I don't think I'm a Nazi

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 for 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.

It's true 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.