Women who stop breastfeeding failed by system that doesn’t support them

Women who stop breastfeeding are failed by a system that fails to support them during breastfeeding and when they can’t, argues Prof Amy Brown.

A professor in the Department of Public Health, Policy and Social Sciences in Swansea University, Prof Brown has written several books on breastfeeding, including Breastfeeding Uncovered, The Positive Breastfeeding Book. And her latest book is Informed is best: How to spot fake news about your pregnanacy, birth and baby.

Her recent book, Why Breastfeeding Grief and Trauma Matter, is different as it takes a deeper look at how women feel when breastfeeding doesn’t work out for them.

Prof Brown says that we have to stop telling women that their experiences don’t matter and instead recognise what each woman who stopped breastfeeding may have lost. “Many women want to breastfeed but difficulties accessing specialist support, misinformation and negative public attitudes mean many stop breastfeeding before they are ready to.”

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Mothers who plan to breastfeed but are not able to or who experience pain or difficulty that leads them to stop breastfeeding are more likely to experience post-natal depression

She is adamant that it's time to stop using language around breastfeeding that isn't helpful to women. Slogans such as "breast is best", campaigns promoting breastfeeding as a choice to the expression "women who fail to breastfeed". Breastfeeding rates in Ireland are among the lowest in the world and while about 45 per cent of women are breastfeeding on discharge from hospital, this falls off sharply with only 15 per cent of babies breastfed exclusively for six months in Ireland.

She believes that breastfeeding is a woman’s reproductive right and it’s important to recognise that women can feel everything from guilt to anger, anxiety, frustration, isolation and even trauma for not breastfeeding or stopping before they are ready to.

Through her research, Prof Brown found that women who stopped breastfeeding avoided friends who were breastfeeding – particularly those who seemed to be having easy experiences. She also found that some women often still had strong negative emotions around their experiences years after stopping breastfeeding.

According to Prof Brown, women who care about breastfeeding enough feel miserable when they stop. “They do not simply decide overnight that they don’t want to breastfeed anymore,” she says. “Usually, something significant and often prolonged, leads to their decision to stop – whether that’s insurmountable pain, a baby who just will not latch, a milk supply that will not increase, a health complication that is preventing breastfeeding or a feeling of being overwhelmed by everything being too difficult.”

However, she argues that not being able to get the professional support they needed to breastfeeding is central to many women’s journeys to stopping breastfeeding.

“Women who encounter difficulties are often told they simply can’t breastfeed and to give a bottle of formula instead, rather than being given any specific tests or clinical diagnosis,” says Prof Brown. “While this might solve feeding the baby, it doesn’t solve the issue that a woman wanted to breastfeed.”

“We need more midwives and health visitors with more time to spend with women, but they often have such large caseloads that sometimes they can’t spend the time sitting with women helping them overcome challenges,” she adds.

Breastfeeding may be natural and normal but it doesn't make it easy. It can take time to get the hang of it

Inaccurate medical advice on which medications interfere with breast milk is another factor in women deciding to stop breastfeeding, according to Prof Brown. "Our research with women who contacted the Drugs in Breastmilk information service showed women are frequently told that they cannot breastfeed on common medications such as antidepressants, antihistamines, antibiotics and emergency contraception - all of which is completely false," says Prof Brown.

When breastfeeding works well, it protects women physiologically from the stress of motherhood, enhancing sleep, reducing stress and inflammation and even post-natal depression. Oxytocin levels which promote feelings of calmness, closeness and togetherness, rise in both mother and baby during breastfeeding. Breastfeeding can also promote healing after a difficult birth – or in cases where women suffered earlier traumas in their own lives.

Professor Brown pays specific attention to the links between women’s experience of breastfeeding and post-natal depression. “Mothers who plan to breastfeed but are not able to or who experience pain or difficulty that leads them to stop breastfeeding are more likely to experience post-natal depression,” she writes.

And there are also cultural aspects to breastfeeding that many people might not realise. “When a woman is surrounded by those who have had positive experiences of breastfeeding, she is more likely to breastfeed for longer. If she was breastfed – and if her partner was breastfed – then she is more likely to be able to breastfeed,” says Prof Brown.

In other words, people who have experience of breastfeeding are more likely to value it and offer support with any challenges.

Her ultimate aim – apart from giving women recognition for grief and trauma they may feel by stopping breastfeeding before they wanted to or not breastfeeding even though they wanted to – is to improve the supports women get.

She advocates for better training on breastfeeding for everyone from GPs to childcare workers as well as specific skilled support when women start breastfeeding – and most importantly – as soon as they experience difficulties.

And, finally she wants more honesty about what breastfeeding is really like. “Breastfeeding may be natural and normal but it doesn’t make it easy. It can take time to get the hang of it,” she says. Women who she spoke to for her research said - just make sure mothers-to-be know exactly any single problem that can happen when trying to breastfeed and how to react quickly. Ultimately, it’s about valuing mothers more and giving them the support they need – after doing the most important task in the world – giving birth.

Read: The battle between women who breastfeed and women who don't