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Saturday, 25 February 2012

The hidden cause of breastfeeding problems.

ISIS - the Egyptian Goddess of Motherhood, Magic, and Fertility

Q: Why do the vast majority of mothers in the West formula feed their babies?

We all know that the vast majority of mums CAN breastfeed.  There is nothing wrong with their 'equipment', and yet they struggle and give up.  Some never even start.  You hear so many different reasons why people didn't breastfeed beyond a few days or weeks.  Often the same ones crop up.
Often mothers who breast feed 'successfully' scoff at these reasons.  Sometimes they say: 'If a mother is determined enough they will breastfed'.  I'm afraid I don't agree.

That comment makes the assumption that all mothers should know where to go to go to seek out the support which would make breastfeeding possible.  It assumes that they know that doctors and health visitors aren't breastfeeding experts.  It assumes they can withstand pressure from their families and friends to give formula.  It assumes they're confident enough to breastfeed in public.  It assumes that everyone should be 'proactive' about finding breastfeeding support.  It assumes that new mums are not hormonal or suffering from PPD/ PTSD and are able to reach out.  It assumes a lot.  

YOU know that good support and information is out there.  But what if you've never even heard of La Leche League or the NCT?  YOU might have heard of them, but that's just you....  What if a person didn't get good breastfeeding support in hospital or adequate information during their antenatal classes?  What if no-one discussed their feeding options with them properly, allowing them to make a fully informed choice?  What if they went to their doctor for help with a breastfeeding problem and were given poor advice?  It happens a thousand times a day.

We know that only a tiny percentage of women physically cannot produce enough milk for their babies.  However, if someone has been advised to give a top up/ doesn't know to put their baby to the breast often enough in the first days and weeks of life/ doesn't know how to ensure their baby is milking the breast properly and painlessly (etc etc) then that really CAN develop into a genuine supply problem.  If they don't know how to correct the problem, then these mothers will find their milk supplies compromised permanently.  They won't make enough milk, and they will develop a genuine supply problem.  When a doctor tells you to do something, you do it - right?


That's a genuine breastfeeding problem.

It won't do any good for breastfeeding advocates to say 'you could have fed your baby if..' because that just sounds like criticism (even though your motives for saying so may be very different).  The truth of it is that our environment is littered with genuine reasons for breastfeeding failure.  When breastfeeding myths are perpetuated in the press and on television, in living rooms, buses, caf├ęs and (some!) doctor's surgeries it's no wonder that so many people believe them to be true.

So I'd like to propose that a sizeable number of women who do not breastfeed their babies are actually suffering from a genuine breastfeeding problem.  I'm going to call it ISIS.

Insufficient Support and Information Syndrome.
'syn·drome  n. 
1. A group of symptoms that collectively indicate or characterize a disease, psychological disorder, or other abnormal condition.
2.  a. A complex of symptoms indicating the existence of an undesirable condition or quality.   b. A distinctive or characteristic pattern of behavior' (from thefreedictionary.com)

What are the symptoms of ISIS?

Well, everyone is different but the symptoms may include
  • Inability to breastfeed (usually leading to formula feeding).
  • A genuine belief that they cannot breastfeed.
  • Emotional issues (eg. grief at the loss of a breastfeeding relationship/ sadness/ feelings of failure/ anger/ resentment/ guilt)
  • Increased medical problems (in mother and baby) as a result of breastfeeding cessation. 
If you look at breastfeeding statistics you will see that ISIS is actually a very widespread problem.
'only 35 per cent of UK babies are being exclusively breastfed at one week, 21 per cent at six weeks, 7 per cent at four months and 3 per cent at five months' (from the UK Baby Friendly Initiative website) 
The long term effects of this syndrome are genuinely massive.  Not breastfeeding is costly both to the health of the mother and child, and leads to greater financial costs in terms of the health care those individuals may need.  These are costs our whole society bears, and yet we seem unable or unwilling to recognise or address the problem.

You'd think given how many people are affected by ISIS there would be teams of intelligentsia meeting regularly in order to address the problem - but strangely enough there aren't.  

