Opinion: When breast isn't best

NZ Herald

26-05-2025

Overwhelming emotions of guilt, frustration and exhaustion were echoed in the largest-ever qualitative study on the impact of breastfeeding difficulties on maternal mental health. Photo / Getty Images
The more my baby breastfeeds, the chubbier his cheeks grow, and the hollower mine become. Yet I continue, captive to the pervasive belief that breastfeeding is the measure of my maternal devotion.
The pressure started before my baby was born. The Meta algorithm served up reels of mumfluencers championing the mantra that breast is best. Even after my baby arrived, I fielded comments from a well-meaning stranger, a retired midwife, who felt compelled to remark on my baby's jiggling fat rolls, saying, 'You can tell he's breastfed.'
But my exhaustion and cracked nipples tell a different story. My husband pleads with me to give the baby a bottle of formula during the early hours so I can sleep, but the guilt lingers. If I truly cared, wouldn't I push through? I feel like a failure, lazy for needing a break.
I see the varied realities of feeding at playgroups and baby sensory classes. We all started with the intention to breastfeed, yet many face challenges. Some mothers struggle with low milk supply while others find breastfeeding unbearably painful due to cracked and tender nipples. Some babies are tongue-tied and unable to latch, while others have allergic reactions to proteins in their mother's diet and thrive better on formula, which can be gentler on their stomachs. There's an unspoken shame and guilt, as everyone seems fixated on justifying their decision.
These overwhelming emotions of guilt, frustration and exhaustion were echoed in the largest-ever qualitative study on the impact of breastfeeding difficulties on maternal mental health.
Recently published in Scientific Reports, more than 1000 women detailed their nursing experiences from the past decade. The findings were both affirming and heartbreaking.
Participants were highly motivated to breastfeed, equating it with being a 'good mother'. Many believed it should come naturally, feeling something was wrong with them when they faced difficulties.
One participant shared their heartbreaking experience, saying, 'My mood was extremely low, I felt abandoned by medical professionals who then judged me for not instinctively knowing how to breastfeed. I felt I was failing and alone.' Another added, 'I was extremely stressed, depressed, alone in my struggles, unheard by midwives who were no help.'
It's well-documented that maternal mental health plays a critical role in the first 1000 days of a child's life. It doesn't just affect the mother, but also an infant's health and the quality of the bond between the parent and child. However, the study highlights how there is a significant gap in Western antenatal education which leaves mothers unprepared for the challenges of breastfeeding. On top of that, judgment from healthcare professionals heightens distress.
This judgment starts from the first night in the hospital. If your milk hasn't come in yet and formula is the only way to comfort your crying baby, you're required to sign a waiver acknowledging the risks, compounding the guilt during a vulnerable time.
Surely then, it's time to reconsider the medical community's focus on breastfeeding when 12-18% of Kiwi mothers struggle with their mental health during the perinatal period? These figures are even higher for Māori, Pacific and Asian populations, widening existing inequalities.
However, Aotearoa is a signatory to the WHO International Code of Marketing of Breast Milk Substitutes, which mandates that health workers protect and promote breastfeeding. Consequently, dairy companies face restrictions on how they can advertise infant formula, a policy with valid concerns rooted in a history of aggressive marketing tactics.
Yes, there are widely documented benefits for both mothers and children. Research shows short-term advantages for babies, such as a reduced risk of gastrointestinal disorders and allergic rashes. Modern parents must weigh these trade-offs to decide what works best for them. While breastfeeding can lower a mother's risk of breast cancer in the long term, this benefit may not outweigh the immediate challenges some face.
Beyond the data, one universal truth emerges: mothers need grace. We need to remember that our happiness and wellbeing matter, too. Why can't we simply choose not to breastfeed if that's what we want? After all, the bottom line is the same for all of us—our babies are fed, warm, and loved. And yet, we still blame ourselves for falling short of the so-called gold standard of exclusive breastfeeding.
Society's contradictions only exacerbate the pressure. You might be ridiculed for breastfeeding an older toddler in public or for having a 'needy' baby attached to you for comfort. You're also expected to wean to prepare for daycare in an economy dependent on two incomes and minimal government-paid parental leave, which ends just six months postpartum.
Even as I continue to breastfeed, judgement finds me. A relative tells me to cover up in a cafe because people are staring. Another blames my caffeine consumption for my baby's frequent night waking. Later, I learn her own children never slept through the night; she shut their doors and left them to cry it out. Looking back, I realise that whether my baby was breastfed never mattered. What mattered was that he was fed, warm, and loved.