Yesterday I was featured on an episode of the US radio/ podcast 'The Boob Group' on the subject of sexuality and breastfeeding. The Boob Group is produced in San Diego and their programmes cover a wide range of breastfeeding issues. Recent programmes have looked at hypoplasia (insufficient glandular breast tissue) and tight frenula (tongue ties) as well as breastfeeding expectations when your baby is a certain age. It's a useful resource.
On the programme where I feature, we reflect on how a woman can deal with society's messages about the purpose of her breast and work to reclaim an integrated self despite society's attempts to separate a sexual woman from a breastfeeding one.
(Presented 16th June 2012. Birmingham)
My background is in primary school teaching and, as a Year Six teacher and Deputy Head, I was responsible for the delivery of the Sex Education curriculum. My embarrassment threshold is HIGH when it comes to talking about sex, which is certainly useful for the purposes of this study and talking about it in front of 120 or so people.
What inspired me to look at this topic in the first place was a conversation I had on the phone with the mother of toddler still breastfeeding at night. She was explaining that night feeding and co-sleeping was beginning to impact on her relationship. And in a millisecond I made a whole bunch of assumptions. I thought that perhaps she was getting pressure from her partner; that he was unhappy about the lack of sex but maybe she would have been happy to continue with the current situation. A whole bunch of assumptions arose from personal experience, cultural messages and who knows where. But it turned out she was miserable as they were only managing to have sex 2 or 3 times a week and this push was absolutely and definitely coming from her.
I wanted to explore how women were balancing their roles as a sexual partner and a breastfeeding mother. I wanted to look at the experiences of breastfeeding mothers and find out more about the variety of experience. I looked at parenting forums. I read books aimed at new mothers like Gina Ford’s ‘The Contented Mother’. I read about the Gogo women of Tanzania and swapped emails with a doctor working in Papua New Guinea.
I thought my talk was going to be about how breastfeeding changes sex.
But the more reading I did, the more I became convinced that the crucial issue is not how breastfeeding changes sex but how attitudes to sex in our society impacts on breastfeeding. How sexualisation in our society impacts on the work we do, how it impacts on the choices mothers make – to feed in public, to continue breastfeeding, to exclusively breastfeed, to breastfeed once back at work.
And if we are to increase initiation rates among certain groups – women under 20 for starters – we need to understand the fundamental role sexualisation has to play.
We live in a society which has lost sight of the primary function of the breast.
We live in an extraordinary culture in extraordinary times.
Spend time looking at our society’s perception of breasts and messages about breasts and it’s frankly surprising our breastfeeding initiation rates are even what they are. The 2010 UK infant feeding survey preliminary results show they are up to 81%.
However if look further, and these results are from the 2005 survey, we have 45% exclusive breastfeeding at 1 week, 3% exclusive breastfeeding at 5 months. At 6 months, only 25% are doing ANY breastfeeding.
Yes, it’s about lack of support to breastfeed, lack of information, lack of good quality antenatal education, overstretched hospital- based and community- based healthcare professionals, lack of breastfeeding knowledge from doctors. It’s about many many new families simply not knowing why exclusive breastfeeding is recommended ahead of any breastfeeding.
It’s about all that.
But I’m also going to argue that the significant drop-off as we approach 6 months is also about women struggling to integrate their roles as a breastfeeding mother and a sexual partner, or even a woman, in this society.
In our society, the nuclear family is on a pedestal. It’s isolated and centralised. The couple is the focus. The extended family, as we hear so often, is largely a thing of the past for most families living in the UK. The average working father who has 2 weeks paternity leave and then returns to employment, who may have very few other new or changed relationships or links to the ‘baby world’, comes home to this central relationship. And the strong message is that a successful relationship is a sexual one.
As breastfeeding professionals and support volunteers, we’re used to debriefing our breastfeeding our breastfeeding experience. But when it comes to sex and libido, a discussion is not encouraged.
We may assume our experiences are normal. But we need to reflect on the variety of experiences women have. The new mother not feeling sexual may feel pressured and uncomfortable but my survey revealed just as isolated is the sexual breastfeeding mother – one described herself as a ‘freak’. Is society comfortable with a woman who is simultaneously breastfeeding and sexual? Are we allowed to talk openly about that integration?
When we talk to mothers about co-sleeping, decisions to wean, evening cluster feeding and the 4 month sleep regression – how often might sex be an unspoken part of that conversation?
As breastfeeding supporters we often think it’s living in a bottle-feeding culture that makes our work hard - the dolls that come with toy bottles while a doll marketed as having any connection with pretending to breastfeed is more likely to provoke an article in the Daily Mail. Formula companies pour money into marketing their products right up to the limits of UK legislation and often beyond. Pregnant mums are signed up to clubs - and logos and images from formula companies get into their homes and their consciousness. Formula companies offer ‘information lines’ or promote forums. Pre-schools may remove feeding bottles from home corners these days but no conversation occurs of what norms of feeding are so children simply pick up glue sticks and continue ‘bottle feeding’.
As Kathy Abbott mentioned in her presentation at the Gold conference this year, bottle feeding does fit with our culture – a culture that values privacy, control, measuring, and compartmentalisation. And when only 25% of mothers are doing any breastfeeding at 6 months, this is not just about perceptions of cultural norms. This is about actual norms. 81% of mothers initiate breastfeeding but that may only be a lick of a nipple in hospital. Something else is happening in the weeks that follow. When mothers get a baby home and live their relationship with their post-natal body surrounded by our culture, something is going on. Women are making feeding choices based on cultural messages about sex and their bodies and womanhood.
If we can’t necessarily control these messages, at least we can encourage a dialogue about them.
Our society bombards us with images of the female body. The rise of the celebrity magazine is a phenomenon of the last decade where body fascism has been taken to new levels. Women are celebrated for weight loss – but you can’t be too thin and unfeminine and they vilified in the next breath if an inch of stomach flops over the top of bikini bottoms when an individual sits down. The window of ‘acceptability’ seems frighteningly narrow. There are television programmes about looking good naked, having embarrassing bodies and the reality show with groups of young women largely defined by their surgery. The perfect female body is expected to have ‘tight abs’ and the sexy rounded stomach of Marilyn Monroe is a distant memory.
The overriding message is that breasts are for male attraction and female bodies are for male attraction. As breastfeeding advocates, we write our letters about misleading formula advertising but we also need to understand that our work is also influenced by the rise of the photo-shopping, body image obsession.
When women fall pregnant, we expect them to make a dramatic mental shift. We expect their partners to make a mental shift and reject decades of messages about what the breast is for - men who like no other generation before have been exposed to images of the sexualised breast through easy access to pornography, advertising and celebrity.
And we ask women to feed exclusively for 6 months or to 12 months and beyond. While at the same time, even those of us working in breastfeeding support do not openly talk about how to incorporate sexuality and breastfeeding.
We ask them to make this dramatic shift on the basis of some colourful leaflets often lacking in evidence-based detail, some conversations with overworked healthcare professionals and a newspaper industry that relishes an opportunity to debunk the breastfeeding ‘myth’.
How many antenatal classes ask new parents to reflect on breastfeeding and sexuality? And in how many classes are teachers terrified to dwell on a topic that might be seen as ‘difficult’ when the focus is on desperately encouraging new parents to consider breastfeeding? The new government programme of antenatal parenting classes (‘Pregnancy, Birth and Beyond’) does touch on some interesting feeding issues such as the risks of formula. It also asks parents to consider the impact of parenthood on their relationship.
It would be nice to imagine at some point, we could talk about sex and breastfeeding. The sum total of information currently seems to be ‘if you’re worried about leaking during sex, you can wear a bra and breast pad’. But what if you’re not worried about leaking? What if your partner likes it? What if he’s struggling with the image of breastfeeding in general? Is he allowed to talk about that and say that out loud? Who can these couples talk to?
Is anyone sitting around with a group of new fathers and asking them why oral sex might be acceptable but a taste of breastmilk is a difficult thought? These are conversations that need to be had.
Think about the teenage mum born in the mid-1990s. What messages have she and her partner received about breasts their entire lives? We often remark that those working with teenage mums will need to anticipate they are likely to have more body issues. But perhaps we can’t assume this current generation will ‘grow out of’ these messages. Maybe if we don’t start to reflect on the implications of the new body image obsession for breastfeeding, a dip in breastfeeding rates is ahead as these women enter their 20s and 30s.
So how do breastfeeding women feel about sex and how can we find out? We need to remember that the population of breastfeeding counsellors and supporters is unlikely to be representative of all women who breastfeed. Most of these women will have fed for a minimum of 6 months in order to undertake training with a breastfeeding organisation. Perhaps these are the women who did ‘integrate’ those sides of womanhood. Maybe they rejected the cultural norm and embraced the biological one.
Or perhaps we didn’t. Perhaps we didn’t manage to be simultaneously breastfeeding and sexual. Perhaps breastfeeding just mattered to us more and we stuck it out.
I carried out a survey of 588 women. They largely came from Twitter, mumsnet and netmums. It’s probably true that if you are struggling to feel sexual the appeal of answering questions on some lactation consultant woman’s bloody survey is small. I tried to make this point and certainly some of the women struggling did come through.
It’s also the case that a high proportion of natural term breastfeeders came through and immediately this means the survey cannot be representative of breastfeeding mothers as a whole – that world where only 25% are doing any breastfeeding at 6 months. The survey is not a great truth but it did throw up some interesting points.
I asked mothers, ‘when did you first have sex after the birth of your last baby?’
If you are a breastfeeding mother reading this, what’s your answer to that question?
How do you anticipate the 588 mothers answered? Do you think you were typical?
The results: When did you first have sex after the birth of your last baby?
(These figures are actual numbers and not percentages.)
Less than 2 weeks: 15
2-4 weeks: 68
4-6 weeks: 96
6 weeks – 3 months: 191
3-6 months: 91
6-8 months: 30
8-12 months: 17
12-18 months: 6
18 months+: 7
Not yet: 67
The ‘Not Yet’ figure also includes mothers with babies under 3 months.
It’s clear that for the breastfeeding mothers responding to my survey having sex under 3 months was normal. And in fact having sex under 6 weeks is pretty normal.
Of course, this doesn’t tell us under what circumstances this sex occurred. Was it enthusiastic or dutiful? One mother contacted me to explain how concerned she was about the phenomenon of health care professionals advising couples to have sex before the 6 week check to ‘test things out’. She was considerably damaged by her birth and followed her instincts not to try, despite a strong urging she should. I wonder how many others don’t follow their instincts.
