On one hand, it could be argued that the only prerequisite for a breastfeeding support worker should be a passion for breastfeeding and wanting to support other women in doing it. After all, doctors treat cancer without having suffered a terminal disease themselves.
On the other hand, text book understanding can only go so far. A breastfeeding support worker with only theoretical knowledge cannot properly identify with the physical and emotional investment that breastfeeding demands.
In many cases, the support worker’s views on infant-feeding are based on their own, highly personal experiences. Surveys show, for instance, that the most important factor influencing the effectiveness and accuracy of a doctor’s breastfeeding advice is whether the doctor herself, or the doctor’s wife, had breastfed their children (Thomas.P). Many professionals carry emotional baggage if they’ve previously failed at breastfeeding themselves and this can affect the manner in which they advise or treat mothers.
This article is going to look specifically at those careers whose sole focus is delivering breastfeeding support. Should it be a prerequisite that all breastfeeding support workers have successfully breastfed their own children? – it’s a tough question. To help answer it I have put together an ‘expert panel’ of some of the biggest players in the breastfeeding arena.
My Expert Panel:
THE DOCTOR - Dr Jack Newman.
THE PEER SUPPORTER - Anne, founder of Dispelling Breastfeeding Myths.
THE LACTATION CONSULTANT - ‘The Analytical Armadillo’, founder of Milk Matters.
THE BREASTFEEDING ORGANISATION - La Leche League representatives - Nina, Eileen, Petra, Jill and Barbara.
THE FORMULA FEEDER - Suzanne, founder of The Fearless Formula Feeder.
THE LACTIVIST – Lisa, founder of Lactivist.net
THE BREASTFEEDING MOTHER - Elita, founder of Blacktating.
THE NON-PARENT – Alison Blenkinsop author of ‘Fit to Bust’.
For simplicity’s sake, during the debate I have used the term ‘breastfeeding support worker’ to mean ‘any person with breastfeeding qualifications who gives breastfeeding support’. This can be breastfeeding counsellors, lactation consultants or peer supporters. Let’s begin.
1. How important is it for a breastfeeding support worker to have personal experience of breastfeeding?
La Leche League (Jill): CRUCIAL - It is only possible to understand a baby's needs, and the maternal requirements involved when you have had personal experience.
La Leche League (Petra): I think it is essential to have personal breastfeeding experience, as a lot of solutions look and feel very different when it is your own child and all the emotions that come with it hit in.
Fearless Formula Feeder: I definitely think a breastfeeding support worker should have some personal experience with breastfeeding. I have a really tough time listening to male breastfeeding experts for this exact reason - until they have fed a baby from their bodies, how can they possibly understand the physical and emotional aspects of that act?
Dispelling Breastfeeding Myths: Personal experience of breastfeeding gives a counsellor a first-hand appreciation for the emotional and practical challenges which a mother might experience - as well as the mechanical. Although everyone's breastfeeding journey will be unique and personal, there are also likely to be elements which are 'universal'. Knowing that the person who is supporting you has 'been there' themselves can be comforting & inspiring. Having said this, is it necessary for a trauma counsellor to have experienced trauma themselves? Or for an oncologist to have experienced cancer?
|Above: illustration from Alison Blenkinsop's book |
'Fit to Bust'. In 1999 Alison was awarded the British
Hospital for Mothers and Babies Award for
Practice in Support in Breastfeeding.
Alison Blenkinsop: I would like to think that it should not be a major requirement, but it depends on the person. Some childless women are brilliant at empathising with mothers (I was a midwife for 31 years in UK and Pakistan, an Lactation Consultant for 10 years, and my last post was Infant Feeding Adviser in an NHS hospital for 5 years. I am married, but have no children). Others with years of personal breastfeeding experience are not good listeners or can't accept someone else's experience, if it doesn't tie in with their own views.
Dr Jack Newman: I think it is important. But it is not necessary that the experience be a good one. Several of the best lactation consultants I know actually had considerable difficulty with breastfeeding. If they learned the right lessons, that can help them be good support workers. It helps such a person be empathetic to the mother who is feeling desperate or feeling things will never work out.
