Transcript: Unpacking Breastfeeding Challenges with Prof. Amy Brown

Jacqueline Kincer  0:37  

Welcome to the podcast. Today we have Professor Amy Brown with us. She is known as professor of the boobs, and she's a professor of Maternal and Child Health at Swansea University in the UK. Welcome, Amy.

 

Amy Brown  0:53  

Good evening for us. Oh, good morning for you from when we're recording this.

 

Jacqueline Kincer  0:57  

That's right. No, I'm so happy that we were able to connect across time zones, and especially with all of the health challenges going on in the world these days. So it's an absolute honor to have you here. Thank you for having me. Yeah, absolutely. So we were just chatting about it's kind of funny, because you know, she's in Wales, I'm in Arizona, and they're completely locked down there and have been for five weeks. And you could basically do whatever you want here in Arizona. So it's quite a contrast, that strategy is not working out. Well, for us, in case anyone was wondering. But here we are safe in our homes able to meet with each other today. And one of the reasons why I wanted to have someone like Amy come on the podcast and actually had thought about her name early on when I launched it last year, actually, it's been almost exactly a year to the day since I watched the podcast the day that we're recording, that's pretty cool.

 

Amy Brown  1:51  

Probably, like a lot longer. It just really has been them. Yes.

 

Jacqueline Kincer  1:55  

Oh, goodness, does it. Um, but yeah, there's so many so many wonderful things that Amy writes about and is involved in, in research and teaching and things that are so relevant to, you know, this podcast and just breastfeeding in general. So we're gonna go to probably a lot of different places today. But there was a post that you made on Instagram, that really caught my attention, because I was like, wow, that that's such a great way of of, you know, just phrasing things. And I'm going to read just a little bit of that I want to read the whole thing and just sit here and read to people. But you had said in quotes that no, there's no need to breastfeed I didn't and my baby is fine. This is something that, you know, breastfeeding moms hear a lot. And the caption here is, that's great. We love healthy babies. But although this might be said in support, we must be careful about the messages we give. First, if a mother wants to breastfeed telling her it doesn't matter, it can feel like you're saying her wishes don't matter if she wants to breastfeed support her to do that. Second, although it's perfectly possible for a baby not to be breastfed and to be fine, because health guidelines are about the chances of something happening. Not that it will not all babies have an equal chance of being fine. And she kind of you know, went into some more explanation about that. But at the end here, she says we we may, we must make sure that we are not stopping women receiving the messages that you that just might make all the difference for them based on what happened to you, even if it is meant in kindness. So you know, that what comes to mind is I've seen a lot of news stories lately about celebrities, and then, you know, wanting to feel supported in their use of formula feeding and their struggles along their journeys. And, and there's sort of this, you know, yeah, like, Oh, thank you for saying something sort of reaction, right? And it feels a little like, people are feeling vindicated, like, Oh, I couldn't breastfeed, so thank you for saying something. But then there's the whole flip side of the coin that sort of feels like we're not allowed to talk about. So I would love for you to just, you know, let's let's go deeper on that topic. You know, why? Why is it that it seems like it's almost stigmatizing to give messages to women that are really supportive of breastfeeding?

 

Amy Brown  4:18  

Oh, it's, it's such a complicated issue, isn't it? And just as you were reading that back to me, I was thinking there, there are so many different parts to it. There's, there's how women feel when they're not able to breastfeed, and they have so many different emotions from that, that different people need different reactions. So sometimes whatever message you put out there, you end up upsetting one person with a method that you're trying to use to help somebody else. So you can kind of see where they come from with those are look formulas, fine. Look, my baby's fine. And trying to unpick it. You can kind of understand that they're trying to make other people feel better, but I think often they're trying to make themselves feel better, which is, you know, absolutely valid. The issue is that is why they are feeling that guilt and those emotions that they want to go away in the first place. So who is making them feel guilty? Why are we still in a position where when women are struggling, they're blaming themselves and feeling guilty when usually, it's lots of different influences outside that have led them to that position, or it's something biological that they haven't got an answer for. So they end up blaming themselves. So you've got the one issue there. The main issue that I have with it is, although they're trying to make people feel better, and they're trying to make themselves feel better, which, of course is important. They're ending up harming others with the message in terms of either other women feeling dismissed and thinking that people are saying that breastfeeding didn't matter when it did matter to them. So maybe they wanted to breastfeed, but they weren't able to do so. And they really wanted someone to actually acknowledge how awful they felt about that, rather than telling them that it didn't matter. But the second issue within that is my worry about women who are in a position of a lot of privilege. And their babies probably will be fine. Pretty much whatever happens because they're in a position of lots of privilege and health benefits, and they have to support and everything around them, blocking any information getting to women who are in less privileged positions. Say it's Kimberly seals, Alice talks about this a lot as well that you have a woman with a lot of money and health insurance or, you know, lots of protective health factors, telling other women that breastfeeding doesn't matter because her baby was okay, when in fact, we know that there are loads of different influences on someone's health. So for a baby in a less privileged circumstance, we know that breastfeeding is even more important for them, it can make that real difference, it can help lift them up the effects of poverty, and other issues that their mother might not be able to control because of issues such as the lack of money or a lack of support around her. And that's where it kind of gets really complicated. You can't tell anybody else that their baby will be fine, because you don't know. And that's not meant in a way to scare people. But it's saying that you know, you, you can only judge what's happened to your own baby. And it's so important. It's a really complicated issue, because the whole thing gets turned into women feeling different things when blaming themselves, women blame each other, when in fact, it's a wider societal public health issue where they've been let down in some form. Usually, if you've got a woman in front of you who breastfed before was breastfeeding, but had to stop before she was ready. It's rarely because she just thought, you know what, I can't be bothered to do this anymore. Usually, she's tried to million and one things and has reached a conclusion that she can't continue. And that's usually because somebody else has let her down along the way, whether that's employment, whether that's society, whether that's family, you know, whoever it is, who hasn't supported her, or she's got that physiological issue, which is perhaps getting in the way with her of making a full milk supply, or there's there's some health issue. And she's probably rarely got the, the answer. I was talking about this on Twitter this morning. It's really odd that we tell women, if they're not making enough milk, or that they can't breastfeed that, it's all right, lots of women can't do that. It's really difficult, as if we've just got a part of the body that often doesn't work. And that's not I can't imagine it happening for any other part, you know, your finger falls off or something and you go to the doctor and the guy, you know, that's quite normal fingers fall off all the time.

