Thursday, 14 February 2013

Academic lactation

When the lecture by Joan Wolf at the University of Kent at Canterbury was advertised, I felt I just had to go. The title immediately raised my interest: 'Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood'. The lecture was based on her 2011 book of the same title. One tiny problem – I have a 7 week old baby. Well, I thought, this may be a good opportunity to breastfeed in public. What better place than a lecture that questions the rhetoric surrounding breastfeeding promotion?

I was a little nervous. I wasn't too concerned about breastfeeding at the lecture as I wanted to make a point by doing so. My greatest concern was that baby has been somewhat colicky for the last few weeks. At around 7 o'clock she starts up crying and goes on till around 9, with the only solution being relentless laps of my house with her in a baby carrier. So, I was a little worried that the cries may begin at some point during the lecture, meaning that to be fair to the other attendees, I would have to leave.

The lecture began and baby was feeding, but a bit squirmy – which is often a sign that colic is coming. Around 10 minutes in I decided to wind her in an effort to postpone the screeching and she proceeded to throw up over me and the floor. I wondered if this was he critique of the lecture? However it did seem to offer her some relief and she breastfed quietly for the majority of the remainder.

I must say that I cannot agree with my daughter's nauseous verdict on the lecture.  I found it fascinating. I feel that in some articles I have read, Dr Wolf has been misrepresented and quoted out of context. In my opinion her reasoning was sound and I would like to offer my interpretation of what I heard.

Dr. Wolf began by questioning the scientific research surrounding breastfeeding, as many studies are methodologically flawed and can only suggest correlations rather than causal relationships. They cannot, ethically, remove all bias as it would be wrong to randomly assign mothers to breastfeeding or bottlefeeding groups to ascertain the outcomes. Therefore, there may be other cultural or social factors that influence the outcomes such as better hygeine or higher levels of education in one group or the other.

Today's society is one that puts great value on risk minimisation. We do all we can to prevent death or disease. In particular, mothers (more so than fathers) are expected to minimise all risks to their children. Dr Wolf claims that in the case of a mother, it is expected that she will do so regardless of the personal cost. For example – does it make sense for a mother to breastfeed if it puts her at emotional or psychological strain? We may argue that it is right given the health benefits to the child. However, as already established, many of those are not irrefutable. Also, why do we so easily disregard the maternal cost? So then perhaps, are there cases where it is less risky to formula feed?

Equally concerning is the advocacy of breastfeeding. Dr. Wolf highlighted that while breastfeeding is promoted by governments with the caveat that women must not feel pressured, in reality this is something of an oxymoron as it surely only adds to the pressure. She also descirbes the 'viciousness' of some advocates in their responses to her book, where she has even been compared to a holocaust denier. It seems that it is inconceivable that one would question that breastfeeding is best for all babies.

As a breastfeeding mother I am of course pro breastfeeding. However, I have seen the emotional struggles of my friends who 'fail' to breastfeed, and therefore feel they have 'failed' as mothers. It seems that to be a good mother, you have to be a breastfeeding mother and I cannot help but disagree. When you look at the experiences of some women it appears that the stakes were against them when it came to breastfeeding and why should that be something that they should feel guilty about? What if they are unsupported, ill informed, or quite simply find breastfeeding abhorrent? Don't get me wrong, breastfeeding has been life-changing for me, but, for others it could be a very negative experience. Surely then it is wrong for it to be promoted at all costs?

What I want to see, and I doubt I will in my lifetime, is a culture that accepts maternal choice. If you can and want to breastfeed then you should be able to do so, fully supported by your peers and by health professionals. You should have information and emotional support. You should have seen breastfeeding as a normal everyday occurrence. You should feel comfortable to breastfeed wherever and whenever you want. However is you want to formula feed then that should be acceptable. No good mother would purposefully harm her child – a decision to formula feed comes from a good place. Formula feeding mothers should be able to do so without fear of condescension or vilification, they should be awarded the same respect as any mother. Equally, they should be supported in their decision and provided with information that allows them to formula feed safely.

As a scientist (I have a bachelors degree in a science discipline and am awaiting the results of my masters degree in a social science) I cannot help but feel that it is only a good thing to question, to criticise. Those who are 'afraid of the big bad Dr Wolf' should feel assured that should the findings of breastfeeding research be correct, her critiques can only result in strengthening them by stimulating further, more rigouous scientific study. But I also cannot help but think that we need to realise that our reasoning for breastfeeding has to come from reasons other than those from science. Science is not the answer to everything, in fact really all that scientists do is generate more questions. So here I must turn to my personal experience.

Personally, I do not doubt the health benefits of breastfeeding. Here I disagree with Dr Wolfs statement that she 'does not think the results are causal'. But putting that aside, breastfeeding has had a myriad of experiential benefits for me. When I leave the house, I do so with a nappy in my pocket. I don't need a big bag full of bottles and other equipment. I am a bit lackadaisical about sterilisation – my baby is exposed to normal bacteria from my skin and is provided with passive immunity in my milk. I don't have to clean and sterilise bottles or worry about when I made a bottle up or what temperature the water is at. I just 'wap 'em out'. For me, breastfeeding is easy and convenient. Also, where a lot of formula feeders say that it is nice that it allows other people to feed the baby, I feel the opposite. Several times a day, my baby is mine, all mine. One day she won't be. My son already is a big daddy's boy and has less and less time for his mummy. But when he was very small, he was mine. That time is more precious to me than I can say and I do feel that it has provided a bond between us. I look back with fondness on those quiet moments every evening when I would feed him till his lids were heavy. But, I would be lying if I said there haven't been costs. It is time consuming. Nobody can help me in the night, so the sleeplessness is all mine. I don't often get a break away from my baby (she wouldn't take a bottle even if I could be bothered to express any milk). But then, having got used to these costs, I think for me it is a good thing I am tied to my babies, for I am the kind of person that would easily have lots of other things to be busy with. Nonetheless, this is just my experience. I have been lucky in that I could overcome the difficulties I have had through researching the issues,and for all health issues to have been small. I am also lucky enough to be able to afford to take long maternity leave. Also, I have a lot of support around me. For others the situation is different and so the scales of profit and cost will tip in different way. While we can use these sort of experiential advantages as reasons to breastfeed we must recognise that they do not outweigh the costs for everyone.

On talking to Husband last night he summed up what I took away from the lecture succinctly I think. “So, basically, if you want to breastfeed that's great, and if you don't then that's quite OK too?” Who could disagree? But, there is a long way to go for society to be that tolerant. I feel that neither choice is a free choice at the moment. When information, support and tolerance are commonplace then perhaps we will be allowed to feed our children however we see fit. But we must be wary of the research and advice that we believe. Equally, we must be supportive of each other's right to feed our children in the way that seems most suitable. I hope that when I read the book (which I fully intend to do) it does have this pro-choice message and isn't the anti breastfeeding rant that some have reported it to be.

Baby settled down for the rest of the lecture. Colicky signs only reared their ugly head towards the end of the lecture and she started to cry as I left, so I was fortunate to be able to hear the whole thing. I am proud that I breastfed at this lecture. Although, I did cover up as it seemed appropriate. What made me especially glad was that somebody else had brought a baby. I think that is a wonderfully good sign, for two babies to be welcome at an academic lecture, allowing their mothers to do so too. Given that the babies were not disruptive there was no reason for either of us to have missed out on a lecture that we wanted to attend. Would two women and their babies have attended a lecture even 30 years ago? Would they have openly breastfed in that academic setting? I very much doubt it. That is a good sign of the times.

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