Lactivist: As long as the support worker is professionally trained and has gone through the hard process of qualifying, personal experience of breastfeeding should not be a prerequisite.
La Leche League (Nina): As Thomas Edison once said, ‘True knowledge is experience, all the rest is information.’ An experienced breastfeeding mother has the heartfelt confidence that mothers and babies can breastfeed.
Analytical Armadillo: If you ask mums if experience is important, they will often answer yes - they want someone who has been there done that. I know a couple of fantastic lactation consultants who haven't had children, but have developed their interest through midwifery - do mums who see them in the NHS even think to check if they had personal experience?
Blacktating: I think it's very important for breastfeeding support workers to have personal experience with breastfeeding. I want the person who is helping me with any breastfeeding problems to have both clinical expertise and a deep understanding of what I'm going through as a mother when my baby is having feeding difficulties. I'm not sure you can have the same level of empathy if you haven't breastfed your own child.
|"Confidence in breastfeeding has been lost in our |
(still) bottle feeding culture" - La Leche League (Eileen).
2. What minimum length of personal breastfeeding experience should be a prerequisite for this occupation?
La Leche League (Jill): The WHO (& NHS) supports breastfeeding for at least two years so ideally this would be preferable. Having said that there would not be many breastfeeding counsellors in GB if this were the case so for now at least maybe one year. I do hope it soon becomes possible to extend this.
|"I think 6 months is inadequate"|
- Alison Blenkinsop
La Leche League (Eileen): I think any counsellor who has no experience (including second-hand) of breastfeeding to at least two years and preferably several examples of genuinely natural weaning (as opposed to self-weaning brought about by "managing" breastfeeding and by lifestyle choices such as separation) will be less successful in helping a range of mothers.
Blacktating: I'm not sure there's a minimum length I'd be looking for. I'm not sure I would even ask. It would be fantastic if all breastfeeding support specialists had breastfed into toddlerhood at least once. Breastfeeding a newbie is vastly different from breastfeeding a 6 month old and the problems moms face change with baby's age.
La Leche League (Barbara): To accredit as an LLL Leader a mother has usually breastfed for the first 12 months and often longer. A mother who has only breastfed for a couple of months may not understand as much about breastfeeding through different ages and stages but she might well be capable of supporting another mother through an initial difficult start to breastfeeding.
Analytical Armadillo: I think there are a lot of qualities beyond experience. Some who have fed for years may have never experienced a single issue, whilst someone who stopped earlier than they would have liked can have become educated and feel driven to empower other mums to do what they couldn't.
La Leche League (Nina): A breastfeeding mother learns a huge amount in the first year because babies are growing and developing at a rapid rate with changing needs. Since the prevailing recommendation is for 6 months exclusive breastfeeding, perhaps that should be the minimum?
Dr Jack Newman: I don't think that there is a minimum amount of time. It helps to go through the whole period from birth to a toddler weaning to know what it is like to breastfeed a toddler and understand the special issues that come up when a toddler breastfeeds. But many people understand without the actual experience.
La Leche League (Petra): I prefer someone who has breastfed for as long as possible to be able to cover all areas; including extended bf and weaning. I also know that this is getting increasingly more difficult as a lot of women have to return to work. Question is: Should we adjust the requirements or should society adjust their expectations and the support it offers to families?
Dispelling Breastfeeding Myths: Even amongst breastfeeding mothers there is such a range of experiences that a person might breastfeed easily for years (as my mother-in-law did!) and yet remain blissfully unaware of the challenges that other mothers can face. Having breastfed for x number of years or months doesn't really guarantee that a person will have empathy or an awareness of the many issues which can affect those they are supporting. Whilst I agree a huge amount is to be gained by personal experience, I also think this requirement might act as a barrier to training for some potentially wonderful supporters. I think there's a lot to be said for judging each case on its individual merits.
3. Should breastfeeding support workers be able to refer to their personal experiences of breastfeeding when advising their clients?
La Leche League (Jill): Only rarely and if a mother shows signs of choosing the same solution to a problem. Offering personal experience up front may pressurise a mother to make the same choices when they are not really right for her.