 

Amy Brown  8:56  

What are you complaining about, you got another nine. But is that so she's ended up in a position where she's struggling with everything and struggling to make sense of it and struggling to make sense of how she feels. And then we fall into all this issues with messaging about whether it matters or not. And whether it matters or not, it's such a personal issue, and such a contextual issue to your own situation around you. We're not all equal in terms of the privileges that we have. So breastfeeding matters in different way to different people.

 

Jacqueline Kincer  9:30  

And so, wow, that's a lot there to unpack. And I like the comparison you gave about the finger falling off, because it's a we say that in the world of treating tongue or lip ties that you know, is there some sometimes the physician will say, you know, oh, well, one day your baby will fall and they'll hit their mouth on the ground and the lip tie will split open and then it will be fixed. Like do you normally recommend accidental injury for medical treatment or so it's sort of sort of the same thing. There's Ways in which breastfeeding seems to be neglected, you know, in that sense of, of support. And you know, I know where you are in the UK, the breastfeeding rates are very low. And sometimes people in the US are shocked to hear that because they think oh, well, so, you know, it's a, it's a well to do countries. So why would that be the case? And, you know, what are you seeing are the reasons for that where you are.

 

Amy Brown  10:28  

I mean, I'd love to do some research, going forward comparing what's going on between the US and UK because it shocks or shocks us that you've got better breastfeeding rates than we do because we have extended maternity leave. So you think that would be one of the biggest things that would help protect breastfeeding for women. We've got all the same reasons that that you have just sort of acting out in different ways. And it's usually a case that put simply a woman wants to breastfeed. She's told that breastfeeding is best for her baby, she's told that she should breastfeed. And then it's almost like society, public health, everything puts all these different barriers in her way, until she ends up at the other end, not able to breastfeed and blaming herself. So it's things like not really being able to get the support she needs right after birth. A lot of problems are arising in those early days. So practical ones, where she's just not able to get that one to one support and care and attention she needs. And that's not blaming individual healthcare providers. It's underfunded NHS, it's it's the fact that we don't have enough one to one support for women after the birth. antenatal education, she's often not told what it's really going to be like. So this is something else I posted a lot about on social media, but we don't really talk about what babies are like and what normal baby behavior is. So you know, women are often told, Well, this is how you latch your baby on. And breast milk is really good for your baby. But none of the sort of practicalities? Well, look, they're probably just going to basically want to feed all the time, they're not going to want to be put down. They're going to wake up lots. And if you feed them, it'll solve everything. Is that what kind of given this almost idea that babies are these little robots that you could feed in this routine every few hours? And there's something wrong if if they don't feed like that? We still got, I mean, we're getting slightly better. But we've still got ridiculous attitudes around breastfeeding in public. That, you know, it's not except I think I think it is slightly getting better. I think it's the one thing that is improving. But we still have, you know, people thinking that it's strange to be feeding out and about sexualizing, all this all those things, just just the kind of a lack of lack of support. But it does really surprise me, given our extensive maternity leave that most women can access, that we don't have higher rates compared to you. In fact, we have very similar initiation rates, but it seems to then drop off. So we only have about a third of women giving any breast milk at all, by six months. exclusive breastfeeding to six months figures are well, officially, they're around 1%. They might be slightly higher than that. But that's the sort of figure that comes out in the data. They're really really low.

 

Jacqueline Kincer  13:25  

Yeah. Wow. Yeah, that's so interesting about that the maternity leave doesn't seem to be affecting it. I know when our son was, I think about six months old, we traveled to Canada and stayed there for a month I have in laws there. And I felt like everywhere I went, people were like, Oh, you're breastfeeding, like, I'm on a park bench or whatever. And they were just kind of shocked that I was because they knew that we didn't have that kind of leave here in the US. So they're like, Wow, good for you. You've made it against all odds sort of thing. And I said, Well, it's um, I don't know, I think maybe there's, you know, there's there's so many factors and, you know, what, what role do you feel like, the more marketing of formula plays in that? I know, it's a such a hot word, I guess to say, for a lot of people because they feel like you know, it. It seems like a difficult discussion to have, you know, breastfeeding and formula, and it's this debate, but, you know, I don't think we can deny that. There's, it's great that we have it when we need it, but the marketing is, it is different in different places in the world. But I do think it poses a lot of really huge challenges for people who want to breastfeed.

