Public health bodies are in agreement: Breastfeeding protects the health of mothers and babies and therefore breastfeeding should be encouraged. But what use is encouraging women to breastfeed if at every corner they face barriers in their way? At its least the simplistic ‘breast is best’ message is useless, and at its worst it can cause significant harm.
Messages urging women to breastfeed do nothing to enable them to do so. Although breastfeeding may be normal, it’s still something that mother and baby learn together, enhanced by skilled expert support. If we instill a belief in mothers that breastfeeding is important but then have little investment in giving them the best possible start, then that is inhumane. Too many women are starting out wanting to breastfeed and stopping way before they are ready through no fault of their own, leaving them with a whole host of negative emotions from guilt through to failure and anger.
We need to take a different approach to this public health issue by creating a culture that nurtures and protects rather than simply promotes breastfeeding. But what would that support look like? Some might argue that there is ‘pressure to breastfeed’ everywhere. But if you sit back, the subtle and not so subtle messages that women get everyday normalise bottle feeding, not breastmilk. With almost all mothers at some point using formula, copious advertising of breastmilk substitutes, and the normalisation of infant formula as a solution to breastfeeding challenges, we really live in a formula feeding culture.
What good is a desire to breastfeed if health services are not in place to guide and support mothers to get breastfeeding off to the best start and to support problems if they arise? What good is it if family and friends continually try to persuade the mother to give formula, particularly in response to normal baby behaviour that won’t get ‘fixed’ by a bottle? What good is it if the public harass her when she feeds outside the home? What good is it if she has to go back to work and her employer makes no adjustments at all? What good is it if she is continually pulled in all directions and urged to ‘get her life back’ rather than being nurtured and cared for through this transition?
If we want to encourage breastfeeding, we need to create an environment in which breastfeeding can flourish. We need to move our focus away from breastfeeding as an individual mothering issue and consider how we make changes at the social, economic, and political levels that allow breastfeeding to thrive. This means targeting the knowledge, attitudes and behaviours of family members, the general public, employers and those policy makers who have it in their power to make change on a grand scale. Breastfeeding is not the responsibility of the mother alone. It is a societal issue and a public health responsibility and our actions and investment should recognise that.
Dr Amy Brown is a Professor of Child Public Health at Swansea University in the UK where she researches how we can better understand what helps women to breastfeed for longer. She is author to three books: Breastfeeding Uncovered, The Positive Breastfeeding Book and Why Starting Solids Matters.