18 Jul

Book review: Why Breastfeeding Matters, by Charlotte Young

You may be familiar with Charlotte Young, the sometimes-ranty but always well-informed blogger known as The Analytical Armadillo, one of the few reliably evidence-based information sources to be found online. Her wealth of knowledge is collected here into 16 neat chapters on the how and why of breastfeeding.

Like other books in the Why It Matters series, this is small but dense, covering how breastfeeding works; the wide range of normal baby behaviour and parental strategies for coping with it; expressing, formula and mixed feeding; and a couple of good chapters on the socio-cultural context of breastfeeding, and the impact of the formula milk industry.

Young is very aware of being a passionate supporter of breastfeeding mothers, in a bottle-feeding society, so much of her work is around myth-busting, whether she’s addressing the nonsense idea that breastfeeding mothers must eat a bland diet, or the notion that Mommy Wars is a feminist advert. She is careful to reference everything; perhaps a little less careful not to sometimes come across as sarcastic.

If you’re looking for an accurate breastfeeding text that pulls no punches, gives both the practical side of things and the context, and explains all of this logically and clearly, then this book is highly recommended.

[Disclosure: I obtained a free review copy of Why Breastfeeding Matters from the publishers. You can order a copy and get 10% discount using the code SPROGCAST, from their website here]

29 Aug

Feeding with a Supplementary Nursing System

Thanks to Jaclyn Currie for this guest post. Jaclyn is a stay at home mum to a busy two year old, British expat in Nova Scotia and La Leche League leader.

We’d been trying unsuccessfully to conceive for almost two years when I was diagnosed with Hashimoto’s. I fell pregnant almost as soon as I started on thyroxine and had a very healthy pregnancy. We moved to Canada when I was around 10 weeks pregnant and there are few midwives in this province but I had excellent care from my doctors, who were very responsive to my birth wishlist! It was only towards the end of the pregnancy I found out there might be a risk of low milk supply but given that I’d planned a natural labour and delivery with a doula in the local maternity hospital, I thought I was doing everything possible to ensure baby would breastfeed well. As I was new to the country I also started attending La Leche League meetings to meet new, likeminded people.

I was referred to the post-dates clinic at 41+5 and hoped to be told all was well and to come back in a couple of days. Baby had been head down for many weeks and was moving well, but unfortunately his heart-rate was dipping dramatically and the decision was made for an emergency caeserean… then thankfully downgraded to monitoring, then induction overnight with Foley catheter, then pitocin to start in the morning.

I had a fast induced labour but managed with gas and air, lots of movement and bouncing! But he wasn’t responding well to the contractions and the decision was made to use the vacuum to help him out (avoided forceps thankfully), but I had lots of tearing and lost around 800ml of blood.

My son was born 9lb with an apgar of 9! Turns out the cord was around his neck but he found his way to my breast easily and I was relieved all was well.

Over the next couple of days I was able to express a little colostrum and the nurse said he seemed to be latching well. He was sleepy though and then had jaundice so he was put under the lights for a couple of days (this can be done in room thankfully). No real concerns around feeding though it was starting to be a little sore on one side.

Finally we got home and he fed ALL the time! I knew this was normal and made myself comfy on the sofa. My son was a happy and sweet soul. He rarely cried and the public health nurse who visited was happy to help with some positioning and tips. I mentioned it was very sore but she couldn’t see a tongue tie. She was a little concerned he didn’t seem to be having enough dirty nappies but was overall content. However between week 2-3 he didn’t gain any weight at all. Looking back at picture, he was a spindly little thing! I was reading everything I could, and had met with my LLL leader who’d suggested some bodywork to help his latch. However, nothing was helping him gain weight so with so much guilt and sadness I realised I was going to have to supplement. I wasn’t well versed in milk-sharing so formula it was (of course, I had some, thanks Nestle *eyeroll*) but I was very wary of bottle feeding him given my desire to breastfeed, and still suspected he had a tongue tie. I had a friend who’d started using an SNS system a few weeks previously (also hypothyroid!) and I asked my LLL leader if she could help me out.

It was such a learning curve, but I suppose equally so would bottle feeding. I hated giving him formula but he drank so much and immediately started gaining weight. He was thriving on every drop of milk I made, plus 8-12oz of formula a day. It was still agony, and we had him assessed at 7 weeks, with a posterior tongue tie diagnosed and revised. Thankfully around 9 weeks breastfeeding finally felt comfortable and easy, even with the tube. I very quickly gave up supplementing overnight so we could get more sleep, which he seemed fine with.

