Is ‘breast only’ for first 6 months best?

Dear Granny

Mummy is breastfeeding me because she knows it’s best
But I expect you’re wanting to help her get some rest

I’m very time consuming because I am so new
I know how much you want to help – there’s lots that you can do

Washing, cooking, ironing – you can think of more
Let Mummy do the feeding ‘cos that is not a chore

Both Mum and I need practice until we get the knack
So please don’t say “Good gracious! Another little snack?”

Granny, you’ve got lots of tips – for you are very wise
We welcome your suggestions – but please don’t criticise

You were once like Mummy and now her turn has come
With your love and patience she’ll make a smashing Mum!

Gill Rapley, 1995

This week we had a lively discussion about ‘Barriers to Breastfeeding’. This is obviously a topic of wide-ranging issues and many of the issues raised struck a chord with one or more of the mums in the group.
What sorts of things prevent mums from having a positive experience of breastfeeding? I suppose a large proportion of them can be seen as cultural (in some ways all of them can). For instance: formula and baby-bottle marketing; attitudes of hospital staff; lack of positive role models in the media; attitudes of work-mates and, that old chestnut, ‘Old Wive’s Tales’ (how many have we heard?).

The influence of society and culture around us is so strong though, that it is almost impossible not to internalise the attitudes and the words of those around us. Many fears are instilled in women which become a real barrier to breastfeeding ’successfully’. For example: a fear of pain; of losing freedom; of a change in body-shape; or simply a fear of failure.

For any woman about to become a mother who fears the changes that are inevitable, some sort of support is essential.
If difficulties do arise in the first few days or weeks of breastfeeding (and for many they do), some women find that the solutions offered to them in our culture do not involve continuing breasfeeding. Family, friends and the media may convince the mother that she will have less pain, more sleep, more normality, if she bottle-feeds her baby.

Again, this led me to think that this is about more than just breastfeeding. As one mum told me about formula milk cartons, I found myself thinking, ‘How convenient!’ – then stopping myself with a huge red light: ‘What am I thinking?! What could be more convenient than breastfeeding?’
This culture, that we are a part of, is so wrapped up in consumerism that we can be easily convinced that we need this, or that, to help us fit into our societal roles. So many things come in a package to make our life easier that we have forgotten one of the most important skills that we have as human beings – adaptation.

The instructor told us that she has visited many mums who have asked her, ‘When will life get back to normal?’ Maybe they haven’t realised that what they are describing as ‘normal’ is actually ‘life without a baby’. Life with a new baby hasn’t met their expectations, because those expectations have been shaped by our modern culture.
Of course, having a baby (especially the first time) is a shock to us all – and so we all need support to embrace the change, adapt and find our own parenting style.

It doesn’t help when a midwife on the post-natal ward tells you your baby needs a bottle of formula, because he is hungry, and then presents you with said bottle and the expectation that you will give it to your baby – the experience of at least one mum in our group.
Or when a new mum is told by hospital staff that her baby must experience a bottle before he is a few weeks old, or he may never take one (and you wouldn’t want that, would you?).

Fortunately, our local hospital has now begun UNICEF training programmes, to work towards the ‘Baby-Friendly’ status. This should make some positive changes to delivery, baby, post-natal and children’s wards. Let’s hope that someone sees the sense in passing that information on to all hospital staff. They must remember that all mothers in hospital for non-infectious conditions have a right to breastfeed too.

For some mothers, the choice to breastfeed couldn’t be more difficult. Medical opinion may strongly advise against breastfeeding for mothers who are HIV positive or who are taking medicines or drugs, but it is still the mother’s decision to make.
Our instructor explained that she feels her position, as a medical professional, is to give information to the mother (or parents), so that they can make their own decision. Then she (our instructor) will respect and support that decision, even if she feels it is not the decision she would have made herself.
The exception to that would be where an issue of child protection exists and I asked if, by choosing to breastfeed against medical opinion when HIV +ve, would that be considered a child protection issue? We were told that only evidence of child abuse occurring – not ‘potential risks’ – would be an issue for us to report.

I also asked if any changes had been made to the level of support given to antenatal women undergoing a HIV test in pregnancy. None have.
Many years ago, I had a HIV test in a London clinic, because I was travelling to an Israeli kibbutz and I knew I would be tested there. In the London clinic, I was given counselling before the test (which reassured me that the behaviour which I had perceived as high risk was, in fact, quite low risk), followed by more counselling before receiving the results and after receiving the results. This high level of care really helped me to deal with the anxiety involved in taking the test.
In current ante-natal screening , mums-to-be receive no counselling at all – unless the test comes back positive, then they are referred to the hospital (but, by then, they have already been given the awful news).
I wonder if this procedure is regional?

Another aspect of parenting that some mums in the group felt the medical establishment needed to catch up on was that of co-sleeping. Although our instructor explained that many professionals accept that mums choose to sleep with their babies, the information given out remains extremely cautious on the subject. My favourite warning is: ‘Do not sleep with your baby if you are excessively tired’ – surely that is exactly when most parents begin co-sleeping!
The implication of the information is still that every parent’s aim should be to have a baby safely sleeping all night through in their cot, even though there is much evidence to suggest that co-sleeping encourages breastfeeding and attentive parenting – particularly in the work of Dr.Sears.

This has been a very long blog this week – following some really enjoyable discussions in the group. If you still have a few moments left, it would be great to see your comments.
Many of the mums in the group have said that they wish they had been on this course when they started breastfeeding and I wondered:
What do you know now that you wish you’d known when you started out on your breastfeeding journey?

Juno