SIMPLY THE BEST…BUT IT’S NOT ALWAYS SIMPLE

I recently posted about my daughter’s birth experience and a reader wanted to know how I felt about breastfeeding. (Well, she said ‘nursing’, but here in Australia we call a spade a spade, and it’s breastfeeding, except when I get sick of writing ‘breastfeeding’ so I write ‘nursing’. OK?)

In my profile, I state that I am a lactation consultant and a doctor, and to flesh that out a little, I have been an LC for 25 years and an MD for 34. My career kind of took a hook turn and instead of completing my psychiatric training, I went and had a bunch of kids, so reality kind of bit me and I abandoned my hospital-based career. Instead I did some sessions in general practice between babies and then, after I had my 5^th, there was this new profession called Lactation Consulting. I was interested to learn more about this because I had always had trouble breastfeeding, usually with low supply being the problem, and there was not a lot of professional help around. There was the NMAA (Nursing Mothers’ Association of Australia, named when some people flinched at the word ‘breast’, and now renamed the ABA, Australian Breastfeeding Association) and they are nice people who do good things, but there was no real professionalism there, and no answers to my problems. So I was intrigued and I read up and passed the exam and have been working in this field, with a medical slant of course, for all these years.

SO. What do I think of breastfeeding? I think it is the best thing in the world. When it is going well. When it isn’t going well, however, it is the biggest nightmare. There isn’t much in between.

When I first started, it felt like a personal wound when a patient weaned, ie, quit breastfeeding. In the intervening years I have gained much wisdom and insight into the human condition and my attitude has shifted.

My aim as an LC is to help women who want to nurse their babies by giving them correct advice and helping them skill up and learn how to nurse, to correctly diagnose and appropriately manage the presenting problem, and to be sensitive to the BIG picture.

If I can see that things are not looking great and that too many things have gone wrong for too long, or if the mother really has done her all and is ‘over it’, then I say this to them:

‘I am not the Breastfeeding Fascist, and I do not believe that ALL babies MUST be breastfed at ANY cost.’

And it’s true. I share their disappointment, but you are not supposed to grind yourself into the ground and suffer and struggle for weeks and weeks and weeks in order to breastfeed. If you want to do that and have the strength to, I will help you; but sooner or later the problem either gets better or it doesn’t. And if it doesn’t, it’s time to wean. If mum feels that she has done whatever she can, then there is no room for guilt and she can move on. Better luck next time.

I have seen everything over the years, and there is no shortage of irony. There is ‘Could but Wouldn’t’ who has the milk but not the desire and the patience to see it through the first few difficult weeks, and ‘Would but Couldn’t’ who struggles and struggles with every problem under the sun until, heartbroken and disappointed, she must give in to the bottle of formula.

I have so much to say about this and any other topic related to the breastfeeding mother-infant pair, but there’s another thing I have learned over the years: NOBODY is interested in breastfeeding, unless it pertains directly to themselves, personally or professionally. Not OBs, not Pediatricians, not GPs, nobody. From time to time some woman is arrested for nursing a 5 year-old or something like that makes it into the news, and suddenly everyone has an opinion, usually negative, and everyone wants my opinion. Who cares about these freaky cases?  Or some prude complains abut women breastfeeding in public, as if the threat of a bit of boob showing while shoved in a baby’s mouth will destabilize civilization. Get over it. That’s all nonsense.

I don’t care about anything so newsworthy. I care about the thousands of women who want to breastfeed but are having problems, often brought on by poor management and ignorant health care professionals, or just plain bad luck. I care about the thousands of babies who are denied their birthright for inadequate reasons. But if breastfeeding doesn’t work, well, sometimes it just doesn’t work, and in the absence of available wet-nurses, it’s the bottle of formula, so the baby won’t starve.

A final comment: there has never been a time in the history of the world when all women could give birth safely with a guarantee of survival of the mother or the baby. Ditto, there has never been a time when all women could breastfeed successfully. Ancient Egyptian mummified infants have been found with feeding pots. We in the West need to be thankful that today most women survive childbirth and most babies survive infancy, including lactation failure. So we don’t have wet-nurses, officially anyway, but we have clean water and adequate formula, and the human organism is very robust. Thank goodness.

Please feel free to comment!