Western Balkan Breastfeeding Moms Thwarted By Corruption And Old Wives' Tales: Discussion

Over the course of this project, we had the chance to discuss breastfeeding with numerous mothers from this region. We found that the very notion that a mother would choose, of her own volition, to feed formula rather than breast milk to her baby was outright offensive to many. The reasons for which mothers from this region end up formula-feeding their babies is, as such, much more complex than “a matter of personal choice”.

According to the World Health Organization:

“Poverty, difficulty in accessing health services, social marginalization, obesity (many pregnant women are now overweight or obese), policies in the workplace and the employment market, marketing of breast-milk substitutes, commercial "follow-on" and complementary foods are just some of the reasons for low breastfeeding rates and inequality in the WHO European Region.”

All the countries we surveyed have universal social healthcare systems, and treatment is accessible even to those who lack health insurance. As such, it would not appear that poverty prevents a large number of mothers from accessing healthcare services. Interestingly enough, we also also didn’t find that a significant number of mothers chose to formula feed because they had to return to work and leave their children in the care of others.

The widespread supplementation of breast milk with formula in maternity hospitals, whether the result of financial incentives for healthcare providers or due to cultural attitudes, seemed to have a larger negative impact on breastfeeding rates.

In addition, the prevalent belief that mother’s milk can suddenly disappear and that many mothers simply don’t have enough milk to feed their babies appeared to play a huge role mothers’ decisions to feed formula.

Asking Tereza Kis Miljkovic, a lactivist active across the whole region, and best known for her group "My Breastfeeding Support", which many of our respondents incidentally cited as one they belonged to, about the current situation as well as potential solutions, she answered:

"What percentage of women truly can't breastfeed? It is common knowledge that we're talking about single-digit numbers here, just like in the rest of the world. I can say, with certainty, that the practice of 'supplementing' is incredibly widespread. Those first postpartum days are very important for successful lactation, and we are dealing with missed days, not hours. I can say from experience that this difficult start can play a role, but not the most important role. After mothers and babies leave the hospital, erroneous expectations, misinformation, myths, and fear enter the scene. To every, even the smallest, dilemma, the offered answer is: bottle-feed your baby. This is where the support system fails, and why so many mothers than come to me and ask for help. Balkan mothers don't have any kind of genetic predisposition preventing them from breastfeeding. What they lack is education, support, and a place to turn."

Breastfeeding rates in the region we surveyed are influenced by a complex symphony of lacking knowledge about breastfeeding among healthcare providers, outdated practices in this area, patient perception of a healthcare cadre that is unwilling to help them or lacks time, insufficient patient awareness of the mechanics of breastfeeding, and detrimental society-wide attitudes towards breastfeeding, particularly the notion that many mothers do not have (enough) breast milk. The path towards higher breastfeeding rates can only be be found in addressing these problems.