This is not a Guilt trip

When the most recent research findings about another outcome difference between breastfeeding versus formula feeding hit the headlines, the reaction was once again predictable. There were those who rejoiced in yet another reason why breastfeeding is good for your baba and those who complained how it guilt tripped parents who didn't/couldn't breastfeed or how breastfeeding is once aspect of parenting and surely so many other parenting choices will have an impact on child behaviour.

There was even voices that pointed out how useless the research was, how it was a waste of money because it wouldn't make a penny of a difference to mums in their choice whether or not to breastfeed.

Now, unlike others who seem to have made up their mind that this piece of research was a waste of money, I believe that as with all research, only time can tell if it was or wasn't good value for money - but hey, that's what research is about! If you questioned every research project in relation to value for money and usefulness, there is a real potential that no research, no progress, would ever happen. It's bad enough that a lot of research has to be funded privately and thus often by people with dubious agendas - but the bottom line is that we need a variety of research to learn, to further ourselves, to progress.

So why is research on impact of infant feeding criticised and always ends up opening a can of worms? Why is there a problem with presenting facts? And, above all, why does anyone feel guilt tripped by the reporting of facts?

It's all about that elusive mad woman in the attic. Guilt. Mother's guilt more precisely because when did a dad last feel guilty about working full time, or his child not being breastfed?

Why do people feel guilty in the first place? Personally, I feel guilty when I've done something knowingly that I shouldn't have done while I had the option of doing something different, i.e. when I chose to do the wrong thing against my conscience.

Now, let's look at the choice between breastfeeding and formula feeding: as far as I can tell, there is a limited number of scenarios and where guilt does or doesn't come in:
a) mum wants to breastfeed, sometimes desperately so, but encounters difficulties, doesn't get the right support and stops. Guilt factor? There shouldn't be one. Mum should be angry about lack of support, and complain.
b) Mum can't breastfeed. This is rare, but for medical conditions or some situations, this might be the case. If you can't breastfeed, why would you feel guilty about it?
c)There is the situation where the mother, in full knowledge of all facts, chooses to formula feed, based on her individual circumstances and with very good reasons.
Guilt? Why? Sometimes life isn't as ideal as we wished it was and we weigh up risks and benefits and come to an informed conclusion that's fine, isn't it? Done, dusted.
d) Mum just doesn't want to breastfeed for one reason or another. Maybe she finds it yucky (yes i've heard that). That is society (culture/peer group) who's given mum that idea, again, mum's not to blame, it's very hard to oppose peer group pressure. Maybe she wants to keep going out/party/continue a life pre-baby or even doesn't want to be tied down to the baby all the time (which admittedly breastfeeding does) - or more likely conforms to peer group pressure to not be seen tied down by baby. Even I feel this pressure to just continue as usual, I see the looks I get when I used a lunch break to feed my baby, the apologetic "she doesn't take a bottle" that I still offer in explanation as if I had to justify myself. It's hard to breast feed exclusively, even if you're in a generally supportive peer group, how hard must it be if you're not? Again, mum shouldn't feel guilty if she gives in to this pressure.

So why do we feel guilty? Why do we read into every presentation of facts that demonstrates why it's better to feed human milk to human babies, rather than modified cow's milk that anyone formula feeding should feel guilty?

Research findings present us with facts. I don't get why fact finding is criticised. To claim that it won't have an impact on infant feeding choices is presumptious in my view - if we had figured out exactly what impacts on infant feeding choices, we wouldn't have those unbelievably low breastfeeding rates in some parts of the UK that I've quoted before (just as a reminder, there are various areas in Glasgow where rates are as low as 8% at the 6-8 week checkup - compare this to 95% in some countries). Now, these rates are too low by any standard and we absolutely need to do something about it. It's not about guilt tripping those who've made their choice - that's done and no research will change those choices or bring back the lack of support or whatever else that led to them, but it's about our future generations, it's about all those mums-to-be out there who are making their choice now and in future.

