Breastfeeding can be an emotionally fraught subject. Many new mums feel unable to feed in public because of embarrassment, according to surveys. While others, pressured by 'breast is best' advice, feel shame if they cannot provide nourishment for their child in this way.
"The first time I took my newborn son out to a café, he cried to be fed, and I walked home to feed him," says mum-of-two, Eleanor. "I was so scared of latching this tiny baby on in public. I hadn't really seen anyone do it before, and it's hard with a newborn as they need a bit of help," she adds. "Right after birth, your boobs are huge, so it's hard to do discreetly!"
Eleanor is far from alone in her experience. A recent survey by The Baby Show found that nearly 9 out of 10 new mums feel unable to breastfeed in public because of embarrassment and stigma.
For her though, it did get easier with time and practice. "I realised I couldn't make him wait and cry just because I was embarrassed," she explains.
Bottom of the breastfeeding league table
There are many benefits of breastfeeding: breast milk provides babies with nutritional goodness, vitamins, and antibodies, which help protect them from infections, and lowers their risk of allergies. Nursing also helps mother and baby to bond, and lowers the mother's risk of breast and ovarian cancer, osteoporosis, type 2 diabetes and cardiovascular disease.
Despite this, a 2016 study showed the UK has the lowest breastfeeding rates in the world, with just one in every 200 new mums (0.5%) continuing with any form of breastfeeding beyond 12 months, compared to 23% in Germany and 99% in Senegal.
But when it comes to the factors behind these stats, embarrassment about public feeding is actually just the tip of the iceberg for many British mums. The same study found that 81% of mothers in the UK had tried breastfeeding at some point, but only 34% were still breastfeeding at six months, and 95.5% had stopped by their baby's first birthday.
So, if most mums are trying to breastfeed, why do so few keep it up? The reasons are complex and manifold, but breastfeeding peer supporter Naomi, who supports new mums to get started with nursing, believes many women are let down by not being given appropriate information or support.
"When you look at other countries where the stats are flipped, and 99% of women do breastfeed, you see how it's largely cultural," she explains.
Feeding difficulties and a lack of support
For Jess, problems with breastfeeding started in the hospital, when her baby couldn't latch on and had to be fed with formula milk.
"It was an awful time - I was so hormonal and thought I was failing. It took weeks before we got a tongue tie diagnosis and a referral to an NHS lactation consultant," she explains.
"We did get it sorted eventually, and I'm still breastfeeding at 18 months, but I can totally see why so many women give up," Jess adds.
Conversely, Natalia says the support she received after the birth of her daughter was amazing. "I'd had a C-section and was reluctant to try breastfeeding, but the midwives talked me round in a completely non-judgemental way, and showed me the best positions as part of my recovery," she explains.
"It was very hard though," Natalia adds. "In the beginning, you feel as if you're depriving your partner of bonding time with your baby if they can't feed them."
Health complications for mother or baby
Around 2% of new mothers are physically unable to produce enough milk but, for some mums, other health issues affect their ability to breastfeed - including birth complications, maternal health problems or medications, or concerns about the baby's growth.
Christiana found herself unable to breastfeed after a traumatic birth, and says: "I was devastated. I've always been pro-breastfeeding, and went to all the classes when I was pregnant."
In practice, though, "I tried really hard for six weeks, but had to give up," she explains. "I had all the pumps and machines, and would sit up all night, exhausting myself, only for him to down a full bottle of powdered milk after hours at the breast. I felt awful going to a café and getting out a bottle but I had to, otherwise my baby would have starved."
Rachel was 21 when her first baby was born, and says: "There was so much pressure that 'breast is best', so I felt I had to breastfeed or I wasn't being a good mum," she explains.
"When I was told to give him formula at seven weeks, I cried. I felt like such a failure," Rachel adds. "But he'd had reflux and wasn't gaining weight. From the first bottle, he stopped throwing up and I never looked back."
Breastfeeding pressure and bottle-feeding stigma
Breastfeeding is understandably an emotionally fraught subject. A recent survey by the Priory Group found that 80% of parents believe breastfeeding difficulties fuel postnatal depression amongst new mums.
"All of my mummy friends seemed to find [breastfeeding] so easy, but my milk, rather than being best for my baby, was making him ill," Rachel says. "When I was bottle-feeding out and about, I always felt I had to explain myself."
Likewise, Christiana says: "Every time someone expressed their view that 'powdered milk is bad', I would tell them I'd tried so hard my nipple bled." She adds: "My son is four now. He's fit, healthy, intelligent, thriving, and we have a strong bond. I'd have loved to breastfeed, but I don't think he's worse off for being bottle-fed."
According to consultant psychiatrist Dr Kathryn Hollins, who heads up the Priory's new family service in Harley Street: "An excessive amount of pressure, although well intentioned, may do more harm than good. New mums need to be gently encouraged to explore all reasons as to why breastfeeding might not be working for them."
Mum-of-two Ellie bottle-fed her first baby and breastfed her second.
For her, nuance, balance and compassion are key. "There are massive benefits to breastfeeding, but no one talks about combination feeding, or expressing, or formula overnight, or why women don't feel comfortable breastfeeding in public - which has nothing to do with individuals, and everything to do with how society views breasts," she explains.
"I know so many women who have experienced serious anxiety around both bottle-feeding and breastfeeding, to the huge detriment of baby's and mum's well-being," she adds. "For my family, bottle-feeding meant my partner could co-feed, I could sleep, and my baby was full, happy and healthy - the most important factor that often gets lost in the conversation."
Jess believes the emotional side of breastfeeding difficulties is too often underplayed. "My friend's mum used to be a midwife and said that breastfeeding is a skill - it's not natural or instinct-based; it's something generations of women taught each other and supported each other with," she explains.
"We don't have those networks now, and a lot of that line of knowledge was broken when formula was widely introduced."
Empowering more mums to breastfeed
According to lactation consultant Shel Banks, a spokesperson for Lactation Consultants of Great Britain (LCGB), this lack of shared knowledge and support means new mums are often concerned about what's normal.
"In our pre-baby world, we really have no idea about how babies are supposed to behave or what 'normal' breastfeeding will look or feel like," Shel explains. "Many new mums worry about milk supply, feeding frequency, or breast pain."
"Fortunately, a friend told me it's not always as easy as we think. She encouraged me to push through the early days and stick it out."
Cafe and other business owners can also help practically, Banks says, by displaying a 'breastfeeding welcome here' poster, and offering a drink or comfy seat to breastfeeding mothers.
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