Health Workers Should Respect Decision Not to Breastfeed

We all know ‘breast is best’ but if a mother decides not to breastfeed, the revised Infant Feeding Guidelines recommends that a mother’s informed decision not to breastfeed should be respected by health workers.

It also needed to be said in the Guidelines that health workers should provide families with all the information and support they need to prepare, store and use infant formulas correctly.

A joint initiative by the National Health and Medical Research Council (NHMRC) and the Department of Health and Ageing, the revised Infant Feeding Guidelines were prepared by experts in paediatric nutrition, nutrition research, nutrition communication, public health and primary health care.

The revised Infant Feeding Guidelines released on 18 February 2013, recommends that infants are exclusively breastfed until around 6 months of age when solid foods are introduced, and that breastfeeding is continued until 12 months of age. If an infant is not breastfed or is partially breastfed, commercial infant formulas should be used as an alternative to breast milk until 12 months of age.

There are many reasons why a mother will decide not to breastfeed her infant. But all too often, mothers are made to feel guilty for choosing to feed their infant what is essentially a viable alternative to breast milk.

The Public Health Association of Australia (PHAA) has called the revised Infant Feeding Guidelines a missed opportunity to strongly advocate for breastfeeding, which is in direct opposition to the Guidelines which recommends ‘that health workers respect a mother’s decision not to breastfeed’.

In a statement released to the media earlier this week, President of the PHAA, Associate Professor Heather Yeatman said: “We need to arrest the dramatic drop-off in the breastfeeding rates so mothers can sustain it up to 6 months of age and beyond. The ‘baby friendly hospital’ environment supports commencement of breast feeding. More research is needed into how to support breastfeeding when mum returns home and perhaps back to work.”

Ms Yeatman then went on to say, “There is also a key role for health workers to strengthen their advocacy of the benefits of breastfeeding.” Which is a really nice way of saying health workers should push more mothers into breastfeeding.

What concerns me most about this and similar statements made to the media, is that it could lead to more women being bullied into breastfeeding, even when doing so could have a negative impact on the mother’s mental health. Yes, breast milk is best and in Australia there are currently some excellent resources and support services available to mothers who are having difficulties with breastfeeding. But above all, what an infant needs most, is a mother who is not under stress.

The Australian Breastfeeding Association (ABA) has taken a completely different approach in their response to the revised Infant Feeding Guidelines. The ABA has chosen not to comment on any of the recommendations relating to infant formula, preferring instead to hype up the ‘very tenuous’ link between bottle fed infants and obesity later in life. By the way, any casual link between infant formula and obesity has not been established.

What health advocates need to realise is that women do have the right to decide what is best for them and for their baby. When making the decision to switch to infant formula, mothers have to take into account not only what is best for the infant, but what is best for themselves, their partner and any other children they may have at home.

Hospitals may be ‘baby-friendly’ but mother’s can’t find that same level of support outside our nation’s maternity wards. You could say with so many people freaking out whenever they see a woman breastfeeding in public, our society isn’t conducive at all to mothers who continue breastfeeding after returning home from hospital.

For more information about the revised Infant Feeding Guidelines, visit the website: www.eatforhealth.gov.au