Breastfeeding: differing advice flows oh so freely

What’s a Baby-Friendly hospital? If you don’t know, you may soon because if the Australian Government’s House Standing Committee Inquiry into Breastfeeding has its way, the three that currently exist in NSW are set to mushroom.

The report is the most recent in a long line of official moans about the stubborn refusal of enough Australian mothers to conform to expert advice that they feed their infants only breast milk for the first six months.

It is possible to question the Committee’s unqualified assertion that every one of the voluminous claims for the health benefits of breastfeeding are proven. Last year, an Australian study found no basis for medical advice that increasing the duration of breastfeeding and delaying the introduction of solid foods prevented asthma or allergies.

But even if breastfeeding offered all the health benefits asserted by its proponents, it’s not clear what this says about a woman’s right to decide how to feed her infant. Does the superiority of breast milk make breastfeeding the best choice for every mother-infant dyad? Does it negate the right of women to make informed, voluntary decisions about how they feed their infants, and justify policies and practices that nudge, manipulate and ever coerce them into “choosing” breastfeeding?

The Baby-Friendly Hospital Initiative, with its stated aim of “protect[ing], promot[ing] and support[ing] breastfeeding” says “yes”. Indeed, evidence to the Committee suggests women may already be suffering from the program’s heavy-handed approach, with mothers who used infant formula telling the Committee they felt upset at being “treated differently in hospital… pressured by health professionals’ voicing their opinion at their choice and [not being] provide[ed] infant formula in a timely manner”.

Despite this, the Committee recommended the number of Baby-Friendly facilities be increased, even though the accreditation standards practically require this sort of damaging and disrespectful behaviour. For example, Baby-Friendly facilities must “inform all pregnant women about the benefits and management of breastfeeding,” “give newborn infants no food or drink other than breast milk unless medically indicated,” and “give no artificial teats or dummies to breastfeeding infants”.

While such demands may be consistent with the program’s aim of “increase[ing] the initiation and duration of exclusive breastfeeding,” they run counter to the requirements of informed consent, which calls for the disclosure of balanced information on both the risks and benefits of all feeding options. They also show barely disguised contempt for the right of women – not ward staff – to decide what to give their infants when it comes to food and care.

The truth is that most breastfeeding advocates think informed consent is as useless as tits on a bull when it comes to infant feeding decisions. This is because their goal is not to empower women to decide what is best for them – based on their own needs and values – but to get as many women as possible to do what they believe is best for those women’s babies, which is to be breastfed.

This is nothing new. There have always been medical practitioners and conservative women’s groups eager to spread their views about what is best for other people’s children and, consequently, what mothers must do to measure up.

What is odd is the silence of feminists on this issue. Real choice, and respect for women as choosers, requires not just that the structural constraints on women’s freedom to choose breastfeeding are addressed – a vocal concern of some women’s groups – but that a women’s choice to feed with formula is respected, too.

Publication history

Moralmaze: Breastfeeding: differing advice flows oh so freely  The Sun-Herald
2008-01-27