Recently, a new phrase in the world of feeding babies has emerged. Inspired by perceived pressure on new mums to breastfeed, the 'fed is best' (rather than 'breast is best') message suggests, that rather than debating how babies should be fed, we should be comforted by the notion that we are able to feed our babies at all. But should we really be accepting fed as a 'best' rather than minimal standard?
Of course we must ensure that babies are fed. However, although the message may sound comforting on the surface, 'fed is best' is simply putting a sticking plaster over the gaping wound that is our lack of support for breastfeeding and mothering in general. We cannot afford to say that how babies are fed does not matter. On a population level, not breastfeeding increases the risk of avoidable illnesses and subsequent costly GP appointments and hospital admissions. This is not about criticizing individual mothers and babies. It is about patterns that on a grand scale that we need to address. This may be an unpalatable message but it's an unfortunate truth and one we must not shy away from.
A generation let down
However, in our efforts to increase breastfeeding rates, we can also no longer avoid the guilt, regret and anger of women who wanted to breastfeed but were unable to. Physiologically speaking only around 2% of women should be unable to breastfeed, but in reality less than half of mums in the UK breastfeed at all past six weeks .
These figures do not add up but the reason why we are struggling so much with breastfeeding is for most not initially a physiological issue but that our society lets new mothers down, which in turn creates a whole host of problems. The government does not invest in the support they need before and after the birth. Antenatal education is rushed. Hospital wards are over stretched. Specialist breastfeeding support services are being cut. Rather than caring for our new mothers after the birth, helping them recover and care for their new baby, we devalue, isolate and pressurize them to get their 'lives back'. In pain, frustrated, exhausted, isolated and feeling utterly unsupported, formula seems the obvious choice.
The outcome is that we are left with a whole generation of women who have been let down. This is not about women who did not want to breastfeed but the 80% who stopped breastfeeding in the first six weeks were not ready to do so. They understandably don't like to hear about the health messages of breastfeeding and welcome messages that suggest fed is best. But this means we're stuck in a circle where breastfeeding desperately needs promoting but promoting it risks the wellbeing of those who could not. However, the fed is best message is not and will never be the long-term solution.
A minimal standard
Firstly, the phrase 'fed is best' is nonsensical. At NO point has anyone ever suggested that if a baby can't be breastfed then they should starve. Luckily in developed countries if a baby does not receive breastmilk they can and should have access to formula milk that can be safely prepared and will give babies sufficient energy and nutrients to grow. Fed is therefore not best, because best implies that there are other acceptable alternatives.
Secondly, at what other point in our lives do we believe that fed is best? With older children do we accept that any food at all is best? No. We campaign for children to receive optimal nutrition. As adults we know that diet can play a major role in our health and wellbeing so why would this be any different for those whose sole nutrition comes from their milk? We should not be repeating such a trite phase, but campaigning for the investment we need, both for better breastfeeding support and cheaper, improved, not for profit formula milk for those who need it.
Thirdly, there appears to be increasing suggestion that many women do not produce enough breast milk. This is untrue and is unfairly anxiety provoking. Sometimes mothers may have a delay in their milk coming in, but in most cases this will be due to a complicated birth, or hospital practices that do not keep mother and baby together and feeding frequently. For most these can be rectified with the right support rather than automatic formula use. A minority might experience such severe problems that their baby becomes dehydrated to the extent it risks brain damage but although this is devastating for those involved, only around 2 in 10,000 babies become this dehydrated, e.g. 0.02%, with few having long term damage. Importantly most of these cases could be avoided if health professionals had more time to monitor mothers and babies more closely and step in with formula, yes formula, when genuinely needed. The issue is again with investment not breastfeeding.
Finally, 'fed is best' sounds suspiciously like a slogan to promote formula milk. Formula is a vital product for babies who need it, but industry has turned it into a competitive, multi billion pound market with the cost of billion dollar advertising campaigns passed onto families whilst CEOs get richer. Rather than going along with Fed is Best, we should be pressurizing the government to ensure that formula is affordable for all who need it, with baby's needs prioritized, not corporate greed.
Ensuring a better future
This is not another article criticizing those who choose or need to use formula milk. I know it is heartbreaking to want to do something for your child and not be able to. But this is where the circle needs to be broken. None of us tick all the boxes as parents. We have to make the right choice for us, based on our circumstances at the time. Whether that's the area we get to live in. Whether our children go to daycare. The schools they go to. It's all part of a bigger picture, although sometimes it seems like the bit we're worried about is the whole picture. No one will ever have the 'perfect' childhood and that's fine and normal.
But that doesn't mean that for future babies we can shy away from the importance of breastfeeding. Many babies will be 'fine' on formula because formula does not definitively make every baby ill but simply increases the risk. However, this does not predict how future babies will react to that risk. Public health messages around breastfeeding are not criticizing choices that have already been made but are looking to how we can improve things for future generations. Statistically a future baby will be at increased risk if formula fed, so we need to ensure those future babies have the best possible chance to be breastfed.
Looking forward we need to challenge the government to invest properly in future mothers, so they get a better chance of breastfeeding their baby for as long as they want. We don't need to be told to forget about all of this because 'fed is best'. What is 'best' is that all mothers who want to breastfeed live in a society that supports them to do so. But unless we put pressure on the government to make changes, we're simply going to end up with more and more mothers let down, and feeling these awful emotions every time we talk about breastfeeding. We need to ensure that the government take responsibility for this issue, rather than leaving families to feel the weight of decisions that they weren't given a fair chance to make how they wanted.