"Breast is best" message under fire - and I agree, really

[hunkermunker]

Interesting, I think

"Current promotional and educational programs which describe breastfeeding as 'best' are undermining women?s capacity to make informed decisions about infant feeding, according to an article published by a University of Wollongong doctoral student in the latest issue of Maternal and Child Nutrition.

Ms Nina Berry from UOW?s Centre for Health Initiatives was joint author of a report with Karleen Gribble from the University of Western Sydney called ?Breast is no longer best: promoting normal infant feeding?. Breastfeeding is not 'best', say the authors, it is simply the normal way to feed human infants.

The article suggested that breastfeeding promotion and education programs should abandon the ?breast is best? message because it is misleading and fails to communicate the importance of breastfeeding.

?In fact, these messages may have obscured the importance of breastfeeding to infant and maternal health and the well-established risks associated with early weaning from breastfeeding,? Ms Berry said. "To say that 'breast is best' is to suggest that what breastfeeding offers is a handful of optional bonuses and that formula-fed infants are the normal standard for comparison. In fact, human babies were designed to be fed human milk."

?Research has found that while most people accept that breastfed babies are healthier, they do not understand that this means that formula-fed babies are likely to be sicker. Because formula feeding is viewed as harmless, women are not getting the support they need to continue breastfeeding and to make informed choices about infant feeding. This misunderstanding demonstrates the failure of the ?breast is best? message and the need to rethink breastfeeding promotion?, she said.

The paper in Maternal and Child Nutrition also illuminates an important addition to the body of evidence pointing to the significance of using breastfed babies as the control group when conducting research.

The World Health Organisation (WHO)?s Multicenter Growth Reference study found that the growth of formula- fed babies deviated from that of breastfed babies and that using growth charts based on formula-fed babies could be contributing to the current obesity epidemic.

The use of formula-fed babies in control groups makes it difficult for readers to see that formula-fed babies are at increased risk of adverse health outcomes, Ms Berry said.

The WHO recommends that children are breastfed for up to two years or more and that they should not be given any food or drink other than breast milk for the first six months of their lives.

?It takes a great deal of support for mothers to reach these goals. However, mothers are not being provided with adequate support because the risks associated with early introduction of foods other than human milk are not well understood by health professionals. Furthermore, many health professionals are reluctant to talk to mothers about risks because they do not want to make mothers feel guilty. This is not about guilt. It is about a mother?s right to have all the information she needs to make an informed choice about how she should feed her baby ? it is about ensuring that mothers have the support they need,? Ms Berry said.

By Bernie Goldie"

lissielou I have loads of nursing tops, didn't cost a lot and aren't covered in flowers, you'd never even know they were because they are so normal looking. Problem is people don't know where to look.

In case anyone is wondering, H&M do the best nursing tops I've found, between £9.99 and £14.99 each depending on style and they are fuller in the bust so you can get a decent size too.

Harpsi, it's really, really tough, isn't it?

On the one hand, I want desperately to be supportive and kind to the women I know who cannot change anything about the way they fed their babies, because they have no time machines and for whatever reason, be it poor support, medical reasons, whatever, they weren't able to breastfeed.

And on the other hand, I want desperately for women who are pregnant now, and will be in future, to have all the facts at their disposal and to have the support to breastfeed, should they so decide, both from professionals and society.

What gets in the way of this, massively imo, is the women who say "Don't make women feel guilty by talking about breastfeeding" "Not everyone can do it you know, you smug fucker" - how is this helping anyone to speak like this?

I am hugely heartened to see women with whom I've had heated debates about this in the past post supporting my view - I really am overwhelmed by the generosity of spirit displayed; the "It didn't work for me, but, you know what? It's not going to make me feel better if I stop other women having the information I should've had, so go for it, let's get it out there". I can think of at least four regular posters on MN who have posted in that vein on here recently and I love them all. Lissie

I love that last article and I agree- breast feeding is seen as an optional extra.
I thing for many it has to be getting over the yuck factor that is most important.
I found that really wierd when I breastfed that people would actually go eurrgh when I asked them if they would breastfeed.
Things are improving but there is still along way to go. My friend had an emergenct caesarioan recently, she turned round and the midwife was giving the baby a bottle of formula, how wrong is that?
She has gone on to bf succesfully btw [my friend not the midwife]

