Pictures of Breastfeeding? Gosh, Take Them Away

A local NHS (National Health Servive) trust came under fire this week for featuring, among its breastfeeding awareness material, a picture of a child pretending to nurse. This picture was deemed unacceptable because it might cause offence to mothers who had been unsuccessful at breastfeeding. And Amanda of mmmm mama made a comment recently about how it is slightly taboo for happily breastfeeding mothers to sing the praises of breastfeeding lest they should step on the toes those who have chosen not to. How has the human race, whose females are equipped with mammary glands for the express purpose of feeding its young, possibly got itself into this ridiculous situation? Why would any mother be offended by a picture of a child breastfeeding, or another mother talking about it?

First of all, I must state some caveats. I am a breastfeeding mother. Though I have been extremely lucky to have had no major problems, I know lots of other women who have overcome serious challenges to establish breastfeeding. I know it can be very difficult. I also go to several baby groups and I am friends with mothers who bottle feed. They are good mums who love their babies and try to do the best for them. Although I support breastfeeding, I have nothing against mothers who formula feed. If we were to debate our feeding choices then we might disagree, but I do not seek confrontation like that. I know that breast milk is nutritionally superior to formula milk and provides better immunological protection to babies. For these reasons, I think we have a duty to encourage mums-to-be to breastfeed. I would like to understand how non-breastfeeding mothers feel when they see breastfeeding awareness posters, talk to breastfeeding mothers or read pro-breastfeeding writing. In the article below I have tried to imagine how I would feel if I was put in a variety of situations. Others may have very different feelings - I can only speak for myself.

I'm going to assume that breastfeeding mothers are not offended by the promotion of breastfeeding. That means it is the mums who either choose not to breastfeed, or ran into problems that meant they stopped, or simply could not breastfeed. I will first consider the mothers who are physically incapable of breastfeeding. There are several reasons why a woman might be genuinely unable to feed her child herself including illness, a pre-existing medical condition, previous breast surgery and having a very premature baby. I feel very sorry for any woman who would have liked to breastfeed but could not. It must be hard to come to terms with, and it must be painful to see and hear about breastfeeding when you so desperately wanted to do it yourself. But if I was in this position I cannot believe that I would be offended by discussion of breastfeeding. Of course I would not be so insensitive as to whitter on for hours about nursing with a friend who was unable to breastfeed, in the same way that I would not ramble for hours about pregnancy with a friend who was unable to have children. But we would be doing a huge disservice to the next generation of babies if we were to suppress the pro-breastfeeding message in order to spare the feelings of this very small minority of mothers (and I must not forget the fact that a mother who is unable to breastfeed might still be very pro-breastfeeding).

So I will move on to another group of mothers - those who have encountered problems that forced them to stop nursing before they wanted to, and those who think that their bodies are not capable of feeding their babies, but who are really the victims of a lack of support and information. How many first-time mothers have tried to breastfeed in hospital, found the support woefully lacking and concluded that they are unable to nurse? I imagine that in this position I would feel sadness, anger and bitterness. It is understandable that some people direct this anger towards the people who encouraged them to breastfeed. The tragic case of Katy Isden, who committed suicide four months after giving birth to a baby boy, is one example of how the blame for post-natal depression is sometimes heaped at the door of the pro-breastfeeding authoroties. Katy was known to be experiencing difficulties with breastfeeding but the sensationalist media wasted no time in putting two and two together to make five, reporting that her suicide came about because of the pressure she was under to breastfeed. There was absolutely no evidence to suggest that this was the case. Post-natal depression can strike any new mother, and breastfeeding is widely believed to have a role in preventing its occurrence. Difficulties in breastfeeding may well contribute to post-natal depression but that is no reason to stop encouraging new mothers to breastfeed. Rather, it shows that they need more support to help them succeed.

The lack of support received after birth can have far-reaching consequences in a breastfeeding relationship. There are mothers who manage to breastfeed for several weeks or months despite experiencing sore nipples which could have been prevented if they had been instructed in correct positioning and attachment. There are mothers who struggle to produce enough milk for their babies because they were encouraged to supplement their milk with formula during the crucial first fortnight, when the milk supply is being established. It might appear as if these mothers have nursed successfully, but it is no wonder that they may feel disillusioned and bitter towards the people who encouraged them to breastfeed if their own experiences have been painful and unhappy.

So I can understand why a mother who wanted to breastfeed, but was not adequately supported, might direct her ill-feeling towards the breastfeeding lobby. She may be saddened or angered by another mother talking positively about breastfeeding. But once again I do not feel that this is sufficient reason to suppress the pro-breastfeeding message. Many (possibly most) of the breastfeeding peer supporters at my local Children's Centre had very difficult experences with their first baby, but went on to breastfeed subsequent children successfully and became very vocal advocates of nursing.

The final group of women is those who choose to formula feed. Some people make this decision with full knowledge of the drawbacks of formula feeding compared to breastfeeding. Whilst I might not agree with their choice, I respect their right to make the decision that is most appropriate for their family. I cannot see how a fully informed woman in this situation can object to anybody else promoting breastfeeding. Research has proven the superiority of breastfeeding for babies' health, but presumably a mother who makes an informed decision to formula feed has judged that, on balance, her family will benefit more if she feeds from bottles. She would also have been aware, before making her decision, that she would continue to see posters about breastfeeding and socialise with breastfeeding women. If I had made such a decision, perhaps these constant reminders would make me feel guilty. But the decision would have been my own, and any negative feelings I had would be my own responsibility.

Unfortunately there are many people who make the decision to feed formula milk without being fully informed, or because they are virtually forced to by their close family. Some inherit prejudices against breastfeeding from the people around them. And there are those who do not give much thought to the decision, and feed formula because it is more familiar to them than breastfeeding. These people would certainly benefit from better antenatal education so that their decision could be made with the benefit of greater knowledge. To really make a difference to breastfeeding rates, the information must also be disseminated beyond the pregnant woman, to her partner and family. I do empathise with those who initially choose formula but later wish they had tried breastfeeding; it is a shame that this is an irreversible decision. Feelings of guilt for not breastfeeding must be hard to shake off, especially when the mother is exposed to pro-breastfeeding information. But I would repeat again that it is wrong to avoid promoting breastfeeding just to spare the feelings of mothers who feel guilty for their choices. It would be better to educate pregnant women more comprehensively so that the guilt scenario could be avoided in future mothers.

Normal human sensitivity must be employed whenever we talk about breastfeeding. Though there are hard facts that prove that breast is the ideal food for babies, it is completely wrong to judge or voice disapproval about mothers who formula feed. They may have very good and complex reasons for doing so. But any formula feeding mother who does take offence at the promotion of breastfeeding should also consider why she is offended, and if her offence really justifies the denial of breastfeeding information to mothers-to-be.

The solution to the whole unhappy situation would be to properly educate pregnant women about their feeding choices and provide robust, reliable support for new mothers who want to breastfeed. This is surely the only way to ensure that mothers are confident in the feeding decisions they make, and that women who want to breastfeed are successful. The mummy wars would not even exist if we were all truly happy with our choices.