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

[KateMumsnet]

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.

Babies getting closer to 6 months than zero can easily go a few hours without a bf, or feed of any kind. With expressing too you can do it on days that suit you, freeze it, and then just use it as and when.
I don't totally get the men losing out if they don't get to feed the baby. They also lose out from not carrying the baby, yet we don't suggest surrogacy to avoid this.

I'm glad you can state I agree that first few weeks can be frustratingly inefficient inthewilderness .

Imo more honesty would def help. My first weeks with no family around, a husband working dire shifts and a colicky baby were just miserable. And when baby cries and cries no one, absolutely no one can tell you exactly why or how long it will last - the HV can say it is probably til the 11th week or 'lots of babies do this' or whatever but you are the v sad, v exhausted mother and none of that really helps.

But advice at the start telling me that the first 6 weeks are often exhausting or 'it takes a few months to settle to what suits you both best' would have been helpful. Instead we hear how wonderful bfing is from the proponents. And not the downsides. The fact that so many give up demonstrates that there is something amiss with the 'support' or maybe it just doesn't fit in with the modern lifestyle. But the lack of acceptance/sympathy from those who do bf means we don't find out why people FF. Probably the shame which many might feel causes them to keep their heads down which imv can't be right but in some proponents would be what they deserve.

it's actually not that most babies will be 'fine' on formula. sadly, like it or not, most babies who are struggling with bf, not putting on weight, constantly hungry, unable to take a proper feed, never stopping feeding, never sleeping more than a couple of hours etc etc etc are a damn sight more than 'fine' on formula.

many, many, many women have seen their babies overnight thrive by supplementing with or switching over entirely to formula. you can't just discount all of that reality because it doesn't fit with the pro bf lobby and it is insulting to do so.

many,many,many women put themselves through months of hell trying to live up to how wonderful, easy and perfect bf is and only switched at the point of utter desperation to find that instantly they had a happier, healthier baby and a hell of a lot happier healthier self.

if breastfeeding works for you and your baby then fantastic! good for you and them and enjoy. it's none of your business how any one else does it though. to say it's just a short period of time till it gets settled belies the experience of women who spent months flogging a dead horse trying to get breastfeeding to work for them and their baby. i don't think women who it all worked out fine for are really in a position to advise women who it isn't working out fine for.

there is also the practical weighing up of what needs doing and what the important things are and whilst feeding is obviously very important there's a lot more that needs doing too for a happy healthy mother and baby. if it comes to mother actually having time to prepare something vaguely food like to eat herself or breastfeeding (which is not going to go well if she is malnourished anyway) then you weigh it up pragmatically not ideologically.

as a single mother determined to breastfeed and getting mighty defensive with anyone who loved me and didn't like to see me struggling suggesting i should give formula/give more formula i really could have pushed myself beyond coping. i probably would have if it hadn't been for some bossy midwife/hv three months in telling me i was doing it all wrong by giving formula for a pre-bed feed and bf the rest of the time and how i needed to stop giving that ff in order to bf properly. thanks to her - and her catching me on an exhausted, paranoid about my babies weight and generally weak day - i cut out the nightime formula feed and set off a whole new 7 shades of hell saga for weeks which finally ended up in me giving up bf entirely and doing a combo of ff and ebm till i finally accepted formula would be fine and it wasn't worth putting ds and me through hell for an ideology.

the sooner people accept breastfeeding just does not work for some people -not because they haven't learnt to latch on properly or because they haven't given time for the supply to set in or ra ra ra orthodoxy but because they've genuinely done everything right for months and it just has not worked the better. it would save a hell of a lot of women from months and months of misery and stress and a hell of a lot of babies from crucial early months with a miserable and stressed mother and whatever risks there are from not getting enough nutrition.

i honestly would not be surprised if we see a lashback in a decades time of kids with brain issues that they finally discover are caused by near starvation in early months of life whilst hvs and the like stood by saying don't worry, baby won't starve to death, it's all natural and good. forgetting of course how many babies used to die before 12 months of age in the good old natural days.

i also think it's a bloody luxury to have 6 months to give to sitting on the sofa breastfeeding constantly. most people just don't have that opportunity even if they wanted it.

I agree, swallowed. I think knowing how much support you will get from your husband and your family with everything else that needs doing - cooking food, do the washing, hoovering, the essentials to keep the house and your life ticking over - factors in to that to. And some women just won't feel happy spending so much of their day sitting and feeding. There's nothing wrong with that, because a f'fed baby with a mum who is coping is better in the long-term than a b'fed baby with a mum who isn't coping.

I always feel one of the genuine difficulties in discussing bf v ff is that women who make the decision to ff for any reason other than their supply not being enough or having problems with the baby latching on can be made to feel they have made their decision for selfish reasons.

What I'm trying to say is that of course breast milk is the best food for a baby, but sometimes breastfeeding isn't best for mum or for a family.

