Commentary: Stop telling mothers who struggle to breastfeed to give formula
Breastfeeding is good for mothers' well-being, but those who struggle need support, not judgment or advice, says one child health expert.
SWANSEA: If you believed some newspapers you would think that breastfeeding was inherently bad for maternal mental health. Headlines regularly shout about “pressure to breastfeed” and “breastfeeding bullies” making mums feel anxious and miserable.
Calls are made for breastfeeding promotion to stop due to the perceived risk of ruining the motherhood experience.
But breastfeeding does not damage maternal mental health. In fact, a good breastfeeding experience can do marvellous things for women’s well-being.
Alongside reducing risk of reproductive cancers, heart disease and diabetes, it can help mothers feel empowered, confident, and heal birth trauma too.
Breastfeeding hormones are even thought to help reduce the impact of stress and sleep deprivation upon the body. It’s no wonder that numerous studies have found that when breastfeeding is going well, a woman’s risk of postnatal depression is lower.
But when women are unable to breastfeed as they had expected their mental health can be badly affected. Having a difficult breastfeeding experience and feeling forced to stop can leave women feeling devastated, grief stricken and very, very angry.
LACK OF SUPPORT
But, I repeat, the problem is not breastfeeding itself. Instead it is the lack of support and investment in infant feeding, new mothers and families more broadly.
More than two-thirds of mothers who stop breastfeeding in the first few weeks do so because they needed more support, had pain, or difficulty latching a baby on.
However, lack of investment in health services means that mothers are often forced to get on with it by themselves – often with the further blow of being told “the main thing is your baby is being fed” – rather than have the one-to-one support they actually need.
In fact, issues such as not getting enough professional help, exhaustion and misinformation mean that more than half of UK babies have had formula by the end of their first week.
Difficult experiences also raise the risk of postnatal depression, over and above the hormonal implications of not breastfeeding.
Our research – conducted with over 200 mothers who stopped breastfeeding in the first few months – shows where women were ready to stop, or stopped for reasons that they perceived to be positive, their mental health was not affected.
But when they stopped because of pain, physical difficulties, or because they couldn’t get the support they needed, their risk of depression was much higher.
This study expanded on a large body of research showing a link between a short period of breastfeeding and postnatal depression.
The findings are perhaps unsurprising. Experiencing pain and exhaustion are both linked to increased risk of depression – before you add on shattered expectations and often a lack of advice about what to do next.
LACK OF RESEARCH
What is confusing is that investment still isn’t being made to support women in reaction to this.
We know that breastfeeding protects maternal and infant health. We know it saves money for healthcare systems.
We know the majority of women want to do it – and lots, once they get past the early weeks, find it simpler, more convenient and cost-effective. And we know the potentially damaging effect on their mental health if they cannot breastfeed.
It’s not as if we don’t know why women are struggling. There is an absence of professionals to support women, no community to take care of them, and lack of a culture that understands, values and protects breastfeeding and breastfeeding mothers whether they are at home, work or out in public.
But instead of investing in the research, staffing, education and protection that is needed, a bottle of formula is suddenly given as the solution to any breastfeeding challenge.
Although formula is sometimes needed when breastfeeding really does not go to plan, the UK National Institute of Clinical Excellence states that women who want to breastfeed should be given intensive support to increase their milk supply if necessary, before formula is offered.
Moreover, formula doesn’t solve the perceived issues that it is often presented as solving. It won’t help a baby sleep at night, does not create a more “settled baby” and does not stop babies wanting to be held.
These are normal baby behaviours, to help a them feel safe and comforted, and often nothing to do with hunger.
Most importantly, simply telling a mother who wants to breastfeed to give formula rather than helping her work through any challenges will not make her any happier – in fact, as shown, the opposite is often true.
Mothers who are let down in this way – often without answers as to why their breastfeeding experience went – wrongly blame themselves, stating that they feel like failures.
Mothers who cannot breastfeed are absolutely not failing, rather, they are being failed – by a government who is far too quick to promote breastfeeding without protecting it.
Amy Brown is professor of child publio health at Swansea University. This commentary first appeared in The Conversation. Read the original commentary here.