Opinion
Shaming new mothers isn’t working. The medical profession needs to change its tune
Emily Cook
WriterIn a few days, my social media feed will be “milk-washed” for World Breastfeeding Week —overflowing with perfectly curated images of mothers, likely in a meadow, maybe wearing a flower crown. They’re lovingly cradling their little nurslings, who gaze up adoringly at them as they fill their tummies with mother’s milk.
It is a lovely image, and I’m all for celebrating a successful breastfeeding “journey”, as it’s now invariably termed. But what these images gloss over is the under acknowledged — and damaging —flipside.
Breastfeeding is consistently promoted over formula, leaving many mothers feeling guilty.
Mothers who cannot, or chose not to breastfeed are “less than”. They are bad mothers, and they have failed their duty to their child. This message is not solely confined to high-horse Insta influencers. It is routine from health professionals from the moment a positive pregnancy test appears. And for some new mothers, it’s a message that has the potential to cause lasting, and even lethal, harm. I know this because I have survived breastfeeding grief and postnatal depression when I couldn’t breastfeed my firstborn.
As I now approach 10 months of exclusively breastfeeding my third baby, I’m realising that I am far from alone.
When breastfeeding fails, many vulnerable and chronically sleep-deprived mothers feel like a failure too. Australia’s maternal mental health records speak volumes of the need to do more to support mothers and babies in every respect, including feeding.
Tragically, suicide is among the top three leading causes of maternal death in the postnatal period, according to the Australian Institute of Health and Welfare. The Black Dog Institute claims that around one in five Australian mothers experience perinatal depression or anxiety, and studies have shown that breastfeeding cessation is a risk factor for these conditions. Conversely, extended breastfeeding has been linked to lower rates of anxiety and depression.
Breastfeeding is the benchmark from which we are conditioned to define ourselves as mothers. Even the word ‘Mamma’ itself is derived from the Latin word for mammal, mamma, meaning breast. Yet, for something touted as the most natural thing in the world, an increasing number of women in high-income nations are shunning breastfeeding.
A recent study with over 530 Australian mothers, published in January by University of Newcastle researcher Renee Reynolds in the International Breastfeeding Journal, gives us clues as to why. While the majority of Australian mothers (95 per cent) initiate breastfeeding, only 39 per cent of infants are still exclusively breastfed by three months of age. The most common reasons for stopping were breastfeeding challenges (47 per cent) and low milk supply (40 per cent).
For decades, the public health response to lift breastfeeding rates has been to promote the benefits of breastfeeding, ad nauseam. All while tightly policing information about any feeding alternatives. As a signatory to the World Health Organisation’s International Code of Marketing of Breast-milk Substitutes (1981), Australia has implemented the Marketing in Australia of Infant Formula: Manufacturers and Importers Agreement until 31 July 2024. This agreement places strict parameters around what infant formula manufacturers can say, in a bid to protect breastfeeding rates. But Reynold’s study indicates that when it comes to breastfeeding success, the issue is not intent — it is execution.
Our pro-breastfeeding public health messaging has overcorrected. Mothers are exposed to countless reminders on the importance of breastfeeding — in the doctor’s office, at midwife appointments, and most zealously on social media. You cannot enter an infant formula website without first accepting a pop-up informing you that breastfeeding is best for your baby. Worst of all, the hospital midwives and medical brochures endlessly referring to formula as ‘artificial feeding’, akin to feeding your precious baby plastic.
Ramming these messages down mothers’ throats is clearly not having the intended outcome. Mothers do not need to be convinced of breastmilk’s superiority. The problem is not education, it is access to affordable and high-quality breastfeeding support.
Visiting an International Board Certified Lactation Consultant (IBCLC) — who provide the gold standard of lactation education and care — can cost upwards of $200 per session. If we genuinely want more women to breastfeed, allowing Medicare plans for lactation support, as we do for other allied health issues, is a good place to start. All the way back in 2007, a Parliamentary Inquiry into breastfeeding recommended giving all lactation consultants a Medicare provider number, but in 2023 this is still a pipedream.
This World Breastfeeding Week, health professionals and policymakers would do well to confront an uncomfortable possibility — that pressuring new mums to breastfeed without providing critical supports to do so is setting them up for failure. Guilting mothers into breastfeeding at all costs is handling the wrong end of the stick.
Support is available from the PANDA National Helpline on 1300 726 306 or Lifeline on 13 11 14.
Emily Cook is a mother of three young children and a freelance writer based in Sydney.
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