 

Amy Brown  14:42  

Because it's the way that sort of gets absolutely everywhere. So even we know we have stricter advertising laws compared to you in the US, they find multiple ways to get around it. They use messages that lots of People will tell you, Oh, you know, I'm not affected by marketing messages, I don't believe them, but somebody must be believing them being affected by them, even if it's subconsciously, because they put so many billions of dollars globally into advertising every single year. It's absolutely not the formula we're against. Absolutely not against women making an informed choice that they want to use formula, it's about the underhand tactics that are used to try and persuade women that it's needed, or it's necessary, or that it will bring about effects that just aren't true. So we have a lot of issues, which I'm sure you do, too, around subliminal or direct messaging around well, you know, formula will help you baby sleep. This formula has all these added ingredients in it. We did some research recently, I can link to that that report, if you like, afterwards, looking at what parents thought about formula and different messaging and different brands, and it was very clear, you know, this, this is the milk that will help my baby do this. This is the milk that helps brain development. This is the milk that you know is comforting for your baby. Even though in the UK, all our first day formula milks, pretty much identical in terms of content, there's no real difference between them. But there's a vast difference in price. And it's all based on that subtle and not so subtle messaging around what each formula does. So I'm not going to name brands, because I'm not here to advertise. But there's, there's, you know, the most expensive formulas, there's a real belief that they are made by scientists, and they're the, you know, the scientific ones that help brain development and all of this, and there'll be twice three times the price of your supermarket brand formula, which is seen as the happy baby formula, you know, the happy families, happy moms, when it's virtually exactly the same thing. So if you add up that cost over time, parents are being persuaded to buy a much more expensive formula, which they often can't afford, when there's no real difference, or real promise that it will make this huge difference for their baby over the other one, when it won't. And we've had stories in the press of you know, parents going without try and by that formula of parents then watering down bottles, believing you know, they have to make it stretch, but they've bought the more expensive one when they didn't need to worrying that they can't afford that most expensive one. So they're harming their baby. And it's all of those those tactics and where they advertise them and how they advertise. I mean, there's some research that was from Australia, it was looking at different formula strategies around the world. And in the US, you don't really have such a market for second stage or follow on formula, do you for babies aged six to 12 months? So

 

Jacqueline Kincer  17:59  

not as not as big? No, definitely not. And I know it's worse in in other countries that are not as well off like Thailand, for instance, they market these toddler formulas up until age five, I believe that they have now convinced a large portion of the population that your your child should be on some sort of formulated milk, like protein shake almost for five years, and these are formula companies, you know, so you know, it's that that makes my heart sad, because there's no way that that's required of every child up until age five.

 

Amy Brown  18:35  

So in the UK, you're not allowed to advertise first stage formula. So first stage formula that actually suitable from naught to 12 months, when your baby gets to 12 months, they can move on to if they need milk, they can have cow's milk just as part of a very diet. But it's because you're not allowed to advertise. And there are laws that we follow you you can't advertise to babies under six months or parents of babies under six months, you can't advertise first stage milk at all because it covers babies from nought to six months. So essentially, they designed follow on formula which is suitable supposedly for babies for six to 12 months old because you are allowed to advertise that. So you see adverts for it absolutely. everywhere. I mean, I think my children nearly disowned me because we're in the cinema. Remember those? Oh, you do still have cinemas? We don't we have an ad in front of you. You

 

Jacqueline Kincer  19:33  

can actually movie here. It's kind of crazy. You haven't been

 

Amy Brown  19:37  

here for a year of watching a children's film and you know you have adverts beforehand. They were advertising follow on film formula for this children's film. And I was just like, this is you know, this is ridiculous. So they advertise it absolutely everywhere. But one of the problems is that a big chunk of the population don't actually realize that they're advertising. Second Stage formula, they just see formula advertised, they just see the brand being advertised. And then they take all their messaging that is actually inaccurate and not supported by science from that second stage formula and apply it in their heads the first stage formula, and then go out and buy the corresponding formula for that baby based on scientific claims that aren't actually true. And there's been lots of research around that lately. So it's that it's the nasty misperceptions and misconstrued, basically lying adverts that I have the rage against, not a mother who chooses or a family who chooses to use formula milk or the formula milk itself, or the, you know, a baby being fed formula. That's, that's not the issue. It's, it's how people are manipulated. Not necessarily into definitely buying the formula, but really believing that this particular formula will solve all their problems. And the more they have to part with money for more expensive ones, and it's just awful, and it just continues, and we keep calling it out, and it keeps getting worse and worse, the address just about everywhere. That, you know, in it, they completely circumnavigate the law that we supposedly got to protect families from inaccurate marketing.

 

Jacqueline Kincer  21:25  

Yeah, I'm not surprised that they found a way to get around. Because, you know, it is it is a very big market. And I agree with you, you know, I don't have problem with formula, you know, it's, it's great that we have it, and if you need it, if you choose it, it's there. Awesome. But it is that marketing, like you said, this perception that parents end up having, and, you know, a common question I get, whenever I work with someone, you know, during their pregnancy, and they want to just be prepared, which formula is the best in case I need it. And there is that, you know, idea that if I pay more, it's better, or Oh, this one has probiotics, meanwhile, you should be mixing that with boiling water. So I don't know if those probiotics are really surviving. And they're, you know, there's all these ideas, right, there's just sold on, you know, this one has, you know, something better for the brain and all those things, like you mentioned, so it, it, it breaks my heart to see parents not getting the information that they're wanting to get, I guess is a good way to put it. And then, you know, coupled with the marketing campaigns that I've seen here, they're very emotionally based here. So I don't know if they're more science based where you are, but it's the I think it was the I won't say the brand, but there was the tagline The Sisterhood of motherhood. And, you know, just this, you hardly even see the milk in the commercial. And that's the way a lot of advertising has gone. And so now it's this feeling right? Like you said, like the happy baby, the happy mom and you're buying into your they're selling a feeling and then you're buying into the feeling. And I think that is so problematic, because of all of the emotional difficulties that new moms already face. So it's hard enough, right? Let's even for breastfeed besides are hard enough to bring a baby into the world and then to parent that baby and all the things now, if you're struggling with breastfeeding, and the doubt and you know, what is is that a thing that just, it's it's something that we do as women is that we internalize these things, like, we feel the guilt, we do self blame, or there's there's anger that, you know, we have this buildup of things and it comes out as anger. Why is that happening for us as women and mothers,

