Dr Michael Gannon, ABC Radio Perth, Breastfeeding

GILLIAN O’SHAUGHNESSY:    Now, for years, new mums have been hearing the message; breast is best. If, for one reason or another, you are one of the mums who couldn't, or who tried and didn't succeed, it was your first major failure as a parent if you couldn't breastfeed your baby. And that sort of guilt can be really overwhelming. Now the AMA has changed its guidelines, still promoting breastfeeding as the best option, but now acknowledging perhaps there needs to be better balance between breastfeeding and supporting mothers who can't or who choose not to. Michael Gannon is the President of the AMA.  Hello Michael.

MICHAEL GANNON:   Hello Gill, how are you?

GILLIAN O’SHAUGHNESSY:    Yeah, I'm very well, thank you. Tell us a little bit more about what prompted this change.

MICHAEL GANNON:    We regularly review our position statements on all matters relating to the public health, but what this really says is that we still maintain that breastfeeding is the best start that you can give your baby, the perfect balance of calories and micronutrients that have evolved over literally tens of thousands of years, protective antibodies against various infections. But not every woman can breastfeed, and we need to be able to find a way to not only support those women who wish to breastfeed, but to not demonise and to find different ways of supporting those who have to or simply choose to formula feed.

GILLIAN O’SHAUGHNESSY:    Has there been unintended consequences- and I think we all understand the breast is best message, and it's a good message, but have there been unintended consequences as a result?

MICHAEL GANNON:   Well even in your intro you've used the concept that it's a failure if you can't make breast milk to look after your baby. And that's simply not the case. Like any other aspect of human physiology, there are variations. Very simply, different women have different amounts of glandular tissue to make milk. Very simply, there are dynamics with each individual infant. So a woman who might have successfully breastfed two of her children might find it difficult with a third child. So what we need to do is to find that balance, to offer the support for those women who need help. So whether that's prescription of medication that may or may not augment milk supply; whether it's referral to milk lactation consultants; whether it's psychological support- any other support they need to get through those difficult first few weeks, when hopefully, potentially it gets easier. But, at the same time, identify that there will always be a group of women who will not be able to breastfeed their baby, and they haven't failed. They just need to be offered advice on the best way to provide their baby with the appropriate nutrition.

GILLIAN O’SHAUGHNESSY:    And how effective are formula replacements these days, if that's the road you go down?

MICHAEL GANNON:    Well, they're extremely effective. And when we look at some of the studies that have come before, in the past, it doesn't give me a great deal of pleasure to say, but some of them have been ideological. You know, formula is developed in a way to, wherever possible, mimic the calories, the nutrients that are in human breast milk. Now, it's not as good because you miss out on that mother and infant bonding, you miss out on protective antibodies. This is not an argument that we should discourage women from breastfeeding. And in fact we've called for better education, for better supports to increase beyond 39 per cent, that proportion of Australian women that are still exclusively breastfeeding at four months. But the reality is that some women just get absolutely exhausted in the cycle of feeding, settling, expressing. And for a minority of women, they should be encouraged to move on and be comfortable with their choice to formula feed their baby.

GILLIAN O’SHAUGHNESSY:    And if you add, I suppose, on top of that the stress of feeling like people are judging you- and people do judge you for not being able to breastfeed your baby, perhaps not everyone does but I think a lot of people do, even with good intentions, it's just an extra stress and a pressure which probably makes the whole process more difficult.

MICHAEL GANNON:    Yeah, I really don't get this idea that you criticise your fellow woman, your fellow man for the choices they make in life. So if you have pain relief in labour, or if you choose to bottle feed your child, or, heaven forbid, you don't feed it on an exclusively organic foods or let it play with the naughty child. That doesn't make you a failed parent. I think we should lay off each other, be a bit more compassionate, realise the demands of raising children and just be a bit nicer to each other.

GILLIAN O’SHAUGHNESSY:    Michael Gannon, what a good message, President of the AMA. Can I ask you also, if mums are feeling stressed or pressured or judged, and so they stop talking, perhaps, to their GP or someone who might be able to support them with good information, where do you find they're turning?

MICHAEL GANNON:   Well, I think that that's the place that they should turn, and when they don't know where to turn that's sometimes where we do see higher rates of post-natal depression. We need to do so much better with health literacy. We need to do so much better in the quality of health education we provide in schools, in the public health arena and in antenatal classes. Not every woman is going to end up with a perfect birth. Not everyone is going to end up with the perfect baby that feeds well and settles quickly. So the first port of call should be your child health nurse, should be your GP. Hopefully they're providing you with accurate, scientific, and, most importantly, supportive and compassionate advice.

GILLIAN O’SHAUGHNESSY:    Thank you very much for your time, Michael, appreciate it.

MICHAEL GANNON:   A pleasure Gillo.

GILLIAN O’SHAUGHNESSY:   Michael Gannon is the President of the AMA.

16 August 2017

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