Alison Blenkinsop: Yes, but they need a good deal of time in training to talk through their experiences (debriefing style), so that painful/emotive/difficult issues are addressed. They should not use their experience as a benchmark for others.
La Leche League (Petra): I think this can be sometimes helpful, but most times it is not needed so the counselling stays about the mum rather than becoming a platform for her debriefing.
Fearless Formula Feeder: I think I would find this quite comforting, as long as it were done judiciously. For example, if a client were struggling and the support worker briefly shared the fact that she had struggled too and then left it to the client to pursue more details... Breastfeeding isn't just a physical practice, it's emotional too - and the best lactation consultant I saw was the only one who approached the issue holistically, and allowed me to really get to know her on a personal level.
Dispelling Breastfeeding Myths: No breastfeeding supporter (whatever their level of expertise) should be using their role as a means to 'process' their own experiences - that should take place elsewhere. However, if their personal experience is directly relevant to a situation and there is something to be gained from discussing it, then it could be quite useful. For example, as a peer supporter I would hate to see a mum get poor advice from a GP when I know from my own experience that another GP in the same practice is more clued-up about breastfeeding.
La Leche League (Eileen): In general it is better to focus on the mother's experience so that the mother is best able to choose what will work for her. There is a real danger of some examples setting up comparisons and goals for the mother which are not helpful.
La Leche League (Nina): As a general rule, it is a waste of time talking about one’s own experience. Mentioning a shared feeling/experience such as new mother fatigue can ease the feeling of isolation and offer hope that this too shall pass. But this personal sharing should be a very small part of the helping relationship.
|"Someone's personal 'baggage' |
could cloud their judgement of a
situation" - The Analytical Armadillo.
La Leche League (Barbara): A good counsellor will only cherry pick from her own experience now and then because there is a great danger of wrongly assuming that what happened to you is of any relevance. You need only look at any chat group on the Net or the comments following breastfeeding stories to see how unhelpful it can be to make such assumptions.
Dr Jack Newman: I don't think it's usually a good idea to discuss your personal experience. Counselling is not about the counsellor, it's about this mother and this baby. I've seen it happen that a counsellor gets too wrapped up talking about herself. I realize that the counsellor feels discussing her experience will help, but often it doesn't.
Lactivist: I think it depends - a peer supporter is someone who has breastfed and you would expect them to be able to refer to their experiences because this is key to the way that they support. But if you are having a breastfeeding problem that a peer supporter cannot help with you would go to see someone with longer training. I think you wouldn't go to see a Psychiatrist and expect them tell you how insane they have been to prove that they are good at their job :-)
4. How do you feel about male breastfeeding support workers? Would you use the services of one?
Lactivist: Yes, I don't have any problem with this at all. In fact they might be very useful in helping dads feel supported at a time when they can sometimes (and this is refering to my personal experience) feel left out.
La Leche League (Jill): I cannot see any point in this.
Fearless Formula Feeder: Erm, no. And I feel like a total sexist pig saying that, but I just couldn't. That doesn't mean I think they shouldn't exist; after all, if men can write breastfeeding books, why shouldn't they be able to counsel women on an individual level? One could argue that since men would be able to disassociate a little more from the process and view it solely as a physical act, they might even be *better* in a clinical setting. But personally, I don't think I would ever use a male breastfeeding support worker. I can't really verbalize why I feel this way, but I do.
Dispelling Breastfeeding Myths: I would personally have no problem with seeing a male breastfeeding support worker. In fact, when I was at my lowest point and struggling to breastfeed my first daughter, it was a male doctor who helped us the most. His unequivocal support (when everyone else seemed to think I was wasting my time) meant the world to me. At that time I couldn't have cared less what gender the person helping me was - all I cared about was getting help. However, it's a really personal thing. Mums who are less confident than me, who might be feeling 'hormonal' or down, or who are simply more modest than me might struggle with a male breastfeeding counsellor. Those women should of course be able to be supported by a women if that's their choice. However, men can make absolutely wonderful breastfeeding supporters, Dr Jack Newman springs to mind (as does my husband)! Our culture is still quite sexist - I personally think that having more men involved in breastfeeding support would be really positive.
|"Women get enough male advise crap; |
I don't think they need more when
they are at their most vulnerable"
- La Leche League (Petra).
