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Why is breastfeeding still controversial?


There’s been a lot about breastfeeding in the news recently. Firstly, there was the front cover of Elle Australia - a beautiful picture of model, Nicole Trunfio, breastfeeding her five months old baby. It caused quite a storm – partly, perhaps, because we’re still surprised to see older babies being breastfed (breastfeeding babies of more than three months seems to make many UK citizens feel very uneasy). The fact that Nicole’s baby was not a newborn also enabled the Elle editors to make a covert reference to the famous Vanity Fair photo taken by Annie Leibowitz of Jerry Hall feeding Mick Jagger’s baby.

And then there was the controversy over ‘brelfies’ – women posting picture of themselves breastfeeding their babies. This has outraged many people such as the journalist, Anna Maxted, writing in The Telegraph. Many women who have chosen to bottle feed their babies, or been unable to breastfeed, are saying they feel judged and labelled as second-class mums because they are not providing their babies with the best start in life.

Breastfeeding promotion has travelled a difficult path since the wonderful work done at Bristol University (my alma mater) and elsewhere revealed over 30 years ago to a surprised professional and lay audience just how significant breastmilk is in the healthy development of the baby. From that point on, the evidence – overwhelming as it is – has obliged health professionals to tell mothers and families that breastfeeding would not just be good for their infants, but would be far better than any alternative. Strong messages, especially if perceived as coercive, inevitably provoke a backlash. Women hit back – I saw this on many occasions in antenatal classes – by refusing to attend breastfeeding sessions because they ‘had already made up their minds’ and didn’t want to be ‘pressurised’. They vigorously asserted their right to make the choice that they felt best not only for their babies but also for themselves and their families (quite rightly).

Many health professionals both at home and abroad have told me that they feel the ‘breast is best’ message has sometimes soured their relationship with women. The requirement to emphasise the benefits of one particular form of infant feeding has hampered them in establishing a trusting relationship with mothers; instead it has sometimes engendered deceit because women have been unwilling to be open about their feeding intentions or practice for fear of being censured.

So while my initial reaction to the brelfies was an aggressive, ‘Well, great – it’s time breastfeeding mums proudly proclaim what they’re doing rather than huddling in toilets because they’ve been told that they are not ‘allowed’ to breastfeed over a cup of coffee’, I was worried by the backlash the brelfies have inspired.

I have written before about how entirely counter-productive it is to make any woman feel guilty about her mothering; she’s almost certainly doing her best given her particular circumstances. Personally, I feel strongly that every baby would get off to the best possible start in life if he or she could have a few months of breastfeeding. As an academic, committed to a strong evidence-base for the information we give to parents, I could hardly say otherwise. However, I do think the time might have come to tone down the breastfeeding strategy; less pressure might actually enable more women to choose to breastfeed.

The picture of Nicole Trunfio in Elle is not, I suspect, great propaganda for breastfeeding. I have the feeling, looking at the picture, that breastfeeding is being presented as a sexual act rather than a nutritional and nurturing strategy. Of course, breastfeeding is sexual; after all, it involves the production of masses of oxytocin and oxytocin is the hormone of orgasm. And I am certainly not saying that the beautiful woman feeding her baby isn’t committed to the best possible mothering she can achieve; of course, she is. But it’s a matter of perception…….what do readers of Elle ‘see’?

And how is the ‘breast is best’ message ‘heard’ by the pregnant woman who is disgusted by the thought of breastfeeding, or worried about ‘failing’ if she gives it a go, or under the influence of a partner who doesn’t want ‘his’ breasts used to feed a baby?

We cannot on the one hand say that health care today is all about the consumer making choices, and then be surprised when some people make choices that we would rather they didn’t.

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