Why not?  Well - it might be because there simply isn't the demand.  Our society genuinely doesn't realise that it's ill.  It might also be because it's an issue that only directly affects women and children - and those women are usually on maternity leave when the situation is at it's most critical.  ISIS generally doesn't affect a woman's ability to earn or pay tax because so few people currently go on to breastfeed and work (although you can!).  It might also be because of the amount of revenue the governments get from the formula companies.  The formula milk industry is worth £119 million in the UK per annum.  
'At the lowest estimate of £5m the manufacturers spend £6.25 for each baby born in the UK. The government spends 9p-16p per baby on breastfeeding promotion'   ~ from Baby Milk Action.
Who are the decision-makers in our society?  How many of them breastfeed or have an awareness of breastfeeding issues?  How often do you see this?


Licia Ronzulli, Italian MEP with her newborn

It is a (largely) invisible illness.  I made the name up myself.

How can ISIS be treated?

The answer is both simple and hugely complex.  We need to address the causes of ISIS.  It is caused by a lack of support and good information.  It is exacerbated by misinformation and societal pressures.

  • We need to train our medical professionals properly.  Breastfeeding should be CORE to their training given how important it is to our health - at the moment they don't need to have any.  
  • We need to ensure that new mothers are given accurate information about breastfeeding and the risks associated with formula feeding before they have their babies and good support afterwards.  Without it they cannot make informed choices.  
  • We need to ensure that the media and mainstream public events targeting parents do not misinform mothers about breastfeeding.  
  • We need to ensure that formula companies adhere to the law when it comes to advertising and targeting mums-to-be.  
  • We need to fully implement the WHO code in law.
  • We need to work to improve legislation to protect breastfeeding mothers (where I live in Northern Ireland our legislation is pitiful - the Equality Act 2010 doesn't apply here). 
  • We need to ensure that properly trained breastfeeding support is widely available on the NHS.
  • We need to re-normalise breastfeeding, both online and in our local communities.  Breastfeeding mums should feel supported to breastfeed - wherever they are, they should not be made to feel they are doing something grubby or obscene.

ISIS is real.  The symptoms are real.  The damage it does is real.  Only the name is made up.    

25 comments:

  1. Great points! I definitely had this with my first daughter, and though I know better now, my supply was compromised so early on I didn't realize what was happening. I remember clearly one of the midwives in the SCN saying "big breasts are no good for feeding little prem babies." Fortunately I already knew this wasn't true, but that could easily have been the last word on the subject. It took us over a month to overcome the early feeding problems, but with support and lots of good information we went on to have a breastfeeding relationship for 16 months.

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  2. Love this! Will share on FB & Twitter...

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  3. bravo,i have always said that,gotta keep trying

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  4. Wonderful! There is a lot of truth in this post. Love the idea of giving a name to the oh so prevalent reasons for breastfeeding "failure".

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  5. Great blog! This is so true. I always got mad when other moms told me that they didn't have enough milk, but how do you tell them that they are fine and if you feed on demand babies sometimes feed very often etc...without offending them. How do you break this news to them?

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  6. So true! With our first little one I struggled as I thought it would all happen naturally and easily. After having Mastitis I gave up, I was not prepared for the ugly side of breast feeding and copped criticism for giving up. This time, things are different, I have read up and prepared myself, the hospital are doing an amazing job at ensuring I'm prepared for breast feeding this time round because I struggled so much the first time. As much as I value their help, shouldn't it be the other way around? Shouldn't health care professionals be preparing/educating women for their FIRST experience of breast feeding?

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  7. I think it's a shame that women use excuses as to why they aren't breastfeeding. There is so much information out there and available, that in my opinion (besides extreme circumstances) they don't breast feed. Women give up too easily. It's accepted in society so I feel that a lot of women don't care.

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    1. What a load of rubbish. I am so angry at the NHS for ruining my BF experience. My daughter was tongue tied and they couldn't get me an appointment to get it cut for 2 weeks. Unsurprisingly she lost too much weight and re-gained slowly, and I was told to give formula top-ups. By the time her tongue tie was cut, my nappies were bleeding so much she was vomiting blood, and I was crying through every 2 hour long feed. I am now combination feeding and trying to build up my supply but had the tongue tie been cut earlier, her latch sorted and more acceptance of her weight loss, I would still be exclusively BF now. Also I had no idea it would be do hard - all the position email press for BF made me think it would be easy. I had no pain relief during my labour but I would rather go through that again than the pain of BF in those first two weeks.