MrsR but that she went on to bf successfully. Has the midwife recovered from her broken jaw? [advocates violence]

It's funny how I don't feel any support from my family for breastfeeding or even just "well done" but my SIL is supported. It's almost like I did something that's easy so why should I be, yet she tried (ahem cough splutter, yes that's what we'll call it for sake of argument) but couldn't do it so she needs support. She can tell me I should give a bottle cause it's easier (yeah right, I don't have any hassles feeding Tink) but I can't talk about how easy/ good breastfeeding is. It's the looks and discomfort I feel when anything is mentioned. Not even feeling support over my Peer Course.

To pick up on a point that "no one wants to [give formula milk]" some mothers do. Some hate the idea of breastfeeding, some think there's more important things in life, some think their boobs belong to their OH etc. My SIL never had any intention of nursing her kids, she did with the third because he is my brothers first biological child and only because my family nagged her. A nurse upset her one day on her first PTB and she wouldn't do it again. Didn't do it with the next child and I doubt she will do it with #5 when he's born.

Ooh, good tip re: H&M nursing tops - am 38 weeks pregnant and planning to bf again (9 months with first DS) so imagine will be on these boards a lot!

Had a really hard time with DS - they gave him formula in the hospital as I couldn't see him for 8 hours after the birth. Then he was always a really fussy feeder and very 'posset-y' - it wasn't until 6 months when I tried him with formula again and he came up in a huge rash that we realised he was allergic to cow's milk! Am convinced it could be to do with the formula at the hospital and that his body reacted to it as the first thing it had? Feel very guilty about all the dairy he had through me, prob he wouldn't have been so sick

Anyway, that's totally off the point, just wanted to say 'hello' and interesting thread!

LOL Hunker- Just about!!
My friend is a gutsy lady and screamed at her which prompted her dh to spring into action and explain they didn't want that

Maybe it is time to get radical

Nothing new to add really, but agree with early post from vlc, and loving the 'normal is scary word' thing!

I received a survey on infant feeding, asking if I knew the benefits of bf etc. There was also a space for other comments for factors that have affected you - I mentioned this and about the fact that there aren't 'benefits' to bf.

This is an interesting thread. I've just started training to be a peer supporter and it's going to be really difficult to know how to handle situations where people chose to bottle feed. I know we shouldn't be judgemental, but I am, I really am, I'm sorry. I am going to have to get past that as a peer supporter though. (this is obviously people who really tried and couldn't bf not withstanding).

How do you deal with this message without offending people?

Although, recently the message has started coming out about childcare issues, i.e. early child care obviously not as good for children as being at home with a parent. Yes this is hard to stomach for people who have to/choose to go back to work, but why should you suppress research just because it is unpaletable. Surely is research like that, and more saliently research in to bfing, which is going to spur government bodies to offer more support. So it is important to get this message out, not just to mothers but to organisations and really the general public who can offer support to new mothers by making it more normal.

Once it is more 'normal' bfing will be self propagating, i.e. more women bf, therefore more women will bf because the reasons not to (e.g. embarrassed in public) won't be there, and the more we see people doing in on a practical level the easier it should be.

Erm, did any of that make sense

BumperliciousIsOneHotMother, I use to feel a similar way to you about bottle feeding, but I have changed my attitude and now I think the following.

I realised that choice is just that, a choice. Women who have a choice will sometimes make a choice which you wouldn't and that doesn't make her decision wrong, just a different option than you would choose to do.

Your goal as a peer supporter is to furnish mothers who want information with that information (or a pointer to a good source of information) and that is it.

The mother will take that information and use it as she see fit. Her choice is nothing to do with you and it is not up to you to change her mind or convince her.

Finally there are so many women out there who want/need positive support/information on breastfeeding and there is where you will be able to make a difference to the women who want your help.

Women who actively choose to bottle fed, do it happily and I am glad they have a good feeding path. It is those women who are forced on to formula against their own wishes, due to lack of support, that I feel bad for. Hopefully these are the women who you will help in the future.

