This review has been a long time coming, since I received the book just before baby three put in his appearance, but I especially want to share it with all my friends who support mothers. Breastfeeding Uncovered explores the factors that influence whether mothers want to breastfeed, whether they do breastfeed, and how long they breastfeed for. In the first chapter Dr Brown explores why these questions are worth exploring. She identifies the key issues as: that there is a health benefit from increasing breastfeeding rates; and that mothers who want to breastfeed but don't feel upset, guilty and criticised, and this can be avoided. The strength of her discussion of these issues is a detailed explanation of the statistics involved in understanding the health outcomes of breastfeeding versus not breastfeeding, for both mother and baby. We all know someone who was raised on artificial milk and is hale and hearty, but in the same way that we all know someone who smoked since childhood and lived to be a hundred, this does not mean that breastfeeding isn't the better option when trying to skew the odds of good health outcomes in our favour.
We live in a society that assumes bottle and artificial milk feeding, and this creeps in to our lives invisibly all the time. Baby dolls come with bottles, and pictures of toddlers breastfeeding their dolls are deemed controversial. Many women never see a baby breastfed until they have their own. Much of this book is concerned with how this affects our breastfeeding decisions and outcomes. Our societal expectations of mothers and babies in general are written by this assumption of bottle feeding as the norm, and this makes it hard for mothers to decide to breastfeed. For example, we can't measure how much our breastfed baby is getting, only the outcome that they are healthy. A mother who finds herself spending a lot of time, day and night, breastfeeding a baby may become overwhelmed, if she was expecting her baby to just have a ten minute bottle every four hours like her friend's bottle fed baby, or her mother says she did. Mothers may also be embarrassed to breastfeed their babies out and about, and either find themselves stuck at home (miserable), or bottle feeding outside the home, which rapidly becomes bottle feeding altogether. They have grown up thinking of their breasts as sexual, and have heard of women being asked to leave places for breastfeeding. I have heard husbands undermine breastfeeding because they feel they need to feed the baby to bond with it (not true. Why not try wearing it in a sling while mum has a nap or out for a stroll, or taking a bath with the baby, or finding a special song that only dad sings to settle the baby?), because they feel that their partner's breasts are sexual, and somehow their property (hello? A woman's breasts belong to her alone, and they are evolved for feeding babies), or because they are embarrassed that other men will see their wives breastfeeding (they should be proud! Look what a great start you are giving your children!). The attitudes of partners and other family members are so influential in whether and how long a mother breastfeeds her baby.
In conclusion, Amy Brown sets out an eighteen point manifesto for a breastfeeding friendly society, which I reproduce here with her permission:
Step 1: Teach mums, and those around them, how normal it is for breastfed babies to feed frequently and why this is important.
Step 2: Tell all new parents and those around them about normal baby sleep, why feeding doesn't affect is, and support them in other ways to get more rest.
Step 3: Tell parents and those around them about normal patterns of weight loss and weight gain in breastfed babies, and why this doesn't mean that they are underweight.
Step 4: Be more aware of how experiences during childbirth may affect breastfeeding. Invest in maternity units to give staff more time with mothers, to help reduce interventions during birth, and ultimately increase breastfeeding rates.
Step 5: Early hospital practices can make a significant difference to breastfeeding. The more Baby Friendly practices a hospital adopts, the better their breastfeeding rates. So it's obvious. Make all hospitals (and neonatal units) Baby Friendly!
Step 6: invest in expert support services for all breastfeeding mums right from the start of breastfeeding.
Step 7: Support new mothers to feed and mother, don't abandon them to juggle everything. Mother the mother.
Step 8: Bin all the rubbish baby care books.
Step 9: Support employers to be breastfeeding friendly.
Step 10: Stop this ridiculous body image pressure on new mothers and come to terms with our own illogical sensitivities and prejudices about human milk and the female body.
Step 11: Give new mothers the emotional and practical support they need, every step of the way.
Step 12: Breastfeeding support needs to be tailored to individual needs.
Step 13: Educate dads to be the breastfeeding supporters they can be.
Step 14: Invest in health services so more health professionals have more time and more knowledge to support breastfeeding mothers.
Step 15: Educate the public to stop being idiots, or at least do no harm.
Step 16: Regulate products that are designed to create anxiety in new mums.
Step 17: Crack down on brand advertising and prevent industry access to professionals and parents.
Step 18: Step up and fund healthcare and breastfeeding support.
I would love for everyone supporting mothers to read this book. For those of us living in the pro-breastfeeding community, we can gain understanding of why women make the choice not to breastfeed. For those in the wider community, knowledge of how our actions and environment can affect these important decisions must surely guide our behaviour.
Here's the exciting bit: Amy has very kindly sent me an extra copy of the book to give away to a reader! To enter, just pop a comment below, and I'll draw the winner on Sunday night! I can only really pay UK postage, but if you're further afield and happy to pay most of your own postage, then go ahead and put yourself forward.
P.s. what targeted advertising did I receive when I looked at the book's Amazon page? Artificial milk (formula). Go figure.