Guilty Secrets: When Breastfeeding Doesn’t Work Out

Written by Lesley McBurney BA, ABA Breastfeeding Counsellor

Breastfeeding associations make mothers who bottle-feed feel guilty. Heard that one before? I’ll bet you have. The implication is that we should either not exist, or have such a low profile in the community that, like children of the Victorian era, we are ‘seen but not heard’.

Let’s look at reality. In our country today, the vast majority of pregnant women wish to breastfeed. They know that breastmilk is best for their infants. Well over three-quarters start while in hospital, but the drop-off rate soon after they go home is huge. By six months, less than half of Australia’s babies are receiving any breastmilk at all. Why? Here are two women of the 1990’s with different stories to tell.

Kylie had read that ‘breast is best’ and her hospital antenatal class touched on breastfeeding, although she had been more focussed on the birth itself. Her own mother fed Kylie for only six weeks because her ‘milk dried up overnight’.

The birth was difficult, a forceps delivery following a long, hard labour, after which the baby, Ryan, did not seem interested in breastfeeding. Within 48 hours, Kylie was at home, with engorged breasts and sore nipples beginning to show signs of cracking. It hurt to feed and Ryan was unsettled. She expressed, with much difficulty, to relieve the pressure in her breasts and rest her cracked nipples, while giving Ryan infant formula by bottle. Her mother-in-law (who bottle-fed all her children) offered to move in so that she could do the night feeds and Kylie could get some sleep.

Eventually the engorgement passed, after a painful dose of mastitis, and the cracks healed. Every time Kylie offered Ryan the breast he fought and struggled, until she gave up and gave him infant formula. Soon he was completely bottle-fed. Kylie felt horribly guilty that she had not given her baby ‘the best’ and felt a failure as a mother. Whenever she saw articles promoting breastfeeding in newspapers and magazines, she felt inadequate and defensive.

Actually, breastfeeding is not ‘best’, it is simply normal. It is the way mammals feed their young and we are mammals. Any other way of feeding infants can only ever be a compromise. Like wheel-chairs and walking, the substitute works, but it is not ideal.

Kylie gleans a bit of information about breastfeeding but is focussed on the birth. This is perfectly natural, but unlike her sisters in most societies in the world, she has never watched a baby being breastfed. She has been brought up in a bottle-feeding culture, where baby bottles are used as the symbol of infancy – on birth congratulations cards, to indicate baby change rooms, in advertising and sold with almost every baby doll. Kylie is not even aware that a breastfed baby needs to be held in a totally different position to a bottle-fed baby. However, she has read in the paper about breastfeeding women being asked to leave restaurants and shops. Nobody has told her about the Australian Breastfeeding Association’, either.

After the difficult birth, Ryan is sleepy and affected by the drugs he has in his system from the labour. At the time when he should be most receptive to taking his mother’s breast, he just wants to sleep. She tries to feed him but he just slips off the nipple. A nurse has told Kylie how to attach him properly, but all the staff are very busy, so no-one has time to do much follow-up. She goes home, still battered and sore, before her milk comes in.

In a traditional society, Kylie would be surrounded by women who had breastfed many babies between them, but her only support comes from women who have ‘failed’ at breastfeeding. Like her own mother, Kylie has not ‘failed’ at breastfeeding; our society has failed her. Our second example is Sheree, who also wants to breastfeed. Her own mother breastfed all her children and Sheree can clearly remember seeing her younger brothers at the breast. She goes to antenatal classes, but also attends breastfeeding education classes early in pregnancy, before everything starts to focus on the impending birth. At her mother’s insistence, she also starts visiting her local ABA group, to get to know other mothers, hear their stories and watch them breastfeed.

The birth does not go as planned and ends in a caesarean delivery, but this does not prevent Sheree from offering baby Kellie the breast at every opportunity, thus lessening the risk of engorgement. When she goes home, her mother brings her meals and does the washing and ironing, so that Sheree can focus on her breastfeeding relationship with the baby and get some rest during the day. When a hard lump appears in her breast one day, she rings the Breastfeeding Helpline and is given tips on management of blocked ducts and mastitis and she is fine again within 24 hours. Sheree breastfeeds Kellie until she weans herself at twenty months of age.

Which is the more typical story in Australia today? Kylie’s of course. Although she feels guilty, the more appropriate emotion is regret. It is a shame that Kylie did not receive the information and support that she needed, but that was not her fault. Guilt should be reserved for something over which we have control.

Motherhood in the 90s seems to involve so much guilt. If a child is unsettled at school, the mother with the paid job feels it is her fault because she is not always there for him. On the other hand, the stay-at-home mother may feel guilty because she is ‘wasting’ her qualifications and not paying her share of the mortgage. In this age of lawsuits and compensation payouts, everything unfortunate that happens is deemed to be someone’s fault; so guilt is everywhere.

Let’s say a mother is fully informed about the differences between breastfeeding and bottle-feeding, has no problems with breastfeeding, yet chooses to bottle-feed so she can leave the baby behind while she spends four weeks in Bali. Surely some twinges of guilt are appropriate for her if that baby develops gastroenteritis. After all, Bali will still be there next year. On the other hand, another woman has been led to believe that there is no difference between feeding methods. She chooses to bottle-feed so that her husband does not feel left out. When her baby suffers from the same illness, she asks what she could have done to prevent it, and is told breastfeeding might have made a big difference. She will say, ‘Why didn’t anybody tell me?’ She has a right to feel angry, but certainly not guilty.

This is why organisations like ABA exist. If we are not telling mothers the truth about the importance of breastfeeding then who will? Not the infant formula companies; they have products to sell and profits to make. The health systems are already overloaded, so it can’t be left to them alone. Anyway, these days many women (like Kylie) leave hospital before their milk has ‘come in’. The mothers of today’s new mothers are generally from the group that had the lowest breastfeeding rates in our country’s history, so their experience may be of little help. The Kylies and Ryans of Australia need ABA’ to be as visible as possible and our message needs to be everywhere. Certainly the health systems and the press need to reinforce that message, or else we will remain a bottle-feeding society and our mothers and babies will be less healthy.

By breastfeeding our babies proudly, by making breastfeeding a normal, everyday event, we are teaching our own families while educating our local communities. Through official breastfeeding promotion, ABA is educating the wider community about the importance of mothers’ milk as a national resource. Hopefully this will mean that baby-friendly workplaces will become more common, health professionals will have a better understanding of the management of lactation, and women will no longer be frowned upon when feeding whenever and wherever their babies need to be fed.

As long as we keep striving for changes to be made that will make breastfeeding easier for all, we have absolutely nothing to feel guilty about.

This article was reproduced from the Australian Breastfeeding Association.