Boob politics.... Mia Freedman article. A must-read.

[Charlotte91]

This is one of the best articles I've read in a long time.
Love or hate Mia Freedman, this is a must read.

THERE are two big breast fights going on at the moment and I'm nestled snugly between them. In the cleavage.

Yes, even as you read this, people are waging war over boobs. The most public battlefront is on Facebook, where discreet images of breastfeeding have been deemed too offensive to remain on the world's biggest social networking site. Wait, let me check the calendar - nobody told me a leap year means we leaped back to 1953.

Facebook, your ban is bollocks. Look, I know Mark Zuckerberg is really young and everything but it seems he doesn't yet know the difference between "breastfeeding" and "topless".

Because unlike, say, flashing your boobs on a hen's night, the only bit of breast visible at feeding is a modest glimpse of skin. It's barely even breast. More like chest. And it's far less than you'd see on display in the average food court. Unless your norks are enormous or your baby teeny tiny, their head obscures most of the action. So come on, Facebook. Pull yourself together and lift your ban. Honestly!



When it comes to bosoms, you couldn't get two organisations more philosophically opposed than Facebook and the Breast Feeding Association. They don't like each other one bit. Do you know what else the Breast Feeding Association doesn't like? Formula.

I remembered this last week during a visit with a friend's new baby when I was drafted into another breast battle, this one far stealthier. Before I explain, you should know this: I've breastfed three babies. Two successfully and one disastrously. I say this to establish my credentials as someone who has both loved and hated breastfeeding, who has felt like a legend and a failure, who has used formula at times and who is well versed in the complex politics of The Boob As Food Source.

My friend's baby was four weeks premature, had lost some weight and was a little jaundiced. Nothing serious but still anxiety-inducing for a vulnerable new mother mainlining hormones and sleep deprivation. Before I arrived, the paediatrition had instructed my friend to give her son a top-up with formula "even if it's just for 24 hours until your milk comes in". She cried.

Tears are a typical new-mother response to most things ("Tea? Coffee? Why are you crying?") but especially to the idea of formula. We feel like we've failed. Guilty. We fear our child will end up living in a cardboard box with no shoes and a pet rat and it will be OUR FAULT BECAUSE WE FED HIM SOME FORMULA!

Groups like the Breast Feeding Association have done a bang-up job at publicising the benefits of breastfeeding, and I'm not being sarcastic. Is there a woman in the Western world who doesn't know breast is best? Message received and clearly understood.

But, in some cases, the pendulum has swung too far, from positive encouragement to negative pressure and borderline bullying.

It happens. It happened to my friend. When I arrived she was quietly seething, having requested formula from a midwife. The woman's expression suggested my friend had asked for a gram of coke and a naked male Twilight star to snort it off. Ah, a Lactivist. These are the lactation "activists" who believe so fervently in breastfeeding that formula is their f-word.

Incensed that my friend had been made to feel so bad about following her doctor's advice, I went to the nurses' station to ask myself. "Hey! Um, would it be possible to have some formula for my friend in room 48? She has to top up her baby after his BREASTfeed." They blinked.

"Doctor's orders," I added sweetly. Finally, a kindly midwife nodded and quickly ushered me into a locked room where she checked my friend's chart and frowned. "Can she wait a few minutes because I need to get two midwives to sign out any formula and the shift is just changing.," she said.

Two midwives? Signatures?

When I collect my son from pre-school, only one signature is required. No medical qualifications necessary.

And he's an actual person, not a small jar of liquid.

When the midwife finally brought the formula - maybe 100ml - to my friend's room, I probed her a bit further about the signing out. Were we feeding a baby or negotiating a hostage situation?

She winced sheepishly and explained that the hospital was in the process of applying for accreditation from the Breast Feeding Association.

And what did this mean, I asked. Well, formula was never displayed anywhere - it was hidden - and so were bottles. NO VISIBLE BOTTLES. She stumbled over the word "bottles" and looked fearful it had slipped from her mouth. Were the lactation SAS going to bust in and haul her away for re-education?

To be fair, this midwife wasn't a hardcore Lactivist (thankfully, most aren't). While she was at pains to point out breastfeeding should be promoted as the first and best choice, she also acknowledged sometimes it just wasn't possible for mothers to breastfeed or do it exclusively.

True, that.

So the moral of the story this week is simple: Let's chill out about breasts. They're not dangerous weapons that must be hidden from vulnerable onlookers, half of whom have a pair of their own. And they're not always a fountain of nutritious love for a baby because sometimes the breasts - or the baby - have other ideas. And Facebook? Stop being a boob.

