Why choose not to breastfeed?

[MissBax]

I work in healthcare and have just been on a breastfeeding workshop as part of my training. I knew the benefits of breastfeeding for mother and baby anyway, but couldn't believe just how incredible it really was!
I was just wondering what people's reasons were for not breastfeeding? I'm not asking about health reasons or those who have suffered abuse etc. But just wondering why some women simply choose not to?
I'm not being a GF either before anyone offers me a biscuit 😉 just genuinely curious why someone would choose to bottle feed?

One of the main things about doing everything 'naturally', and that includes breastfeeding, is that Mother Nature is interested in survival of the species.

So if everyone solely breastfed, as a species, the human race would continue because a sufficient number of children would be fed well, be healthy, and would survive.

Mother Nature is NOT interested in survival of the individual. So it is irrelevant if some children don't flourish or survive, or if some mothers don't cope, get PND, etc, etc, etc.

But as a civilised society, we DO care about the individual, about the mother's happiness, about the baby not only surviving, but flourishing. And if FF does that (which it does for many!) then that is to be encouraged, right up alongside BF.

Having a baby is hard work. For some women the pregnancy stage is horrendous. For others, it is child birth. Then for another large group (which can overlap with the other groups), it is the infant stage, and that can be for many individual reasons, and for a lot of people, numerous individual reasons that add up. Even when everything goes smoothly, having an infant is exhausting. When it doesn't go smoothly, you do what you can to make it easier. FF a child is one of the ways that for many, can make a difficult situation a lot easier, for lots of reasons, and a lot of women have the instinct to recognise that even if they don't tick of the reasons, one by one.

So asking 'why' is a ridiculously simple question that just cannot have a simple answer. 'I don't want to' is a way of answering when instinct has told that person that for THEM, FF will make life easier.

I wonder whether bf rates would improve if the nhs gave balanced information about formula feeding and breastfeeding. At the moment they're not allowed to do anything that even remotely looks like its promoting formula. Which includes giving any useful advice to a first time mum whose milk never came in.

HCP can and should give information about formula feeding. It's a complete misunderstanding of the requirements about not promoting formula to think that they aren't allowed to give any advice. If a HCP tells you they're not allowed to tell you about formula they are wrong and it needs to be complained about. There is plenty of information on the NHS website about bottle feeding, for example.

TalkinBoutNuthin

Very well put!

Cherries
Quote from the PROBIT paper
"Our experimental intervention increased the duration and degree (exclusivity) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life. These results provide a solid scientific underpinning for future interventions to promote breastfeeding."
How on earth can you say it showed no benefit to breastfeeding?
Mis-information from you at best...

Promotion of Breastfeeding Intervention Trial (PROBIT): A Randomized Trial in the Republic of Belarus (PDF Download Available). Available from: www.researchgate.net/publication/12090591_Promotion_of_Breastfeeding_Intervention_Trial_PROBIT_A_Randomized_Trial_in_the_Republic_of_Belarus [accessed Jun 23, 2017].

I am exclusively breastfeeding my 3 month old son. It took 5 years and 4 rounds of IVF to get pregnant. I wanted to do something the 'natural' way and have battled through severe weightloss requiring readmission to hospital, allergies, requiring me to go dairy free and major cluster feeding/sleepless nights. It is now easy, no sterilising, no faff. It's free. And as an allergy baby I know I have (by accident) made the best decision for my son.

HOWEVER the attitudes of some HCPs re breastfeeding are ludicrous. On discharge from hospital we asked what to do if I couldn't express enough ( we were on a feeding schedule with 'x'ml required every three hours to counter the weightloss) and told it was not recommended to give formula... What do we do then? Leave him hungry? Let him lose more weight? Return to hospital?

On the flip side, I've been asked by family when I will start feeding him the 'normal' way and told breastmilk is 'disgusting' and 'weird'.

Yes, breastmilk is nutritionally best (though I believe possibly overstated), it's convenient for me (I was always going to be doing the night feeds due to amount of driving DH does, and I'm having a year off work), so it works for us. BUT for other people social, personal, work or whatever reasons mean that in practical terms FF works better. And that's fine and a totally valid choice, in the same BF is.

Basically, who cares...

tea

Again you are directly misinterpreting what I have said.

I never said there were no benefits to breastfeeding, I've said the opposite, several times.

It's not misinformation at all. What the studies, not just PROBIT, suggest is that many previous claims of long term significant advantages to health and cognitive development advantages claimed to be linked to breastfeeding are consistently being found to be at best, massively overstated and exagerrated.

This is not the same thing at all and lesser incidences of gastroinentistinal illnesses is fairly consistently seen to be less common in breastfed babies, while they are babies. That's one of the only remaining benefits when all confounding factors are removed.

And if you really want to talk about misinformation, what about the Brown study''s huge flaws I pointed out? I notice you had no objection to that study being banded around on this thread as misinformation.

