When Ella was 5 days old, I called one of my best friends’ mum from my bed in tears. She was a volunteer for La Leche League*, and despite me asking for (and getting) help with latching Ella every few hours in hospital and every day at home, something wasn’t working. My nipples were so damaged and cracked that every cry for a feed sent dread into my chest, every bra or top I wore was stained with blood, and I had even asked my midwife if there was any chance that my nipples would fall off. Luckily she laughed at my question, which I found strangely reassuring.
On the phone, amongst other advice, my friend’s mum recommended that I read a book called The Womanly Art of Breastfeeding. At the time I was genuinely confused that the book had 576 pages. How could a book about breastfeeding be so long? Didn’t you just….feed the baby!?
In the 3 years since that phone call I have fed two babies, and from latching issues to recurrent mastitis, lactose overload to oversupply, reverse cycling to nursing strikes, and food sensitivities to tongue tie, my breastfeeding journey has justified the length of that book many times over. More than that though, it has repeatedly shocked me just how little we know or are told about breastfeeding, how much it is neglected as part of our antenatal care and education, and how for me at least, I have only managed to ‘make breastfeeding work’ by using skilled and expert help that was unavailable to me through the NHS. When you consider the basic fact that breastfeeding is the way in which newborn babies are designed to feed and survive, the lack of detailed support and knowledge available is frankly surreal.
We are all probably aware of the fed is best/breast is best ‘debate’. I don’t see the same level of vitriol, pain, and defensiveness circling many other parenting feeding decisions. I think it is less common for mothers to fall out over whether or not they allow their toddlers to have sugar, to drink fruit squash, or to eat meat. Conversations around breastfeeding versus formula however, are such a sensitive topic that I am even nervous writing this piece. Why is that?
How we feed our babies is spoken about as though it is a decision over whether to offer the breast, expressed milk, or formula. In my experience though, amongst the mothers I know, I have rarely observed it as a ‘decision’ in the true sense of the word. In the vast majority of the mothering I have witnessed, it has instead been a route that somebody is steered down, or ends up feeling is the only option, or even the best option, but often based on inadequate information or a lack of support. We should not be expecting new mothers, with bruised bodies to heal, sleepless minds to rest, and new identities to forge, to be in a position to dig deep and actively search high and low for the help they need to feed their babies. Nor should we be putting pressure on pregnant women who cannot yet imagine how breastfeeding is going to feel, or unfold, to plan for this additional support. It should be actively offered to all mothers as standard when our baby arrives.
In order to breastfeed a baby, a mother needs more support than our society is set up to provide. If 76% of mothers are deciding, by 6 weeks, that breastfeeding is too hard, too depleting, and too damaging to their mental and physical health, we need to ask: are they actually making that decision, or is the decision being made for them? Of course there are plenty of mothers who don’t want to or can’t breastfeed, but the low rates of breastfeeding in the UK coupled with the level of emotional sensitivity and grief that surrounds this conversation, to me indicates that women are being failed. In other words, I do not believe that 76% of women want to stop breastfeeding after 6 weeks.
When I had recurrent mastitis with Ella because of a poor latch on the righthand side, I returned home one morning with a course of antibiotics, and was given a huge hug from our cleaner Gabi. She told me that she had no idea how women breastfeed in this country; when she had her babies in Hungary, a feeding support nurse came to see her every week for the first 3 months and every month for the next few months, to talk to her about feeding and help her as it shifted and changed over those first 6 months. I don’t know if this still happens in Hungary, but it is telling that by 6 months, exclusive breastfeeding there sits at 34%, compared to just 1% here in the UK.
I have come extremely close to feeling that breastfeeding needed to end with both my children, ultimately much earlier than I would have liked. With Ella, I developed postnatal insomnia after a difficult birth. Needing to be ‘on’ at night in order to feed her, or to pump, exacerbated the problem and meant that I could never get a full night’s sleep, which often due to my wired emotional state meant that I simply never fell asleep at all. Many people in my life sensitively suggested that stopping breastfeeding would be a sensible plan to preserve my mental health. With Frankie, feeding was difficult and confusing from day 1, but took until months 3 and 4 to work out that he had cow’s milk protein allergy and a tongue tie, and to get to a place where feeding ‘worked’, was enjoyable, did not cause him pain, and he slept. Again, before we had worked out the reason things were so difficult, family and friends frequently recommended that I consider formula for both mine and my family’s sake. I still find it hard to think about just how much Frankie cried as a newborn, in pain and in hunger. In both instances, I got to a place of feeling pretty calm and happy about stopping. In both instances, I was lucky that things started to improve just at that threshold point of exit. And in both instances, had I stopped, I know that I would feel deeply sad about it now – mostly because in the first instance what I needed was counselling for birth trauma and in the second instance what I needed was a large pair of scissors in Frankie’s mouth!
In the process of both these periods of difficulty, I spent a lot of time considering the Pros and Cons of breastfeeding, and working out how heavily each of them weighed for me personally. As long as women are fully informed on each of these aspects, and can spend proper time working out how they balance for their family, we can get to a place where how we feed our babies is an actual decision. A decision that we can own, that we are empowered to make in whichever direction is right for us, and a decision that we can feel stable and good about in years to come.
I am going to share a few of the biggest items on my lists – everybody will have their own very different things to consider depending on the health of their baby, their employment situation, and their family set up etc.
