Infant Feeding - Massive Straw Men with Ambivalence & Gaslights

[Ineedacupofteadesperately]

I've felt for a long time that something is 'off' about the discussion in the media around infant feeding. Apart from anything else the fact that the alternative to a mother breastfeeding is automatically accepted to be formula rather than donor milk, and no-one seems to ever question this. Why? Throughout history the alternative was wet nursing, not feeding cows milk. We have successful blood donation - why have all the milk banks been destroyed, we used to have more? Why is no money put into this in a supposedly rich country?

Anyway, someone sent me this link and I found it thought provoking. I think the comparison of adult feeding habits very pertinent at the end, but I do think part of the problem is that there are vested interests very focused on this remaining seen as individual choice rather than individual decisions in a very stacked environment without proper investment to support women, which often means there is no real choice at all.

www.analyticalarmadillo.co.uk/2019/02/infant-feeding-massive-straw-men-with.html

Breastfeeding etc act 2005.
It's an offence to stop a baby under 26mths being fed in public.

Id heard of cluster feeding - I thought I didn’t have enough because he fed constantly and didn’t gain weight.

With an older kid though, I couldn’t spend hours just sitting. I dont have enough support around me to do that.

Totally agree @Bowlofbabelfish

I have said before in different threads that the main issue is that the people giving the support- although generally kind and well meaning- alreadybhave a set point of view on breast feeding (breast is best) and are never going to say to a desperate and struggling mother that it is ok not to push on if they are making themselves ill.

Not because they aren’t concerned. But because the current thinking is that suggesting anything but EBF is zealotry.

Ideology is the issue here. A rigid ideaology will lead even the most kind and caring of people to make unkind or unhelpful decisions.

Exhausted, hormonal, post-partum women are so often looking for guidance from experts that they are in a position of power over those women. There needs to be a hard look at how well trained and how actually helpful some of those people are.

I donated 72 litres of milk to my local milk bank.! They were very thorough and wonderfully supportive. It helped me recover from ptsd after a horrific delivery and emergency section. I still feel proud of myself and have kept 2 letters from women who’s babies received my milk. It was altogether a fantastic project and I am very sad it no longer exists in our borough.

1Offence of preventing or stopping a child from being fed milk

(1)Subject to subsection (2), it is an offence deliberately to prevent or stop a person in charge of a child from feeding milk to that child in a public place or on licensed premises.

(2)Subsection (1) does not apply if the child, at the material time, is not lawfully permitted to be in the public place or on the licensed premises otherwise than for the purpose of being fed milk.

(3)A person guilty of an offence under subsection (1) is liable on summary conviction to a fine not exceeding level 4 on the standard scale.

(4)In this section—
“child” means a person who has not yet attained the age of two years;

“feeding” includes—
(a)breastfeeding; and
(b)feeding from a bottle or other container;

“licensed premises” means premises licensed under—
(a)section 12 of the Theatres Act 1968 (c. 54);
(b)[F1the Licensing (Scotland) Act2005 (asp 16);]
(c)Part II of the Civic Government (Scotland) Act 1982 (c. 45); or
(d)section 1 of the Cinemas Act 1985 (c. 13);

“milk” means breastmilk, cow's milk or infant formula;

“public place” means any place to which, at the material time, the public or any section of the public has access, on payment or otherwise, as of right or by virtue of express or implied permission.

I'd always look at the whole picture and suggest formula top ups, mix feeding or straight formula, if expressing or donor milk weren't appropriate for that mum.

It's the bigger picture. And it's highly emotive. A dear friend simply cannot feed due to her medication. It really cuts her up.

for all.

Shiklah that's a tremendous amount of milk to donate. Well done.

I remember expressing as much as I could for a fortnight in prep for leaving DS over night. I was all proud to have 4x 125ml bottles. Then he wouldn't touch a drop.

In England it is covered by the Equalities Act 2010 which states a woman can't be discriminated against for breastfeeding a child of any age. Which means you can't be asked to leave or cover up in a cafe, leisure centre, shop, public place etc whilst breastfeeding

breastfeeding.support/uk-breastfeeding-laws/

I've written a mammoth post and it won't post so I think I've gone over a character limit

In short this is what I see as the barriers to breastfeeding, the factors making breastfeeding difficult in the UK:

• Breastfeeding from the mother's side isn't an instinct, it's a learned behaviour. People seem to mistake this. Mothers-to-be could do well with a general basis in breastfeeding knowledge, perhaps by including lactation in the reproduction part of the biology curriculum, and the professionals and supporters around her when she first gives birth need to be experienced and/or well trained in breastfeeding support to make up for the fact her family and friends most likely are not.