My survey population were breastfeeding for a long time. Huge numbers were breastfeeding for 24 months plus. Half of respondants had fed for more than 18 months. Perhaps these are the women with the partners who either value breastfeeding enough to tolerate what they’re not comfortable with or they are comfortable – and these women can be simultaneously sexual and breastfeeding. They are rejecting the cultural ideal of the non-sexual mother of an infant.
I asked women how they felt about their breasts being touched during sex.
Any breast contact is popular: 125
Breast contact is OK but I don’t like my nipples being touched: 123
Varies from time to time: 172
Prefer breasts not to be touched during sex: 160
This amount of variation was also reflected in Ann Sinnott’s results when she did her own survey for her book, “Breastfeeding Older Children”.
When Alfred Kinsey undertook his research on female sexuality in 1953, 50% of women enjoyed breast stimulation. However 98% permitted the touching of breasts and 87% permitted oral contact.
It’s interesting therefore that some of society’s discomfort around breastfeeding – and breastfeeding older children especially – is the perception that the act itself is a sexual act. Not only is that untrue, research suggests that even if George Clooney was involved it wouldn’t automatically be a sexual experience for the woman.
Are women tolerating breast contact or even sex unhappily? Are they dutiful wives forcing themselves to get ‘back in the saddle’? Are they having some sort of ritualistic sex to prove something almost as the Gogo women of Tanzania have a ritual act of sex between 3 and 4 months post-partum (and then they remain celebate for the rest of their breastfeeding experience).
Are women with biologically low libidos having dutiful sex?
I asked women if they were happy with their sex lives.
Yes, very: 80
Yes, pretty much: 198
No, I wish I had sex more often: 235
No, I wish I had sex less often: 11
No, unhappy for other reasons: 35
I think those results would challenge the notion that these are women reluctantly having dutiful sex.
The open-ended questions revealed a huge variety of feelings about sex and body image. Some women felt empowered and came alive with breastfeeding, after decades of perhaps feeling negatively about their bodies. Others were feeling self-conscious and uncomfortable.
I aksed the question, ‘How has being a breastfeeding mother affected your self-image and feelings about your body?’
Among the huge variety of comments given were these:
“Although my OH finds my changed figure wonderful, I am far less confident in the initiation of sex and also (sorry if TMI) I am limited in choosing different positions due to leaking. Niiice :)”
“Given me confidence in body’s ability, which has knock on benefits for sex. LOVE my bigger boobs!!”
“We usually have intimate time soon after baby goes to sleep. I usually nurse him to sleep so my breasts look ‘deflated’ and I usually feel too self-conscious to let them hang down, so I prefer to lie-down or keep a shirt on.”
“It has de-sexed my breasts.”
“I want to continue bf but my husband is desperate for me to stop.”
“I am here as a carer, not a lover right now.”
The impact of breastfeeding was often over-shadowed about a mother’s views about her general post-natal body. Many women commented on feeling self-conscious about their stomach area or their weight gain. This is also often reflected when you talk to new mothers self-conscious about feeding in public. If the concern is about nudity, it’s often not about breast exposure but ‘belly’ exposure.
I asked women about their libido.
How do you feel breastfeeding has affected your libido?
Libido is greater now that I am breastfeeding: 25
Libido is the same as before I was breastfeeding: 163
Libido is lower but difficult to judge whether this is down to new parenthood or breastfeeding: 328
Libido is slightly lower and I feel this is down to breastfeeding: 19
Libido is significantly lower and I feel this is down to breastfeeding: 60
We’re often quick to think libido is about biology and hormones. We talk about how lower oestrogen levels affect vaginal lubrication. Or how libido might be impacted by an overabundance of prolactin ( a theory mentioned by Ann Sinnott). Clearly it’s difficult to separate factors and new mothers themselves can’t.
However if only 3% are exclusively breastfeeding at 5 months, are depressed oestrogen levels continuing as an issue for many? And if you are breastfeeding beyond 18 months, prolactin levels are not likely to be remaining at a constant elevation.
It appears to be coming back to culture again. Surely repressed libido levels are also about women not seeing themselves as sexual while they are breastfeeding. They are not fitting society’s ideal of sexually attractive woman. A society that values the non-functioning breast.
These days it appears that for many, the augmented breast is the ideal breast and its purpose is to attract the male gaze.
This year marks the 50th anniversary of the first ever silicon implant surgery in Houston, Texas. Augmentation surgery costs approximately £4000 and implants last around 10-15 years. It’s the most common breast surgery with women making up around 90% of the population having cosmetic surgery.
Obviously there are women who use implants in reconstructive surgery and women with severe asymmetry who feel augmentation surgery is hardly about trying to look like Pamela Anderson. But for the majority of women, this is about feeling inadequate with their natural breast size and feeling society expects them to look different.
From 2009-2010, augmentation surgery was up 10%.
From 2002-2007, it was up 275%.
Rajiv Groover, the secretary of BAAPS (British Association of Aesthetic Plastic Surgeons) feels this is down to ‘raised awareness of the procedure and media exposure’.
In our current society, the separation of the breast and its biological purpose is pronounced. While it’s true that many women with implants go on to breastfeed successfully (Pamela Anderson among them), if you look at the literature given to women prior to surgery this is barely mentioned by clinics and organisations and sometimes breastfeeding gets NO mention in a leaflet focusing on breast surgery for pre-menopausal women. Some procedures may leave ducts intact but damage occurs to the fourth intercostal nerve with incisions that impact enormously on successful breastfeeding as the milk ejection reflex and release of oxytocin hormone is hindered.
Ironically, if we study the shape of the augmented breast it is an engorged and full breast that very much resembles the breast of a new mother. This is the sexy image.
Picture Pamela Anderson running slo-mo down her Californian beach.
But the moment we add a drip of milk to that breast, it is immediately desexualised for the vast majority in our society (expect for the small group who reach my blog using certain search terms – you know who you are). The sexy breast is overwhelmingly the non-functioning one.
We may think, ‘Oh come on! Surely men are attracted to that type of breast precisely because it suggests fertility and provision of milk? Aren’t they just all cavemen looking for successful mates?’ That isn’t the case.Cultures vary enormously in their attitude to breasts and for many the breast simply isn’t sexual. Kathy Dettwyler in her essay, ‘Beauty and the Breast: the cultural context of breastfeeding in the U.S’ published in the wonderful book, ‘Breastfeeding: Biocultural perspectives’ emphasises the fact that this is not the default setting for all human beings.
In the 1950s, the anthropologists Ford and Beach studied 190 cultures worldwide. Of those 190, 13 found breasts sexy.
9 liked large. 2 liked long and pendulous and 2 liked upright and hemi-spherical.
I had an interesting chat with ABM mother supporter, Yolanda Forster, who is originally from Belize and remembers from her childhood, women from Southern Belize with exposed breasts who only covered up as the roads going South became paved and social mobility increased. Even today she feels that breasts are not the ‘big deal’ for many Belizeans that they are in other Western cultures and breastfeeding is the norm.
The battle to integrate the dual functions of the breast is not being fought universally.
Kathy Dettwyler says, “Most Americans view Chinese foot-binding as the barbaric practice of backward people. Yet breast augmentation surgery is essentially the same thing. A perfectly healthy, functional organ, the breast, is mutilated through surgery into something useful only for male sexual pleasure.”
And, as she points out, if a cultural view exists that breasts are primarily sexual objects this impacts on whether older children receive breastmilk, whether public feeding is acceptable and the compatibility of breastfeeding and the workplace. Do women feel comfortable discussing a topic potentially laced with sexuality with their employers and colleagues and bringing something ‘intimate’ into their place of employment?
As Kathy Dettwyler suggests, the realistic aim is not about to be asking everyone to suddenly stop finding breasts sexy. However it’s useful to recognise this as a cultural attitude if the biology is at least going to get a look in.
A leaflet in pregnancy about how lovely breastfeeding is and with references to reduction in ear infections and hospitalization is unlikely to win over decades of social conditioning.
We know that culture is bombarding us with messages about body image and attraction. If you look at the government inquiry into body image last year led by Jo Swinson m.p. and the research being done at the University of the West of England, Britain’s body image is in crisis.
We all tut when we hear of 5 year old girls worrying about being fat. Or we see the bikini tops marketed at 3 year olds.
But consider the implications for breastfeeding in decades to come. Currently, half of all 16-21 year olds would consider cosmetic surgey (University of the West of England research).
There’s a world of ‘fat talk’ where being feminine means control over food. When slim is the aim and the ideal and flat ‘abs’ is increasingly a focus, the post-natal woman is likely to feel excluded. And when overall weight loss occurs, breasts often diminish so augmentation becomes more of a requirement for many women wanting to attain the ideal body shape.
Susie Orbach wrote ‘Fat is a Feminist Issue’ in 1978. She’s currently working on a research project on the transmission of body image from mothers to daughters. She’s pushing for midwives to get involved. She says, “New mums are caught up in problems with their own bodies when they’re bringing a new body into the world. We need a counterpoint to the nonsense that we should have a pre-pregnancy body 6 weeks after having a baby or ever.”
When it comes to considering the forces against women breastfeeding to 6 months, it’s also worth mentioning a theory put forward by a man called John W. Travis and others. This theory is also touched on by Ann Sinnott in ‘Breastfeeding Older Children’. It’s one of those theories that makes for uncomfortable reading. It makes most of think, ‘mmmmm…uhhhhh…rrrreally?’ but it’s worthy of mention.
The theory suggests that the current generation of daddies of breastfeeding babies largely grew up in the 1970s and 1980s and were unlikely to have been parented according to the biological norm. This may impact on their ability to accept their sexual partner as a breastfeeding woman.
In his essay, ‘Why men leave – a hidden epidemic’ (2004), Travis states:
“As infants, most men in our culture have been bottle fed and subjected to other culturally-endorsed patterns of normative abuse, such as sleeping alone or being left to cry when their needs weren’t met. It’s no surprise, then, that most of the unbonded boys in our culture grow into men who spend a good deal of their time unconsciously seeking (and fueled by advertising that prominently features the breasts they were denied) a mommy-figure to provide them with the nurturing they were denied. ..When our “mommy” gives birth and suddenly turns her focus toward her newborn, we usually lose much of the nurturance we were getting from our partners.”
It’s a possibility.