So again, just to make very clear, I do not believe there are no benefits to infants receiving breast milk

What I believe is that our system of breastfeeding advocating is massively letting women down by making them feel there is a huge gap between health outcomes for FF babies vs BF babies, and this causes mums who don't or can't breastfeed huge levels of guilt and negativity around infant feeding, and can have a dmvery detrimental impact on maternal mental wellbeing.

In short, breastfeeding is wonderful if you can do it, but there is no evidence to suggest that long term health outcomes are significant enough in term's of breastfeeding vs formula feeding in a developed country to warrant the insane levels of guilt and pressure women feel to breastfeed.

In short, breastfeeding is wonderful if you can do it, but there is no evidence to suggest that long term health outcomes are significant enough in term's of breastfeeding vs formula feeding in a developed country to warrant the insane levels of guilt and pressure women feel to breastfeed.

Perfect summary, Cherries

Just to add a little bit more citation for my points, here is a good study that explains just how many covariates need to be ta ken into account, and the results of this study also concluded there were no cognitive advantages for breast fed babies.

www.ncbi.nlm.nih.gov/pmc/articles/PMC1633819/

Thanks Aye :)

I'm sorry if I'm coming across as a bit of a battle axe here , but this issue is so important to me because of my own experience and because of the shared experience so many other women report.

With my second I'll be perfectly happy and feel empowered and guilt free when I think about whatever feeding option I choose for my baby. I want more people to feel this way .

The very real problems experienced by lots of women should not be used to diminish the benefits of BF.
Be angry at the system. Women have been let down by governments and society and very aggressive marketing campaigns by the formula industry. See my earlier comments yesterday. You haven't addressed those issues Cherries.
No I haven't read all the comments and links you have referred to. I do have a life to get on with and work to do.
You do seem determined to show BF to be no better than FF. You believe what you want. I'll follow the science. Just look at the composition of breast milk compared with formula, there is no comparison.

There is nothing more to add as far as I'm concerned so will make no further comment.

And it is also interesting to note that organisations like the NHS never provide this information.

They rarely if ever provide the statistics, just state that there is evidence.

There is never any mention of even possible study limitations or confounding factors that are better attributed to the perceived benefit.

There is never any mention of the fair amount of studies that take into account these confounding factors in a more accurate way - nor any mention that these studies show conflicting evidence regarding these benefits.

However if you look at a small article written on the NHS website about a study suggesting that formula fed babies have a better emotonal wellbeing than breasted babies, then they are very quick to point out all of these limitations!

I'm not saying at all that the formula fed = happier baby study is in any way less flawed/inaccurate than the other studies around breastfeeding benefits. It just illustrates my point that they do use information so support their own agenda rather than feeling that women deserve/can cope with more accurate, balanced information.

In short, breastfeeding is wonderful if you can do it, but there is no evidence to suggest that long term health outcomes are significant enough in term's of breastfeeding vs formula feeding in a developed country to warrant the insane levels of guilt and pressure women feel to breastfeed.

Completely agree with this.

I'm also not convinced by the argument that breastfeeding is free. I needed to buy new bras, clothes, breastpads, a pump, steriliser, bottles, extra food etc. Plus all those lengthy pumping sessions meant I spent a fortune due to online shopping!

I HAVE NOT SAID THAT BREAST MILK IS NOT BETTER THAN FORMULA MILK.

If you would rather ignore the reality of advances in research (some not so advanced, the lack of evidence for cognitive development advantages have been illustrated and we'll explained since at least 10 years ago).

It does come across to me that you are (as so many if us do) put your own emotions and perceptions above what research is showing us.

I'm not asking anyone to take what I say at fave value - the opposite, I really want to encourage people to be more discerning about the information they receive. I'm also not trying to convince anyone that breast milk is not better than formula when looked at in isolation.

I am trying to explain that there are a lot of misconception's about the effects of breast feeding and this ultimately contributes to an anti-feminist, anti-choice attitude towards infant feeding.

Regardless of what you believe about breastfeeding vs formula feeding, is should be respected and accepted that some women will choose to formula feed for whatever reason, and there should be no guilt perpetuated around this decision, but in reality there is. A lot.

I'm happy with the points I've made and I'm happy with the conclusions I've drawn when I've taken it upon myself to look into the actual facts behind what we accept as evidence. It's not my intention to attack anyone on a personal level.

So as I've posted more than enough to express my views, that's it from me!

But I hope as a society we can move towards a less patronising, more balanced and more compassionate care system for pregnant women and new mothers. The current structure is riddled with flaws, poor training, misinformation and guilt.

It needs to change for the benefit of all women, regardless of your "stance" infant feeding.

Cherries that article link you posted about cows milk is interesting and I'm going to try and find more info about that. I'm sure the NHS says cows milk from 1yr and that's what we were planning, but maybe we should stick with formula a bit longer

The problem you have there teaforme is that cherries is looking at the science, whereas you saying look at the different composition isn't. The fact that formula and breastmilk have different ingredients and composition,which they clearly do, isn't evidence that they actually do anything significantly different.

Probit does show some small differences, one of which being a reduction in gastro intestinal illnesses, and that's good evidence because it's the closest we get to controlling for social factors. That reduction is small enough not to make much difference on an individual level, but on a population level it does. Cherries never suggested otherwise.

