"If we continue on our current path, we will face the collapse of everything that gives us our security: food production, access to fresh water, habitable ambient temperature and ocean food chains. … And if the natural world can no longer support the most basic of our needs, then much of the rest of civilization will quickly break down." Sir David Attenborough 24 February 2021, United Nations Security Council session on climate

Mother-blaming remains widespread (but is often quite unconscious)

In a workshop I gave on Preventing Overdiagnosis in Early Life, at the 7th International Preventing Overdiagnosis Conference in 2019 in Sydney, a kind Professor of General Practice, who had only the best of intentions, tried to take over and wrap up for me at the end. I think he decided I was floundering.

"Essentially, these poor mothers are all much too worried," he explained with some authority to my small group of participants, "and they need reassurance that the baby is alright so they can relax."

Hmm. Wouldn't you be a tad uptight, I wanted to reply (but didn't), if your baby was screaming whenever you tried to feed him or your nipples were a bloody oozing mess and everything you read explained in some detail why breastfeeding is best for your baby's development?

Frankly, the conviction that the range of baby behaviour problems which emerge in early life are 'because baby is picking up on your anxiety' is only removed by a matter of degree from the 19th century practice of diagnosing puerperal mania for a wide range of physical and mental problems experienced by women after birth, including the delirium caused by sepsis, psychosis, and postnatal depression.

Or it's only removed by a matter of degree from the diagnosis of hysteria which was given to a range of female neurological and psychological problems, including epilepsy, up until a decade before my birth.

I am reminded of a lovely young psychologist who suggested to me that women who gave up on breastfeeding were perhaps just not able to handle pain, didn't have the mental strategies to persevere. She herself had endured and came out the other side.

But only the lucky ones find that their problems resolve with the passage of time. For others, no matter what they try and through no fault of their own, breastfeeding is a nightmare that goes on and on, until they stop.

Both mother-blaming and pathologising the baby shift responsibility away from health system blind spots

Mother-blaming shifts responsibility away from health professionals and the health system itself back onto an individual woman, who is diagnosed with psychological vulnerabilities and whom we then need to treat. Sometimes this might even reinforce our sense of competence as health profesionals. Our health system's unconscious and widespread mother-blaming is deeply internalized by women with babies, and promotes postnatal anxiety and depression.

Breastfeeding advocates continue to accidentally promote mother-blaming whenever they use phrases like: "it's your anxiety affecting the baby", or "your nipples are flat".

For the past fifty years, baby-blaming (reflux, allergy, tongue tie, asymmetries, muscle tone) has helped to shift the focus away from the woman's supposed failings, onto the baby.

But both mother-blaming and baby-blaming conveniently ignore the historical devaluing of research into clinical breastfeeding support and our lack of effective strategies for repairing the inevitable breastfeeding problems which emerge within our biomedically and technologically advanced health systems, and how these unidentified problems affect all aspects of life with an infant.

We live amidst disrupted and devaluing attitudes towards the female body

Late capitalist society rewards lifestyles which limit daily movement, which disrupt musculoskeletal ease, alignment and strength (for example, through long hours in front of the computer.) We live in a society which promotes foods and drinks that are not wholesome for the human gut or immunity, which promote weight gain.

We also live in a society which highly values certain female body and breast shapes deemed attractive to men, and which marginalises or demeans the body of the 'other' - the gender fluid or transgender body, the 'fat' or the 'ugly' or the unusually shaped or the disabled body, sometimes even the homosexual body. This is cruel but widespread, still, and perhaps even worsening at the moment. As women, we diet and undergo surgery and work-out for long hours in the gym and may even develop eating disorders in order to sculpt ourselves into an acceptable shape.

Is it any surprise that we learn to dissociate from the needs of our sensitive creature-body in order to fit in with societal demands, in order to belong? Each of us, as women, needs to reckon with this internalized societal pressure at some time in our lives. In a world that remains, for all the tireless work of our feminist forebears, disruptive of an easy, health-affirming relationship with our female bodies, there is still so much that damages our physicality and embodied identities.

We've lost the opportunity to notice women casually doing the work of breastfeeding as we go about our lives, for instance. We've lost the great myths, the lactating divinities who taught us, once upon a time, the heroism and magnificence of this work of breastfeeding our babies.

In a body-disruptive world, it's not a surprise to find that breastfeeding ease is also often disrupted

In our body-disruptive world, it is not surprising that there is not only a great deal of difficulty fitting a baby into a mother's body for pain-free and efficient breastfeeding, but that this fundamental problem is still largely 'unseen' by the very health professionals and researchers who specialise in helping women with breastfeeding.

We certainly give answers, but these answers often pathologise the mother or baby and are not cognizant of the surprisingly subtle and exquisitely sensitive interface between the two bodies concerned, or of skills for helping them fit together effectively.

Despite the highly breastfeeding-disruptive context of medicalised births, we are only beginning to develop the art and science of clinical repair. This is scandalous, given that we spend billions of dollars sending rockets into outer space, or transporting people into outer space, or on arsenals of weapons of mass destruction. This societal failure mirrors our historical difficulty with female embodiment.

In the meantime, a breastfeeding woman feels helpless in her experience of breast or nipple pain or her baby's distress, and because she is brave, she grits her teeth and heroically endures for as long as she can. Health professionals and bodyworker therapists may accidentally reinforce the societal belief, which becomes a woman's own deeply internalised belief, that the body - her baby's, her own - is against her, the body fails her, the body is incompetent.

Then we label a breastfeeding woman's desperately worried thoughts, her grief and her tears, her shutdown exhausted numbness, her simmering anger that everyone is giving her different advice, as her psychological dysfunction! Her unreasonable anxiety! Her depressed mood!

As health professionals we give her a hundred reasons why she should pursue the ideal, which is breastfeeding her baby, then in private conversations we might shake our heads, frustrated by what we refer to as new mothers' worsening anxiety and perfectionism.

How unkind we can be to breastfeeding women, even though our intention is only to help!