Thursday
Sep102009
Societal Barriers to Breastfeeding
Thursday, September 10, 2009 
When people think of breastfeeding difficulties, the things that probably come to mind are supply issues, bad latch, cracked nipples, constant feedings, and the like. Certainly, there are women who are afflicted by those difficulties and who cannot overcome them. But I believe the societal barriers to breastfeeding (propagated by the kyriarchy) have a much more significant impact on breastfeeding rates than the medical or technical issues.What are the societal barriers to breastfeeding?
- Formula advertising: Everywhere you look, formula is being pushed on new moms. Buying maternity clothes? You can enter a draw to win a year's worth of formula. Buying a parenting magazine? Expect a few two-page spreads telling you about the latest hype on formula being closer than ever to breast milk. Giving birth at a hospital? Expect to go home with a sponsored bag full of formula samples and coupons unless you are lucky enough to give birth in a baby friendly hospital. Surfing the web looking for breastfeeding advice? The formula companies will try to deceive you into clicking on their ads by pretending they are about breastfeeding. We need to push to make compliance with the WHO International Code of Marketing Breast-Milk Substitutes into a standard or a law or find some other way to ensure that formula and bottle companies are not acting unethically and unnecessarily sabotaging breastfeeding in pursuit of corporate profits.
- Insufficient education of medical professionals: Women having trouble with breastfeeding often turn to their pediatrician or to a general practitioner. Unfortunately, the amount of education that these doctors have in breastfeeding is insufficient. It will obviously range from school to school and jurisdiction to jurisdiction, but I have heard of some doctors having merely a few hours of training on breastfeeding. In addition, pediatricians attitudes about breastfeeding are declining, doctors whose skills are most lacking are least likely to seek training to upgrade their knowledge and skills, and there are plenty of medical professionals who are just downright not supportive of breastfeeding, either on purpose or out of ignorance. So when I hear people say, the pediatrician said "X" and I trust him, so we followed his advice, forgive me for being a bit skeptical. If you are having breastfeeding difficulties and your doctor does not refer you to a lactation consultant, you should be concerned. Be proactive and build your A-Team before your baby arrives.
- Lacking access to lactation consultants and breast pumps: People who are struggling with breastfeeding need access to qualified lactation professionals, i.e. International Board Certified Lactation Consultants, and may often need access to a quality double electric breast pump to help maintain or increase supply while working on breastfeeding issues. However, a lot of people who do have access to health care still do not have access to these essential breastfeeding supports.
- Lack of maternity leave: In the United States, women do not have access to decent maternity leave. Some have no access to maternity leave at all. In Canada, most women have access to maternity leave, but there are things that prevent many women from being able to take leave or that force them to go back early. It can take months to get breastfeeding well established and many women are back at work before that has happened. The lacking maternity leave provisions in many countries pose a significant barrier to breastfeeding.
- No workplace support for breastfeeding: Whether they are forced back to work due to lacking maternity leave provisions or choose to go back to work, women do not have sufficient support for breastfeeding in the workplace. Some states have laws that protect women's rights in this regard, but many do not. Even among those that do have laws, employers are known to put pressure on breastfeeding women or make them feel bad for needing facilities or time to pump. There is also not enough support for babies at work programs, which allow women to bring small babies to work with them if they choose. Without the right support, women often find themselves trying to pump enough milk sitting on a toilet without frequent enough breaks to maintain milk supply.
- Milk banks not a priority: As I explained in my post on blood, milk and profits, there is an entire industry and infrastructure set up to collect, screen, and distribute blood to those that need it. But milk banks are not a priority. There are too few of them and the ones that exist appear to be in it more for the profits than for ensuring every baby has access to breast milk. Making milk banks a bigger priority would allow women with excess milk to provide it to those that need it, thereby reducing the dependency on formula.