Blacktating: Although it's illogical as I've had many male gynecologists over the years, I probably wouldn't. I suspect if the person sent to my hospital room to help me with breastfeeding was male I wouldn't balk but I would never choose a man out of a list. However there are a lot of men who have incredible amounts of breastfeeding knowledge and are passionate about supporting moms and babies. Dr. Newman immediately comes to mind. Still I must admit I find the idea of using a male IBCLC strange.
La Leche League (Eileen): I probably wouldn't myself. I usually prefer to consult female professionals in all kinds of areas. But the important thing for the breastfeeding counsellor is always the amount of confidence and the range of ideas. For example, I would have more confidence in a man whose partner has breastfed, overcome some challenges and weaned naturally than in a woman who had learned everything from books and had little contact with real breastfeeding mothers, a woman who had fed her own babies on a strict schedule and weaned in the early months, or even a woman who thought breastfeeding was easy.
La Leche League (Nina): There are male midwives and I think being a breastfeeding support worker would be similar. These men no doubt have to have high motivation to go for this occupation, hopefully they would be interested and effective. Having said that, if I personally have a choice between a man and a mother, I would choose the woman.
Alison Blenkinsop: It would be a rare man who could support a mother in the way that another woman can, but I don't think sex should be a barrier on its own if personal experience of breastfeeding is not thought essential.
Analytical Armadillo:My thoughts are why not - look at Jack Newman? We have male midwives and gynaecologists.
|Dr Jack Newman is a Canadian physician specializing in |
breastfeeding support and advocacy. He speaks regularly at
conferences (La Leche League, IBCLC), and has been a
consultant for Unicef's Baby Friendly Hospital Initiative.
Dr Jack Newman: Well, I am obviously biased. I think a man does need to have lived with a breastfeeding woman to be able to empathize and understand. Otherwise, unlike many women, he just won't understand the mother's feelings and needs.
5. Should someone who formula fed by choice be able to become a breastfeeding support worker?
La Leche League (Jill): Providing that she would no longer make that choice due to changes in knowledge or circumstances, or if the circumstances indicate that breastfeeding is medically contra-indicated, and if she has other relevant breastfeeding experience, I see no problem with that.
La Leche League (Barbara): Yes, indeed, provided she has also gone on to breastfeed. If she has not then unless she has worked through the feelings of her failure with a counsellor and would act differently in the same situation she is unlikely to be a positive influence on any breastfeeding relationship.
Alison Blenkinsop: It could depend on the reason for choosing formula, but probably no. However, I would want to give such a person a chance to support mothers in other ways.
La Leche League (Eileen): I wonder why she might want to. I also wonder what she could bring to it.
La Leche League (Petra): Dangerous ground - if it is really by choice (and I'd question that) ...probably not. I think a woman would always question why she is supporting something she choose not to do herself.
Dispelling Breastfeeding Myths: I guess that would depend on their motivation for wanting to become a breastfeeding supporter, and on their reason for formula feeding. If someone formula fed because they genuinely believe it doesn't matter how you fed a baby, then you'd have to question why they wanted to become a breastfeeding counsellor or supporter in the first place. However if someone chose to formula feed because they genuinely felt they had no other option, or because they made a decision which they later came to regret, then that person might well be impassioned to support others.
Blacktating: I can't imagine someone who formula fed by choice would want to be a breastfeeding counsellor, but she should be allowed if she is educated, knowledgeable and most importantly PASSIONATE about helping moms and babies succeed.
Analytical Armadillo: Would many mothers who had formula fed by choice want to become a breastfeeding support worker? If so I would want to consider the whole picture and their motivation for wanting to do so.
Dr Jack Newman: Not if they "chose" to formula feed and still feel it was the right choice. There are counsellors who formula fed by choice but realize now it was not the right thing to have done. How can they possibly help a mother desperate to breastfeed? At this extreme it's very easy to see how one's personal experience may interfere with trying to help.
|"I would suspect masochism or sabotage |
as a motivation" - La Leche League (Nina).