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  8. ^^^ It should be clear from the blogpost above which you may (or may not!) have read that I totally and utterly disagree with your comment 'anon'. I think it would be very hurtful to many people. Did you maybe forget to use the word 'some' in every sentence? Perhaps you have to remain anonymous because you don't actually HAVE a name - since you apparently come from a different dimension (or perhaps on another planet) to me.... anne

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    1. I am grateful I found La Leche League. If I hadn’t heard of it in college several years earlier, I don’t know where I would’ve turned for help. When I was pregnant, I read about breastfeeding and made up my mind to do it, but I had no idea how hard it could be. I thought it would come naturally. I hadn’t read about how hard it could be, and I didn’t really know anyone who breastfed. I might’ve just given her formula in the first two weeks when I was struggling with the poor latch, low supply and finally mastitis. However, my daughter hated formula, threw most of it up, and looking longingly at my breast. I had to pump all day for 4 days because I had damaged nipples after I got through the mastitis, and my daughter drank from a bottle. She drank it all, but she looked so sad not being able to be at my breast. LLL gave phone support till the next meeting a few days later where the leaders helped me with the latch and moral support. I made it through the first 8 weeks, at which time I just tried to make it through each day, and then made it to 6 months, and now a year. Now, I am aiming for 24 months. I am considering becoming a La Leche League Leader because breastfeeding is so important to me and I want to be able to help others the way I was helped. There is definitely a need for more information and support with breastfeeding.

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  9. And can I also add that you don't have to have given birth to breastfeed your baby? I've nursed 5 of my 6 children but have only given birth to 1 of them. (the 6th was unable to nurse due to medical problems - for him, I pumped and tube fed him breast milk). Also something NO ONE in the medical profession knows about!

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  10. Fantastic...this needs to be an actual medical term! Sharing this post all over the place!

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  11. This doesn't sound right. Frankly, it sounds pretty ridiculous to me. I think that if Mom's were in their right minds then they would already know what to do or else they would go online and get information they needed if they really didn't know what to do. How hard is that? I think that whole ISIS thing is a load of bologna. I also think that we shouldn't be giving Mom's out there yet another excuse to not breastfeed. What did Mom's do back before humans were civilized? They breastfed their babies of course...and without a support group or any information or instruction manual at all. It's called natural instincts. All women still have natural motherly instincts and should block out everything else and listen to them. I'm a mother of a 3 year old and I'm appalled and disturbed by mother's today. I had just turned 19 when I gave birth to my baby and yet without any support or people telling me what to do/ how to breastfeed I just already knew. I already knew it was absolutely the best thing for my baby. I knew how to make him comfortable against my bosom and I knew when he was hungry, I just knew what to do. I listened to my instincts, I didn't think about anything else but what my baby needed and how I was going to give it to him. It all came naturally to me...and I was young and had no one helping me. Even after I got home and he started to cry a lot and push away when I tried feeding him I didn't give up, I went and bought a breast pump and endured the painful soreness of constant pumping to get my baby the breast milk he needed and deserved.

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    1. Well, bully for you. You're a very lucky woman not to have gone through anything mentioned in the article. I suppose there should be no advice available about prostate cancer either, seeing as it's never happened to you.

      What did Mom's do back before humans were civilized? They breastfed their babies of course

      ... and were used to the fact that about a quarter of their babies would die in the first few weeks. I don't know, I'm one of those sheltered people who assumes that letting such children die is a bad thing

      ...and without a support group or any information or instruction manual at all.

      No, just every other member of their tribe or family... and if they did have supply problems, another woman would quite often breastfeed for her.

      I also think that we shouldn't be giving Mom's out there yet another excuse to not breastfeed
      Except that if you go around pretending problems will never happen with breatfeeding just the same as they can happen with every other part of the human body, how is anyone supposed to address them, if we just stick our fingers in our ears and go 'lalala, not listening, your breasts only hurt and your baby only isn't latching on because you don't love him enough!'

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  12. ISIS- this is exactly how I feel about the matter! society needs to be addressed, too much pressure put on the mother. When I feed in public part of me is already prepared for how i'd deal with an altercation calmly. Why should a person put themselves in that situation willingly?
    Poor attitude Kat; how can we begin to understand what it's like for women who struggle to breastfeed and don't succeed. We each have personal victories in our bf journey, yes celebrate them but don't use them as a basis to judge others.