 

Amy Brown  23:48  

I think was socialized into doing it. I think society encourages it because it keeps women in their places such I think you know it that's just basically advertising isn't it? They we've got to a place where women have been made to feel so guilty and so lacking in various ways over the decades, that it's a really kind of clever trap as such that you know, there is a line somewhere, isn't it? You know that if women woke up tomorrow and recognize their worth, a lot of businesses would go completely bust? Because they wouldn't be buying all this all this stuff and in no way blaming women for feeling that way. It's something that is is layered on them. And I think we do it. You know, even even to children, people treat little children differently, don't we? We expect little girls to be different the little boys. I mean, I don't mean on an individual level. I mean, what society tells them the messages about you must be caring. You must worry about this. You must worry about that. Men just don't get the same level of blame and guilt put on them when they become fathers. They're praised for far lower standards of care. They're praised for doing To the minimum, they get away with far worse behavior. It's something can't remember what it was that we were talking about at some point. But you know, society doesn't, you know, chastise men to an extreme level if they walk away from their children, but a mother who did that would have such hatred given to her for doing it, it's that double kind of standards that are used. And I think we just internalize it, and marketing plays on that. There was a research paper that was published earlier, just think it was just before Christmas, sometime. It was published in Scotland, I can't remember which university it might be the University of Stirling, where they actually managed to interview formula company wraps around the techniques that they used, and I made it, the paper is just everything you would expect, but can't believe is written down. So they have these reps talking proudly about how, you know, guilt is a brilliant sales tactic. And how if you can draw a first time mother in with all these inflated claims and lies, then you've basically got her life. And it is so cold, but just repeats, everything we sort of knew was happening, but never had the hard profiles. And they just talked about how they use emotion and how they label mothers of different types. So you have three types of mums, I can't remember, the third type of the two main types are science educated mum, who wants you know, the science milk, and wants the probiotics and wants adverts with people in white coats, labs making milk, and then you have the mum who just wants her baby to be happy, and wants them to grow up and have a good life. So you have the you know, the baby laughing in the advert because they're so happy, or the baby being a ballerina and having a lovely life being a ballerina. And they've kind of marketed specifically to these two types of mum, and you just think this is awful, given how much guilt and emotion and worry that mothers carry through the whole of pregnancy and birthing and caring for the baby. I mean, some of them are absolutely fine, you know that they're not the ones I worry about at all, who happily make an informed decision. They want to use formula milk. And that's that great, lovely, it's the mothers I really worry about who really wanted to breastfeed and then couldn't, or the mothers who are breastfeeding and getting all the messages continually from from family and friends that they should be giving their baby formula, because that's something we see a lot of, you know, breast, you still have families who believe that science milk in a bottle is better than breast milk could ever be. So they're getting the pressure there. And for industry to come along and deliberate, you know, openly say, Yeah, we take advantage of that to sell our product. It's awful to see it just written down. I mean, I had to read this paper so many times, I was so angry at it, but also so glad that it been done. It's just shocking to say

 

Jacqueline Kincer  28:11  

it's terrible, you know. And it's ironic, because I feel like anytime anyone or an organization wants to do something to promote and support breastfeeding. There is often a backlash that says that we are guilting moms, we are shaming them. How dare we contribute to the guilt of moms. And here are the formula for a representative saying, Oh, we love guilt, we use it as a tool to sell our product. And I'm over here like no means supporting breastfeeding has nothing to do with formula. I'm just supporting breastfeeding to feel like a go away, like move on. And just you know, speaking from many colleagues and personal experience, with some things I've posted on social media, we're, you know, this, this is a great offense is taken and you know, well, you should support whatever a mom chooses. Yes, I do. But I specifically have a job that supports breastfeeding moms. I don't have a job that supports exclusively formula feeding moms. So that's just not my role. I stay in my lane. But it's it's just like you're you're sort of damned if you do damned if you don't. The guilt is just all around. And I think it's a huge problem for getting the messaging out about breastfeeding. And I'd like to see that change. I'm sure you've thought about this, it was of i What do you think are some of the best ways that we can and get supportive messages out there to the moms who need and want to hear them?