• Babies can only access their breastfeeding instincts if the right conditions are met. Supporters need to be aware of this (e.g. difficult birth, small baby) and know to compensate for it.

• Formula top ups are sometimes necessary as a TEMPORARY measure and must be seen as such - in the UK they are usually not. They are seen as the fix. Obviously, if a family decide that mixed feeding is their preference and want this to continue that's not a problem (We did, for DS2) but they should be given options and a plan to reduce the formula use long term and/or fix the underlying issue making the top up necessary.

• Mothers are surrounded by misinformation about babies and breastfeeding, which makes it hard to see typical newborn/breastfeeding behaviour as normal. New mothers are usually (and obviously) inexperienced with breastfeeding meaning they are poorly equipped to evaluate the quality of advice/support they are receiving - therefore it is imperative that front line support is available which is well trained, experienced and evidence based. Whether that means training health visitors and GPs, hiring trained breastfeeding specialists or pointing mothers towards volunteer run services does not especially matter but the generally poor level of support now offered is a substantial barrier.

• Small issues such as poor latch tend to snowball into big issues - mothers need pre-emptive support with this which also does not exist as standard in the UK.

Oh FFS no - it was just a slow server issue. Well. Long version incoming.

(Or not - still having issues - well - let me know if you want me to elaborate on any point.)

There is no way - absolutely no way that the "98% can breastfeed" (or whatever this meaningless, never backed up stat is) applies in the UK. The structural and societal barriers are too high. It's meaningless to bleat on about it because it doesn't exist here. It honestly doesn't matter what percentage of mothers can breastfeed in perfect conditions because that's not what we have.

We can see how many mothers have problems breastfeeding in this country by looking at the infant feeding surveys. ~81% initiate, ~34% continue to 6 months, meaning 58% (of that 81%) stop before 6 months. 68% report experiencing problems. Of those who stop by 9 months, 63% report they would have liked to have fed longer, so I estimate the UK figures to be that 68% of mothers experience problems with breastfeeding, and 37% (or 54%, slightly over half of those experiencing problems) experience problems bad enough to cause them to stop.

That means as of 2010, there is a very rough split into three: Mothers who had no problems and fed as long as they wanted; mothers who had problems but were able to feed as long as they wanted, and mothers who experienced problems causing them to stop before they wanted. That's the reality in the UK and we need to deal with that figure, not some percentage from another culture which isn't relevant here.

Of interest:

files.digital.nhs.uk/publicationimport/pub08xxx/pub08694/ifs-uk-2010-chap6-feed-hth-aft-earl-wks.pdf

I honestly don't think you can say any mothers had no problems and fed as long as they wanted.

I attended BF support groups and know a fair number of women who BF to 6mths and beyond. Nobody got through the first 6 weeks without without issue. Everybody has their story of cracked nibbles, mastitis, glued to the couch cluster feeding, getting supply established lack of sleep as baby feeds during the night.

The big issue is are mums able to ignore the other stuff, and persist to get to 6weeks. It gets easier at that point.

The issue I have with donor milk is the sheer bloody torture that pumping represents for me - seven months, every two hours, nowhere near enough for my twins, constant tears, PND, feeling like an absolute failure. The thought of benefiting from other women going through that awful experience makes me very uncomfortable but then I guess pumping isn’t like that for everyone. Just the sound of a breast pump makes me feel sick now.

I have worked with lots of mothers who had no problems from the start. Not possible for all but very possible for many. The idea that it has to hurt for 6 weeks can become another way that they system lets the problems of mothers and babies be ignored.
It can be another feature of misinformation.

There is no way - absolutely no way that the "98% can breastfeed" (or whatever this meaningless, never backed up stat is) applies in the UK. The structural and societal barriers are too high. It's meaningless to bleat on about it because it doesn't exist here. It honestly doesn't matter what percentage of mothers can breastfeed in perfect conditions because that's not what we have.

Yes, exactly this. It may be that 2% of women can’t produce milk or have a physical issue that prevents breastfeeding but that’s very different from 98% being able to successfully breastfeed in practice.

I tried so fucking hard. I got so much abuse from a bfing fb group that I went to for help. I had one twin at home, one in nicu for two months, I was completely broken. One of my boys needed specialist formula over and above breastmilk for medical reasons, and I had women there saying they wouldn’t give their child “that poison under ANY circumstances”, women telling me that prematurity doesn’t affect breastfeeding (it does if you can’t hold them or latch them!), and on and on.