The period of time where it feels like you are feeding all the time is not very long in the overall scheme of things. I can barely remember now what it was like and my baby is only 7 months old.

And anyway, does formula feeding really make that much difference to how long you are "tied up" with feeding? Surely the preparing of a feed takes up an amount of time, the feed itself (which I guess is quicker than a bf), followed by winding etc and then the washing up/sterilising of equipment ready for next time?

I would also say that breastfeeding shouldn't be viewed as a waste of time where you are stuck on a sofa, unable to get on with household tasks (or whatever else you might want to be doing). It should be seen as time that you are putting into your baby's development!

As it happens, I could get a lot of "stuff" done one handed as long as I thought about it in advance. Things like doing the online grocery shop, emailing, online banking etc. All whilst catching up on tv series that I had not had time to watch whilst at work!

Maebe, having older children I agree would make breastfeeding more complicated, but surely would have the same effect on formula feeding?

This is purely my personal experience but no, the routine of getting bottles ready didn't take up much time and could be shared between me and DP, but more importantly DP could do as many feeds as I could. We could take turns on who stayed up and did a later feed, who got up in the middle of the night, who got up in the morning etc. It also meant when we did have family around they were able to feed DD.

Every situation is different, every family is different, and every woman is different. Personally, I knew that I wouldn't manage doing all the feeds (so all the night wakings, all the early mornings, all the late nights) and continue to function in any rational way when I didn't have someone around in any routine to help me, even something as simply as getting dinner ready. Of course plenty of women will have managed in that situation or 'worse', but I knew I wouldn't.

It's interesting as there is another thread going on tonight about ff not being as big a faff as some people think it is. But that's the same as bf, really - if you are finding something easy then it is difficult to imagine another way

it isn't instead of doing stuff 'you want to be doing' - it may instead of doing stuff that HAS to be done. washing needs doing, food needs to be prepared if you're not going to starve or live on chocolate and biscuits, clothes need to be dried as does bedding etc all of which seems to be constant with a new baby i found and sleep needs to be had. sleep is kind of important.

and for you it didn't take long before baby was feeding fine and not all the time etc. it's not like that for everyone. for me i could feed for hours - i mean hours - and ds would be falling asleep but still not having taken enough milk so that he'd wake screaming hungry minutes later. i can remember having food cut up for me and put beside me on the sofa at my mum's house when i visited because i couldn't stop feeding which would have been fine if he was actually managing to get enough milk to satisfy him but he wasn't because he wasn't feeding effectively and never managed to. this was for months! when i started supplementing it was incredible - you'd give him a small bottle of formula and he would just gulp it down and be like another child and so visibly finally satisfied.

so again - great if it has worked out for you - seriously - that's what most of us wanted and would have loved. don't make out it's because you did it right and everyone else must just have been lazy or not bothered to try hard enough. you were lucky that you and your baby took well to it and it worked out. that doesn't mean that that is the case for everyone.

and no formula feeding doesn't take long - sterilising and all that is a simple once a day routine that can be fitted around making a cup of coffee and doing the washing up in the morning and needs no more equipment than a few bottles, a big tub with miltons and water in it and a brush.

Well said Swallowedafly

so much pressure comes from those who sincerely want others to experience breastfeeding as the wonderful bonding experience they enjoyed. But lack the imagination to realise that for others, it can never be a good experience. It just doesn't always work.

I wonder about the statistics because it would be very difficult to properly control for all the health issues affecting mother and/or baby. The baby might not feed because of undiagnosed sn. Either might be in poor shape after a complicated pregnancy or a traumatic birth. The mother might not be in the best of health.

swallowedAfly - I don't recall where I said that others must have not tried hard enough,not done it right or been too lazy to breastfeed?!

And as a matter of fact, I was not "lucky" and my baby did not "just take to" breastfeeding at all. He was in SCBU for a week when he was born, and was not fed orally for the first day as he was very poorly and on a drip. He then had a NG tube through which he was fed for a couple of days. I had to express what I could and that was given via the NG tube, plus being supplemented with formula as instructed by the hospital. He had no ability to latch and did not equate being at the breast with getting food and so would become hysterical at the breast. I had to persevere to get him to latch on and feed. The whole time he was having formula top ups. When we were discharged home we continued to have issues with latching on, and excessively long feeding times. But after a lot of hard work and lack of sleep he got the hang of it. We eventually dropped the formula top ups as my supply caught up with him.

So not an easy or lucky process for me. BUT after the first couple of months it became easier and quicker and now at 7 months I can barely remember the bad times it seems so long ago.

I was fortunate in that although I received a lot of conflicting advice, I was always encouraged to continue breastfeeding. I also was fortunate that many of my family and friends bf their babies so I had some awareness of the process.