It's just that Probit also found no significant differences in various other outcomes. Some of which quite surprisingly, like allergies. I'd assumed breastfeeding would be protective there. I wasn't shocked it isn't protective against obesity because that's kind of counter intuitive, but I was about allergies (though I admit I'd not thought much about it as we have no family history). If you take issue with the Probit findings, tell us why rather than getting annoyed that someone dared to cite them.

In short, breastfeeding is wonderful if you can do it, but there is no evidence to suggest that long term health outcomes are significant enough in term's of breastfeeding vs formula feeding in a developed country to warrant the insane levels of guilt and pressure women feel to breastfeed.

Exactly this. Well said Cherries.

Don't think anyone can disagree with that, Cherries.

On account of my professional knowledge and experience I need to weigh in about this one last, related thing. I work with perinatal mental health, and the many societal/political/structural problems (and those linked to low funding and appreciation/support of new parenthood, specifically) contribute vastly to the rising MH problems. Most (mothers more usually, but fathers are greatly affected too) feel crushing guilt and confusion over many issues from pregnancy, to birth to infant feeding and care. They also feel alone and unsupported. In some areas there is help offered for those unable to trawl groups around town and/or pay for nanny/cleaner/housekeeper, such as HomeStart. In others (usually more "affluent", less "deprived"), there isn't, apart from home visits from HV, which might not be frequent enough or as supportive as they could be. In other words, if you don't fall in a specific bracket, there is very little to nothing to help you, despite MH problems in new parents being a great contributor for variety to severe problems in the future for parent(s) and child(ren).

This area desperately needs more funding and a considered long term approach. Not cost cutting, prohibitive rules and unconsidered practices, which only serve to make struggling people feel more guilty and like they are doing it "wrong", however hard they try. Dismissive and patronising attitudes are also rife, but understandable due to all the cost-cutting.

Here I'm categorically not blaming individual HCPs (I am one too), but the system. For example, these days people often live far away from family and friends, or their family and friends are not helpful, too old/poorly, or simply too busy. The society needs to step in to help for the future of these people (of which there are many and numbers seem to continually be rising) and the society as a whole.

Lately PND has been more in the news and on TV, and various celebrities have announced they have suffered from them, so at least the level of general knowledge (and perhaps through that acceptance too) is rising. Just shows that it can happen to anyone and that help should be more readily available, whether it be BF support, formula vouchers, cleaner once in two weeks, free hours of childcare for respite, counselling, etc. Not all of these people need or can use the same approach and their individual choices should be respected and supported (unless dangerous etc.). Preferred method of feeding included.

I myself haven't decided whether I'm going to breastfeed or not. There are lots of benefits from doing so but all facts a side.. sometimes people just cant! Whether it be complications in labour meaning you can't breastfeed because of medicine, it might just hurt the mum too much physically to do it or even the baby just doesn't latch on. My mum didn't breastfeed any of us because she didn't want to (cried after deciding because she thought she was letting people down). I myself do not want to worry about the pressure of it so I'm going to try it but if I can't do it or I don't feel comfortable doing it then I don't want to feel guilty because of that. X

Good points about MH and support and it keys into feeding method too, as breastfeeding when you wanted to breastfeed is associated with better MH than not breastfeeding when you had wanted to.

Personally I was happy to BF because it had been "normal" in my family. I had observed my mum feed my twin brothers & my aunty feed my cousin.

I think it's often family influence that leads to bottle feeding, it's whatever is normal to you.

Obviously other factors come into play but that's my point of view.

To answer the op, more often than not it isn't about choice. And it can be heartbreaking when you are at your most vulnerable.
So being breezy about it shows either naivety or lack of human empathy.
Hope this helps you as a mum to be AND as health care professional as you claim to be.

The 'cup of tea' analogy works well except that nobody gets harshly judged on whether they choose to have a cup of tea or not.

People get angry and defensive, OP, because your question is a loaded one, however carefully and 'innocently' you try not to make it sound like one. Even mothers who do not have your newly-acquired detailed scientific knowledge of why 'breast is best' are well aware that it has health benefits and that they will be judged (even if only silently) for their decision and their reasons why they don't breastfeed.

Scrunchy It is an interesting study isn't it!

But before you get too worried about cows milk, remember it's also very important to note that absolutely no confounding factors were taken into account for the study, even children's differing ages. So I wouldn't worry too much. I personally did give follow on until about 16 months because I just found I easier as DD still drank a lot of milk, so was useful too have in the house!

I think it's true about people doing whichever is more 'normal' to them. Probably the reason I tried breastfeeding, even though I had appraised myself of the research showing that benefits are trivial at the individual level and wasn't keen on doing the night feeds, was that I'd seen a lot of it already. I was curious. Whereas I'd already bottle fed babies the odd time so I had tried it already and no reason to do it just to see what it was like. If I'd not been around so much breastfeeding I might not have wondered what it was like. So that's a good point imvho.