Is Infant Feeding Really a Choice?
Nancy Mohrbacher Tuesday, November 23, 2010 at 2:15PM Many of us talk about breast or bottle as a choice. I used to think that way, too. But I’m beginning to see it differently.
On November 1, I had the privilege of speaking to a group of amazing and inspiring British women who work with breastfeeding mothers as peer counselors. The night before this talk in West Bromwich, 
England I stayed with Anne, one of the Training Coordinators of La Leche League of Great Britain’s Peer Counsellor Programme (LLLGB/PCP).
Anne told me a story I will never forget. It began when Anne’s son’s partner, Kelly, moved into her home while pregnant with her second child. Kelly became involved with Anne’s son during this pregnancy, so her unborn baby was not Anne’s biological grandchild.
Kelly had bottle-fed her first child and was planning to do the same again. In preparation, she bought a sterilizer and an array of feeding bottles, which one day Anne came home to find covering her kitchen counter. Knowing that many young mothers would be coming there for breastfeeding help, she asked Kelly to keep her purchases on a shelf out of view. Anne was concerned about giving one message with her words and another with the obvious bottle-feeding paraphernalia. Kelly did not really understand Anne’s concern (in Kelly’s mind babies, bottles, and sterilizers all just went together), but she agreed.
After her baby was born, surprise! Kelly gave birth in a Baby-Friendly hospital where after delivery all newborns are placed skin-to-skin with their mothers. When this happened, Kelly’s baby crawled up and attached to her breast. Kelly responded, “Well, I guess she’s breastfeeding after all.” She went on to exclusively breastfeed and nursed her for several years. No doubt her exposure to Anne and the breastfeeding mothers she met helped Kelly make breastfeeding a reality.
When the baby was about a week old, Kelly said to Anne, “Why don’t they tell you about breastfeeding? It’s easy, isn’t it? If I’d known that, I would’ve done it before.” She had only ever thought of breastfeeding as hard work and a source of problems. Then Anne asked Kelly something 
Nancy illustrating a concept with a balloon in West Bromwich, Englandshe’d been wondering for a while: “Why did you choose to formula feed your first baby?” Kelly’s response startled her: “I didn’t choose. I just did what I thought you did to feed babies. It was not a choice as such. I didn’t think of it that way.”
Kelly had only ever seen babies bottle-fed. She didn’t know anyone who had breastfed and she knew nothing about it. To Kelly, feeding babies by bottle was just how it’s done. Asking her to consider breastfeeding would have felt to her like asking her to perform surgery or argue a legal case in court. She knew some people did those things but definitely not her.
Anne has a special interest in how a mother’s confidence in breastfeeding builds and often asks new mothers when they really began to feel like a breastfeeding mother. According to Anne, some mothers raised in breastfeeding families see themselves as breastfeeding mothers even before becoming pregnant and giving birth. In Kelly’s case, it took about a week. For others it takes a few weeks or even months of breastfeeding. Anne has noticed that once “breastfeeding mother” becomes part of a woman’s self-image, she is unlikely to let breastfeeding problems get her way. Some term this phenomenon “breastfeeding self-efficacy,”1 which is really just how much confidence a mother has that breastfeeding will work for her. Not surprisingly, greater breastfeeding self-efficacy has been associated with longer duration of breastfeeding, even in cultures where fewer women breastfeed.2
What can we do to enhance mothers’ confidence in breastfeeding? Physician Christina Smillie describes one way as “oozing confidence in the process.” Most breastfeeding advocates do this naturally. Showing mothers tricks that make breastfeeding easier is another. Contact with other breastfeeding mothers--either one-on-one or in support groups--is a big one. Spending time with mothers who enjoy breastfeeding has a major impact, as does their encouragement.
The wonderful women I met in West Bromwich, England do this every day in their role as peer counselors. It felt good to thank them personally for the important work they do.
References
1Dennis, C.-L. Theoretical underpinnings of breastfeeding confidence: A self-efficacy framework. J Hum Lact 1999; 15(3):195-201.
2McCarter-Spaulding, D. and Gore, R. Breastfeeding self-efficacy in women of African descent. JOGNN 2009; 38(2):230-43.
Reader Comments (5)
What a wonderful story. I'd say I considered myself a breastfeeding mother before I actually did it. I just planned to do it. I listened when the other moms said, "Don't let formula in your house." And "Give it six to eight weeks and it gets easier." I trusted them and they didn't let me down. When I faced challenges, I asked or I looked it up (often on kellymom) and voila! I'm tandem nursing now and very proud that I've done it in a society where it's uncommon to make it 6 months, let alone my first goal of two years (how long my sister and I were nursed, according to my mother).
I loved the story its real and factual about alot of things that happen with breastfeeding mothers. I wonder how I could move beyound just a love for breastfeeding and be a advocate for other mothers. Women all across the world breastfeed but, we still have a hard time getting others to breastfeed in more industrial cities. I'm not a backwoods old fashion aged out generation that enjoys the pioneer living. I'm just a mother that wanted the best for her daughter. And as one mom told me" I just dont want to give up the time it takes to breastfeed" Its such a big choice as a parent, what I hope for every mother is that they enjoy motherhood, breastfeeding can be apart of the process. It has been a wonderful expereince. Just wish there were more ways to advocate.
For me it really wasn't a choice. I knew I would breastfeed my children long before I ever seriously planned to have any. I was formula fed, my mum told me how difficult she had found breastfeeding my older brother and said she "couldn't do it" (It was the 1970s, the height of the 4 hour routine culture, she just wasn't given the right advice or support) so didn't even try with me. So it's not like I came from a BF background. By the time I was pregnant I was already pretty well read on the topic, I knew it could be hard but as I so proudly told my health visitor about a month before my son was even born "Failure is not an option for me". It wasn't easy for us, but we got there and still going strong at 20 months. I pretty much always thought I would BF for 2 years, but now I can't see us stopping, I am happy to let him wean when ready, even if that means tandem nursing if we have another before he wants to stop.
I really didn't need to give it any thought, I didn't need to choose. I learned about the risks of formula when I was a teenager, both through my own health issues and general reading into it and I just knew it was something I would do.
This partially explains why my parents 22 grandchildren have all been breastfed...the 3 daughters all grew up seeing BF and knowing they could do it...the 3 daughters-in-law were supported by their hubbies, saw BF (and how easy it can be!) at all family gatherings, and were cheered-on by sisters-in-law (one of whom is an LLL Leader)!!
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