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The Guardian - UK
The Guardian - UK
Comment
Rhiannon Lucy Cosslett

Turns out breastfeeding really does hurt – why does no one tell you?

A mother nursing her baby on the edge of a bed
‘When it starts to go well, it’s lovely, and if your baby isn’t premature and you don’t have to deal with tongue tie, undersupply, oversupply, mastitis or blocked ducts it might be a very simple, very peaceful, happy process.’ Photograph: Michelle Gibson/Getty Images

I never thought breastfeeding would be hard. When I thought about it at all, my mind conjured beatific scenes suffused with a sort of religious glow. There I was, genteelly offering the child a nipple in the manner of a renaissance Madonna, which the child accepted politely and cherubically. What a pretty picture we made.

Well, those preconceptions were – excuse my language – complete horseshit. These days I envisage more of a triptych: the infant Jesus spluttering at the breast, face purple with hangry fury; the infant Jesus possetting milk down Mary’s front; the infant Jesus and the nappy explosion.

A few weeks ago, I wrote about the negativity surrounding parenthood, and how people love to bombard pregnant women with it. The only exception I’d make to this is breastfeeding. Breastfeeding has incredible PR. You’re told constantly how amazing it is for you and the baby. It’s the best way to nourish and bond with your child, who will become a genius as a result! It’s so convenient! You’ll lose so much weight! Most importantly, it’s hugely beneficial to the baby’s health!

No one says: it hurts. At least not beforehand. Once you tell other mothers it hurts they say, grimly, “yep”. It makes sense that it would hurt, because having a small creature attacking your nipples every 40 minutes would hurt, wouldn’t it? It’s OK though, because, you’re told, they’ll “toughen up”. Tough nipples: just what I always wanted.

Meanwhile, if you tell professionals that it hurts they will tell you that you’re doing it wrong, which makes it feel worse. (Maybe you are doing it wrong – historically, you’d be surrounded by experienced female relatives who would help position you and the baby correctly.) Perhaps you already feel like enough of a failure, because desperately wanting to feed your child with your body and not being able to taps into something quite fundamental, really. Something that may have the potential to make you depressed.

The UK has one of the lowest breastfeeding rates in the world, with just 24% of women exclusively breastfeeding at six weeks in England and 1% at six months, which is recommended by the WHO. Eight out of ten women stopped before they wanted to. Furthermore, while breastfeeding is linked to lower rates of postnatal depression, a large-scale survey also found that women who wanted to breastfeed but did not (or could not) were over twice as likely to become depressed as mothers who had not planned to, and who did not, breastfeed.

I’m not surprised. The culture of guilt – much of which manifests in subtle, almost diffuse atmospheric pressure, though social media obnoxiousness also plays a role – makes me want to smash things, but I’m too tired. Breastfeeding, I read, is the equivalent of walking seven miles a day. Another thing they don’t tell you is that you might not ever get more than three hours’ sleep, none of it deep. And you’ll realise how profoundly uncomfortable your sofa is.

I can see why they don’t want to put women off, what with the enormous public health benefits of breastfeeding, for babies especially. Besides, many women have a fine old time of it. They are “EBF” – exclusively breastfeeding – a phrase I’ve started to imagine accompanied by jazz hands. Some post photographs of all the milk they are expressing and freezing – look! So much milk! Their proud tallies: 14 months! 18 months! 36 months! And they should be proud. It’s work. I find myself thinking about the wet nurses throughout history who would take in extra infants to feed as well as their own. The labour involved would have been intensely physically and emotionally draining. I also sympathise a bit more with the women who chose to outsource it than I perhaps once did.

Saying all this, when it starts to go well, it’s lovely, and if your baby isn’t premature and you don’t have to deal with tongue tie, undersupply, oversupply, mastitis or blocked ducts it might be a very simple, very peaceful, happy process. I’ve been mostly very lucky with the support I’ve received with the challenges of feeding a preterm baby, but others have not been so fortunate. There is something wrong with a culture wherein the mother’s sanity can be sidelined to the extent that – as one parent and psychologist described – the only professional who might tell a woman that it’s OK to give her baby formula is part of a perinatal mental health team. Promotion of breastfeeding, important though it is, should never come at the expense of a mother’s mental health. To quote one expert: “Breastmilk does not care for, nurture and bond with the baby. A mother does.”

Meanwhile, my friend who has had a double mastectomy is irritated that there’s a law prohibiting the discounting of infant formula. She also, having observed the culture of guilt, says she feels glad the decision how to feed her baby was taken out of her hands. Think on that statement for a moment.

As it is, my own “breastfeeding journey” (another phrase I hate) has involved a rail replacement bus. I’m grateful for the existence of formula for keeping my baby alive when I couldn’t, and for helping my baby grow to a healthy size while I established breastfeeding. I’m not about to become a shill for big formula, who have behaved despicably in all kinds of ways, but nor will I self-flagellate. Or I’ll try not to, at least not all the time.

As for advice from all the self-appointed freelance paediatricians, I can do without it. A good lactation consultant, though, is worth her weight in gold. Turns out, with the right support, it can get better – as it has for us. It’s a shame that so many British women lack that support after years of government cuts.

There are a multitude of reasons why a woman might stop breastfeeding, including a lack of support, needing to work, pathetic paternity leave provision (having a partner who can feed the mother while she feeds the baby is a luxury few have), the stigmatising of public feeding, or mental health concerns. Guilt-tripping parents who are struggling or hiding the challenges of breastfeeding from them will not solve, and may even worsen, the problem.

What’s working: I’m not sure the artist Keith Haring ever envisaged his work becoming part of a baby range, but Etta Loves have reproduced it on sensory strips and my baby, who can currently only see in monochrome, is fascinated and mesmerised by them. It’s his first experience of art and has made me tempted to go on a tour of all the black and white works that can be found in galleries – Brigitte Riley, Malevich, etc. Though I’d have to hold him very close to the canvases.

What isn’t: A TikTok video of a baby being swaddled, its cries immediately silenced, went viral this week. Sadly, it hasn’t worked for us, only serving to enrage the child further.

  • Do you have an opinion on the issues raised in this article? If you would like to submit a letter of up to 300 words to be considered for publication, email it to us at guardian.letters@theguardian.com

  • Rhiannon Lucy Cosslett is a Guardian columnist

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