Dr Michael Gannon, ABC Radio Melbourne, Breastfeeding

RAFAEL EPSTEIN:   The AMA have tweaked their advice on breastfeeding. It's still recommended as the best way to feed a baby but if you've had experience, there's been people in your circle who've gone through that experience, sometimes the mother feels blamed for not being able or choosing not to. So the AMA have responded.

Dr Michael Gannon, joins us. He's President of the AMA. Good morning.

MICHAEL GANNON:   Good morning, Raf.

RAFAEL EPSTEIN:    What's the difference with the new breastfeeding guidelines?

MICHAEL GANNON:    Well, this is our Position Statement. It still very much sets out breastfeeding as the preferred method of infant nutrition. And in fact it calls for greater support to increase the number of women who continue breastfeeding. Ninety-six per cent of women commence breastfeeding but by four months it's down to 39 per cent. So, a very important element of our Position Statement is to ask for more support to assist women get through those difficult times. But no matter how much support you give some women, they won't be able to breastfeed and they shouldn't be made to feel as if they've failed.

RAFAEL EPSTEIN:    So, how do you do that balancing act, Michael Gannon? Because that's interesting, if say four in 10 women- it's only four in ten women who are still breastfeeding at four months, you want that number to be higher but you don't want women to feel guilty if they can't or won't. How do you balance that?

MICHAEL GANNON:    Well, the practice of medicine is full of everyday balancing acts and it's full of many, many shades of grey. But I think that you go back to what the patients themselves want. That's a really important starting point. So, if a patient comes and sees a doctor and says that they want additional support, they want prescription of medications that might augment milk supply, if they want advice, if they want to be helped through that really difficult time in the first few weeks so that they can get through, that should be afforded. But we should also respect the decisions of women who - for whatever reason - can't breastfeed or choose not to. It's like every other bit of human anatomy and physiology, some women make enough milk for not only their own child but potentially another four babies down the street. Other women, for whatever reason, will struggle to breastfeed their baby.

RAFAEL EPSTEIN:   Do you think women are made to feel bad if they don't breastfeed?

MICHAEL GANNON:    I think they are and I think that's entirely inappropriate. It's a personal decision and there might be reasons why they choose not to. One thing for sure is that there's a lot of women - and some young mums listening to your program will see the truth in this - they might feed their baby for up to an hour and they might be settling their baby for up to an hour, then they might be sitting on a machine expressing breast milk for another hour. And if that cycle is anything much more than three hours, you can see why they get exhausted, you can see why difficulties in breastfeeding might be a substantial contributor to postnatal depression.

RAFAEL EPSTEIN:    How does that happen, do you think, that women- I mean, I know in my experience of child rearing, there's a lot of judgement around on everything you decide to do from every nappy to every decision at a playground. But what sort of things are said to women, do you think, that have an impact?

MICHAEL GANNON:    I think women can be awful to each other. And I think that so many of them set themselves up to fail with unrealistic expectations about what child rearing is about. I mean, fortunately we live in a part of the world, we live in a time in history where the expectation is that women will survive their birth, for a start. It's not that far back in history - and there are certainly- there's 40 countries on the planet where being pregnant, you literally take your life in your hands. We've moved from that in the space of two or three generations to now judging people who make the choices that others decide aren't appropriate. So, we judge women on whether they have pain relief in labour, we judge them on whether or not they can breastfeed. I think we need a bit more compassion, a bit more understanding, and just realising that everyone's a bit different.

RAFAEL EPSTEIN:   And please don't take this as a judgement on the AMA [laughs] because I have a lot of respect for your organisation. But how many GPs are going to change what they do because you changed your advice policy?

MICHAEL GANNON:    Well, it's really important that we put out policies on this area and on other matters of public health. Quite often when we say things, they're controversial but the AMA is out there trying to lead Australia's doctors and do whatever we can to protect the public health, make Australia a better place for our patients wherever they are.

RAFAEL EPSTEIN:   Okay. Thanks so much for your time.

MICHAEL GANNON:  Pleasure, Raf.

RAFAEL EPSTEIN:    That's Dr Michael Gannon, the President of the AMA. Still saying breastfeeding's best but also saying mothers may feel a sense of guilt or failure and it's important their GPs and other medical practitioners reassure them about the efficacy and safety or formula feeding and that they work to remove any stigma.

15 August 2017

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