Monday, 24 September 2012

The big breastfeeding controversy

I am a firm believer in breastfeeding. I breastfed my eldest son for two years and his brother for a year and a half. Baby is eleven months and I'm still nursing - it's up to him how long we'll keep it up.

I am baffled by how much controversy seems to surround breastfeeding.

I know some people who chose not to breastfeed their babies but went straight to formula and bottles. This choice astounds me. The World Health Organization states that "Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants...As a global public health recommendation, infants should be exclusively breastfed." Health Canada makes it clear: "Breastfeeding provides nutritional, immunological, and emotional benefits to infants and toddlers. Breastmilk is the best food for healthy growth and development."  Why would anyone choose NOT to do what the World Health Organization, Health Canada, and the medical organizations of every other developed nation in the world recommend as best for an infant's growth, health and development? What all medical research for all of recorded human existence shows is the best and healthiest option? When even the advertising for infant formula says "breastfeeding is best but..."? I simply can't understand why any mother would have the first decision they make for their newborn baby be second-best.

I also know what seems to be an extraordinarily disproportionate number of people who say they "tried" to breastfeed but "couldn't" - usually because they "weren't producing enough milk." Medical research shows that in fact it is incredibly rare for a mother to be unable to produce enough milk to satisfy her baby's needs. Health Canada tells us that "in most cases the lack of milk is perceived rather than actual. Only a small percentage of women are unable to fully lactate, due to breast abnormalities, surgery, or hormonal abberations." I know how unpopular this opinion is going to be, but I suspect that some of these moms who "couldn't" breastfeed may not have tried for long enough.

Breastfeeding isn't easy, at first. Or comfortable, or fun. It can actually be quite painful and frustrating, particularly during those first few days and weeks when baby seems to need to eat constantly in order to bring the milk in, when he can't latch on every time and you're wrestling with this screaming, starving, wriggly little red-faced monster, when your breasts are so swollen and sore even the water from the shower hurts, when every time he nurses it triggers excruciatingly painful labour-like contractions, when your nipples are dry and cracked and bleeding and sore, when you're waking up every hour on the hour to stumble to baby's room, cursing your husband for getting to sleep peacefully through it all, when you're so exhausted and frustrated and hormonal that you're constantly bursting into tears for no apparent reason. Some people legitimately can't breastfeed, for one reason or another, and I acknowledge that. But - and I know the reaction I may get for saying this - I think a lot of people who claim they are not able to are in fact choosing not to.

Then there is the backlash in society against breastfeeding mothers - both for breastfeeding in public and for breastfeeding too long.

Frankly, I don't know anyone who has ever just whipped out their boob in the middle of a public place to feed their baby. They'll find a corner, a bench off to the side, a separated area to sit in and nurse their baby in as much privacy as possible. In the interests of modesty - and to keep baby from getting distracted - most will toss a blanket over their shoulder to cloak baby's head and Mommy's breast. But, particularly with newborn infants for whom breastmilk is the only source of food, if baby is hungry then baby is hungry and he has to be fed. An infant is not a nine-month-old who can be given a rice cracker or banana to tide him over until family-friendly facilities can be found. And if you're the sort of person who would be offended by the accidental glimpse of a bit of boob because a baby is trying to eat, then I'm guessing you'd be even more annoyed by the endless tortured screams of a thirsty, starving infant if the mother chose to ignore her child's hunger in favour of your sense of propriety.

The notion of "how long is too long" is a tricky one. The World Health Organization and Health Canada recommend a minimum of one year of breastfeeding. There is no maximum. According to Health Canada, "healthy term infants should be exclusively breastfed to six months of age and then continue to be breastfed with appropriate complementary feeding to two years of age and beyond." The average age worldwide for a child to stop breastfeeding is in fact about four years old. This notion that breastfeeding is gross or unnatural or - are you kidding me? - in any way sexual is a very Western notion - and one held, it seems, exclusively by people who have never had children and never breastfed themselves. I don't disagree with the idea that once a child is approaching school-aged - say three years old - they should probably be weaned simply for societal reasons. They will be interacting with other children on a daily basis, they are old enough to start forming early memories, and there is a social stigma attached to long-term breastfeeding in our society - whether you agree with that stigma or not, your child still has to grow up in that society. I chose to stop breastfeeding my boys when I did - at eighteen and twenty-four months - because it was what was right for them. I don't think that anyone should judge a mother for choosing to breastfeed her children longer, if it is what is right for them. That mother is choosing the healthiest option for her child -  why is there stigma attached to making the healthiest choice for baby, a positive thing, but no negative reactions associated with NOT breastfeeding?

I don't judge any mother for the decisions she makes regarding how she feeds her infant. There are a myriad of reasons why someone might choose to breastfeed or not. There are a myriad of reasons why someone might be able to breastfeed or not. Perhaps there are health issues - for Mom, for baby, for both of you. Maybe Dad's the one taking parental leave - Dad simply doesn't have boobs. For some people - lower income families, single parents - it's not practical or feasible to take a leave of absence from work at all - and no-one can spend all day and night hooked up to a breast pump. There are a myriad of reasons why someone might stop breastfeeding sooner than a full year, and just as many reasons why someone might continue until three years old. What works for each child and each family is what works, and if it works for you then that's what's right for you.

But in my humble opinion, all other things being equal, there's a very good reason that every respected medical professional in the world recommends breastfeeding and there's a very good reason that in millenia of human evolution we haven't come up with a better solution to feed our young:
breast is best.

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