OK, I get BF, but am totally fucked off with the smugness

[FunnysInTheGarden]

Most of us are failed BF, but the tone on here recently has really pissed me off. We generally FF? Non? So why the smug shit and the passive aggressiveness towards those who have to/chose to FF?

So tempted to name names, but I won't.

Just stop being so smug and holier than thou please, some people

It's depressing to see how this conversation has unfolded: lots of mothers expressing indignation at the tone they perceive in the comments they read about the use of formula, and no discussion at all about the central facts:

• most women don't need to use formula
• most babies are better off with breast-milk
• culture drives breastfeeding rates
• breastfeeding rates are exceptionally low in the UK
• other countries have changed their cultural attitudes to be more supportive of BF through legislation and other means and have seen increases in BF rates

instead, there's a toxic mix of strawmen arguments, conflation of anecdotes about unusual circumstances with what is generally true, over-reading, and fingers-in-the-ears / lack of response any time someone talks about the evidence.

as for all the discussion about smugness: one person's smugness is another person's pride. And women would be a lot less proud about BF if it were a more normal thing to do. So if it's a bit too smug for your liking in the UK, then you should be encouraging as many mothers as possible to BF.

What I never actually see though is proper, actual action points for improving rates. Just woolly comments about 'more support' and attacks on formula companies.
I also think things might change generationally as well. It was hard for me to worry too much about switching to ff when bf became difficult at every level due to healthiness and intelligence of dh and myself with barely a drop of bm between us.

Well, the personal may be political and all that, but most of the actions are best undertaken by government, and individuals' most fruitful route is to campaign for change. Actions could include:

1. Restricting marketing for formula
2. Funding 24/7 in-person on-call support for BF mothers (ha! but it's what many developing world countries have)
3. Funding more extensive paternity leave coupled with...
4. Training HCPs, including training them to train fathers and family on how to support mothers incl. the practicalities eg taking on household chores

God knows, this is just a quick braindump and I'm sure that there are many other much more effective actions that could be taken. But they will be characterised by state action and resourcing if they're going to effect change for millions of people. I'm sure that others out there have given serious thought to doing something about it.

Yes, things change generationally. It was only a few generations back that everyone BF. It took active work to change that, and it will take active work to change it back

What about formalising midwife involvement in hospitals? It may be this is already done but in my experience (only one so far though) it doesn't appear to be.
What I mean by that is that midwives when they come on shift are given a group of brand new fresh from the birth mums and are KPI'd on getting them feeding well over the course of the shift. An initial meeting and starting point and then two hourly checks thereafter (or whatever, I am no expert!).
It needs to be solid, set targets for people to achieve to be seen as performing in their jobs and these have to be formally set out and measured against.
What about allowing hvs and midwives to prescribe medication for common bf problems? This would allow much more control to rest with one or maximum two people for each mother. it might also make GPs more breast feeding supportive if they don't have to add bf problems to their list of less than urgent patients each day.
Having been through the setting up bf experience it just seems so.... unstructured.

"What I never actually see though is proper, actual action points for improving rates. Just woolly comments about 'more support' and attacks on formula companies".

There have been lots of discussions on this board about increasing breastfeeding rates. The majority of women nationwide initiate breastfeeding, but part of what's causing the HUGE drop out rates in the UK is the casual and ubiquitous use of formula in the first few weeks, which usually damages breastfeeding. Formula companies are implicated in the normalising and idealising of bottle feeding in no small way, so it's right that they should have the finger pointed at them. I think someone did mention earlier on in the thread that countries which have banned all advertising of formula have seen large falls in rates of bottlefeeding.

"due to healthiness and intelligence of dh and myself with barely a drop of bm between us."

I think comments like this are very revealing of the distorted understanding the health and development issues underlying infant feeding choices. No one has ever made a case that there is a clear causal link between formula feeding and low IQ or poor health.

Titty, I think your last paragraph also has a lot to do with it, that for most of us, everywhere we look, bf appears to make no clear difference in the longer term, and that is perhaps why mothers do not perservere with something that might be difficult and painful when there is a very acceptable alternative. What I mean is, the evidence in favour of bf is absolutely clear when you look at stats based on thousands of babies etc, but if the evidence of your own experience is that every ff child you've ever known is perfectly fine, then you might be inclined to think 'what's the big deal'.

