Are we medicating instead of supporting?

This week's theme on the Keep Britain Breastfeeding Scavenger Hunt is 'Breastfeeding Support' and this week we've got TWO amazing prizes to give away!  Ardo have donated another Amaryll Manual Breast Pump, and the fabulous Juno Magazine are giving away A YEAR'S SUBSCRIPTION!  Information about how to enter is at the bottom of this post. 

DBM is all about breastfeeding support, and our Facebook group is almost two years old now. In that time it has turned into a vibrant online community with links to lots of other communities.  If the peer support we provide isn't the answer, then it's easy for us to signpost people to where they need to be.  Sometimes that means providing them with information about other online resources, and sometimes it means facilitating contact with real-life support groups or counselling.  In the early days I encountered disapproval from some quarters about the idea of having an 'online support group'.  Even just two years ago a few people seemed uneasy about someone using the internet as a means to support breastfeeding mothers.  Now though, it seems like everyone is doing it!  Lactation Consultants are taking part in (online) seminars about how to make the social media 'work' for them and many offer consultations over Skype.  Established breastfeeding support organisations are setting up Facebook groups.  Researchers are studying the impact of online breastfeeding support.  Mothers are even sharing their milk through online milk-sharing resources.  I'll predict that the next big thing in online support will be a 'Google+ Hangout' where breastfeeding mums can chat face-to-face. join DBM on Google+  - more info on our 'hangouts' will be coming soon - you heard it here first! ;)

Q: 'Why is there so much demand for online support?'

The background to breastfeeding's 'fall from grace' dates back (roughly) to the industrial revolution.  Small, mostly rural populations began relocating to the big cities in search of work and long-established communities were broken up (more on this here).  The upshot was that the support and knowledge previously found within those tight-knit communities got lost.  That included knowledge about breastfeeding.  As families struggled to cope with economic strain they increasingly turned to artificial feeding methods.  

Formula milk can be life-saving.  In the UK it is sold as a food, but some people think it should be re-classified as a medicine and indeed it is developed and produced by Pharmaceutical companies.  If we ask the question 'who benefits when breastfeeding fails?' then the answer most definitely is 'Big Pharma'.

How many of you live in the same street as your parents or extended families?  How many of you live close to another lactating mother you trust?   How many of you grew up watching your mother/ sisters/ cousins breastfeeding?  

If you answered 'yes' to any of these questions then I probably don't need to tell you you're in a tiny minority.  In two hundred years not a whole lot has changed.  Now, as then, in our fragmented society individuals are very often not part of a close-knit and supportive community where breastfeeding is the norm.  As a result breastfeeding is more likely to fail.  In step the pharmaceutical companies with their breast milk substitutes and away we go..  In 2005 'Big Pharma' were feeding almost 100% of British babies at age 6 months.  Although 25% of infants were still getting some breast milk, the number being exclusively breastfed was 'negligible' (IFS 2005).  

When you had your baby did a close friend or relative come to stay with you?  Did someone else prepare meals for you to eat?  Was there usually someone around to hold your baby for you while you went to the toilet or took a quick shower?  Did you get the emotional and practical support you needed in the weeks and months after birth? 

Obviously I hope your answer to all of these questions is 'yes', but speaking personally, not a bit of it!  In the past 9 months I've had a baby and looked after my older child at home whilst also breastfeeding a lot. It has been tough going at times! Some tips on how to manage breastfeeding a new baby and looking after a pre-schooler are here. I've not suffered from post-natal depression, but there have been moments when I've asked myself:  'is this hormonal and sheer exhaustion or something more?'.  If I had been suffering from post-natal depression and I'd talked to my health visitor or doctor about it, what do you think they would have done?  Would they have sent me round a post-natal doula to help lighten the load?  Would they have put in place a 'care plan' for the new mum with PND/ PPD?  Doubtful.  I think it's likely that I'd have been given a prescription for an antidepressant following a ten minute consultation.  Now not for a single minute am I saying that anti-depressants are a bad thing, absolutely not.  For some people they are a life-line (and I've had my share), but isn't it possible that in some cases what new mums really need is good old-fashioned support?  Someone to help out with the practical stuff, provide a listening ear and some tea and sympathy?  When a tearful new mother goes to her GP in search of help is a pharmaceutical product always the best option?  And if it's not, what other realistic options are there?  

A 2004 study published in the British Journal of Psychiatry looked at unhappiness following childbirth in various countries around the world and found that:  

'the strongly uniting emergent theme was that of acceptance, understanding, and social support from within family and social networks and of talking therapies if professional help was sought.' (I highlighted the words 'social networks' in the above because I think it's interesting...)

In a fragmented society where new mothers often struggle for lack of support are we filling the gap with pills instead of people?  

When you were growing up, did you listen whilst women in nearby houses gave birth?  Did you know the name of the local midwife who was likely to attend you in labour?  Did your family or another family nearby own a birthing stool?  Did you have a good idea of where you would give birth when the time came?