 

Amy Brown  29:39  

I think it's a sort of two pronged approach in that you need to be able to talk openly about breastfeeding and supporting breastfeeding. But what I've been working on over the last couple of years or so is really reaching out to those who haven't been able to breastfeed and having that open and honest conversation with them. And I think we've genuinely, at least in the UK seen quite a shift in the last couple of years, where more women are realizing just how much they've been let down, that this isn't their fault, and also that we're not criticizing formula milk. And to be able to say, I really wanted to breastfeed is not saying, I wish, you know, I wish I wasn't formula feeding or formula milk is awful, you know, you can absolutely be completely grateful and happy that you're now formula feeding on your baby are thriving, but also still be really grieving not being able to breastfeed. But you know, that they're not two completely opposing that you can hold them at once. And it's not saying, you know, by saying I'm really, really grieving, not being able to breastfeed my baby, it's not saying I hate formula, you're an awful mother for formula feeding, I think we're finally seeing more women open up and be able to say, well, actually, it was really important to me. Because as always, women are left out of the conversation when it comes to having a baby in a way that they don't matter research. You know, it's like birth trauma, isn't it? Look, your baby's fine. What on earth? Are you upset about that message that women get? Well, you know, your baby can be absolutely fine. And you can be really grateful that we have the technology and the medical expertise to give you that crashes area and section, but you can still be upset about it. And it's the same thing with breastfeeding. And I think more women are openly saying, well, actually, I wanted to breastfeed for all sorts of reasons that were important to me, not my baby. It's something that involves two people. And if you ask a woman, why why do you want to breastfeed? Why is breastfeeding important to you, she almost guaranteed will say, I will, because it protects my baby's health. And you're like, Well, okay, so that's one reason why else, and it's sometimes you can see women are hesitant to go, I will actually it's just kind of how I wanted to mother, my baby, it's how I wanted to care for them all. I wanted to because we've got a breast cancer risk in our family, and I wanted to reduce my risk that way, or I just felt it was more convenient. Or, you know, I just wanted to do what I expected my body to be able to do, or my religion says it was important. And it's important to me for religious or cultural or family reasons. They're all good reasons. And actually opening the conversation in that way, I think is helping women realize that they're being let down. Rather than internalizing everything and feeling guilty. What I'd love is for no one who stopped breastfeeding, to feel guilty instead to feel angry, who let them down along the way. And I think this is just a really important conversation to keep having. And there's talked about a good psychological technique, which, when you blame yourself for something like, I don't know, we failing the exam. Is it all your fault? Or are there other things that happened along the way where you were let down so your teacher wasn't very engaging, or your partner didn't take the load off you or this or this or this who you know, who should be shouldering a little bit of blame here. And it's the same with with breastfeeding, if you've stopped breastfeeding? Was it really your fault? Or was it because you couldn't get the medical support you needed? Was it because your partner wasn't supporting you? Your mother in law was saying this, your employer was saying that society was saying this. And you know, it's it's all of them things and if we can get that push back for him to realize that they've been let down. And a big way is coming back to this idea of they're just not being medical tests. And in the UK, we don't really have a medical specialism so you have lactation. What's the word? Breastfeeding medicine specialists. You have doctors who you know who have in their official title here. We don't we have we have increasing number of medics who are interested in it and passionate about it, but it's not necessarily their title. We don't really even have many medics who are also ibclcs. So too many women are getting incorrect. medical advice, then not getting the tests they need if something goes wrong, they just told it it doesn't matter give a bot the formula. We see just got me going off a complete tangent.

 

Amy Brown  34:35  

So with the with the vaccination COVID vaccine in the UK, you are far better than us. We when it originally came out and we had the message that you're going to start from like next Monday we're going to start vaccinating healthcare professionals. It was like nobody had ever considered that healthcare professional might be breastfeeding. And they because it wasn't tested with women who are breastfeeding. And they put out the message that women who are breastfeeding couldn't have it along with a message with or they, you can just have it when you stop as if that's going to be next week or something. And women look going look, you know, breastfeeding this baby, I've got no plans to stop, then I'm probably going to have another and there is no future at the moment where I can see me stopping. And a group of medics and pharmacists, and lots and lots of people got together and basically lobbied for the licensed for it to be okay, for breastfeeding women, they can make the decision to have it, that's fine. But still that hasn't trickled through. So women are still turning up to have their vaccination and being told oh, no, we're told that breastfeeding women kind of this. So even though they can that messaging still hasn't got through it. And it's also it's medical negligence, surely to be giving women incorrect information, but we have it all the time with medicines, hear, women are told that you can't breastfeed with that when you can, or you have to stop breastfeeding to take this medication. We did research a few years ago that showed that if women are forced to make that decision, they'll put their baby and breastfeeding first over the medication. So it's not that they stopped breastfeeding to take it. They don't take the medication and risk their own health because it's so important to them. I don't really hear that. That was from what should we do? Well, first, as a medical issue, we've got it have have it taken seriously that this is a a health medical issue. Breastfeeding as a health issue. It's it's part of health and medicine. It's not some weird hobby that women do for fun, which I think is almost how its treated some time like some kind of strange hobby like, oh, look, you tried, I don't know, whitewater rafting hasn't worked out, sorry, you can't do that anymore. Rather than it being part of their body, I just can't get past this idea that women are told their body doesn't work and have no explanation or test for that. And then blame themselves. It's, it's it's so mixed up. But it comes back to the idea of getting women to shoulder the responsibility and the blame. Because if they actually push back against it, we'd have to do something to change it. And I don't mean we I mean, public health governments, etc.

