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Thursday, 28 June 2012

Cavewomen Didn't Have Breast Pumps – Breastfeeding Works

Cavewomen didn't have breast pumps.

Cavewomen didn't have breastfeeding pillows, or breastfeeding capes, or nipple shields or books that dictated arbitrary feeding times and schedules. And they certainly didn't have formula.

But what the cavewomen probably did have was something we often don't – faith. Faith in the physiological process of breastfeeding: a simple continuation of pregnancy and birth. Faith because they grew up seeing breastfeeding every day; they knew it was the only way to feed their young. And on the rare occasion that it didn't work or a mama couldn't for whatever reason, there was always a sister or aunt or friend there to help out with a willing hand. Or breast.

It is commonly accepted in western culture that 'breastfeeding is best, but it's hard.' Recent statistics show that although 96% of mothers initiate breastfeeding, by 3 months old the exclusive breastfeeding rate is only 39%. Remember that in terms of human life on the planet, formula is a very recent invention, having only been around for about 150 years. If these statistics were indicative of the human mammal's actual physiological capacity to nourish their young, humans would have died off a long, long time ago.

The fact that I am sitting here writing this post (and you are reading it) is testament to the fact that breastfeeding has worked overwhelmingly well for millennia – and humans have thrived.

So why then, in today's culture, does breastfeeding often seem so hard?

Well, here's is a list of things that can (and often do) compromise a breastfeeding relationship:
  • Birth trauma to mother or baby
  • Cesarean section, assisted delivery or analgesics used during birth (ie. epidural, pethadine)
  • Post birth separation of mother and baby
  • Imposition of routines or timed, restricted or scheduled feeding
  • Use of dummies (pacifiers)
  • Use of bottles (for 'top-ups' with formula, or expressed breastmilk 'so they get used to a bottle' etc)
  • Lack of physical support for the mother: ie. no one to help with the housework or cooking
  • Inexperience in seeing other women breastfeed
  • Inexperience or lack of understanding of normal newborn infant behaviour
  • Separation of mother and baby: ie. baby sleeping in a separate room
This list is non-exhaustive – these are just the most common factors. And common is the operative word here; arguably, a new mother in the west is exposed to many - if not all - of these points.

Mothers aren't often told that these things might make breastfeeding difficult for her and her babe. She isn't informed that the epidural might affect her babe's suck reflex, making his latch difficult for a few days, making it harder for him to milk the breast. She isn't informed that topping up with formula is often not only unnecessary, but can have a cascade effect toward early weaning. She isn't told that keeping her baby close helps keep her milk-making hormones flowing, and she isn't encouraged to ignore the housework and rest with her baby.

She isn't told these things. She isn't reminded that these problems are not her fault - but the fault of a society that just doesn't know a lot of truths about breastfeeding.

She also isn't told that the majority of problems caused by any number of these setbacks can be worked through with the right information and support.

With faith – in herself, in her body, in her baby.

In the early days with a newborn, breastfeeding can seem hard. But although learning to breastfeed can take some time and patience from the mother and child, it's not breastfeeding per se that is so exhausting - it's life with a newborn that is so tiring. With a newborn in the house, when days and nights seem an endless parade of exhaustion, interrupted sleep, and constant breastfeeding, life can seem so overwhelming.

From the moment of conception, women are led to believe that their bodies are faulty and untrustworthy. Pregnancy is fraught with a list of tests and a check boxes of things she cannot eat, activities she cannot do. In birth, the control is rarely something in the hands of the woman.

Following on from a pregnancy perhaps filled with medical checks and tests, a hard or tiring or traumatic birth, suddenly a needy newborn and sore nipples and a constant need to have your breast out can just all seem to much. There is too much beyond our control. So the idea of taking some control – any control – can seem appealing. For many women, although they grieve the idea of giving up breastfeeding – being able to give up something understandably represents the taking of some control.

So, however sadly, she feels she must wean; and in our culture, this is so very easy to do. For the cavewomen – it wasn't. (And lucky for us, right?)

In the vast majority of cases, a woman can breastfeed just fine. More than fine - most lactating women have the capacity to feed two or three or even more babies.

So what is the one thing that can mean breastfeeding success?


Unwavering faith; to adopt a kind of 'there-is-no-alternative-to-breastfeeding' approach.

Like the cavewoman did.

