Tuesday, June 06, 2006

Breast is Best

As the fifty percent of the population who don't actually have their own to play with would aver almost to a man.

So why do I find myself prescribing milk powder to a 13 week old infant this afternoon? The answer is complex and small "p" political but here we go...

Society increasingly expects women to play a full part in working as well as domestic life. Indeed for most couples there is a need for both partners to work simply to service the silly prices we pay for our accommodation and chosen lifestyles. Furthermore we define women still as much, if not more, by how they look rather than by their other capabilities. Then, when they have children we worthily spout on about how important it is that they breast feed and devote all their time to baby as though all the other stuff ceases to be important.

In my limited experience this is not a universally popular message. Some women are denied the option as their milk production fails to establish properly, but the vast majority are so denied either because of financial necessity or through personal choice, to preserve their shape,or to resume their other roles in society. Thus in our "enlightened" society of "equal opportunity" far too many babies are rapidly put on powdered milk.

It's logistically much easier to cart about bottles of formula than to breast feed on the hoof as it were. This is partly because our climate here in blighty is seldom conducive, but mostly because society still tends to go all "Benny Hill" around breast feeding women, instead of giving them the help and support to make it easier to do.

Then there's the whole "getting single mothers back to work" thing. This leaves many younger less experienced mums feeling pressured to return to employment far sooner that is right for them or their children.

Ah say the "Guardian Readers", they could always express milk to give in a bottle if they wanted to continue to feed naturally and work. Any mum who has tried this will regale you with horror stories about "milking machines" and awkward damp patches in best blouses etc... It might be a short term expedient for some, but is hardly a sensible life choice.

So we come back to poor little George. I don't know exactly why his mum was unable to breast feed, and now it hardly matters since that option is now lost to him anyhow. After a few weeks on ordinary formula feeds he was increasingly fractious and difficult. His health visitor advised mum to try switching to soya milk and he improved dramatically. So it seems he may be lactose intolerant (as indeed was his mum). But soya milk, used for lactose intolerance, becomes a medicine as well as a food, and so is prescribable.

So there you have it.

9 comments:

PI said...

Breast is best of course - provided the mother really wants to and actually can. As a matter of interest - with each suck you can feel the uterus contracting - or whatever it does to get back in place in record time. Also its nice to know your baby is being protected by your own immunities. Six to nine monthe isn't such a great sacrifice to give a child the best possible start. Just saying!

Doctor Jest said...

Pi-- you wont find me arguing against. Problem is as a society a lot of our shared "values" seem to actively discourage many mums.

tracy said...

I am rather surprised(as a member of the Mid-Essex breastfeeding working group and MSLC) that a health care professional has such a view on things.
For a start breastfeeding still is an option for this little baby. There is such a thing as relactation. Even adoptive mums are able to breastfeed. Had the mother consulted a qualified breastfeeding counsellor or lactation consultant? Most breastfeeding problems can be easily overcome with the correct advice.
It is actually surprisingly rare to truly not be able to breastfeed (see the stats for Norway) but it's the unreasonable expectations of babies, schedules and poor advice or lack of support that usually causes failure to breastfeed. Hopefully the new NICE guidelines will improve education among healh professionals.
http://www.publichealth.nice.org.uk/page.aspx?o=529212
I'm also rather surprised soya is still being prescribed these days considering the concerns over phytoestrogens.
Oh and how on earth can it be easier to cart round formula! Just last week I managed to discretely breastfeed my 6 week old standing up on the tube in a sling. No searching for somewhere to heat milk up, no crying, no washing up plus the huge list of health benefits. I don't see a problem in devoting time to my baby (not that I really am, he just fits in with the family) when those first years are so important and will affect the rest of their lives so I'll do the best I can.

wendz said...

Well I am just going to lower the tone here a bit...my boobs are mine, see, all mine...and I rather like the fact that at 40 they're still perky and stretch mark free...

...and my boys were on the bottle from day 3 (they did get a few days of colostrum but oh man that breast feeding thing sucks - so messy and sore and tedious) and I was the boss of feeding schedules and they are healthy and fine and have great teeth and bones and all the necessary things that a 6yr old and an 8 yr old should have..apart from an obsession with boobs but that's really just a male thing, isn't...they've clearly just started young....but no strange diseases and no nutritional lacks and we're all just hunky dory with the no-breast feeding thing anyway.

Doctor Jest said...

tracy-- thanks for the feedback. Essex sounds much more sorted than Borsetshire from your comments. I just wonder if you are in fact "preaching to the converted though". I have no quarrel with your arguments, but sad to report, in sixteen years in GPland I have had one enquiry re "lactation support" and dozens for lactation suppression.

Wendz-- I come from an almost universally bottle fed generation and so far also have no ill effects to report, though there is an impressive body of evidence for the benefits of breast-feeding. Still I would endorse any woman's right to choose the method that suits her needs best, so long as she has made a fully informed choice. It's my job to try to make sure my charges get the facts, what they then choose to do I will always try to respect.

I do think it's a bit of a shame that any woman should have to worry about stretch marks though. That said I know of plenty of blokes who probably should worry rather more ;-)

The Boy said...

I think you hit the nail on the head with the working mother argument. Its NOT easy to balance the two at all. My wife was lucky enough to have four months off after each of our three, then moved to half and half (the breast morning and night, powder during the day). It worked, but was not easy. She tried expressing at the office during the day, but having to go find a place to hide to do it, then having no cold storage just didn't work. To make this right society has to rebalance again, from letting women work, to letting women work and still be women...

Doctor Jest said...

boy-- shameful isn't it. We've been aware of the message for at least two decades and still public policy does nothing to help...

Mr Angry said...

I had planned to make a joke here about being ever-so supportive of women getting their breasts out whenever needed.

But having read the tone of the comments I don't think I will.

It was going to be very funny mind you.

Doctor Jest said...

Mr A-- Please don't hold back on my account. I almost heard the tin-opener slicing the top off the can of worms as I wrote the post, but as I hope you will have already gathered I'm a big fan of levity, so feel free.