When breastfeeding gets outsourced...

A group of mothers breastfeed their babies during a rally outside of Congress in Valparaiso City, about 121 km (75 miles) northwest of Santiago, August 1, 2012. The women are demanding a new law to give them more than one hour each workday to breastfeed their babies. This rally is part of the global breastfeeding week celebrated in 170 countries between August 1 to 7 to commemorate the Innocenti Declaration, which was formulated by the WHO and UNICEF in 1990 to protect, promote and support breastfeeding and improve the health of babies worldwide. REUTERS/Eliseo Fernandez (CHILE - Tags: HEALTH POLITICS SOCIETY CIVIL UNREST)

A group of mothers breastfeed their babies during a rally outside of Congress in Valparaiso City, about 121 km (75 miles) northwest of Santiago, August 1, 2012. The women are demanding a new law to give them more than one hour each workday to breastfeed their babies. This rally is part of the global breastfeeding week celebrated in 170 countries between August 1 to 7 to commemorate the Innocenti Declaration, which was formulated by the WHO and UNICEF in 1990 to protect, promote and support breastfeeding and improve the health of babies worldwide. REUTERS/Eliseo Fernandez (CHILE - Tags: HEALTH POLITICS SOCIETY CIVIL UNREST)

Published May 28, 2013

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London - At first glance, the scene appears to encapsulate the precious bond between mother and newborn. As four-week-old Esme starts grizzling, Cat Homer instinctively unbuttons her top and tenderly puts the tiny baby to her breast.

After Esme has finished her feed, sated with milk, she dozes off in the woman’s arms. But soon it’s time to go back to Mommy, who has been looking on with pride. Because Cat is not Esme’s mother. That role belongs to Natasha Batsford, who has just watched her newborn being breastfed by another woman.

It’s a scene some will find unnatural. After all, there are few activities more intimate than breastfeeding your child and many mothers feel this time together is the most cherished of all. But Natasha is one of an increasing number who turn to other women to provide their babies with breast milk when they can’t.

Informal arrangements like Cat and Natasha’s are on the rise in the UK as the breast-is-best lobby exerts increasing pressure on moms to eschew formula milk, while the NHS promotes as “ideal” the ambitious - and seldom realised - target that all new moms should breastfeed for the first six months.

Some desperate mothers place requests on Facebook for someone - anyone - to feed their baby. And a website, Human Milk 4 Human Babies, unites lactating moms who have surplus breast milk - and are either offering to express it or act as wet nurses - with mothers who are unable to feed their own babies.

Human Milk 4 Human Babies has several online offshoots targeting women in different countries, including Canada and the US, but its British network is by far the busiest in the world, with many thousands of users. It estimates that at least 3 000 women in the UK have used the site to share milk. However, Natasha and Cat reached their arrangement after becoming friends through a National Childbirth Trust group when their first children were born.

Natasha had no milk after suffering health complications during Esme’s birth. But Cat, whose son, Rory, is seven months older than Esme, had a surplus she was willing to share.

The two women discussed the possibility of wet-nursing and then, one day when Esme was about a month old, they seized the moment at a coffee morning.

“Esme was hungry,” recalls Natasha, 35. “She’d lost a lot of weight because I hadn’t been able to feed her and she was grumbling for food.

“I’d been telling everyone how my health visitor had been putting pressure on me to formula feed to get her weight up, when Cat just said: ‘Do you want me to feed her now?’

“So I said: ‘Actually, yes please,’ and passed Esme to her. Esme latched on and started to feed at once. She was utterly content; blissed out. She fed till she was milk-drunk.”

Natasha, an IT manager, insists she did not feel that the bond with her daughter had been compromised.

“It did not occur to me to feel jealous that Cat was providing what I could not,” she says. “I just felt she had made an incredibly generous and life-affirming gesture.”

For the next six weeks, Natasha ferried Esme to Cat’s home every afternoon for breastfeeding sessions.