 

Jacqueline Kincer  37:26  

Yeah, no, I think what you just said there about, we have to really look at breastfeeding as a health issue, which it is because you know, too many people, I think, find themselves trying to DIY everything as well. And so then that's where that shouldering the blame comes from, they don't even sometimes there's even just lack of awareness of, you know, lactation consultants or any sort of lactation professional that we exist, or we exist outside the hospital, sometimes that's really an unknown. In fact, I just met a woman today when I was working, who works in health care, and was surprised to hear that there are lactation consultants who don't work in the hospital. And I know, she knows, but, you know, there's just still such a lack of awareness of things I feel. And then the other issue that I see is, you know, several times a day where women contact me and say, Oh, I've tried it all, and I just cannot make breastfeeding work. And so they come to me. And it's not that they, they've tried everything they know how to try, but they've never looked at breastfeeding through the lens of it's a health problem. So they try all of these ancillary things that sadly, because of marketing, and it's you know, foreign formula marketing, baby product marketing is just really poor in general. So they think, Oh, this special swaddle will fix it, or this, you know, pacifier will be the magic bullet that we need to fix this problem or, you know, whatever it is. And so, you know, I, I feel for these moms, because they a mom who has enough, you know, wealth to use on products like that isn't a better position, because they still have money left over to seek out some, you know, help from someone like me, a mother who's not in that position, though, probably one can't afford to work with me privately. And, you know, also cannot spend money on any of these other solutions. And she probably doesn't have the time to invest in it. She's probably already back at work. So she can't just sit on Amazon and read mom blogs all day. She's got you know, other priorities in life or maybe has other children to care for in all the circumstances. And so I always think if we just bring breastfeeding back to the lens of a health problem, and if we get the health care community and society and governments and things and so forth, to look at it through that lens, then that can hopefully trickle down to other people. Just my thoughts, but it's always funny when people sort of go Oh, press problems or health problems? Oh, like, it's like a light bulb goes on, you know?

 

Amy Brown  40:04  

I mean, it's that that lack of awareness about ibclcs the lack of them being everywhere. I can't, I don't even know when I first found out about them. It certainly wasn't before I had my first baby. It was some time afterwards, they actually realized that they were a thing. I don't think I realized that peer supporters or breastfeeding counselors were even anything until I'd had that first baby to realize that there was a specialist it It took far longer. And I think a lot of the general population such certainly in the UK aren't aware that there is a specialist who can help them. We often people have lost their positions in hospitals in cuts in the UK. So sometimes there isn't even one available for them on the NHS. There is that strange, strange kind of perception that somehow spending money on a lactation consultant is expensive, they don't want to spend that it's, it's not worth it, where people will go out and buy very expensive products, I guess it's the quick fix thing, versus paying for who they see as a therapist or something I don't know, when you can often solve the problem in the long run far more cheaply, really. But it's, it's that I think it's just that lack of awareness of it all. And the fact as well, that so much of this is propped up on volunteers. It's really weird. So in the UK, we have so much that is reliant on voluntary peer supporters and volunteer breastfeeding counselors, and passionate volunteers in other roles. And you just think, for what other area of health? Would we do this? Can you imagine kind of like heart attack peer supporters? So you have a heart attack? And you're like, well, right, then just pop down to this local heart attack peer support group down the road, where everybody's had a heart attack, and they'll tell you what to do it, you know, it's, it's nonsense, laughable when you think about it, but that's essentially what happens for something that's I don't know what the, you know, the percentage of women having babies, but you know, let's say 75% of women have a baby at some point in their life, it's going to apply to 75% of women at some point. It's, it's, it's not like some niche health issue. It's, it's a really common thing. Even if you just have a few percent of women having difficulties based on health issues, but still a lot of women. So it's, it's just really weird. When you start picking it like this,

 

Jacqueline Kincer  42:47  

it is weird. It is weird. And I, I was a voluntary league leader, which is, you know, volunteer breastfeeding support before I ever became an ibclc. And I done some business coaching for colleagues as well. And just as a community as a whole ibclcs have a really hard time charging enough for their services or even charging at all. And, you know, I know that there are many people in health care that, you know, do certain volunteer hours. But that's usually like a pre planned thing. Or if they haven't, a set sort of number of pro bono appointments, they'll do a year, whereas lactation consultant seem to find themselves getting roped into the role of the volunteer again. And the unfortunate truth is that they all have to face at some point as if they're running their own private practices. If you don't make money, you can't help other people. How it's not a it's not a charity. And truth be told charities do make money, they just ask other people for money and not the person that they're serving. So we have to have this flow of money, to be able to support the things that we do. It's great that women come together to volunteer to support each other in these efforts. But I try to remind people that you know, the role of the support group, support groups are great their support groups, for people that are going through cancer treatment, they just don't treat the cancer there. So please don't show up to a breastfeeding support group and expect them to help you let your baby treat your sore nipples check if there's a tongue tie, know, if you're making enough milk, that's not what they are there for. And so, unfortunately, I just think that these groups have been put into a really terrible position where, you know, pediatricians will tell the Mother Oh, you're having a hard time breastfeeding, go to this meeting. And that's, that's not a referral that that we shouldn't be referring to support groups for that, like you said, and, and I'm over here going, I'm right down the street from you. Why aren't you referred to me? You know, and so it's, it's just such a multifactorial problem where I think that because most ibclcs are women and mothers and mothers who have breastfed that it's like that internal guilt that you're talking about. trickles down into our own employment. We feel guilty about helping other mother. Well, we don't feel guilty about helping them. But we certainly feel guilty about charging them for what we do. And that is also a problem in this whole mess that we're in the whole

 

Amy Brown  45:14  

women doing so much unpaid labor, isn't it that women are propping up society with all the unpaid labor that they do? And the whole same guilt issue that plays on breastfeeding mothers minds is playing on the lactation consultants as well, I think, you know, as you say, it's such a female dominated profession that they get away with it, when in fact, what was it Oh, it was Twitter today. And Liz Brooks was talking about, you know, we should be paid for our expertise. Any other profession would demand this, and any other equivalent trained health profession, I mean, how much you pay to go to a chiropractor, you don't see chiropractors, giving away free, whatever they do free manipulations, or, you know, he wouldn't go to a dental specialist specialist or a plastic surgeon and expect them to be doing loads of stuff for free. It's so strange, and it's, again, just this engrained. And I think, also the type of woman who often goes into lactation consultants, they care, they've usually seen so many bad experiences, or had that challenges themselves, that they're then driven by that empathy and driven by wanting desperately to help. And of course, it's to their own detriment. And it's also to the professions detriment in the idea, as you said, of, you know, until everybody stands together and shapes about their worth, and everybody recognizes they're worth it, you just kind of carries on going.