- Attitudes and imagery: People will breastfeed if they see others breastfeeding. Peer pressure, feeling normal, having role models. Call it what you like, it is what it is. If the predominant image in public, in magazines, in movies, on television, is bottle feeding, then people will see that as normal. If it is not, then fewer people will breastfeed and those that do will be ostracized and discriminated against by the anti-nursing-in-public brigade. This is one of the reasons I think it is so important to breastfeed in public. This is why I think we need at least as many breastfeeding dolls as bottle feeding dolls.
We need to keep providing medical, technical and moral support to women who are struggling with breastfeeding. That will always be a requirement. But to truly facilitate breastfeeding, we need to break down these barriers so that all families and all babies can benefit from the health benefits of breastfeeding and the economic benefits of breastfeeding.
Which of these barriers have you faced? Did it prevent you from breastfeeding for as long as you wanted to? Are there other societal barriers that I missed?
Reader Comments (78)
[...] are many societal barriers to breastfeeding and two of the key ones are formula advertising and health professionals lack of knowledge about [...]
[...] I think Nestle should focus on the societal barriers to breastfeeding that it can directly do something about. By eliminating any marketing of formula, Nestle [...]
[...] Work on the local, state and national level to encourage law-makers to draft and pass legislation that expands maternity and breastfeeding protections. [...]
Wow. Great post. I think attitudes and imagery is way up there at the top with support from friends or family. I know a lot of people who think of breastfeeding as gross, a huge time sucker, a burden and uneccessary. If friends and family are not okay and encouraging of breastfeeding it is easy to not try or give up.
We have great lc's available where I am and still a TON of women say that their pediatrician and LC advised them to stop or that they were just not getting the hang of it so their milk supply disappeared. The hospital is very good at saying breast is best, but many women never even try.
I am rambling because I am just so fed up with all the (what feels like) anti-breastfeeding views out there. I was actually made fun of at a baby shower the other day for breastfeeding my kids until 1 and doing it in the mall or in a restaurant or wherever my babies got hungry. The girls thought it was gross and then laughed at how I must have had no life with all that boobie time. They just kept talking about how they did not want to be attached to the baby like that.
Attitudes, imagery and support patterns need to change.
Thanks for posting this!
[...] Societal barriers to breastfeeding [...]
[...] are many sources of support for breastfeeding, for sure. But maybe it would catch on more if people could post their pictures [...]
[...] continued low breastfeeding rates and early weaning. I tend to agree. With all of the true barriers to breastfeeding (ones that we need to work hard to dismantle), we really don’t need stupid myths like this [...]
[...] Societal Barriers to Breastfeeding – PhD in Parenting Blog [...]
I have come across your site late in the game, it seems, but I'd really like to add my 2 cents here. I know this is going to be a little long, but I have to add my experience/my story. I would say medical professionals can do some of the biggest damage. They had me in tears!!
We had tons of problems bf my daughter early on. She had problems latching and turned out it was due to "extreme" tongue-tie and it was diagnosed/cut at 2 weeks. She didn't latch on properly until she was 2 months old. Then at 4 months, we went for our doc apt and her weight wasn't much greater than it had been at 2 months. I just started crying because I was up every hour with her at night and feeding her ever 2 hours during the day. I was exhausted. He said to come back in 2 weeks and perhaps it was just a glitch with their machine (they had trouble with it all day).
We were back in 2 weeks and she had only really gone up a few ounces. So he said, "I don't normally do this, but you need to give her formula". Don't normally do this? Then why was it the FIRST and ONLY thing that you recommended? So we were then referred to a pediatrician at our local hospital (outpatient services). We get there and they are concerned with her weight (as we were - don't get me wrong - I was terrified). He sends in a nutritionist to talk to us. She said, "This is what you're going to do. You are going to replace 2 of your feedings with formula." And I asked her, "won't this hurt my supply?" and she shrugged her shoulders and said, "oh well. Just do it." When I refused ("I am not going to do that"), she was so shocked she started yelling at me (yes yelling). I guess no one had said no to formula before? There was NO suggestion about seeing a lactation consultant or to send me upstairs to see one in the maternity ward. When I suggested pulling out my OWN bm supply out of my freezer (over 100oz), she scoffed at it and said "no, formula is better". We were kept there for 4.5 hours and they didn't make it comfortable for me to even bf my daughter there and I had to sit on the floor. I'm crying about it now as I write this, just as I did then.
