One of the many great pleasures of starting this blog has been writing posts in support of awareness raising days and weeks for causes I feel passionately about. I’ve already written about World Meningitis Day, International Kangaroo Care Awareness Day, Volunteers Week and Carers Week. Posts on these topics, all so close to my heart, have pored out of me rapidly and without forward planning. So why is that I have spent all week yo-yoing back and forth about whether or not to write a post for National Breastfeeding Week?
It’s not as if I don’t have strong feelings about breastfeeding, or more particularly about the medical, social and cultural support women need in order to learn and to continue breastfeeding. It’s not that I don’t understand the benefits of breastfeeding to babies and mothers and I feel strongly about the need to give mothers-to-be sound, unbiased information on these benefits. It’s not that I haven’t experienced for myself the wonderful bond breastfeeding can create between a mother and child.
No: I have to admit that part of my reluctance stems from sheer cowardice. Feelings run high when it comes to breastfeeding, and while I’m not too worried about angering people (although that’s far from my intention) by my blogging, I would hate myself if I made anyone feel bad about their choices or those foisted upon them.
And that’s what worries me about this whole business, really. It’s that I worry how something so natural – as we keep being told breastfeeding is and obviously should be – has turned into a cultural debate in which mothers are often the losers. A debate which can have psychological consequences that may run as deep as breastfeeding’s benefits. And you know what? Like most of the cultural debates that surround women and their bodies, this is an old chestnut. Centuries old. And that worries me too. Because what a longer, historical view of the breastfeeding debate shows is that whenever the word nature is evoked in relation to women, culture is lurking in the shadows, teaching women how to behave in natural ways and berating them if they won’t or can’t do.
Before I raise my head even further above the parapet or pump (to choose a more appropriate metaphor), here are my breastfeeding experiences.
It never occurred to me that I wouldn’t breastfeed my kids. The reading I’d done suggested it was a no-brainer. The health benefits to any children I might have and to me were obvious and I wanted my kids to bond with me and their brains and bodies to develop well.
I thought, though, that I wouldn’t beat myself up if I couldn’t breastfeed. I was breastfed, my sister was bottle fed. She is bright, has a very close relationship with my Mum and has always been in excellent health. I aspire to be a smart cookie, adore my Mum, but have had pretty rotten health for most of my life. Anecdotes can’t stack up in the face of medical research to the contrary, but I admit it was handy to know I could cling to this example if the worst came to the worst and I couldn’t breastfeed my kids. My sister did just fine.
In the event, though, the worst came to the worst and the anecdotes were no help at all. Sissyboo nearly died during labour and I had a brutal and botched c-section that saved her life. I am still in pain because of it. As I lay in my hospital bed in the days after she was born, I felt numbness in my abdomen and excruciating pain simultaneously. I tried to feed Sissyboo but she wasn’t getting enough milk. She screamed constantly and was badly jaundiced. I was getting more and more exhausted.
They kept doing the heel prick test to monitor the jaundice and she got acute impetigo on her ankle where the doctors were holding her. She was put on high-dose antibiotics. So was I. She got oral thrush; I got nipple thrush. We kept giving it back and forth to each other. Breastfeeding was just about the most painful thing I had ever experienced. I called an NCT breastfeeding counsellor when I got home and she was amazing. I said I felt I was doing it wrong and failing my daughter. She said that wasn’t true: we were both ill. We needed medical intervention. Creams hadn’t worked, so I was put on Fluconazole by a sympathetic doctor. It was nearly Christmas and this had been going on for nearly 6 weeks. I loved my daughter, but hated my life.
When the Fluconazole ran out I’d been advised I could get one more dose to try to clear the thrush. I went back to the doctors but saw a locum who saw my daughter’s white and red, horribly sore mouth and my inflamed nipples and told me (this is no lie) that I needed to get over it. ‘Breastfeeding hurts’. She refused the costly (around £20) prescription. I knew she was wrong but was too devastated by the past 6 weeks to argue. I went home in tears via the chemist and bought a box of formula. The guilt was extraordinary. I thought I was poisoning my baby; that she would hate me. She’s 5 1/2 now; we couldn’t be closer. She’s very healthy (touch wood) and bright as a button. Putting her on formula, though I felt utterly defeated and the guilt was excruciating at the time, was the best thing I could have done for us in those early days.
