Through the years I've talked to a lot of people about breastfeeding. I won't lie, there's been times I've made an ass of myself and turned people off breastfeeding rather than turning them on. But I've learnt better, thank god, and I hope others will join me in changing the way we advocate breastfeeding.

Do not say….

"Formula kills."
This just sounds over the top. Technically you could say formula 'kills' in certain circumstances (a severely allergic, ill, or immune compromised infant), but in the same vein you could say 'breastfeeding kills' in certain circumstances (a meth addict's infant recently died due to meth-tained breastmilk). The simple statement "formula kills" without any type of context is very leading and inflammatory. If you want to be taken seriously make realistic, detailed comments with specific context.

"Breastfeeding is normal and natural."
I know this seems like a rather true statement, and while it is true, it only tells us one side of the story. It does not tell the whole truth, the part that says for some of us breastfeeding doesn't always come naturally or feel normal – hours of pumping to produce tiny amounts of milk, or raw, bleeding cracked nipples does not feel normal or natural. When a woman encounters problems breastfeeding, as most women do, it entrenches the idea she has failed as a mother, and is neither normal or natural. A more realistic, inclusive statement would be: "Breastfeeding is the biological norm for our species, though in the beginning it is a major biological and lifestyle transition for any woman in which help is often needed, and in the rare occasion it is unsuccessful."

"Formula is disgusting crap in a can."
This statement is so belittling to a mother that relies on formula. For them this 'crap in a can' is a lifesaver. Formula isn't as healthy as breastmilk, but it serves its purpose. The above comment is a bit like saying a person in a coma living on nutrients through an IV is living on 'disgusting crap'. The IV isn't as good as eating a nutritious salad, but given the circumstances this person relies on it to stay alive.

People will often say, "but I'm not saying you're a bad mother for formula feeding, I'm just saying the formula is crap." But calling formula disgusting is not going to make them decide not to formula feed and switch to breastmilk, because they can't, they have no choice (or they believe they have no choice, when possibly there are options out there they just don't know about). Either way, calling the food they rely on to feed their infant "disgusting crap in a can" is simply going to make them upset or pissed off.

"Nine times out of ten women who say they can't breastfeed can, they just didn't try hard enough."
Where are the studies to back this up? Studies show the real reasons women stop breastfeeding are very different to "not trying hard enough". Here is an adapted excerpt from Dr Jane Philpott's blog, detailing the main points of why women don't breastfeed from a national UK survey…

A focus group study in the UK suggested a number of reasons why women may not breastfeed or why they stop breastfeeding early. These were as follows:

Worry about insufficient milk supply – this was the most common reason women stopped breastfeeding. Women worried that insufficient milk supply was causing poor weight gain, and said that health visitors were 'always worried about weight gain'. Women often interpreted an unsettled baby as an indication they had an insufficient milk supply.

Believing the child was old enough to wean – this was the second most common reason women stopped breastfeeding, being reported by 35.7% of women. However 78% of these women had stopped breastfeeding by 12 months, meaning these women were unaware that breastfeeding is recommended well beyond 12 months.

Physical or medical problem – this was the third most common reason women stopped breastfeeding. It was reported by 14.9% of women who did not breastfeed, and 26.9% of women who had breastfed, but had now stopped breastfeeding.

Society's negative attitudes towards breastfeeding - women felt that breastfeeding in public was unacceptable and embarrassing, while bottle-feeding was accepted by everybody and in all places. A lack of places to breastfeed out of sight restricted women's ability to get out of the house. This may be a bigger issue for low-income women, who may not have the option of breastfeeding in the car. Some women reported breastfeeding in public toilets as the only option. Women wished that cafés and shops could provide places to breastfeed with some privacy.

Influence of family and friends - some women said that even family and friends found it 'repulsive' to be in the same room when they were breastfeeding. Some grandparents thought it excluded them from having the chance to feed the new baby. It was clear that the opinion of family and friends was a stronger influence than that of health practitioners.

Lack of knowledge - women vaguely knew that breastfeeding was supposed to be beneficial, but they could not name any benefits, and were not convinced about them. In the study only one woman had learnt at school about benefits of breastfeeding; most did not hear about it until they were pregnant. Feeding was not well covered in antenatal classes.

Lack of professional support - women experienced difficulty in trying to establish breastfeeding but were unwilling 'to bother the midwife'. Bottle feeding seemed easier.
Experience - breastfeeding seemed difficult and painful, and many women experienced problems ranging from getting the baby latched on, sore nipples, and disturbed sleep. Some women complained of a lack of freedom to travel/socialise/work.

"Most formula feeding mums are just lazy and uninformed."
A great way to ostrasize and insult the people you are trying to win over.

Think of the formula feeding mothers who have visited numerous lactation consultants, pumped endlessly, suffered through raw bleeding nipples, were forced to work, face immense stressors in their lives, had no support, or suffer through severe post-natal depression. Yeah, they're going to think you're an asshole (because you are behaving like one). The reply I often hear is, "well I'm not talking about those women".

Yet even if a person is 'uninformed' or 'lazy' as some so eloquently put it, saying so is insulting, stereotyping, arrogant, and it's likely to make a person shut down rather than listen to you. Sharing anecdotal info about how you were once uninformed, and found great success in researching the benefits of breastfeeding, is a much more effective way to get your point across (while not being an asshole or pointing the finger).

"I'm not making you feel guilty, you make yourself feel guilty."
There is no debate some mothers who formula feed feel guilty. Some feel a sense of failure. Knowing this, in a conversation about formula or breastfeeding you've got to tread carefully, with respect, sensitivity and tact.

I didn't harbor guilt or failure when I formula fed, but I understand others do. There are experiences (such as not being able to produce enough milk) where I can't even pretend to know what it's like, and to pretend I do would be insulting to those that have been through it. I will say I hope mothers are able to one day realize that at any moment they are only ever doing the best they possibly can with the resources they have (be they health, info, finances etc). I hope they can be proud of all they have accomplished, and are able to let go of inadequacies others point out.

So how can we effectively help?
Based on studies about why women don't breastfeed, we need to offer specific info about…

• Normal infant weight gain, checking whether baby is getting enough milk, the reasons why baby may be unsettled other than being hungry.
• The importance of demand feeding, dangers of schedule feeding, the fact that newborns do need to feed often, the dangers of sabotaging breastmilk supply by supplementing babies diet with formula, and effective ways to build supply.
• Recommended age to wean and the benefits of breastfeeding into toddlerhood.
• Common medical problems associated with breastfeeding difficulty, prevention, and treatment.
• Breastfeeding in public, women's rights to breastfeed in public, how to deal with rude commentors, specialized nursing clothing and covers women can wear if they wish.
• How to deal with unsupportive family and friends, how to include them in caring for baby without negatively affective breastfeeding relationship, how to accept their opinions or advice about breastfeeding while keeping the advice of lactation consultants paramount.
• The specific benefits of breastfeeding, provide studies to back up the benefits, and explain in detail the mechanisms by which breastfeeding is beneficial.
• The necessity for lactation consultants, the stats showing how much more successful women who have professional support are. Provide local contact details, websites and prices.
• The reality of what breastfeeding will be like, problems they may encounter, prevention & treatment, dealing with sore nipples, disturbed sleep, and incorporating travel, social life and work in with breastfeeding.