The photo above ilustrates a newborn breastfeeding in a way that may cause fussiness at the breast due to positional instability and nipple and breast tissue drag resulting in nipple pain and damage.

The belief that there is 'no right way to breastfeed' is ideologically constructed and obstructs research into the efficacy of fit and hold interventions

Today, when research studies are designed and also when clinical protocols are written, it is usually assumed that each woman with pain has or will receive optimal fit and hold intervention tailored for her specific needs by the International Board Certified Lactation Consultant (IBCLC) whom she consults. Unfortunately, these IBCLC interventions remain an omitted variable bias within most breastfeeding research, because of the absence of

• Any discussion about what is being aimed for biomechanically by that IBCLC

• Any discussion about how different styles of fit and hold impact on the biomechanics of breastfeeding.

The belief that “there is no one correct way to do [fit and hold]” has become a catchcry amongst many breastfeeding support professionals and peer support groups. An insistence that this lack of clarity is actually best for mothers and babies prevails. Lactation consultants insist that "each mother must find her own way, there is no right way, just her way."

This idea is vigorously defended in both peer support and professional breastfeeding organisations, and enshrined in principles of neutrality, independence, and maternal empowerment.

Why has the belief that there is 'no right way to breastfeed' become so widespread?

It seems to me that providers and breastfeeding advocates hold to this perception because otherwise, those of us who care very deeply about breastfeeding women have to face up to the excruciatingly painful possibilities that, through no fault of our own,

• Leading voices in our field are failing breastfeeding women due ideological blind spots and inappropriately selective use of science

• That world-wide, our conferences and educational courses and professional support groups are in large part focussed on fundamentally ineffective clinical tools

• That breastfeeding support is a frontier and we have to rethink all that we thought we knew.

Although some leaders acknowledge that breastfeeding remains a clinical and research frontier (e.g. Stuebe 2021), the painful implications for clinical practice, day by day, are ignored. Because this is incredibly upsetting to contemplate, most breastfeeding medicine or lactation consultant leaders simply can’t afford to acknowledge this situation.

Yet knowledge about what we are aiming for biomechanically to achieve pain-free effective breastfeeding is fundamental to the empowerment of breastfeeding women, both preventatively and if they encounter nipple pain (which is the case for 80% of women who set out to breastfeed their babies).

It’s not even true to say that named approaches aren't used by our non-profit breastfeeding advocacy organisations, which continue to hold to the adage there is 'no right way to breastfeed'. ‘Baby-led breastfeeding’ (with widespread use and distribution of the video which benefits a private business Geddes Publications) and the trademarked ‘biological nurturing’ approach (demonstrated in a video used in hospitals) have been actively promoted by these organisations for many years.

If we insist to women there is 'no right way, only your way to breastfeed', breastfeeding support professionals are absolved from responsibility for developing new clinical skills, or from paying attention to new fit and hold work which comes out. Attempts to offer a systematic approach to fit and hold intervention remain highly resisted, including with social media backlashes against ‘trying to brand breastfeeding’.

Why is it essential (if practice is to be science-based) that we name and detail the specific approaches to fit and hold which we implement as clinicians?

Specific, research-based intervention models need to be named so that they can be distinguished from other approaches, replicated, and properly evaluated. This is fundamental to implementation science, which translates the research into a clinical or educational intervention, and then evaluates it.

Ultimately, breastfeeding women and their babies suffer unnecessarily when research-based efforts to innovate are met with ideologically motivated 'silencing' or commercial and social media backlash 'cancelling'.

Recommended resources

Why the saying there's no right way to breastfeed, only your way doesn't help

Selected references

Stuebe AM. We need patient-centred research in breastfeeding medicine. Breastfeeding Medicine. 2021;16(4):349-350.