Aaargh these threads. I so wish there was a way to just suck all the emotion out of the subject of infant feeding so that we could discuss it like civilised grownups instead of wounded children clutching our favourite toy.
My opinion is as follows, fwiw:
I disbelieve the 80% of women want to breastfeed statistic. I think it is probably influenced by people saying what they think they're 'supposed' to say and want when surveyed by HCPs.
I think it would be a lot better for everyone if the women who, genuinely, would be just as happy to/far rather formula feed, did not feel huge social pressure to 'try' when frankly they don't want to do it. Better for them, better for the women who genuinely do, and better for the quality of the discussions around feeding. I am always delighted when I see a woman who has CHOSEN to formula feed, genuinely chosen it, announce it without shame - this is one of the best things about formula, in countries with supply of safe clean water it does actually provide mothers with a safe, suitable alternative. Choice is good!
Whereas I put my head into my hands when I read posts from women who 'really tried' but whose milk didn't come in after by day 3 so 'had to switch'. This either means they were woefully underinformed about how breastfeeding actually works (as I was, but when it turned out to be bloody difficult I got informed quick because I actually, really, wanted to breastfeed) or they didn't really want to at all, found it a pain in the arse and were glad to have a 'good reason' to stop. Yes I know, some women don't produce any/enough milk (a very small percentage). But you do not know that is you by day 3.
IF we lived in a sensible dispassionate environment where women felt freer to just say "nah, not for me, formula is perfectly good enough for my baby and I'd prefer it", then what precious little resource, time and energy there is could be dedicated to women who do, really, honestly want to breastfeed - who are willing to go through the difficult first weeks, who are desperate to access support, who have to wait in pain too long for tongue tie assessments and revisions, who may be the only person in their family to do this, who may have older children and little support and be struggling to manage. NHS provision in my area was so bad I ended up relying entirely on charitable and online voluntary support groups for practical guidance, emotional support and reliable evidence. This is just ridiculous.
If the (I believe) minority of mums who were genuinely committed to/invested in breastfeeding got proper support, more of them would achieve their goals, and the critical mass of women openly and proudly and successfully breastfeeding would have a knock on impact on the rates without any cajoling being necessary in my view.
So yes, I think we need to stop with the persuasion tactics (and the shaming, if there is any, although I am sceptical about this because how on earth can an under-resourced 1% minority shame the vast majority?). Treat the two choices as ethically neutral. And then support the living crap out of any mother accessing breastfeeding support services, make that a gold standard experience, not sitting in the middle of the night crying in pain with your crying baby calling three 'helplines' your midwife gave you on rotation that no-one ever answers because they're too busy.
Spend decent money getting ALL midwives adequately trained as breastfeeding support workers and maintaining the currency of their evidence base and knowledge, as it is midwives who can have the greatest impact in the early difficult weeks, and midwives by and large who are guilty of either simply saying 'keep trying' to struggling mothers without having the knowledge or the time to actually help them try better, or dismissing any difficulties by saying 'oh just give him a bottle dear' to a woman who is distressed precisely because she desperately wants to breastfeed.
The goal at the moment seems to be that EVERY woman should breastfeed (or jolly well ought to try). No, sod that. From this place, where we are now, at the absolute bottom of the league tables for the developed world, let's target resources at those with a genuine passion and need to feed their child from their own bodies; let's help and empower those women, so they can achieve their goals and go on to support and encourage their own sisters, daughters, friends. Let's increase the critical mass of positive breastfeeding stories, so that the message stops being either "It was way too hard, I couldn't do it" or "I moved heaven and earth to breastfeed, it was SO HARD and i had NO SUPPORT but I did it anyway because I LOVE MY CHILD" (which is of course a pressurising and alienating message for women who either haven't fed yet or chose/ended up feeding by formula).
And for God's SAKE, let's stop the artificially confected mummy wars, which are stirred up and kept going by the formula companies to ensure that breastfeeding can NEVER be discussed, no matter how dispassionately and innocuously as in this documentary, without the discussion never getting to the actual evidence presented but always remaining stuck here on how the presentation of that evidence makes us feel.
Ugggghhhh.