[nickle730]

I don't have strong feelings about Mia Freedman one way or another. I have, and continue to, successfully BF DD2. I was unable to BF my first two children. So, what I'm saying is that I have been on both sides of this fence. The ridiculous thing is that there is pressure on every mother regarding the way she feeds - FF mothers are made to feel that they are feeding their child poison, BF mother's are told to put their boobs away and isn't your kid too old for that now? We should all be doing what is right for our babies and for ourselves. As women, we should be supporting each other in our choices (although I can vouch for the fact that the way in which I feed my babies is not always a choice). Enough of this terrible pressure we place on each other and on ourselves, motherhood is hard enough!

I really like this article. And I think Facebook is being a right boob.

[STARRYSKY]

as a baby who was whisked away from her mother and fed formula before her mother had even comprehended the fact that I had been born...I'm GLAD that hospitals do that! (condemn me to evil "Lactivist" now!)
and yes, FB is a being silly about the whole thing.

[Astrid]

Well, it is the Breastfeeding Association - not the formula feeding association - what do people expect from them??? My Aunt-inlaw was livid that her DIL could not get formula feeding advice from the ABA, once again what did she expect.

Poor form really to bag the Breastfeeding Association (sorry can't tell if she was referring to the actual ABA). If the hosptial does not want to become a breastfeeding friendly hospital, then don't. If the midwives don't support it, then say so. Acting all sheepish about it helps no-one and just undermines the whole process. Really, it is just two signatures, why make an issue if it?

[nothing2lose]

I don't have strong feelings about Mia Freedman one way or another. I have, and continue to, successfully BF DD2. I was unable to BF my first two children. So, what I'm saying is that I have been on both sides of this fence. The ridiculous thing is that there is pressure on every mother regarding the way she feeds - FF mothers are made to feel that they are feeding their child poison, BF mother's are told to put their boobs away and isn't your kid too old for that now? We should all be doing what is right for our babies and for ourselves. As women, we should be supporting each other in our choices (although I can vouch for the fact that the way in which I feed my babies is not always a choice). Enough of this terrible pressure we place on each other and on ourselves, motherhood is hard enough!

I really like this article. And I think Facebook is being a right boob.

Right on! I had to spread the love so, sorry, no reps!

[LuluHB]

I agree with nickle 100%. I would love to see women everywhere being more supportive of each other, whatever their choices

[Amaunet]

I find this article...interesting I agree FB are being ridiculous and that women should NeVER be made feel guilty about how they feed their babies... BUT what frustrates the hell out of me (as a passionate and unashamed lactivist) is that when women are told to "top up" their babies with formula, it never seems to come with the extra information that introducing formula can make bf even harder! I have several friends who really wanted to BF (so they said) but were never sat down and explained about the mechanics of BF (and sadly didn't research themselves) and didn't understand that replacing a BF with a FF was not going to help build their supply and capacity to feed they often lamented that they "couldn't bf" when in reality, they weren't supported to establish and maintain BF and were probably completely capable of BF if armed with knowledge and support! To me, the hospital that doesn't just hand out formula is doing the right thing... if you WANT to FF! I have absolutely NO problem with that (and those mums should have full access to formula), but if you really WANT to BF, then not offering formula (at all) is (IMO) part of the support new mums need.

Disclosure I am a member of the ABA and exclusivly BF

[RhiChiChi]

I don't have strong feelings about Mia Freedman one way or another. I have, and continue to, successfully BF DD2. I was unable to BF my first two children. So, what I'm saying is that I have been on both sides of this fence. The ridiculous thing is that there is pressure on every mother regarding the way she feeds - FF mothers are made to feel that they are feeding their child poison, BF mother's are told to put their boobs away and isn't your kid too old for that now? We should all be doing what is right for our babies and for ourselves. As women, we should be supporting each other in our choices (although I can vouch for the fact that the way in which I feed my babies is not always a choice). Enough of this terrible pressure we place on each other and on ourselves, motherhood is hard enough!

I really like this article. And I think Facebook is being a right boob.

Totally agree about supporting womens choices, not just in feeding your baby.

I find this article...interesting I agree FB are being ridiculous and that women should NeVER be made feel guilty about how they feed their babies... BUT what frustrates the hell out of me (as a passionate and unashamed lactivist) is that when women are told to "top up" their babies with formula, it never seems to come with the extra information that introducing formula can make bf even harder! I have several friends who really wanted to BF (so they said) but were never sat down and explained about the mechanics of BF (and sadly didn't research themselves) and didn't understand that replacing a BF with a FF was not going to help build their supply and capacity to feed they often lamented that they "couldn't bf" when in reality, they weren't supported to establish and maintain BF and were probably completely capable of BF if armed with knowledge and support! To me, the hospital that doesn't just hand out formula is doing the right thing... if you WANT to FF! I have absolutely NO problem with that (and those mums should have full access to formula), but if you really WANT to BF, then not offering formula (at all) is (IMO) part of the support new mums need.