Lactivist: I truly believe that formula is there as a last resort but we have many cultural barriers that need to be broken down before this is universally accepted. People FF by choice for many reasons and I think that as long as a person who FF by choice did not carry baggage or guilt about their choice and acknowledged that there is a hierarchy of best feeding practice (mothers milk, expressed mothers milk, donated milk, formula (World Health Organization. 2003)) there is no reason why they should not be a great breastfeeding support worker. It's all down to the training.
Fearless Formula Feeder: I don't see why she couldn't, as long as she had also breastfed at some point as well. If she felt passionately about helping other women achieve their breastfeeding goals, then why wouldn't we want her helping them do so? I would assume that if she had formula fed by choice at some juncture in her life, and then decided to pursue a lactation career, the choices she had made were not black and white. On a personal note, I've considered training to be an LC. Someone brought it up to me once and at first I laughed, thinking they were taking the piss. But the more I thought about it, the more it made sense. I would love to help women navigate the challenges I faced.
6. How would personally experiencing ‘breastfeeding failure’ (i.e. giving up short of their initial personal goal) influence a breastfeeding support worker’s practice?
Lactivist: It should not as long as they were well trained and supported through their training.
La Leche League (Barbara): Probably not very positively if she hasn't gone on to breastfeed a subsequent baby unless she has worked through her emotions and informed herself about why she might have gone wrong.
La Leche League (Petra): It could stand in the way of a good and supportive counselling session or it could become a rich pot of experience to dip into during counselling; it depends very much of how much debriefing and how 'finished' this experience is.
Dispelling Breastfeeding Myths: Hopefully it wouldn't affect their practice at all. Ideally (in my opinion!) a breastfeeding support worker is there to help mothers to achieve their own personal breastfeeding goals. If a breastfeeding supporter is so affected by their own experience that it is influencing their practice, then in my opinion there is a problem.
Analytical Armadillo: How people respond to events in their life varies hugely person to person. Mums who are failed can respond in many different ways as we can see just from spending half an hour online. Some feel angry they were failed, and/or strive to learn more - others become defensive and close their minds. A fantastic LLL leader I know formula fed several children before cracking breastfeeding and then went on to breastfeed several more, I find people rarely fit into neat boxes.
Dr Jack Newman: It may help or hinder. It depends on each particular person.
La Leche League (Eileen): It might go either way - it might make her more determined to help other women avoid the same disappointment or it might limit her own confidence in breastfeeding.
Blacktating: On the one hand she would be empathetic to a mom who is unable to breastfeed and might be able to offer another level of compassionate support. On the other hand it might make her pessimistic if she encounters a mom with a similar situation to her own. Breastfeeding is so personal, it might be difficult to separate your experience from your client's.
La Leche League (Jill): Sometimes women who have failed to breastfeed read more widely and become more knowledgeable and are more committed once they have made it work. Before that they can be quite pessimistic. Personal experience of breastfeeding and attitudes need to be assessed carefully in each individual situation.
La Leche League (Nina): This depends entirely on the individual. Sometimes an unsatisfactory experience can motivate ongoing learning and processing of “what went wrong”, this can lead to a resolution and good practical empathic helping. An unresolved situation can impact practice without awareness because of underlying issues that have not been fully understood and accepted.
Fearless Formula Feeder: I think it could go one of two ways: a woman who has struggled to breastfeed could become more understanding and accepting of others' experiences, or she could become less tolerant, thinking that her own experience trumps all others. I see this attitude among bloggers... some of the least compassionate people I've encountered are those who say things like, "Well, I had to formula feed because of x, y, z, but that was just because I was booby-trapped. If you were as smart as I am now, you'd know better." It makes them more judgmental. So I really think it would depend on the individual and her world view.
7. In what ways do you think it is possible for a breastfeeding support worker to consciously or unconsciously sabotage their clients?
La Leche League (Petra): Whenever we have an area in our experience that is still painful (for whatever reason) it is possible for that to shape the information we give or what we do in a positive or negative way. To limit the possibility of that happening 'supervision' is essential.