Thanks babieseverywhere, you are right, and it's misplaced anger really, it's not the mother's fault it's society's fault (and I don't say that lightly, I'm not one to usually absolve people of responsibility), and other people, crap HCPs, members of the public, government/NHS who make me angry as they make it so damn difficult for bfing mothers.

I've seen some people on here who are very laid back and easy going about this. And I especially admire the extended bfers who say "yeah I know, I would have been freaked out by it too before I did it, but it's cool, I'm not going to preach about it" or something like that! I just feel so defensive. I guess because bfing has been a battle for me and I have had to defend myself. Now people in RL think I'm a bit preachy

"Now people in RL think I'm a bit preachy"
I can understand that overcoming problems to breastfed, make you value that breastfeeding is now going well for you and that is great news. I had a similar rocky start to nursing myself.

Now you are full of energy and want to help other nursing mothers, that is great to hear. You are now channeling your energy in a positive way, hopefully this will naturally cut down on the preaching.

Attitudes can be altered over time. I don't think I am laid back yet but I am working on it

Mrs Badger - really like the mother's milk for every mother's child idea and agree about the 'human milk' thing Caz10 (just look at the film 'meet the fockers'...) The mummy milk one's a nice one too, I have seen some cute slogan baby clothes about mummy milk (?)

The scary normal article is really interesting humnkermunker.

Is it a similar situation to the real nappy debate (and I agree it's a personal choice) in as much as the disposable companies have spent an awful lot of money sidelining campaigns for real nappies and funding their own research into disposable V reusable and they have a lot more money to do this than Govt agencies? (Yes, maybe a bit paranoid! )

Similar for formula companies? As they do have a tendency to make massive profits and so need a good market share (the price of formula is astounding! Couldn't believe SIL spend over £8.00 a tub!) And I understand that a certain large company is still promoting formula in LED countries...

Maybe one promotion could be the free factor?

Hi, this is really interesting stuff, especially as I dropped the bf part of combining with bottle 4 days ago for my 2 month old...

I really, really miss it but found it almost impossible and ds never got much out of me! Even great support at bf clinic, babymoons, domperidone etc couldn't help..

I just hope that all the breast is best stuff (although true!) won't mean people start looking down on bottle feeders like us - we might not be doing it by choice

sorry to hear that loosey, hope you are feeling ok. it is so difficult, such an emotive subject. my dd is almost 3 mths, we are still bf-ing but only just, with question marks hanging over it because of weight gain issues...if i end up having to stop i don't think i'll be able to handle, eg, reading a thread like this.

This is a really interesting article. I also dislike the Breast is Best nonsense. Like so much else that happens from the moment you fall pregnant, it treats women as though they have no brains and can't analyse information in a critical and intelligent way.

It is, of course, a very sensitve issue but one which needs to be much more fully discussed by HCPs, peer support etc. I think that the big issue is that the HCPs are good at pushing the message that mothers ought to breast feed, that it is best for baby etc. but there is bugger all support when you have problems and it is the HCPs who suggest topping up with formula at the first sign of any problems. This just means that a lot of women end up not breastfeeding and feeling awful and stressed about it. If HVs got proper training as BFCs, this would solve a lot of problems.

It is such a shame that BF is not seen as the normal way to feed a human baby. Having said that, I don't think that anyone should be made to feel bad about the feeding choices that they make, they should simply have access to all the information and support that they need.

Caz - With the weight gain aren't most of the logarithms/charts used based on 'normal' weight gain for FF babies and so BF babies tend to come up a bit on the lean side anyway? Thought the WHO were going to review the tables (relatively recently) because of this. Don't know your situ, but thought the info could put a different spin on weight gain?

LooseyC, sorry to hear of troubles, I don't think anyone would start 'looking down' on fm mummies and babies because there are often so many different reasons for using fm. Like you say not everyone has a choice and thank goodness fm does exist for some babies. I will never forget my SIL sobbing down the phone as she made her changeover - she'd fought cracked nipples, nonsupporting health professionals and after another month of not sleeping for more than 1 hour at a time finally had to try something else! It works for her and that particular baby.

I think it's more about being honest about the options and giving women who are in a position to choose, the right and 'correct' information so they can make an informed choice and be supported in that, not about bashing bottle feeders (IMO).