In this C21st I suspect most people would answer 'no' to these questions, however until relatively recently in the UK (within living memory in some cases), the answer would likely have been 'yes'.  These days the homebirth rate averages around 2% in England (and a mere 0.5% where I live), so the vast majority of people are now giving birth in hospital.  Funnily enough, most of us don't feel at our most confident or empowered when we're in a hospital, after all, it's someone else's domain.  Small things like having to ask where the toilet is or whether you're 'allowed' to eat or have a drink, can make even the most confident person feel uneasy - especially at such a vulnerable time.  The hormones of birth work best when we feel comfortable, calm, and safe.  Small wonder then, that so many healthy women who start out labouring well at home find things slow down on arrival at a hospital full of bright lights, strange noises and new faces.  It's not a problem though, because (you've guessed it!) there's a pharmaceutical solution!  Artificial oxytocin (aka syntocinon/ pitocin) can be given to force the uterus to contract and get things moving again - but it's not without risk.  And of course there are the many medical and non-medical solutions mothers can turn to if they feel they need pain relief.  

BUT, incredibly perhaps, it seems that simple support can actually reduce the amount of pain relief mothers need, and it makes medical intervention less likely.  Research also shows that mums are more likely to breastfeed when they have a doula(1).  When women have the constant support of a trusted birth companion they birth more easily and need fewer drugs - it's as simple as that.

A recent experience parenting my three year old really brought home to me how tempting it can be to medicate our way our of human problems.  My eldest daughter has various food intolerances (we're a work-in-progress) and of late she had been reluctant to use the toilet.  She had begun holding on for a day or two, getting grumpier and grumpier in the process.  She wanted to put on a nappy to poo.  We took her to see a doctor regarding something (apparently) unrelated, and whilst there we mentioned her reluctance to poo.  The consultant we saw told us to give her a daily laxative to 'give her no choice' but to go, and we were to keep giving her this for 6 to 9 months.  Once we'd picked our jaws up off the floor, we returned home wondering what to do for the best.  After all - this was a doctor's advice!  

But then I remembered, I'm her mother.  

We didn't fill the prescription.  One of the things I did do to help her* was spend the best part of an evening sitting on the bathroom floor with her sitting on the toilet in something of a suburban 'Mexican stand-off'.  Without going into too much detail she didn't need a laxative at all, she just needed my time, some dietary changes, emotional support, and a bit of an incentive...  That was more than a month ago now, and since then she has 'gone' on the toilet at least once a day and usually more.  She is very proud of herself and I'm proud of her too.  I'm also very relieved that I didn't give her a drug which put her at risk of soiling herself just to get her over the hump**. 

Are we sometimes turning to the pharmaceutical industry for solutions instead of investing time and energy in one another?  Are doctors writing prescriptions because they simply don't have the time to do anything else?  Are we all so disconnected from our 'tribes' that we've forgotten that we need them?  In an ever more stressful and disconnected world are some of us turning to alcohol, drugs, or food to fill the voids in our lives?  Are we self-medicating?  Where does it all end?

I believe that social media has enabled people to begin to revive and reconnect with some of the knowledge and support lost over two hundred years ago.  The help I got via the internet helped me to breastfeed my first daughter, it helped me to birth her sister peacefully and it's helping me to make better choices in many other areas of my life.  Through social media, we are finding new sources of support - and it's not all virtual.  Friendships made online very often become real-life friendships - I know they have for me.  With friendship and acceptance comes confidence, and with confidence comes change.

I don't know if there are any statistics on it, but I would like to bet that human milk-sharing takes place more often than five years ago, meaning that fewer babies receive formula milk than might have done so otherwise.  I will also bet that more women are continuing to breastfeed their babies beyond infancy and if I'm right, then I believe the internet will have played no small part in that.  We certainly have a long way to go before everyone has the support they need on a practical level, but the internet can provide sources of emotional support and information 24/7, and where breastfeeding is concerned that's invaluable. 

Can the internet help provide support in other areas of life too?  Of course it can!  Post-natal support groups?  Check.  Information about alternatives to medication and non-mainstream therapies?  Check.  Information about pregnancy and birth options?  Check.  I could go on.


So, why is there so much demand for online support?

A: 'There is a demand for online support because there is a lack of real-life support.'

Some anthropologists argue that we are essentially tribal beings, and I think I agree with that.  The internet goes some way towards fulfilling a need we all have for a sense of community and support - that's why social media is so successful. 
But can the 'virtual' ever be tangible?  For me that's the real challenge for communities like ours at DBM.  If we can build on our online foundations, then perhaps we can establish real-life connections too.  There is a shift happening - and you're each part of it.  Using the internet as tool we can reseed the lost common knowledge about breastfeeding in our real-life communities, and that will become real-life support.

Additional info:

*I should point out that I set the groundwork to our 'Mexican Standoff' over several weeks by a) trying to ensure sure her diet had nothing in it that she couldn't tolerate, b) giving her additional omega oils, probiotics and aloe vera daily to help calm her gut (which was functioning poorly because of her intolerances) c) ensuring that her poos were no longer hurting her (the reason for her reluctance), and d) I chose my moment very carefully!

**In some people may feel this sort of intervention was right for them, of course.  All I'm pointing out with this anecdote is that medication wasn't necessary in our case.

1. If you think you can't afford a doula, you might be mistaken.  Help does exist to enable mums find the support they deserve - find out more here and here.


For your chance to win a year's subscription to Juno Magazine, or an Ardo Amaryll Manual Breast Pump, please enter using the rafflecopter below! 

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Now why not visit one of these other the blogs participating in 'Keep Britain Breastfeeding' Scavenger Hunt?

Where Roots Flourish

Really Rachel

Petra

Diary of the Milkshake Mummy

Smilernpb