Saturday 5 August 2017

Don’t infantilise pregnant women, tell them how tough breastfeeding can be

Of course British attitudes need to change, but let’s be honest, telling women about how wondrous breastfeeding can be is to tell only half the story, writes Lizzy Davies is international news editor of the Guardian:

As I type this, the clock hands are creeping towards 2.30am, and my baby daughter is slumbering beside me having had her first feed of the night. There will, unquestionably, be more. I am on hand 24/7 to meet her dietary needs, an always-open milk bar with only one thing on the menu and only one employee serving the drinks. There is very little customer feedback, though occasionally I am rewarded with a loud and strangely satisfying burp.

In my bleary-eyed state, I read that paediatricians, MPs, midwifes and other experts are calling for the “multiple barriers to breastfeeding” that exist in Britain to be broken down, and for steps to be taken so that the practice can be considered “a normal, natural part of everyday life”.

It’s hard to disagree. The UK has one of the lowest breastfeeding rates in the world, a shameful statistic that speaks volumes about the incoherence of our approach to child-rearing. Despite the well-documented benefits of breastfeeding, only 43% of mothers in Britain will still be doing it by the time their babies are six to eight weeks old. Only 1% of babies are exclusively breastfed to six months, as the World Health Organisation recommends. It’s clear that, as a country, we have a problem.

But how to fix it? In a letter to the Guardian on Tuesday, 18 experts called for better education in schools, more practical support from healthcare services, and for the government to ensure that women aren’t put off breastfeeding by workplace constraints. I would add one more strategy: don’t baby mothers-to-be. Be honest with them about how tough breastfeeding can be.

During my pregnancy I, like thousands of other well-intentioned pregnant women, assiduously attended National Childbirth Trust (NCT) classes, merrily bought an electric breast pump, even watched a video on how to get your baby to latch on perfectly with no fuss. The background music was soothing. The baby sprang on. On a different video shown to us in our NCT class, the mother was shown adopting the “laidback” feeding position, lying down and letting the infant to do all the work. This was greatly encouraging. I could do laidback! I’d just let nature weave her magic!

 ‘To tell women that breastfeeding is a bringer of health benefits and wondrous bonding is to tell them only half the story.’ Photograph: KidStock/Getty Images

Forewarned, as our mothers, and their mothers, and their mothers, used to tell us, is forearmed
Fast forward to 20 April, at 6.28pm, and my mewling daughter, just born, is showing a distinct lack of interest in my breast. A procession of midwives – all of them kind, all of them determined to show me just how straightforward nature can be – grapple with my baby’s head and my nipple and try to bring them together in perfect harmony. It does not work. I spend my daughter’s first evening on earth painstakingly squeezing out tiny droplets of colostrum into a minuscule syringe. It is only the next day that, infuriated perhaps by my increasingly cack-handed attempts, she eventually complies. And it is then that I realise: nature can be marvellous. She can also be capricious. And it is supremely bloody painful.

Compared to many women, I got off lightly. Friends speak of months of nipple shields, jelonet gauze dressings, bleeding, cracked nipples, mastitis. And those are just the physical difficulties. The psychological challenges of breastfeeding – the pressure (yes, and privilege) of being your baby’s sole provider; the mindbending fatigue of early weeks spent half-comatose and half-dressed in the half-light – are just as formidable, perhaps even more so. One friend switched to formula at three months because, amid the sometimes terrifying anxiety of early motherhood, she needed to feel her body was once more her own.

We need to hear these voices, and act on them. To tell women that breastfeeding is a bringer of health benefits and wondrous bonding is to tell them only half the story. Is it really surprising that a first-time mother, told by all and sundry that it should be easy, painless and emotionally blissful, turns away from breastfeeding, feeling herself a failure, when none of these things turns out to be true? Are we so intent on infantilising women that we won’t tell them the truth?

Forewarned, as our mothers, and their mothers, and their mothers, used to tell us, is forearmed. Better, no-nonsense education is needed. Women need to know of the cons of breastfeeding as well as the pros, so that they are better prepared for the potential challenges ahead. So that if in the early days they are faced with a dagger-like pain, they are not shocked. So that when they are sitting alone on the sofa at 5am, they are expecting it. So that they don’t feel like failures if their bodies simply won’t cooperate. So that they are less likely to give up because of a misguided belief that if they find breastfeeding hard it is their fault. So that they can stock up on nipple cream.

Some will say that this would serve only to lower the breastfeeding rate further; that fewer women than ever will do it if they have all this spelled out to them. But in my experience new mothers will walk over hot coals if they are told it will help their babies. Moreover, they have just given birth; they are not easily scared off. So tell them breastfeeding is a magical fairytale and they will, fairly quickly, call you on it. But tell them the truth and you might just be surprised. That your wailing newborn probably won’t leap up your body via your linea nigra to your breast, like in the videos, but that that’s really OK, and that after a while, they’ll probably get the hang of it. That, yes, breastfeeding can be relentless, but if you catch yourself feeling lonely and exhausted in the middle of the night, you’re one of many. That it’s free. That it helps you lose weight. That cabbage leaves soothe the soreness and that, once the initial discomfort has passed, it can be easy and practical and really rather lovely.

It might not be the sexiest sell, but at least it’s not setting you up for disappointment and frustration. Instead, perhaps it will leave you better-equipped, both physically and mentally, to continue breastfeeding.

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