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Friday, July 16, 2010

Breastfeeding: guilt, statistics, support, and making a choice

... OK I know that many of you are going to shake your heads and say "Here she goes again..." but I have to pull out my soap box and rant on this topic some more.

Two recent articles in the Globe & Mail talk about breastfeeding in Canada (although this articles could seriously be about about the US or England just as easily).  One is the usual media propaganda about how mothers are made to feel guilty for not breastfeeding their babies, and the other one is about Canada's abysmal breastfeeding statistics.

Lets talk about the ridiculousness of the first article:
What’s wrong with feeding your baby formula?

Laura Leyshon for The Globe and Mail

Women who feed their babies formula face guilt – not to mention the unkindness of strangers.

*Before I even start reading the article my hackles are immediately up. Why is there this instance that there are finger pointers hiding around every corner and why are Breastfeeding advocates the usual suspects?!

    From the day he was born, Alison Evans breastfed her son Christopher with the understanding that breast milk is the most nourishing, natural and healthy thing a mother can feed her baby. So when, at four weeks old, he suddenly began rejecting her milk and stopped gaining weight, Ms. Evans was distraught and uncertain about turning to infant formula.

    “I’d had this ... idea [breastfeeding]’s what I’m supposed to do,”
 ...Followed by the comment that her son's health immediately improved on a formula diet.

 This is the story that we hear constantly.  Parents-to-be take a class in childbirth, read books about all the important things you're suppose to know about babies, they give birth to these wonderfully beautiful beings and are sent on their way home to enjoy their new family life...

Mothers know they're suppose to breastfeed their babies.  They know it's the healthiest choice and will give their babies the best start in life- offering them some of their mothers immunities and some vital protection from diseases, lessening their risks of diabetes, certain cancers, obesedy, and maybe even increase their IQ by a few points along the way.  As an added bonus, mom's are offered some protection from breast & ovarian cancer, post partum depression and might even loose that baby wieght a bit faster!!  And it's FREE!!  Over all it's a "win-win" situation, right? 

But what happens when that mother gets home? She probably tired, maybe sore from the birth, perhaps dealing with unexpected trauma from the birth of her baby: inductions, forcept/vacuum assisted birth, episiotomy, Caesarean section..(all of which are known to have a negative effect on breastfeeding)..?  Is the baby sleepy because of medical interventions used during his birth?  "How is he feeding?  Does he have a good latch?" are the questions a new mum might hear, but how the hell is a new mom suppose to know?!   One book said that breastfeeding is hard and it can hurt, another book said that breastfeeding is natural and only hurts if there is a problem with the baby's latch.  One book says to nurse the baby for 10 minutes on each side every 2 hours, one book says to nurse the baby on demand when ever they want to eat.  One web site says that this is the best nursing position, one site says that that position will cause blocked ducts and will cause problems because you can't see the baby's latch. One nurse in the hospital told her to use this method to get the baby to latch, but the night time nurse told her that it was wrong and she should use this method instead.  This is what we call a recipe for failure- before this baby is even a week old, he's already on the road to bottles of formula because his exhausted stressed out mother is unsure of anything to do with breastfeeding.  She can't get any support to make breastfeeding work for her or give her the confidence to persevere and keep nursing regardless of any issues that might arise. The emotionally wrung out mother goes to the doctor with her crying baby and begs for help and advice.  The doctor is affraid to cause her guilt about breastfeeding, or has no interest/education in lactation management, so instead of sending her to the right people to get proper support and advice, he pats her on the back and tells her it's ok, some women/babies just can't breastfeed and that formula feeding would be so much easier because then her husband/mother/sister could feed the baby and let her sleep.  He gives her a perscription for some sleeping/anti depressants/anti anxiety pills and sends her on her way with a gift pack of formula samples and a book of coupons for free baby bottles and matching diaper bag.

Then the Media make s a big production about how women are MADE to feel guilty about not breastfeeding.

Guilt?!  The last thing this mother should feel is guilt!!!!

This woman should be rip roaring mad!!  She should be stomping her feet and demanding WHY she didn't have the support and information she needed to do something that women have been doing for a millennia!! She has nothing to feel guilty for- she was failed by every single person and place she went to to look for information and support and advice! 

