Mother’s milk: the politics of breastfeeding

I probably should have gone with some sort of breast related pun for the title of this but couldn’t quite bring myself to do it.

A couple of things have got me thinking back to breastfeeding this week – an article I read looking at the reasoning behind a hospital choosing not to give free formula milk  http://www.thefword.org.uk/blog/2011/10/baby_friendly_b , and a student in one of my groups at work planning a research project looking at a cultural analysis of breasts and their functions (so far called: “breasts: food or sex?” – a bit catchier than my title).

On the surface, the politics of breastfeeding seem simple. The formula companies exploit the difficulties of early breastfeeding in order to sell women something their bodies could produce, for free, with millions of added bonuses including antibodies and increased lifetime protection from various ailments and conditions. As my student has already spotted at the age of 16, this goes hand in hand with a nonsensical cultural norm system in which breastfeeding is viewed as something which should be hidden from view while shelves are lined up with rows of soft porn.

When I was pregnant for the first time, I was asked at various stages by both my midwife and various female relations whether I would be breastfeeding. I didn’t have to think about my answer much – I didn’t have any idea that there would be any difficulty involved whatsoever, having some worries about whether the baby would initially latch on and possible soreness but beyond that had heard that after the few days it got much easier. Whenever I replied that I would be breastfeeding I was met with beams of approval.

Things went ok initially; he latched on well and was sleepy from the anaesthetic from my c-section. By the second night, however, I was really struggling. He was latched on, dozing without really sucking, but screaming whenever he was unlatched, for about 6 and a half hours. My milk had not come in, and all the skin was coming off my nipples. I was hormonal and teary, recovering from surgery with no sleep having no idea that it was possible to co-sleep while he nursed. After various attempts to change his position, which resulted in the same sleepy sucking, the midwife spoke with me and we agreed to top him up with a few ml of formula. Finally, he was satisfied and went into a deep sleep. I think basically what was happening was that he wasn’t getting enough to fill him up, so he was comfort nursing through the hunger. The supply issue carried on – I would do hours and hours of nursing, finally giving up and topping him up again, watching in tears while a nursing assistant fed him with one of those little cups. Exhaustion, pain, and more than anything, a deep sense of failure. He had mixed feeds till the age of 8 months, when he weaned himself.

Fast forward to my daughter being born a couple of years later. I had received a good deal of redirected disapproval (mainly aimed at the hospital) for Ben being topped up, as apparently this was what meant I never then managed to get the supply to fill him up. This time I wasn’t going into breastfeeding with the ignorance I approached it with the first time round – I knew that if I just kept at it long enough, my supply would match my babies demands. I knew that there was no need to worry about getting no sleep at night, because my baby could sleep in with me, latched on all night long if she wanted to, and we would both get some rest. I knew there would be pain and difficulty, but that we would work through it and make it work.

Megan was exactly like her brother, in that she was a comfort nurser who wanted to sleep constantly on the boob. Difficult to manage with a 2 year old who is desparate for attention, a husband with no paternity leave due to a redundancy while I was pregnant, and recovery from another c-section, but by filling the living room with toys, gradual use of slings once she would tolerate them, and c-beebies on for the entire time, we got through the difficult first couple of months. However, there was a problem. Megan had really bad reflux, meaning she was constantly in pain from the acid being thrown back up through her digestive system, rarely kept a feed down, and hardly gained any weight. She was 8lb 8 when she was born, and dropped down the growth charts like a stone. I reassured myself constantly – she was a slight build, like her dad, and was just adjusting now she wasn’t being fed through my placenta. She was very sick, but it would pass in a month or two, and she would be fine.  I also spent nights clutching my baby wondering about whether the lack of growth meant a lack of nutrients which would be affecting the development of her brain in someway. She was getting longer, but skinnier. Every week when I took her to be weighed at the clinic I filled up with a sense of dread. I was still failing – I was achieving the goal of exclusive breastfeeding, but my milk was not enough to give my daughter what she needed to thrive. Initially we tried baby gavascon, which seemed to make her gain weight in the first week before her weight stalled again. At 3 months (by this stage she was waking hourly at night, and was increasingly discontent) the senior health visitor was called to see me, and after assessing the situation she asked that I start giving Megan a bottle a day. I burst into tears in the middle of the clinic in front of a group of strangers. We talked a bit longer, and she commented that she felt health visitors were constantly driven towards looking after the babies’ needs, but mother’s needs were being ignored as secondary or unimportant unless there was some sort of deep psychological issue (in which the baby could be endangered). I gave Megan one bottle a day until she got to 6 months, at which point I was about to go back to work, so gradually transferred her over. She night weaned at about 8 months, the same as her brother.

Nothing prepares you for the massive changes that motherhood brings, and for the first few months, when meeting the baby’s needs is all consuming, it feels like the choices you make are a big part of what defines you as a mother. I got lots of support and care from friends online (particularly Megan’s due date community), but the wider world of breastfeeding support seems to be unfairly dominated by an all or nothing mantra where even that one bottle a day is failure – explanations for why a baby would ever be given formula seem to be similar to mine to get sympathy, and extreme lactivists would still feel the need to lecture me on where things went wrong. The reality is that the comparison between breast milk and formula is a one horse race, as far as meeting the nutritional needs of the infant go, but the psychological needs of the mother, whether these are the need for non-judmental, practical advice, the need for reassurance that all new mothers are thrown into a whirlwind of emotion, stress and exhaustion and that she is doing fine, the need for a society which either allows her access to her baby in the workplace because she cannot afford to be at home feeding him (pumps are not universally usable) or stops condemning her for choosing a roof over her baby’s head over long term nutritional benefits, are seen as of minor or no importance, and that is decidedly non-feminist. In an ideal society, women would have the support of all their community sisters around them to care for demanding toddlers, help with latches, supply etc, rota childcare when work becomes possible, but life isn’t like that, and we need to make sure it is the system that stops this from happening which is targetted rather than the individual mother.

There seems to be a class divide in breastfeeding, with a distinctly higher levels in middle class than working class women. This may be in part about work (middle class women can afford to take more time off), partly about education, but could also be due to the level of trust these groups have in the state and authority in general. It is very likely that (some) health visitors will be able to transmit information in a more level way to middle class women whereas it can be at least perceived if not given out as judgement when working class women are being assessed. Surestart had a great role in getting community women involved as breastfeeding buddies to give a much more accessible information and support point but the whole system is under threat and levels of working class breastfeeding will almost certainly drop as a result, leading to bigger profits for the formula companies and a bigger weekly bill for those no longer being supported.

My daughter will be 2 in November and I don’t feel any guilt about either of my babies any more – I know that I did my best for them, just like the vast majority of mothers. They are both thriving, are no more sickly than any other children, advanced with their language skills, moving on to new challenges constantly that make that sleep-deprived blur of early motherhood fade into the distance. I like to think that I am more confident both as a mother and as a feminist activist than I was 2 and 4 years ago and should I have another baby will be more robust in dealing with criticism. I think we have to go with the same principles for breastfeeding as abortion – woman’s body, woman’s choice – recognising that the needs of a mother are important, not simply because they will impact on a child, but because she is an equal human being. If the hardcore breastfeeding activists really want to achieve a higher level of breastfeeding for all babies, they need to learn from others within their movement and look at targetting a selfish society which often does not provide the support new mothers need rather than accusing mothers themselves of selfishness.

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