We started BLW at 6 months, which he loved but ate very little. He always preferred to breastfeed. Around 8 months it started being a battle to get the tube into his mouth, and at 9 months he would yank it out of his mouth. I decided at this point it wasn’t worth the battle for the 1-2 oz he was having so we stopped supplementing at this point. I was so worried, and his weight did fluctuate until he started properly eating good portions at mealtimes, around 15 months.

It was such a battle, and so many people didn’t “get” it; I had people laugh out loud at the tube, and wondering why I didn’t just give him a bottle… but I am sure given his tongue tie he would definitely have preferred it to my low supply boobies! He was 2 in May and still loves to breastfeed often. It brings us both a lot of peace and calm. I felt so much guilt for the longest time, but I am so glad we persevered.

13 Jun

Mommy Wars Much?

Yesterday the Royal College of Midwives released a new position statement on infant feeding. It includes the stunning new idea that ‘the decision of whether or not to breastfeed is a woman’s choice and must be respected.’

Inevitably there is a two-pronged kneejerk reaction to this. The Daily Mail and all radio talk shows trumpet an end to ‘Breastfeeding Tyranny,’ which is that thing where anyone remotely connected with supporting breastfeeding mothers is cast as the tyrant (or other even less savoury words); and parents who have had a difficult experience of breastfeeding complain about a) pressure from midwives, and b) pressure from everyone else.

Meanwhile the above-mentioned tyrants divide themselves into separate camps, those who criticise NCT and those who are NCT (and some have a foot in both camps). In the first camp, we have those who criticise NCT for not covering formula and bottlefeeding in antenatal sessions [Spoiler: we do! Have a look at our Infant Feeding Message Framework, which has been revised this year, but nothing new on formula in there, we’ve been covering it for years]; and those who criticise NCT for not cheerleading about breastfeeding enough (usually members of other breastfeeding charities who exempt the NCT from their non-judgemental approach).

As usual, I’m not here to speak for NCT, despite being proud to have been an NCT breastfeeding counsellor for a decade. However I do want to congratulate everyone responding to this new position statement on perpetuating the divisions in infant feeding. Nice one.

How about instead of the kneejerk reaction, we take some time to reflect on the context in which this statement and the responses to it occur. You really don’t have to look very far for reasons why women feel unsupported, whatever feeding decisions they make. We know very well that the majority of women in the UK see a number of different and busy midwives during pregnancy, and still get asked whether they plan to breastfeed or bottlefeed, without the time it would take to have a nuanced and informative discussion about this. Just asking that question frames it as an either/or choice, never mind the evidence that decision making about infant feeding is so much more intricate than that. The path women take is influenced by their family history and social context, by adverts that tell them their nipples will hurt and news stories that tell them they’ll be thrown out of Sports Direct. By every person who ever tells them not to beat themselves up if they can’t do it.

At birth, pressure does come from midwives who encourage early breastfeeding in the knowledge that the option will disappear for that mother if they don’t try to protect it; what a difficult position for those midwives to be in, within the time constraints of their workload. What would be a better way to address this at such a crucial time? There is no easy answer, because this demands cultural change and an end to society operating on the assumption that breastfeeding is difficult and women will be judged for not doing it. Locally, the well-trained volunteer breastfeeding support has been withdrawn from the wards and now also the children’s centres, because there is no longer funding to run the project, adding to the burden on midwives to handle this with sensitivity, kindness and accurate information. Within the time constraints of their workload.

And then there is the rest of the breastfeeding journey, and I know from encounters with women of all ages who tell me, when they find out what I do for a living, stories that some of them have carried for decades. Women feel guilty when they struggle to breastfeed and when they choose not to continue, and they feel angry when they don’t have the knowledge or the support to make decisions they feel happy with; and these stories matter to them. NCT is the best-known of a number of different charities that support breastfeeding mothers, and so of course it is the one that wears the sash of shame about judging and putting pressure on women. NCT is also the one that does most of the antenatal education, including on breastfeeding and on formula and bottlefeeding, and so of course is perceived as a source of guilt and judgement largely because of the impossibility of adequately preparing parents for the realities of life with a new baby. “All my friends found breastfeeding really hard, I’m not going to beat myself up if I can’t do it,” they tell me before their babies are born. And afterwards? “Why didn’t you tell me it would be so hard?” What words, what activities, what level of reflection will square this impossible circle, without changing the entire context?