Disclosure I am a member of the ABA and exclusivly BF

I think this is the key - there is not enough support to establish & maintain for women. I don't know the ins & outs of staffing or budgets in hospitals but why can't there be dedicated lactation consultants? - That their sole job is to help women establish bf (if that is what the women want to do). IMO I felt unsupported and confused about all the differing opinions and information from different midwives on how to establish bf and continue.

[surprised]

I think this is the key - there is not enough support to establish & maintain for women. I don't know the ins & outs of staffing or budgets in hospitals but why can't there be dedicated lactation consultants? - That their sole job is to help women establish bf (if that is what the women want to do). IMO I felt unsupported and confused about all the differing opinions and information from different midwives on how to establish bf and continue.

The hospitals I went to had dedicated LCs. Is this not standard practice everywhere?

I was actually relieved to know when my DS was in special care that they needed my signature to give him formula. Because I wasn't rooming in with him, I had been concerned that this may happen without my knowledge.

The reality is, I believe, this is always going to be an issue. So really, it's up to individuals to learn to stand by their decisions (as they are entitled to) even in the face of opposition. How you feed your child is just one of the first of many decisions you make as a parent that you need to own.

[*LittleMissSummer*]

I don't have strong feelings about Mia Freedman one way or another. I have, and continue to, successfully BF DD2. I was unable to BF my first two children. So, what I'm saying is that I have been on both sides of this fence. The ridiculous thing is that there is pressure on every mother regarding the way she feeds - FF mothers are made to feel that they are feeding their child poison, BF mother's are told to put their boobs away and isn't your kid too old for that now? We should all be doing what is right for our babies and for ourselves. As women, we should be supporting each other in our choices (although I can vouch for the fact that the way in which I feed my babies is not always a choice). Enough of this terrible pressure we place on each other and on ourselves, motherhood is hard enough!

I really like this article. And I think Facebook is being a right boob.

I really wanted to Rep you as i LOVE this post! We definitely have too much pressure on us as mothers so we should all be supporting each other.

[sushee]

It sometimes feels like we women are our own worst enemies. If we outwardly voice that we want breastfeeding to be supported more, and more education being given about it, then there is the perception that we're taking our own sisters' rights away if they have to formula feed. Or that we make them feel guilty. And yet, our breastfeeding rates are horrendously low, so as much as Mia may say that the msg that 'breast is best' has infiltrated our consciousness, that actually isn't translating into significant increases in breastfed children at age 6 months.

I agree that we should be kinder to each other, but I think that being kinder does not mean we don't do the things that need to be done to make breastfeeding, especially breastfeeding beyond infancy, the thing that is tried first and foremost. That saying 'just give your baby a bottle for a little bit' is NOT the first thing that comes out of dr's mouths, as it has happened for years.

If a woman choses FF because that's what she wants, for whatever reason, she owns that decision and no one should have an issue with it, and if they do, well tough, because no one can know her reasons for it, nor should it be anyone else's business. But when a woman wants to breastfeed and cannot get the right info, the right support or the right msg to ensure she has every chance to build a strong and lasting bfing relationship with her child, then there still remains a problem. And from the stats of women who bf in Australia, there obviously is a problem still.

So this shouldn't be about who FFs and who BFs, but how the system is not helping the women who really want to BF. That is the gap that still is not being bridged, and is something that BFing associations are trying to bridge, albeit not always in ways that make their desired outcomes clear to anyone else, as I imagine is the case in Mia's ham-fisted example.

I say do what's best for your family and own that decision. And don't derive guilt from those of us who say that there should be more support and education for women so that more children are bf'ed for longer. That's a whole different fight that is not about your individual choices.

[Floweryfields]

I find the 2 signatures thing a tad odd - do they have to get 2 signatures to issue a medicine?? At work we do 2 signatures to give medicine to a child, but we don't require anyone to witness the mixing of formula. Perhaps it's just another example of having to cover their backside. I suppose the nurses passing on that kind of info - what they have to do because they are a pro breastfeeding hospital, does add to the guilt being felt by the ff mum.

[Traveller]

I find the 2 signatures thing a tad odd - do they have to get 2 signatures to issue a medicine??

yes, this is common practice for many drugs

[Phteven]

I find the 2 signatures thing a tad odd - do they have to get 2 signatures to issue a medicine?? At work we do 2 signatures to give medicine to a child, but we don't require anyone to witness the mixing of formula.

In one hospital I have been in they didn't just need 2 signatures to issue a medicine they needed 2 witnesses to administer it and I had to tell them my name and D.O.B. which they checked against my wristband and the details they had written down. Even for a panadeine forte.