Alison Blenkinsop: Support workers may sabotage by not understanding themselves and their own reactions, or their own experiences; jumping to conclusions; not listening well; allowing themselves to be influenced by commerce (eg using formula company literature/stationery) or by childcare authors lacking good credentials; getting too emotionally involved with clients.
Lactivist: If the breastfeeding support worker had a negative experience of breastfeeding they could possibly be subconsciously prejudiced in certain situations. I didn't think this was possible until I did teacher training when I learnt that we hold all sorts of memories and grudges that come out at weird times when triggered. Only through training and consciousness of ourselves can we avoid that. I'd be really surprised if anyone who wanted to go through the gruelling process of training to be a breastfeeding supporter would go into it consciously deciding to jeopardise the breastfeeding relationship of their clients. Unless they were Nestle.
Fearless Formula Feeder: Excellent question! I hear so many stories from women who I think could have ended up successfully and happily combo-feeding, but end up exclusively formula feeding instead (and feeling disappointed and depressed about it to boot). And in many of these stories, it was because breastfeeding support workers made them feel like they were failures before they even "failed" - that the very fact that they were having trouble was their fault - because they had an epidural, or agreed to induction, or because they'd been "talked" into supplementing at the hospital, or because they weren't woman enough to deal with the discomfort (ignoring the fact that maybe these women were experiencing pain far beyond what the LC in question had ever experienced in her personal lactation history). When these women felt judged and "given up on" by the very people who were supposed to be helping them breastfeed, it made them feel like it was a lost cause. In some cases, it probably was. In others, I'm not so sure.
Dispelling Breastfeeding Myths: It may be possible for a counsellor to influence/ sabotage their clients if their own personal experiences and beliefs are not kept in check. Just because something worked (or did not work) for *you* doesn't mean that it will (or will not) work for everyone.
La Leche League (Nina): I have noticed many health professionals who have no direct experience of breastfeeding assume that mothers who are in pain or struggling want this pain to stop as a priority and readily suggest bottles and alternatives at an early stage. Of course, human beings want to reduce/eliminate pain and there are ways to do this that can preserve breastfeeding, rather than stop it. There can be a lack of appreciation of the depth of maternal instinct to do the very best for her baby, including working for many weeks, months, even years to overcome difficulties with natural feeding.
La Leche League (Eileen): Bad advice; confusing and conflicting advice; advice that isn't tailored to the mother's ability or willingness to follow through; too little explanation of the basic biology to enable the mother to understand *why* a suggestion is made; a lack of confidence in the mother's ability to know and respond to her baby; a lack of confidence in breastfeeding at all.
La Leche League (Barbara): There are so many it's hard to know where to start! For instance, if a support worker jumps in to give answers too soon the mum hasn't usually got to the point of what is actually wrong.
La Leche League (Jill): By being hurried or short of time, being brusque, being ill informed, belittling the mother's attempts, doubting baby's health in relation to feeds, forcing a baby to breastfeed when he/she is upset, not spotting potential challenges or addressing situations early enough, not recognising feelings, not listening, trying to latch baby on herself rather than helping the mother to learn how to do it, not explaining that bottles/ dummies/ thumb sucking/ formula feeds/ top ups can compromise breastfeeding/ milk supply, expressing concern about frequency of feeds and night waking, instilling doubt about the quality/quantity of mums milk, not encouraging comfort feeding. The list is possibly endless.
Analytical Armadillo: I think respecting remit is hugely underrated. Those who give advice they are not really trained to give, can with the best intentions be wrong. It also shows they do not value what their actual role is. A while ago a supporter in the community referred a mum to me whose baby had been readmitted to hospital for low weight gain, the mum had returned home but was still having problems. The supporter diagnosed a tongue tie, and advised the mum got in touch with us - she did to say she had decided to stop breastfeeding as it was just too much. With the best intentions, what the mum needed at that point from that supporter was not actually a diagnosis from someone who then couldn't do anything immediately about the problem except leave the mum with further worry. Mums who have had readmission to hospital with weight issues are amongst the most vulnerable, we must be extremely careful about the language we use and how information is presented. What would have been hugely valuable to that mum was moral support, that she was doing amazingly - that sometimes things took a little longer and needed a little extra help to click, that she would be there to support her, hook her up with some really good help and she COULD do it, things WOULD get easier.