And that’s why I’m so frustrated, this morning, with all the news and social media that does nothing but reinforce the assumptions and the cultural context within which breastfeeding can be hard, but breastfeeding support can be harder.

01 Aug

RCPCH discovers barriers to breastfeeding

The Royal College of Pediatrics and Child Health has today published new recommendations that women should be supported to breastfeed for as long as they want to. While I’m fully behind that suggestion, I can’t help feeling like this isn’t exactly a new way of thinking. It’s almost as though the RCPCH have just stumbled across the fact that the UK has the lowest breastfeeding rates in the world, and despite their well-established links with the formula industry, are finally catching up with the rest of us.

Their report quotes UNICEF‘s five year old figure of a £40m saving to the NHS if women were supported to breastfeed for a little longer, and this is a compelling argument of course, but what really matters is respect and support for women’s choices, and societal change to make those choices realistic and achievable, so that no mother is judged either for her decision to breastfeed, or for her decision not to.

I do applaud the recommendation to normalise breastfeeding within the PHSE curriculum in schools, but having seen the cringey sex-ed video shown in Year 5, I would love to see this done in a modern, straightforward and unembarrassed way, preferably facilitated by people specifically trained in this sort of education. NCT Breastfeeding Counsellors, for example.

And yes, please do bring back the Infant Feeding Survey, for which funding was withdrawn in 2010, showing just how much of a priority breastfeeding is for policy makers at the very highest level.

Of course I am pleased to see large and influential organisations like the RCPCH talking about the barriers to breastfeeding in our society, and particularly so when there is such a strong media response, raising awareness across the UK. Now let’s see those recommendations put into action.

24 May

Basics of Expressing Breastmilk

1. Mothers may express milk for many reasons, and at many different times. A mother with gestational diabetes might express colostrum before her baby is born; mothers also express if they are separated from their baby, if their baby won’t latch on, or to relieve engorgement. Once breastfeeding is established, many families share feeding using bottles of expressed milk.

2. Different pumps may be useful in different circumstances. Hospital-grade electric pumps can be hired locally. If you are only expressing now and then, a manual pump might be suitable. Colostrum can be expressed by hand without a pump.

3. Expressed breastmilk can be stored at room temperature for about 8 hours, in the fridge for 5 days, and in the freezer for 6 months. Defrost in the fridge and warm if necessary by putting the container of milk into hot water.

4. If you are giving both breastmilk and formula milk, you might want to offer them separately, giving the breastmilk first to maximise the amount taken, rather than diluting it with formula.

5. Expressed breastmilk can be given to the baby with a syringe, a spoon, a feeding cup, or a bottle. These will need to be sterilised.

6. If you are only expressing and your baby is not feeding at the breast, it is helpful to express very frequently: around 10 times in 24 hours, including once during the night, to mimic the feeding pattern of a baby.

7. Expressing in addition to breastfeeding usually increases the milk supply. Expressing instead of breastfeeding may decrease the milk supply.

8. Closeness with your baby stimulates release of the hormone oxytocin, which helps the flow of milk. Closeness with your breastpump is less likely to have this effect. Some women find that their milk does not flow easily for the pump. Therefore, the amount of milk you can pump is NOT a good indication of the amount of milk you can produce.

9. Warmth, gentle massage, and the sight/sound/smell of your baby can stimulate oxytocin and help milk to flow. Sometimes expressing in a warm bath can be effective.

10. The best time of day to express is whenever you have the time. Breasts produce more milk when they are frequently used, so it is possible to express before, after, or even during a feed. If you can’t find time to express, and you don’t have to, then leave it for a little while until things settle down.

For support with any aspect of infant feeding, you can call the NCT Feeding Line from 8am to midnight, every day, on 0300 3300 700.

23 May

Basics of Breastfeeding

While the basics of breastfeeding are the same, the experience is different for everyone. If you need help or support, call our NCT Feeding Line on 0300 3300 700, 8am-midnight, every day.

1. Colostrum is the first food for your baby. This protein-rich substance is packed with antibodies, and mothers start producing it during pregnancy.

2. Following the baby’s birth, it is the birth of the placenta that triggers build-up of the hormone prolactin, which controls the mother’s supply of milk.

