In Italy there seems to be a wonky disconnect between recognizing the importance of breastfeeding and actually supporting and promoting it effectively. On the one hand, when Peanut was a baby, perfect strangers regularly asked me whether he was getting latte materno, smiling approvingly when I answered in the affirmative.On the other hand, I’ve heard more than once that Italian women prefer not to nurse because it “ruins” their breasts.

The latter may just be a casual anecdote, but it hints at a widespread national attitude that has surely been both exacerbated and caused by a regrettable lack of institutional support. Back in 1991 when the World Health Organization and UNICEF launched the Baby-Friendly Hospital Initiative to ensure maternity facilities do their utmost to encourage and assist in breastfeeding, Italy had zero hospitals that met their criteria. Now it has 24. That may not be bad, but neither is it commendable if you compare it to the 34 in Canada, a country with a little over half the population of Italy.

We’re actually extremely lucky in Florence with a full three such hospitals located within a 40-km radius. I regrettably did not benefit from any of these since I cavalierly tried to get into maternity “heaven” (the Margherita birthing centre) and wound up in hell (Careggi hospital). I therefore did not even get to touch my baby until nearly 20 hours after he was born. Neither was any lactation consultant ever assigned to me, so I had to cobble together the varied and sometimes conflicting advice from whatever pediatric nurses happened to be in the same room as I nervously made my first attempts to breastfeed. And despite staying just down the hall from him, I was told I could only see my baby twice a day (until I discovered on the second-to-last day of my week-long stay that I’d been given the wrong information and could actually have visited him more often).

View from my bed in the Careggi maternity ward

Formula feeding instructions, Careggi maternity ward

If a woman is lucky enough to still get breastfeeding going here despite such obstacles, she’s then bombarded with pressure (from medical professionals and family members alike) to obsessively weigh her baby after every feed and give her aggiunti — to supplement her breast milk with formula.

Now, I certainly understand the importance of monitoring the weight gain of a preemie, but for a baby whose birth weight is well within the healthy range, as mine was (3.5 kilos), surely it is enough to weigh him once a week? I dared suggest this to my mother-in-law and she could barely disguise her shock. Ma, non si fa!(Why, that’s just not done!)

While this was one battle I ended up winning, that of the aggiunti was not. Peanut had been given formula from a bottle for 90% of his 11-day stay in the hospital, so getting him to switch exclusively to boobie once we were home was crazy hard. With him crying and sputtering at my breast as though I were forcing him to guzzle gasoline, I gave in after less than 24 hours.

With hindsight, I wish I’d stood my ground, because I’m sure we would have been fine after a couple of (albeit surely intense) days. Instead, it took several weeks before we somewhat miraculously were able to stop supplementing, during which time I came perilously close to abandoning the whole endeavour altogether.

Now, having experienced the anguish of my baby wailing at my breast because I didn’t have enough milk; having had to attach and re-attach him over and over again until my nipples felt like they were on fire; seeing that giving him a bottle of formula was the only thing that stopped him from screaming; well, I will forever understand women who choose — horror of horrors! — not to breastfeed.

This is coming from a woman who knew she wanted to nurse long before even trying to get pregnant, who paid to go to a special “nature-centered” pre-natal class instead of a state-paid one in order to get the best possible tools and advice, having already gathered that breastfeeding is not necessarily as easy as you’d think for something so “natural”.

I’m really proud of myself for having put in that time and effort, both in preparation and during the “launching” phase, since I’m convinced Peanut would be a formula-fed infant if I hadn’t. Even the pediatrician whom we saw at the hospital for a two-month follow-up was impressed with my perseverance, since she knew all too well the odds we had faced. Indeed, the planets have to be aligned perfectly or something for a woman to succeed at nursing otherwise. A fellow new-mom friend acknowledged as much after hearing my story. She pretty much took the opposite tack, not taking any pre-natal classes and barely reading a thing before giving birth, which she just happened to do at one of Italy’s few Baby-Friendly hospitals. She highly doubts she would have breastfed her baby if she’d gone through what I did, where I did.

I find it monstrously unfair that, for the most part, the onus is placed on us women to make sure breastfeeding gets off to the proper start, rather than on the institutions and professionals we depend on during and after childbirth. In fact, according to the ostetrica who taught my pre-natal class, the vast majority of nursing problems can be attributed to maternity-ward staff giving newborns a bottle during those first precious, impressionable hours of their lives. This can easily lead to “nipple confusion”, among other things, since sucking on a bottle is vastly different from nursing, both in terms of mouth/tongue placement and milk flow.

Accordingly, I also think it’s deplorable how we judge women who choose to bottle-feed their infants, since we have no idea the mental, emotional and/or physical pain that might have led them to make such a choice. In all likelihood, it hardly felt like a choice at all but rather the result of being separated from their baby during the pivotal first two hours of mother-infant bonding that gives mum and baby a fighting chance at nursing. (Which is not however to say that women who choose to bottle-feed for other reasons should be judged either).

What’s interesting is that this judgment usually comes from the very people ostensibly advocating for mothers, yet somehow mothers themselves end up bearing the brunt of the blame and criticism. For example, I paid the same ostetrica who taught my class to visit us at home about a week after we’d brought Peanut home. What I’d hoped would be an informative and encouraging consultation was instead an extended exercise in “I told you so” (she had in fact warned me about the hospital where we ended up) and making me feel quite pessimistic by saying it was unlikely I’d be able to sustain the nursing past a few weeks at the rate I was going. (I do feel not a little smug having proved her wrong).

It’s hardcore “lactivists” like this whose scorn I fear when I admit to having supplemented with formula throughout Peanut’s first six months (or more precisely having someone else give it to him). While I’m the first to sing breast milk’s praises, I also frankly feel grateful that Peanut was flexible enough to afford me the spur-of-the-moment freedom of having that second drink at Christmas dinner or enjoying a night out with the girls. I wish there was more encouragement for this kind of middle ground, that we mums were told more “whatever works, you’re doing a great job,” rather than having to deal with all the judgment, guilt and blame.

During those fraught postpartum weeks when I didn’t know if I’d be able to pull this nursing thing off and someone like the grocery store clerk asked me if I was giving Peanut my milk, I’d respond with a mixture of defensiveness and hope: “I’m trying.” So I truly feel for all those women out there who have to answer that question in the negative, through no fault of their own; who are thus made to feel inadequate and are constantly reminded of how they don’t quite measure up to Italian society’s contradictory expectations of them.