It's a bit like learning to walk. At first, we may stumble and fall down. But by watching others do it, and by holding the hand of someone more experienced, we eventually find our own balance, and walking becomes so easy we don't have to think about it.

Falling down can hurt; it can be frustrating and even embarrassing. But once mastered, it's as easy as breathing.

And for the significant majority of the population, learning to walk works out fine.

There are a small number of cases where physiological breastfeeding can be difficult or not possible. These cases include women who have insufficient glandular (milk making) tissue through breast surgery such as mastectomy or reduction, or breast hypoplaysia. In some cases, women with Polycystic ovarian syndrome (PCOS) or other severe hormonal imbalances may be unable to produce sufficient milk. Estimates of these cases are around 1-5% of women.

This doesn't seem to accurately represent the 61% of Australian mothers who, by 3 months postpartum, are not exclusively breastfeeding.

The World Health Organization (WHO) recommends that in the case of a woman being unable to breastfeed, the milk of another human mother is the next best option for her baby.
"The vast majority of mothers can and should breastfeed, just as the vast majority of infants can and should be breastfed. Only under exceptional circumstances can a mother’s milk be considered unsuitable for her infant. For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances...For infants who do not receive breast milk, feeding with a suitable breast-milk substitute – for example an infant formula prepared in accordance with applicable Codex Alimentarius standards..." (World Health Organization Global Strategy for Infant and Young Child Feeding, page 10, para 18)
Put simply, this means that the WHO recommends the following:
  1. Breastmilk from the mother's breast.
  2. Expressed breastmilk from the mother.
  3. Breastmilk from a healthy wet-nurse or a human-milk bank.
  4. Breastmilk substitute (ie. infant formula) 
So for those small amount of cases where a woman is physiologically unable to breastfeed adequately, breastmilk from another human is the next best option. Luckily, as the awareness of the importance of human milk for human babies grows, milk sharing is becoming an option more available to many women.

All mothers (and their babies) deserve unconditional support and the right information. All mothers deserve to be able to make informed choices that suit them and their family. And all women – whether breastfeeding fully, partially or or not at all – deserve to feel completely comfortable with those choices. And with the right information, I believe they can.

So, if you're about to become a new mother, or if you have a new baby (congratulations!) and wish for breastfeeding success – do it like the cavewomen did. 

Don't give up. Hold someone's hand. 

Breastmilk is something that all babies can have – and it's something that every mother has the right to the pleasure of providing.

Peace and love to you. xoxo


    1. Love this - thanks for posting!

    2. Beautiful summary - thank-you.

    3. Hi Little Leaf, I congratulate you on an intelligent , well researched, informative article. I agree that over the course of a century systematically women have indeed lost faith in their bodies. The extremely dangerous thing on my mind recently is that currently a women's faith in her ability to mother her own children is the thing I see as the next very real threat to women, children and society. In NZ for example for women on a benefit with preschoolers enrollment in a childcare center for a set number of hours is a condition of the receipt of the benefit. This kind of policy gives a powerful message to all women. Also as I read your article I was wondering about how women can return to a sense of faith in the ability of their own bodies. Here you have advocated for women to maintain their faith and persevere. Women I hear from when bf has not worked out often have done this to the point that they reach crisis and they are no longer able to function normally something has to give and that thing has been bf. While initially this is a relief many women I hear from grieve for the loss of their dream of being a bf mum. So for me there is more needed here than faith. We live in a culture that advocates trust in experts. Sadly, when it comes to bf the experts women put their faith in often give them conflicting and inaccurate information which then leaves them with bf not working out. Women do not know this is likely to happen. Having faith in your body when the information about how it works is incorrect does not lead to bf success. I wish all of this was more simple but women's faith in their own body is only one factor in why so many women have bf not work out. It is a complex series of factors that all need addressing at once. The only place I have seen this done successfully is in La Leche League meetings. In these meetings women see bf. They hear how other women have overcome difficulties. They get options on dealing with negative pressure from others. They get accurate information on how bf works and normal infant behavior. They also learn to trust their own instincts and to see themselves as experts on their own baby. Ideally La Leche League meetings will be attended early in pregnancy so that this all is firmly inside a women before her baby is born. These meetings kind of create an alternative culture to the dominant one in which women live. Warm thoughts, Karen Holmes creator of:-