3. In the first few days, babies feed very frequently (around 10-14 times in 24 hours). Each feed stimulates the release of more prolactin, and builds up the milk supply.

4. Spend as much time with your baby skin to skin on your chest as you can. This encourages newborn reflexes such as mouthing, rooting, and stepping, which help babies to position themselves and latch on.

5. Lots of skin to skin contact helps to stimulate the milk supply too. It also calms the baby, regulates his/her temperature, and helps to populate their immune system. Skin to skin with dad is great too!

6. Around 3-4 days after the birth, the volume of milk increases, sometimes dramatically, and the breasts may get engorged. If this happens, gentle hand-expressing, a warm flannel, or a bath may help.

7. A good position for breastfeeding is any position where the mother is comfortable and the baby’s body is fully supported by her body, not just her arms.

8. Feeds can last anything between 5 minutes and 45 minutes. Follow your baby’s lead, and try not to restrict the length of the frequency of feeds, because this may mean they don’t get enough milk.

9. If breastfeeding hurts (beyond the first few seconds), this is usually a sign that the baby is not well latched on. This can make feeds less effective, and reduce the supply of milk. Hold your baby comfortably so that he/she can open wide and get a good latch. If you need some face to face support with this, there are many local drop-in groups you can go to.

10. Newborn babies need to be close to someone most of the time, so there is plenty of opportunity for dads to help out with soothing, settling and cuddling, and babies will usually sleep well on their father’s chest.

22 May

Basics of Formula Feeding

1. All brands of formula are made to the same standard, so no brand is better than another. You don’t have to stick to the same brand.

2. Each brand produces several stages/types of milk. The only one suitable for a newborn baby is Stage One/First Infant Formula. This is suitable until the age of one, when your baby can have ordinary cow’s milk.

3. Formula comes in ready-made liquid form, or as a powder. The liquid is more expensive, but quicker to prepare. The powder is not sterile, so it is very important to follow the instructions for making it up, to prevent the growth of bacteria.

4. Your baby will tell you when he/she is hungry, by smacking their lips, rooting (head-turning), and sucking their fingers. Crying is a late hunger cue, so try to respond to these early cues, to minimise everyone’s distress.

5. When you bottlefeed, hold your baby close and upright, so you and your baby can make eye contact. Enjoy the opportunity for a cuddle.

6. Pace the feed: Hold the bottle close to horizontal, touch it to your baby’s lips, and allow them to latch on to the teat. When they let go of the bottle, it’s okay to offer it again, but don’t insist they finish the whole feed. Your baby can tell when he/she has had enough.

7. Newborns and breastfed babies trying bottles for the first time often prefer a slow-flowing teat. Be patient while they learn this new skill.

8. Spend as much time with your baby skin to skin as you can. This calms and soothes, and helps to build your baby’s immune system.

9. In the early days, your baby has a tiny stomach and needs small amounts of milk, very frequently. If you are able to give your baby colostrum at this time, even for a single feed, this is a very healthy start for them.

10. If you are in any way unhappy or unsure about your situation, you can talk to a Breastfeeding Counsellor. We won’t try to dissuade you from your decisions, but will listen and support you. You can call the NCT Feeding Line from 8am-midnight, every day, on 0300 3300 700.

17 Feb

Fed Is Best misses the big picture

There is a growing movement of vociferous breastfeeding skeptics, more organised and insidious than the usual lone voices of disappointed, angry, grieving women whose breastfeeding experience was not what they had hoped for. I have ignored it for long enough, but they now seem to be everywhere I look, and their words are dangerous and damaging.

As is so often the case, this “backlash” arises from one sad incident that happened to one articulate and privileged woman whose baby failed to thrive in circumstances where, if I understand it correctly, no baby could have thrived. I will refrain on commenting on a situation about which I know very little, as any well-trained and mother-centred breastfeeding supporter should. But this movement has easily, inevitably snowballed, gathering followers from that huge group of women who have been failed by society at a most vulnerable time.

This is a group of parents who are so upset that breastfeeding did not work for them, that they would prefer it not to work for anybody. Rather than campaign for better support and a more breastfeeding-friendly society, they present breastfeeding as an unnecessary choice, that mothers would be better off without. As with much of the anti-breastfeeding literature, we see the people who offer breastfeeding support portrayed as cruel, evangelical bullies and the well-evidenced disadvantages of formula milk downplayed.

