Comment

Breast is best but formula is still an option

Healthcare professionals should avoid appearing dictatorial in the choice between breast or bottle feeding

Healthcare professionals should avoid appearing dictatorial in the choice between breast or bottle feeding

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The BMJ announced recently that it would no longer carry adverts for formula milk. This decision is to be respected, of course, and their reasons for it at first seem valid. 

However, a cynic may think this is a step closer to censorship and a step away from respecting free maternal choice. 

The benefits of breast milk are irrefutable – nothing manufactured could be better for a baby than their mothers’ own milk.  

Midwives are educated and trained to promote natural breastfeeding; neonatal nurses strongly encourage mothers to express their milk so that the smallest, sickest and the most vulnerable infants can benefit from it. 

The RCN has promoted and supported the continuation of breastfeeding in hospital wards and departments because we all recognise that there is no better means of nourishment. 

Breastfeeding is not compulsory

Companies that manufacture formula milk, also known as breastmilk substitute, understand this, and state clearly on every pack and in every advert that breastmilk is best. They also provide links to information on breastfeeding on their websites.

But we do not live in a dictatorship in which breastfeeding is compulsory, and mothers who cannot or choose not to breastfeed should have an alternative means of feeding.

And infants seem to thrive on formula milk. Many mothers report better sleep and more rest for themselves, their infants and other members of the family.

Yet some mothers are made to feel guilty for not breastfeeding. They endure the disapproval of friends, family and professionals, even when there were good medical reasons for their decision not to breastfeed.

Unbiased advice and support

There are varieties of types, formulations and compositions of infant milk alternatives. The profession needs this education and the best source for it is the industry itself – they make formula milk, they know what is in it and they know how to ensure it is safe. 

We need to keep an open mind about what is best for mother, child and family, and ensure we can offer them professional, unbiased advice and support. 

Otherwise we risk the healthcare professions being seen as dictatorial and unhelpful.

Strong beliefs and opinions can inhibit progress. We should be able to debate emotive matters, respectfully but robustly, for the overall benefit of the families in our care.


Doreen Crawford is a nurse consultant, at Crawford McKenzie. Here, she is expressing a personal opinion, not that of Nursing Children or Young People journal or the RCN

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