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Many health care professionals, government agencies and formula manufacturers make the excuse and argument for not promoting and supporting breastfeeding that they should not "make the mother feel guilty for not breastfeeding". Even some strong breastfeeding advocates are disarmed by this "not making mothers feel guilty" ploy.
Because, indeed, it is nothing more than a ploy and a lousy excuse for not assuring that each and every baby has the best start that he or she deserves in life. It is an argument which deflects attention from the lack of knowledge and understanding of most health care professionals about breastfeeding. This allows them, the care givers, not to feel guilty for their ignorance of how to help women overcome difficulties with breastfeeding, which could have been overcome and usually which could have been prevented in the first place if mothers were not so undermined in their attempts to breastfeed. This argument also seems to allow formula companies and health professionals to pass out formula company literature and free samples of formula to pregnant women and new mothers without pangs of guilt, though it has been well demonstrated that this literature and the free samples decrease the rate and duration of breastfeeding. As a former breastfeeding mother of five children, I, too, experienced this type of "non-breastfeeding pressure" and total lack of support and education when I was attempting to establish and maintain breastfeeding of my babies.
This is the way it is.... If a pregnant woman went to her health care provider or midwife and admitted she smoked a pack of cigarettes, is there not a strong chance that she would leave the prenatal visit feeling guilty for endangering her developing baby? If she admitted to drinking a couple of beers every so often, is there not a strong chance that she would leave the office feeling guilty? If a mother admitted to sleeping in the same bed with her baby, most health care providers would make her feel guilty for this, too, even though it is the best thing for her and the baby. If she went to the office with her one-week-old baby and told the health care provider that she was feeding her baby homogenized milk, what would be the reaction of her care giver? Most would practically collapse and have a fit. And they would have no problem at all making that mother feel guilty for feeding her baby cow's milk, and then pressuring her to feed the baby formula. (Not pressuring her to breastfeed, it should be noted, because "they wouldn't want to make a woman feel guilty for not breastfeeding".)
Why such indulgence for formula? The reason of course, is that the formula companies have succeeded so brilliantly with their underhanded advertising to convince most of the world that formula feeding is just about as good as breastfeeding (which it is NOT!), and therefore there is no need to make such a big deal about women not breastfeeding. As a vice president of Nestle in Toronto was quoted as saying "Obviously, advertising works". It is also a soothing excuse for the consciences of many health professionals who, themselves, did not breastfeed, or their wives that did not breastfeed. "I will not make women feel guilty for not breastfeeding, because I do not want to feel guilty for my child not being breastfed".
A closer look at this issue reveals that formula is certainly theoretically more appropriate for babies than cow's milk. But, in fact, there are no clinical studies which show that there is any difference between babies fed cow's milk and those fed formula. Not one. Breastmilk, and breastfeeding, which is not the same as breastmilk feeding, has many more theoretical advantages over formula than formula has over cow's milk (or other animal milk). And we are just learning about many of these advantages. Almost every day there are more studies telling us about these theoretical advantages. But there is also a wealth of clinical data showing that, even in affluent societies, breastfed babies, and their mothers incidentally, are much better off than formula fed babies. They have fewer ear infections, fewer gut infections, a lesser chance of developing juvenile diabetes and many other illnesses. The mother has a lesser chance of developing breast and ovarian cancer, and is probably protected against osteoporosis. And these are just a few examples.
So how should we, as midwives and health care providers approach support for breastfeeding? All pregnant women and their families need to know the risks of formula feeding. All should be encouraged to breastfeed, and all should get the best support available for starting breastfeeding once the baby is born. Because all the good intentions in the world will not help a mother who has developed terribly sore nipples because of the baby's poor latch at the breast. Or a mother who has been told, almost always inappropriately, that she must stop breastfeeding because of some medication or illness in her or her baby. Or a mother whose supply has not built up properly because she was given wrong information. Make no mistake about it - health care professional's advice is often the single most common reason for a mother's failing at breastfeeding! We have a great deal of control over what a new mother does and does not do since they depend on us, as professionals, to give them the right advice and support with accurate pros and cons.
If mothers get the information about the risks of formula feeding and decide to formula feed, they will have made an informed decision. This information must not come from the formula companies themselves, as it often does. Their pamphlets give some advantages of breastfeeding and then go on to imply that their formula is almost, actually just as good. These pamphlets are obviously very one sided since they, as formula companies, want to make a profit from their product. If mothers get the best help possible with breastfeeding, and find breastfeeding is not for them, after at least giving breastfeeding a good try, the mothers will get not receive any scolding from me, as a midwife. But they need to at least try it and give the baby as best of a start as possible in life. It is important to know that a woman can easily switch from breastfeeding to bottle feeding. In the first days or weeks - there is not a big problem in switching. But the same is not true for switching from bottle feeding to breastfeeding. It is often very difficult or impossible, though not always, to get a baby to switch from the bottle to the breast.
Finally, who does feel guilty about breastfeeding? Not the women who make an informed choice to bottle feed. It is the woman who wanted to breastfeed, who tried, but was unable to breastfeed. In order to prevent women feeling guilty about not breastfeeding what is required is not avoiding promotion of breastfeeding, but promotion of breastfeeding coupled with good, knowledgeable and skillful support. This is not happening in most North American or European societies. This comes back to us as midwives and health care providers to supply this information, education and the needed support that these mothers need. The ball comes back into our court and it is our responsibility to provide the best care we can for moms and babies. If we do not, then we should feel guilty, ourselves, about slacking off of our duties in our profession.
This page has been adapted from an article found on About.com: Pregnancy & Childbirth - Breastfeeding & Guilt
MoonDragon's Articles: 101 Reasons for Breast-feeding
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