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  13. Sorry, but it is not the world's job to take care of you. If you need help then it is your job to seek it out. With such a plethora of information and support available at the click of a Google "search" button, I find it astounding that we would still be telling people that it's everyone else's fault that new mums are badly informed. Yes, there is a lot of conflicting advice out there, but that is why it is the job of the new parent/parent-to-be to research the topic thoroughly and come to their own conclusions.

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  14. You are really assuming a lot when you say just a Google click.away. that mom has a computer orphone which is internet capable. That she can afford home internet. That anyone ever informed her formula has risks. That she lives in an urban area with plentiful local support group and well.trainees.lc's available. That she knows breastfeeding isn't supposed to hurt and she isn't a wimp or.bad mom for being unable to cope with the pain.
    That being said I used to think.like you. I had my gift at 18 and breastfeeding came easily and naturally. No problems at all the same with number 2. Then along came number 3 with tongue tie, lip tie, a high arched palate, sore raw nipples, and pain like jot nipples upon nursing. As an experienced mom from a breastfeeding family I knew this pain was WRONG but what if Id keen a ftm with no one around who.ever.breastfed? I can tellyou what would have happened. I would have quit. Even knowing her tongue tie would.be repaired soon(it was seperated when she was 12days old) I was pumping and bottlefeeding by 8 days old. Had I not been knowledgeable independently of my health practitioners I would have given up.

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  15. Information and support are key. I did lots of reading before birth, but none of it was on breast feeding! I didn't know it would be hard! I didn't realise that with some more information, I could be reassured that the ceaseless feeding in the early days was absolutely normal, and not a sign that I didn't have sufficient milk ( which is what I thought at the time). I've read so much since then and fortunately I did get through that early danger period without formula, but I can see why people give in to formula.... Most of the time they just don't know how bad a thing it is, because they haven't been adequately educated on the topic.

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  16. Fantastic1 You've hit the nail right on the head :) I totally agree that ISIS *is* a real problem (even if the name is pretend ;) ) I struggled massively - turns out I habe breast hypoplasia putting me into the 'rare' cases of women who physically can't (exclusively) breastfeed. I'm lucky that I do produce milk, even if it wasn't enough in the early months before solids. All this wasn't helped by my son's posterior (hard to spot) tongue-tie, lip-tie and high arched palate. I am convinced that I would have given up if I had not had access to amazing support through my local LLL group. I did have to be pro-active in seeking it out, the NHS was quite frankly rubbish! If I hadn't have had all the information and support with supplementing I would have given up, assuming I just couldn't do it (which actually did have some truth in my case). Thanks to this support I didn't get ISIS, and still feed my 16-month old son. I know others who live elsewhere (where support is harder to come by than in Cambridge where I live) who were not so lucky. This shouldn't happen, and I'm trying all I can in my own little way to make a difference and help spread the word about breastfeeding through the struggles!

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  18. My daughter is now six and I am still absolutely heartbroken that I could not make my breastfeeding relationship last longer than 4 very painful, traumatic weeks, where my healthy girl went downhill and I became so afraid of the pain that I began to detach myself from her... It was the worst experience of my life and my health visitor could only give me supplies of wound dressings and advice to carry on... The infections in both nipples became so bad I was delerious before the emergency doctor made the decision for me to feed my baby formula. Thank goodness he did! I could finally look at my beautiful baby without crying in fear and the searing pain that travelled all over my chest and back every time I attempted to feed. I tried to express once I had healed a bit, but there were just drops of milk after hours of pumping and I needed my baby back, to hold and love, not sit with a machine attached to me. I still didn't give up. I researched cases where mothers had nursed their adoptive children and I longed to try again. I visited a local breastfeeding group and borrowed a video to try and learn what to do... It didn't work so I went back to them in the hope someone would help me. I just remember trying to talk to the group leader in the hall, sobbing uncontrollably, and then being asked to feed my baby outside because the other mothers did not welcome bottle feeding. I have never recovered emotionally, or had more children. I had no advice before I gave birth and I honestly thought it would come naturally... Why wouldn't you think that if you aren't told otherwise? In times gone by, my baby would have died or been fed by another woman. On reflection, the birth was so traumatic we both would have died then anyway. The truth is that when you see a woman feeding her baby with a bottle, she is not necessarily being lazy. You can't assume everyone is the same.

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  19. OMG I am so, so, sorry to read about your experiences. Thank you for posting. I hope you don't mind if I share this comment with my group (anonymously). I think it would be good for some people to read. Sending hugs - there is so much more to mothering than breastfeeding x

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