The Incompetent Mother

The majority of breastfeeding mothers stop breastfeeding before they are ready, and long before their babies are ready. I will bore you with only one statistic: the World Health Organisation recommends exclusive breastfeeding until the age of six months, but in the UK, fewer than 2% of babies are breastfed for that long, whether exclusively or not.

The knee-jerk response to this is actually not to blame the mothers who stopped before six months, or indeed who never started (although those mothers perceive blame anyway, because feeling guilty is what parents do); but to blame healthcare professionals and volunteers for failing to provide adequate support, to blame employers and economics for forcing women back into a workplace ill-equipped to facilitate breastfeeding; and to blame “society” for disapproving of breastfeeding in public.

These factors do play a part, particularly where the people supporting mothers in the early days with their newborn babies fail to help, and put the blame on the mother by telling her she will never feed, because her breasts are too small, her nipples are the wrong shape, she hasn’t got enough milk, etc etc. A mum I’ve been supporting, despite having such copious milk that she was able to hand-express it prior to giving birth, was then told that she couldn’t feed because she had inverted nipples. One wonders why she had never noticed this before. A few days later another midwife advised her that that was rubbish; in fact her child doesn’t latch on because she has a tongue-tie. But what a great way to make the mum feel responsible for not being able to feed her baby, just because the original midwife couldn’t find a way to help her.

But there are deeper reasons, higher barriers, which are much harder to tackle, not least of which is the guilt that makes open discussion so difficult. But most mothers are not responsible for the difficulties they encounter in breastfeeding, and therefore it is inappropriate for them to feel guilt. Anger, sadness, and more anger, and perhaps acceptance that they can’t change what has happened, but not guilt.

“Guilt is only appropriate when, with full knowledge and free consent, you deliberately chose something detrimental to your baby for some trivial selfish reason.” – Maureen Minchin

The very existence of artificial milk undermines mothers’ belief in their own abilities to feed their babies. The fact that we believe we must have our babies weighed and checked regularly erodes our confidence, and allows an opening for doubts to creep in, widened by the conviction that artificial milk will cure all ills: it will make your baby sleep [research does not show this]; it will help your baby gain weight [so will effective breastfeeding]; it will resolve lactose intolerance [just plain nonsense; what do these people think the sugar in cows’ milk is?].

Added to this is the assumption at policy-making level that there is a widespread need for artificial milk, which at its worst has prevented – in America – publicity about recalls of faulty products. Apparently it is better to maintain the status quo, avoid panicking parents, than to tell people the truth about the nature of the food they are giving to their babies. Surely they have a right to know?

Meanwhile the subtle negatives about breastfeeding appear in literature from supposedly pro-breastfeeding books (What To Expect When You’re Breastfeeding… And What If You Can’t?), to apparently supportive retailers (Boots’ nipple cream advert offers the information that the worst thing about breastfeeding is the inevitable sore nipples, therefore all mothers must need to buy their cream, which cures it. Wrong. No cream will cure pain that is caused by incorrect positioning of the baby at the breast; but correcting the positioning will); to – of course – the babyfood manufacturers (Aptimil follow-on milk, for “when you decide to move on from breastfeeding” – as apparently we all should do before one year, when a child can drink unmodified cows’ milk). The prevailing mythology is that a breastfeeding mother needs to eat more (500 calories extra per day is normally quoted), implying that breastfeeding takes something out of you.

The pressure to get our babies into routines that are usually incompatible with breastfeeding, which works best when the infant is fed on cue in the early weeks; added to the insistence that mothers need to be separated from their babies for their own sanity, and the idea that fathers and grandmothers can best bond with the new baby by being involved in feeding, makes a recipe for inherent difficulties. Routines, separation, and messing with the milk supply by expressing milk or giving the odd bottle of artificial milk are all contributory factors in mastitis and in perceived or actual loss of milk supply.

Finally, the pervasive images of bottlefeeding make that the normal way that people expect babies to be fed. The Richard Scarry book that I bought for Bernard, having enjoyed it myself as a child, shows one newborn being bottle-fed on her (rabbit) mother’s lap in hospital, and one naughty wakeful child being bottle-fed by her (doggy) father, to get her back to sleep. Meanwhile, how are breasts portrayed by the media in general? As sexual objects belonging to men.

Each of these points deserves far more than a paragraph in a blogpost (perhaps one day I will find the right PhD opportunity!), but surely even this brief outline of the huge barriers to making breastfeeding normal demonstrates one of the most important things I have learned over the last few months: that mothers themselves are the last people to blame for low breastfeeding rates.

Originally posted elsewhere on 15th May 2008