 

Jacqueline Kincer  46:49  

It Yes. And it's it's unfortunate, because I, I think like you said about the world is propped up on the unpaid labor of women that when we serve those women, we know that we're witnessing, doing them doing the unpaid labor, right. They're the they're the ones who, you know, at least here even in January, I forget the number that came out. But it was 140,000 jobs or something had been lost in the United States. And every single one of those were female jobs. So when it comes to the challenges that our society faces, and you know, the choice of who's gonna stay home with the children on disproportionately it falls on women. And, you know, there's a lot of reasons for that. So when, when we go in, as you know, professionals to serve these women, we recognize that they're doing this unpaid labor and may have even, you know, they've made sacrifices to be able to bring this child in, most notably, you know, their income and their professions. And so we feel, we feel, we're like trying to support this vicious cycle of, you know, like, we want to cut them a break, because we know, they're having a hard time that we feel it, and we hear it, and we sense it, and it just is. But like you said, you know, having things like this, you know, paid time off after having a baby is no guarantee that breastfeeding is going to be supported, like, you know, in the UK. So it leads us to a lot of a lot of different issues from policy and privilege. And, you know, just the heart of the actual people themselves. And I know that you do such a good job of talking about the impact to the parent, and I love that you brought up, you know, moms might want just want to breastfeed because they want something out of it for themselves. It's not that they're selfish, but so much of that focus is on the baby. You know, we call it you know, we can we obviously infant feeding as a part of breastfeeding, but it is not all of breastfeeding. And, you know, how are we We're, I guess, what are you seeing when it comes to women's mental health regarding breastfeeding, and just, you know, the new parenting in general.

 

Amy Brown  49:05  

I think it's just also tied up in it and so complex, and as you were speaking there, I was just thinking about the, the underlying factor that mothering is undervalued. So it's not valued, of what it adds. It's not just practically caring for the child in that, given the moment. It's shaping and creating and supporting the adult that they're going to become. And the same with with breastfeeding how much Judy Smith in Australia did a paper on how much breastfeeding is worth. And it turns out, they're not just doing the unpaid labor of feeding the baby, they're doing the unpaid labor of propping up the economy essentially in in what the impact of breastfeeding will be. So all the studies about how much breastfeeding saves or formula feeding costs and economy in terms of healthcare costs, you know, hospital appointments, GP appointments And the knock on effect across a population on things like IQ and work and productivity going forward is huge. There's a, there's a big paper that was done in the US as well, that really estimated, you know, what, how much money will be saved by scaling up breastfeeding. So every baby being breastfed, I think it was 12 months and six months exclusively. So it's that layer, upon layer of layer. But women aren't valued for any of this. In fact, it's almost the opposite. So they're kind of played down and ignored and belittled for being at home with their baby and caring for their baby and told they're only really worth it. If they're propping up the economy in some way, by having a job when actually they're doing loads by supporting that child growing up and breastfeeding that baby. It's just just, I think that lack of lack of value of a mother plus being told continually, she must be grateful and love every second of it. And she must all give her everything to the baby. I think that's why sometimes some people struggle with the idea for some reason of a woman enjoying breastfeeding, or it being time saving or convenient to a mother. People seem really kind of twitchy about that as if like, How dare my mother's life be easier within all of this? How dare she find things slightly easier, she should be suffering, she should be giving everything because we don't value her. It's saving all those layers of pressure. And I wonder we've got so much, you know, postnatal depression going on. Mothers and new parents feel under so much stress and pressure because all these messages that they keep getting, we know in terms of mental health, if breastfeeding is going well, it's really protective, for for mental health, for all sorts of reasons, sort of physiologically, in terms of the hormones that are there. Prolactin can help her mum sleep. Oxytocin, we know is just wonderful. But also the expectations and the ability to do what she wants with her body. But we then know that if breastfeeding goes wrong, her risk of depression and anxiety and grief and trauma just skyrocket. Because of all of the stuff around it. The pain, we know pain causes depression, we know a lack of sleep and stress causes depression. And within all of that, she's then being told none of it matters. And nobody cares. And luck. Just just give formula.

 

Jacqueline Kincer  52:30  

And I can't imagine there's a lot of people out there who are thinking, Well, I have this breastfeeding grief, let me go see a counselor. Right. So it's I mean, maybe recognize postpartum depression and anxiety. But I think breastfeeding grief and traumas, just like birth trauma right? There. But I think breastfeeding grief and trauma are much more under recognized than the birth trauma is and it really can be traumatic. I almost maybe once a week, I hear from someone that says, I have not breastfed for X number of months. But it's really important to me, and I'm, I've, you know, I've now found you are this resource. And I understand I can possibly re lactate, you know, I would love to do that. And that just breaks my heart because you know, they they're still out there searching. Right? So part part they're trying to process the grief and they can't. They're kind of stuck on it. It's you can you can relate to it. But it's just it's it's harder work, right. And I just, I see a lot of people who even come and follow my page on social media and what have you, and they're not breastfeeding anymore. But they want the information for the next baby, right? They're trying to, to heal something, sometimes they get a lot of comments. This explains what went wrong with my baby. And I remember doing that after my son's birth that was traumatic for me. So I wish that we had more support in place. But you've written a wonderful book on the topic, actually. So that's a good start for people that are looking for something to help support them through that.

