Tuesday, September 30, 2008

Selling breastfeeding - warts and all

This is the crux of a perennial debate going on between mothers who do and mothers who don't breastfeed.

Having been on both banks of the river, I've always found it interesting to listen to the ongoing debate. It is one that can get really loud and passionate. Because at the very heart of this, it is not about defending a product ie the quality of breastmilk vs the quality of formula - though both are very valid issues. Rather, it is the defense of an ideal of motherhood.

When you consider that throughout history, across cultures, the image of motherhood is consistently personified by a mother with a baby at the breast, it is not difficult to understand why breastfeeding forms the sensitive core of our definition of womanhood and motherhood. Women everywhere debate this - within themselves, with other women, with doctors etc. This is why guilt is such a key issue in any formula vs breast debate.

What makes a good mother? If I choose the path less travelled, am I less of a mother? If I choose not to give my baby 'the best', do I freely admit this as a lifestyle choice I have made, or do I cloak under the excuse of 'not enough milk' and be defensive about my choices? On the other hand, what about mothers who breastfeed but do not enjoy it, mothers who decide to "breastfeed only the acceptable minimum period - ie 6 months, or a year or whatever the authorities decide is recommended". Does this make them better mothers than mothers who choose not to breastfeed at all? Or what about mothers who breastfeed all the way, and are in favour of child-led weaning?

It would be easy, according to your own value systems, to place such mothers on pedestals. But this would be overly simplistic and in the end, just not a fair assessment. Motherhood is touchy business.

So whenever people debate the merits of formula vs breast, I think they are debating deeper issues. And in my view, there are no winners, only opinions.

To me, breast is not about just infant feeding or infant nutrition. Clearly when you look at the facts, there is no contention that formula is vastly inferior. But breastfeeding goes far beyond just a dietary choice. There is emotional baggage attached to it - if not for the mother, certainly for the baby. Hence the mother who is eager to wean and baby who is not eager and in fact, exceedingly reluctant. When you get this sort of dichotomy, then any weaning efforts can potentially be painful - for both mother and baby.

I wonder if this is something all new mothers are told. Often, in my work when I meet mothers, they invariably say: oh sure, I'd like to breastfeed if I can. But this is because they have been told that 'breast is best'. And nowhere in the fine print are they told about the amount of attachment that breastfeeding commands in a relationship. Maybe they know vaguely about bonding, but I suspect they don't think so far as to what this exactly means - WHO is bonded? For how long?

Well and good if a mother enjoys nursing her baby - the ride is likely to be smoother and the baby nursed for longer. But imagine if they don't enjoy it? Chafe at the lack of 'freedom'? Resent frequent feedings and so on? Many women don't expect how much hard work breastfeeding can be. Many women come into the maternal relationship expecting auto bonding and for breastfeeding to 'come naturally'. But it isn't always so.

In the interests of making informed choices, perhaps birth educators, lactation consultants and breastfeeding counsellors should be honest and upfront about these issues as well. By all means, give the facts on the superiority of breastmilk, but make it clear that it demands commitment, hard work and perseverance as well. And the fruits of all this hard work? Ah, then we can 'sell' the merits of breastfeeding.

For now, in case anyone wants to see an interesting fact-based debate on formula-feeding, they can access this site: http://www.opposingviews.com/questions/will-formula-feeding-harm-my-baby

This is a debate between a La Leche League representative and Dr Joan B Wolf from Texas A&M University. Like I said, this debate is perennial. But it is never boring.

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