/ 15 November 2013

Comment: Breast may be best, but bribing mothers to nurse is not

Unless you've been living on another planet, here's one thing you'll be certain about. Breast is best. 

Babies who are breastfed are less likely to get infections in their early months, probably won't get diarrhoea or constipation, and are at lower risk of eczema. When weaned, they are more likely to enjoy the taste of solid food. 

As they grow up, their IQ is higher, and they are less likely to need orthodontic treatment. As adults they have lower cholesterol and a reduced risk of diabetes or obesity.

It's not just babies: mothers who breastfeed are healthier. They're at lower risk of breast and ovarian cancer, and postnatal depression. If ever nature gave us a key to improving health, this would surely be it. 

So it has to follow that as a society we should be doing all we can to encourage every new mother to do it.

That presumably is the thinking behind a study being run in the United Kingdom counties of Derbyshire and South Yorkshire where mothers are being offered shopping vouchers worth up to £120 if their babies are breastfed to six weeks, and a further £80 if they're fed to six months.

"[T]ragic" that more women don't breastfeed
I fed each of my four babies until the age of three. I think it's tragic that more women don't do it, and I believe low breastfeeding rates are a scandal. I never imagined I would end up writing a piece against a project to promote the practice. But this idea is the worst pro-breastfeeding initiative I've come across. 

Researchers at Sheffield University's School of Health and Related Research have decided to bribe women into doing something that "they" have decided is best.

But no woman in history has ever successfully breastfed without being convinced in her heart that it was right for her and her child. 

And "right" is not as simple as "read the research", because breastfeeding is an incredibly complex issue, as much to do with psychological factors as with physical ones.

Family history, guilt, pain, lack of confidence, society's attitude towards women's breasts, a mother's relationships with others (especially her partner and mother) are all part of the jigsaw that needs to be pieced together for it to work. 

Whether a woman believes it's best for her and her child is deep-rooted, and what presents as a problem is sometimes not the real problem at all. It's one of the paradoxes of breastfeeding that something so simple could have become so multilayered and complicated.

It adds insult to injury that the scheme is being tried out among "disadvantaged" women on low incomes, whose breastfeeding rates are lowest of all. 

Money could be better used
The thinking seems to be that these are the people who can be told what to do. But the motivation for breastfeeding does not vary according to whether you are rich or poor, though some of the pressures on women regarding breastfeeding (how women are regarded from a sexual point of view, for example) may be more pronounced in some socioeconomic groups. 

The money this study is spending to bribe these women would be better used looking into the reasons why some make the choice not to breastfeed and the results of such research could benefit all women.

In navigating the tricky territory of breastfeeding, new mothers have, if they're lucky at least two allies: the midwife and the health visitor. 

These professionals (and most are women, many of whom have had babies themselves) understand some of the indefinable elements of breastfeeding; they are people a mother can seek out for support. Only not in Derbyshire or South Yorkshire, where midwives and health visitors will become the milk police. Do it, or you will lose your vouchers. Do it, because we say so. Do it, or you are wrong. 

One of the problems with modern medicine is that it's too much about the body, and not enough about the mind. For hundreds of thousands of years, breastfeeding mothers have instinctively understood that putting a child to a breast is about a great deal more than getting milk inside the child. 

The members of the research team should have known that too; if they had, this project would have been binned the day it was floated. Shame on them that it wasn't. – ?© Guardian News & Media 2013

Joanna Moorhead writes for The Guardian about parenting and family life