I have wanted to write my ‘infant feeding story’ for years. After all, I co-founded Infant Feeding Alliance and helped in a small way with contributions to a new book by my friends at the Fed is Best Foundation. Clearly I have a story or, perhaps more accurately, stories to tell.
I have noticed that stories in this area are often not about meeting the nutritional needs of babies. Instead, what we call ‘infant feeding’ is a platform on which various ideologies, politics and sociocultural concerns play out their dramas. Ideas about motherhood and fatherhood, gender norms, opposition to the excesses of global industry, nature versus technology, the role of public health and others are often the focus of infant feeding discourse. In an environment where infant feeding is about almost anything other than feeding a baby, the everyday experiences of families navigating caring for a newborn are often lost.
When I have told my story, I have found that it’s rarely allowed to stand for itself but is retold to prop up other causes and ideologies. I’ve lost count of the number of times others have turned my experience into a story of ‘a lack of support to breastfeed’. Perhaps most surprising are the lay and professional people alike, confident that my daughter, whom they’ve never met, must have had an undiagnosed tongue-tie or some other anatomical abnormality. My experience of excruciating breastfeeding is often blamed on the baby’s anatomy or a ‘lack of support’, as if the reputation of breastfeeding mustn’t be sullied.
This even happened when I participated in research, along with my now good friend and fellow founder of IFA, Sue Haddon. We both shared stories about how breastfeeding had detrimental effects on us and our babies. Researchers turned the data we submitted into stories of ‘barriers to breastfeeding’ and ‘heart-breaking’ examples of women ‘not receiving the support they needed’. They seemed oblivious to the point that we were far better off formula feeding and wished we had done it sooner. We answered back in Social Science and Medicine to reclaim our stories.
As I have followed commentary on infant feeding in the press, in research and on social media, I have read countless stories, not dissimilar to my own, of damaging pressure to breastfeed and relief at introducing formula. They almost invariably start by affirming the public health story about breastfeeding: that it has many benefits and must be ‘promoted and encouraged’. Then follows harrowing experiences of women trying to attain exclusive breastfeeding to the point of exhaustion and extreme stress or their baby requiring hospitalisation for jaundice or dehydration. I have seen these stories used by breastfeeding advocates and healthcare professionals as examples of the need for ever more breastfeeding support. Others parade them as examples of women’s defensiveness or need to prove themselves as good mothers and justify why they couldn’t breastfeed. I have seldom, if ever, seen anyone stop to ask if these sometimes nightmarish stories might contradict the very creed they start by affirming.
As a practicing clinical psychologist, I am aware that how we tell our stories can diminish us and keep us in shame, leaving us powerless. I know that our stories can also be told in ways that give us dignity and honour our strength, holding our pain with compassion and grace. Such a retelling of stories can lead the way to hope. It can help us imagine new possibilities for how we make sense of and experience our lives. So, I want to try telling some stories about my infant feeding experiences in more affirming and enlivening ways.
Others have written more articulately than I could on the sociological and political aspects of current infant feeding policy. My strength may lie in shifting from the macro to the micro and exploring how an individual’s (my own) experience might play out in the current climate. In some ways, I have seen writing this as an attempt to take back my personal stories from sociocultural and public health narratives that I have experienced as oppressive and domineering.
This is not my final word on my stories and I am open to them evolving in new ways. It is not a commentary on anyone else’s experiences, nor an invitation to comment on what could have been done differently. It is not a review of the scientific evidence, nor is it seeking to advise anyone else on how they should think, much less how they should feed their babies. However, I also know that in hearing other peoples’ stories, we can find fresh ways of viewing our own. So, I offer my stories in a public forum and hope that they might open up possibilities for anyone in need of a new story about their own experiences of infant feeding.
The ‘facts’ of my story are mundane. I attempted to breastfeed and did so for quite a few weeks. I was in excruciating pain, meanwhile my daughter didn’t sleep much at night. Practical recommendations included help with feeding positions, often with different professionals giving equally strident but completely contradictory advice. Other advice bordered on the amusing to the absurd. My favourite was being advised that if breast pads couldn’t contain my leaking milk, I could put nappies down my bra. But nothing eased the pain or solved the issue of a baby not sleeping for more than an hour or so at night.
Given that I was in pain and sleep deprived enough to fall down the stairs on one occasion (thankfully I wasn’t holding the baby and the only injury was to my pride), I started to consider whether formula feeding might be a better option. I wanted to know how to switch, I was suffering with engorgement and I feared mastitis. Now the story gets more interesting…
The response of healthcare professionals to my problems was to tell me how well I was doing to still be breastfeeding. They told me how proud I should feel for doing such a great job as a mother. I never got a straight answer about how to reduce breastfeeding. The reply was always, ‘Oh, you don’t want to do that. It will reduce your milk supply!’ One health visitor remarked that all the mums on my leafy street breastfeed and that it was only the young mums from the council estate that needed convincing. Those who know me well may be surprised to hear that I said nothing in response to this incredible classism. I merely stared in horror, too sleep deprived and shocked to muster up a challenge on the spot.
