16 February 2013

Are We Putting Too Much Pressure on Women to Breastfeed?

Recently I've read some articles bemoaning the "Breast is Best" campaign as putting too much pressure on mothers to breastfeed. Those who know me know I'm very much a lactivist, yet I think I can see whence the idea comes even if I disagree.

Why do I disagree? Simply because I can see all the ways in which we are pressured to stop, or never start, breastfeeding. Yes, women are told "breast is best" (a slogan I actually dislike because breastfeeding isn't best, it's the biological norm) and are told they should breastfeed, but then aren't given adequate, or any, support from nurses, doctors, family, and society as a whole. So you end up with the breastfeeding campaign on the one hand talking it up and how you really should do it, but on the other hand most aren't given practical support. Not only that, but the challenges are sometimes downplayed in an effort to increase initial breastfeeding rates, but that helps no one if the possible challenges are simply ignored.

Yes, there are challenges, or at least there can be. I didn't know about many of them when I started breastfeeding. Luckily, Kieran took to it without a hitch, and when a challenge did present itself, I'd then started doing reading of my own to know how to handle the thrush, mastitis, biting, oversupply, food intolerance, tongue tie, and latch issues that later appeared at different times. While these weren't discussed in the breastfeeding class I took during my first pregnancy, I hadn't expected it to be a cakewalk, just as I didn't expect parenting in general to be a cakewalk.

But what if I hadn't known about these problems? In my breastfeeding class, we were told that breastfeeding shouldn't hurt past 10 seconds, and if it did something was amiss. With Leo, it hurt to feed him. Every time. Between that, the clicking sounds, and the lack of weight gain (among other things), I knew there was a problem. I even knew what the problem was. But when I raised my concerns with two different doctors, those concerns were dismissed. One doctor said he was fine, and another said to give him a bottle. Had I not known to contact an IBCLC and get a referral to a doctor who could help, Leo no doubt would've been "failure to thrive" before long. I suppose some could interpret the first doctor's advice to just carry on breastfeeding as I was as pressure, since I knew something was wrong, but I saw it as ignorance. No, the pressure I felt was the other doctor telling me to just give a bottle, though again that was ignorance.

Now, when I speak of ignorance, am I belittling or chastising the person? No. I am ignorant about cardiology, but that doesn't make me stupid. It just means I have not studied cardiology. No, I am instead lamenting the widespread ignorance in society, and especially among medical professionals. Because of that and the rampant misinformation given, many mums have to navigate the rapids alone unless lucky enough to know other mums who have been successful at breastfeeding. I suppose that does put a lot of pressure on mums, and if the pressure is only on mums, then that needs to change. I do not consider myself better for knowing to keep looking and how to keep going, though, just lucky.

Also, we can say "breast is best" all we want, but if she has to return to work in 6-8 weeks, that doesn't mean much. Some employers aren't breastfeeding-friendly and don't want to provide pumping breaks. I can imagine how hard it would be to be in an environment hat is hostile to pumping and breastfeeding. Let's also remember that pumping is very different from breastfeeding: not every woman will respond well to expressing milk. We need better maternity leave and accommodations for parents in the workplace.

It also doesn't mean much if we tell mothers to breastfeed on the one hand, but then society tells her not to do so in public. While I decided I don't care what others think and will breastfeed my child openly wherever I am, not everyone is comfortable doing that, and I can't fault them. I do not say this to say I'm better or braver or whatever, because I'm not. Even now I sometimes get nervous breastfeeding openly because I'm also non-confrontational and don't want negative comments. I just wish society were as welcoming of public breastfeeding as of, say, Victoria's Secret ads.

And what about support? We can, and do, put all the information online, but misinformation also abounds online. For example, my mother encountered a woman who told her doctor that breastfeeding hurt. Instead of determining why it hurt and seeing if it could be rectified, the doctor just said to pump and give a bottle. Had the doctor said to continue breastfeeding anyway, that could be seen as undue pressure, when in reality it would just be less-than-helpful advice. Conversely, true support means being honest about breastfeeding and not stringing a mother along by telling her she can do it but not supporting her, or telling her she can do it if she actually cannot for some reason, be it physiological, medical, or psychological (I have friends with IGT and DMER, for example; some with those conditions can breastfeed with the right support, but some cannot. In either case the support must go beyond just telling her to carry on). And if a woman has already made the switch to bottle-feeding, or started out that way, it does no one any good to condemn her. We can gently share information in case they later wish to breastfeed, but this must be done in such a way that is not judgmental.

So, too much pressure? I think instead it is a conflict between those promoting breastfeeding and the lack of actual support combined with widespread ignorance about breastfeeding. Those who promote breastfeeding are trying to get the information out there and fighting against entrenched ignorance and prejudice against breastfeeding. Because of that, we can come across strong as we try to slowly turn the tide. We do need to remember to use precise, supportive language, and we cannot put the onus on the mother to do it all without support from her doctors, family, friends, and society as a whole, of course. But I don't think most lactivists try to put all the pressure on the mother, either, but try to disseminate information to help as much as we can.

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