"bf appears to make no clear difference in the longer term, and that is perhaps why mothers do not perservere with something that might be difficult and painful when there is a very acceptable alternative"

Yes - it's odd though that we can understand that healthy eating and exercise are worthwhile, even though don't necessarily make a perceivable difference to individual children's health. There are children in my dd's school who eat utter shite for breakfast, lunch and tea and who go home and get smoked all over by their parents. I challenge anyone to pick these children out from the rest of the children in the playground (except by going up and sniffing them!)

Ooo tbb did you just compare ff to eating shite and passive smoking. Oo that might cause a stir...

pdt, your suggestions for hcps make great sense -- but I think any truly effective solution will go much wider than health care

Maybe Slhilly. But trying to change marketing through government regulation would surely take a lot longer than changing the structuring around the immediate support with clear targets? I can't say for sure as am totally private sector minded/experienced.
Surely this would be short term with marketing regulation as long term. Any quick wins in the short term section still count even if it's just the odd couple of percent on uk wide bf rates...
The other point that might get flamed is...corporation tax. The NHS is run on taxpayers private tax and business tax. Formula companies making money might seem unethical to some people but to the nations coffers (esp at the moment) it is all pennies that count dearly in terms of paying for what we all want to be there (and what, we might not too). As, I said earlier as a disclaimer, totally private sector :)

Titty, I quote: "the growing chorus of voices like yours" [ie mine] "rubbishing the benefits of bothering with exclusive breastfeeding."

Whereas, far from rubbishing the benefits of "bothering" with it, I have worked myself to the bone over the past 3 months to establish exclusive breastfeeding. If I appeared confrontational it was because I took exception to your assumptions about my motives and my beliefs. It's not a case of "bothering" to exclusively breastfeed - it's a case of whether or not it is possible. It is possible for me now, but it was not possible a month ago. Attitudes like yours make many women give up trying because the holy grail of exclusive breastfeeding seems unachievable. It is acknowledged that some breastmilk is infinitely better than none, so why frighten women off, and deny babies those benefits, by making them believe it has to be all or nothing?

I don't think that titty IS saying that mixed feeding is bad - exclusive is the only option. I think she's saying (sorry to put words into your mouth) that mixed feeding is over-used when it's not needed (and, she says, most mixed feeders don't need to in order to give their babies enough food), and this is being done without an understanding of how it can affect longer term breastfeeding.

It's nothing personal, she talks about statistics, not what an individual person on this forum does.

Thanks organic. I do understand what you and Titty are saying about mixed feeding being overused and over-advised - I agree. But I do feel that in trying to combat that problem the actual benefits of temporary mixed feeding are overlooked and women actually don't get the help and advice they need to progress back to exclusive breastfeeding. That's my experience anyway.

With DD1 I exc bf, then we hit a problem and she was mix fed for aabout 1 month and then with a lot of hard work we managed to get back to exc bfeeding again, so I think mix feeding definitely has its place.

I do think though that women are advised to 'top up' their babies far more often than is really required by HCPs, leading to mixed feeding and in some cases an end to bfeeding earlier than would otherwise have happened.

At which juncture I need to acknowledge the help of a friend who pointed out to me what should have been obvious. IE that when DD started waking twice in the night again, at around 12 weeks, she was looking to increase my milk supply. That was when I realised that if I wanted to continue breastfeeding I had to now commit to breastfeeding in the night.

I simply couldn't feed at night for the first few weeks and I believed this would lead to my breastfeeding winding down gradually, because everything I read told me that breastfeeding in the night was crucial. I didn't like the thought of stopping altogether but accepted it as inevitable.

My rather longwinded point is that it actually wasn't inevitable. In reality it took very little work to cut out the bottles when I was ready and able to do so. I don't believe I am exceptional in any way, but everything I have read on the subject would suggest that my situation would normally lead to the end of breastfeeding.

