Every mother is a breastfeeding mother.

This is why breastfeeding support matters.

In Australia, very few babies are not put to the breast at all. Initiation rates are among the highest in the world, especially compared to countries like the US and UK, who we tend to think of as similar to us.

However, the drop-off rate beyond those first attempts is dramatic. Within weeks, a significant number of babies are partly or fully formula fed. In some cases, this is by choice. In the majority, though, it is due to breastfeeding challenges.

Some women describe feeling pressured to breastfeed. It is true that the importance of breastfeeding in lifelong health means it is something most women should strive for. However, a lot of that perceived pressure is really poorly framed support.

When encouragement comes without empathy or corresponding resources, it can be experienced as pressure. Simply telling a mother to keep going, it will get easier is not support. It is dismissive.

Mothers repeatedly describe needing more support to breastfeed. But they don’t want platitudes. In trying to appear inclusive, those working with families will often give guidance which can be summarised a bit like this:

• Breastfeeding is natural.

• Breastfeeding is very important (best?) and all babies should be breastfed.

• You just need to keep trying, it will get better/easier.

• Its okay, not everyone can breastfeed.

• Happy mother, happy baby. F e d i s b e s t !

This messaging is confusing yet this is what you will come across in most information given to parents about feeding their babies! Its no wonder “conflicting information” is the most common criticism parents have of the help offered to them when learning to breastfeed.

How, not why

Messaging around infant feeding has focused on which method to choose. While this is important during the fightback against blatant formula advertising, it often comes at the sacrifice of information on how to breastfeed. In educational resources for medical students and expectant parents, lists of “benefits” dominate. If barriers to breastfeeding are mentioned it is without corresponding guidance on prevention and management of common problems. There is a belief that confronting pregnant women with what can go wrong might risk them not breastfeeding at all. Yet research shows most people make choices about infant feeding long before their first pregnancy.

We need to adopt a different approach.

By tiptoeing around the feelings of the minority who choose not to breastfeed at all we confuse the majority who do intend to breastfeed. We can see the same happening in the birthing sphere, with caesarean birth being normalised alongside vaginal delivery. Being sensitive to the feelings of those - like myself - who birthed surgically does not mean we should play down the risks of major abdominal surgery. And being sensitive to those who genuinely cannot breastfeed should not mean downplaying the risks of formula feeding.

Infant feeding is not a lifestyle choice. Opting out of breastfeeding, like choosing a caesarean without medical cause, should involve a full risk assessment, counselling and education. It should not be a decision made in the supermarket aisle based on advertising.