A Breastfeeding Network supporter made an interesting point to me at the ABM conference. She suggested that perhaps this sometimes comes down to whether women feel that sex is about ‘giving’ or receiving. If a woman ends a day feeling ‘touched out’ and feels that sex is yet again about meeting someone else’s needs and giving yet more – that feels very different than if sex is a time ‘for her’. For some women, sex will be a time to feel pampered, loved, cared for. Not a time to do yet more ‘giving’ but a time for loving ‘receiving’. So perhaps the couples that move forward with successful integration are simply the ones where the men are better lovers and better communicators and better at being skillful smooth operators?
The breastfeeding supporter didn’t mean to make an overly-simplistic point. She was just touching on the idea that couples who already possess a healthy mutual communication around sex are likely to find this period easier. Of course, we need to be sympathetic. Men struggle during this time too. My survey identified many couples where a woman was feeling confused and rejected and as with women struggling with sex, men can struggle for a host of different reasons. Sometimes women in the survey were feeling desperation and described how their husbands were uncomfortable about their lactating breasts or their change in body shape. How new fathers feel about sex in the post-partum period needs to be examined in more detail and can really only be touched on in this discussion. My work also failed to examine the impact of breastfeeding on lesbian couples.
One thing that seems to come across strongly is that young men and women often struggle with the notion of the lactating breast before they become parents themselves.
The discomfort around breastfeeding in public and the ‘ewwwwww!’ factor that surrounds breastfeeding isn’t always to see. As with racism, MOST people who are revolted by breastfeeding understand this is perhaps not the modern acceptable view so tend to express their views in private or unconsciously or quietly.
However this is when social media can be useful because people see breastfeeding in public, have an immediate and visceral reaction and pick up their smartphones to express it, often imagining they are tweeting quietly to their friends.
The number of people who misunderstand that Twitter is not a private forum is rather sweet and for these purposes, quite useful.
And hats off to the breastfeeding supporters (such as @Wolf_Mommy) who trawl through Twitter and try and engage with some of these people. They are often young men and women in their late teens and early 20s:
@onyx918 I don't think there is anything normal about having any of my children sucking out anything that i put into my body.
@deonmcallister still can't get over that lady breast feeding in the library today, WHO IN THE RGHT MIND WOULD WHIP A TIT IN THE LIBRARY OF ALL PLACES!
@mariahurtado92 So I came to drink my shake and there this women breast feeding her child #ewww
@_MizJohnson Is this lady really breast feeding in our restaurant!!!!!!?????!?!?!?!?! @ the table too!!! That's what we have a bathroom for! #ClassLESS
There is a common view that a toilet is the place to feed an infant. But even women feeding their children here can’t win:
@booboo_92 This is why I hate public restrooms. I do not need to see you breast feeding your infant child!!! Ughh.
When these tweeters are challenged, they often talk about their preference for mothers to use formula or to cover up or for mothers to pump their milk and use a bottle.
The power and rise and development of the electric breast pump may have done us no favours in this arena. It removes the oral contact which for many is the area of discomfort. And in a society where campigns often revolve around the benefits of ‘breastmilk’ (see New York City currently), technology may not be our friend in this battle.
Our society is confused. While the couple is prioritised and sexuality is key, we also promote the desexualised view of motherhood. Can you be a ‘yummy mummy’? Yes, if you fulfill certain criteria. Can you be sexy WHILE you are breastfeeding? In that moment? Just as in Papua New Guinea and among the Gogo women of Tanzania, we are desexualised during breastfeeding. Women are supposed to be a functional part of a couple but they are expected to put their sexuality in a little box. They need to compartmentalize themselves. One minute they are the mother figure. When the baby is away from them, they are allowed to switch on the other type of ‘Madonna’. There are no Mother and Baby magazine articles on breastmilk and foreplay. There are no open discussions about breastfeeding and sex. One mother confided to me that she and her husband had on occasion been having sex while she was breastfeeding her infant. That concept would provoke a strong reaction for many. We need to think more about why? Would a mother even be ‘allowed’ to look lustfully at her partner while breastfeeding or use sexual language? That doesn’t follow the expectation of compartmentalization.
Sometimes women who are not feeling sexual during motherhood are told to ‘grin and bear it’. This is a phrase actually used in the ‘The Contented Mother’s Guide’ by Gina Ford. And several mothers quoted in the guide talk about using wine to force themselves back in the saddle. Women are encouraged to switch off certain sides of themselves while at the same time feeling a pressure to meet society’s expectations of successful coupledom.
If you google ‘nursing bras’ and look at the images that appear, the image is of a lingerie model seductively opening her strap clasp with the wind machine in her hair and fully made-up. She’s still doing her sexy model thing. Would she be allowed to look like that if there was a baby sitting on her lap?
Look at the images using by pump manufacturers of women with pumps attached.
Scroll down to find the lady in beige. She’s gazing seductively at her Medela pump. If there was milk in that collection bottle, would she be allowed to look like that?
And while you are opening internet windows, remind yourself of the recent cover of Time magazine.
The woman who doesn’t put herself in a box and doesn’t compartmentalize, who is sexually ‘integrated’, pushes a lot of buttons. Imagine if this woman wasn’t staring out at us with that gaze, if she was wearing loose and unfashionable clothing, if her hair and face was different. What about if she was breastfeeding a baby but still looked like that and looked out at us like that?
As another tweeter @sassycrass says, “It’s not a woman’s nudity that upsets you. Nope. It’s her liquid movement from the realm of the sexual into the realm of the maternal and back, if and when she wants.”
If the compartments were broken, if bras and breastpads came off in the bedroom, if breastmilk and sex wasn’t icky, what would the power of woman be? What couldn’t she do?
Some ‘take home messages’:
1. Breastfeeding affects sex but perhaps more significantly - our society’s thinking about sex affects breastfeeding. Things going on in bedrooms are affecting breastfeeding and it’s time to talk about it.
2. Breastfeeding supporters may need to be some of those people having those conversations and we may need to start by reflecting on our own experiences of sexuality and breastfeeding.
3. Antenatal education needs to be a time when honest conversations about sex can happen. Talk about the sexualisation of the breast. Look at advertising images. Have father-only chats. Talk about tasting breastmilk and fears and how we might be getting to 6 months happily.
4. Discussions with our daughters (and sons) about photo-shopping and body image is not just about their self-esteem or whether they might end up wanting cosmetic surgery, it’s about making a future generation of breastfeeding women and father who support them. A crucial element is how we talk about our own bodies in front of our children. We are role models. The charity ‘Media Smart’ has just launched a parent pack aimed at supporting parents in the conversations they have with their children about body image. You can download the pack here: http://www.mediasmart.org.uk/parents-pack.php
And while we’re talking about sex perhaps we should also talk about supporting breastfeeding women with contraception.
As breastfeeding supporters, we often feel that it’s important that breastfeeding women understand the value of L.A.M (Lactational Amenorrhea Method). If women are feeding a baby under 6 months and their periods have not returned and they are feeding regularly throughout a 24 hour period (at least every 4 hours in the day and every 5 hours at night), then breastfeeding alone is considered as a method of contraception of around 98% effectiveness.
Of course, if only 3% of women are exclusively breastfeeding by 5 months, these conditions may not be applying to a large volume of women.
And for many women who have spent a lifetime worrying about unwanted conception, there may be psychological barriers to trusting this method alone.
Most women understand that hormonal contraception containing oestrogen is regularly connected to a diminishing milk supply. Progesterone is also anecdotally connected to supply problems but it’s important to understand this is only anecdotal and provided a mother is 6 weeks post-partum, there isn’t evidence to suggest progesterone-based contraception is routinely a problem for breastfeeding women. If there is concern, a possibility is to trial a progesterone contraceptive pill and provided there are no issues, a different method such a the depo-provera injection or implant is a possibility. The Mirena coil delivers a localised dose of progesterone to the uterus and seems less of a concern in these anecdotal reports.
Emergency contraception is also available to breastfeeding women. The Levonelle emergency contraceptive pill is licensed for breastfeeding women and can be used up to 72 hours after sex. A copper IUD can also be inserted up to 5 days later.
For some women, the issue is not trying to avoid getting pregnant while breastfeeding but a strong desire to conceive again without ending a breastfeeding relationship.
This is likely to become even more of an issue as the average age of motherhood continues to increase. In the UK it was 28.5 yrs in 2000, 29.4 yrs in 2009 and 29.5yrs in 2010.
The Office for National Statistics states that from 1990 to 2010, the number of live births to mothers over 40 has trebled.
If you practice ‘ecological breastfeeding’ and follow all the Department of Health and World Health Organisation recommendations, the average time for the return of a woman’s periods is 14.6 months. Many women don’t feel that they have that long to wait.
If we are supporting a woman who wishes to fall pregnant, one message is that abrupt changes in breastfeeding patterns are more likely to provoke hormonal changes and cycle changes than gradual slow ones. But what else might it risk? Blocked ducts and mastitis? Or distress for a nursling? Mothers are having to make decisions that feel difficult.
The later a woman’s cycles return, the more likely that ovulation will occur before the first period. When periods return earlier, the early cycle is often infertile and a woman may not achieve luteal competence.
There is a massive range of normal. But I think it’s important to be honest as breastfeeding advocates and state that for some women, continuing to breastfeed may be compromising their fertility. There are those of us who fall pregnant easily while breastfeeding but we must not pretend this is going to be everyone’s story.
Some breastfeeding women are considering whether to undergo IVF or fertility treatment. Many clinics will ‘require’ women to stop breastfeeding. And some women will simply mislead clinics and claim they no longer breastfeed when they do. Some fertility drugs have not been studied sufficiently to ascertain their safety while breastfeeding. Clomid is commonly used but has also been used elsewhere to suppress lactation and has been connected to a reduction of serum prolactin.
Older women and women with a history of fertility problems are likely to be those mothers with a particular commitment to breastfeeding. The dilemma of whether to prioritize breastfeeding or conception can be a painful and difficult one.
I’m still thinking about sex and breastfeeding. And it appears quite a few other people are, based on the search terms that lead people to my blog.
<Waving hello to the seeker of a ‘sexy lactating woman’ or the person looking for something on ‘breastfeeding woman sex>
As previously mentioned, I’m speaking on the subject at the Association of Breastfeeding Mothers conference in Birmingham in June. I’m reading survey data (580 respondents), reflecting on academic papers and examining photographs of Pamela Anderson.