I agonised over making a decision to formula feed. I have a recollection of sitting on the sofa in our front room, clapping my hands as if to wake up some sleeping common sense and saying, ‘Come on, this is a crisis. You work with patients in crisis all the time. Put your work hat on. What’s your recommendation?’ Ever the pragmatist and often the straight shooter, I said out loud, ‘I’d say, this woman needs some bloody sleep immediately. No wonder she can’t make a decision, look at the state of her! Send her to bed, for goodness sake! What are you thinking letting her stay up all night for weeks on end? This is absurd!’
Formula purchased, my partner and I made up the first feed together. I watched, snapping photos, as he did the honours. I don’t know what I expected to happen at such a momentous occasion as our baby having her first bottle of formula. It wasn’t very exciting at all – she burped and fell asleep. But a night with dad for baby meant a night of sleep for me and with it came a rapid restoration of common sense. I decided to stop breastfeeding entirely, since it had brought us only misery. Comfort, contentment, and clarity of mind ensued.
But the health visitor was very disappointed indeed. She tilted her head sympathetically and softened her tone, as if someone had died, and commiserated sadly, ‘But you tried so hard. You didn’t get the support you needed’. She was at pains to say how sorry she was as she documented in my baby’s records that I was formula feeding. No further comments were made about what a wonderful mother I was, much to my relief.
For me, the interesting parts of this story are not the breastfeeding experience, but how the healthcare professionals responded. I am interested in how they used classism, identity and praise to shape my behaviour. Everything I said was twisted to suit a breastfeeding promotion agenda. Somehow the health visitor turned my experience of breastfeeding as painful and causing severe sleep deprivation into a story of the maternal hero suffering to achieve ‘feeding goals’. It was discombobulating to hear how well I was doing, when I was feeling more hammered, depleted and exhausted than at almost any other time in my life. Then she took my story of formula feeding bringing contentment and relief and turned it into an equally unrecognisable tale of sorrow and loss.
I later found out that the service’s policy was to praise women for any breastfeeding they do. I was furious to discover that, unbeknownst to me (and quite possibly to those implementing it), I had been subject to a behavioural intervention known as ‘contingent reinforcement’. In this case, praise was being used to reinforce breastfeeding, with the aim of increasing and maintaining the behaviour the service wished to see.
This was not the first experience of my story being misinterpreted. Before the health visitor there was a lactation consultant, who began to realise that no amount of advice she could offer would solve the problems I was having. She simultaneously told me that it was not ‘my fault’ and suggested books about how society is to blame and how women sabotage their own and each other’s breastfeeding. I wasn’t looking for anyone to blame and had no interest in finger pointing. All I wanted was to know if this apparent expert in breastfeeding could solve the problems I was having (with the unspoken intention that if she couldn’t, they would have to be solved in another way). On realising my intentions, the lactation consultant seemed to need to find something to blame, rather than acknowledge that some breastfeeding problems are not tolerable or solvable.
The health visitor and lactation consultant were also not the last to find my story unpalatable. When I shared that I had introduced formula in an online breastfeeding support group, I was kicked out and told I could return if I apologised and promised never to use the F word again. Perhaps ironically, this group turned out to offer me a surprising amount of support. A professional acquaintance of mine had also been in the group and noting my absence, made contact to ask how I was. When I told her what had happened, we laughed and raged together and our friendship grew closer.
Another time I shared a petition from the Fed is Best Foundation on Facebook. My private message inbox suddenly became unusually full. There were tender messages from friends sharing their own stories in support and solidarity, but others took me aback. Friends told me that I had not failed but was ‘failed by society’ and ‘didn’t get the right support.’ This was rather presumptive, as I had not mentioned my own experience. Neither had I said that I felt like a failure, indeed, I never have. I certainly didn’t lack what most would consider to be ‘professional breastfeeding support’.
It seemed that my protest and advocacy for what I think would be considerable improvements in infant feeding care had to be squashed. To protect the reputation of breastfeeding, a story had to be told which cast me as a hapless victim of a ‘lack of support’. The idea that a thirty-something, educated, professional woman with a reputation for straight talking might have come to her own feeding decision didn’t seem to cross anyone’s minds.
Later, I was astonished to find my mental health called into question on Twitter. A doctor suggested that I might have PTSD and offered her ‘support’. My symptoms? Questioning the safety behind current advice about bed-sharing as a means to support ongoing breastfeeding!
There is a word increasingly used that feels resonant with my experiences: ‘gaslighting’. It originates from the 1944 film Gaslight, in which a husband manipulates his wife, including by turning on gaslights and then denying he has done so, in order to convince her she is mentally unwell and steal from her. Colloquially it is used to refer to a form of emotional abuse that makes someone doubt their own experiences and question their own reality and even their sanity.
As someone with a clinical interest in narcissism, I know all too well the damage that gaslighting can do and I don’t use the term lightly. I make no allegations of intentional emotional abuse in my case and I suspect ideology induced blindness, rather than malice. However, there is an uncomfortable familiarity in seeing my accounts of my experience denied and twisted to push me to continue breastfeeding, when it caused me significant harm. It seems to me that such psychological gymnastics serve to protect the reputation of powerful health institutions, public health policy and, most of all, breastfeeding itself as always optimal and good.
