Call the Midwife is back for a fifth season and so are the faculty of the Vanderbilt University School of Nursing with a weekly guest blog. Watch the show 7 p.m. Sundays through May 22, then read the blog each Monday morning for historical and contemporary context about the previous night’s episode. SPOILER ALERT: Some posts may contain spoilers.
By Bethany Domzal Sanders
Vanderbilt University School of Nursing
Perhaps one of the most gut-wrenching phrases to say to any mother is: You want what’s best for baby, right? It’s a rhetorical question, and a loaded one at that. Underlying the question is some kind of judgment or opinion about the mother’s parenting and an implication that she is doing it wrong. Those words can be especially powerful in the first few days after birth when parents are often exhausted and extra protective of their new baby.
You’ve probably heard the phrase “breast is best” and while there is a lot of truth to that, it can also open up a can of worms. Controversy over breast-feeding is nothing new. As early as 1865, formula was being marketed as “the perfect infant food.”* The 1940s and 1950s saw increasing acceptance of infant formula as manufacturers, while prohibited from advertising directly to consumers, had close relationships with physicians. Breast-feeding rates subsequently declined. While rates of breast-feeding have increased since that time, there is no lack of opinions about breast- versus bottle-feeding and a Fall 2015 New York Times op-ed entitled “Overselling Breast-Feeding” added more fuel to the debate.
In this week’s Call the Midwife episode, Sister Evangelina found herself navigating these dangerous waters while trying to help poor Connie. Her intentions were good, even if overzealous at times. This is a familiar situation for many midwives. How do you normalize breast-feeding, support and encourage women in nursing while also being sensitive to the fact that not all women want to or can successfully breast-feed? How do you switch gears from helping a mother in the early days of nursing to affirming her choice to stop? As midwives, we are called to listen to and advocate for women but it’s particularly hard when a mother’s choice doesn’t line up with our own expectations. We don’t always realize the effect our words have on our clients either, as Sister Evangelina learned.
Ultimately, the No. 1 rule of breast-feeding is FEED THE BABY. While babies are equipped with special fat stores and reserves to tide them over until a mother’s milk comes in, guidelines exist to help identify when there is too much weight loss and supplementation with either donor milk or formula is needed. Improvements in the manufacturing of infant formula have made it much safer and it continues to be an acceptable alternative for many families. Breast-feeding has always been, and always will be, the biological norm. We just need better ways to support all mothers, since after all we are all trying to do what’s best.
Bethany Domzal Sanders, MSN, CNM, is a member of the Vanderbilt Nurse-Midwives, the clinical practice of the Vanderbilt University School of Nursing located at West End Women’s Health Center.
*Source: A History of Infant Feeding by Emily Stevens, Thelma Patrick and Rita Pickler. The Journal of Perinatal Education. Spring 2008, Volume 18, Number 2.