<Waving hello to the person who finds this blog after searching ‘Pamela Anderson’>
Let’s reflect on Pamela Anderson* for a moment. Let’s picture her in 1995 jogging along a beach in an efficiently- measured red swimming costume. And let’s think about her breasts.
Yes, perhaps if you are a breastfeeding mother. Yes, because that’s what newly- engorged maternal breasts look like.
The cult of the augmented breast is all about that inflated engorged look. Picture it running in slow motion...
Men do the manly equivalent of swooning.
That same breast with a baby attached or a baby nearby or...
...a drip of milk hanging?
Good God, no.
Because that would make you WEIRD, wouldn’t it? Surely?
One subtle difference – referring to the inherent purpose of the mammary gland, the one associated particularly to that shape of breast - and WHOAH, a switch is expected to be flicked and sex is disconnected.
The Western cultural view of the attractive woman is an ultra-thin woman with large breasts. We are in a mix-up. Maternal engorged breasts but ‘tight abs’ and a non-maternal torso. Young women must diet to achieve the torso shape, inevitably leading to a reduction in breast size, so augmentation surgery becomes the norm. An ‘A cup’ is seen as abnormal, even a ‘B cup’. There is a proliferation of young women starting their adult life by artificially increasing their breast size to fit our cultural ideals.
Kathy Dettwyler makes some points in her essay, “Beauty and the Breast: the cultural context of breastfeeding in the United States” that are shocking to us because we are so embedded in these assumptions, even those of us constantly reflecting on the world of breastfeeding, that we struggle to see the big picture.
Dettwyler asks us to think about the foot-binding tradition of China. The tradition that existed in China for a considerably length of time where the fetish of the tiny foot developed to an extreme and young women mutilated themselves to fit the ideals of men’s desire and sexual attraction.
“Just as it was inappropriate for people in Chinese society to let the cultural idea that deformed feet were sexually stimulating overshadow their primary biological function for walking…it is inappropriate to let the very Western cultural idea that breasts are for men, overshadow their primary biological function for feeding children”
[P.202 Breastfeeding: Biocultural perspectives. Ed. Patricia Stuart-Macadam, Katherine A. Dettwyler]
You may think, “Come on!” It’s hardly a Western cultural idea that breasts are fanciable. Men are hardly able to control their urges that come from biology and inherent attraction. Give the poor guys a break. It’s not ‘culture’ that has the Baywatch slow-motion run so admired.
You may think. You may think, “Hey, it’s evolution. We’re attracted to the breasts that look like they’ll be good providers – or something”.
However, the concept that the female breast is attractive is very much a cultural one and remarkably unpopular when you get down to the anthropology.
In 1952, Ford and Beach undertook a cross-cultural survey of 190 cultures from around the world.
In just 13 of those cultures, men found breasts sexually appealing.
9 liked large breasts. 2 liked long pendulous breasts. 2 liked upright, hemispherical breasts.
And by the way, evolution would tell you fairly sharpish that large augmented-type breasts don’t necessarily make the most effective long-term breastfeeding breasts anyway. Those long pendulous ones may well do the job far better.
Humans live in societies that find breasts sexy and they LEARN to find breasts sexy.
This isn’t bad. This isn’t wrong. But it’s where we are.
It would make life a lot easier if we somehow managed to combine this reality with the notion that the primary purpose of the mammary gland is feeding young. If we could JUST find a way to value both of those things simultaneously, life would be a lot easier.
But we struggle. New mothers are struggling to work out how to incorporate their breasts into their sex lives. New fathers are not quite sure how to process some confusing feelings and whether they are allowed to talk about some of these confusing feelings. ARE we allowed to be turned on by dripping breasts? Are we allowed to find our wives feeding erotic? Is my mouth still allowed to touch this breast?
These are not conversations for the NCT dads’ night out in the pub.
So we forge on alone.
And there are huge repercussions for the wider view of breastfeeding in society. Dettwyler is particularly talking about American society but it’s applicable to the UK. She talks about how if breasts are primarily fulfilling their cultural purpose to be sexually attractive, then a woman breastfeeding must shun that view for a while (as long as she can bear) in order to fulfil her biological purpose.
Of course, feeding in public becomes a very different concept in the society of the highly sexualised breast. That means that women also are much less likely to see breastfeeding around them and girls grow up without ever having seen breastfeeding first hand.
HOW much TIME do those of us who support breastfeeding mothers spend talking about positioning and attachment?
And how many of those conversations might be redundant in a world where, when we finally come to breastfeed and hold our own child, our brain is full of images dating back decades?
And if breasts are sexual and breastfeeding is private and part of our ‘private world’, when a mother wants to bring breastfeeding into the workplace she’s sometimes up against it. Not least because breastfeeding is supposed to be short-lived, surely? What’s she doing still wanting to pump after 6 months or even a year?
We live in a society where the extended family is often Skype- based at best. The couple at the centre of the nuclear family is exalted. Our partners are expected to fill a huge space in our lives and we also live in a highly sexualised society.
And if we’re in a bit of a tizzy about how a lactating breast fits into our sex lives and how a lactating mother continues as a sexual person, is it so surprising that the rates of mothers still exclusively breastfeeding at 6 months is so underwhelming? I’m not saying exclusive breastfeeding rates at 6 months is hardly measurable because people just fancy a shag, but I am suggesting that our cultural attitudes towards the breast has a part to play.
Dettwyler was writing in the mid-1990s.
I think if she was writing today she may take a moment to also consider breastfeeding rates among young women. If you were born in the mid to late 90s and you are a teenage mum today, what imagery of the breast have you lived with your entire life? How much more explicit is the world of the music video? How many bare breasts are used in advertising? How many celebrity mums are ‘bouncing back’ into shape? That CAR ADVERT on TV this week has the cartoon jiggling lass with the impressive cleavage.
They have been bombarded their entire lives. And they get pregnant and we expect them to switch ALL that off instantaneously and embrace a concept that they may never have SEEN or thought about before that leaflet gets thrust into their hand. This isn’t just about whether their mothers might have breastfed. This is about the fact that they are surrounded by models of the normal breast as the one designed for sexual attraction. Constantly. We expect them and their partners to just switch all that off.
Spend 10 minutes on Twitter and search for the term ‘breastfeeding’. You’ll find the supporters and lactation consultants. And you’ll also find some very very confused teenagers and young people who are occasionally encountering women breastfeeding out of the home and they literally don’t know what to do themselves. They pick up their smartphones (which they imagine are entering them into a private dialogue with just a few friends) and express this confusion.
So what next?
Anyone educating young people about breastfeeding or working with teenage pregnant mums should explicitly talk about this culture. Watch the music videos. Look at the advertising. Talk about what’s been going on and where their feelings come from and acknowledge breastfeeding might not yet feel ‘normal’ and then try and explain why in fact it is.
And let’s talk to any new parent about breastfeeding and sex. Let’s not simply leave that to the lactation fetishists.
<Waving hello to the lactation fetishists>
A breastfeeding woman can be sexy without needing to go to bed wearing an industrial bra and breast pads and a desperate fear milk might APPEAR. I’m not expecting ‘Mother and Baby’ magazine to discuss how lactating breasts can be a normal part of foreplay but if an article like that was possible, I wonder how women might think about their bodies differently? Could there be a world where women can be both sexy and breastfeeding simultaneously without compartmentalizing themselves into the polarities of ‘Madonna’ or ‘Wife on a mini-break leaving the baby with the mother-in-law’? And if that integration happens, might more women and their partners imagine happily breastfeeding for longer?
I don’t know. But if we can find a way to find breasts sexy without losing touch of what their biological purpose is, it would be a brave new world.
*And the rather fabulous Pamela Anderson breastfed successfully with her implants. This isn’t about implants being incompatible with breastfeeding. It is about WHY implants are happening in the first place and what this tells us about how our society views the breast.
Yesterday, I set up a survey on the subject of sex and breastfeeding.
I’m speaking at the Association of Breastfeeding Mother’s conference in June on the subject and although surveys have been done before, I wanted a chance to gather some raw data of my own from women currently breastfeeding.
Inevitably it’s a sensitive subject. Men and women are out there now carving new roles for themselves as parents and working out how to meet the needs of everyone in the family at the same time. And they are tired. And sometimes sore.
And we don’t live in a world that has really got its head around breastfeeding and sexuality.
We encourage women to breastfeed but we blush at the idea that a breastfeeding woman can simultaneously be a sexual woman.
There are mothers feeling isolated and uncomfortable because they continue to feel their breasts are sexual while they are feeding. They worry something might be wrong with them.
There are mothers feeling isolated and uncomfortable because they can’t comfortably see themselves as sexual women while they are feeding. They worry something might be wrong with them.
Perhaps by talking about this a little bit more, we can realise what a huge range of ‘normal’ there is and maybe no one need feel alone.
We ask fathers to support breastfeeding unequivocally and we ask them to put their own needs and desires to one side for a while. Are they even allowed to express them? The views of fathers in a breastfeeding family are the subject of another survey.
For now, I’m focusing on breastfeeding mothers and in less than 24 hours, I’ve had 132 responses to the survey.
It was just over a year ago when I took a call from one particular breastfeeding mother. She was still feeding her 18 month old and they were co-sleeping. She wanted to talk about sex. My immediate assumption was that her partner was uncomfortable with the situation, sex was infrequent and she was looking for ways to try and resurrect their sex life for his benefit. Perhaps she was struggling with her libido. I made all these assumptions in a micro-second.
But in fact, SHE was desperately unhappy with the amount of sex her and her husband were managing to have. And she wanted support with night weaning so she was less tired in the evenings.
Because at the moment, they were only managing to have sex about once a week and they were both completely miserable.
There’s a big range of normal.
Of the 132 women who have so far responded: woman aged 31-35 make up 34.8% of the respondents.
26% are 25-30.
25% are 36-40.
I first asked how long they had been breastfeeding and I’m only focusing on those currently breastfeeding as I’m not sure our memories can be entirely reliable if we’re looking back after our breastfeeding experience has finished.
A lot of my followers on Twitter are breastfeeding beyond 12 months which may not represent the average experience of the general population but I think provides some interesting insight into how breastfeeding might affect sex in the longer term. A lot of the initial response probably came through Twitter.
14% are still feeding at 3 yrs+.
Overall 47% were still feeding beyond 12 months and the rest were scattered in the age groups below 12 months.
5 women had been breastfeeding less than a month.
I asked how long after the birth of their most recent baby they had resumed having sex. It was completely up to the individual woman how she chose to define sex.