Saw an interesting tv broadcast a while ago about how sexual imagery and attitude towards womens sexuality could affect the concept/acceptability of bfing. It's OK to show a nipple on page 3, as that's nice and artistic and a pleasure to see (IYSWIM) but all a bit yucky if a woman uses her chest for feeding a baby. If she does that then she's just a bit of an exhibitionist and showing off. It was exploring this idea and I think on the whole men and women (generally) found bfing more disturbing than page 3.

I think the concept of 'normalising' bfing is an excellent one.

Hijack over!

I might be being a bit emotional here, dd is only 6 weeks old. I tried desperately hard to bf after NO support from any of the hospital staff when it proved difficult. I tried everything, clinics, counsellors but had to finally accept that it just wasn't going to happen. I couldn't even express. I really appreciate everything that is being said on here and wish to God I had got the help I needed from the start but I didn't and every bottle I give her hurts. Every blasted forum I go on has breastfeeding tickers which upset me to the point of staying away from them. Whichever way any campaign or awareness drive goes, please let it not be one that criminalises or frightens mothers who ff because I really do not need to lie awake at night scared witless that my daughter has a higher chance of SIDS. And, as most of you probably know, that's how hormonal new mothers think.

The standard feeding charts are based on a large number of babies who's feeding wasn't differentiated. The breastfed specific charts don't help babies with a weight gain issues, as it would show the same baby as even lighted than average.

Caz, I have read a couple of your threads I thought the doctor said your baby was fine ? There is a lot more to babies health than simply weight, your baby is active, alert and has plenty of outputs and that is more important in the long run.

lighted lighter

Jodie, don't know if you'll see this but with ds1 I only fed a few weeks- he was IUGR, it was Millenium time etc etc and there werre no support staff available.... ds2 4 months....

DS3- 16 months.

The difference? A breastfeedingt raining course gave me the confidence I could do it.
And a supportive midwife who leant me ehr entire LaLeche collection of files.

One Bf experience can really affect the next (positive or negative) but you can challenge that and it can work. Good luck.

This baby could come soon (starting to engage early- yikes) and I will definitely be BF. But I have been recommended to be gluten free as part of the ASD avoidance strategy we are using (2 kids with asd), so if ic annot take the diet beyong 3 months I will not beat myself up- you just do the best you can with the circumstances you have been handed, and should feel proud of that. beuing stuck in hospital with a jaundiced poor feeder is not optimal circumstances and you shouldn't feel bad.

Sarah - I think this is why it's really important to get a system that works and gives enough support and information, so mums who do need to move onto ffing feel that they've been given enough help and so don't feel guilty about doing what they need to do in a tough situation for their beautiful babies! Big hugs to you and your dc!

Yonks ago girls would have seen women bfing at home and it would have been just another thing that was done. Also there would have been a lot more women around you after having a baby (IMO, could be a choccy box view of post-war UK) who had xp of bfing and looking after babies. Now we (generally) seem to be spread out away from our families and have to cope on our own with the professional advice that is around us, which does seem to leave a bit to be desired. It's something that needs experience and the apprenticeship scheme could be a brilliant one.

It is interesting to read about the need for antenatal training for breastfeeding, one of the things I think helped me was that I attended NCT run "Bumps and Babies" sessions, before I had ds and got the opportunity to meet bfing mothers and ask them questions about it - I had had no experience of Bfing as none of my friends breastfed.
One of my friends had a baby 15 weeks before I had mine and gave up on day 3 because her baby refused to latch on, probably because she became engorged when her milk came in - the same thing happened to me. I firmly believe (but I never told her as by the time I realised it, it was far too late and what would be the point?) that it was a problem that could have been solved with the right help, but she herself was uncomfortable with bfing and her DH was against it. In fact he has to leave the room when I have to feed my ds when I visit them!
In my case I had my DH's support 100%, so I think a big part of education on breastfeeding has got to be aimed at the partners of expectant mothers.
When I did the NCT Bfing class, I was the only mum-to-be who brought her partner and we both thought it was important or him to attend and find out the facts of breastfeeding - however out of respect to the other women who may have felt uncomfortable with him there, I sent him home.