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.

[detoxlatte]

Each and every time this issue comes up, I always conclude that this debate is really about the mother's own psychology and emotional make-up.

Plainly, for every one piece of research suggesting this or that, there will be another suggesting something different.

What is offensive is the moral high ground taken by the pro-bf absolutists. It is so insulting to one's intelligence for anyone to state "breast is best" as a bald statement.

Nothing in parenting is that straightforward.

My own view is that for the baby there is very probably a nutritional benefit to bf over ff, and that there are possible long-term phsyiological benefits to the mother. However, those benefits can be and often are counter-balanced by the disbenefits of bf (of which there are plenty to the, say, working mother of two or more living in the West (which I am not, incidentally)).

The benefits to baby and mother are not so great as to make all other considerations irrelevant - if they were, the debate wouldn't be raging as it is.

[Springdiva]

I think sometimes those who vehemently promote breastfeeding don't understand that some mothers might like time away from the baby.

That would be my reason to not push breastfeeding. The switch from a fulltime professional in an interesting job was a shock to me. Being tied to the home and baby a pretty extreme change.

The rapturous pleasures of sitting breastfeeding for hours day in day out passed me by. Would they have been opened up to me if I'd had more support at home, or at the hospital to get the hang of it.
I'm not too sure, as a fidgety, always busy person the sitting about with baby was not always enjoyable.

I think the mother's temperament comes into things too. Oh and the baby's.

But the mother's needs are not allowed to come into the bf/ff argument. So I have some agreement with Prof Wolff.

[13Iggis]

Breastpumps have allowed me as much time away from the baby as I needed. Or could've tried mixed feeding. Interested re the 'hours spent bf' - has anyone calculated the time spent bfing (especially after the first few weeks when it's established) as opposed to the time a ff takes from start of sterilising to finish? I suspect it's not much different, which is why I'm always surprised when people say ff is 'easier' than bf. I think bf has a particularly difficult start to it, then gets easier and easier, whereas ff stays the same level. But that's just me pontificating.
I think it is very inaccurate of pp to say the woman does not come into debates on ff/bf, as on mumsnet that is a recurring theme - happy mother, happy baby; bf leading to pnd etc.

[worldgonecrazy]

I think that the whole debate and issue would be helped greatly if, instead of focusing on ff/bf, we, as a society, focused on the support that mothers get once their child is born. There is no doubt in my mind that, for the vast majority of women, bf makes life a lot easier (especially those who have to return to work full time) if they have the right support. That support doesn't only need to come from family, but from employers and the general public.

I'd like to see promotion of "mothering the mother". I'm lucky enough to have my mum living close enough that I could spend every single day with her once my husband returned to work. A lot of mums are left alone in a house with a new baby and no support once the partner returns to work. In that post hormonal phase when every triumph and set back are magnified to the nth degree, its easy to see why a slight hiccup or worry with bf means women turn to ff. In some Asian countries, women spend the first 40 days after birth with their own mother, so all the new mother has to do is feed the baby and be looked after. I'm western but we borrowed this idea and it made so much difference.

It also shouldn't be seen as "weird" to express milk. It's not a pleasant thing to do, it's just one of the tasks of parenthood. Mums need to be supported in this so that they don't feel like milk machines. And yes, it is important to get some time to feel human again, and again, it's all about having the right support to be able to go to the hairdressers or get your nails done, or whatever it is that a mum wants to do for a couple of hours.

Studies have shown that bf mums get 20 minutes more quality sleep. Cosleeping bf mums get even more, yet cosleeping is seen as weird and hippy, when actually it's the most normal and natural thing in the world. Babies and parents aren't designed to sleep in separate rooms but there is no support for parents who want to do this, and modern houses aren't built for it, and societal pressures are all about getting your "adult" relationship back on track. Is 6 months such a big sacrifice against a lifetime of benefits? Seriously, there is no way I could have returned to work fulltime and stayed sane when my daughter was a couple of months old if I hadn't been bfing and cosleeping. Three of my colleagues took this approach and we had few sleepless nights. Two of my colleagues who ff did nothing but moan about how little sleep they'd had.

So to sum up, if we could get real and better support for new mums, the breastfeeding rates would go up without the need for any promotion of "breast is best". What women need is support, not posters or preaching. Promotion of breastfeeding is doing nothing to improve breastfeeding rates. Providing useful support will increase rates without any other intervention being necessary.

[StarlightMcKenzie]

'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?'

Yes. Both.

Whichever one can beat the mother at the time is used imo, by our misogynistic society. Both these serve it well.

[StarlightMcKenzie]

I support the right of any woman to chose the method of feeding that best suits their family.

However, I would campaign for a society that makes breastfeeding the better suiting option (or at least equally suiting).

This issue starts with society, not the individual woman, and support needs to come from society, not the indidvidual woman's close aquaintances.

[JumpHerWho]

I agree with lots of what you write world gonecrazy, especially the main thing should be supporting a new mother. IMO it's a disgrace how bad the postnatal care is in the NHS in comparison to the excellent antenatal care I and my NcT friends all got. The attention just vanishes at the time you need it most!