In a climate where everything non-statutory is being cut, breastfeeding support is waning and becoming more than patchy. And if there's one thing that's needed, it's quality support. It's vital that at least some voice out there keeps the importance of infant feeding on the agenda because there is an established link between low rates of breastfeeding and health inequalities in later life. Of course this is not just due to breastfeeding, and of course other parenting choices impact too (such as quality time spent with child every day, such as healthy weaning diet, such as access to exercise) but we can't exclude breastfeeding just because it doesn't sit well with us and formula has become oh so convenient like ready made meals. And as long as formula companies are allowed to market their product in rather questionable ways, shouldn't information marketing/promoting human milk be welcomed at the very least as a healthy balance? And how about we mums take a stance to market our product, regardless of how we fed our kids? It's cheap, convenient, high quality, no risk and tastier. Nevermind the feel good factor of being able to supply all your child needs. How come it's ok for formula companies to take airspace, advertising space in neonatal packs and the like, when research demonstrating the goodness of human milk is criticised? How come that at prenatal breastfeeding workshops facilitators are accused of being pushy when all they do is provide information and allow debate, and sometimes are even accused of being breastfeeding nazis (Breastapo is the word that I take real issue with. Nothing excuses using the evil of the Nazis in a wordplay on those promoting breastfeeding. Nothing.).

Back to the whole guilt issue. Guilt is a personal feeling. Information doesn't make us feel anything. It's neutral. How we respond is our personal choice. So to everyone who feels guilty, nobody is making you feel guilty or trying to do this, honestly. Unlike the suggestions on many platforms, news media or blogs, the research is not publish to make people feel guilty or to hit them with the breastick. Often, guilt is a sneaky feeling that turns something which should have an outward direction inward towards and against a person. Thus, instead of feeling angry with the lack of support to succeed in breastfeeding, we feel guilty for not managing. It's destructive at worst (PND anyone?) and unproductive at best.

How about we just stopped feeling guilty? How about we replace it with responsibility, knowledge and confidence?

An infant feeding research dilemma

Just after Snowflake's birth, we were asked if we'd be willing to take part in a piece of research on infant feeding. The research was explained to me and once both parents had consented, we embarked on a route of rather a lot of data gathering. Part of this is noting down every feed in the first 9 days, regular measurements and a poo and feeding record at certain intervals (my initial enthusiasm is a bit dampened because the whole thing is a pain in the bum, especially with a cluster feeding baby and a mummy who doesn't wear a watch).

Initially, my understanding of the research was that it attempted to increase knowledge of how breastmilk and formula affect the development of obesity and heart disease in the population. There seems to be some understanding that if an infant is breastfed exclusively for even just the first 10 days, this leads to a significant reduction of cases of obesity and heart disease compared to formula fed babies. What is not established is why exactly this is so. The research tries to compare three groups of babies - those breastfed exclusively for the first 10 days, those fed exclusively on a normal formula and those fed on a newly developed formula which mirrors breastmilk in that it contains less calories from fat (less than normal formula). So the idea is that the calories from fat content in formula milk in the early days may set up the body in a way that it will require more fat and carbohydrates in the future.

Breastfed babies who take part in this study (i.e. Snowflake) provide the base line against which negative effects in relation to obesity/heart disease of either formula are measured.

The background to the effort is that because so many mothers decide not to breastfeed, if a formula could be designed which was closer to breastmilk in that it had the same beneficial effect on preventing obesity and heart disease, this would significantly improve the nation's health.

So here is my dilemma: I'm taking part in a study which, in effect, may lead to the promotion of formula feeding. While I accept that some mothers can't breastfeed and some choose for very good reasons not to breast feed (and I'm supportive of this choice), I'm also dismayed at the low breastfeeding rates particularly in the so called "deprived" areas of Glasgow (and the country), the link between poverty and low rates of breast feeding cannot be denied and it contributes to creating health inequalities from the point a baby is born, arguably earlier. I've talked about the significance of promoting breastfeeding from a poverty and health equalities perspective before.

I accept that it is easier to change formula than it is to change culture. I'm not sure if it's the right way or if it will most likely lead to even more mothers not breastfeeding. My worry is also that the knowledge obtained through this study, which is supported by the NHS, funded by pharmaceutical companies, may eventually be used by formula manufacturers who don't have the same ethics that the current funders and researchers have. It's all good and well to assure me that breast milk will always be best for baby, but a formula that can be marketed as preventing obesity and heart disease just like breast milk must be extremely attractive for less ethically committed manufacturers.

For now I've done my research and all the background of the study is kosher, but once the knowledge is out, can there be control over how it's used? And another question, who am I to decide that the only way to improve the nation's health is to go the long way and change culture, would it not actually be better to change what we can as soon as we can? If this new, fat reduced formula is better for the infant's health than the formula currently available, and if particularly mothers living in deprived communities aren't going to breastfeed anyway, is the ethical thing to do not to support the development of an improved formula that will help reduce health inequalities?

I have no final answer to my questions, but would be interested to hear what you think about all of this.