Nearly all women can breastfeed successfully and make enough milk for their babies to grow and thrive. Why then are the drop-off rates so alarming?
Professor Mary Renfrew, Director of the Mother and Infant Research Unit at the University of York makes a very good point when she states that “women do not fail to breastfeed, health professionals, health agencies and governments fail to educate and support women who want to breastfeed.”
Without support and encouragement, many women give up when they encounter even small difficulties.
We all understand that “breast is best” but everywhere we turn we are given conflicting information of how to establish successful breastfeeding practices.
Before formula was introduced, breastfeeding was seen as a normal activity based on mimicry and learning within the family and the community. But today what should come naturally has become extraordinarily complicated. Not only have we lost the sense of community and associated social support, the media is constantly reinforcing the notion that feeding our children artificially is about lifestyle rather than health, and that the modern woman’s body is simply not up to the task of producing enough milk for our babies.
It was only in the last 60 years that we began to give babies highly processed convenience food in place of breast milk. Infant formulas were never intended to be consumed on the widespread basis that they are today. They were conceived in the late 1800s as a means of providing necessary sustenance for foundlings and orphans who would otherwise have starved. In this narrow context – where no other food was available – formula was a lifesaver.
However, as time went on manufactured breast milk substitutes were sold to the general public as a technological improvement on breast milk. Surprisingly, the medical profession also contributed to the decline in breastfeeding from the early part of the 20th century. Demand feeding was seen as disorderly and inexact and interfered with hospital routines, so a more scientific method was introduced. On day one the baby would be given two minutes on each breast, then four minutes on day two, seven minutes on day three and so on. The babies were kept in a nursery away from the mother and routinely “topped up” after every feed and then again through the night to avoid waking the mother. This practice interfered with the natural law of supply-and-demand. Babies did not demand the breast due to frequent top ups and consequently the mother’s supply diminished. It also interfered with the natural bonding between mother and child.
It is not surprising that most of these women left the hospital thinking that they were not producing enough milk, or that their milk was not “good enough”. Formula was offered as a ‘nutritionally complete solution’ that was ‘modern’, ‘cleaner’ and more ‘socially acceptable.’
At least two generations of women were subjected to these kinds of damaging routines and although things have changed, hospitals are still not providing the support and education required. As a result, many of today’s mothers find the concept of breastfeeding strange and unfamiliar, and framed as something that they might ‘have a go’ at but, equally, something that they shouldn’t feel too badly about if it doesn’t work out. Their mothers who felt the impact of these routines most strongly are not confident enough to offer the encouragement that is needed to their daughters.
Although there are now stricter limitations on the advertising of infant formula, manufacturers use psychological strategies that focus on the natural worries that new parents have about the health of their babies. Doctors are provided with growth charts that establish the growth of formula fed babies as the norm, subtly reframing perceptions of what is appropriate and what is not. Products are marketed as solutions to medical problems such as ‘lactose intolerance” and ‘reflux’ – even though many of these problems can be caused by inappropriately giving cow’s milk formula in the first place.
To this day, despite restrictions on advertising, baby-milk manufacturers spend millions devising marketing strategies that keep their products at the forefront of public consciousness and undermine women’s confidence in their natural ability to feed their children.
The impact of these types of promotions should not be underestimated. A 2005 NCT/UNICEF study in the UK determined that one third of British mothers who admitted to seeing formula advertisements in the previous six months believed that infant formula was as good as or better than breast milk.
According to Professor Renfrew ‘the concept of ‘self efficacy’ – in other words, whether you think you can do something – is quite important. You can say to a woman that breastfeeding is really a good idea, but she’s got to believe various things in order for it to work. First of all, she has to think it’s a good idea – that it will be good for her and her baby. Second, she has to think: ‘I’m the sort of person who can do that’; third – and maybe the most important thing – is the belief that if she does have problems, she’s the sort of person who, with help, will be able to sort them out.
We have to change our perceptions of breastfeeding and take responsibility for learning about and understanding the physiology of this completely natural progression of pregnancy. Ongoing support from a trained advisor will give you the confidence that you need to get through the first demanding weeks of frequent feeds until your supply is well established. By 6 weeks your baby should have naturally settled into a manageable routine and you should understand your baby’s cues so that you are able to respond appropriately. Trusting the process is the key to feeding our babies the way that nature intended.