In the past decade, I have written this again and again: we do not need to divide mothers and babies into the false categories of Breastfeeding and Formula Feeding. The first rule of infant feeding is to feed the baby, but “fed” is only best if “not fed” is the only alternative. And with better knowledge about breastfeeding and a more supportive environment, not fed should not happen. A woman with the confidence to trust her own instincts does not restrict feeds just because she has been told her baby’s stomach capacity is small; a well-informed woman who wishes to breastfeed understands that frequent feeding is what builds up a milk supply, and the delightful contents of every nappy can reassure her that this is happening; an educated health professional can support her with this knowledge.

Those key elements, maternal instinct and good information, slip through the cracks. And why do they slip through the cracks? Because in western society we believe, in the face of the evidence, that breastfeeding does not work. And why do we believe that it does not work? Because the voices of anger and disappointment are louder than the voices of women who just got on with it because it was no big deal.

There is no money in breastfeeding that works, unless you count the savings made in better overall health outcomes (and families who don’t have to shell out for formula): if anyone was really counting that, the governments of the western world would be investing in breastfeeding support and promoting a society that is truly supportive of breastfeeding mothers. Instead we have one where vitamins are marketed to them in case their milk isn’t good enough. One where lanolin cream is advertised for when their nipples hurt, as if this were inevitable. One where babies are expected not to inconvenience their mothers by requiring to be fed and to be held. One where qualified doctors can flatly deny science and continue to speak with the authority granted by their white coat.

It is a scientific fallacy to believe that cows milk, modified in a factory and dried into a powder, is better for human babies simply because it is sometimes more readily available. And it is a fallacy of privilege to believe that it is always readily available. It is not uncommon even in the UK for parents using formula not to follow the guidelines when making it up: too much powder (to make the baby grow), too little powder (to make the pack last longer), or water that is not hot enough to kill the bacteria (because it’s inconvenient, or they just don’t know, or they haven’t got a kettle). An 800 g tub of a popular formula costs £12.99 and would last roughly ten days for a newborn and five days at six months, if you feed according to the instructions on the side of the pack. Babies need breastmilk or a suitable formula until they are a year old. Breastfeeding support is free at the point of access. So tell me which of these is the choice of the privileged family?

Perhaps it is only the affluent and educated who can afford the privilege of lashing out at the passionate but inadequately funded network of people who could have helped them, and of missing the big picture of what is wrong in a world that let them down so badly.

17 Jun

Breastfeeding support matters, but it’s not all about the individual

Will breastfeeding, too, one day have its historian-chronicler who tries to unravel the train of events leading to the early 21st century’s failed mass alternative-nutrition child-feeding trials?
James Akre in the Huffington Post

I recently heard a talk by researcher and breastfeeding advocate Maureen Minchin (and interviewed her for Episode 15 of Sprogcast), in which she discussed exactly this question. Her new book Milk Matters picks up from and expands upon her 1985 book Breastfeeding Matters, a detailed and dense book covering both the political history of breastfeeding in modern times, and specific information on the management of breastfeeding which is useful for both mothers and health professionals alike. In person, her tone is as assertive and her views as uncompromising, as they come across in this book. In 1985, Minchin wrote “Those who conceal information, for the sake of sparing mothers anxiety, are doing greater harm.” She still firmly believes this.

Quoting, with irony, an old Cow & Gate advert, Minchin says that “what you feed them now matters forever.” Her milk hypothesis is that breastmilk is the bridge from the womb to the world, enabling the baby to develop a healthy microbiome, which regulates the immune system and optimises development. Furthermore early nutrition is the single biggest influence on gene expression following birth.

There is plenty of evidence for this, and emerging evidence that exposure to cows’ milk protein actively interferes with gene expression, triggering a trajectory of growth not only for the life of that baby, but if she is a girl, for her children and grandchildren too. More details about this can be found in her presentation here.

Minchin accurately predicted a backlash against honesty about the risks of not breastfeeding, and cites the huge vested interests of the baby milk industry, which has successfully divided mothers for decades, co-opting the phrase “breast is best” to create an aspirational ideal, and undermining breastmilk as the normal infant food for our species.

