Plenty of women don't know bf is best, or don't believe the "hype". see the thread on Cherry whatsit and her bf tv programme "is breast best". Some people think doctors / midwives / HVs are only trying to meet politically correct EU targets. Some people don't want to accept that for most babies it is clearly the healthiest and best option, regardless of the mother's desire whether or not to bf. (of course i'm not saying anyone should be forced to bf - just that many people make a choice first then justify it afterwards with false science or by saying it makes no difference)
Some (especially teenage) mums think boobs are "sexual" or that "only posh people bf, not people like me". Some think their milk isn't enough in terms of richness or volume. Like confuddled says, many mums get grief from their families for cultural reasons - I have a friend who married into an extended east end family. She chose to bf until about 12 months. The whole family thought she was weird, the baby would grow up with strange sexual ideas and that she was starving him because he wasn't "chubby" like his formula fed cousins. I think that's as bad if not worse than the so called bf Nazis whose position is at least supported by some scientific evidence!
But I agree the message that bf is ideal has been done to death - so why not tax formula advertising to pay for more bf support workers, or training all HV to have basic bf support worker training, or research into why mothers who expressed a preference for bf decided to stop.
I guess for me it's the implication that you ought to reach a stage where you're ready to "move on" - like you're somehow immature or doing the wrong thing if you don't want to change to formula. It sets an expectation that at some stage you "should" move on. Whatever happened to the biologically ideal route of bf until weaning? cut out the middle man (middle cow!) and the profits and make your own.
With the right support its amazing what you can achieve. I didn't have major surgery but I did have one of the worst possible starts in terms of successful breast feeding outcomes. I gave birth very early at 24 weeks, and my baby wasn't expected to live. (hmm, come to think of it, I did then have surgery too...) Despite this, I was still approached and asked if i'd like to bf and the shown the mechanics of expressing milk. That early on, you have no lactation hormones and it is painfully slow to persuade your body to make some. I went through 3 days of painful hand expressing colostrum every 4 hours and getting 2 or 3ml a time. To do that I had to take time away from my critically sick son, which was immensely difficult. Later my proper milk came in and it was pump expressing, which is a skill in itself (so much respect for the dairy cows!) Over time my supply improved but I needed medication to increase it, and later on I needed help to try bf directly with a tiny baby who was still on breathing support. Thankfully he survived, and having my milk was one of the factors that helped him to survive - formula fed premature infants are at higher risk of the life threatening gut disease NEC. You should see how precious a few ml of EBM is on a NICU unit. Some units will pay for donor ebm it's that important. Every drop counts, every drop possible is fed to the babies.
Due to my son's lung problems he always needed lots of calories and we ended up mixed feeding, which was the right thing for him, based on medical advice and a clear diagnosis. I am so proud that we got through 5 hard months of expressing 7 times a day and were able to bf at home for a further 9 months until my supply finally gave up and my son self weaned. We went through cracked nipples, mastitis, 3 hour long cluster feeding sessions, all the fun of the fair. But we did it. I couldn't have got there without some fantastic on-unit support and a very brave midwife who suggested it was possible in the first place. Bf at home also meant he got fewer coughs and colds and so had fewer readmissions to hospital. It has saved the NHS thousands of pounds already in paediatric ward costs - let alone any future health benefits.
So obviously I have a lot of baggage here.... but my point is that any encouragement towards formula as a "normal" thing or by implication a "better choice" after a certain stage is a discouragement from breast feeding. It encourages mothers to persevere a little less. To think that it's an either or choice rather than moving to an inferior product. To think that once their baby is a certain age it's better to move to formula or to cows milk.
There are few mothers who have a worst time of it than me in terms of an easy road to bf. So, I get really angry at those who don't try. OK, so it's not a life and death decision for most babies. But it can mean healthy immune system or asthma, emotional stability gained from skin to skin time or not, faster brain development from receiving ideal amounts of trace elements or not. And how much of the bottle brigade "don't judge me" attitude is actually referred guilt from an underlying "i understand bf is best but i couldn't do it" belief?
Not having appropriate support to help you succeed is one thing. Of course we should do more here to make bf as easy, comfortable and enjoyable as possible for mums. If you don't get the advice and are in pain / bleeding / full of mastitis and stop bf as a result, noone should judge you.
Giving up before you start because you can't be bothered / don't feel its for you / want your boobs to stay nice and perky is entirely a different matter. A huge percentage of mums in the UK don't even try one first feed - something like 35% i think. The mum's choice is overruling the baby's choice I fear. And i'm afraid I do feel very judgy towards this group.
(rant over). Damn, I have completely turned into a bf Nazi.