Now, fast forward to Boo, born 11 weeks early, on a ventilator for a time, in an incubator for 4 weeks, having suffered a massive brain bleed. Guess what? Yep: I breastfed him effortlessly and successfully for 11 months. You see this birth and its aftermath were traumatic, but I knew the potential benefits for Boo, as for all prem babies, were even greater than for his term sister. I expressed every three hours until he was fully breastfed at 35 weeks gestation. You can read more about my experiences of kangaroo care and learning to breastfeed Boo here. But what made the difference between my experience with him and his sister was the wonderful support of a neonatal nurse (without her I don’t think it would have happened) and sheer luck (not a word I use often in the context of Boo’s prematurity). I was psychologically traumatised by the birth, but after a couple of weeks I was physically OK in a way I wasn’t after his sister’s arrival. And for inexplicable reasons, Boo had read this manual even though he’s pretty much ignored all others. He knew what to do. From 32 weeks gestation. Even though he was too weak to take more than a few sucks at a time.
What my experiences have taught me is how important the right support is when you start breastfeeding. But they also taught me how crippling the guilt can be when you can’t. I know you’re not supposed to say it, but sometimes you can’t. Sometimes it is better to give up. Sometimes the dire consequences of not giving up outweigh the benefits you hope to enjoy.
So the support for mothers should cut both ways, in my view. Yes: encourage women to breastfeed; do more, as this awareness week is doing, to make breastfeeding more culturally acceptable in public (and it gets me really annoyed we have to even fight this particular battle in 2013). But also, let’s support mothers who aren’t able to breastfeed, despite their best efforts.
As I said before, the guilt associated with breastfeeding (as with many aspects of motherhood) is not new. One of my favourite novels is Maria Edgeworth’s Belinda, published back in 1801. Edgeworth was an Irish novelist much beloved by Jane Austen. Part of the story of Belinda concerns an enigmatic socialite called Lady Delacour, who likes a bit of cross-dressing (as you do in 1801) and makes a disastrous marriage to a man wholly unworthy of her. During a pistol duel over a male lover (I told you think was a good book, there are ghosts, too) her pistol misfires and bruises her breast. She spends much of the rest of the novel locked away in her dressing room administering lotions and potions because she has convinced herself she is dying of breast cancer.
Initially we think she believes this because of the bruise she’s sustained, but it transpires that maternal guilt (familiar all those centuries ago) is to blame. Lady Delacour had a child. It died. At the time it was routine for women of her status to put their children out to nurse (that is, to have a wet nurse) but she breastfed the child herself. What becomes clear is she thinks her fashionable lifestyle (because everyone tells her this) has poisoned her milk and her baby. If she’d given him to a wet nurse, she says, he might have lived.
So when her next child, a girl is born, she is put to nurse and raised by another family. Lady Delacour doesn’t have cancer and by the end of the novel is reconciled with her daughter but her guilt haunts the reader long after you close the book. The cultural assumptions of the day led her to believe she was an unnatural woman. And it nearly kills her. It’s a work of fiction, but the demons conjured are very real. Still.
It is almost unimaginable now that breastfeeding mothers could feel the guilt Lady Delacour does, although sadly we do know stories of breastfeeding mothers whose drink and alcohol dependency does affect or even kill their children. No: her guilt is more commonly experienced by those who see themselves failing because they formula feed their children.
I guess what I’m saying is that I fully support the work of National Breastfeeding Week. I am eternally grateful to the NCT breastfeeding counsellor who tried to help me with Sissyboo and I thank S, the neonatal nurse who gently encouraged me to feed Boo when the odds were really stacked against us. But as well as advocating for the appropriate levels of support for breastfeeding mothers, please let’s also support those who struggle or can’t.
And here’s one particular piece of practical support we can and should give to formula feeding mums. I was horrified when Boo was hospitalised with infantile spasms earlier this year to find that parents of hospitalised babies who have to room in with their kids don’t get food provided unless they are breastfeeding. In Birmingham Children’s Hospital, where we were first of all, they didn’t offer me a lunch or dinner menu because they assumed that Boo, as a premmie, was formula fed. Thank God for my Mum, who sent in picnics via my sister. When I moved to my local hospital they agreed to feed me as I was breastfeeding, but a woman two isolation rooms down, and giving her very sick boy SMA, was not.
When you are exhausted, permanently attached to a screaming child you can’t leave unless someone comes in to relieve you (and you are lucky enough that Norovirus protocols aren’t restricting visitors) you are fortunate if you can pee or shower. You are running on emotional empty. You should be fed. Whether you buy Aptamil or not.
So this week please so support National Breastfeeding Week and breastfeeding mothers, but spare a thought for our bottle feeding sisters. Sometimes we’re the same people, you know.