30% had had sex before their 6 week check-up.
67% had started having sex again by the time their baby was 3 months old.
89% had restarted by the time their baby was 6 months old. And of course, a chunk of respondents had babies younger than this and had yet to restart.
How did the women feel breastfeeding had affected their libido? Predictably the majority, 63%, said their libido was lower but felt this was about new parenthood and not necessarily about breastfeeding. Tiredness was a theme that came up again and again in the comments.
20% felt their libido was the same as before they were breastfeeding.
And 15% felt their libido was lower because of breastfeeding.
How often are breastfeeding mothers having sex?
1% every day.
14% more than twice a week.
23% about once a week.
20% more than once a month.
29% less than once a month.
And how often do breastfeeding mothers initiate sex? 35% never initiate it. 65% do.
How do breastfeeding women feel about their breasts being touched during sex?
29.8% prefer not. 24% aren’t sure about nipples being touched. 22% say ‘any breast contact is popular’.
I then asked women how they felt their partners’ views about sex had changed now that they were breastfeeding. The vast majority felt there was no change. A small group felt their partner was more enthusiastic (sometimes due to increased breast size). A small group felt their partner was wary of touching their breasts and concerned about triggering a letdown ( a milk ejection reflex).
Some women were unhappy their breasts were being touched less and wished their partners were less reticent. Some women preferred their breasts not to be touched and were also wary about milk appearing.
Are breastfeeding women happy with their sex life?
9% say ‘Yes, very’.
39% say ‘Yes, pretty much’.
39% say ‘No, I wish I had sex more often’.
2% say ‘No, I wish I had sex less often’.
12% are unhappy for other reasons.
And how has being a breastfeeding mother affected their feelings about their self-image and their body? Some typical quotes:
I love it more than ever, I respect the magic of being a woman much more and I know I'm a goddess
I don't think BFing has changed it. But pregnancy did. I was happy with it during pregnancy, but now weight 20 pounds more than before, and my tummy looks deflated and lumpy.
It's actually made me feel more sensual
Breastfeeding has been a positive factor. My libido has crashed due to PND [Post-Natal depression].
I feel more powerful & strong, and this confidence makes me feel sexier.
I feel flabby, droopy and unattractive despite my partners reassurances. I'm sure I'd feel more like having sex if my baby slept for more than 2hrs together!
I love my breasts and that they are feeding my baby. I don't like my post baby body. I don't know how much of my aversion to sex is from birth trauma and how much is due to breastfeeding.
I feel more comfortable about not being perfect.
Feel pleased with myself that I’ve managed it for so long but often get 'touched out'. Body shape is ok, much like pre birth. Be nice if attractive nursing bras didn’t require a second mortgage.
I love it my breasts are very slightly bigger than before and I feel very womanly.
I see myself as a mother before anything else, and my leaking breasts reaffirm this. I do not feel at all sexy or sexual.
I'm overweight, with big saggy old boobs. Breast feeding makes me feel that my body is doing great things, even if it doesn't look it's best. It's the best thing about my body at the moment
103 women responded to the question about self-image. 66 either said breastfeeding had not affected their self-image or expressed positive feelings about their breastfeeding body – pride, self-confidence, a sense of womanliness. 37 felt more negatively about their body and their self-image.
I hope more women will respond to the survey. It’s completely anonymous and I have no way of tracing the respondents. At the conference, I will be speaking to a lot of breastfeeding counsellors, breastfeeding supporters and healthcare professionals. We all benefit from knowing more about how breastfeeding mothers are really feeling.
And as breastfeeding mothers, we benefit from not feeling alone and from knowing that there is almost certainly someone out there somewhere who feels the same as we do.
You can find the survey here:
I’m sometimes asked by mums-to-be or their family with chequebook poised, what do people need to breastfeed?
When you’re pregnant, what do you need to add to your list and what can you usefully do to get ready?
A lot of people are desperately keen to breastfeed and are determined to make it work but most of their commitment to breastfeeding in pregnancy is buying a super expensive breast pump, a bunch of bottles and a steriliser.
Hold your horses.
That might all prove to be useful and especially useful if you are intending to be one of the many women who provide breast milk to their child once they return to work - but there are other things to prioritise in the beginning.
If something goes wrong, a breast pump might be your salvation but companies like Ameda can dispatch you a breast pump to arrive the next day and it will be hospital-grade and fully serviced and you won’t be stuck trying to patch through with the breast pump you probably bought for a completely different purpose. (http://ameda.co.uk/ameda-elite-hospital-grade-breastpump-rental-program)
The most useful thing you can do in pregnancy is get information.
That’s better than getting anything else.
Because unless you live in Alaska, most other things can be sourced efficiently and effectively should the need arise and having a house full of them may not send the best message to your psyche.
That might sound trite, but your belief in your own potential and your belief that breastfeeding is going to work and your faith that it probably will is part of your arsenal. Those who start with a ‘hmmmm, well, I’m going to give it a go and just see what happens. If it doesn’t work, at least I gave it a shot’ might be missing a piece of the puzzle. Your commitment and your understanding that you are a big piece of why this is going to work is pretty crucial.
Of course, for some people it might not work out. But the truth is that for the vast majority of people who really want it to work, it does. If you are prepared, if you know where to get help and when help is needed and you get help soon enough – the chances are you WILL be OK.
Those who give up early on and are unhappy about it, didn’t recognise when problems were occurring, didn’t realise what was normal breastfeeding behaviour for a newborn and struggled to find help when they needed it.
So what pieces do you need for your puzzle?
1. Read about breastfeeding.
This can start early. Do you really need to read a lot about the benefits of breastfeeding? Possibly not, but you might still not have an understanding of why exclusive breastfeeding is recommended.
Read some studies – not just a couple of pages in a jolly leaflet. This stuff matters.
You may well spend hours carrying around a book of baby names. Devote hours to this as well. Take some time to really understand what breastfeeding does for your baby and what NOT breastfeeding may do. There are links to many many studies here: http://www.unicef.org.uk/BabyFriendly/About-Baby-Friendly/Breastfeeding-in-the-UK/Health-benefits/
But read some books too. Books like ‘The Food of Love’ by Kate Evans or ‘The Womanly Art of Breastfeeding’ published by the La Leche League or Dr. Jack Newman’s ‘Guide to Breastfeeding’ or his ‘Ultimate Book of Answers’.
Make sure you have an understanding of the relationship between ‘supply’ and ‘demand’ in breastfeeding, what a good latch and body position looks like and what is a normal pattern for the first few days.
2. Think about how breastfeeding might link with your other parenting choices.
Research tells us that the majority of mothers who breastfeed sleep in the same bed as their baby for all or at least part of the night for at least some of their breastfeeding experience.
They might start out believing strongly that this won’t happen to them but somehow along the way, it seems to end up feeling like the best choice.
It’s important it doesn’t happen accidently but happens with careful thought.
Bed-sharing isn’t safe for all families but with the right precautions it can aid breastfeeding and make a family safer as a result.
You can read some important guidelines in the UNICEF ‘Caring for your baby at night’ leaflet: http://www.unicef.org.uk/BabyFriendly/Resources/Resources-for-parents/Caring-for-your-baby-at-night/
If you want to look at this issue even further, take a look at some of the work of Dr Helen Ball (http://www.dur.ac.uk/sleep.lab/projects/bedding-in/). Her study on where infants sleep in the post-natal ward and how this impacts on breastfeeding is a real eye-opener. Also have a look at the work of Dr James McKenna: (http://www.naturalchild.org/james_mckenna/)
Using a sling - not a structured upright baby carrier where the baby’s weight is compressed onto their lower spine, but a wrap or sling that allows your baby to rest in their natural position and with their baby weight evenly distributed – is something that also seems to fit naturally into the breastfeeding relationship. You can read more about this exciting world of shopping possibilities on www.thebabywearer.com and how the decision to ‘wear’ your baby is about so much more than shopping or ease of travel on the bus.
3. Write a feeding plan.
Got your birth plan? Write a feeding plan too. One sheet of A4 that explains to everyone around you what you consider important: your priorities for skin-to-skin and that early feed, what you want to happen in the event of a c-section or your birth going in an unexpected direction. On that sheet have phone numbers of helplines and local support and some key phrases to help you focus on what early latching and positioning will look like.
4. Find that local support
Don’t leave this until you are sitting there in a dressing gown with sore nipples, wondering what happened to the last couple of days.
While you are pregnant, do your research. You want 3 types of support – someone on the end of a phone, someone who can come to your home, and local groups where other mothers meet and you can develop a network of peer support and coffee friends.
Your midwife might be able to point you in the direction of all three. But if not, get hassling.
In the UK, there are FOUR charities that support breastfeeding: The Association of Breastfeeding Mothers (ABM), The NCT, the Breastfeeding network (BfN) and the La Leche League. Their contact details can be found on my links page. There are FIVE breastfeeding helplines. One for each of the charities and a fifth – the National Breastfeeding Helpline – funded by the Department of Health and staffed by the ABM and BfN.
In different parts of the UK, different charities are more active than others. You might have an active La Leche League group round the corner from you – with a dedicated La Leche League Leader and a network of supportive mentors. Or an NCT or ABM counsellor who does home visits and is a devoted volunteer. Or a Breastfeeding Network supporter who runs some local drop-ins and is a star. You might have to phone the charities to find out who is in your area.
Find who they are, talk to them WHILE you are pregnant and even better, if you can, go to a group and see some people breastfeeding. This might sound a bit weird but it really isn’t. It makes a huge difference to see some good latching and different positions and talk to others about their early days. You will be welcomed.
If someone asks you what lovely present they can buy you - the babywipe warmer or the cashmere booties? – ask for a session with a qualified lactation consultant (IBCLC). Get one round to check your latch and positioning in the first few days and answer a thousand different questions about breastfeeding and check to see you are on the right path. You can find who is your local LC by checking www.lcgb.org listings. Ask them to show you their IBCLC badge and check they have professional indemnity insurance.
You should also find some of your antenatal education focuses on breastfeeding. This will vary enormously depending on the type of class you are able to find. It’s a good place to find out who is active locally and start to build up the network of peers who may see you through some tough times.
5. Tell the people you love why breastfeeding matters.
Buy your mum ‘The Food of Love’.
Get your partner to read the UNICEF page which links to relevant studies.
Make sure people know how important this is to you and what a normal breastfed baby does in the first few weeks and what growth spurts are and what cluster feeding is. Tell people to spend an hour on www.kellymom.com and they’ll learn some things that will help them to become members of your team.
