What to use instead of best or normal?

[hazchem]

I had a meeting today and a midwife said "breast is best" and I said well no "breastfeeding is normal". One of the other attendees said that she was uncomfortable with the use of "normal" as it can make people feel abnormal if they can't breastfeed and would make them feel bad.

I've tended towards breast is normal because it think it takes some pressure off and suggest that it just something that humans do. I hadn't thought about it making women feel worse.

Has any else come across this? Is there a move towards another term. Natural?

"Breast is best" is quite catchy though - Don Draper would be proud of that slogan I think!

"Breast is normal" doesn't really have the same ring. Plus if you mean "normal" as in standard, usual or accepted then formula feeding is also normal, at least in this society.

Isn't it generally accepted in midwifery circles that in most cases breast is best - for the baby at least? I thought the point of the slogan was to promote the benefits of breastfeeding particularly antenatally - otherwise what's the point of it?

Is being abnormal any different from being second best?

Surely best is whatever works for you and your baby. I only managed to bf one of my three. My first one didn't latch on, and no midwife in the seven days Post op in hospital, could get a latch. My second took straight to it, but caused me all manner of problems, but I persevered for 6 months. My 3rd one was so poorly after birth that he ended up back in hospital and was virtually force fed a bottle as his blood sugar was so low. After that, I wanted to know exactly what he was taking. My youngest is now 4 and the oldest 11. All 3 are very healthy and strong, so really, don't let anyone pressurise you one way or the other. Do what you think is right for you

It's a difficult one because it is (or seems to be) impossible to have any discussion about infant feeding without someone feeling offended.

Breastfeeding is biologically normal for our species, there are risks involved with other feeding methods, but that's not to say formula isn't good enough and a perfectly valid choice/alternative. There's not really a catchy way to phrase that though, and I'm sure even that would be offensive to some!

My point, and others more qualified, is that breast isn't best it is normal as in it is biologically normal for human mothers to feed human babies human milk directly from the mothers breast.

Part of me wants to totally change the slogan to say "breast milk substitute feeding carries risks as it deviates from the biological norm " but I think more likely to do harm and well it's not very catchy.

This isn't very catchy either, but what about "breast is best for some mothers and some babies". Then you're not leaving anyone out.

Babmum3 The meeting was in professional capacity. So it's really just a discussion for discussion sake if that makes sense.

I know a slogan wont save the world but I would like everyone to be able to meet her own feeding goals with support and acceptance and with protection from unethical marketing practices. As I'm passionate about that I know I need to speak carefully because I don't want to make someone feel bad.

"biologically normal" is rather good though, I think. Although that word 'normal' does inherently have a value judgment attached to it.

When you say support and acceptance and with protection from unethical marketing practices though, it does sound rather biased in favour of breastfeeding.

As slogans go, I think "every breastfeed counts" is more useful because it's completely true (any amount of bm confers benefits) and can be used to support all kinds of mothers - those who only give colostrum, those who struggle on for a few weeks, those who mix feed for six months, those who feed to natural term, etc.

Vocabulary in clinical situations (eg nutritionally optimal) is very different from what one should use in a support relationship or marketing campaign.

Unethical marketing practices effect formula feeders though, so why would that be biased towards breastfeeding?

There is nothing you can say about breastfeeding that won't make someone feel bad. You could tie yourself up in knots about the least offensive way to state that breastfeeding is good for babies and still have someone tell you that you made them feel bad because they ff.

The only thing (imo) that can be done really is to give the best support possible to women who want to bf. The more women who succeed, the more "normal" and achievable it becomes. But that's much more expensive than a slogan unfortunately.

It's actions not words that count here, because unfortunately too often HCPs say one thing (breast is best) and do another (don't support bf, suggest or insist on formula at the first sign of trouble).

Plus, I think a large part of the problem is that a hell of a lot of midwives, nurses, doctors don't think "breast is best". They were ff themselves and ff their children and so they can feel defensive and criticised for their choices, and in their turn undermine the message because "well, I/my children turned out fine".

How about 'breastfeeding has many advantages but not breastfeeding isn't actually going to damage your child'? Because that actually is the truth, and it has the advantage of not demonising anyone.

The worst possible outcome comes from making mothers anxious and miserable over something that, in this country at least, actually matters very little indeed. Health promotion needs to be pragmatic and to consider the entire breadth of health and well-being if it's going to be effective.

I say that as someone who breastfed her children. I just really think we need to work in a strengths-based way and to assess risk in a reasonable manner. You can provide support and make it easier for women to breastfed without moralising the issue or making people feel like 'failures'.