 

Amy Brown  54:10  

Hey, a lot of women read reading it have said how healing it is. Even from just reading the the opening chapter is about what breastfeeding means to women and why it's why it might be important to them. So lots of different reasons around what women value. And just hearing that, and chapters on how women feel when they can't breastfeed, I think has just been so validating for women, mostly not saying I'm the only person saying this in lactation world, but in the rest of the world. They keep getting the message that it doesn't matter. So one of the key features of you know, lasting grief and trauma is being dismissed. So nobody pays attention to how you're feeling And you keep getting told it doesn't matter. And I think just sometimes someone turning around and going, Oh, wow, this, you had an awful time, this clearly really mattered to you. No wonder you feel dreadful. This is all completely normal. Here. Here are lots of other women who feel the same way. I think that can be really validating and helpful to read. Because to understand that you're not alone, or you're not weird for feeling this way. A lot of women write to me and go, I don't know how you've done it. But it's like you're writing about me in this book. But you can't be because you know, it was published before they had their baby. And I think it's just been so powerful in helping women realize that it is important, and it's okay for them to grieve, and it's okay for them to miss it. One point you said there about women coming back with a second baby, when other quite surprising findings when I was doing the research for the book was that sometimes women had the first baby and they couldn't breastfeed, and they had all these difficulties. And they, they moved on to formula and they kind of shoved it all to the back of their mind locked up in a little box and didn't think about it. And then when they had their second baby, what I expected was when they had the second baby and could breastfeed them that that would make them feel better. But it actually made them feel worse. And when all the grief actually came pouring out because they realized it wasn't them that they weren't broken. That stuff had got in the way before. And they started being able to identify what went wrong, and they felt awful, but it was the start of them being able to heal because we know with grief and trauma, you can't actually just put it in a little box and forget about it, it will come back at some point. And I think it's just about giving people the space to just say it was terrible. And people go, yes, it was. I'm so sorry. Rather than go lucky, doesn't matter. Your baby's fine. You know that it's it's so invalidating when someone says that. And obviously we've got to work on a one to one basis here. So for some women, that's maybe what they want to hear, they need that reassurance that their baby will be fine. But for others, it's just like a slap in the face like nobody cares. They couldn't breastfeed, and then everybody told them, it didn't matter. After they were told in pregnancy, it really did. So it's just holding that space for them. And I think there are some great perinatal counselors who are able to support women through this, we need more of them, we need more recognition of it, and I think it is growing. Do keep saying to women go, you know, you can go to an ibclc. You can can go to them for support with breastfeeding grief, you don't have to actually be breastfeeding to go and see a lactation consultant. They are, you know, so well placed to help you because they see see this over and over again. And often that I think sometimes I don't know if it's like this in the US, but in the UK, we have almost Some people believe that lactation consultants or any lactation consultants, because they had this glorious breastfeeding experience where nothing ever went wrong. And they want to make sure that all women breastfeed from now on where it can be further from the truth. So many lactation consultants are there because of the challenges that they had. And that made them want to help others.

 

Jacqueline Kincer  58:23  

Yeah, I don't think I'd be doing what I do if I had an easy time. I would not because I needed to find the answers. I couldn't stop until I figured out what was wrong. And and I was I was invalidated, you know, so. And I actually saw an ibclc it wasn't her primary role. She was also a physician, but everything looks fine. And I was like, Why does it hurt so bad? And so I just kind of never stopped looking. And then at that point, fell in love with the field. So and then I and then, you know, like you said, I sort of made an internal vow, like I don't ever want another woman to have to go through what I did and not have the support that I needed. And so and that's a big reason why I started the podcast was well, people love podcasts, I think, I don't know, a lot of people seem to listen to them. And you know, maybe if you listen to Joe Rogan, you're not gonna find this one, but or whoever you like to listen to. But if I can reach someone somewhere with even just a one minute clip of an episode that somehow changes something for them or pushes them in direction they were looking for, then I want to do that. So that's so important that we're having the conversation that we've had today, which is really just so so many different entanglements and it's, you actually answered my question. I was gonna end the episode with already, which was so beautiful, but, you know, for I guess, maybe, maybe we could go with this, um, for anyone who's listening, that's a healthcare professional of some sorts. You know, What? What would you want to say to them? You know, this is your little soapbox moment to say something to them if they're listening, and then for the moms out there, what would you want to leave them with? Oh,

 

Amy Brown  1:00:09  

wow, okay. No pressure, I go for the line for both of them. But you know, breastfeeding matters because women matters. It matters because it matters to women, it matters because their bodies matter. They deserve the support, and help and everything else that they do. If a woman tells you that breastfeeding is important, work with her to make sure she gets the support she needs. If you don't have the skills, signed poster to the people who do, and for women, don't ever let anybody tell you that this doesn't matter. If it matters to you, then it matters.

 

Jacqueline Kincer  1:00:54  

That's beautiful. So beautiful. Well, I just have to thank you so much for coming on today. And for anybody who wants to explore more of Professor Amy Brown's musings, which are just absolutely wonderful. She has a blog, I will link that up in the show notes. She has amazing books, I will link up the list of those in the show notes. And she's quite active on social media. She told us about her little Twitter adventure this morning. So you know, there's lots of wonderful places to follow her and her incredible work. So thank you for being on the show today. It's been wonderful.