Side (but important) note: I was appalled to find out recently that this happened in a "baby-friendly" designated hospital. I am now going through the process of filing an official complaint.
After we left there, with me bawling my eyes out, I went through the trouble of making MY OWN apt with the newman breastfeeding clinic (who are so amazing BTW). When I had to get a referral from my doctor, he tried to talk me out of it. Its too far away (about 1.5 hour drive). Me: "I don't care". (I would have driven even further if I had to). But It cost $40 for the visit. Me again: "I don't care". I had to fight every other excuse he threw at me for that apt! But I kept pushing and I know I shouldn't have had to. [As a side note: turned out, my daughter's tongue-tie had grown back and they clipped it at the clinic. She gained a 1lb in 1 week!]
If I had just listened to these doctors/nutritionist, I never would have known what was wrong and we wouldn't still be breastfeeding today @ 11 months old!
Women need to be aware that the medical profession is not always helpful or conducive in supporting bf moms! And I was VERY shocked to find that out as a first time mom. I thought that choosing to bf my daughter that medical professionals would be there to help. It was a hard lesson to learn.
Michelle, thank you for sharing that. You ROCK for sticking to your guns! Good for you. That must have been such a rough and scary time.
@ Dou-la-la
Thank you so much for saying so. That means a lot. It was so difficult for me to do and it was even more more difficult when I encountered the backlash from family and friends who insisted I was hurting and/or starving my baby (even from my mom and sister).
[...] there’s the whole “breast vs. bottle” debate, or the natural childbirth one (or the one which suggests they may be connected!)…which has [...]
[...] each mother has the right to decide how to feed her child, I do think that there are way too many societal barriers to breastfeeding and those barriers are what keeps breastfeeding rates much lower than they should [...]
Breastfeed Ladies! The bottom line is that it is healthy for the kids. We as a society are becoming more and more judgemental. Everything is the new something instead of our old fashion values that our country was built for. My daughter was breast fed for the first year of her life. Her mom wanted to do that and I was happy about that. it is natural thing to do and people should not have a word to say if a woman is breatsfeeding anywhere. That is what breast are truly made for. So ladies just do it and who cares what society says know you are doing your god given right.
I just want to thank you for the thoughtfulness and time you put into this site. I pop by every couple of weeks or when a tweet catches my eye, and I am so impressed each and every time with how (that you do, and the way you do it) you cover such important issues.
Personally, I feel very fortunate to have serendipitously landed in an incredibly baby-breastfeeding-subculture (madison, wisconsin) when I was 6-months pregnant with my first child. The problem is that since I have been/continue to be so supported with breastfeeding and many of the other health and lifestyle issues that fall under the 'natural parenting' label (fwiw, I hate labels and checklists) I forget that others face huge barriers and I disengage from the effort to educate/advocate.
Thank you for the reminder.
you know I meant baby-breastfeeding-FRIENDLY subculture. (i.e. Great community of midwives, holistic MD's, natural food co-ops, early parenting resource centers, local shops of cloth diapers/slings, etc. etc etc)
A barrier I faced was with the family court system which forced my baby to spend significant time with his father such that breastfeeding became impossible without my taking pharmaceutical drugs and pumping to keep up my supply. Even then my supply dwindled. My son was/is allergic to dairy and I suspected he was also allergic to soy (actually, that soy suspicion is resurfacing) so he could only safely have hypoallergenic formula as a supplement. Of course, it tastes awful so he would refuse it. Needless to say this resulted in long term problems for him that I'm still struggling with 4 years later.
Hi
The dilemma here in South Africa has an extra, severe, dimension. In a country/continent where breastfeeding IS popular, the HIV infection rate is preventing mothers from doing so. The risk for their babies then, is lack of knowledge, denial, poor sanitation and even erratic supply of (free) formula. I find my heart torn in two, by this debate. Perhaps, what I'm asking myself is whether "robin hood" aka nestle, is doing wrong? How big is my "big picture"? How about those of us who are blessed to be able to breastfeed, as well as have the means to choose to feed formula, buying their milk/donating, instead of using it to feed our babies?