For many of us, the first time we see breastfeeding up close is when we will do it ourselves. That’s not always going to end well.
We don’t live in a culture where we’ve absorbed latching and positioning and normal breastfeeding behaviour since we were little girls. We live in a culture where bottle-feeding has been the norm for decades and as infants, fewer of us were breastfed than at any time in history.
If we want to change that, it's down to us.
Pregnancy is a great time to learn more and take responsibility.
It’s exciting and scary all at the same time – as are most things that are important in life.
And one little warning - once you start reading, it’s not always easy to stop!
I’m hoping it’s a myth that the term ‘Breastfeeding Nazi’ is thrown around willy-nilly. Usually I’ve seen it being talked about in the context of what a bloody stupid phrase it is and how could anyone possibly use it and be so dismissive of concepts like genocide, fascism and racism.
But I have to assume it’s been spoken in anger a few times genuinely. I’ve heard a minor celebrity chuck around the phrase ‘breastapo’. I imagine it can’t simply be restricted to a tabloid column.
It seems to refer to the idea that there are a group of breastfeeding supporters (who might call themselves ‘lactivists’) who are focused on demeaning mothers who use formula milk with their babies and see the role of breastfeeding promotion and protection as synonymous with making formula-feeding mothers feel rubbish.
I don’t know where these people are. I’ve been to conferences, breastfeeding picnics, training days, informal get-togethers, committee meetings with Breastfeeding Counsellors and professionals and Lactivists and I’ve yet to meet someone who would fit this description.
Oh, how I wish I would meet one because it would be a joyous moment to be able to sit one down and have a conversation with one of them and ask them what the hell they are playing at.
And if I ever met a mother who had met one of these people (haven’t had that experience either), I would ask them to write a letter to whatever organisation they were from and complain just as I urge people to complain about poor experiences at the hands of health professionals.
I know enough about the training offered by the NCT, Breastfeeding Network, Association of Breastfeeding Mothers and the La Leche League to find it highly unlikely anyone who has completed that 2 years+ training focusing on listening and empathy and helping an individual woman to reach their goals could ever be blatantly unkind to a mother who is not breastfeeding.
If someone gets through the training of any one of those organisations and can fit the criteria of a ‘breastfeeding Nazi’, those organisations would definitely want to hear about it.
I have to imagine the real ‘breastfeeding Nazis’ are the untrained or the sketchily trained: Women who don’t understand why breastfeeding might fail and are unable to empathise with why a mother might choose to use formula; Women who have their own personal issues that they have yet to come to terms with and lack any delicacy in their ability to deal with fellow human beings in many areas.
This is why I believe I am not one of these people: I have spent countless hours with families who struggle to breastfeed for a host of complex reasons. I absolutely know how hard it can be for some people and how painful it can be – physically and emotionally. I know it doesn’t work out for everyone despite their best efforts. And I spent a lot of time trying very hard not to upset people.
I often meet people who have already chosen to use formula by the time they seek professional support with breastfeeding. This is true of a lot of IBCLCs.
What on Earth would be the point of alienating these families on the first meeting?
What a breathtaking lack of intelligence and skill that would represent on my part.
90% of the time when a parent tells me they have given their baby formula, it is a fragment of a long story and not the focus of anything useful. It was something they chose to do in that moment based on a series of complex factors. In many many cases, it was the right thing to do at that time. In some cases, it was a decision based on desperation or a misunderstanding (like not knowing young babies might cluster feed for a period of 24 hours) but it was still a decision based on the best knowledge they had at that time.
Of course, I meet the people who desperately want to make breastfeeding work.
I rarely meet the people who don’t even want to try.
But don’t assume those of us qualified in breastfeeding are intent on treating those women with disrespect either.
We reflect on why families may not choose to breastfeed in our training and we get that a mother using formula in a cafe may have a background that includes issues such as insufficient glandular tissue, hormonal abnormalities, a history of breast cancer, breast surgery, significant childhood burns or sexual abuse.
We WILL NOT be the people raising our eyebrows at the mother mixing her formula bottle. Lactation Consultants and qualified breastfeeding counsellors should be the LAST people to do that because even if you weren’t one of those people and you simply didn’t fancy breastfeeding, we will still go out of our way to offer a smile.
We want you to walk away and remember our face as a friendly person.
You might want to give breastfeeding a go next time. You might need us in the future.
You might have a friend who is struggling with breastfeeding, perhaps a friend who is mixed feeding, and we want you to feel we are a person you can trust. We hope that we are.
A Lactation Consultant is professionally REQUIRED to support an individual mother to reach her goals. If a mother tells us she wishes to wean at 3 months, we support them to do that. If a mother wants to breastfeed once a day and formula feed the rest, we support them to do that. We work with a lot of people who want to try and return to 100% breastfeeding after using some formula but we also work with a lot of people who simply don’t. They want to continue using some formula and THAT is their decision. We are professionally required to support them and we do so warmly and empathically.
A few times I’ve been in conversation with a new mum who is exclusively breastfeeding successfully and they ask a question about whether to introduce the odd bottle of formula. Maybe they have a friend who does it and they don’t have to 'worry about pumping' or they’ve heard a rumour it might give longer blocks of sleep. They want to talk it through. These mums are asking for information and in those cases I do give it. I talk about why exclusive breastfeeding is recommended and how occasional formula use can change the Ph level of their baby’s gut. I discuss how this will then affect the bacterial colonisation of the baby’s gut and the symbiotic relationship between friendly bacteria and our human immune system and how these friendly bacteria help the breastmilk to protect the baby’s blood stream from allergens and pathogens. I talk about how giving formula might impact on a mother’s milk supply. I talk about the research surrounding formula feeding and sleep and how the digestion of an increased proportion of dairy casein proteins may have a negative impact on a baby’s sleep cycle and healthy sleep as well as a rumoured positive one.
I usually find that a mother asking this question has read a lot about the benefits of breastfeeding and has perhaps attended some antenatal breastfeeding education but is completely unaware of how formula use might change things. We might throw the term ‘exclusive breastfeeding’ around but it’s rather stunning how many people don’t understand what that actually means and even why it’s the recommendation.
Would I give all that information to a mother already formula-feeding?
Extremely rarely. Because it would be inappropriate and usually painfully unhelpful.
I give it to women who HAVE the choice about whether to exclusively breastfeed and are mulling that decision over. If a woman has the luxury of making that choice, they usually respect someone who gives them straight information appropriate for their situation. And if I meet that mum next week and she chose to use formula despite the information I gave, that was her choice. I want her to want to come next week.
So I don’t go up to the mother who is feeding formula to her premature baby and talk to her about risk of SIDS. That conversation may arise if a mother has opened a dialogue or if they are encouraged by the amount of breastmilk they are now able to express - if that information might be motivating or helpful. But there may be times when it would be the least helpful thing possible to say.
Lactation Consultants and Breastfeeding Counsellors tip-toe. We are careful. We know that we live in a society where not everyone gets the information we would like them to have about breastfeeding but we also know that we are unable to look inside everyone’s heads and see if that information is there.
If we get it wrong, please call us on it. Because the requirement for professional reflection and self-improvement exists every day and after every interaction.
I want there to be exceptionally good quality antenatal education. I want every woman who wants to be able to breastfeed, receive the support to be able to do so. Because it’s often the women who don’t, who become the angriest.
They are so angry at the system failing them, the information they were not given, the helpline call that was never answered, the things their antenatal class did not tell them - that they understandably want to lash out on occasion. The Breastfeeding Counsellors might seem like the just the sort of smug bunch who deserve some of that lashing. We are often in love with our own breastfeeding experience – perhaps nauseatingly so. We talk about it being ‘the best experience of our lives’. We might wear little badges and T-shirts. It’s easy to see just how frakking annoying this all might be to the person whom breastfeeding didn’t work out for.
However it’s too easy to perceive a raised eyebrow or imagine someone turning away from you in conversation when you are livid and sensitive and in pain.
We may not always understand each other's motivations.
Accepting you do not understand someone’s decision (to breastfeed the 3 year old, to formula feed the 3 week old) does not mean that person should not be treated with kindness, care, consideration.
If anything we should try harder to be kinder to the people we do not understand. It's how dialogue happens, how we learn how to support fellow human beings, how the future gets better.
It’s in professional codes of conduct and it needs to be in every action, gesture, glance between every mother.
I spend a big chunk of my life talking to new families and supporting them. I offer breastfeeding support at 3 children centres in North London. I meet a lot of people in the first few days after they’ve just given birth and often see them through the following weeks or months.
I have taken approximately 700 helpline calls in the last 4 years and the majority of those were from parents in the first month post-partum.
It’s an honour to be in a position where I can feel I am making a real difference to people’s lives.
But sometimes I feel like climbing to the top of the BT tower and screaming from the top of my lungs, “I’m mad as hell and I just can’t take it anymore.” (as Peter Finch did in his Oscar-winning performance in the film ‘Network’, though he was less concerned about boobs).
Something has gone fundamentally and criminally wrong in the way breastfeeding is supported in this country.
It’s gone so wrong, it’s jaw-dropping. Some of it is surreal. Some of it is literally incredible.
Mother gives birth in a hospital. She might come across a midwife who is able to offer her some initial breastfeeding support. She may come across 5 who all tell her something slightly different, using slightly different phrasing. Oh – and one grabbed her breast and shoved it towards the baby.
Mother leaves hospital and she is sore. Something is going not quite right with breastfeeding. She perseveres and her midwife visits in the next couple of days. However she is never given even a rough idea of when the visit might occur – just a day – so she can’t plan her baby’s feedings to correspond with a visit and when she gets lucky the midwife can attend only briefly. She says something else that contradicts entirely something the new mother was told in hospital.
The mother is getting sorer.
She calls a helpline. Maybe the National Breastfeeding Helpline. The breastfeeding counsellors there are well-trained and they can help.
But let’s pause for a moment – this new mother has spent many hours in a hospital under professional care. She’s under the care of a midwife. And her best shot now rests in the hands of a volunteer who trained with a charity – a charity which counts the pennies and struggles to meet their goals as government grants disappear. This volunteer has one child watching Peppa Pig in the room next door, another asking for crackers and dinner on the hob.
Can this mother get a home visit from a trained breastfeeding counsellor? That is utterly dependent on whether she happens to live near a volunteer who has a home life which can support that possibility and the money for transportation. A counsellor may come and visit but no one will be paying her expenses. Often a counsellor might not be available and will do the best she can over the telephone.