Why is it so hard to talk about breastfeeding in a positive and helpful way, that doesn’t incite an emotional response? The day after hearing Minchin speak, I was at the Association of Breastfeeding Mothers (ABM) annual conference in Birmingham, listening to speakers who truly understand the challenges of supporting individual mothers, in a social context that is not supportive of breastfeeding. The health, social, and emotional issues are the background noise against which we all work with mothers; but too much of what society knows about breastfeeding comes from a middle class media that categorises women according to the way they feed their baby. As Lactation Consultant Sally Etheridge pointed out at the ABM conference, “just because a mother isn’t breastfeeding, it doesn’t mean she didn’t want to.”

Earlier this year, a report in The Lancet demonstrated that the UK has the lowest breastfeeding rates in the world. Whose responsibility is it to change this? Those whose vested interests lie in women breastfeeding less would have us believe that anyone offering breastfeeding support is a member of the Milk Mafia, with an earnest belief in boosting those numbers bleeding nipple by bleeding nipple. Breastfeeding happens within a complex socio-economic context, and a focus on public health rather than on individuals does not preclude individual support. In fact the goal of most breastfeeding supporters is to help improve individual mothers’ experiences, to support their feeding decisions, and to empower women to make those decisions. According to researcher Heather Trickey at the ABM conference (also on the next episode of Sprogcast), it is not the responsibility of the feeding supporters, or of any individual mother, to improve breastfeeding rates; it is the responsibility of society, of the health services, of government. The only people who gain from pussy-footing around women’s feelings about breastmilk and formula are those who make a profit from exploiting mothers, to the detriment of public health.

[Cross-posted from the Huffington Post]

21 Mar

Media manages to shut Jamie Oliver up over breastfeeding. Nice one.

As soon as Jamie Oliver opened his mouth, it was open season for bashing the breastfeeding supporters once again. To be fair, his choice of words was poor. ‘It’s easy, it’s more convenient, it’s more nutritious, it’s better, it’s free,’ he said. Well, it’s certainly free.

Cue a whole cornucopia of articles arguing the rest of those points, largely from journalists who experienced a variety of difficulties in feeding their own babies, most of whom seem to be using this most inappropriate platform to debrief their feelings of guilt and anger and disappointment.

The typical argument goes something like this:

He’s a man. How dare he stand up for women?
It’s not even true. How dare he say that breastfeeding is a good thing? Lots of women can’t do it. I couldn’t do it.
Breastfeeding support is all about pressuring you to continue. All my friends said so too.

This argument is generally concluded with either “I actually fed my baby for 18 months but don’t beat yourself up if you can’t;” or “I gave my baby formula and she’s fine and I’m fine so shut up.”

And this is how journalists manage to perpetuate the social and cultural difficulty of breastfeeding. I have no problem with them reminding us that breastfeeding can be hard; this is supported by experience and by evidence. The sadly now-discontinued Infant Feeding Survey showed in 2010 the drop-off rate from around 80% to around 55% of mothers breastfeeding their babies by six weeks, and 34% at six months (none of this is exclusive breastfeeding, just a baby getting any breastmilk at all). The 2005 survey showed that 90% of the mothers who stopped by six weeks, had planned to breastfeed for longer. This is the statistic that we should be shouting about, because this represents all that guilt and anger and disappointment.

We need to stop setting up straw man arguments like the Smug Self-Righteous Lactivist, and ask why councils are closing down breastfeeding support services run by highly-trained breastfeeding counsellors and attended by huge numbers of mothers. To take one example, 17% of all new mothers attended the Hampshire drop-ins, and 98% of them would recommend the service to others. This doesn’t speak of pushy, pressurising, “well-meaning” (translation: “ineffectual”) supporters who spout about “breast is best” and insist you carry on no matter what.

Generally speaking, breastfeeding counsellors are trained to listen and support women (and sometimes men); to give them a safe space to figure out what they want to do and how they want to do it; and to share information to help with that decision making. Breastfeeding counsellors don’t use words like “easy” and “convenient,” mainly because their experience is of working every single day with women who are not finding it easy or convenient. Nor do they use such phrases as “breast is best,” since they are well aware that parents tend not to make feeding decisions on the basis of evidence about nutrition. No, parents make decisions on the basis of what’s happening to them at the time. Telling a struggling mother to continue doing something that is making her miserable, because it is best for her child, is contrary to the philosophies and the training of all the UK breastfeeding support organisations.

Yes, Jamie oversimplified breastfeeding in his statement on the radio, but that was a droplet compared with the oversimplification of the state of breastfeeding that followed, media-wide. Well done for enabling a backlash that prevented someone speaking out for supporting women.