Women like me are painted as having ‘complex’ emotions and as the victims of ‘heart-breaking’ circumstances. We are described as unduly influenced by formula advertising and by our own formula touting mothers and mothers-in-law. We are seen as in need of never-ending ‘support’. But this ‘support’ feels more like a means to correct heretical thoughts and maintain us in the fold than to foster our autonomy and meet our needs.
For me this sits as an unwelcome reminder of those who cannot admit mistakes, embrace guilt and make amends to build mutually respectful relationships. Instead of humility, and course correction when a public health agenda clashes with women’s accounts of their experiences, the fault must be turned on us, or those around us.
Out of the stories I have described, others emerged. As I have so often advised the people I work with as they come out of emotionally abusive relationships, I tried to make space to be with myself and my experiences. I aimed not to judge them as good or bad. I sought to disentangle what I was experiencing from the layers of meaning it could easily get caught up in and to reject stories that didn’t fit for me. This taught me to soften to myself and to not seek right or wrong, but to tune into my own, my daughter’s and our family’s needs. I learned to trust myself and lean on my own wisdom and compassion to make good decisions. I found myself straightening my back, planting my feet firmly on the ground and taking the reins to stake my position as mother in the family.
My decision to formula feed felt like the first decision I had made independently as a mother. It felt a little rebellious, like a part of me was resisting cultural expectations of endless self-sacrifice and honouring my own needs and wishes. The decision to formula feed marked a transition from self-doubt to self-assuredness that has stayed with me far beyond infant feeding.
In paying open-hearted attention to my experiences, I also walked into a story of regret and guilt. I regretted the hours, days and weeks spent struggling with painful breastfeeding, hoping the advice I was getting was right – keep going and it will get easier. I felt guilty that I hadn’t acted wisely to alleviate mine or my daughter’s suffering. I recognised that my mistakes here were costly for me, my daughter and our family. Unnecessary suffering in the form of pain, sleep deprivation and stress ensued from them.
However, my experiences of regret and guilt don’t feel like wagging fingers or soul crushing sources of shame. They feel like brutally honest friends telling it as it is, pointing out my blind spots and refusing to allow me to be overtaken by outside agendas not focused on what is good for my family. Regret and guilt have been an invitation to a wiser, kinder self to step up to the plate, draw boundaries and act from a place of compassion and clarity.
While my story emphasises autonomy, independence and going against the grain, it isn’t a story of one woman against the world. I didn’t get to where I am now alone. The switch to formula also marked a transition from a focus on the ‘mother-baby dyad’, emphasised in breastfeeding promotion, to a far more community orientated perspective. As I began to realise that meeting my daughter’s needs was not my sole responsibility and that my needs were also important, I developed a greater appreciation for my community. Aside from being able to share night-time care with my partner, I began to feel freer to appreciate the relationships my daughter was developing with grandparents, aunts, uncles, cousins and friends.
As I went down the rabbit hole of exploring how current infant feeding policy and practice came to be and how other families had experienced them, I connected with others, each with a story to tell. I’m grateful to the people from across the globe who have shared their stories with me. I hope I have listened with an open heart. I am grateful to those who have heard my story without trying to re-author it, creating a space for me to find my own words. In the sharing of stories, I have noticed a growing voice of resistance, with movements forming and reforming, organising and re-organising as we find our own positions. One thing seems increasingly clear: we are no longer lone voices against a seemingly unstoppable tide. The old creed is no longer safe or beyond question.
It remains to be seen how the world of infant feeding will respond to this growing protest and to stories like mine. Will current approaches and all the social and political dramas currently taking centre stage fight for survival, double down and attack objectors? Or will our protests be enough to trigger self-reflection and a willingness to reconsider cherished beliefs? Will the infant feeding world yield space to families to take our rightful place at the heart of policy and practice? Will we all finally screw our heads on sufficiently well to make infant feeding primarily about feeding babies?
As I see it, as long as the quest to increase breastfeeding rates is steadfastly at the helm, infant feeding policy is not focused on what families need. Any harms or costs that result from current practice can only be seen as stories of ‘barriers to breastfeeding’, rather than a cause for significant concern and reason to question whether current policy is good for families.
What if infant feeding policy was our servant? What if the guiding principle was the needs of families, including the nutritional needs of babies? What if current dictates were replaced by the humility to ask, not tell, parents what they want and need? What if healthcare providers were unconcerned about breastfeeding rates and honoured parents’ wisdom and judgement regarding what is needed for our families? What if infant feeding research could adopt an attitude of curiosity and an interest in families’ experiences without being in the shadow of a public health breastfeeding agenda? And, what if research into breastfeeding asked questions about preventing and alleviating the problems it brings to families, rather than trying to figure out how best to get more people to do it?
I imagine a world in which infant feeding policy ensures babies are fed and parents are in charge. We may not be able to control all of our infant feeding experiences or the challenges that come our way, but how we make sense of them is our story to author.
Ruth Ann Harpur