Even as an inpatient we got zero feeding support. Absolutely zero. I now see that nicu didn’t want us to breastfeed, much easier for them to tube or bottle feed expressed milk on a schedule. We were set up to fail.

I think milk banks are great for babies who’s mums are too poorly to bf or otherwise can’t do so, either physically or due to medication for example. However I didn’t BF basically because I didn’t like it and didn’t want to do it, it wouldn’t have been right for me to get to use donor milk when the reason for not BF was basically because I couldn’t be arsed.

SinkGirl - that sounds horrific for you

I found expressing easy after the first few weeks (apart from feeling like a dairy animal - I sent the electrical pump back to the hospital and used a hand pump to mitigate this a little bit) but then again the reason I was pumping from the start was because I had a prem baby in NICU, and having started I didn't stop except for when he was having a growth spurt and I was feeding all the time.

Which takes me to my point....that pumping itself is a specialist technique, and understanding how best to do it to help stimulate increased supply and without physically hurting yourself isn't something that I was ever told, it's something I found through trial and error.

I wasn't offered donor milk for my prem baby, as the hospital where he was born didn't have that facility, and I remember feeling guilty about him having FF top ups (on top of feeling guilty for not being able to keep him inside for a bit longer). Now I look back and realise that was silly - but hindsight is wonderful, and the postpartum weeks are not characterised by completely rational thought...

Posted too soon....

Even as an inpatient we got zero feeding support. Absolutely zero. I now see that nicu didn’t want us to breastfeed, much easier for them to tube or bottle feed expressed milk on a schedule. We were set up to fail.

Yup - I hear ya. I was definitely made to feel a nuisance for wanting to establish BF, when it was so much easier for them to pour FF down his feeding tube on schedule. And I had nearly zero support for BF, not least because I spent most of my time on the NICU (funny that) where I wasn't the patient and the nurses there aren't BF / new mother specialists

I was on the brink of giving up but one night an older nurse (who I had previously thought was rather standoffish) found me struggling with DS and sat down and helped me get the latch right. It took her less than 10 minutes but it was the turning point we needed. 10 minutes. Surely every new mother deserves 10 minutes of uninterrupted 1:1 time with a healthcare professional to work on BF (if that's what they want?)

I think the first point to make is that it's just wrong to say that throughout history, the alternative has been wet nursing. It has when available, but the reality is that there have long been babies for whom sufficient breastmilk wasn't available for whatever reason who were fed on whatever other milk and cobbled together supplements were available. With corresponding impact on mortality. That's actually the reason infant formula was created. There hasn't always been and isn't always breastmilk from another woman available. Because breastfeeding is labour, because it uses valuable calories and time. It's actually a rather significant ask. This is why it was a job.

I can see that there are fewer milk banks than there were, which is a bad thing for those who might want to use them. That's something that could be addressed.

However I think you're also being rather unrealistic about the practicalities of this. The group in the UK with some of the lowest breastfeeding rates is white working class women. I'm from that community myself. It's not lack of milk banks making that group use formula. You're talking about a group who have much lower car ownership than average, who are disproportionately likely to live in food deserts, doing their shops on foot and with limited choice. Donor milk is by its nature liquid, heavy to transport. Formula is dry, light and compact. You can very easily fit a week of food for your baby under a small buggy that you can get onto the bus, with room for more besides.

The level of investment that would be required to logistically make donor milk available in some of the communities with the lowest rates is colossal, even in the event that supply were sufficient. At a time when Healthy Start vouchers fall further and further below covering the actual cost of formula, frankly that would be rather hard to justify, and I'd be astounded if white working class women as a whole wouldn't prefer the Healthy Start vouchers to be worth more/extended in scope.

I can see that some women would want to use milk banks and I respect that, but I'm not sure it's the poorest or those from groups least likely to breastfeed who would do so. Frankly the need to tackle sub optimal formula feeding in these groups is a more pressing one than facilitating the provision of donor milk to families who will already be less in need of help simply by virtue of the characteristics that would lead them to want it in the first place.

Basically what I'm saying is, you could put a milk bank in my area with enough breastmilk for all the babies and there would still be lots of the poorest women for whom it would still be unavailable and irrelevant. Because it's heavy and would require more time, money and effort to transport it than they've got. It would be a white elephant.

I'm not saying middle class families dont deserve help, not at all, but do be clear about the reasons why this wouldn't be helpful to some of the communities with the highest formula feeding rates.

I wanted to order "The Politics of Breastfeeding" but am finding several books with this title. Can someone direct me to the one that you are refering to? Thanks.