Why ‘breast is best’ is out of control


Every morning I get ready with my daughter and the Today programme vying for my attention. But yesterday morning, I was uncharacteristically riveted to the radio when a certain item caught my ear. I bet it caught yours, too (or your eye, depending upon your media of choice).

Researchers from the University of Sheffield are examining ways of boosting the low rates of breastfeeding in the UK (and they are low: the NHS’s recommendation is that babies should be exclusively breastfed for the first six months. But, according to this study, only 34% of UK babies are breastfed at six months, and only 1% of those are exclusively breastfed at this stage. The UK has one of the worst breastfeeding rates in the world.) Breastfeeding, explained Dr Relton (the principle investigator) is “stigmatised” in certain parts of the UK, and socially patterned: “If you live in an affluent are four times more likely to be breastfed than if you live in a deprived area.”

Their solution? “Incentivise” women to breastfeed. Give them shopping vouchers. In a pilot study to be trialled in South Yorkshire and Derbyshire, women will be given £120 of high street vouchers if they breastfeed for six weeks; a further £80 if they continue to feed their babies ‘til the age of six months. It will be policed by midwives and health visitors signing off that mothers are breastfeeding. (Ye-es. You’re thinking what I’m thinking, right?) Put crudely: you’re either paying or rewarding women with money for breastfeeding; giving it a currency, if you like. “If I wave a £5 note around we all know what it means, it’s a very quick way of communicating with people regardless of their age, their gender, their ethnicity, their level of deprivation or their education. It’s a shorthand way of valuing things in society,” explained Dr Relton.

Within minutes my Twitter and Facebook timelines were aflame.  “As if women don’t feel enough pressure”’; “really helpful when mothers feel they are at the end of their tether”; “just another way of making women feel inadequate”.

Oh my. Can of worms opened and contents literally everywhere. Seriously? I demanded of the radio. You think paying women to do it is going to solve the problem?

What the reports – with their breastfeeding obsession (yes, I’d call it that) – don’t tell you, is that this act, which is presented as natural and instinctive and nature’s way of feeding your baby, is all those things, but it can also be incredibly hard. Pretty much every woman I know (and I appreciate that these women fall within a certain social demographic so not an entirely a representative random sample) tried to breastfeed. For some of them, it worked. For others, it was an uphill struggle. And for some it was a battleground. Insisting that women try – against in some cases insuperable odds – is a surefire way to pile on the pressure.

“I’d naively thought that breastfeeding would come naturally. That my baby would just latch on and the milk would flow and away we’d go but it wasn’t as easy as that,” emails my friend, Sarah (she of the wonderful Poppy & Peonies). “But I was a wreck – and so was she. My nipples were bleeding and every time I had to feed her I remember just crying because it hurt so much. The midwife said it would get easier. It didn’t.
I’d never even been advised about how to feed my child by anyone, so when one of my friends came to the rescue, suggested I try expressing my milk I jumped at the chance to try it and avoid the ‘deadly’ formula everyone seemed to hate so much. It worked for a week or so, hooking myself up to this little pump. I felt like I was doing a good job. I was trying to give my baby as much of my meagre amounts of breast milk as I could and I topped up with formula.
When Poppy was a few weeks old I got a visit from my (male) midwife. He was horrified when I told him I was expressing my milk and told me I must stop straight away and start breast feeding again. He made me demonstrate my breast feeding technique to him, which I found embarrassing and awkward. I still couldn’t do it, and when he left my house I was left feeling a total failure as a mother than I wasn’t able to feed my child.
The final straw came when Poppy was about a month old and my mum came to visit and I was hooked up to the expressing machine sobbing because I just couldn’t get any milk out. I remember her saying, ‘Enough is enough, Sarah, you don’t need to do this anymore’. And what a relief. I went on to feed Poppy formula until she was old enough for solids. She has turned out fine and I was so much happier. But I will never forget the failure that male midwife made me feel because I wasn’t breast feeding my child. No-one should make a new mother feel pressured to do anything. The way she feeds her child is her choice and no-one else’s. Some women just can’t feed their children by breast alone.”