Which is why I wish there was better quality support for mums post natally with breastfeeding. It is unacceptable how varied and disorganised this seems to be across the country. At the same time women should not be judged for using formula if this is what works for them.

no not easy but for you it became easier and quicker after a couple of months. that is lucky actually especially given his start! for you it became easier and worked out. for others it won't have done.

and lucky you had the support network to be able to do that.

and if you hadn't and had just formula fed? not the end of the world.

We had to mix feed for a while (until DS's tongue tie was cut) and I HATED all the effort involved - always having to have bottles sterilized and ready, taking the right number of feeds out with you, worrying if you'll be late back, the expense of buying milk etc etc. It didn't make DS feed any less often, and whilst it was a godsend while he literally couldn't get much out of me, I was so so glad to be able to go to just breastfeeding. I love the convenience of bf; how the hormones it generates in you while feeding enable you to actually feel rested after a night spent waking regularly to feed a baby; how it means that if I get a cold he won't catch it from me; just rolling over in a semi-asleep state, grabbing a baby, feeding and dropping back off to sleep at night; the fact that it might mean he gets less allergies than me. I do think if you end up ff it's hardly the end of the world (I was ff and I'm fine lol), but bf rocks!!

Isn't all this babies crying and being demanding just, em, normal for a baby?People ARE using formula mainly because they find it more convenient and not really because they 'couldn't breastfeed', nor because they were part of the 1% who genuinely didn't have any milk. Thing is, you rarely hear mothers just out and out say that they used formula because they couldn't be bothered with the inconvenience of breastfeeding their baby, most people say 'I wasn't able to' or 'my milk wasn't enough'. It's a shame that formula has become an alternative instead instead of being there for the babies who really do need it, IMO anyway.

yes we're all just liars and lazy arses who couldn't be bothered.

helpful and massively compassionate.

I wasn't trying to offend. What I meant was it's kind of refreshing to have people admit that they use formula for convenience rather than for genuine medical reasons.

Though still a shame that it has come to this through such aggressive marketing of formula over the years. That women have been hoodwinked or coerced into giving up what should be a natural thing. It doesn't help that women just don't get consistently good and educated help when breastfeeding is problematic.

At least some women are honest about why they formula feed, somehow it's better than hearing from women who clearly have been booby trapped by those people who could have helped them to breastfeed.

booby trapped?

My understanding of being booby trapped is when a woman who wants to breastfeed is given bad advice which disrupts her cycle and stops the whole supply on demand thing happening.
so

Midwives/health visitors recommending formula top-ups at night to make the baby sleep better or to cure colic or to space out feeds = the natural 1-2/3 hour feeds are not taking place so your body gets confused and milk isn't produced and supply gets disrupted.

It could also be family suggesting that they get a chance to feed the baby, or husbands who feel like they need to bond through a bottle etc.

When my son was in neo natal he was offered formula within hours of his birth, I had to ask for help to express, no one asked me if I would like to feed him, no one was there to help. When I visited him I was looked at disaprovingly because I tried to breastfeed on demand but the staff wanted to stick to 4 hourly feeds (of my expressed milk).

Even after he came home a midwife suggested I give him a top-up. I worked extremely hard to get him off bottles and back to being exclusively breast-fed.

I refused to be booby trapped.

I went to this lecture and blogged about it after respectablebreastspectacle.blogspot.co.uk/

My baby is nearly 8 weeks old and have managed to BF so far but he is such a hungry baby that I can not keep up mentally with his demands which are every 2 hours morning, noon and night .

To get a bit of my life back I have decided to give him both bottle and breast which he will gladly take but feel guilty about this as he is doing really well with his weight. The midwives and Health Visitors always bang on about Breast is best but is it if I am unhappy!!

I have ponderd for several weeks now and I am getting more miserable with sleep depravation so have decided that it is more important for baby to have a happy mummy who can function!!

bless you. the pro bf folks will tell you it gets easier and in your case i'm sure it will as your baby becomes able to go longer between feeds. however i think it's also true that given how reliable your milk has been and how well your baby is feeding you will also likely find combined feeding goes well and presents no problems.

i don't think the whole either/or thing helps people. lots of people do successfully combine feed, some people have no choice, some find it's the balance that works for them. if your baby is still getting plenty of your milk then they're still getting the benefits.

the thing is it is your choice entirely and you need to own it and feel ok with it to avoid regret/guilt/whatever later on.

i wish we could remove the whole 'morality' edge to this debate and let women make choices without all the guilt and self torture.

Well breastfeeding supposed to help kids climb up the social ladder. bit.ly/18cM8Ix

Breastfeeding has important health benefits but sometimes mothers who don't breastfeed for all sorts of reasons e.g. because their baby was premature or their baby has tongue-tie or they are in too much pain are made to feel that it will weaken the bond with their baby. Research shows that breastfeeding does not affect the mother-baby bond. wp.me/p29Oas-1R