Breastfeeding-only advice ‘puts mothers under unfair pressure’

Recommendations that babies are breastfed for six months, without introducing solid food or other liquids, is considered “unrealistic and unachievable” by many families, they argued.

Promoting this ideal – as set out by the World Health Organisation and the Department of Health – is “perceived as setting parents up to fail”.

Experts from the University of Aberdeen and the University of Sterling based their findings on 220 interviews with 36 women, 26 partners, eight of the women’s mothers, one sister and two health professionals.

They said their findings also showed that health services were not providing the right help to women following birth to enable them to breastfeed.

“By promoting six months exclusive breastfeeding, policymakers are encouraging idealistic expectations and goals in pregnancy, but health services are not providing the skilled help required to establish breastfeeding after birth.”

The experts found the “mismatch between idealism and realism” could mean mothers feel pressurised into breastfeeding.

All the women in the study intended to breastfeed and were keen to “give it a go” but the researchers found a range of views emerged, including that families saw sharing the responsibility of feeding as an opportunity for fathers and grandparents to bond with the baby.

Some found expressing milk difficult, time-consuming and distasteful, while others said breastfeeding in public was difficult.

Some families felt that delaying giving the baby solids went against their intuition.

Antenatal care was also found to paint an “unrealistic picture” of breastfeeding, while NHS staff were not always available to help with feeding in the early stages.

Care of women who want to breastfeed was seen as “highly variable and determined to some extent by luck”.

The authors, writing in the journal BMJ Open, concluded: “Adopting idealistic global policy goals like exclusive breastfeeding until six months as individual goals for women is unhelpful.

“More achievable incremental goals are recommended.

“Unanimously, families would prefer the balance to shift away from antenatal theory towards more help immediately after birth and at three to four months when solids are being considered.”

The latest England figures on breastfeeding from the Department of Health show that 74.1 per cent of women started off breastfeeding in the third quarter of 2011/12.

Six to eight weeks later, this figure had dropped to 47 per cent.

Breast milk provides babies with valuable nutrients and research has shown that breastfed babies suffer less chance of diarrhoea and vomiting.

They also have fewer chest and ear infections than bottle-fed babies, are less constipated and are less likely to become obese.

Editor-in-chief of BMJ Open Dr Trish Groves, said: “Any research or other article that seems to be ‘anti-breastfeeding’ is, rightly, highly controversial.

“This study is not, however, against breastfeeding: far from it.”

Gail Johnson, education and professional development adviser at the Royal College of Midwives, said a shortage of midwives can leave some women feeling unsupported with breastfeeding.

She added: “The evidence to support and promote the value of exclusive breastfeeding for the first six months remains unchanged.Breastfeeding should not be seen as an idealistic target, it should be part of the continuum of care for babies. Midwives and other health professionals have an ongoing responsibility to support parents in caring for their babies and breastfeeding is a part of this.”