To think my sister is selfish for choosing not to breast feed?

[IHateWinter]

She hasn't even had her baby yet but has already decided that she doesn't want to try it and if she does she'll only do it for a month at most.

I've told her that breast milk is healthier and gives the baby antibodies etc, but she won't listen to me. I gave her a baby book that explains why breast is best but she won't read that either.

What else can I say? I worry about my future neice. I understand that she many not want to carry on doing it for a long time, but I really do feel that if you have a baby you have the responsibility to try and give it the best start in life. I really feel she is more concerned about what her breasts will look like than her babies needs.

I'm suprised by how strongly I feel. I find myself avoiding her in case I end up saying something upsetting. Am I being unreasonable?

Oh, and before anyone says, I AM NOT A TROLL I am a regular poster who has name changed.

Joanne, you are right that the discussion has focussed on medical or at least physical health-related risks....I absolutely agree that other things matter, too, including the risk to the mother's mental health and well-being. Everyone must make an individual decision - there are also social and practical factors that may have a role to play.

By the way, the 'NCT doom mongers'you refer to - are they volunteers like me, who give their time to share evidence-based information with women who come to them for support and discussion? Not nice to be called a 'doom monger'

The fact - yes, fact - is that mixed feeding from birth is very likely to lead full formula feeding rather sooner than the mother intends. It is not 'doom mongering' to tell a woman this - it's giving her information on which to base a decision.
Don't you agree?

Tiktok, I didn't mean to offend you, and I agree there's nothing wrong with saying that mix feeding could lead to earlier full formula feeding. But that isn't necessarily a bad thing.

And I also think that more information and support could and should be given by NCT and other breastfeeding groups about the benefits of mixed feeding, because I think there is a large group of women out there (myself included) for whom the choice was either mixed feeding or exclusive formula feeding. If the message these women are given is that mixed feeding usually doesn't work (and that is the message I got from NCT, so apologies if your own view is different), then they may just think 'sack it, I'll just bottle-feed'.

No offence taken, joanne

It is up to the woman to judge whether earlier full formula feeding is a 'bad' thing or not - we would not pronounce on that. Mixed feeding from birth is actually very likely to lead to full formula feeding - it's not a vague possibility. It's not my 'view', but the research and actually, my experience of speaking to and working with many, many women...and the whole biology of how breastfeeding works, too.

People do call and ask how to make mixed feeding work, or they ask in class. We share the facts with them - if they want to use formula, then if they want to preserve the option of breastfeeding, then the later and the more infrequently they use formula, the better. From birth is absolutely not a good time to start - if they want to breastfeed.

joanneg - makes it sound as though you have always seen normal breastfeeding as somehow pathological, and ff as intrinsically emotionally healthier for mums.

If this is the case, why is normal breastfeeding generally associated with better mental health in new mums, rather than worse?

And it doesn't necessarily stand to reason that frequent feeding in the early postnatal pariod = terribe sleep = inevitable postnatal depression, even for those of us (like me) who have had depressive episodes in the past. I bf on demand with all three of mine, and yes, did have pretty interrupted sleep, but it wasn't devastating emotionally because a) I was well supported by my partner b) learned to feed lying down so didn't exhaust myself as I could feed and doze and c) I prioritised sleep in the first few weeks and months of my baby's life and caught up at other times. That's how it is for most bf mums, and they cope fine.

The problem here as I see it is that the people who are very pro breast feeding just keep on going on and on about the benefits, and what I fail to understand is what it is you are intending to achieve. Most women on here are educated and know the arguments for and against, you don't need to keep on telling us how much brighter your children will be.

Most mothers do their best with breast feeding however, some women have a terrible time of it and it is not made easier by people telling us it is the only way to feed our children.

Whilst I admire people who can put up with cracked nipples for days on end or a terrible bout of thrush it is not really reasonable for people who have suffered with this to have a positive experience and be extolling the benefits - with people who suffer like this I can more than understand why they would choose the bottle.