Here’s a major one that was a Pro for me, but might be a Con for others: Do I Enjoy Breastfeeding? I have a very good friend here in the village who did not enjoy breastfeeding. I won’t single her out, but I’d love for her to contribute to this week’s conversation if she can. Breastfeeding in the early days is almost all you do. If you don’t love it, personally I think that’s a pretty good reason to consider whether it is the best approach for you and your baby. I also think it’s great to start the balancing act by considering an aspect of breastfeeding that is about you, your happiness, and your mental health. Too often breastfeeding conversations seem to be about the baby in isolation, as though a mother’s happiness and joy does not directly affect their newborn. For me, this was near the top of my list of Pros. I have always adored breastfeeding. It must be something about how my body responds to the hormones, and my natural propensity towards intensity. In the early days of Ella I talked a bit about that intensity here. Despite the joy it brings me, breastfeeding has still been the hardest thing I have ever done, so I can barely imagine how differently I would have felt had I simply not enjoyed it as an experience.
Another big item for me was Parenting Inequality and Imbalance in the Home. There is no getting around the fact that an exclusively breastfed baby is quite literally attached to the mother most of the time. I have seen a few of us share the Aptamil-funded ‘research’ claiming that it is important to bottle feed your baby so that the father can bond with it. This is absolutely not true. If it is important to you that you are both able to bond with your newborn in a similar way, or if you are finding it hard that having contributed to your lives together so equally (e.g. working and earning money) you are now not enjoying the adjustment to a (relatively brief) period of one of you being the breadwinner and one of you being the caregiver, then of course, bottle feeding is a great way to redress this balance. But if you don’t feel this way, there is simply no need to involve bottles. I found it very tough that Christian’s relationship with both of our babies was so different from mine. I also found the sensation of valuing the financial contribution more than the nurturing one an interesting challenge that I didn’t want to ignore or bypass. Ultimately this was a definite Con for us, but one that didn’t weigh quite as heavily as the Pros. This balancing exercise is not an exact science! It’s a list of thoughts for mothers to feel their way through.
The biggest Pro for me and the item that always swung the balance in favour of continuing, was a combination of the Health Benefits and General Magic of Breastmilk. I am endlessly fascinated by everything I read and study about breastmilk. From its cancer-fighting properties to its millions of stem cells per teaspoon, from the significant reduction in cancer risk to both mother and baby, to the way your immune systems become one thing, from the fact that our magic boobs know how old our baby is, what viruses or bacteria they have been exposed to, and what time of day it is, to how breastmilk builds our baby’s gut microbiome, from how I can heal cuts, scratches and eye infections in my children with my milk, to the live white blood cells I pass to my baby at every feed. It is also worth noting that some of these fascinating processes do not happen, or at least do not happen in the same way, if you are expressing and bottle feeding. Again, whether that matters to you is personal. But it is important that we know the facts. For me, it matters enough that I mostly feed my babies from the breast, but not so much that I don’t occasionally express a bottle to allow myself to socialise baby-free. Medela has some amazing writing about breastfeeding, including an eBook you can access for free here, and some great information on the benefits of breastmilk for premature babies.
This item is perhaps the most difficult to talk about when we discuss breastfeeding. I think this is partly because it will weigh very differently in balance to the other items for every mother – and that is okay. But I think it is also because a lot of this information is just not given to us. Ever. Sometimes it isn’t even known by the people providing our babies’ care. And so to find some of it out in retrospect can be very painful, especially if it changes how this item might have stacked up against the others when considering your options.
The final item I’ll discuss in detail here is Body Image and our Relationship to our Bodies. This was a Con for me, but one that was feather-weight. Both times around I have not felt fully present as owner or inhabitant of my body while breastfeeding. For a start I am usually very flat-chested, and almost all my clothing choices reflect this. I find it hard to dress when I have a chest, and feel that I don’t quite look myself with a different body shape. Hormonally I also feel softer, and more in touch with the nurturing ‘yin’ side of my personality. Naturally I am a slightly more ‘yang’ and productivity-driven sort of a person. I should probably say something profound about it being important to have a period of time that balances that yang out, but I won’t, because I would be lying: I find it slightly annoying and cloudy, like I’m just waiting for ‘me’ to start again. Whatever that means. I can imagine this being a pretty big Con for some of us and again, I know many of us in The Village whose body image has struggled directly as a result of breastfeeding. If this one tips the decision over the edge for you in either direction, great – you, armed with all the available information, have made a decision that is right for you. This is what we should be celebrating and allowing mothers to do, wherever it sees them land.
My dream, and something I hope The Village can eventually provide is lactation-board-certified support to every new mum who wants it. Each of us should be in a position to decide what is best for our babies, our families, and for us as individuals. Often this sort of conversation feels too tricky to start. Even now as I write it I feel like I am going to be accused of saying that formula is bad. I am absolutely not saying that – and I know many of us whose babies, minds, and relationships have been saved by formula – but the fear of being interpreted in this way makes a lot of us hold onto information that we should be sharing with one another.
In the spirit of information sharing, here are some incredible free resources:
*Breastfeeding support network La Leche League – https://www.laleche.org.uk/
National Breastfeeding Helpline – https://www.nationalbreastfeedinghelpline.org.uk/
The amazing Olivia Hinge, midwife and lactation consultant who shares information via her Instagram profile – https://www.instagram.com/olivia_lactation_consultant/
The Medela content mentioned in the article above -https://www.medela.co.uk/breastfeeding/mums-journey/mothers-milk