In February I took my little girl out in the cold to Canterbury Christ Church University to a lecture by Dr. Joan Wolf. I had expected (from the vitriol I had been reading on the internet) an anti breastfeeding tirade. It wasn't, as I blogged at the time. One thing that particularly resounded was Joan Wolf's remarks concerning her critics who hadn't actually read her book. I felt that before I could have a real opinion on the matter I ought to read the book too. In fact, I find it a bugbear when I read or hear people's comments on books they have never read. A review or a synopsis tells you nothing. For example, many people cite Moby Dick as an amazing classic and will even cite certain lines even though they haven't read it ('Call me Ishmael'). I read it. Truth is (in my opinion) that it is dull. My point essentially is 'don't believe the hype', make your own decisions.
Now, clearly I am a breastfeeding advocate, or I wouldn't write this blog. But I am interested in Joan Wolf's work for a few reasons. Firstly, being a breastfeeding advocate does not necessarily make you anti-bottle feeding. It is likely to make you have certain feelings about formula companies, or about support provision, but bottle feeding itself is not the same thing. Secondly, I believe that you should 'know thine enemies'. I mean this in the sense that you should be fully versed in opposing views to your own. That doesn't mean just sitting and reading them in a seething rage, but to put yourself in another's position and cogitate upon their opinions. It can serve to strengthen your own views or to tear down those that do not have strong foundations. This kind of critical reflection takes you away from being hot-headed and opinionated and takes you further into the realms of knowledge. I believe that in this respect, criticism is not dangerous and shouldn't be the source of anger. Rather, it should be welcomed.
So, shortly after the lecture, my copy of the book arrived in the post (slightly grubby, which I was a bit miffed about, although its my own fault for buying second-hand). I delved in with excitement and trepidation. It isn't easy to find reading time with two young kids - I generally listen to audio books so that I get the chance - however I managed to get through this book in a fortnight as I found it fascinating.
Primarily, I feel that Joan Wolf has a point. Breast isn't necessarily 'best' for everyone. I wish I lived in a society or a time where breastfeeding was totally normal and enabled. But I don't. I am lucky enough to have a family and friends with breastfeeding experience and to be able to access good support groups. Therefore, I had a good chance of establishing successful breastfeeding. I also am financially able to not work for a long period of time (I took a year off on maternity with my son). I haven't had to worry about expressing at work and then somehow ensuring that my baby gets that milk. What if I had have had to return to work after 3 months in order to pay my bills? What if my family were unsupportive? What if, despite my best intentions and efforts, my baby was unsuccessful in breastfeeding and was becoming seriously ill? At what point do the scales tip so that breastfeeding is actually detrimental to the new family?
Another interesting point is that concerning the importance of the child. Of course, given the vulnerability of our children, we do our utmost to protect them and provide for them. However, that does not completely remove our self-worth. Indeed, any parent makes sacrifices, many of them. However, at some point the strains that breastfeeding puts on some mothers can surely be considered too much. At what point do we say that the damage to the mother is not worth the benefit to the baby? At what point is formula potentially better for the baby? Perhaps allowing the mother to work means that the family have a roof over their heads? Perhaps removing the pressures of breastfeeding improve the mother's mental health?
Breastfeeding is not possible for everybody, it really isn't. Not in our current society. Sure, we can look at tribes who have no breastfeeding issues as a source of guidance, but our society is a long way off. We can live in an idealistic world and say that the majority of women are biologically capable of breastfeeding and therefore that is what we should aim for. However, there has to be some recognition for the fact that at present it is not enabled for everybody. Who are we to question anybodies motives?
Given this situation, there has to be a realisation that the extremely pro-breastfeeding message that is continually promoted may be marginalising mothers who had no choice. If we consult UK breastfeeding statistics we find that two thirds of mothers are not breastfeeding by 6 months, even though 81% initiated it . It seems to me that the issue lies more with extending breastfeeding than initiating it. We need to look at issues such as public breastfeeding, support networks and general societal acceptance rather than brow-beating mothers who have every right to make the decisions that they have. We know breast is best (fi societal influences are removed), so lets start enabling people to do it rather than just hassling people about something they are aware of. Even a revulsion towards breastfeeding is a good reason not to do so if it effects the psychological experience of motherhood. The only way of tackling that issue is ensuring a future society where breastfeeding is 'everyday' and therefore not something to find uncomfortable.
Nonetheless, I feel that certain elements of the argument that Joan Wolf puts forward are stronger in American culture. For example, I believe that in the UK we receive far better maternity provision than in America. Therefore, if we need to take longer off work to breastfeed then it is easier financially, it is less likely to put you on the breadline. Therefore the 'middle class breastfeeding mother' is a bit less of a stereotype. But that doesn't mean to say that it doesn't exist to some extent in this country, just to a lesser degree. Her description of breastfeeding promotion too is wholly based on America, and I agree that the promotion has been heavy-handed there (even more so than here int the UK it seems).
I feel it is wrong of Joan Wolf to choose to discount breastfeeding specific journals. I understand her decision to do so in order to eliminate bias, however the result was completely ignoring highly important studies, particularly from the Journal of Human Lactation. Rather than doing this I feel that she ought to have used the best studies, but considered the potential bias that could arise from publication in a specific journal. I feel that this detracts from her argument that the science showing the medical benefits of breastfeeding is paltry. She argues that there is a lack of science showing the mechanisms of health benefits. I disagree. We know that breastmilk is a 'live' substance. The antibodies within it prevent illness, the enzymes breakdown the constituents and so forth. But, there is some need to ensure that scientific studies (particularly epidemiological ones) are more rigorous.
Putting the argument for health benefits aside, I feel that there is an omission concerning the other benefits of breastfeeding. Joan Wolf does discuss the concept of breastfeeding being 'free', and clearly shows that there are more costs to weigh up than just that of the accoutrements needed for formula feeding. However I think that one must consider more than just health. Convenience, bonding and the myriad small reasons such as dummy use, smelliness of poos and kitchen space. There are a plethora of reasons that must be put onto the balance when considering infant feeding choice. It is a huge issue.
The book is thought provoking and beautifully written (except that she uses the word putative a lot and for some reason it annoyed me). It has made me consider my standpoint concerning breastfeeding promotion and I now know where I stand. I believe in ensuring that those who want to and can breastfeed receive the support they need to do so, whilst those who choose to formula feed are awarded the same respect. Neither party should be discriminated against for their choice. We are all mums doing the best for our children.
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