It is a brave person who dares speak out either for or against breastfeeding in public these days. I know of one highly experienced research press officer, who had worked on controversial issues like human animal hybrids, GM crops, animal research, minimum alcohol pricing and climate change, who admitted:
"Nothing had prepared me for the most polarising, knee-jerking subject of all: breastfeeding."
Whether you are Jamie Oliver trying to show support for breastfeeding and rightly recognising a genuine problem - that women who want to breastfeed in this country often face barriers that mean they can't - or a new mother just blogging or tweeting about her personal experiences, speaking out puts you in the direct path of the opinion juggernaut which careers headlong into anyone who dares to take a stand on either side of the polarised infant feeding debate.
In some ways, Oliver was an easy target for criticism: a public figure not afraid of being outspoken, resilient, successful. Those attacking him would not have been concerned about his personal wellbeing. It is a different story for the mothers, midwives and health professionals whose daily work is supporting mothers who want to breastfeed, who often find themselves on the receiving end of similar criticism for putting pressure on women to breastfeed. Indeed, the UK context has become so fraught that those who advocate for breastfeeding are regularly accused of being breastfeeding Nazis or part of the "breastapo". Any chance of having an inclusive, factual and non-judgmental conversation about breastfeeding is shut down.
So it is time to change. First, we need to be upfront and admit that yes, sometimes, well-meaning efforts to promote breastfeeding have been insensitive and over-zealous. No mother should feel pressurised, or manhandled, around feeding her baby; we must do better than that and provide non-judgmental information and support so that a woman can genuinely choose how she wants to feed her baby, and is able to follow through on that choice.
Second, we must also be upfront with the evidence around breastfeeding. Recently three new major studies funded by the Gates Foundation have been published, including a series in the Lancet, which delivered resounding and extensive evidence that breastfeeding saves lives, improves health and cuts health service costs in every country, rich or poor. Children who are breastfed for longer periods have higher intelligence, fewer infections, fewer dental problems, reduced morbidity and mortality, and are less likely to be overweight or diabetic in later life. For mothers, breastfeeding protects against breast and ovarian cancer and diabetes.
This is powerful information that mothers will want to know when making a decision about how to feed their child. But even writing it down here presents a dilemma as it will be upsetting for many families who have not breastfed, or who have experienced the trauma of trying very hard to breastfeed and not succeeding. We all understand that pain because we know those women - many of them are our friends, our families, and some of us.
So thirdly, we need to change the conversation. We can stop laying the blame for a major public health issue in the laps of individual women, and acknowledge the collective responsibility of us all to remove the barriers to breastfeeding which lead to eight out of ten women reporting they had to stop breastfeeding before they had wanted to. These include 1) cultural norms that discourage long term breastfeeding, 2) a widespread misconception by almost everyone that formula milk can replace breastmilk without any harm, 3) a lack of postnatal care and trained support to help women get breastfeeding off to a good start, 4) formula company marketing that invests huge amounts of money in normalising bottle feeding and undermining breastfeeding.
On the back of the recent new evidence around breastfeeding, Unicef UK Baby Friendly Initiative is launching a Call to Action , which sets out the situation in the UK, and calls on the UK and all devolved governments to implement four key actions that will kickstart a supportive, enabling environment for women who want to breastfeed.
The Lancet series has highlighted what can only be described as a crisis in breastfeeding in the UK. We have one of the lowest breastfeeding rates in the world and one of the biggest formula milk industries. Our culture so often stops us from speaking out about the problem because we fear the backlash of opinion. Any rational debate about how to make things better for women who want to breastfeed in the future becomes almost impossible. Isn't it time that as a nation we stop treating each other as enemies and start to work together to make things better for future generations?