The Benefits of Breastfeeding (aka the 'so-called' benefits of breastfeeding)

This post was originally written as part of a series of blogs for the 'Keep Britain Breastfeeding Scavenger Hunt' 2012.  

Gah.

The 'Benefits of Breastfeeding' - a favourite phrase trotted out left, right and centre by doctors, and formula companies alike.  

If you don't do an *eye roll* when you hear (or read) about the 'benefits' of breastfeeding/ breast milk, then fair enough - it's an innocuous enough turn of phrase on the face of it.  However rather than trying to explain why I, and so many others, might prefer to say 'the so-called benefits of breastfeeding' I'm just going to invite you to watch this:

Dr Karleen Gribble speaking at the 'Hot Milk' Debate, 2008

You see, there really aren't any benefits to feeding your child at the breast.  Children who do not receive breast milk are not receiving what they are biologically programmed to receive, and what their small bodies are expecting.  They don't receive the protection their immature immune systems require and they don't receive the growth factors, and even stem cells, which have an impact on their physical development.  Infants who aren't fed at the breast may not receive the same regular, physical skin to skin contact that they are emotionally programmed to receive (although suggestions to help get around this are listed here).

But forget all about how gushingly *amazing* breast milk is (because there are people out there who really don't believe it's that big of a deal..) and think about what the baby experiences.

When a close friend of mine had her first child she had an experience that I think many new mothers can relate to.  She struggled in vain to get her new daughter to breastfeed (small wonder when a midwife shoved the back of her baby's head right into her breast so hard that the child developed a strong breastfeeding aversion), so my friend expressed her milk for several weeks until it all became too much for her.  Her partner wanted to feed their child, so did various grannies and aunties etc and so, within days of birth my friend's first child was being held and fed by a variety of different people.  Now, please don't get me wrong, this mum has an absolutely fantastic relationship with her daughter - she has taught me a huge amount about patience and understanding (and is a lesson to anyone about how being a mother isn't all about the breastfeeding *sigh*) - BUT - the  biologically expected order of things (the continuum) was effectively eroded for them both when breastfeeding failed.  How breastfeeding begins is important (and before you say it, NO, it's not everything and bad starts CAN be mended, but nonetheless it's important), for mother and for baby.  

  

When a baby is fed from a bottle, the general consensus amongst many people in our culture seems to be that it's ok to 'have a turn' at feeding them.  This is the same regardless of what's actually in the bottle.  When a baby is breastfed, it generally means that (in the early days and weeks anyway) the baby is only fed by it's mum, and she's often not far away.  That's simply the normal order of things.  We can argue until the cows come home (if you'll pardon the pun..) about how much any deviation from this biological norm matters or doesn't matter, but the reality is that breastfeeding is just what our 'inner monkeys' expect.  

The baby at it's mother's breast, smelling her smell, feeling her warmth, hearing her heartbeat, drinking her milk, feeling safe and secure.  Situation normal.

But what of mothers?  I don't think we talk enough about mothers...   

What's 'best' for mums?

Well - unsurprisingly - breastfeeding is.  Again, let's forget all the so-called 'benefits' (cancer reductions, diabetes reduction, weight loss, no periods etc etc),  and let's talk about the emotional stuff.  How do mums feel if they don't breastfeed?  The truth is that some mums are 100% fine with it - they stop and they quite simply never look back.  They say they're not bothered and I for one, absolutely believe them (not that it matters what *I* think anyway).  However, not breastfeeding isn't fine for everyone - because after a pregnancy our bodies do expect to breastfeed.

When my first daughter was on one of her (frequent) feeding strikes my husband gave her a bottle of expressed milk and she wolfed it down.   I cried the whole time.  After that, every time he gave her a bottle I'd leave the room and cry somewhere else.  Some people will think that that was plain stupid of me but I think others will understand.  I didn't know it at the time, but the sadness and loss I felt during those bottle feeds was perfectly natural.  Our 'continuum' had been broken, my daughter was getting fed but it wasn't by me (even though it was my breast milk in the bottle).  I felt a failure, but more than that I felt a sadness I couldn't rationalise.  

You see for me, having my baby at my breast, smelling her smell, feeling her warmth, feeling the suckling, knowing she was safe and secure meant a lot to me.  It meant 'situation normal'.

Numerous studies now show how skin to skin contact benefits babies, but the bottom line is that it benefits mothers too.  One study showed that mothers who had skin to skin contact for several hours daily during the first month post-partum scored lower for post-partum depression.  Other studies have similarly shown that mothers who breastfeed their babies at night are at a lower risk of PPD.  A 2011 review in The British Journal of Midwifery stated in 2011 that:

'there is clear evidence that breastfeeding helps to protect against PND.'

Most interesting to me personally is a theory which suggests that:

'Opting not to breastfeed precludes and/or brings all of the processes involved in lactation to a halt. For most of human evolution the absence or early cessation of breastfeeding would have been occasioned by miscarriage, loss, or death of a child. We contend, therefore, that at the level of her basic biology a mother’s decision to bottle feed unknowingly simulates child loss.' 

http://www.scientificamerican.com/article.cfm?id=bottlefeeding-mimics-mourning

Now I know that it's not always as simple as a mother 'choosing' not to breastfeed her baby - I really do know.  I know it's often hard for mums to get the support and information they need to breastfeed, that's a big part of why DBM exists.  However, it's also true to say that rates of post natal depression (PPD) are higher than ever these days.  Women (and doctors) often cite an unhappy breastfeeding experience as a factor in developing PPD - and rightly so.  All too often new mums really do have a dreadful time of it.  Who could blame a woman who has endured repeated bouts of mastitis, cracked nipples and poor weight gain in her baby for stopping?  Not me!  However I can't help but wonder how that same mother might feel a few weeks/ months/ even years down the line...  I wonder if sometimes an initial feeling of relief is replaced by a sadness and if, for some people, that sadness contributes to depression.  To me it seems completely logical that supporting mothers to breastfeed properly would help towards a percentage reduction in PPD.  Sure I don't know how big a percentage, sure there are lots of factors which contribute to PPD and breastfeeding is just one, but all the same, isn't it worth considering?

I get mad when I hear that medical professionals are telling mothers to wean because of an oft-mistaken belief that you can't take anti-depressants and continue to breastfeed.  I get mad when doctors tell mums to switch to formula instead of directing them towards trained breastfeeding support to help them resolve their breastfeeding problem.  I've seen joy and relief on the face of a mother who has gone from weeks of pain to just a 'tickling' sensation in a matter of seconds with only a small adjustment.  Me, a (lowly) volunteer peer supporter called in desperation, helping when a procession of midwives, health visitors and doctors had failed to provide relief.  One GP in my locality even mistook that same mother's large breast abscess for a blocked duct!  How can any of this be right?  It's not right.

Breastfeeding is not 'best' - there are no 'benefits'.  However NOT breastfeeding is a much bigger deal than just denying your child a few antibodies.  Mothers and babies don't stop needing each other once pregnancy ends.  Even after the cord has been cut they continue to need each other on an emotional and very physical level - of course they do.  The inevitable separation of mother and child can be sudden or it can be gradual, and gradual is better for both.  So instead of talking about breastfeeding, we should be shouting about supporting mothers and babies properly.  If we did that, then the 'breastfeeding' bit would start to take care of itself and it would just become normal again.  And that would benefit everyone.