“My baby ended up on special care baby unit for four days after birth,” relates Helena. “He had a problem with feeding, and I was put on a schedule of gruelling three hour cycles day and night – I would express milk for almost an hour then spend the rest of the time trying to feed my perplexed baby. Eventually, so exhausted I was hallucinating, a kindly nurse suggested I give him a bottle at night and feed in the day. This turned out to be a great solution and, despite being told mixed feeding means that you won’t be able to continue breast feeding, I was able to breast feed happily until 5 months. So many of my friends have wanted desperately to breast feed, but for many it just didn’t work out. Many felt like they had failed by not being able to feed, when in reality they were great Mums doing a brilliant job. I would be sceptical about anything else that ups the pressure on new Mums, and makes them feel even more guilty if breast feeding doesn’t work out or isn’t for them.”

Exactly. It seems to me that the obsession with breast-feeding as an end within itself (we know breast is best – that message is drummed into us from the minute we first visit a midwife; many hospitals (the one where I had my daughter included) are bottle-free zones) has blinded the researchers to common sense – and, I would argue, to compassion. To the fact that there are women who can’t breastfeed and don’t get the support they need to do it, and then feel that they have somehow failed (vis-a-vis the growing pressures on mother today and rise of PND). The report also fails to acknowledge why some women simply don’t want to. In other words, the voucher scheme isn’t helpful because it fails to address the issues behind the low breastfeeding rates.

Take heart those who tweeted this new scheme ladled on the pressure to already over-stretched women who feel we have to do and be it all (and do it perfectly, thank you very much) – and at a time when women are at their most vulnerable (i.e. post-birth, sleep-deprived). For I fear that in its very conception this scheme is riddled with holes. If anyone has failed here, it is the researchers – for failing to address the real issues.

Take the first – the can’ts not the won’ts. There are plenty of reasons why it doesn’t work out. Lack of milk. Issues with latching on. Pain. When the desire is there but there is a lack of support or encouragement from family and/or healthcare professionals.

“The thing that struck me about the report,” emailed my friend Lucy (two boys, both breastfed for 4 and a half months. “With the first it was hard-going, but once I got past three months it got much easier. With the second, it was a real labour of love – SO hard with a needy two-year-old.”), “is that the main barriers that prevent women breastfeeding are usually either a lack of immediate support to help mum & baby get off to a good start in the early days – midwives often too busy, health workers do not visit home often enough – or physical issues: despite their best efforts, some women can’t produce enough milk. I’m not sure how the vouchers scheme would help overcome either of these problems.”

Even Anna, who breast fed both her boys well beyond the recommended six months and would surely be in line for some serious vouchers and gold stars (she fed her second ’til he was nearly two and a half), writes of how “very hard” she found feeding at first, “I had no idea of what I was doing. The money would be better spent investing in helping mums to breastfeed who find the process difficult, such as breastfeeding cafes or more one-on-one with midwife – or an experienced breast feeding consultant.” Interestingly, the one friend who didn’t have any issues with breastfeeding spent five days in hospital following an emergency c-section – and thus had the support of “an amazing team of midwives around me who showed me what to do and encouraged me when it got tough”.

And the won’ts? I suspect the won’ts simply don’t want to – and these are the women the scheme is really targeting. Those for whom it is virtually stigmatised.  “If more people are seen to be breastfeeding, it might seem like more of an option to those who assume it’s either embarrassing or taboo,” remarks Grace Timothy of The Pregnant Beauty Guide. “But I can’t help but feel the money might be better used funding support for those struggling with breastfeeding.”