A midwife might come again. She might even say, “the baby’s latch looks OK” and when the mum seems doubtful she will refer the mum to some local support groups.
These local groups will again often be run by volunteers and may be in children’s centres where funding has been slashed and there are now closed for certain days of the week or for several additional weeks each year.
Maybe the mum has had a c-section and can’t travel. The breastfeeding counsellors on the telephone have tried but they suggest a face-to-face consultation with a trained expert is really needed to find out what is going on.
The mum pays £60-75 for a consultation with a lactation consultant she finds through the Lactation Consultants of Great Britain website (lcgb.org).
The IBCLC immediately identifies the baby has a tongue-tie and needs a small procedure at the local hospital. The tongue is released the next week and the baby goes onto to breastfeed successfully for many months.
That story is not freakish or strange. It’s pretty standard.
The baby’s tongue tie was supposedly ‘checked’ by the paediatrician in the hospital. It wasn’t picked up by the midwife. The telephone support wasn’t able to pick it up. Luckily that mother had the money to pay to see an IBCLC or breastfeeding probably would have ended within a few more days.
Or maybe the baby didn’t have tongue-tie. Perhaps the IBCLC just gave some support with latching and positioning that for some reason the midwife was unable to give.
I write out that story and I see faces of mothers and babies flash in front of my eyes. The mother with the 6 week old who had been struggling to breastfeed with damaged nipples and had finally made it to a breastfeeding group and we could see the baby was significantly tongue-tied within a minute. The father who tried to describe the range of advice they had received in 24 hours: feed from each breast for 10 minutes, for 30 minutes, just stay on one breast, stay on one breast until the baby loses interest and then offer the other. The mothers who are confused and distressed at the most emotional time in their lives.
This system is FAILING.
I sound like I’m blaming midwives. I’m blaming the system that governs them. I don’t believe for one second a midwife would CHOOSE to only get to spend 20 minutes with a desperate new family and then thrust some information about groups and dash out of the door. Hospital midwives might be supporting 10 women on a post-natal ward overnight. Several of them might have had c-sections and not even be able to lift their own baby. Hospitals might employ a lactation consultant who probably only works office hours. You might even bump into some volunteers who offer breastfeeding support on the ward. But a common tale is a mother desperate to get out of there. Or maybe the dad is phoning a helpline from the pavement outside the hospital (there’s been a good selection of those in my 700 calls).
I spoke to one midwife (who went on to train as an IBCLC and become a specialist feeding midwife) and she recalled hiding in the nurse’s station because she knew a mother needed breastfeeding support and she just didn’t feel up to the job.
And why is there even such a thing as a midwife who specialises in breastfeeding? Surely that demonstrates the flaws in our system eloquently. Why aren’t ALL midwives specialists in breastfeeding? If they are not, can we please get some people who ARE into new families' homes in the first couple of weeks?
Can I blame the system that governs health visitors too? The system that results in some golden health visitors who know exactly what they are doing. And others who see a baby struggling to gain weight and literally have nothing else to say other than ‘top up with formula’. They know nothing about how a mother might improve the efficiency of latching and positioning or use breast compressions with a sleepy baby or how a mother might develop her own milk supply or use expressed milk as a top-up.
This whole system is based on luck and fluke and more often a lack of lucky fluke.
And thousands of mothers and babies are being failed every single day.
The last full national infant feeding survey to be published recorded that 90% of mothers who gave up breastfeeding in the first 2 weeks wanted to continue.
That’s such a massive group of women being failed in hospitals and by a lack of community support up and down the country. They are starting new motherhood with a struggle and sadness and that can never be recovered from entirely.
And these mothers can be so angry. And of course they should be. They’ve been fed a lie that we are a breastfeeding-friendly NHS and a breastfeeding -supportive system. Wouldn’t you assume your midwife had a clue about breastfeeding beyond the basics? You might even assume they had equal training in breastfeeding to a breastfeeding counsellor – whereas a midwife might have had a TENTH of the training that volunteer handing out crackers has received. Wouldn’t you assume a paediatric consultant knew how to identify a tongue-tie in an infant? And would be looking for one?
We live in a country which mumbles the phrase ‘BREAST IS BEST’ (Oh, how I hate that phrase because breast isn’t ‘best’, it’s just normal). We have the posters and the snazzy pens and the helplines but it’s a system built out of balsa wood. Held together by PVA glue mixed with water.
The support IS NOT THERE.
What should happen?
Let’s start by aiming for UNICEF baby-friendly status across the country and get people properly trained. Let’s look at the quality of night staff and agency staff in hospitals in particular.
But before we even get there, let’s give everyone who deals with mothers and young babies ONE sheet of paper that describes a handful of basic facts: the importance of mother and baby skin-to-skin, what a good latch and body position looks like, how a young baby might feed on one breast for 10-45 minutes and may or may not want the other side, how to tell if a baby is swallowing, what nappies look like in the first week, how cluster feeding and growth spurts work.
Put that on one side of A4. Give everyone an hour to look at some online videos of good latching and a bit of breast compressions. How much would that cost?
Give health visitors another sheet about latching and positioning, techniques to increase milk supply and ways to optimise breastfeeding management. Of course, some know this and a great deal more. But let's give out these sheets and start conversations where the golden ones have open dialogue with the health visitors that need the basic information desperately.
I think those 2 sheets of A4 could do a lot. And they already exist in various forms but who has the inclination and money to distribute them. Would all midwives and health visitors read them?
Because there are midwives who believe their ’10 minutes one side, 10 minutes the other side’ is right and their overconfidence is hurting new families all over the country.
There are GPs advising mothers to stop breastfeeding because they have mastitis or misunderstanding the symptoms of nipple thrush and their overconfidence is hurting new families all over the country.
Distribute those A4 sheets and give those hours to watch videos and of course it saves money in the long-term. Some babies aren’t readmitted with dehydration or with gastroenteritis in their first year. Some employees have less absence when their 7 month old baby is still breastfeeding and has a reduced likelihood of ear infection or respiratory infection. And a reduction in likelihood of illnesses and conditions carries on into adulthood. A baby girl breastfed is less likely to develop breast cancer herself. How much training do you think can be paid for out of the bill it would cost to treat one woman with breast cancer?
Train health professionals in breastfeeding to an adequate level and we save money over decades.
But it’s not happening and those of us passionate about breastfeeding are picking up the pieces. And the health professionals in the system can only be stretched and miserable too.
I’m mad as hell and it appears I just have to take it. Because this is the ‘big society’ where money leeches out of the NHS and the people handing out crackers give the frontline breastfeeding support.
What will change it? If every mother and father who had received poor information in hospital or in the community subsequently wrote a letter to say so – the system would start to notice. If hundreds and thousands of letters came pouring in, that cannot be ignored.
So the next time you meet a mother who tells you about an experience that falls short of what they deserve, urge them to write that letter. It’s a small start.
There are a million other things we could do but we can at least start there. Let’s at least start telling people we’re mad.
Babywearing [verb] : carrying a baby in a soft pouch, sling or wrap - sometimes for several hours in a day. Babywearing is often about a physical convenience but advocates also believe it has an important emotional and psychological benefit to the mother/ baby dyad.
Why do you think babywearing often seems such a natural step for a breastfeeding mother? Why is it that when you go online the parenting sites that are openly supporting breastfeeding past 12 months inevitably have a membership also passionate about slings and babywearing?
It doesn’t seem much of a stretch to suggest that when a mother achieves the biological norm of breastfeeding successfully, babywearing naturally follows and is often an integral part of that instinctive natural parenting style.
If we are advocates of breastfeeding, then babywearing is profoundly and intimately connected with that and should be. There is evidence that is hard to ignore. It’s not fashion any more than breastfeeding is fashionable.
It is not the babywearers who should justify themselves but those found really only in modern industrial societies who value a baby’s ‘independence’ and ‘self-reliance’ over their natural evolutionary instincts.
As Meredith Small says in her book, ‘Our Babies, Ourselves’: ‘during 99% of human history the pattern of infant eating, sleeping and contact was thus – human infants were carried all the time, probably slept with their mothers and fed frequently throughout the day’.
A society losing touch with the concept of mother/child physical closeness finds that losing touch with breastfeeding is really not far behind.
And is it really just coincidence that as breastfeeding rates climb again it becomes less and less unusual to see a baby in a Moby Wrap in the supermarket queue?
To promote babywearing and discuss it as the biological norm obviously can make other mothers who choose not to do it uncomfortable or even feel guilty (here comes the 'uncomfortable reading' bit). There are able-bodied mums who would be perfectly capable of baby-wearing but will instead strenuously support their desire to travel around town with £400 worth of baby tank in the belief this is more 'convenient'.
A Bugaboo Cameleon currently retails at Mothercare for around £765. For that price, you could get a decent sling and actually hire someone else to walk alongside you carrying your baby for you.
The anti-babywearing group make statements like:
‘It wasn’t right for my family’,
‘Not all babies are the same’,
‘I didn’t do it with my baby and she was perfectly happy and healthy’
‘My friend did it with her baby and she was so attached she could never put her down’
‘Perhaps it was the best thing for my baby but I don’t think it was for me and of course – a happy mother means a happy baby’
‘I tried it but I could never get comfortable. I tried to find someone to show me how to do it properly but I could never get the hang of it so I gave up’.
These arguments sound familiar to those of us working in the frontline of breastfeeding support.
And just as we may tip-toe the line between promoting breastfeeding and NOT making those who choose to formula feed feel guilty, there is some evidence that is impossible to ignore with babywearing too. Whether or not we make past or present mothers feel uncomfortable cannot be the driving force. New families are entitled to the correct information and then they can use that to make the choice that feels right for their family. But without information, there is not a genuine choice being made.
Our society – that is the Western industrialized society – is an unusual one. As Gabrielle Palmer wrote in Politics of Breastfeeding: “Western culture seems to have a drive to separate mothers and babies. The goal of independence starts at birth and mothers who want to stay with their infants most of the time are viewed as ‘possessive’ or ‘eccentric’.”
In the society where babywearing is rare, breastfeeding rates are lower. Why? We can assume babywearing makes breastfeeding easier, more effective, more likely to continue.
Perhaps there are also reasons deeply seated in our culture. The society that wants a baby to be self-reliant as soon as possible, self-soothe and sleep independently then creates adults who as parents have less inclination to babywear or embrace breastfeeding.
