One of the most powerful arguments many health professionals, government
agencies and formula company manufacturers make for not promoting
and supporting breastfeeding is that we should "not make the mother
feel guilty for not breastfeeding". Even some strong breastfeeding
advocates are disarmed by this "not making mothers feel guilty"
Because, indeed, it is nothing more than a ploy. It is an argument
which deflects attention from the lack of knowledge and understanding
of most health professionals about breastfeeding. This allows them
not to feel guilty for their ignorance of how to help women overcome
difficulties with breastfeeding, which could have been overcome
and usually which could have been prevented in the first place if
mothers were not so undermined in their attempts to breastfeed.
This argument also seems to allow formula companies and health professionals
to pass out formula company literature and free samples of formula
to pregnant women and new mothers without pangs of guilt, though
it has been well demonstrated that this literature and the free
samples decrease the rate and duration of breastfeeding.
Let's look at real life. If a pregnant woman went to her physician
and admitted she smoked a pack of cigarettes, is there not a strong
chance that she would leave the office feeling guilty for endangering
her developing baby? If she admitted to drinking a couple of beers
every so often, is there not a strong chance that she would leave
the office feeling guilty? If a mother admitted to sleeping in the
same bed with her baby, would most physicians not make her feel
guilty for this even though it is the best thing for her and the
baby? If she went to the office with her one week old baby and told
the physician that she was feeding her baby homogenized milk, what
would be the reaction of her physician? Most would practically collapse
and have a fit. And they would have no problem at all making that
mother feel guilty for feeding her baby cow's milk, and then pressuring
her to feed the baby formula. (Not pressuring her to breastfeed,
it should be noted, because "you wouldn't want to make a woman feel
guilty for not breastfeeding".)
Why such indulgence for formula? The reason of course, is that
the formula companies have succeeded so brilliantly with their advertising
to convince most of the world that formula feeding is just about
as good as breastfeeding, and therefore there is no need to make
such a big deal about women not breastfeeding. As a vice president
of Nestle here in Toronto was quoted as saying "Obviously, advertising
works". It is also a balm for the consciences of many health professionals
who, themselves, did not breastfeed, or their wives did not breastfeed.
"I will not make women feel guilty for not breastfeeding, because
I don't want to feel guilty for my child not being breastfed".
Let's look at this a little more closely. Formula is certainly
theoretically more appropriate for babies than cow's milk. But,
in fact, there are no clinical studies which show that there is
any difference between babies fed cow's milk and those fed formula.
Not one. Breastmilk, and breastfeeding, which is not the same as
breastmilk feeding, has many more theoretical advantages over formula
than formula has over cow's milk (or other animal milk). And we
are just learning about many of these advantages. Almost every day
there are more studies telling us about these theoretical advantages.
But there is also a wealth of clinical data showing that, even in
affluent societies, breastfed babies, and their mothers incidentally,
are much better off than formula fed babies. They have fewer ear
infections, fewer gut infections, a lesser chance of developing
juvenile diabetes and many other illnesses. The mother has a lesser
chance of developing breast and ovarian cancer, and is probably
protected against osteoporosis. And these are just a few examples.
So how should we approach support for breastfeeding? All pregnant
women and their families need to know the risks of formula feeding.
All should be encouraged to breastfeed, and all should get the best
support available for starting breastfeeding once the baby is born.
Because all the good intentions in the world will not help a mother
who has developed terribly sore nipples because of the baby's poor
latch at the breast. Or a mother who has been told, almost always
inappropriately, that she must stop breastfeeding because of some
medication or illness in her or her baby. Or a mother whose supply
has not built up properly because she was given wrong information.
Make no mistake about it—health professionals' advice is often the
single most common reason for mothers' failing at breastfeeding!
If mothers get the information about the risks of formula feeding
and decide to formula feed, they will have made an informed decision.
This information must not come from the formula companies themselves,
as it often does. Their pamphlets give some advantages of breastfeeding
and then go on to imply that their formula is almost, actually just
as good. If mothers get the best help possible with breastfeeding,
and find breastfeeding is not for them, they will get no grief from
me. It is important to know that a woman can easily switch from
breastfeeding to bottle feeding. In the first days or weeks—no big
problem. But the same is not true for switching from bottle feeding
to breastfeeding. It is often very difficult or impossible, though
Finally, who does feel guilty about breastfeeding? Not the women
who make an informed choice to bottle feed. It is the woman who
wanted to breastfeed, who tried, but was unable to breastfeed. In
order to prevent women feeling guilty about not breastfeeding what
is required is not avoiding promotion of breastfeeding, but promotion
of breastfeeding coupled with good, knowledgeable and skillful support.
This is not happening in most North American or European societies.
Dr. Jack Newman, MD, FRCPC
Breastfeeding and Guilt
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