The rest of the time, she fed Esme using breast milk donated by a stranger she had met via a Facebook page, where women can offer to donate their milk.

The practice of wet-nursing dates back to ancient times - there are references to it in the Bible - and was traditionally the preserve of well-off families. But it fell out of fashion in the 19th century amid health and moral concerns.

While Natasha and Cat feel their arrangement was simple common-sense, there are a raft of reasons - practical, health-related and emotional - why experts warn the practice can be problematic.

Clare Byam-Cook, author of What to Expect When You’re Breast-Feeding... And What If You Can’t?, says: “If you live in a developing country where there is no safe alternative to breast milk it’s the perfect solution, but in Britain formula milk is so sophisticated that it really is a very safe alternative.

“I can’t understand why any mom would think it is so vitally important to breastfeed that she’d get someone else to do it for her. The mom is missing out on intimate bonding time with her baby, because you can cuddle your baby as you bottle feed, just as you can when you breastfeed.

“Essentially, another woman is giving your baby her bodily fluids, and there is a chance of infection. It’s an extreme example, but mothers with Aids are advised not to breastfeed because of the risk of passing on the virus.

“Medications could also be passed on to a baby. If you do it, you really have to trust the other person.”

Byam-Cook is a breastfeeding advocate who has advised, among many others, actresses Helena Bonham Carter and Kate Winslet. But she is still concerned that zealots are exerting unnecessary pressure on new moms to breastfeed when many are unable.

“We’ve been brainwashed into believing that breastfeeding is the panacea for perfect infant health. If we formula-feed and something goes wrong, we assume it’s because of the bottle-feeding,” she says. “There’s such a huge amount of hype surrounding breastfeeding that mothers feel inadequate when they’re unable to do it.”

For Natasha, who is married to Keith, 33, and has an older son Alfie, now three, there was a reason why she could not produce milk herself. She had become perilously ill during Esme’s birth in November 2011 with a very rare complication of pregnancy that caused her heart to fail.

She recalls: “After Esme was born, I spent ten days in coronary care. I had every test imaginable: angiograms, ECGs, and I was advised not to breastfeed because the radioactive dye used in the tests could harm my baby.

“I was also put on strong diuretics to disperse fluid that had gathered in my chest, and I was completely dehydrated. So I was unable to produce milk anyway.”

Many mothers would have considered this adequate reason to formula feed, but Natasha put out a Facebook alert for frozen expressed milk.

“I knew the benefits Esme would get from breast-milk,” she says.

These include a reduced risk of developing chest and ear infections, becoming obese later in life and of developing eczema. In addition, her son, Alfie, was extremely allergic to cow’s milk, which is the main component of baby formula, and she feared Esme would have the same reaction.

A mom who lived nearby, Helen Coulson, saw the appeal on Facebook. She had a surplus which she expressed and donated. Natasha didn’t know Helen then, but the two have since become friends.

While Helen’s spare milk kept them going for a while, Natasha needed a contingency plan and searched constantly for back-up supplies. Then Cat, 27, offered help. For six weeks Natasha and Esme shuttled between their home in Arlesey, Beds, and Cat’s in Letchworth, Herts, so that Cat, a trainee midwife, could breastfeed her.

Natasha did not pay for the services of her informal wet nurse, and simply returned her friend’s altruism with gratitude.

Cat, who also has a daughter Heidi, four, with her husband Stephen, 30, a technical services manager, insists the arrangement was a pleasure.

“I didn’t mind feeding Esme,” she says. “I’d do it for anyone, even a stranger. I had the milk and as my son, Rory, was seven months old, he was feeding only once or twice a day.

“I knew how important it was for Natasha that Esme should have breast milk. It was never a chore.”

While she insists her husband was fine with the situation, some friends, she concedes, were concerned when she told them about the arrangement. “They wrinkled their noses,” Cat admits. “I don’t think they understood because a lot of women think it’s a very private thing between a mom and baby. They would not want it for themselves. And I can accept some women would feel envious if another woman was feeding their child.