But the idea of a bf mum getting more sleep... do you have a link to a study which shows this? Because my experience is different to you. Of my NCT group, 4 bf and 4 ff. Without exception, the bf mums were still feeding throughout the night at around ten months, whereas all the ff babies were sleeping through from 2-4 months!

I know it's against MN protocol to point out benefits of ff, but I thought that (no doubt for all sorts of negative reasons, and it's not necessarily a good thing, etc) ff babies in general sleep vastly better than bf babies, due to formula being more difficult to digest it 'fills them up' for longer, bf is easily and quickly digested so babies become hungry more often. Is this not a true fact?

Despite my regret not being able to bf my first, I have already decided to ff my second as I have come to the conclusion that any tiny difference in health outcomes is pretty much outweighed by my happiness at being able to spend time away from baby, sleeping well, having my body as my own, DH being able to feed baby too and so on. It's a mild an emotional regret now, not a logical one. I regret it in much the same way I regret not birthing naturally (c-sec) but in hindsight it was best for us. I do suspect that if I'd managed to bf it would have contributed to pnd in my case.

[itsMYNutella]

"breast is best" it makes sense that since it is what we have evolved to nourish our newborns with it should work best. But as can be seen in nature things that are meant to be are not always so straightforward.

I think it's right to point out that everyone has a different experience with BF. My son is 6 weeks old. We are in Germany and the BF support here is pretty amazing. Plenty of midwives, all trained in giving support & advice and they have the time to do it. Of course there are still those militant ones that would have you believe formula is poison

But I would love it if DP could feed DS. I don't express because I can barely find the time to go to the toilet, to shower or feed myself or do other normal things so why would I want to spend more time with something attached to my boobs??

I have learnt that bf is hard, it is stressful, it is boring ( I know terrible of me to say such a thing). Nevertheless I hope to carry on. I consider myself lucky because we don't have any real problems, latch is fine, no tt, no infection of any kind, my nipples haven't even been too sore and no other trauma. I just feel rather isolated by it. Sat at home on the sofa with my beautiful DS is great, but I'd love to get out and meet people.

If I'm really honest my biggest motivation for bf is the weight loss. I'd like to be back in normal clothes.

I think that this debate shouldn't be ff vs bf. It should be a question of why aren't all the mothers that want to bf given the support and time to do it? What we are missing with this rose tinted "natural" "it's what has always been done" attitude is a total failure to take into account how much society has changed and that we often lack community support that would have been present previously.
I believe that mothers are now under so much pressure to do everything "right" that we do ourselves no favours when we judge how each individual mother copes with that pressure.

[stargirl1701]

YY Nutella.

[worldgonecrazy]

Links here:
blog with link to research

reserach into cosleeping and breastfeeding

It's not about just sleeping through the night, it's also about quality of sleep, etc. Some of the studies used motion sensors to ensure that the research could be objective. My DD didn't stop feeding in the night until 9 months, but I hardly had to stir myself to feed her and it didn't affect sleep quality at all. So with support I slept well, had time away from baby, DH could feed too.

Incidentally I also feel regret at not having an entirely natural birth (forceps!)

It's interesting that you think the risk of PND is increased by breastfeeding when everything I've seen suggests that the hormones released through breastfeeding may help to lessen the risk. I wonder how much of the risk of PND increasing is because of the lack of support of all bfing mums?

[worldgonecrazy]

Bit more here about PND, breastfeeding and sleep.

Of course, it should always be remembered that a study can only ever show an overall generalisation, not the everyday truth for an individual.

[worldgonecrazy]

And if you aren't asleep, there's a bit more here

[weenwee]

NEITHER IS BEST. NEITHER. GET IT? NEEEEEEEEEEEEEEEEEEEITHER.

I am beyond sick of this debate, and I say this as someone who breast and bottle fed. All it does is demonize one side for the others' benefit, and it's ridiculous.

You find out what works best for you and your child, and you do that, and that's it.

www.sheawong.com/showdown-at-the-titty-corral/

[Hypnobirthingmum]

Thanks Mumsnet for heating up the "Mummy Wars" and for helping the good Professor to help sell her book. The Professor, her publishers and publicists have used the tactics that controversy gets headlines and boy has it worked. 78% of new mothers initiate breastfeeding which you could extrapolate that 3/4 of women want to breastfeed. The declining rates of breastfeeding after leaving hospital are due to the lack of support from breastfeeding mothers. The failures in this scenario are the government, health professionals, health visitors, family members, the media, business and society in general to not supporting breastfeeding mothers to reach their own breastfeeding goals.

[reviewerofbooks]

Breastfeeding doesn't come naturally because it's no longer a part of our everyday culture.

Support is lacking because those who don't understand it can't be of much help, with the best will in the world. And training in the health care system is minimal (often only a few hours even for paediatricians, midwives and health visitors).

Myths surrounding breastfeeding abound and our expectations and the reality of new motherhood are mostly very different, regardless of how we feed our babies.

