Out of the Blues is a Dubai-based group created to support mothers suffering from postnatal illness (PNI), many of whom have had difficulties with breastfeeding. We read with a great deal of interest of the mandatory breastfeeding clause in the new UAE Child Rights Law and felt compelled to respond.
As a group we wholeheartedly agree that breastfeeding should be encouraged and that the sentiment is a good one that clearly follows international guidelines.
However, as many of the new mothers we encounter are already under significant pressure, we are concerned that enacting a law that leaves mothers facing potential punishment could be a step too far.
It’s great that the new law will only apply to mothers who are able to breastfeed. It is unclear, however, who will be responsible for making that assessment. At this time, the law doesn’t state that each and every mother having difficulties breastfeeding will be assessed by a specialist. Lactation consultants and breastfeeding specialists can be hard to access in the UAE, which leads us to ask who will make the judgement on who is and isn’t “able”?
There are so many reasons why a mother may not be able to effectively breastfeed her child. One, Dysphoric Milk Ejection Reflex (D-MER), is a hormonal reaction that presents itself with slight variations depending on the mother experiencing it, but it has one common characteristic – a wave of negative or even devastating emotion just prior to let down. Although D-MER is treatable, it needs to be properly diagnosed early on to avoid it leading to postnatal depression and other negative feelings associated with breastfeeding.
Women who have had breast reduction surgery can suffer from a low supply of breast milk and often won’t be able to nurse exclusively. There is also a chance that women who have had breast augmentation may also find they suffer supply problems.
In both cases mothers would ideally be able to swap between breast milk and formula, however, for working mums this would be dependent on establishing a good breastfeeding routine and established supply and demand prior to returning to work.
Some women have great supply but their babies continue to lose weight, and sadly, in a large percentage of such cases, doctors will insist mothers supplement with formula. There are alternatives, but more breastfeeding education and support for mothers is needed to ensure these are more widely used.
Mothers of babies in neonatal intensive care units with medical difficulties are often not allowed to even hold their babies, and many aren’t allowed to nurse or even feed for a period of time. Again, with support and education a lot of these babies would learn later to latch and probably nurse well. However, where that care and support isn’t readily available, these babies have no choice but to be bottle fed as, without the appropriate stimulation and bonding with their baby, mothers supply will be affected.
There are many more circumstances that result in women failing to breastfeed effectively and, in its present form, this law does not seem to make allowances for these women. The danger is that with the threat of punishment, these women could face additional stress at an already challenging time, risking serious repercussions and potentially contributing to postnatal depression.
It would also be very difficult for many working mums to be able to breastfeed for two years without additional allowances from employers, which will not currently be enshrined in this law. Perhaps the same sentiment could have been achieved by increasing funding for breastfeeding education, legislating mandatory support from health professionals for breastfeeding women, clarifying their right to breastfeed in public, compelling employers to support breastfeeding and pumping at work, and perhaps even providing incentives for successful breastfeeding as in the case of certain European countries.
New mothers are extremely vulnerable and need more support, encouragement and education. It is our opinion that, while encouraging women to breastfeed is a laudable aim, it is by supporting those who can and want to breastfeed, and not by punishing those who can’t, that we will reap the benefits we all want to see in our society.
Out of the Blues is a support group for women with postnatal illness based in Dubai