Sorry to hijack, but I was so close to giving up on the whole thing that I feel very very strongly about this issue.

pdt:
Not sure why it's necessarily slow to change marketing through government regulation: government passes law, companies banned from marketing, job done. The trick is building the political consensus / momentum to pass the law in the first place, and that may indeed take a while. But trying to change the behaviours of tens of thousands of midwives and HVs also takes a long time! (and targets is now a dirty word, of course -- the focus is all on outcomes, natch)

Re corporation tax. I refer you to the classic Yes Minister quote:
"Jim Hacker: "Humphrey, we are talking about 100,000 deaths a year."
Sir Humphrey: "Yes, but cigarette taxes pay for a third of the cost of the National Health Service. We are saving many more lives than we otherwise could because of those smokers who voluntary lay down their lives for their friends. Smokers are national benefactors." "

If you want to be utilitarian about it, you would have to do a full cost-benefit analysis which estimated the costs-to-treat of the excess morbidity incurred by non-breast-fed babies throughout their lifetimes, and set that against the increased tax revenues. Plus, you would also have to calculate the impact of non-FF mothers having more money in their pocket. I don't think this is a sensible road to go down...

"Attitudes like yours make many women give up trying because the holy grail of exclusive breastfeeding seems unachievable".

Aaargh! What 'attitudes' are you talking about?

"It is acknowledged that some breastmilk is infinitely better than none, so why frighten women off, and deny babies those benefits, by making them believe it has to be all or nothing"

I haven't! Pointing out that a) exclusive breastfeeding is possible for the vast majority of women with appropriate advice and support and b) that there are benefits to it is NOT the same as saying 'there are only benefits to breastfeeding if you do it exclusively!

You're making a case that women aren't aware that it's a) possible to mixed feed and b) that there are benefits to breastfeeding even when you're giving formula as well. I've pointed at that the vast majority of women who are breastfeeding are mixed feeding anyway!

Again - it's so infuriating this distortion of my and other people's arguments so that you can make a point about the way these issues were communicated to you by those whose job it was to support you with breastfeeding. It wasn't well explained to you, but that's not because of any national policy to actively discourage partial breastfeeding.

Re: the phrase 'bothering to try to exclusively breastfeed' - it wasn't used pejoratively to make a sly point about women not trying hard enough to breastfeed. You have just chosen to read this inference into it to bolster your case that women who promote exclusive breastfeeding may be unkind and judgemental.

'excess morbidity incurred by non-breast-fed babies throughout their lifetimes' slhilly it is statements like that which are riduculous, inflamatory and pointless. Why compare FF to smoking? This is the type of attitude which really pisses me off

Oh my goodness, what a difficult and spiky thread this is.

The most angry, intemperate voices are those from mothers who have had upsetting and emotionally-damaging experiences feeding - I'd even say these experiences actually distort their perceptions. This is not surprising - mothering is an intensely emotional experience and why wouldn't you get worked up about it and see and hear things and extrapolate out from them to make huge generalisations which absolutely do not apply, generally? But these extrapolations don't help clarify anything.

Skewed perceptions also make some people unaware of what is actually being said and what has been said for years and years - not just on mumsnet.

We already have solid research that shows governments and public health bodies how to increase bf rates, initiation and maintenance. No one sensible thinks that vague calls for support are any use any more - real, practical, effective measures involving far better HP training, community/lay intervention, ending of unethical promotion of formula, legal protection for bf mothers at work and 'in public'....when all these measures can be put in place, things change.

It is frustrating when an intelligent argument using smoking is dismissed because of sensitivities around the idea that FF is somehow being compared to it. Smoking and public health is something all of us know something about. We know that there are business interests involved. We know human behaviour is involved. We know that social and cultural norms are involved. And we know there is a level of health impact that affects us all as a society. So there are helpful parallels when it comes to a discussion.....or there could be, if people did not immediately knee-jerk a squawk of protest as if smoking and ff were being equated.

Funny - it would be just fab if you could take a bit of time to gen up on some research. There is quite a lot which indicates the long-term effect on health of how people were fed as infants. It makes perfect biological sense, too. It's not 'pointless' to say so, but sadly, in your case it is indeed inflammatory as it certainly makes you foam at the mouth.

