Ruth Pay is a birth doula working in Kent and southeast London. You can find her at www.mothermother.co.uk and @mothermother_doula
I want to talk about feeding babies. More specifically about how mothers want to feed their babies. How they want to feed them but don’t.
I am not talking to the mothers who want to feed with formula. I am not talking to the women who cannot breastfeed (but who are they? More on that in a moment). I am talking to the mothers who want to breastfeed and would do so for longer if they were given adequate support, and the ones who would start if given more information.
The immense vulnerability of birth opens us to particular trauma in labour and the months after. Then the tidal wave of hormones and varying degrees of sleep deprivation increase the likelihood of new parents being open to emotional triggers or new traumas. And perhaps there are echoes of our own powerless cries as infants, as we nurse and pace and sing and rock to comfort our child, to try to fix and soothe them.
I don’t think anyone is in any doubt – having a baby (in any way, biologically or otherwise) is emotionally charged. So I suppose the ways in which we care for them and keep them alive will also be fraught with emotion: worry, guilt, shame, pride…
So, why am I interested in how someone feeds their perfectly happy, healthy child? Well, I’m not really interested in the child at all. I’m interested in you. How you were respected, listened to, supported. Or not. It is because I am angry. Angry that parents are not adequately supported in making and maintaining that decision. That there is pressure in all directions and barely anyone feels they are doing the right thing. It’s a trap, we are all made to feel that we are in the wrong and that the other mothers (who are also feeling like shit!) are the ones judging us. I’m fucking furious.
Maybe you are thinking right now “who are you to say that my decision was not based on valid evaluation of information?” Stay with me, don’t be cross just yet? (You can totally be cross at the end if you like). I think that reaction – and the reaction from all those people who tried to stop me breastfeeding (a whole other post…) is pain of loss. Is pain of being let down. None of us want to think that we might have been able to do something we really wanted if years later we are told there is now a way. “Fuck that. I wasn’t able to! Why couldn’t they have helped me?!” We all have pressure points. My personal brand of pain is in knowing I lost control over what my baby was fed straight after birth. I know there is more to this than a decision made because we can’t be arsed. We very much can be arsed.
Let me do some dodgy maths a second to show you what I am trying to figure out…
There are 700,000 births a year in the UK, and prevailing wisdom is that 1% of women cannot breastfeed due to a physical issue like milk supply, which would be 7000 women per year. There are 65 million people in the UK and 1.5 million people living in Kent (where I live, and come across other mothers), 2.3% of the total population. 2.3% of 700,000 is 16,100 births in Kent, 1% of 16,100 is 161.
161 should be the approximate number of women in Kent that have given birth in the last year and have a physiological reason for not being able to breastfeed.
I had met more than 50 mothers, with babies under 1, at groups and sessions in the 1st 6 months of motherhood. You would think that I might have come across one mother (0.5 people being 1% of 50) who is formula feeding due to physical reasons. And even then, I may not have spoken to her about that, or she might not have shared that with me.
So, says my brain, most of people (so far I’ve counted between 15 and 20) who have talked about having too low a milk supply to keep their babies fed must have been wrong, misdiagnosed or feeling ashamed about stopping right?
I am cringing writing this – I can hear you all thinking, “can I have some evidence please?” and “it’s none of your business if they could or couldn’t” and maybe “no wonder they didn’t tell you if you are this judgemental…” But I’ll try and get to my point..
1) Is the 1% number I’ve seen in antenatal / breastfeeding literature utter bollocks? The only peer reviewed studies I’ve found talk about 15% of women struggling, with 4% having chronically low supply. Statistics are dangerous. People like me cling to numbers and ignore the facts, the skew, the story. If 1% is false, why?
2) Why are so many mothers that talk about formula feeding, with the little head dip and shoulder shrug that says “please don’t judge me”, ashamed at all? Do they wish they could have carried on and feel a loss? Do they just feel judgement from belligerent breastfeeding activists and aren’t sure they are doing the right thing? (Who is though really?)
3) Do people have enough physical and mental support to breastfeed? I think (and we have established that my thoughts are based on not very much except my experience and a couple of books), that breastfeeding takes quite a lot of physical support to keep you going. I think it is quite physically draining, and if you are cutting calories, not staying hydrated, and not getting enough sleep (lol, right?), it will have an effect on your supply. If you are sitting or lying feeding your baby every 20 to 40 minutes for 8 weeks or so, as I was, then you can feel pretty isolated and it is hard to look after yourself and feel well enough to continue.
I have been incredibly well supported by my husband, mother and the NHS. In the first two weeks I had my husband at home bringing me all my meals and keeping my water bottle filled. He brought me my medication so I didn’t forget, he injected me with anti-coagulant after my C-section. He would take the baby and dog for an hour long walk on Saturday mornings so I could sleep. He asked me if I needed to get help when I was crying with painful feeds. I snacked like there was an impending snack crisis. He stayed home for two weeks after the birth, then my mum arrived for a week. She fed me and made me nap. She cleaned the kitchen and bathrooms and walked the dog.
I had various levels of support and information from the NHS – midwives, NICU nurses, health visitor, GP. One particular NICU nurse was completely wonderful and said exactly the right thing when I needed it. Most professionals effectively told me to keep breastfeeding and that it would get easier. If I told them that I was worried he was getting enough milk, they reassured me and said it was all OK and he was good. We aren’t perfect by a long stretch, but I think I was in a very privileged position. (I was thrown a lot of curve balls too, don’t worry, I didn’t have some sort of #blessed journey).
In conclusion, our breastfeeding journeys are all as different and as similar and as complex as we are. A lot of women choose not to breastfeed, and other choose to do it, but some seem to have their choices taken away. This is a point of social justice for me. Women have the right, for example: to move in labour, to choose to be examined or not, to breastfeed or not. A new mother deciding to breastfeed needs to be supported in order for it to be successful. It is not enough to tick a box and it is not acceptable to try to encourage her not to, however well meaning. The women who’ve had their choices quashed, who were not “allowed” to breastfeed, are feeling that loss decades later.
To have our autonomy taken away, our motherly purpose in a way, can be traumatic in the right circumstances. If we speak out about our choices to one another, if we listen without judgement and share without shame, then we have an opportunity to find out how a person actually wants to be supported and to hold each other in right way.
These thoughts were part of the reason I retrained as a doula. If I could be there and mother the women the way I was mothered, then maybe they will get the chance to breastfeed longer if they want to. Maybe I can help start taking some of the shame out of this and healing some of the hurt that has been done in previous generations. I hope that I will never be guilty of assuming what someone needs, but instead listen to their thoughts and choices before supporting them in those.
I hope this says what I intend; I think mothers are fucking awesome and I raise my glass to you all right now. It’s gin. Not milk.
And, if you want different support in pregnancy and birth next time around, I would be honoured to stand there with you.