There’s been a big push in the right direction to help and support mums to breastfeed, but is it enough? Prior to giving birth to my daughter, I was surprised to receive a CD on breastfeeding positioning and attachment, as well as leaflets outlining the benefits. It was a good start to my novice education on the subject – but it lacked something.
Reflecting back on my expectations and goals for breastfeeding, I was clear on the benefits, and had in mind making it to a year. I never imagined I’d continue for longer – simply because the idea had never occurred to me. Perhaps that was the education I was lacking. The information I received focused more on the minimum term for optimum health of my baby, rather than normal terms such as breastfeeding for the duration my child wanted to – until she self-weaned, or until the day I decided I needed to stop, or I had to stop. It was not helpful to tell me about the recommended minimum duration for health benefits once my mind had already accepted a pre-conditioned ‘norm’.
Normalising breastfeeding past infancy seems an impossible hurdle culturally, but some simple steps could help. There are already breastfeeding support groups, as well as online forums, counsellors, helplines, and a wealth of information on the topic. This is giving rise to a new generation used to peers who are breastfed into toddlerhood. Nevertheless, breastfeeding a toddler can be a taboo subject. It still isn’t a ‘norm’ acceptable to most people. So what else might help?
My suggestion would be to start with health professionals: educate them further, so that their inherent language talks about long-term breastfeeding as optimal – not 1 year, not 2 years, but until self-weaning age, whatever that may be. Then simply support mums, without judgement, in their breastfeeding or their bottle-feeding journey (or mixture of the two). Thirdly, make the same updated training language available to all health professionals – not just to the frontline staff most commonly brought into contact with breastfeeding mums (midwives, health visitors, lactation consultants, and so on), but also to all health professionals a mum may come into contact with, such as GPs.
And of course, for health professionals to be convinced of this way of thinking and approach, they’re going to need some swaying. This will need to come from a reliable and trusted source, so probably what’s laid down in the guidelines will help. This is what the World Health Organization (WHO) recommends: Exclusive breastfeeding for the first six months of life. At six months, other foods should complement breastfeeding for up to two years or more.
But the wording is vague. With insufficient clarity on the recommended duration for breastfeeding, the guidance is easily overlooked or misread. Countless times now, I’ve heard some health professionals interpret the WHO guidelines incorrectly – often misinterpreting them as recommending breastfeeding up until 2 years of age. This is unacceptable misguided information, which only exacerbates the problems surrounding breastfeeding: a society that on the whole doesn’t accept breastfeeding children past 2 years of age; mothers receiving incorrect information, resulting in decisions that they may not have made given the correct advice; and the health of some children compromised when their mothers had instinctively been doing what’s best for them. Let’s set the record straight: the WHO recommends breastfeeding for up to 2 years or – that all-important word – MORE. But what does that really mean?
‘More’ suggests that the WHO has reason to believe that past the 2-year marker point, nutritional benefit still exists, but it isn’t entirely sure in what quantity or for how long. But the fact that benefits to the breastfed child continue leads me to ask why we should not uncap the timescale for breastfeeding. Balance the unknown risk of uncapping breastfeeding duration with the ongoing emotional benefits and continued nutritional benefits (albeit unknown exactly for how long), and I’d argue that there’s good reason to uncap the timescale. My suggestion would be wording along the following lines:
The recommended ideal duration for breastfeeding is until a child self-weans from breastfeeding. Exclusive breastfeeding is recommended for the first six months of life. At six months, other foods should complement breastfeeding.
To my mind, this wording is far clearer and almost gives permission for mothers to continue to breastfeed for longer, if they and their child wish to, secure in the knowledge that they are following recommended guidelines. That’s not to say that mothers have to follow this advice, as I appreciate not everyone wants to breastfeed for this length of time, or even at all. But if we put the correct information out there, starting with professionals, hopefully it will become viral, thus contributing to children’s and mothers’ good health and improving their social acceptance.
Equipped with this knowledge, mothers can make their own decisions about what suits them and their families. Health professionals can then take the role of supporting them, knowing that they delivered the information to enable them to make an informed decision.
Amy Skilton works for a mental health organisation and is mum to Ruby Rose, aged 3 at the time of publication.
Photo by Criativa Pix Fotografia
First published in issue 34 of JUNO. Accurate at the time this issue went to print.