Women feel shame and stigma whether they breastfeed or bottle feed

Women feel bad about how they feed their child whether they breastfeed, use formula or a combination of the two, a pair of studies on mothers' emotional experience of feeding their babies has found.

Breastfeeding mothers felt guilt, stigma and the need to defend their method of feeding. Formula-feeding mothers reported exactly the same negative feelings, but in greater numbers.

One of the studies, published in Maternal and Child Nutrition, looked at the emotional experiences of 845 mothers who only breastfed or who combined breastfeeding with formula. The second study, published in the same journal, surveyed 890 mothers who used formula for part or all of their child's feeding.

The 'good mother' problem

In the breastfeeding-focused study, 15% of the mothers reported feeling guilty, 38% stigmatised, and 55% felt the need to defend their feeding choice. Sophia Komninou and Victoria Fallon of the University of Liverpool, authors of the two studies, told The Conversation that stories of breastfeeding mothers being asked to leave public places or to cover up left them feeling "confused, conflicted and contemplating formula over breastfeeding".

In the formula-feeding-focused study, the figures were 67% reporting guilt, 68% reporting feeling stigmatised and 76% feeling the need to defend their choice. "It seems that our portrayal of formula as 'risky' or 'dangerous' alongside the 'breast is best' message may alienate those who intend to exclusively formula feed and create reluctance among women to seek professional advice about their 'suboptimal' feeding method," the authors say.

"Regardless of whether they breastfeed or not, this catch-22 situation is making life unnecessarily difficult and stressful for mums," they say.

Harmful messaging

"Women who breastfeed feel stressed about neglecting the rest of the family and other obligations, whereas women who do not breastfeed feel a sense of guilt about feeding their child something sub-optimal," says Komninou. "They also feel shame about having to explain to others why they are not breastfeeding which leads to them feeling like they are failing to achieve the socially constructed status of the 'good mother'."

"The 'breast is best' message has, in many cases, done more harm than good," says Fallon. Less than 1% of mothers in the UK exclusively breastfeed for the six-month period recommended by the World Health Organization, she says.

"We need social reform to fully support and protect those mothers who do breastfeed, and a different approach to promotion to minimise negative emotions among the majority who don't."

Formula-feeding should be framed in a more balanced way in public health campaigns and information for mothers, she said. "It is crucial that future recommendations recognise the challenges that exclusive breast feeding to six months brings and provide a more balanced and realistic target for mothers."