In recent weeks, the old heated discussion about breastfeeding or not has been making the rounds in the mummy blogosphere. There have been numerous (let's call them pro-choice) posts, such as Little Mummy, and over at Perfectly Happy Mum other bloggers are keen to help everyone breast feed who is able to do so and are sick of being called the breast feeding police (and I apologise having used the term myself, even if jokingly). There are also those pregnant unsure what to do, or new mums struggling with a constantly feeding babe such as Metropolitan Mum (oh I know how bad it can be!).
Something has been overlooked in the debate. And this is where I dare to chip in (of course I also went through a rather horrible and beautiful time breast feeding and touched the formula carton for the first time when Cubling was 12 weeks but that really is another story). Breastfeeding, or rather lack thereof, is linked to poverty (see this breastfeeding and poverty bloggers' carnival), social class and basic health. " poor mothers are less likely to breastfeed and this association remains after controlling for other factors. Also after controlling for other factors, cohabiting and lone mothers, lack of qualifications, being a young mother, having more than one child, being white and living outside England are all associated with significantly lower rates of breastfeeding." (source)
The reason why the "breast is best" message is pushed by the UK health services, government, local authorities and community planning partnerships is little different to the reasons that breast feeding is a life saver in developing countries. In the UK, low breast feeding rates are firmly linked to poverty. That's child poverty, inter-generational poverty, long term, people-can't-manage-to-get-out-of-it poverty. Poverty as persistent as we haven't seen it in a long time.
You see, the breast is best message is not actually aimed at us middle class mums, who are well informed and are able to make up our minds. Mums who, if they decide not to (or end up not being able to) breast feed, will make up for this with hundreds of other ways of being an excellent parent. It's also not meant to send us on a guilt trip if things don't work out. Actually, nobody cares what choices we middle class, secure in our little houses with two disposable incomes or one big one decide to do.
The "breast is best" message is aimed at people in the UK who live below the poverty line and in communities of multiple deprivation, where breast feeding rates are shockingly low, and where people move from not breast feeding to feeding their kids on junk food, causing obesity, health issues and the much quoted difference of 20 years of life expectancy between Shettleston in Glasgow's East End and Bearsden in Glasgow's North West. A life expectancy in the case of Shettleston which is similar to that of developing countries. And I'm not labelling these parents as bad parents, the reasons for this pattern are very complex.
So, government, local authorities, everyone really have looked into how to change this cycle of disadvantage. There are overall aims and objectives, and a vast number of indicators which serve to show that change is taking place. One of these indicators is breast feeding rates at 6-8 weeks postpartum, specifically for instance in aim 12 of the government's 2007 public service agreement to improve children's and young people's heath and well-being, as well as ESD indicator NI53, where breast feeding is linked to higher access of maternal services which in turn means that women who breast feed are more likely to access services. In turn, supporting breast feeding also provides an " impetus to enhance health and children's support services to mothers to sustain breastfeeding and thus give children a good start early in life."
Now I'm not arguing that you eradicate poverty by increasing breast feeding rates. That would be ridiculous and naive. However, if breast feeding rates go up, other stuff has happened which indicates that there are changes in behaviour which, along the line, means that people are enabled to get out of poverty, by themselves or by taking up help to get them there.
If breast feeding rates go up, this tells us a lot about the effectiveness of maternal support services. Again, I'm not talking about 100% breast feeding rates, but something which is better than the 13% in the area where I work for instance. The WABA (World Alliance for Breastfeeding Action) 2005 Progress Report succinctly states that:
"Therefore, we believe that breastfeeding outcomes can be an indicator of a woman’s quality of life throughout childbearing. Does she get adequate food and rest, good health care, maternity protection at work? Is she free from violence and discrimination? Support for breastfeeding demands that we pay attention to the well-being of the woman behind the breasts." It's about supporting the woman, protecting her and enabling her to find suitable support. Where breastfeeding rates are low, this support may not be accessed. It is not about women who do access services and are doing reasonably after giving birth (and may or may not choose to breast feed or bottle feed).
That's why the breast is best message is necessary and in my opinion should continue to be pushed. If we're middle class mums who have had problems with breast feeding of a medical nature, a comfort nature or any other nature feel pushed a tad too hard, please get over it and look at the bigger picture. The UK has the lowest breast feeding rates in the EU, and one of the lowest child wellbeing rates, with one in 3 (please stop and read this stat again!!!) children growing up in poverty in the 5th richest country of the world. There is a link, even if it is a complex one, but if we want to be serious about ending this lamentable state of affairs, it's important to start pushing at all ends.
The breast is best message is one of many ends.