It's often quoted, but exactly where does the ‘Breast Is Best' message come from?
In 1978, British authors Penny and Andrew Stanley wrote a book of this title, which went on to become a bestseller.
At that time, breastfeeding rates in the UK – and most western countries – were so low that breastfed babies were the minority.
Heavy marketing of formula had convinced people that bottle feeding was better, and support for breastfeeding was at an all-time low.
In that context, the message Breast Is Best was necessary to increase awareness of why breastfeeding matters.
Four decades later, this message is no longer commonly used to promote breastfeeding in Australia. Awareness has improved to the point where most mothers offer their baby the breast in hospital. However, they need more support to reach their breastfeeding goals.
Here are 5 facts that are important to understand about the Breast Is Best message:
Fact #1: Mothers Are Not Getting Enough Support
Despite making an excellent start, Australian breastfeeding rates quickly slide down the scale, with only 15% of babies reaching the recommended six months of exclusive breastfeeding. This trend is similar in many other countries.
The World Health Organization recommends exclusive breastfeeding for babies to 6 months of age, and thereafter for breastfeeding to continue alongside suitable complementary foods for up to 2 years and beyond.
The National Health and Medical Research Council recommends exclusive breastfeeding for around 6 months and then for breastfeeding to continue alongside complementary food until 12 months of age and beyond, for as long as the mother and child desire.
Statistics from the 2010 Australian National Infant Feeding Survey results indicate that 96% of mothers initiate breastfeeding. Thereafter, exclusive breastfeeding rates drop off. Less than half [39%] of babies are still being exclusively breastfed to 3 months (less than 4 months) and less than one quarter [15%] to 5 months (less than 6 months).
Supplementing breastfeeds with formula is widespread, as is premature introduction of solids before the recommended six months. Both of these things impact on breastmilk supply.
Fact #2: If Breastfeeding Were an Olympic Sport, Australia Would Bomb Out
If breastfeeding was part of the Olympics, Australia might get a medal in the 100m but wouldn’t even complete the marathon.
Around 2005, the proportion of children who were ever-breastfed varied widely across OECD (Organisation for Economic Co-operation and Development) countries, ranging from less than 70% in Ireland and France, up to almost 100% in Denmark, Sweden and Norway. However, some countries who make a great start are failing to make the finish line.
Although subject to considerable cross-national variation, the proportion of children being breastfed declines with age everywhere. On average, almost half of all infants 3 months of age are being exclusively breastfed. However, by the time infants are 6 months old, less than 25% are exclusively breastfed.
The medal presentation, according to these OECD figures, would feature Hungary, Iceland and Norway! Australia and New Zealand come in 5th and 6th, while the US lags at 18th place and the UK just behind in 21st place.
Fact #3: Breast Is No Longer Best
Breastfeeding is not ‘best', says Nina Berry and Dr Karleen Gribble, authors of the 2008 report of the same name. It's simply the normal way to feed human infants.
The report suggested that breastfeeding promotion and education programs should abandon the ‘breast is best’ message because it's misleading and fails to communicate the importance of breastfeeding.
Describing breastfeeding as best suggests that infant formula is the standard, with optional bonuses available to those who manage to breastfeed. Yet the reality is, human babies are designed to be fed human milk and alternatives are not without risk.
Parents are encouraged to set the global recommendations as their own goals, yet are not given the resources need to reach them. The risks associated with early introduction of foods other than breastmilk are not well understood by health professionals and they are often reluctant to discuss them. Fear of making mothers feel guilty is preventing them being given all the information they need to make informed choices; information is key to breastfeeding support.
By normalising breastmilk and increasing awareness of risks of premature weaning, we allow parents to truly make informed choices.
Fact #4: Breast Is Best Is Now A Marketing Message… For Formula!
If breastfeeding advocates have moved away from the Breast Is Best slogan, why is it still out there?
Because it's part of the message being used to promote infant formula. The one consistent place to see the variations on the message “Breastmilk Is Best” is in the fine print on formula packaging, advertisements and marketing materials.
Nowhere is this more apparent than in the US, which is one of only six countries worldwide who do not support the World Health Organization's International Code of Marketing Breastmilk Substitutes (commonly referred to as the WHO Code). Without the WHO Code to regulate them, formula companies use the full extent of media to sell their products, each with that little reminder about breastmilk being best.
“We learned from the best … so we could give you and your baby the best. Nothing else is breastmilk. Nothing else is [product name]”
“[Brand] recommends breastmilk as the best start for babies”
“Breastmilk is best. Ask your doctor”
The one consistent word in all is … BEST!
“At [brand] we firmly believe breast milk is the best nutrition for infants….”
In the US, promotion of infant formula begins almost at conception – with targeted marketing strategies not only in the media, but sent directly to the family home. Once the baby arrives, hospitals hand out full-sized samples, with more likely to be on your doorstep when you take your baby home.
Jennie shares her experience:
“It was spring in upstate New York in 2008 when I walked into the local maternity store. I was 8 weeks pregnant, and like most first time mothers, I was excited to get my first maternity clothes. Checking out, the cashier asked me for my contact details — email, phone, mail — so they could send me coupons. Discount clothing? Score!
Two weeks later, I found a package at my front doorstep. Inside that box was the start of a flood — two full sized cans of formula and a packet of coupons for that same formula. I was 10 weeks pregnant. At 11 weeks I received another package, this time it was two full cans of the competitions formula, with coupons. I now had four full size cans. The deluge continued, with letters containing small sachets of formula, to small bottles of ready mix.
In hospital, the day of discharge with my daughter, we had breastfed fine. No problems – she was a natural. The nurse came in with my papers and said to me “If we write on your chart you are mix feeding you get a free bag.” In the bag? Two bottles of ready mix, and a full can of formula. Not a jot about breastfeeding. When my daughter was 6 weeks old I got ill and had to bottle feed breast milk for 4 days due to medication. One night, after much screaming that she couldn’t get it from the source, I gave up and warmed a bottle of that ready mix. I am thankful every single day that she refused to take it”.
This begs the question, “well why are formula companies pushing the breast is best message?”
Because they know it causes angst. Being ‘best' is superior, but who is superior? Not many of us would call ourselves that. So best isn't essential. Next best is fine, right? Formula companies create divide this way. And they're making a load of money from it.
Fact #5: When You Know Better, You Do Better
In parts of Europe, big changes are happening in hospitals around the care and support of babies and their families.
Recently released on iTunes, the American documentary The Milky Way explores some of the barriers to breastfeeding in the US – and how these are being knocked out of the way in countries like Germany and Sweden.
The contrasts are stark:
- In Sweden, mothers get 18 months paid maternity leave — in the US: none
- European hospitals are moving away from the current model of care for premature babies, instead accommodating babies AND their parents together for the duration of the infants stay and using skin to skin contact to replace high-tech incubators
- One German hospital sends new mothers home with ten weeks access to in-home midwife support to ensure they reach their breastfeeding goals
- While in the US, breastfeeding mothers are bombarded with formula samples and advertising
- In Sweden one company has its products removed from sale for six months as punishment for not abiding by the WHO Code
When we truly support women to breastfeed, women will breastfeed.
Read 9 Sneaky Ways Formula Companies Try To Win You Over to learn more about formula marketing tricks.
- Australian Breastfeeding Association: Breastfeeding Rates In Australia
- OECD Family Database: Breastfeeding Rates
- The Star: Breastmilk Is Best, Nestle Says
- The Star: Nestle Breaking The Rules