More information is needed to tackle concerns about breastfeeding, writes Claire O'Connell.
Every year in Ireland, almost 60,000 mothers choose whether to feed their newborns breast milk or formula. Many of these women could feel they are damned whatever they do: bottle-feeders are reminded at every turn that breast is best, yet the 40 per cent of mothers who start breastfeeding are often advised to fall back on formula as soon as there's a hint of difficulty.
Formula feeding has been the cultural standard in Ireland for the last two generations but medical evidence has overwhelmingly shown that breastfeeding has benefits for most mothers and babies. This has led to a drive to increase our breastfeeding rates, which are the lowest in Europe.
National Breastfeeding Co-ordinator Maureen Fallon says we need timely information and support to increase breastfeeding rates in Ireland and help parents feel confident about their infant feeding choice, whether breast or bottle.
She believes our strong tradition of formula feeding can undermine a woman's confidence in her ability to breastfeed, and distort our perception of normal breastfeeding events, such as frequent feeding in the early weeks. "Because breastfeeding mothers often don't have that expertise within their own families, they have well-meaning people around them that offer bottle-feeding solutions to what they consider to be breastfeeding problems."
According to Fallon, recent surveys show the majority of Irish women have made up their minds about feeding their babies by early pregnancy, if not before. This highlights the need to promote breastfeeding awareness at a whole society level to help parents make more balanced decisions. The goal is to inform women about infant feeding before they are pregnant, and imbue families with more realistic expectations when the baby arrives.
Parents receive information about breastfeeding from health professionals but once they leave the hospital or GP's clinic, where do they go? This is where peer support groups come in. Public health clinics, the Community Mothers Programme and organizations like La Lèche League or Cuidiú (The Irish Childbirth Trust) encourage mothers to help each other by sharing information about feeding their babies.
Fallon says the support from community peer groups is vital for building women's confidence in breastfeeding. "It is qualitatively different from the support that health professionals give - it provides access to mothers who are actually breastfeeding, as well as a being good source of information." She recommends that parents get in contact with local groups antenatally, to find out what's involved in breastfeeding and get to know who can help when the baby arrives.
Cuidiú provides peer support through its 12 local branches in Leinster and Munster. The organisation's president, AnnMarie Smith, says their aim is to provide education and support for parenthood before and after the baby is born. "Antenatally, we encourage people to be informed about breastfeeding, so if they do decide to breastfeed they know how to position the baby and reduce the risk of difficulties in the very early stages. Postnatally, we give breastfeeding information and support and, occasionally, if a mother just wants to know what to do, we give advice."
Cuidiú trains volunteer breastfeeding counsellors who answer telephone queries and run local support groups for all breastfeeding mothers, whether Cuidiú members or not. Catriona Corcoran has been a counsellor in Mullingar for nine years. Last year she responded to 80 phone calls from new mothers about breastfeeding. "As counsellors, we give people the options to overcome the difficulties they are having. A lot of the time it's just about reassuring the mum and giving her the power within herself, which is always there, but unfortunately she's in a society that doesn't always support breastfeeding. We've lost that tradition."
Does Cuidiú's focus on breastfeeding mean that bottlefeeders need not apply? On the contrary, says Smith, who adds that many formula-feeders attend Cuidiú's informal social mornings, where they can discuss their feeding concerns with other parents. "We don't give information on bottle feeding because we are not medically trained. So if a parent has a question about, for example, formula or bottles, we usually advise them to contact the public health nurse. But two mothers sitting beside each other talking about bottles is different."
However, the emphasis on breastfeeding can create an airy earth-mother image that undermines their credibility. "The only way to counteract that image is to get people to come along to our groups and see that we are normal - we don't wear flowery skirts and sandals all the time," says Smith. As a mark of their commitment to shaping official breastfeeding policy and promotion in Ireland, Cuidiú has representatives on the National Breastfeeding Committee and many of the hospital breastfeeding boards.
Fallon values the contributions of health professionals and peer supporters in promoting breastfeeding. She also believes that increasing awareness about infant feeding will help parents make choices with confidence. "The guilt comes when they may not have had the information and they make an ill-informed decision. I certainly think we should not go down the road of making mothers feel guilty, that's not the issue. The issue is making sure every parent makes informed decisions about infant feeding, then respecting those decisions completely and offering the required support."