Anthropologists have noticed an undeniable pattern.
Dr. James Prescott has made a career out of identifying the origins of violence and social alienation. In a series of studies for the American National Institute of Child health and Human Development, he found that he could predict with an 80% accuracy the peaceful or homicidal violent nature of 49 tribal cultures from a single measure – was the baby carried for the majority of the day for the first year of life?
Jean Liedloff in ‘The Continuum Concept’ places a very very high emphasis on this ‘In Arms Phase’. And if this is missed the child lacks a fundamental piece of their confidence and emotional development. So we can assume those reading (and writing this) are deficient then? Well, she would say ‘yes’.
She says “normal deprivations are now so tangled in the meshes of our cultures that they are almost unremarked except at such extremes as manifest themselves in cost and danger to the rest of us (through violence, insanity and crime for example)”.
Noone wants to be told they have made parenting mistakes. It is the sort of discussion that cuts to our core and there is noone angrier than a mother who is told, 'perhaps you didn't make the best choice'. I didn't babywear my first child anything like the way I wore my second. He spent time occasionally travelling here and there in a popular brand of upright carrier which I have since learnt resulted in his body weight being compressed on his lower spine and did him no favours either physically or emotionally. Will he be emotionally stunted? A damaged adult? A less responsive father?
I don't know.
Has it been painful reading and researching babywearing? Learning how true babywearing optimises infant respiration, heart rate and growth and reduces crying? Remembering how he spent hours lying in a moses basket with no human contact? I was physically able to carry my baby in a sling for a significant portion of the day but I didn't. Largely because I had never heard it was a good idea. I had never come across a discussion of the evidence and noone had ever mentioned it to me as a possibility. Carriers and slings were simply for getting from A to B. They weren't 'better' than prams. They were just easier than on the bus.
It's not easy reading about what he might have missed out on. But I am not about to stick my fingers in my ears and say, 'La La La La La' and ignore the overwhelming evidence.
It would have been better for him to spend more of his first year in a sling. It would have made his life easier and my life easier.
In a society which prizes mother/baby separation, the promotion of babywearing and breastfeeding is an inevitable struggle.
We may blame the 20th century baby 'scientists' for instilling us with the strong sense that sleeping through the night, longer feeding intervals and baby self-soothing are the ultimate goals. But in the 21st century the core values appear to be the same.
For Tracy Hogg, 'the baby whisperer', and another best-selling nanny 'guru', the central aim for parents is assumed to be independently sleeping babies with appropriately spaced intervals between feeds.
In ‘Secrets of the Babywhisperer ‘, we are told that on the fourth day a baby should start their EASY routine – feeding ‘every 2 1/2 to 3 hours’. When Hogg discusses babywearing she says, “Parents often don’t know when the comforting ends and the bad habits begin. They continue to hold the baby way past meeting his need...Instead of holding him endlessly, pick him up when he starts to cry but put him down as soon as he is calm...You might have to pick that baby up twenty or thirty times or more”.
It seems that for many baby 'gurus' and sadly for some health professionals in the community too, the baby is not to be trusted. Rather than being seen as a sophisticated product of evolution it is mistaken or at worst attempting to manipulate.
When a baby wants to be constantly held something is wrong. Mothers can create ‘rods for their own back’ with constant attention. It is not in some 1950s nightmare where people talk of how you can spoil a baby.
When we trust baby and trust our own maternal instincts to hold, to respond to cues – breastfeeding is more likely to succeed and humans fit their evolutionary expectations.
Unless we face up to the juxtaposition between our society’s desire to increase breastfeeding rates while simultaneously valuing the separation of mother and baby what can the future be? Will breastfeeding rates simply plateau?
Why do we think breastfeeding is a good idea? It’s not just about nutrition, white blood cells, enzymes and lower rates of diabetes – it’s also about nurturing and emotional health. As Gabrielle Palmer again says, ‘it’s not just the milk that counts’.
Babywearing aids breastfeeding and also aids us to meet the goals that breastfeeding also strives to meet. When we speak to a mother struggling to ‘put a newborn down’ and pushing against her maternal instincts or guiltily 'confessing' she let her baby sleep near her let’s not assume she has chosen her parenting style or was even consciously aware she had options.
In the future a decent sling may be seen as important to a baby’s overall health as a car seat. And future generations may look back on our sluggishness to babywear as I look back on my parents’ generation in the 1970s who didn’t breastfeeding in their millions and commented they 'didn’t even realize it was important’.
A collection of articles here: http://www.thebabywearer.com/index.php?page=bwbenefits
Hunziker UA, Garr RG. (1986) Increased carrying reduces infant crying: A randomized controlled trial. Pediatrics 77:641-648
The Baby Book. William and Martha Sears
The Continuum Concept. Jean Liedloff.
Dream Babies: Childcare advice from John Locke to Gina Ford. Christina Hardyment.
Why love matters: how affection shapes a baby's brain. Sue Gerhardt.
Our babies, Ourselves: how biology and culture shape the way we parent. Meredith Small.
For support with babywearing:
Copyright Emma Pickett 2011 (portions appeared previously in Association of Breastfeeding Mothers magazine and in an ABM conference report)
It’s not rocket science, it’s biology. Part 2.
Is this a mother with a supply problem? No, it is not. Her baby may continue to feed 2 hourly or even less for a few months during the day, cluster feed at certain points and perhaps continue to wake a couple of times hungry at night. Her friend’s baby may settle into a pattern of feeding less frequently over a 24 hour period. This friend’s baby may not be receiving more milk overall.
I’ve got a lot to say about breastfeeding and parenting. Some might be new but a lot of it will be old. In fact that should be spelt as ooooooold. Stone- age old. Pre-stone age old. But it has to said anyway. If I sneak it out during the X-factor live show maybe not many people will notice.
We need the science bit.
Mammals comfortably split into 4 groups in terms of their parenting styles. These parenting styles are directly reflected in the constitution of their milk – fat and protein and carbohydrate levels vary dramatically among mammals. Guinea pig: fat levels can be 46%. Human milk: pretty stable at less than 5%.
We’ve got the cache mammals who hide their young away somewhere hopefully inaccessible from hungry coyotes and potter off and look for food and presumably do other useful things for up to 12 hours. These mammals need to have milk rich in fat and protein and these youngsters are left to fend for themselves. And at birth, the newborn mammal is relatively mature. Think rabbit. You don’t see rabbits hitching a ride on mum’s back. But – hang on - what’s a rabbit going off and doing for up to 12 hours at a time? Let’s not dwell on that bit. They’re cache mammals.
I think you can imagine where I’m going with this.
Nest animals will feed about every 4 hours (Wolves, dogs, cats). The more immature young will huddle in their group and need to feed more frequently than a cache mammal.
Follow animals feed about every 2 hours. Cows and Giraffes are again reasonably mature at birth. They are capable of keeping up.
And carry animals feed virtually continually. Feeds will often be clustered and intervals might be quite short. Fat content of milk is extremely low (Apes, marsupials, us).
In terms of maturity, these carry newborns are as about as dependent as it gets. Without close bodily contact with parents, respiration rate and oxygenation rate, heart rate, growth, stress hormone levels – this stuff doesn’t start to look good.
When it comes to the maturity thing, we are spectacularly rubbish. And you can blame a battle we’ve been fighting for hundreds of thousands of years: Human pelvis shape Vs. Human brain size. Our brain is enormous and our skull reflects that. But – oooops – we seem to like walking upright and that produces a problem. We need a neat upturned pelvis that holds our weight and gives us nice straight legs. Any more extreme than what we currently have would not be ideal for the easiest birth experience. So nature holds back a bit and we might give birth to a relatively huge-brained baby but brain development is still nothing compared to what it will be. The brain is still barely only a quarter of its adult size. By aged 2, it’s about 80% of its adult size. We do a heck of a lot of our development outside the womb.
Just as little squirmy pink kangaroos are born and wriggle into their mother’s pouch and stay put for as long as they can get away with, so our newborns need us profoundly.
No, this doesn’t mean they need a nutrition fix and then get wrapped up and put back in their moses basket across the room again for several hours. You’ll have caught the bit where we’re not wolves or wild cats.
And nor should we be pulling our hair out if they’re not sleeping through the night for a 12 hour stint at 2 months. Not rabbits either.
You can read more about this if you look into the work of Dr Nils Bergman who has been pioneering Kangaroo Mother Care in South Africa. In his eyes, close contact with baby and frequently offering the breast isn’t about the care of premature or unwell babies. It isn’t some freaky hippy option preferred by the muesli-knitters. It’s just science and it’s who we are as a species. If it makes you sad, by all means try something new and try and find something that works for your family. A lactation consultant can help you try and tweak your baby’s routine. And yes, constant feeding and unsettled behaviour might suggest a problem that needs addressing.
But know that frequent feeding and a baby ‘that just won’t go down’ is the norm. The baby that feeds and settles and but wakes and becomes unhappy when placed on a cold unhuman surface is the norm. Put clocks away and tap into those millions of years of evolution. Trust that we’ve got to where we are as a species because baby’s exhibit useful cues and we respond. Babies grow with milk and love. And it works.
This message is at the heart of a lot of what we need to talk about when it comes to parenting.
We need to know how things went pear-shaped in the mid to late 20th century and why our breastfeeding rates reached an ALL-TIME low as a species when we tried to impose artificially- constructed ideas onto our biological norm.
We need to know how many of the most popular babycare books on the market today are STILL informed by these 20th century ideas – that were just a blip on the landscape of human society historically and globally.
And there are parents out there right now who think a baby that longs to be in their arms is some kind of personal failing. Phrases like ‘spoiling a baby’, ‘rods for our back’, ‘show them who’s boss’ come from this unnatural blip. Our parents and grandparents embraced the mid-20th century blip and sometimes need desperately to see a validation of their own parenting choices in the decisions that we make. It doesn't make for easy family relationships when we say, "actually we don't feel wearing my baby in a sling or feeding more than 4 hourly is 'spoiling my baby', thanks gran."
New mums who worry that their baby still feeds 2 hourly most of the time at 3 months and that this means something is ‘wrong’ need to know the science of breastmilk and breasts. There are babycare books with sales booming who fundamentally misunderstand how breastmilk storage capacity might impact a mother’s intervals between feeds and have ignored research from the last 2 decades. There are mothers out there who genuinely think they should be aiming for 4 hourly intervals.
More on how biology informs our natural feeding intervals and this new research in the next post.
To be continued.