[Loveinamist]

To be honest I would doubt the advice of the doctor in this article. In my experience and the experience of many others I know including the lactation consultant for our area, doctors and even Peads have little knowledge of breastfeeding. Also if the doctor had 'prescribed' the formula surely the mother would not have to ask for it? Sounds to me more like the doctor said something along the lines of 'it's up to you but if you are really worried you can top up with formula' I think the sheepishness from the nurses was probably more along the lines of 'oh dear here we go again..Dr whathisname has undermined a mother's confidence again'
Formula isn't poison but undermining a new breastfeeding mother's confidence by pushing it is wrong.

[Melbournemumma]

I agree re FB, absolutely stupid.

With the issue of FF I used formula with DS1, mostly in conjunction with EBM for the first 10 weeks due to bad nipples. However at 10wks he went back to the breast and fed that way until he decided he was done. The hospital I went to were bad with giving mixed advice to new mums and every nurse/midwife had their own opinion and there seemed to be no consistency. This contributed to some of my issues with DS1.

DS2 was born at a different hospital. He was slightly jaundiced and the Paed recommended that he needed extra feeds to help him work through the jaundice. He never once suggested that the additional feeds came from FF and the mid wives would hand express me at the end of every feed to make sure ds2 got enough. (He was a sleepy feeder). He is still breast feeding. We have had none of the issues I had with ds1 and ds2 doesn't seem interested in giving up any time soon, thankfully . I am proud of the effort I put in with both my sons, but the support of the midwives and the consistency of information is vital in the early days of establishing breastfeeding and this is probably all that this hospital was trying to do.

Neither of my boys are worse for wear no matter where there milk comes from. Women do need to support each other, that includes encouraging a breast feeding mother to really be certain in her decision and making sure that it's HER decision. Once made we should have each others back whether we agree or not

[lee09]

My comments here are based on my own experiences and feelings, and I don't presume to speak for other FF mothers, but I just wanted to say this.

This line in Mia's article jumped out at me:

"And they're not always a fountain of nutritious love for a baby because sometimes the breasts - or the baby - have other ideas."

The core message I heard when BF was this: it's natural. Your body can do it. Your baby can do it. Try, try, try again, because there's no biological, anotomical reason why it cannot work. You can breastfeed. You should breastfeed.

All positive, supportive messages - important messages that I believe need to be communicated to new mothers. When I was pregnant, I knew it all to be true, and I was going to breastfeed for at least a year. I read books, studied diagrams, went to antenatal breastfeeding classes. I was educated, prepared and willing. FF was not an option for me.

But DS wouldn't attach. He wouldn't suck. Midwives rammed his face into my breasts over and over. He reared back. He screamed. He didn't latch. He didn't feed. He cried. I cried. I expressed colostrum. I finger fed him. I syringe fed him. My nipples were shredded with the repeated attempts to attach him over and over. During the following weeks I went to breastfeeding counselling groups, saw my GP, hired a private LC. My mum is a midwife and she sat with me for almost every feed, trying to get it right. It looked good from the outside, he was attached well, and there was no pain. But my nipples were destroyed - some of the worst damage the professionals had ever seen. And DS was hungry. My supply couldn't establish, even though I tried and tried and tried. I used nipple shields, so he could feed, but they also impacted my supply. I tried and tried and tried. Because I "should" be able to do it. There was no real reason why this shouldn't be working. That's what the books say, that's what the experts say, that's what I knew.

The guilt, anxiety and anguish I went through to establish breastfeeding was hard. I comp fed until about 21 weeks, and I still feel sad about it - probably always will. The ABA has an important job to do, educating and supporting new mothers. And I understand that they need to focus on the "breast is best" message. But I felt there was no place for me, and my situation. I didn't choose to FF, and so I didn't feel comfortable with doing it - I didn't "own it", because I didn't want to do it. But that meant I was a failure, because apparently it is so extremely rare for a mother and baby to be physically incapable of establishing a breastfeeding relationship.

Is is possible that somehow we can acknowledge that actually yes, sometimes the boobs or baby have other ideas about what they "should" be able to do, without compromising the pro-breastfeeding message or endorsing FF? Perhaps there could be more education and support on what else mothers can do to get BM for their babies - exclusive expressing or donated EBM. I think that would be more helpful to me, and mothers like me, who feel like they only have one of two options: baby on the breast, or formula.

[sushee]

lee09,

To be honest the information needed to get mothers who CAN breastfeed to breastfeed or to continue breastfeeding isn't even getting out there, let alone information for mothers for whom breastfeeding is not possible. I would love a world where a woman is supported, educated, assisted in whatever her choice or circumstance may be, to own her choice and/or to come to terms with what needs to be done. But right now, it's not happening at any real level for women in general, especially in the feeding/birthing arena.