I suspect that it’s going to take more than a financial incentive to make girls who are brought up thinking that breasts are first and foremost sexualised objects, to be concealed (and only whipped out a la Miley and Rihanna in order to titillate ) – to use those self-same breasts to feed their children. “No-one is a better mother/more closely bonded with their baby because they breastfeed – that just smacks of smugness,” fumes my W&W co-editor. “Instead of giving away vouchers, why not use that money to train up helpful, non-condescending people to help you? Or use the money in schools to teach kids that breasts aren’t just something that someone like Miley Cyrus whips out to thrill the boys, they do have another function…? I imagine a lot of girls who won’t even try it are very young, a bit scared and worried about peer pressure telling them they are weird for doing it.”

“Once I’d got over the whole business of spitting out my tea in disgust, my thoughts on this were that it is never going to work because it is ultimately highly illogical,” writes Rachel, who has recently had her first child. “There is already a clear financial incentive for women to breastfeed – i.e. breastfeeding is free while formula milk costs money, and lots of it – so bribing women to breastfeed is obviously not going to work – why would it? If the researchers in this study REALLY wanted to help more women breastfeed, they’d spend the money on offering more real support when there are problems (surprisingly hard to come by when you need it).

But for me the bigger issue is that you can’t expect women to spend their entire lives being fed the message that their breasts are sexual things that must be covered up at all costs and then expect them to feel comfortable whipping them out all of a sudden just because they’ve had a baby. It’s just not going to happen…”
Once again, the breastfeeding debate has been overshadowed by the fervency of breastfeeding advocates. Their inability to see beyond the ‘breast is best’ mantra to the real reasons why the UK’s breastfeeding rates are so low is why this scheme is, ultimately, an empty one. Breastfeeding has become lionised by our society to the extent that you are somehow less if you don’t do it – it goes hand-in-hand with the ‘glory’ of natural birth. Remember the hoo-hah over Kate Middleton giving birth – as though she had somehow had a baby ‘better’ because she had done so without intervention? Breastfeeding has become a shortcut to ‘supermum’ status – witness instagrammed pics of Miranda Kerr doing it; or Brad Pitt’s intimate pictures of Angelina feeding one of their children; Gisele Bundchen (admittedly the quintessence of smuggery) waxing rhapsodic about her mediation-only birth and opining that “there should be a worldwide law…that mothers should breastfeed their babies for six month”.
Come on, people. Time to get over it. We need to offer women the support they need – not bash them over the head with diktats. “I was feeding Adam a bottle in the parked car when I heard this!” says a friend, now on her third baby and so in the relaxed zone. “I have risen above the whole debate. The breast is best polemic is unhelpful. We know breast is best, but what if baby is still hungry?! I’ve tried good and hard with breast feeding but mixed feeding works best for us. Another study I heard recently was about how new mums are prone to mental health issues for up to three years after their babies are born. One of the key reasons given for feeling depressed was a feeling they must meet unrealistic expectations.”
If you didn’t (tried but couldn’t/didn’t) breastfeed, and are riddled with guilt (or were made to feel guilty at the time – I remember having a little weep on the way back from the health visitor when I’d admitted to supplementing my milk with a bottle of formula in the evening. Fortunately, I had an excellent doctor who banged her fist on her desk, informed me that she “refused” to let “midwives and their ‘breast is best’ obsession” allow women to feel guilty), this article is well worth a read.
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1 Comment

  • Reply
    grace timothy
    November 13, 2013 at 1:00 pm

    So good to see such a range of experiences, although all contributing to the fact that this doesn’t seem like the smartest or most sensitive scheme ever. I was very lucky that my daughter and I found a good feeding rhythm from the minute she popped out, but I’ve seen so many people going through hell trying to force it, whether it’s the physical difficulties for the mother or a breast milk intolerance of the child. It’s not necessarily best for everyone. But even as someone who has had a wholly positive experience of breastfeeding, there are downsides – it is very easy to create a dependency in your child, mess with sleep habits and make the breast into a kind of crutch through tricky weeks (i.e. big developmental strides or illness) that can make breastfeeding into an emotional minefield. No midwife, health visitor or breastfeeding expert has ever touched on those subjects with me. Bravo, Natasha, love your post x

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