Breast or bottle? It's time to change the language...

Whenever I was asked about River’s diet at his early appointments, it was always “bottle fed or breastfed”. And I never really knew what to say. He was exclusively bottle fed, but it wasn’t formula. He was also exclusively breastfed, but he wasn’t nursed. And I always found that I had to explain myself, because it almost always raised an eyebrow, or prompted follow up questions that were clunky and at times, hard to answer.

There is a whole group of women who aren’t being catered for in the feeding conversation- and though we may be small, we’re totally valid. Exclusive Pumpers is the term given to mums who feed their child breastmilk from a bottle only, and not directly from the breast itself. Sometimes it’s a choice from birth, more often it’s a backup plan, for the nursing plans that went awry for whatever reason. In my case, being a lockdown baby meant that there was no practical help around (Zoom can only help so much) and a shallow latch due to an undiagnosed tongue tie meant that my nipples were damaged beyond the point of return. I pumped exclusively for 8 weeks while they healed, and by that point, nursed occasionally, but found that the pumped bottles worked so well for us. So we stuck to that, and kept that up until his first birthday. Exclusively pumping saved my breastfeeding journey. My issue is this. Formula and breastmilk are different (and yes, both totally valid). They require different advice, different approaches, and sometimes, different results (think poo consistency and frequency, whether or not they’ll need a bit of water in hot weather, or identifying an allergy). For example, if you feed formula, you won’t need to add any vitamins into your baby’s diet, but a baby who drinks breastmilk will need a Vitamin D drops supplement. I worry that some mums are going to receive the wrong advice, based on how thorough the answer they give is. If they just answer ‘bottle fed’ at their appointment (which would be accurate), they won’t be given the Vit D advice. If they answer breastfed (also accurate), they may not receive any additional help when it comes to storing their milk safely. Vital info could just be completely missed.

It’s also doing a huge disservice to exclusive pumpers, as though their choice isn’t a valid one. It swings back to the idea that breastfeeding means being fed directly from the breast. It doesn’t. Breastfeeding takes many beautiful forms, and if your child is on a diet of breastmilk, then they are breastfed, whether that’s straight from the boob, a bottle, a tube, or donor milk. Nursing is the correct language here when talking about feeding directly at the breast- it doesn’t alienate, and it’s a far more accurate term.

I propose a change to the language and line of questioning.

1.Are you NURSING or bottle feeding?

And then if the answer is bottle feeding, a follow up question-

2.Breastmilk or formula?

Don’t put the responsibility on the mum, who may not have any idea that she’s answered incorrectly for her and her baby’s needs. She’s not the expert, it’s not down to her. Arm her with the right advice and information for her circumstances, so she and her baby have the best possible start and opportunity to thrive. A first time, sleep deprived mother may not have any idea about the differences in milk, she’s just trying to get through her days in one piece, as she heals and learns. It’s important that the healthcare professionals who look after our children have as much information as possible, and such a small change could ensure that things aren’t missed.