture.

We have perfectly good formula alternatives in countries with clean water easily available. There's no need to be chained to your baby for infinitesimal health benefits. the important thing is the baby gets fed. We do all sorts of "unnatural" things on a daily basis but the only time it gets questioned now is if it is something that put an enormous drain on a woman's time and resources. If it saves men time, energy and money no one bats an eye.

Thanks Bertie

No. And I'd argue this is particularly prevalent in some groups.

The mixed messages certainly don't encourage trust in the medical establishment

Ed - s for UK, z for US :)

Wow, I'd expect a paediatrician to know about bacteria in formula powder

To be clear, that wasn't the advice of one random doctor - that website is run by the AAP and so is their equivalent of the NHS advice pages.

We're still sterilising, boiling the water, etc etc for 8 month old DS - I'd feel too nervous to stop but part of me knows it's a bit ridiculous now - he eats food off the floor sometimes!

Off topic my dyslexic brain can't decide if sterilise is spelt with a s or z, anybody?

The logic with sterilising esp with dishwasher washed stuff is the heat that dries is hot enough to produce steam. Therefore in theory that is exactly the same as steam sterilising.

The same logic applies for bottles etc used for expressing. I was never 100% convinced so sterilized any way.

My standards have since dropped, toddlers dummies get lobbed in the dishwasher. Despite the face 'there's chemicals in there'

France took the view that the risk of scalding from the use of boiling water is higher on a population level than the risk of formula contamination with e-sakezakii. So maybe the US made the same calculation. Don't see how that would explain not sterilising though? You can use cold water steriliser after all.

I'm not sure why advice changed, but the UK's advice is quite overkill compared to other nations. Most recommend sterilising for a reduced time, just for premature babies or not at all. Most don't advise boiling the water or using hot water. It's interesting. I don't think it's a conspiracy to put people off, but I do think it's from a base of needing evidence based advice via NHS.

I would guess that around 2000 there was a study which showed increased risk from making up in advance, or perhaps that people were fudging it and using one from a day and a half, so they changed the focus to make up fresh. In practice, make up fresh is extremely inconvenient, particularly when combined with advice to feed on demand (you have to wonder who decided to release both of these pieces of advice, I would guess the latter came after 2000 though, routine was king then, less popular by the end of the 00s) - and many people were receiving the "make up fresh" advice over and above the "use hot water" advice, and hence making up fresh with cooled boiled water. So in practice, advice which pushed "make up fresh" has resulted in more babies receiving less safely prepared formula. Because (as I understand it) the hierarchy goes:

Ready made UHT
Made up fresh with hot, flash cooled to baby temperature
Made up with hot, flash cooled, stored no more than 24 hours
Made up with cooled boiled as needed

(It would be interesting BTW if a study was done comparing bacteria levels, both with normal formula and deliberately contaminated formula.)

And now you have the Perfect Prep method which had been touted on forums for years but is now sold as a machine, without the shaking step between hot/cold the forum advice version usually has, and we don't know quite where that ends up in the hierarchy.

But really every level of it is safeguards against the others not being performed properly. The UK guidelines are designed that if you skip or fail at one or even two steps, the rest should ensure you're OK. Perhaps this is because we have such a high formula feeding rate compared to other nations and more of our very young babies are formula fed, whereas in other nations older babies on average are receiving formula and their immune systems are more robust?

• Wash bottles well in hot soapy water (remove traces of old milk, bacteria)
• Sterilise as well (in case any remnants left behind)
• Wash hands before touching bottles, ensure clean surface to prepare bottles, don't put the scoop down on the counter (avoid introducing new contaminants)

• Make up with over 70c water (kill bacteria present in powder)
• Boil water (kill bacteria in water)
• Don't keep bottles hanging around at room temp (prevent small numbers of bacteria multiplying)
• Cool quickly, store in fridge (reduce time in "danger zone")
• Discard after 1 hour after saliva introduced (more multiplying danger)
• Discard unused powder after 4 weeks (combination contaminants and reduced quality)

Certainly I had always felt these were extremely important but in actual fact when DS2 was quite reliant on formula I was forced to admit that it's extremely difficult to meet every condition perfectly. When we first switched to powder I was following DH around snapping that he had just touched his jeans after washing his hands and the counter wasn't clean enough (the counter, of course, was a bloody state because nobody keeps their kitchen spotless when you have a newborn baby) and had he levelled the scoop exactly and then I felt he didn't cool the bottles correctly - he used to make them up, and we did use boiling despite local recommendations stating water which has cooled to 40-50C - and then stick them in the fridge door. He had to tell me to back off in the end and point out that even really stupid people have babies and formula feed and the instructions have to have a bit of room for error. DS2 was fine obviously.

Wow, I'd expect a paediatrician to know about bacteria in formula powder

In the US the official advice is that it's fine not to sterilise bottles and to use cold water from tap, which I find very surprising!

www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/How-do-I-mix-and-serve-infant-formula-for-my-baby.aspx

I can get the WHO recommendations are WORLD recommendations so cover very hot countries, and poor countries who may not have reliable fridges. So freshly made bottles makes logical sense.

But countries with mild climate, fairly reliable fridges should maybe advise mums to make use of the fridge.

I too believe that its to try and put mums off switching to formula. My friends baby screaming for a bottle certainly put me off switching mine.