Breastfeeding’s been in the news again over the last few days, and some irritating coverage of a paper in the BMJ got me thinking again about why Irish breastfeeding rates are so poor.
The British Medical Journal has just published a paper suggesting a rethink of the current World Health Organisation guidelines on weaning babies – that is, that optimally, babies should be exclusively breastfed for six months, then weaned onto solids. The papers leapt all over it, of course. The Daily Mail chose to focus on “warnings that exclusively breast-feeding for six months ’causes allergies‘” while the Telegraph breathlessly (and with poor grammatical structure) announced that “Only breastfeeding for six months may increase anaemia in babies: experts”
Now, mothers with new babies usually don’t have the time to brush their teeth or read to the end of a takeaway menu. In the few spare chunks of time they get they’re more likely to be sleeping (or in my case, sobbing) than knuckling down to review scientific papers, but they might well wheel the pram past sensationalist headlines such as the one the Guardian chose on Friday: “Six months of breastfeeding alone could harm babies, scientists say” and take them at face value. In fact, of course, the paper is couched in far more cautious terms and says that the (British) Department of Health might agree with a recent European Food Safey Authority conclusion that complementary foods may be introduced from four to six months and that six months of exclusive breast feeding may not always provide the necessary nutrients in exceptional cases, etc etc.
But while I initially thought, Christ, here we go, with the media whipping up a mini-frenzy and creating more confusion over babies’ health recommendations for parents to digest, my immediate follow-up was to think that, depressingly, in my experience in Ireland, the WHO recommendations haven’t exactly been highlighted and hammered home here yet anyway.
Perhaps on paper we are behind the WHO, but when I had my last baby two and a half years ago, not one medical professional I encountered suggested exclusive breastfeeding up to six months. I was told to feed for a few weeks if I really wanted to, and switch to a bottle if I had “a hungry baby” or if I wanted to rest, and wean onto solid food from about four months.The early days of breastfeeding are hard work and often very painful, and they’re not made easier by mothers, instead of being encouraged and supported in their (often hideously painful and disheartening) early attempts at breastfeeding, being encouraged to give a bottle or mix feeding early on, by which I felt I’d be risking either the supply dwindling or the (faster-flowing) rubber teat becoming more appealing. The message I got was, formula bottles are easier all round, but we won’t stop you breastfeeding if you want to, and yes, it is better for the baby.
I do want to feed the baby myself, I said, and they said that was fine, and wasn’t I great, but the formula option was always there, especially if I wanted the baby to feel fuller for longer and get a bit more sleep myself. This was also what the public health nurses told me, saying that I had a large baby and he would prove hard to satisfy. On the one hand, you might think it a surprisingly human and mother-centric approach, but on the other hand it’s not the official Department of Health line, which is to endorse the WHO in saying that the best route for your baby is to be breastfed exclusively to six months, and weaned onto solid food from then on.
The pro-breastfeeding lobby takes a battering every now and then: get back in your yurt, knit yourself a Breastapo membership card, stop bullying new mothers who already feel overwhelmed, stop trying to make women feel guilty, didn’t you know some women can’t breastfeed? Ultimately, every woman will choose for herself and her child, which is as it should be, but the choice should be made on the basis of all available information and I’m not sure how well educated we are here. There’s no getting away from the fact that Irish breastfeeding rates are among the lowest in Europe – described in the Irish Medical Times in 2009 as “abysmal”. Why is this? Why is it still so rare here to see someone breastfeeding in public, even though it’s perfectly legal, even in pubs (thank you Equal Status Act and Intoxicating Liquor Act), and precisely what your breasts were made for? How is it that until I came to write this blog post I didn’t even know that if you are breastfeeding when you go back to work, you can have an hour off in every eight-hour day to facilitate your feeding? If I’d known that would it have made a difference to how soon I went back to work?
From the point of view of public health education, there is overwhelming evidence that breastfeeding is your best bet, as, for example, it decreases the likelihood of diabetes and obesity in the child, and of breast cancer and post-natal depression in the mother. There are tons of other benefits too, which an artificial milk cannot replicate.
On the other hand, we are active in the formula business and Batt O’Keeffe announced just after Christmas that once Danone gets cracking in Cork one in five babies worldwide will be fed on Irish-produced infant milk formula.
You get what information you can, you read your baby as best you can, you skim the leaflets scattered about the health centre, you trawl the internet for impartial advice, you believe the person you trust most. What is really shaping our view of breastfeeding – who are we listening to? Why are our rates so low, and how could we boost them?
Edit 19th January:
I thought, given that I’m complaining about lack of support and information, it might be useful if I actually added a couple of general support links:
Cuidiu (The Irish Childbirth Trust)
Friends of Breastfeeding (Ireland)
And the HSE provides weekly breastfeeding clinics at local health centres. And there are usually discussions going on at any of the parenting websites like eumom, Rollercoaster, Mumsnet, MagicMum and probably a thousand others.