I sat in wretched disbelief as the infant specialist GP explained that my newborn baby daughter was screaming constantly because she was starving. Just weeks into new motherhood my generous dam of breast milk had, for reasons unbeknownst to anyone, evaporated into a small puddle.
I was handed a script for Motilium pills that may or may not have increased my supply in a few days’ time. “That’s three days away, she’s so hungry – do you think I should feed her a top-up of formula in the meantime?” I asked. The doctor’s seat squeaked as he shifted uncomfortably. He guessed it couldn’t do any harm “for the time being”.
Now the mother of an energetic toddler, I can pinpoint that conversation in the doctor’s surgery as the moment I realised the “breast is best” dogma would skew the care and advice I’d receive going forward. Like many women, I held up the World Health Organisation’s recommendation of exclusive breastfeeding for at least six months as a shining goal I’d strive towards.
I’d heard people say that breastmilk was best and I wanted only the best for my baby. But when my milk dried up, my daughter struggled to latch and her weight plateaued, my goal morphed from realistic to devastatingly out of reach. I began to wonder whether a distraught mother with little breast milk and a hungry baby was really the “best” outcome.
According to the 2010 Australian National Infant Feeding Survey, 96% of Australian women initiate breastfeeding but by the time their babies hit the five-month mark, only 15.4% of them are still being exclusively breastfed. For those who aren’t able to breastfeed exclusively for whatever reason (or who don’t want to), the “breast is best” ideology pushed by the medical industry can be both frustrating and isolating.
A 2016 study by Liverpool University found that 67% of women who formula fed their baby felt guilty, 76% felt the need to defend their feeding choice and 68% felt stigmatised. Despite the current Australian breastfeeding rates illustrating there’s not a one-size-fits all approach to feeding an infant, our medical professionals are still perpetuating the “breast is best” narrative and it’s causing mothers undue harm.
The breastfeeding advice from well-meaning doctors, nurses and call centre volunteers to only avoid formula at all costs made my first few months as a mother a desperate grapple between doing what they told me was right and doing what I intrinsically knew was the best option for my baby and I. While I have no doubt the pro-breastfeeding advice and care I received during my struggle was given with the utmost best of intentions, it simply wasn’t helpful when it came to my set of circumstances.
It’s this rigid “breastfeed at all costs” message communicated by the medical industry that needs to change to better support the thousands of women who struggle to breastfeed, or who simply don’t want to. These women deserve access to the right care so they can feed their babies in a way that’s best - and safest - for them.
It’s something the Australian Medical Association (AMA) has acknowledged and is making progress to change. In the Infant Feeding and Parental Health 2017 Position Statement, president at the time Dr Michael Gannon said it was “important” for the medical industry to strive to remove the negative connotations around formula feeding.
“Mothers may feel a sense of guilt or failure, and it is important that their GPs and other medical practitioners reassure them about the efficacy and safety of formula feeding, and work to remove any stigma,” Dr Gannon said in the statement.
The AMA’s current president Dr Tony Bartone told Mamamia that judging women about their feeding choices could even be a contributing factor to mental health issues.
“New mothers can have a difficult time breastfeeding and, while there is evidence to support breastfeeding as the preferred way to feed babies, this should not be pursued to the extent that it can shame women,” explains Dr Bartone.
“Looking at women’s [feeding] choices negatively has the potential to contribute to postnatal depression. Mothers and other caregivers who cannot or choose not to breastfeed must have access to appropriate care and assistance to formula feed their children.”
Initiatives like the AMA’s new Continued Professional Development material, accredited by the Royal Australian College of General Practitioners, are slowly helping to shift the way the medical industry supports and engages with mothers who struggle to, or choose not to, breastfeed.
However, unlike the United Kingdom, where the push to promote a “fed is best” dogma is helping to prevent extreme cases of babies being put at risk of undernourishment - and even death - because of the shame associated with bottle feeding, there’s no rush to change the “breast is best” lexicon here.
Cath Curtin is someone who has witnessed formula feeding shame play out first-hand. Midwife of over 40 years and author of new book, After The First Six Weeks, Midwife Cath, as she’s best known publicly, says shifting to a “fed is best” approach will help to alleviate the undue stigma placed on mothers who aren’t able to breastfeed.
“There’s so much pressure placed on mothers to breastfeed and the truth is that sadly not all mums are able to, or it mightn’t be something some mothers feel they can do. That’s OK and we should be supporting these mothers rather than making them feel as though they’re ruining their child’s health because they’re feeding them formula,” Curtin explains.
After talking with my partner, family and friends, I decided to stop mixed feeding and switched to exclusive formula feeding when my daughter was five and a half months old. I could feel every cell in my body exhale. Feeding my beautiful baby was no longer something I feared.
Suddenly my husband was able to share feeding duties and he cherished cradling our baby on his lap, bottle in hand, grin fixed in place. But above all else, feeding was something I now enjoyed and my robust baby girl didn’t seem to mind where her meal was coming from in the slightest. For us, fed was most definitely best.
While there’s no denying the health benefits of breastfeeding, medical industry professionals pushing the “breast is best” paradigm in circumstances, like mine, where it is not “best”, can pose serious risks to a mother’s wellbeing. They’re just three little words, sure, but to mothers struggling to breastfeed (or choosing not to) they can pierce deeply.