Some weeks back, I cast my vote for the institution of a national breastfeeding co-ordinator and a national breastfeeding strategy. I do hope this doesn’t prove to be a mistake.
The trouble is, it’s not possible to assume that just because a strategy is aimed towards a worthy end it’s going to be a good strategy. For example, the recent article about the US breastfeeding campaign, currently the subject of much discussion in blogworld, leaves me highly dubious.
Objections that this sort of approach might make formula-feeding mothers feel guilty have been met with much indignation from certain quarters, and although some of this does seem to be due to a "What? You mean I actually have to consider the feelings of a woman so beneath contempt as to feed formula to her baby?" attitude, a lot of it seems to be based more on a belief that breastfeeding is so important that if mothers’ feelings get hurt along the way then that’s a price worth paying.
The problem with this is that it completely misses a crucially important point: People’s feelings play a huge part in determining their actions. The question is not just whether we should be willing to sacrifice women’s feelings on the altar of increased breastfeeding rates, but also whether sacrificing women’s feelings might do breastfeeding rates a lot more harm than good. Ever hear that old saying about how you catch more flies with honey than with vinegar? In general, alienating people isn’t a great way of inspiring them to take your help and advice. It’s a great way of inspiring them to get as far away from you as possible, muttering darkly "What does she know, anyway?"
Think about this. Suppose your knowledge of breastfeeding consists entirely of a general awareness that Breast Is Best and a lot of horror stories from family and friends about how Lots Of Women Don’t Have Enough Milk, Dear, And Besides Cousin Elsie Was In Agony With Her Nipples Until She Switched To A Nice Bottle. Even though you feel you should probably try breastfeeding, the stories you’ve heard about it leave you pretty worried about what the whole business might be like. But, more than that – you’re worried about how you might feel if you try it and it doesn’t work out. Or, worse – suppose you know how you’ll feel if you try it and it doesn’t work out, because it happened to you once before. Suppose you want to try, feel you ought to try – but, at the same time, can’t face the thought of feeling like a failure if you can’t make it work.
Now, suppose that what you see of the pro-breastfeeding camp is an advert designed to put across the message that formula feeding is so dangerous, unnecessary, and generally idiotic that it can be appropriately compared to riding a mechanical bull while heavily pregnant. Or, to put it another way: Hello! We’re here to give you breastfeeding support with a double helping of extra criticism and guilt on the side!
How likely do you think you’d be to call and ask those people for breastfeeding help and advice?
The standard answer to concerns about the guilt issue (and one with which I wholeheartedly agree) is that if a woman really couldn’t breastfeed, she shouldn’t feel guilty. I know that; the lactivists know that. Do the women who need to know that know it? We often make the mistake of talking as though guilt is a logical, rational response. This is even less true in motherhood than in other areas of life, because of the widespread belief that we should all be Supermummy, capable of dealing successfully with any problem or crisis, always getting it right.
Anyone who has worked with people who have been abused in any way knows that, ironically, guilt is a common reaction on the part of the person abused. Emily (whose story I used to have a link to, but, unfortunately, her site has been abandoned and then hacked and so I’ve had to delete all links to it) is an example of this. I’m not talking about the abuse she received as a child, although I’m aware it’s relevant to her reaction; I’m talking about the abuse she received at the hands of the medical professionals who were meant to help her breastfeed and screwed up dismally. Emily was left feeling as though she, rather than they, was the failure. Is that logical? No. Did the lack of logic stop her feeling that way? No. Is it constructive or helpful for her to have people giving her the message that not only is it All Her Fault that she didn’t breastfeed, but that if that message makes her feel guilty then that’s her problem for reacting to it the wrong way? I’m guessing probably not.
Oh, it’s entirely possible the advert works on some people. Guilt can sometimes be a powerful motivator – I’m sure we can all think of times when it’s spurred us into tidying that cupboard, getting that presentation done, going for that workout at the gym. Thing is – how many times have you pulled the door firmly shut on that messy cupboard or sat eating chocolate to drown your guilt over not exercising? How many times has guilt had the reverse effect, pricking you into trying to get your thoughts as far away as possible from whatever it is you’re trying to avoid doing?
Do we have any idea how many people were put off by this advert rather than inspired by it? Do we really want to risk the possibility that this approach does more harm than good?
But this advertising campaign bothers me not just because of the possible harms, but also because of the missed opportunity. The information it gave wasn’t the information that is actually needed most.
I really don’t think there are substantial numbers of people out there who are genuinely oblivious to the fact that there are certain claimed advantages for breast milk. There are certainly people who choose, for whatever reason, to ignore the fact; but something tells me that showing them a picture of a pregnant woman on a mechanical bull isn’t going to make them slap their foreheads and cry "Mechanical bull? Dammit, those breastfeeding advocates were right all along!" (I’m concerned it might be more likely to have the opposite effect; "Mechanical bull? These idiots are trying to claim that formula is as risky as taking a fetus on a mechanical bull? Well, who wants to listen to anything they have to say?!") The biggest area of ignorance in breastfeeding isn’t about whether or not it’s better, but about how to do it.
When a woman is being told that her baby needs formula because he isn’t getting enough milk, she doesn’t need yet another lecture on how breast-is-best, not even if that lecture comes with detailed statistics as to the reasons why it’s best. What she needs is advice on how she can increase her breastmilk supply. (And, for that matter, advice to help her determine whether there’s even a problem with the milk supply in the first place.)
Just imagine that the advertising campaigners had used their brief slot on screen to try to put across that sort of information. Oh, of course you can’t use that kind of timespan to make the public into breastfeeding experts – but I don’t think you need to. I think that it could have been responsibly used to make people aware that problems can usually be overcome and that many of the supposed indications for stopping breastfeeding are actually nothing of the sort.
So, for example, the voiceover could have said something like "I didn’t think I could make breastfeeding work at first – my nipples were sore and I felt exhausted. But when I contacted <whatever the organisation’s called> they were really helpful, and now everything’s going wonderfully – I’m so glad I persevered." There are a lot of possible alternatives I can think of – the "My doctor told me I didn’t have enough milk" story, the "I thought I wouldn’t be able to combine breastfeeding and work" story (with the variations of either pumping at work or breastfeeding morning and night while formula-feeding at other times), the "Other people told me I could never do it…" story.
And for the camera work? Scenes of a woman working breastfeeding into her normal life. Sitting comfortably at home feeding a baby, doing something one-handed while nursing the baby with the other, nursing in public. Just pleasant ordinary scenes of how breastfeeding can be happily and naturally integrated into life in general – a subtle positive message to the subconscious, to counteract the bottle-as-norm images that we seem to see everywhere else.
If we ever have a national television advertising campaign encouraging breastfeeding in this country, then that’s the kind of thing I’d like it to show. But it still strikes me as a lot less important than other things that need to be done. For example, while we already have the excellent maternity leaves that US mothers yearn for, what we don’t have is legal support for the right to breastfeed in public. I’d like to see that put in place. And I’d really like to see proper, evidence-based breastfeeding education made a mandatory part of the education of doctors, midwives and health visitors.
Those are the things I hoped for when I signed the petition. I really hope that those, rather than yet another round of Do Things This Way Or Forever Wear The Bad Mother Label Of Shame, are the things we get.