If you want to breastfeed there's no substitute for finding a network of support through one of the breastfeeding charities who can also point you towards specialist lactation consultants where necessary.

[loquaciouslactator]

I blog on the topic of breastfeeding, specifically the political and sociological side of it. I have alluded to Professor Wolf's recent splurge of opinion here lactator.blogspot.co.uk/2013/02/i-breastfed-my-baby-but.html

[DuelingFanjo]

Breastfeeding is normal and natural.
Far from society pressuring women into breastfeeding, my experience and that of many of my friends is that women are pressured into giving their babies formula. Hospitals definitely don't seem to have caught up with the breastfeeding message.

I also think there's some kind of stupid assumption that women who work can't breastfeed long-term. I am feeding a 2 year old and have been back in work full time since he was 10 months old. He still gets much of his nutrition from breastfeeding.

I think many women need to adjust their expectations when it comes to having a baby, full stop. So many women seem shocked by the amount of time and effort you need to put in during the first few weeks (For breastfeeding and all other baby stuff) and seem to turn to formula often because it's 'easier' or it will give them more sleep time. Do these women not do any research into what having a baby is like?

I am not anti-formula but I am anti a society which makes breasts into something sexual and dirty, which makes women think that htere is something wrong with public and natural term breastfeeding and which peddles mis-information about the quality of formula when compared to breast-milk. Breast-milk is, without a doubt, the best thing for a baby. There is no convincing argument against that statement. Formula is not even the second best thing to your own breast-milk.

When breast-feeding is an 'awful experience' it is usually because of lack of informed, educated help. Only a small percentage of women 'make no milk' and most women who have problems could overcome them if they were given swift and worthwhile help.

Formula feeding doesn't make you a bad parent.

[amothersplaceisinthewrong]

Can someone tell me how the mother of a newborn and a toddler with all family living 250 miles away (and working full time) and a husband who has a job involving 12 hours work plus two hours commuting is meant to sit around breastfeeding the baby on demand all day, as the breast-feeding lobby would have us do.

[bellamysbride]

Got as far as the post from zavi and thought why bother? Comparing breastfeeding in public with pooing in public. Just ignorant. Breastfeed or bottlefeed, whatever suits you and yours best, just hold off on the dimwitted comparisons.

[Alibabaandthe40nappies]

amother you read to your toddler, stick the TV on for them for a little bit, feed the baby while your toddler is sat having their meals.
DS1 used to come and cuddle up while I was feeding DS2 and we would chat and read stories and sometimes he would drop off to sleep.

You are just showing ignorance with your post, because you don't sit around all day
Also, it is recommended that FF is also done on demand to avoid babies being encouraged to take too much milk at one time - and that surely has got to be more time consuming to make up fresh bottles etc rather than just sit down and latch a baby on?
What do people do - leave the child to yell until it is 'bottle time'?

I think many women need to adjust their expectations when it comes to having a baby, full stop. So many women seem shocked by the amount of time and effort you need to put in during the first few weeks (For breastfeeding and all other baby stuff) and seem to turn to formula often because it's 'easier' or it will give them more sleep time. Do these women not do any research into what having a baby is like?

This. I can never understand why people are so desperate to start running around again. Babies need that time of cuddles, and feeding and fairly constant attention for what - 8-12 weeks? Can people really not put aside other things for that long so that they can respond to their babies needs? Sure it gets more complicated when you have other children, but by no means impossible or anything remotely approaching it.

[DuelingFanjo]

"Can someone tell me how the mother of a newborn and a toddler with all family living 250 miles away (and working full time) and a husband who has a job involving 12 hours work plus two hours commuting is meant to sit around breastfeeding the baby on demand all day, as the breast-feeding lobby would have us do"

you don't have to sit around 'breastfeeding all day'. Is that what you did with your toddler?

Yes - having children is hard but there are lots of other things that are hard about having a toddler and a baby but they still get done.

Why do you call people 'the breast feeding lobby'?

[DuelingFanjo]

and another question - isn't preparing the bottles and doing the sterilising just as difficult when you have a toddler?

[Briseis]

There is actually some sensible stuff being written here. Isn't the top and the bottom of the problem the fact that no one can ever really understand the position another woman is in. One of my friends breastfed her two children. I tried and did a bit with both mine before going to ff. When I see her doing it it is honestly like something completely different to what I was doing to an extent that it is almost comical. In the nicest way she just can't "get" how it was so hard for me and it was just totally, totally different.
I do think this debate extends far beyond how you feed your children though and really goes to how we view women and mothers as a society e.g. the sacrifices we expect women should make, when does it become too much etc, and not just in relation to feeding.

[BettyandDon]

I would just like to add that making bottles and sterilising requires about the same effort as making a cuppa.

I am amazed about the fuss people make about how long it takes or how difficult it is. As with anything it gets quicker with time and you find ways of speeding up the process.

I would also like to add that it is very difficult to manage a newborn if they are cluster feeding as mine did - for up to 7 hours at a time - if you have a toddler and no help. No amount of books or cbeebies will wipe a child's bum, cook them a dinner or put them to bed .