The actual outcomes from different kinds of infant feeding in this country really don't merit the enormous fuss there is over infant feeding. It really does matter that current policy alienates a large number of people.

I much prefer 'breast is best' to breast is normal. There's something horrible about normal - the inference is that not BFing makes you abnormal. Don't like it at all. Whereas 'breast is best' but FF is a pretty good substitute. (And I BF for over a year to give context).

What about your body - your choice? Leave women to make their own choices please.

This is such a puzzle, I agree.

It's no use saying 'breastfeeding has many advantages' because that sets formula feeding as the norm, the benchmark, which breastfeeding has 'advantages' over.

'Normal', is, I agree, presenting ff as 'abnormal' and by an accident of the English language, this sounds worse than it is! 'Abnormal' has undertones of 'freakish and deviant' - not what should be implied at all.

'Biologically normal' is a mouthful and too science-y.

'Breast is best' is too slick and ignores the fact that there may be a number of individual reasons for individuals why breast may not be 'best'.

When I have to present something like this I say 'exclusive breastfeeding for 6 mths has been shown to give the best health outcomes' or 'human milk is tailor made for human babies, and when you give other milks to babies, this is not the case'.

But it's all very clunky!

'Breast feeding should be the default feeding method'

True, but not at all catchy

Stick with 'Every breastfeed counts'. For people who intend to or have given at least one breastfeed, it's supportive, positive, encouraging, understanding.

I am all in favour of promoting breast feeding, but it has gone so far that way, that there is now no support for mothers choosing to bottle feeding for whatever reason. We all know that breast feeding is best, normal for humans,easier, safer etc, but not giving any bottle feeding advice is actually dangerous IMO as many parents are making bottles up wrong, not sterilising bottles properly, and feel doubly guilty. I know of a mum who didn't think she needed to sterilise bottles if they were washed in the dishwasher, and another who put the milk in the bottle before the water. There needs to be a better balance in the advice mothers get.

(For most people) breast feeding is the easiest and cheapest option. Also biologically ideal for your baby.

Bitscary I applaud that statement wholeheartedly! A slogan like 'Every BF counts / helps' I could really get behind.

There is too much emphasis on exclusively BFing. I know so many people who felt like they were 'failing' when they started mix-feeding (usually very hungry babies and low supply) so abandoned BFing altogether, when actually they should have been encouraged to keep feeding once or twice a day.

ps - it is a skill both baby and mother need to learn and can be tricky in the first few weeks. That I think is an issue most people are unaware of.

It's a bit of a myth that there isn't any support for bottle feeding - there's no reason that midwives and health visitors can't advise on safe bottle prep and the NHS have several leaflets and web pages on how to use formula. People don't make up bottles incorrectly because the information isn't available, just as people don't wean at 3 months because no one ever told them to wait til 6 months.

I don't think the 'enormous fuss' made over bf/ff in the UK has anything to do with health, calamitously....the health impact on individual babies of bf/ff is small, and though the impact on a population level is costly and measurable, most ff babies grow and develop just fine.

I think the fuss is to do with these issues:

• the continued daftness over bf 'in public' - most bf babies can be bf everywhere and anywhere and no one gives a toss, but just occasionally some jobsworth decides to tell a mother she can't do it there
• the continued daftness about breastfeeding babies beyond newborn and the utter hysteria over breastfeeding toddlers and small children...on which people have quite strong opinions totally at odds with 'your body your choice'
• the continued difficulty women have in bf at all without friends and family (and sometimes HCPs) undermining that choice with stupid ignorant remarks (see current thread in this folder where mothers and mils and others are reported as making observations that go some distance from 'your body your choice'

So it's not really health. It's a cultural distaste and discomfort with bf, that impacts on women's choices and which has very little if anything to do with health.

How about breast can't be better or can't be beaten. You could always dilute the traditional slogan to breast may be best.

I suppose technically breast is best as it's actually produced naturally fit babies. Knowing that breast was in fact best is what swayed me when choosing my feeding options. I guess I was lucky in that I was able to have the choice xxxz

Badmum - there is a ton of info about ff.

• there are universally available leaflets, easily obtainable, from HCPs, maternity units, internet
• most babycare books have a section on it (everyone gets the Bounty book - it's in there)
• instructions on making up formula are on every pack - I don't understand why anyone would fail to see these, or make an error with powder/water

I have heard of midwives and HVs refusing to recommend a particular brand of formula, and that seems to me to be ok - it's not withholding information, because there are no grounds for saying one is better than another. Any HCP who says they cannot give information about ff generally is not doing their job properly, but it's just not right to say there is no info about ff.