I think what I am trying to say is that for most people ff is not the primary choice, but what it is, is an alternative for when bf has failed.

joanne - would also want to add that the vast majority of women in the UK already do mixed feed. Only 1% of 6 month old babies have had nothing other than breastmilk (though many will also be on solids as well by that time).

The problem isn't that not enough women are mixed feeding. The problem is that large numbers of women who want to breastfeed for more than a few weeks are stopping breastfeeding early, usually because of supply problems caused by supplementing with formula milk early on!

"The problem here as I see it is that the people who are very pro breast feeding just keep on going on and on about the benefits, and what I fail to understand is what it is you are intending to achieve".

The posts about the benefits of bf are written in response to the many, many posts which 'go on and on' about bf having 'no proven benefits' and in response to the many posts which insist that how a baby is fed in the first few months of life is largely irrelevant. OK?

"you don't need to keep on telling us how much brighter your children will be."

Actually all the posters which mention how brilliant their children are defending ff as having no impact on intelligence or health.

"Most women on here are educated and know the arguments for and against"

I would suggest that many of the responses here suggest otherwise.

To whoever I offended by JOKING that formula fed babies are doomed my huge apologies it was delivered with a large dose of sarcasm! I was just trying to get the point across that there are a huge number of factors involved in what allows us to grow into healthy adults not just what we eat in the 1st year of life. From what I can see whichever way you do things your damned. I formula fed my eldest from 2 weeks and was frowned on and breastfed my youngest til she was 2 years old and was told that was revolting. Sadly how we feed our babies is no longer a practical decision but has become a moral judgement of what sort of parent we are. Maybe we should consider ourselves lucky that we CAN make a choice unlike many women in the world who cannot breastfeed due to malnutrition and can only make up formula with dirty water maybe our energy would be better spent campaigning to make things better for them perhaps

"Most mothers do their best with breast feeding however, some women have a terrible time of it and it is not made easier by people telling us it is the only way to feed our children"

Read the thread. Nobody has suggestede this, or suggested that bf is easy.

"I can more than understand why they would choose the bottle."

So can I. We all do!

"I think what I am trying to say is that for most people ff is not the primary choice, but what it is, is an alternative for when bf has failed."

No argument with that!

Sabire - "If this is the case, why is normal breastfeeding generally associated with better mental health in new mums, rather than worse?"

Can you provide a source? Link, journal citation, whatever.
And has it been shown that the relationship is one of direct causation - i.e. that breastfeeding qua breastfeeding has a beneficial effect on mental health after controlling for other factors?

"Sadly how we feed our babies is no longer a practical decision but has become a moral judgement of what sort of parent we are".

Says who? I don't know anyone who believes this and I would challenge anyone who expressed this view in my company.

"Maybe we should consider ourselves lucky that we CAN make a choice unlike many women in the world who cannot breastfeed due to malnutrition and can only make up formula with dirty water"

Even quite malnourished women can usually breastfeed, believe it or not. Breastfeeding failure is actually rare in developing countries where bf is the norm. If a woman is so impoverished that she can't afford even a barely adequate diet for herself (which would enable her to bf without making herself ill), then she certainly couldn't afford to buy artificial milk for her baby!

"maybe our energy would be better spent campaigning to make things better for them perhaps"

some of us already do!: www.babymilkaction.org/ babymilkaction

But actually the children who are least likely to be breastfed in the UK are also those from the most impoverished and uneducated households, and they're also the most likely to end up being admitted to hospital with respitory illnesses and gastro-enteritis, both diseases which bf helps prevent. Improving bf rates in the UK will be good for the children from these poor households, which is why social campaigners see this as an important issue in this country as well as abroad.

sabire - there are not similar risks, I was not saying that at all, you feel I imply that. I was trying to make the point that there are risks in anything and that sterility is not necessarily desirable. It is a point about semantics again.

