Breastfeeding is a mother’s first choice
By Inês Bridges
Often a hot topic within new mothers’ circles, breastfeeding has been polarising and dividing women for the last 60 years since the widespread introduction of artificial milk as an alternative to breastfeeding. Breastfeeding sparks the most passionate arguments because it speaks to the innermost core of motherhood. Portrayed as natural and instinctive, throughout pregnancy, women are bombarded with images of peaceful mothers sitting in rooms bathed in light, breastfeeding sleepy newborns wrapped in fluffy shawls, rejoicing at the opportunity of finally holding their baby.
According to 2010’s UK Infant Feeding Survey, over three quarters of mothers want to breastfeed. It’s their default choice before giving birth. Why? The health benefits. It is largely accepted that artificial milk fails to provide the benefits that breastmilk does. In addition to tailor-made nutrition, breastmilk provides antibodies, protection and is enriched with substances such as HAMLET (Human Alpha-lactalbumin Made Lethal to Tumour cells) which can kill cancer cells. Breastmilk also benefits mothers. Whereas women are able to cite breastfeeding’s weight-loss properties, they are less aware of how breastfeeding can reduce their chances of developing ovarian cancer by 30% and breast cancer. Artificial milk, however, is associated with an increased risk of obesity, diabetes, leukemia, infectious morbidity and SIDS. When the facts are presented, the choice is straightforward but the choice to breastfeed, prior to giving birth, is still largely emotional. The percentage of mothers that opts for bottle-feeding formula milk cites their perception of father’s attitude and uncertainty about quality of breastmilk as main reasons for their choice. Here we find two problems: one is the notion that men/partners/fathers have ownership over women’s bodies and the second is lack of information/education.
Whereas you can’t deny the powerful bonding experience of breastfeeding, it is a steep and demanding learning curve for which mothers are neither prepared nor supported as proven by the statistics. At birth, 69% of mothers in the UK are exclusively breastfeeding. A rate only slightly lower than those who say they wish to breastfeed prior to giving birth and easily justified by change of mind or birth complications or the need for medical treatment. Within these 12%, it is possible many are breastfeeding at birth but not exclusively. However, at six weeks only 23% of infants are still exclusively breastfed. This is a huge drop in numbers. By six months only 1% is exclusively breastfeeding. The World Health Organisation recommends breastfeeding up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond. This means, ideally, infants would be exclusively breastfed for the first six months and then breastfed along with other foods until, at least, the age of 2, but with such low percentages, why are the WHO’s expectations so high and women’s expectations so low?
According to a Canadian study the most common reason for exclusive breastfeeding cessation is the perception that infants were not satisfied by breastmilk alone. Mothers are biologically designed to care for their children, assuring their survival and thriving is their biggest goal and therefore, from birth, mother and infant develop a close nurturing bond. A mother is, indeed, equipped to provide everything a child needs to survive but we live in a time where this caring is not done by the mother alone: there’s a medical team of nurses and doctors and there’s a family. As infants barely communicate and medical assessment is limited, their growth is measured in developmental milestones and quantifiable aspects: height and weight. Breastfeeding is not quantifiable. You can’t assess milk intake accurately so if a baby fails to meet their weight goals, all evidence points out to “low milk supply” or nutritionally deficient milk. Artificial milk is carefully measured and administered and therefore, better controlled by parents and the healthcare team and ends up being the fail-safe option. For decades, mothers have been bombarded with images of bottle-feeding in both the media and real-life. More than likely, mothers weren’t breastfed themselves.
Why are breastfeeding rates so low?
A study published in 2014 looked into the reasons why women stopped breastfeeding. The most commonly cited reason was “Inconvenience and fatigue”, closely followed by “concerns about milk supply” and “return to work”. Indeed, the cornerstone of breastfeeding success is breastfeeding on demand. In fact, scheduled feedings are associated with slow weight gain and early weaning. As breastmilk is produced on a supply and demand basis, it is important that the baby gets to feed as often and for as long as they need to. This is no easy feat though, in a fast-paced world where so much is demanded of women, it is difficult to sit down, abandon all hopes of a clean house, a healthy meal for the whole family, a hot shower and a satisfied husband. Women are so used to being on the go, it is hard to accept that during those first few months their role is to feed a baby. In fact, breastfeeding has been associated with lower levels of maternal wellbeing despite the overwhelming advantages to their mental and physical health and that of their baby. Breastfeeding is exhausting before it becomes rewarding and the pressure is immense. Bottle-feeding artificial milk provides the mothers with better control over infant weight gain, a chance to delegate feeding and more time to spend in other activities.
What can we do to improve breastfeeding rates?
By opting out of breastfeeding, women are consciously choosing poorer health outcomes for both themselves and their babies. If breastfeeding is the biological norm, what is missing to make breastfeeding rates higher? A study from 2017 corroborated by UNICEF seems to indicate that mother-centred support is the key issue. This support must be non-judgemental, ongoing and face-to-face. Mothers are naturally insecure, especially first-time mothers, and when nobody around you has breastfed, it’s easy to fall prey to the marketing ploys of formula companies and the stereotypes of bottle-feeding we see depicted everywhere. Doctors and nurses receive little training in breastfeeding during their studies and their time constraints often keep them from offering tailored and ongoing advice. Likewise, mothers need to be supported by their families, especially their partners. In fact, a study by Rempel and Rempel showed that men’s prescriptive breastfeeding beliefs predicted the strength of their partners’ breastfeeding intentions, over and above the women’s own breastfeeding reasons, and they predicted breastfeeding behaviour over and above the women’s intentions. Through empowering women to take ownership of their bodies and providing them with adequate support, we can improve breastfeeding rates and assure mother and infant health have the best possible outcome.
Ultimately, breastfeeding should be a conscious decision
It is important to note though that
infant feeding should be a mother’s choice. The mental demands of motherhood
are high enough and women should be able to make to choose whatever method they
feel suits them best. This choice should be science-based at its core but we can’t
ignore a mothers’ well-being and their personal choices regarding their bodies.
What we have to strive for is that this decision is never made out of lack of
information, support and empowerment.