A good friend of mine once told me something very important:  "No one can make you feel guilty.  Guilt is an emotion that is caused by internal struggles"  Don't believe me?  How about this:

Pronunciation: \ˈgilt\
Function: noun
Etymology: Middle English, delinquency, guilt, from Old English gylt delinquency
Date: before 12th century
1 : the fact of having committed a breach of conduct especially violating law and involving a penalty; broadly : guilty conduct
2 a : the state of one who has committed an offense especially consciously b : feelings of culpability especially for imagined offenses or from a sense of inadequacy : self-reproach
3 : a feeling of culpability for offenses

It's also been my experience that it's the mothers who've had to struggle under severe pressure and unbelievable situations that feel this "breastfeeding guilt" the most.  I have a friend who has gone through one of the worst nightmares a parent can possibly live through. Her son was born just weeks before her older child had to have cancer surgery.  This mum had to travel 3 hours every day to be with her child at Sick Kids Hospital... with a newborn.  Then during the ensuing weeks, she had to leave the baby with her husband to care for her child during chemo.... and the outcome was that her little baby became use to the bottles and refused to nurse any more.  So she pumped, and pumped.... but when her supply dried up she turned to formula.  This mum feels "guilty".  Its makes me want to cry.  Here is a woman who has been through so much and done so much for her children, and SHE feels guilty about not breastfeeding longer.  This Mum should be MAD.  What support did she get to continue to breastfeed?  None. Yet she feels the guilt that the media says she must feel. ....and that makes ME mad!!

And it's the inflammatory articles like this one in The Globe & Mail that really make me angry, because they feed the flames of the breastfeeding  vs formula feeding debate:  "What's wrong with feeding your baby formula?" goes on to say:
"While research clearly shows the benefits of breastfeeding, the intense demands breastfeeding places on a mother are not captured by the medical studies. The messages mothers receive about breast milk versus formula are “phenomenally black and white and unequivocal,” she says.

Breastfeeding lobby groups have become increasingly influential on social policy, and they have put the onus on individuals to “choose health” or else risk becoming a social burden, Dr. Lee says.

“The moral dimension, I think, comes in with babies where people say, ‘Well, actually it isn’t just your choice, Mum. What’s at issue is another person – a particularly vulnerable person – so actually it’s not right to say, ‘Well I just don’t want to do this.’...
The bottle-feeding taboo is especially strong when it comes to women who choose not to breastfeed for non-medical reasons. Recently, an article by Kathryn Blundell, the deputy editor of Britain’s Mother & Baby Magazine, caused a stir because she said breastfeeding was “creepy,” she wanted her “body back,” and her “fun bags” were part of her sexuality. The piece sparked criticism from online commenters who called her “selfish,” “self-centred” and “vain.”
Sparked criticism?!  Oh please, if the shoe fits....

When it comes to parenting debates, formula vs breastfeeding is the pinacle fight.  This article is yet again tryign to play the guilt card for formula feeding mothers. But you have to ask the question WHY the debate exists to begin with?  I think that Dr. Jack Newman's thoughts on Breastfeeding and guilt hit the mark, a bullseye that the media  seem to miss entirely:

Breastfeeding and Guilt    
Written by Dr Jack Newman , MD FRCPC
One of the most powerful arguments many health professionals, government agencies and formula company manufacturers make for not promoting and supporting breastfeeding is that we should "not make the mother feel guilty for not breastfeeding". Even some strong breastfeeding advocates are disarmed by this "not making mothers feel guilty" ploy.

It is, in fact, nothing more than a ploy. It is an argument that deflects attention from the lack of knowledge and understanding of too many health professionals about breastfeeding. This allows them not to feel guilty for their ignorance of how to help women overcome difficulties with breastfeeding, which could have been overcome and usually could have been prevented in the first place if mothers were not so undermined in their attempts to breastfeed. This argument also seems to allow formula companies and health professionals to pass out formula company literature and free samples of formula to pregnant women and new mothers without pangs of guilt, despite the fact that it has been well demonstrated that this literature and the free samples decrease the rate and duration of breastfeeding.

Let's look at real life. If a pregnant woman went to her physician and admitted she smoked a pack of cigarettes, is there not a strong chance that she would leave the office feeling guilty for endangering her developing baby? If she admitted to drinking a couple of beers every so often, is there not a strong chance that she would leave the office feeling guilty? If a mother admitted to sleeping in the same bed with her baby, would most physicians not make her feel guilty for this even though it is, in fact, the best thing for her and the baby? If she went to the office with her one week old baby and told the physician that she was feeding her baby homogenized milk, what would be the reaction of her physician? Most would practically collapse and have a fit. And they would have no problem at all making that mother feel guilty for feeding her baby cow's milk, and then pressuring her to feed the baby formula. (Not pressuring her to breastfeed, it should be noted, because "you wouldn't want to make a woman feel guilty for not breastfeeding".)

Why such indulgence for formula? The reason of course, is that the formula companies have succeeded so brilliantly with their advertising to convince most of the world that formula feeding is just about as good as breastfeeding, and therefore there is no need to make such a big deal about women not breastfeeding. As a vice-president of Nestle here in Toronto was quoted as saying "Obviously, advertising works". It is also a balm for the consciences of many health professionals who, themselves, did not breastfeed, or their wives did not breastfeed. "I will not make women feel guilty for not breastfeeding, because I don't want to feel guilty for my child not being breastfed"....

