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Ann Bradley

Breast source of advice

When it comes to the issue of how to feed your new-born baby, there is no rational discussion to be had. Breast is unquestionably best. Your doctor will tell you so. Your midwife will tell you so. Every guide to baby care and 'parenting' manual will tell you so. Antenatal clinics have their walls plastered with posters about how to breast-feed, where to breast-feed and who to contact if you need help with breast-feeding. You will not see one poster or leaflet putting the case for bottle-feeding because they are not allowed.

Health promotion agencies seem to concur that, because breast-feeding confers certain health benefits on the baby and mother (which it does), and because almost all new mothers can successfully breast-feed (which they can) if they try hard enough, they should be denied any information on the convenient alternative in case they are swayed from the healthy natural choice.

This attitude, in effect, leaves women with no real choice at all. Opt to breast-feed your new-born and you have teams of midwives falling over themselves to offer instruction. Opt to bottle-feed (or even to mix the two) and the support system falls away. If you are lucky, your midwife or health visitor will supply some information on the dangers of failing to sterilise your bottles properly and guidance on how to avoid over-feeding or starving your child. It might be a touch too cynical to suggest that the tone of much of this suggests you might want to think again, but the barely concealed question seems to be: if you love your baby and respect yourself, how could you knowingly choose less than the best?

Yet bottle-feeding can be a rational, sensible choice and it is one which many women want to make. Eighty per cent of mothers in Britain use infant formula at some time in the first year of their child's life. The overwhelming majority of breast-feeders switch to bottle-feeding when they return to work - yet while I have seen dozens of leaflets that advise women on how to continue breast-feeding, I have never seen one that advises women on how to successfully switch from breast to bottle.

The paucity of information on bottle-feeding drives women in search of information straight to the companies that manufacture the baby milk. If your health visitor looks blankly when you quiz her about the benefits of Gold Cap as opposed to White Cap SMA it makes sense to quiz the medical department of the manufacturers, Wyeth. Infant formula manufacturers claim they receive thousands of queries every year from parents hungry for information about their products.

Now, even this source of information is to be dammed. Soon to be released Department of Health guidelines will ban baby-milk manufacturers from replying to any customer's letter requesting infor-mation about their infant formula brands. It has been alleged that the information ban is due to concerns that companies will inevitably take the opportunity to push their own products and encourage mothers to consider formula instead of breast-feeding. Dr Lindsay Smith, chairman of the Royal College of General Practitioners' Clinical Network, reportedly told the Mail on Sunday that it was right that women should rely on health professionals rather than the industry.

In one sense this is uncontentious. Women should be able to rely on health professionals to provide the accurate information they need. But they cannot because of their anti-bottle bias. Furthermore, some women do not want to rely on health professionals. Some women may feel that they are in a better position to judge what is best for themselves and their family than a health visitor who is paid to regurgitate whatever happens to be the favoured 'line' of the moment. Many women - even those who choose to breast-feed - feel that they should be able to make their decision after assessing the pros and cons of breast versus bottle for themselves. They do not want dumbed-down, pre-interpreted health promotion propaganda.

Concern that manufacturers will take advantage of women's ignorance and seek to bend their minds in favour of their products should be taken as given. The companies that manufacture infant formula obviously want to increase sales, but women are not so mindless and vulner- able that they need to be protected from this. They are as capable of making a judgement about the worth of Wyeth's information on baby milk as they are on any of the company's other products.

If the minister for public health wishes to serve the interests of new mothers she will throw out the guidance she is currently considering on the restriction of baby-milk manufacturers' advertising and promotional activities. She will start treating new mothers as capable beings who can be trusted to make sensible, rational decisions. She might even suggest that the HEA, Maternity Alliance and the like produce some literature that would really meet women's needs. 'Handy tips for breast-feeding quitters' would fill a gap in the literature line. Finally, she would do well to remember: many new mothers would like to have a nanny to take care of their baby; few want a nanny state to take care of their decisions.

Reproduced from LM issue 110, May 1998

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