The Royal College of Midwives’ new position statement on infant feeding, released today, represents a change in approach to be more inclusive of bottle feeding parents, ensuring that they have the support they need to bottle feed safely and to have opportunities to bond with their baby. As a researcher in this field I am wholeheartedly behind this change in stance. Previously, the unilateral advice to breastfeed exclusively for 6 months was unachievable for many mothers in a society where the physical, practical, mental and emotional support for breastfeeding is not available.
It is essential to note what the change in stance does NOT mean. The RCM maintain that breastfeeding is the optimum way to feed a baby. The evidence still shows that increasing breastfeeding rates would have wide ranging and significant impact on public health from reductions in sudden infant death, reduced rates of serious infant illness and hospitalisations, to reduced obesity for both mums and babies, and reduced rates of female cancer. These differences should not be played down. Formula milk provides adequate nutrition for babies, but cannot be considered equal to breastfeeding.
The change in stance is needed because the vast majority of parents in the UK find they give their babies at least one bottle of formula; breastfeeding promotion sits in opposition with a UK social norm of bottle feeding. Without supporting parents to do so safely, we risk increasing the health inequalities associated with formula feeding. Leaving parents with little support to make up bottles leaves them vulnerable to errors or shortcuts which could further increase the risk of their babies becoming ill.
During a time of significant cuts in public spending to provide breastfeeding support, we also risk marginalising mothers who bottle feed, whether or not that is a result of their own choice or because breastfeeding has not worked out for them. This marginalisation of bottle feeding may only serve to deepen the social divide between bottle feeding and breastfeeding mothers, and may be a risk factor for postnatal depression.
An alternative model of breastfeeding promotion might instead focus on the universal message of adopting a more responsive style of parenting, focusing on close physical contact between parents and babies, and fostering close connections and relationship building within the family. A societal, cultural shift towards a more responsive parenting style is likely to be beneficial for infant developing in its own right. It may also have benefits in terms of both increasing parents’ desire to breastfeed, and their ability to so do, by creating an environment in which mothers and babies are kept close and breastfeeding can work most successfully. Indeed, this shift of focus has already been recommended by UNICEF’s Baby Friendly Initiative.
This alternative model has been the theory behind a new infant feeding website ifeed, due to be launched in August. All parents who access the ifeed website are encouraged to think about ways to maximise the bond between themselves and their baby, and to engage in skin to skin contact. When developing ifeed we aimed to encourage parents to come to their own, informed decisions around infant feeding, including giving parents an opportunity to think about personal barriers to breastfeeding and consider ways to reframe these to be more positive about breastfeeding. Most importantly, the site includes practical and emotional support for parents, however they are feeding their babies.
For more information contact Dr Naomi Bartle firstname.lastname@example.org.