Expert / 12 June, 2021 / Professor Amy Brown
Three little words – ‘fed is best’ – are the subject of many a social media debate. And one reason is the different ways in which the message is used and interpreted. Some feel it means ‘if you need to supplement your baby that’s the best thing you can do for them’. Or ‘don’t feel bad you couldn’t breastfeed’ if a woman is struggling. But for others, another interpretation of the phrase can hurt. Telling a woman that ‘the main thing is that your baby is fed’ can seem like their feelings and experiences, particularly their right for their body to work as expected, are being dismissed.
Before I go any further it’s vitally important to distinguish between better supporting women who want to breastfeed and any implication that all women can or ‘should’ breastfeed. It is never right to pressurise a woman to breastfeed or tell her that something terrible will happen to her baby if she can’t breastfeed or doesn’t want to. We can all agree that when it comes to decisions around our babies, not much is straightforward, and every woman is doing her ‘best’ in her own circumstances.
But challenging the use of the ‘fed is best’ message is not about implying that every woman can or should want to breastfeed. It’s about fighting for justice for those women who really wanted to breastfeed, but encountered difficulties, only to find that the thing they were told was so important during pregnancy, suddenly didn’t seem to be anymore. For them the message can hurt – and it’s important we listen to what they are saying.
For some women, when they hear ‘fed is best’ it feels like they are being told that their wishes, desires and experiences do not matter. They describe it as akin to being told after a traumatic birth that ‘the main thing that matters is a healthy baby’. Of course, healthy babies are the ultimate goal, but it doesn’t have to be an either/or situation. Saying that you are distressed by your birth or feeding experience does not mean that your emotions come over and above the health of your baby. We are allowed to feel more than one emotion at once. We are allowed to be simultaneously very grateful for access to formula milk and mourn the fact that we couldn’t breastfeed and our bodies haven’t worked as expected.
For women who really wanted to breastfeed, listening to their story and recognising how they feel helps validate their experience. Listening to how they wished things were different, making space for them to talk about the guilt, regret or grief they feel, and really hearing what they are saying is important in helping them move forward. Notably, a key trigger of trauma is that you experience an event that is traumatic to you, but everyone dismisses it and tells you to ‘pull yourself together’. And for some, the fed is best message feels like that dismissal.
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A further problem with the message that ‘the main thing is your baby is fed’ is that it feeds into a culture that doesn’t prioritise maternal and infant health, and particularly not infant feeding. Despite the ‘breast is best’ message, breastfeeding support is still so woefully underfunded. Many women are finding their health professional is so busy they cannot spend the time desperately needed. Or their local breastfeeding support group which provided both practical support and a shoulder to lean on (and decent cake) has closed down due to funding cuts.
This is leading to far too many women being left exhausted and in pain trying to increase their milk supply alone – or simply being told that some women can’t breastfeed and to give formula milk instead. This might solve the pressing issue that the baby needs feeding but it does not solve the issue of why a woman’s body is not working as expected. Where is the branch of medicine in the UK that specialises in lactation? Why are women simply being told it doesn’t matter if part of their body doesn’t work? Why is it acceptable that women are in pain? Would we accept this for any other part of our bodies?
A further kick for these women, is that breastfeeding doesn’t have to be like this. If you look at breastfeeding rates in other countries they are much higher. Take Norway for example – whilst over three quarters of women there are breastfeeding at six months, just a third are in the UK. Norwegian breasts are not somehow designed to be better at producing milk than British ones; differences come down to differences in the support system, both for breastfeeding and the value of mothering and parenting more generally.
How does ‘fed is best’ affect this? Well if we are led to believe that breastfeeding doesn’t matter and we shouldn’t mind how our baby is fed, then this reduces pressure on governments and health services to make the investments needed to better support women. And we should all care about that, no matter how we feed our babies as this is all part of a wider issue that women’s health, especially reproductive health, is not invested in. Five times as much research is conducted on erectile dysfunction (that affects around 20% of men) compared to research into premenstrual syndrome (which affects around 90% of women).
And finally, there is increasing recognition of how families who have decided to formula feed for whatever reason, are being misled by the formula industry. Misleading advertising means that parents can end up choosing to buy specific, more expensive brands because they think they are ‘better’. However, there is very little difference in content between milks; by law, all formula milks have to meet specific requirements in terms of content, and if any new ingredient was discovered to have a benefit, it would need to be added to all milks by law. Yet the recent Channel 4 Dispatches programme showed us that many families are struggling to afford formula, risking watering down bottles to make it go further, or overstretching themselves by buying the most expensive one. This misleading advertising in the name of profit not infant health needs to stop.
We deserve more than our babies simply being fed. We deserve investment and value whatever approach we decide is best for our families – and importantly support, answers and recognition if our body isn’t working and we can’t feed our baby in the way we wanted.
Professor Amy Brown, author of ‘Why Breastfeeding Grief and Trauma Matter’ Pinter and Martin £8.99.
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