I will not accept that the risks are known and proven. They are categorically not known and proven. I feel it is damaging for HCPs or people generally to promote the findings of research papers or institutional advice as though it is fact.

tiktok - I am not confused in any way. I understand that you were talking about pathogens in formula. I was objecting to the semantics of your post. Formula feeding has not been proven to have risks. Breastfeeding has not been proven to have benefits. It is thought that breastfeeding has benefits, this does not mean that formula feeding is thought to have risks. Separate research has been done which has produced a conclusion that 'artificial' (not necessarily formula) feeding is thought to have risks. Research has been done into the safety and adequacy of formula (and some ingredients of formula) as a method of feeding infants. The research is actually very complicated, the methodology is not perfect and the conclusions are also not proven facts. You cannot dispute these points. The NHS, WHO e.t.c. advice is not fact, it is not meant to be fact, it is meant to be the interpretation of the research and current thinking of HCPs. That's all.

You seem to be confused about what it is I am actually saying. I believe this is due to what you are trying to read into the things I say. If you stick to what I say rather than what you think I imply then it is rather simple. i.e. if I say something like a modern theory is that sterility is not necessarily desirable then it does not follow I am saying I personally believe people should feed babies with dirty bottles does it?

fairycake: not sure what sabire's take on this is, but I have collected some refs about this very issue. It's a difficult one to research, as it is subject to 'reverse causation' - that is, if depression is more common in formula feeders (as it seems to be), then mothers might be ff because they are depressed...not that they formula feed and then become depressed.

However, this paper explores the evidence for a biochemical link to indicate that when breastfeeding is going well, it is protective of maternal mental health:

www.internationalbreastfeedingjournal.com/content/2/1/6

There's also this paper which focusses on a very specific population and looks at social factors, finding that bf appears to be protective of mental health (you can't say this would apply to other groups of mothers, though, necessarily):

Breast-feeding and maternal mental well-being among Bangladeshi and Pakistani women in north-east England
Public Health Nutrition: 11(5), 486?492

Anyway, there is a lot of research - social, medical, public health - that explores this whole issue; controlling for variables is very hard to do, because of the risk of reverse causation muddying the waters. I think common sense would suggest strongly that if bf is going badly with pain, or with the mother experiencing massive fatigue or stress, it could be a factor in PND. Not because of the 'breastfeeding qua breastfeeding' but because of the surrounding circumstances.

Perhaps it is extreme pedantism but I feel particularly sabire and tiktok, you are not really understanding the importance of the words you are using or their real meanings.

In this debate the applicable defintions (i.e. correct linguistically) are:

'risk' is a harm or loss.

'benefit' is an enhancement or advantage.

'proven' is having been demonstrated or verified without doubt.

'fact' is something demonstrated to exist or known to have existed.

'thought' a product of thinking.

'advice' opinion about what could or should be done

The words people use are important. Portraying things as proven when they are not to demonstrate why your choice is superior makes people making the opposite choice feel upset and also does nothing for your argument as it immediately falsifies it.

Sabire (oh no why do I even bother)

Every midwife textbook....children least likely to be breastfed are those

No hang on, I'm not quoting you in order to refute (at great length) what you say. You are probably correct. Just shows, as I've said before, step into an ante-natal class, talk to a MW, get visited by the HV and you will be given information about the benefits of breastfeeding.

But even if you doubt that then surely its pregnant women you should be aiming your message at, not those of us on here who have already had kids (this is MumsNet) and have pretty much made our minds up about how we want(ed) to feed them - maybe in a manner you like, maybe in a manner you don't but in any case that horse has already bolted. Indeed, given that what you say is true - and I'm not disputing - your message should be aimed at a particular socio-economic class to have 'most beneficial effect', and whilst I'm certainly not saying that that is totally unrepresented on MN (thank heavens, if there was not diversity of all kinds MN would be very boring indeed) I somehow doubt that this is the best forum to reach what must surely be the most needy audience (just taking your own words).

And yet, you devote what must be hours of your time in circular discussions on here. I just find that strange that's all. Please don't consider that rude - compared to some of the abuse I saw on this thread last night I really don't think I'm rude. But that abuse helped to make me think that probably people are getting too heated and once more I really just agree with Scottishmummys conclusions.

A.Dunnewold, J. Crenshaw. Breastfeeding and postpartum depression: is there a connection? Breastfeeding Abstracts May 1996

But the study does make a point that it's only in mothers who are well-supported.