So what are my thoughts as ‘The Alpha Parent’? In some respects a successful breastfeeding past is not necessarily a prerequisite for a competent breastfeeding support worker. Even if a woman has extensive experience of breastfeeding, if that experience has been ‘easy’ she is unlikely to identify with the struggling mother. Moreover, people like Dr Jack Newman (who obviously hasn't breastfed before) can provide fantastic breastfeeding support. Their lack of first-hand experience can lead them to be more objective in the way they view the experience of women.
However someone who has never breastfed cannot see from the inside of the breastfeeding relationship - the enormous internal pressure that some women feel to continue, the ambivalence (or even sheer desperation to stop) that mothers can feel, the urge to run away screaming as baby wakes up *again*.
Regarding support workers who are ‘failed’ breastfeeders, we could muse that we wouldn't go to a dentist with bad teeth or a hairdresser with bad hair. It helps if the person teaching the skill has sufficient practical experience of the skill they're trying to teach - a piano teacher or tennis coach needs to be able to play to a sufficient standard, to have the benefit of experiencing the process of learning and fully understanding the technicalities. However, just being skilled and successful in practical terms, does not make anyone a good coach, teacher or information provider. For a lot of mothers, even if the actual technique of breastfeeding comes easy to them, they find the work and time required in the beginning considerably hard and a massive shock to the system.
Regarding the length of breastfeeding experience that a support worker should have, someone who has breastfed for a very short time is unlikely to understand the challenges that can arise during various growth spurts, the introduction of solids, and nursing toddlers for example. A struggling mother preferably needs support from someone who has been there - and most importantly - got through it.
What about mothers who chose to formula feed from birth – should they be able to become breastfeeding support workers? As some members of the panel pointed out, a conflict of interests may arise. When vulnerable mothers are making real life decisions based upon whatever advice they can find, I feel it needs to be clear what background that advice is based upon. Quite often in life we have underlying reasons for doing things without realising them. This is where the issue of sabotage raises its ugly head. It is the elephant in the room. People suspect it of professionals but never openly acknowledge it. Baring in mind what a competitive sport breastfeeding has become, with hierarchies of feeding length (6 months < 1 year < 2 years) and hierarchies of feeding method (exclusive breastfeeding < combination feeding < full formula feeding). I would hasten to guess that some advisors may, at least subconsciously, be reluctant to offer suggestions to a client if this meant the advisor’s own achievements would be trumped by the client. After all, if the client achieves a higher standard of success than the advisor herself, this may be seen to diminish the advisor’s authority; and if her authority is diminished, her justification for advising is questionable.
Touching on the issue of dangerous professional bias, Penny Stanway in her book 'Green Babies' questioned the motives of experts who “give advice which makes breastfeeding fail”. The paragraph is worth sharing in its entirety:
“Some health care professionals may work with mothers and babies for reasons which are unconsciously compelling, though consciously unknown... I suggest that the need to keep these potentially painful emotions buried motivates them to separate babies from their mothers’ breasts by giving them faulty advice: to supplement breastfeeding with infant formula, for example, or to feed to a schedule. The bottle of infant formula symbolises their need to avoid the emotional turmoil that the intimacy of the breastfeeding relationship would stir up”.
(On the topic of professional sabotage check out: ‘Health Visitors: Help or Hindrance?’)
A mother's ability to obtain quality breastfeeding support sadly seems to be a matter for fluke. I find it discouraging that something so vital to the health and well being of mothers and babies depends on luck.
Breastfeeding support workers can often disagree with each other, just as my expert panel disagreed on the issues raised here. What are your views? Have you been sabotaged by a breastfeeding support worker? Why not leave a comment bellow or visit The Alpha Parent Facebook page and debate with other members.
BEFORE LEAVING A COMMENT: Can I ask readers that if they wish to leave a comment on this piece, to please be respectful of the panel members, otherwise comments may be removed. I normally have a policy of not deleting comments, no matter how controversial they may be, however in this unique instance the panel members (Dr Newman, La Leche League reps, Alison, Anne, etc) have donated their valuable time, therefore basic courtesy is due.