Ha--I just got back from the bathroom, where I've pumped three times a day for the past nine months. There are several just-married women in my workplace and I hope that, when they have children, they'll remember my forays to the bathroom (breast pump in hand) and realize that, inconvenient as pumping can be, it CAN be done, and it SHOULD be done for the sake of their little ones.
[...] real breastfeeding support. Women who want to breastfeed are still undermined every day by the many societal barriers to breastfeeding or the “booby [...]
HUMAN MILK 4 HUMAN BABIES is an organization that can help get women in touch with other women that have or need milk!!
There were 4 other mums in my pre-natal classes. One said she would ff, because of problems bf her older child. The rest of us all 1`1st time mums wanted to bf. We were told for the 1st 6 weeks of a baby's life, bf is harder than ff, but if you persevere, after 6 weeks bf is easier.
It did not put anyone off, who intended bf, even the mum who said she would do it for her baby's sake, although she did not like the idea of doing it. I think she found it nicer than expected, as she bf several months like the rest of, at a time when 3 months was considered 'long'.
Stephanie, I got the same from my mother, as you did MIL. From one, two months etc she would ask if I was still nursing, in a tone that said I should stop. I think she just assumed I would either 'dry up' or get 'fed up'.
When my daughter was about 3 months, Mother told me 'When they get teeth, they bite you'. I thought, I'll worry about that if it happens. [It did not.] Also, I knew she did not speak from experience, as the longest she bf, was 6 weeks.
My mother was supportive, of when to start solids though. The advice at the time, was exclusive bf until 4 months to prevent allergies. [That was in the late 1980s, UK.]
I said as my daughter was 1 month premature, I thought it best to wait till 5 months. Advice at the time, also said breast or formula till 1st birthday, so I planned to cut down to one feed on her birthday.
Mum was pleased when I stopped, but suggested blood test, as 'nursing too long can make you anemic.' Well , I had the answer to that! I donated blood before I stopped bf, asking the nurse if it was ok first.
A mother having her second or later child, chooses her feeding method based on previous experience. BUT there are 10 reasons for a 1st timer to BOTTLE-FEED from BIRTH, too!
1] Medical reasons - seek advice if you think this applies.
2] The baby is to be adopted
3] You don't want to disappoint family and friends, who would like to share the feeding. But don't worry about being left out. There will always be the night feeds.
4] You think breastfeeding is too animal-like. And wouldn't it be great if IVF was cheaper, so we did not have to procreate like animals.
5] You are so bashful, you could not even go to another room to breastfeed, because 'everyone will know what I'm doing' [But the fact you got pregnant, tells them what you did.]
6] You or your baby's father works for a baby formula company. Bottle-feeding is good for business.
7] Either or both of you have shares in a baby formula company.
8] One of the things you hate about pregnancy is lack of periods. If you bottle-feed, they tend to return quicker.
9] Why should you miss out on the joys of preparing formula, washing bottles, or sterilizing?
It's such fun!
10] You sincerely believe that the milk nature designed for your baby, which actually adapts to their need, is inferior to a synthetic alternative,
I'm going to have to say that bad advice is better than none. A friend of mine had her milk supply dry up at 2 months, and was telling me how awful she felt about switching to formula. I wasn't about to point out why that didn't need to happen, so I just reminded her that some BFing is better than none, and that it's hard to find good support. She said she did have support, but given what had happened with her the advice she was getting wasn't very useful. (She had been pumping exclusively, ended up with oversupply and tried to reduce it and then reduced it too far. Even if the pumping was necessary, and she couldn't bring her supply back up, she could have been mixing breastmilk and formula, and I'm sure we can all see the problems with pumping.)
Had she not gotten bad advice, she'd have known to look to other sources. As it was, she felt that she'd done everything and just had really bad luck.
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