Do grow up.

FunnysInTheGarden, I don't understand. Are you saying you don't believe the extensive evidenced that there is a meaningful difference in health status between BF and FF babies that extends throughout their lifetime? People have posted links to this evidence before, but you've not responded to any of them.

There is nothing ridiculous, inflammatory or pointless about that statement. It simply reflects the evidence: babies who are BF will, on average, have better health outcomes than babies who are FF. The difference between the two is the "excess morbidity".

As for the smoking thing....words fail me. I was referring to a satirical show called Yes Minister which was quite popular back in the day and was doing so specifically to reject the notion that it was worth trying to do a cost-benefit analysis of BF vs FF that included calculating corporate tax receipts. I think this may have flown over your head somewhere, judging by your response.

Titty - we're clearly not going to be able to see eye to eye on this, and I am aware that my comments are coloured by my own experience - that's inevitable. But I am an intelligent womean who cares deeply about doing the right thing for my children. I am simply saying that I found the standard advice about breastfeeding to be unhelpful and damaging and I don't believe I am alone.

"I found the standard advice about breastfeeding to be unhelpful and damaging and I don't believe I am alone."

gaelic but isn't the point here that there is no standard message? Trying to encapsulate the whole story of breastfeeding into the phrase "breast is best" doesn't work. HCP are not trained sufficiently in BF support. It turns out that BF experiences are so individual that it's not surprising how long BF counsellors take to train.

Taking mixed feeding as an example. You say yourself that you realised that you were giving formula instead of increasing your supply. In which case, had you not realised, your milk would have reduced - hence the slippery slope. But using formula to get through some problems, with the proper assistance of a qualified HCP can be really helpful.

"I am simply saying that I found the standard advice about breastfeeding to be unhelpful and damaging and I don't believe I am alone".

If you were not taken through all the options and the evidence base for them then you were not given 'standard advice'. You were given 'substandard advice'.

True Slhilly, I certainly wouldn't be up for doing that kind of analysis! You would also have to determine where you drew the line on 'bf babies'. At least colostrum? One month? The six month recommendation? The two year recommendation? Thorny ground it would seem - this thread is evidence of that alone.
I think that's what I meant tiktok - not that I am the only person to desire/think out these steps but to feel real confusion as to why they haven't happened yet. I am a difficult to please manager at work - can you tell ? :)
I suspect the answer will always be a time/interest and funding split one...

I thought this thread was about the fact that some people are, well, a bit smug about bfing? Much the way some people are smug about having bought property before the boom and raking in cash as a result, or having clever kids or being superskinny while eating KFC for lunch daily?

Might it be possible for someone to state that they have felt judged and belittled by other women sometimes, without it becomin about whether people need to formula feed, or bfing rates or advice or HCP advice or what have you? I know conversations 'evolve' but it seems to me that many of these bfing threads evolve to say the same thing.

There are some smug bitches about. Why is it so hard to believe that maybe everyone who bf's is not sweetness and light and, given that it is a sensitive topic for some people, use bfing to make other women feel bad?

Perceived tone, bollocks. Because of my poor, hurt feelings? Seriously, women sitting bitching about another woman not 'trying hard enough' is just bitchiness. It's not unintentional or because of their passion for the cause, it's just bitchy.

Christ on a bike, there's no need to dissect individual women's experience and psychoanalyse them, or make it into a 'let's look at all the evidence about bfing again, shall we?'.

I will say it again: I despise women who sneer at mothers who ff. Not because I am a poor ickle fwower who hasn't gotten over my early feeding experiences, but because in general, I feel contempt for people who sneer at others' experiences because their life took a different path. And make no mistake, some people do sneer. And make that sneering obvious. And it is not all 'perceived tone' or skewed perceptions. It's just life.

I suppose you think that people don't crow about their other achievements in life, either? Because, well, all mums are just so nice. I find it insulting to be lumped in with this non-entity of a grouping if motherhood is just about being nice. I rather thought it was about being human, which is an altogether more interesting and colourful affair.