When asked the optimal method for feeding an infant, in the first months of life, a well-known saying will often come to mind: ‘breast is best’. This campaign slogan was part of the 1999 campaign which aimed to increase the number of mothers breastfeeding in the UK. Tessa Jowell, public health minister at the time, launched this campaign because it was apparent that, in comparison to other countries, the UK did not have many breastfeeding mothers, and given vast evidence supports nutritional benefits, it appeared important to increase this number. The ‘breast is best’ slogan definitely stuck in the minds of people, and led to more and more mothers wanting to breastfeed because of the associated benefits. However, not all women are able to breastfeed their infant, and this notion that mothers should breastfeed can stigmatise any alternatives to breastfeeding. In this post I want to raise the awareness on why people may choose not to breastfeed and why that is perfectly okay to do so.
Why is breastfeeding deemed ideal?
Lots of research has been conducted to investigate the benefits of breastfeeding. Studies have suggested breastfeeding can bring health benefits to infants as it reduces the risk of diabetes, obesity, hypertension, cardiovascular disease and other harmful diseases (Binns et al. 2016; Allen & Hector 2005), and breastfeeding is also associated with money saving benefits, as formula can be expensive (Lawrence 2000). So, should the people reading this that cannot breastfeed worry because their child is not being breastfed? Of course not! I have highlighted that breastfeeding can reduce risks of certain diseases, but so can other things, for example when your child grows up you can try and ensure that they have a healthy diet and this can reduce their risk of the harmful diseases which are outlined to benefit from breastmilk. On the other hand, just because a person was breastfed it doesn’t make them immune to diseases, they still need to practice health behaviours when older in order to reduce their risk of the diseases.
When is formula best?
Sometimes formula is best for the baby. This is because formula milk allows you to choose the type of milk you need to best suit your baby’s needs. For example, if your baby is lactose intolerant then they are intolerant to breast milk, therefore they may require a lactose-free formula. For more information on different formulas please visit the NHS website as there are many different types (NHS, 2019).
Some babies may have conditions which breastfeeding alone can harmful to, for example if a baby has Phenylketonuria then babies cannot breakdown phenylalanine, therefore breastmilk may lead to a build-up of phenylalanine, which can ultimately cause brain damage. In this instance it may be preferable to give both a small amount of breastmilk and formula. It is important to say here that most formulas should be given only when medical supervision has been consulted. Some medication prevents people from breastfeeding, and this is why I first became concerned with the ideology that breast is best. Certain types of antidepressant medications are not safe to breast feed with, as well as certain chemotherapy drugs, and even some basic medications which are used to treat colds, can have adverse effects when breastfeeding.
To be told that because of a medication you take to keep you healthy, you cannot breastfeed, can be particularly devastating, especially to those with mental health issues. As part of my psychology degree, I studied Perinatal Health, and this highlighted to me how harmful the stigma surrounding not breastfeeding can be. People with postnatal depression can already be overwhelmed with feelings that they are not good enough as a mother, and societal opinions that you are doing wrong by your child if you do not breastfeed, exacerbate these feelings. Individuals with postnatal depression often already feel that they do not have a bond without their baby, without society needing to make this worse by saying that breastfeeding creates a bond with your baby. Therefore, as not everyone discloses what medication they take, and nor should they, we as a society need to be mindful that not all people can breastfeed due to their medication.
A mother may also opt for formula milk if they have a condition that prevents them from having a large enough supply of breastmilk. Some conditions that can lessen the milk supply in mothers are: polycystic ovary syndrome, hypothyroidism, previous breast surgery, prior breast cancer treatments and others. As these conditions can lower the supply of milk their baby may require additional supplements of formula milk, but this is not to say their quality of breast milk is reduced.
How does not breastfeeding impact a mother?
I mentioned earlier how bad it can be for a mother with a mental health illness to receive criticism or feel inferior due to not breastfeeding, but any mother may feel judgement by society for not breastfeeding. I spoke to a mother that can’t breastfeed her infant that described it as “hard when people always say you should be breastfeeding”. But, she also highlighted to me positives that often do not get enough mentioning when talking about formula feeding. The mother suggested that by formula feeding, both parents experience the bond of feeding the infant, something that would be experienced only by the mothers if breastmilk were to be used. Also, the mother said it is easier for others to help out with the baby, and this added help can be invaluable to a new mother. This perspective from a non-breastfeeding mother shows that it is not all negatives to formula, and sometimes fed is best.
Where do we go from here?
I hope from this post that you take away that we should all do our part to eliminate this stigma from society as not all mothers are able to breastfeed their baby. It is not acceptable for mothers to feel judged, especially as it is often not their choice, but something they must do to protect both themselves and their infant. Ultimately, no two people are the same, and neither are two babies, so we cannot expect breastfeeding to work for every mother and infant. So be kinder to mothers, and refrain from giving your input on what they should and shouldn’t be doing, because you don’t always know their circumstances. Remember breast is not always best.
Guest writer Beth Tripp
References
Binns, C., Lee, M. and Low, W.Y., 2016. The long-term public health benefits of breastfeeding. Asia Pacific Journal of Public Health, 28(1), pp.7-14.
Lawrence, R.A., 2000. Breastfeeding: benefits, risks and alternatives. Current Opinion in Obstetrics and Gynecology, 12(6), pp.519-524.
https://www.nhs.uk/conditions/pregnancy-and-baby/types-of-infant-formula/National Health Service, 2019. Types of formula milk [online]. Available from https://www.nhs.uk/conditions/pregnancy-and-baby/types-of-infant-formula/ [Accessed 11 November 2020)