I can see how in a society which is hostile to normal bf (as we are in the UK, despite all the cant about 'breast is best') that many mothers may experience depression exacerbated by problematic breastfeeding...... I have met so many women who are unsupported with breastfeeding, pressured by partners and parents, made to feel insecure about their milk supply, not given the support to establish bf (which usually requires them to feed a great deal in the first few weeks). Add into that the physical problems like sore nipples, mastitis etc, women have caused by poor postnatal care......

Point I'm making is - it's a complex issue!

Sorry my quotes didn't come out right - but I think you can identify the two statements of yours that I was actually agreeing were probably true.

Anyway, enuf (one hopes).

Also the term 'artificial feeding' - refers to feeding that is not breastfeeding. It does not only apply to formula feeding, it also does not demonstrate anything about formula. The composition and production of different formulas being slightly different it is logical to assume that they will all have slightly different physiological affects. This is why the term 'artficial feeding' is used because it covers the use of different types of formula as well as the use of solid foods, basically anything other than breastmilk.

I'm lost, curiosity.

I have never said anything is 'proven'. I have a research background and know better!

'Risk' is not a synonym for 'loss' or 'harm' - I think you mean 'risk' implies a possibility of 'loss' or 'harm'...yes? In that case, ff has risks...not 'proven' risks, of course.

A 'fact' is something shown to be true. I used 'fact' when I said it was a fact mixed feeding from birth had a risk of leading to premature (ie before the mother wanted) end of bf. This is, indeed, factual.

Um....that's it, really!

Bellisima - don't bother then!

You are saying the same thing over and over again.

Give up!

Sabire, has it ever occurred to you that there are reasons why we try to defend our position?

I have read the thread entirely - I have followed it for days and it has focused on the benefits of breastfeeding, which having read the link tiktok sent to me I am not disputing (in fact I never disputed them entirely in the first place).

All I am trying to do is to explain to the pro bfers, like yourself, is that when a woman chooses to ff it is a decision which is made based on practicality.

Also, on occasions it does sound like you are making a moral judgment.

How lucky we are to have curiosity to check our vocab for us [hmmm]

I am not sure why you are discussing the term 'artificial feeding'. I think we all know it means 'not breastfeeding'; in practical terms, in the UK, in research papers, too, it means feeding formula by bottle. It's just a technical term, really, as it's not a term used by mothers, or people talking with mothers, on the whole.

I don't think I have ever used it myself - certainly never said it.

Many thanks for that, tiktok.

I really, genuinely do not mean this in a snide or rude way, but I'm sure you will understand that I am slightly hesitant to accept the International Breastfeeding Journal as a source, given that it has an explicit agenda, namely that bf is good and ff is bad. I feel that any scientific journal that is openly biased is likely to be less reliable than one which is not biased in such a way.

But I will certainly be looking for other journal articles about the link between bf and mental health because I do think it's a very interesting issue.

Hi All, I'm brand new to this site and this is the first discussion I've read. Was surprised to see the strength of feeling being expressed but it's good to see what people really think though.

I'm pregnant with first and have a bit of a strange issue with BF and will try to explain at the risk of being criticised. It's not something I can control yet though and hope that it doesn't stop be BFing as know it's gonna be a v.positive thing to do.

The very thought of BFing makes me feel very very queasy! I suppose it's coz at 32, these boobs have only been used for a sexual reason (and to rest cups of tea on) until now and it feels difficult to make the transition in my mind. It's also the thought of a liquid coming out of me going into my lovely little baby.

I hope people can try to understand where I'm coming from as this is a genuine mental block.

Sabire - I've said quite a number of different things and put forward quite a number of different points. I can see that you are not going to 'give up', as you clearly see it as some kind of battle royal - just brow beat them at length with enough quotes, come back again and again on every point made by anyone who expresses (oops, there I go again!) the slightest disagreement with your message, whether they bf or ff themselves, and...and...and what? Is that a good use of your time? Does that enable you to achieve what you are hoping to achieve?