Torch-bearers for breastfeeding are faced with the delicate act of balancing passion with purpose. Comparatively lower figures of breastfeeding in Ireland and the UK are frequently lamented and chin-stroked over. Likely reasons for these low rates are cited and fitted out with several column inches, more often than not by veterans of the game. And why not? No point drafting in a vegetarian to discuss the merits of a meat based diet.

Even so, I wonder about the quality of the debate on breastfeeding in this country in general. It is currently freighted with a lot of unequivocal assumptions that often transcend both purpose and passion. There is a tendency for the prevailing discussion to be fairly restrictive and pre-occupied with telling us what we already know, with the orthodoxy on the purported benefits going largely unchallenged.

The historical and cultural factors are probably a given at this stage, and we live in a world where women’s access to information (by choice or by thrust upon us) is unprecedented. Irish women aren’t beyond the reach of reason or reality of comparative scenarios elsewhere.

There is the over-arching assumption that if only women had more access to support, exposure to breastfeeding, and a better understanding of the “gift” of breast-milk, the current trends would be reversed. Mention is frequently made of the hangover of religious prudishness and so on. These are all valid concerns, and would undoubtedly lead to a more supportive environment, if eroded.

Few women, if anyone, would disagree with the underlying factors that contribute to historically low rates, but in making the case for the need for better support, and individual resilience, a more rounded and open discussion is required.

If the purpose of engaging in the debate is to facilitate the uptake of breastfeeding, then exposing the deficits in medical and community support, labour management, and calling out hostile societal attitudes is fair game. So too is speaking from an impassioned place of positive experience that too often competes with negativity on the airwaves of anecdotes.

However, openly making a judgement on the ability of women to currently withstand (or not) perceived pressures to give up is not. Nor is chalking low levels up exclusively to a culture of giving up. I’ve no doubt this is the case for some women, but not all, because I personally don’t identify with such a neat argument. Nor is over-stating the harm of formula and the far reaching benefits of breast-milk.

In walking this precarious trapeze, Zoe Williams of The Guardian comes closest to striking the balance for me.

“I could not have loved breastfeeding more if I’d been brainwashed; I experienced it as a kind of hallucinogenic experience. A bit like taking an E.

But I also had the strong suspicion that the claims made for its benefits – the higher IQ, the protection against obesity, the superior bonding, the warding off of disease both now and for ever, both for baby and for mother – were mostly bogus. A lot of the reasoning seemed syllogistic (babies born into low-income families end up fatter; low-income mothers breastfeed less than high-income mothers; therefore breastfeeding prevents obesity) or frankly lame. I knew a lot of mothers who formula fed; they didn’t seem to love their babies less. When I wrote a book about pregnancy, I included some of this lameness, while underlining the fact that, speaking for myself, I didn’t care whether or not the health benefits were real, I’d do it again even if it made the baby’s IQ go down.”

A year later, Williams attended a conference on infant feeding, which included a presentation from American academic, Joan B Wolf, who conducted a rigorous, close-range examination of the science behind pro-breastfeeding advice. She concluded the case for breast milk is hyperbolic. For more on this and other challenges of measuring benefits, and the questioning of current medical and scientific orthodoxy, see here.

We also live in a world where women are contending with busy lives and self-preservation comes in many guises. I know many women equipped with all the necessary knowledge who chose not to breastfeed, or gave up, for reasons concerned with vanity, convenience, mental health and so on. Each as legitimate as the other. We can assume that many women do not continue with breastfeeding due to frustration, lack of support etc., but I suspect that is not the full picture and until such time as the issue is unpicked more thoroughly, and credibly, the current cul-de-sac of chat will leave the majority (I jest) of us a little unsatisfied.

A rigorous discussion on attitudes and perceptions to breast-feeding in Ireland should address issues concerning entitlement, biases inherent within the health system and corresponding intimidation, the perception of breastfeeding as being a predominantly middle-class activity (having at one time in Ireland been associated with poverty), lack of support, affordability of resources, and the right to private choice versus the pressure from public health policy. Women need ownership of the discussion as much at the activity, but large swathes of them are missing. Advocates can’t presume to speak on their behalf, so an in-depth study in Ireland would be useful. And timely.

As Williams states: “In order for breastfeeding to have the no-alternative, liquid-gold status it enjoys in public health, its benefits would have to be so much more pronounced and demonstrable that you wouldn’t even need to demonstrate them. Furthermore, breastfeeding activists (or lactivists) shouldn’t have to borrow risk factors from the developing world to make mothers in Eastleigh feel breast milk is the only safe foodstuff for their children. …And maybe, for the public health effect the establishment is after, the inflexible approach is the right one, since it definitely keeps mothers plugging away.”

Meanwhile, all sorts of reasons will continue to be authoritatively cited including prudishness, vanity, and other cultural barriers. Non-breastfeeding women will continue to be excluded from the wider debate.

A few other unhelpful narratives not often highlighted: women giving expression to the awkwardness they feel about their bodies and its functions is just that, not a judgement of the successful and uninhibited breastfeeding habits of others. If there is a sincere desire to support women to overcome barriers to breastfeeding then ridiculing them with a basic biology lesson will probably only serve to undermine that objective. If they have an idea how they got pregnant, it’s likely they will have some understanding of the biological function of breasts. They’re not stupid. Support begins with hearing and understanding fears, not minimising them, or the challenges concerning the reconciliation of primal functions and sexuality, or modesty. Simplifying this with statements of the obvious has done little but patronise the very women requiring support.