So how should we approach support for breastfeeding? All pregnant women and their families need to know the risks of artificial feeding. All should be encouraged to breastfeed, and all should get the best support available for starting breastfeeding once the baby is born. Because all the good intentions in the world will not help a mother who has developed terribly sore nipples because of the baby's poor latch at the breast. Or a mother who has been told, almost always inappropriately, that she must stop breastfeeding because of some medication or illness in her or her baby. Or a mother whose supply has not built up properly because she was given wrong information. Make no mistake about it—health professionals' advice is often the single most significant reason for mothers' failing at breastfeeding! Not the only one, and other factors are important, but health professionals often have influence and authority far beyond their knowledge and experience....

Finally, who does feel guilty about breastfeeding? Not the women who make an informed choice to bottle feed. It is the woman who wanted to breastfeed, who tried, but was unable to breastfeed who feels guilty. In order to prevent women feeling guilty about not breastfeeding what is required is not avoiding promotion of breastfeeding, but promotion of breastfeeding coupled with good, knowledgeable and skillful support. This is not happening in most North American or European societies."
HERE to read the entire article on Natural Mothering

And again I say:  Guilt is internal.  If a mother feels guilty for a decision she's made, then she needs to evaluate her guilt, find the cause of it, scrutinize the situations that lead to that decision and look at it honestly.  Then either change the decision if possible, or make the changes necessary to make the best of the situation that she's choosen.  But don't blame the Breastfeeding advocates or the medical recommendations that babies should be exclusively breastfed for the first 6 months and for breastfeeding to continue for two years and beyond. Giveing out facts and good advice are NOT a ploy to make mothers feel guilty and miserable.

If you failed at breastfeeding and you want to point a finger at someone, then point the finger at a target that deserves your anger and frustration: The government that refuses to adequately fund breastfeeding support services and education, and the media who creates a circus by pitting mothers against mothers and allowing authors to muddy the waters by writing articles entitled "What's wrong with feeding your baby formula?"

The Globe and Mail printed another article that at least touches on the real problems that face mothers.

Why aren’t more women breastfeeding?

 Health experts are increasingly concerned about the lack of increase in breastfeeding rates in Canada, which they say is tied to a lack of support for mothers from the medical community and the influence of formula manufacturers.

Many mothers seek advice on breastfeeding from family doctors, but they often don’t have answers about techniques or other specific breastfeeding issues. “They don’t necessarily know how to counsel the mother on how to breastfeed,” said Catherine-Maude Pound, assistant professor of pediatrics at the University of Ottawa and consulting pediatrician at Children’s Hospital of Eastern Ontario, who participated in a discussion of the challenges to Canada’s breastfeeding rates at a conference held by the Canadian Paediatric Society last month.
In Canada, about 90 per cent of new mothers start breastfeeding when their children are born – an excellent rate. . But by three months, only half of them are still exclusively breastfeeding, while about two-thirds combine breast and bottle feeding, according to a study of more than 6,400 Canadian mothers published in the journal Birth in June, 2009....
For the majority of women who do want to breastfeed, not finding support when they encounter problems - such failing to get the baby to latch on, or pain during nursing - can cause them to turn to formula. The situation needs to be addressed by policy-makers if anything is to change, experts say.

The key issue is that mothers often don’t receive sufficient guidance on proper methods of breastfeeding from the health-care system, said Jean Kouba, president of the Canadian Lactation Consultant Association. Although there are lactation consultants in Canada, there aren’t enough to meet the need, Ms. Kouba said.

That’s why Dr. Pound believes doctors should receive some formal training in breastfeeding techniques.
HERE to read the entire article

Hence the need for FUNDING. Funding for the Newman Breastfeeding Clinic & Institute (NBCI) so that they can keep their doors open to help mothers and babies reach their breastfeeding goals, and to educate the medical personell who are in contact with new mothers and babies and NEED to be able to offer REAL support based on scientific studies and facts, not on myths and personal opinions.   Until our government steps up and starts providing the funding and the backing to breastfeeding support, our babies will continue to end up on a bottle  of formula, and mothers will keep spiraling down in the abyss of guilt that is not their own.

Honestly?  I'm surprized that more women don't give up within the first week after their baby is born. I'm not saying that they should, but it certainly proves the point that women are strong and resilient and capable of overcoming ridiculous odds to beat the obsticles thrown at them. How else would we be capable of breastfeeding our babies at all when most of the support women find is hidden though piles of old wives tales and incorrect information.

I have one last thing to add (which will probably get me verbally flogged by the Kathryn Blundell's of the world)..... We don't choose to use a car seat.  We do it because it's the safest method of travelling in a car with our infants.  Breastfeeding IS Best.  Breastfeeding IS the Norm.  Everything else is inferior.If you can't breastfeed- TRULY can't. Then Don't feel guilty.  You can only do what you can do. Guilt is your internal monitoring system and only you can see inside and know the truth.