“I know it’s unusual to be as dispassionate as Natasha and I were. But I’m a logical, not emotional, person.

“Of course, I felt close to Esme when I fed her. I held her. I winded her. I cuddled her when she dozed off. But I distanced myself emotionally. I wasn’t supposed to be bonding.”

Natasha, meanwhile, says she simply felt “overwhelmed” by Cat’s help. “Esme had been losing weight,” she says. “I’d had heart failure, a Caesarean section, and I had a demanding toddler. I had no milk. A lot of moms in my position would have given up and bottle fed.

“There was no emotional tug - it was just a practical arrangement. It was nice to sit and chat to Cat as she fed.

“Esme was such a new baby, so unaware. She didn’t seek eye contact with Cat. I didn’t worry she was forming an attachment that would be difficult to break. I’d formed a very close bond with Esme. We’d slept together, I’d carried her around in a sling practically constantly. I didn’t feel that closeness was being eroded.”

Natasha insists she did not feel even a frisson of envy that she was unable to perform this intimate task herself. And she says her husband, Keith, happily accepted the arrangement.

“My main concern was not to impose on Cat,” she says. “I didn’t want to take advantage. I’d just text her each day and ask: ‘Is it OK if we come over?’ Then, after six weeks or so, it stopped as quietly as it had started.”

Esme was, by then, two-and-a-half months old. She had gained weight and was the right size for her age. Natasha had also stopped taking her medication and begun to produce her own milk. So she began to bottle-feed Esme with a mix of donated milk and her own expressed milk.

“She’d been a fractious baby, but she became contented,” says Natasha. “I’m so grateful to Cat.”

While such informal arrangements among friends and sisters are becoming more frequent in the UK, in the US wet nurse agencies are commonplace.

Christine Hill, author of Pregnancy Guide and an antenatal teacher, laments this. “I think it’s really sad mothers are being so programmed by breast milk fanatics that they feel it’s preferable for their baby to be nursed by someone else than to have formula milk.

“In my view, if a mother can’t feed, a bottle is better for both baby and mom.”

For years, too, child psychologists have insisted that a mysterious bond forms between a woman and her suckling infant. Indeed, the actress Isabella Rossellini describes in her autobiography how she and her twin sister, Ingrid, were cared for by a wet nurse in Italy in the Fifties.

She recounts having an extraordinary emotional response as an adult to a man in a crowd many years later. He turned out to be the son of her wet nurse, her ‘milk brother’ as she called him, and she had sensed their connection immediately although she had seen him only once, 30 years earlier.

Will a similar kinship persist between Cat and Natasha’s families? Despite the intimacy she shared with baby Esme, Cat is doubtful. “I don’t feel any closer to Esme than I did before I breastfed her. It wasn’t an extraordinary thing for me to do,” she says.

Esme is now 17 months old and Natasha is pregnant with her third child. She is making back-up plans in case she cannot breast feed again, and two friends have said they will help out.

Clare Byam-Cook, meanwhile, sounds a note of caution. She urges all new moms not to become obsessed by the compulsion to provide mother’s milk at any cost.

“I’ve just visited a mom whose baby has had three operations on her mouth to help her suckle, but she still becomes hysterical every time she’s put on to the breast.

“The parents’ home looks like a special-care baby unit. They’ve spent a fortune on a lactation consultant and that hasn’t worked either. They haven’t left the house for four weeks; everyone is anxious and wretched and the baby isn’t thriving.

“Many mothers cannot breastfeed for a multitude of reasons, and I worry that when other moms breastfeed their friends’ babies they are just adding to the hype and hysteria and creating more pressure.

“I expect a torrent of criticism for saying it, but I’d advise them that sustaining a relationship with their husband or partner is more important than dashing off to a friend’s house so she can breastfeed the baby.

“I’d say: ‘Just go out as a family for a walk in the park, enjoy the sunshine, sit on a bench - and give your baby a bottle instead.’” - Daily Mail

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