Monday
Apr122010
It's not about picking on moms, it's about breaking down societal barriers
Monday, April 12, 2010 
I'm getting tired of hearing the same old thing over and over again. Every time a study comes out that talks about the benefits of breastfeeding, whether it is the benefits to the child, the benefits to the mom, or the benefits to society in general, people get their noses out of joint. They say things like "don't make moms feel guilty for formula feeding" or "quit picking on moms who don't breast-feed". In fact that second statement is the title of a post published today on creators.com by Lenore Skenazy, the author of Free Range Kids.
In her post, which is in response to the study The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis, which I wrote about a few days ago, Lenore says:
Why are we so eager to terrify mothers who don't breast-feed? Why don't we terrify the moms AND dads who put their children in cars? Every day, five or six children die in car crashes, even kids in car seats. Yet we don't run national stories that say, "IRRESPONSIBLE PARENTS CONTINUE TO DRIVE THEIR CHILDREN," or, "COUNTRY COULD SAVE BILLIONS IF PARENTS QUIT TRANSPORTING KIDS IN CARS." That's because driving is too important. Everyone understands that if we couldn't drive our kids around, we couldn't do anything. Walk them everywhere? It's impractical. It's impossible. The benefits don't outweigh the costs.
But when it comes to a mother's time, who cares? It's hard to breast-feed? So what. It hurts? So what. It's exceedingly difficult to go back to work and pump and schlep and get up for all the nighttime feedings and still function during the day? What are you, lady, some kind of baby killer?
I think she (and many others) missed the point of the study altogether. The intent of the study is not to pick on moms or to make them feel guilty. The point of the study is to achieve greater societal, political, and institutional support for breastfeeding.
To borrow from Lenore's analogy, I think it would be more pertinent to compare support for breastfeeding with support for public transportation. We all know that travel by car is more expensive, more dangerous, and worse for the environment than using public transportation. However, when a study talks about the ills of car travel and points to the need for greater support and investment in public transportation, no one starts whining about car drivers being picked on (okay, maybe not no one....but those who do certainly come out looking like idiots).
It is time that we accept the facts. When compared with breastfeeding, formula has risks. That doesn't mean that every mom who doesn't breastfeed is "some kind of baby killer." What it does mean is that every mom who does want to breastfeed deserves a fighting chance to be able to do so. She deserves knowledgeable health care providers. She deserves a supportive family. She deserves a supportive work environment. She deserves access to maternity leave. She deserves to be able to breastfeed in public without being harassed. She deserves to not have unsolicited free formula showing up on her doorstep.
I'm with you on this Lenore - it is time to quit picking on moms who don't breast-feed, but it isn't time to quit talking about the importance of breastfeeding and the risks of formula. At least not until most moms who want to breastfeed are able to do so.
Read more:
- Societal Barriers to Breastfeeding - PhD in Parenting Blog
- What are the Breastfeeding Booby Traps - Best for Babes
- Breastfeeding and Guilt - Jack Newman, MD, FRCPC
Image credit: JAWarren on flickr
Reader Comments (84)
Bah, you beat me to it. ;-) I was going to write a post about this very issue, though with a different analogy. I'll let you know when mine's up, if you want.
I think this is a great analogy - if donor milk, wet-nursing and so on were readily and freely available, just like if accessible sustainable transport were readily and freely available, even people with physical inability to breastfeed or walk to the bus-stop could choose not to use formula or drive a car. But until then, some people are stuck with it.
And because there's more profit in the market this way for the big players, it's really difficult to make real change happen.
Breastfeeding isn't driving a car or public transportation. Breastfeeding isn't carseats. Breastfeeding isn't drinking water or eating vegetables. Analogies only go so far, people. Let's not cheapen what breastfeeding is by insisting it's just like what it's not.
I guess my biggest confusion about the outrage against breastfeeding studies is that I fundamentally do not believe that we should ever stop researching/studying/learning/talking about/reporting on anything in the name of protecting people's feelings or not making people feel guilty for their choices.
The minute that we stop education in the name of "don't pick on that mom for..." is a sad day. Research and education are a GOOD thing.
Wonderful post, Annie! I often don't say anything about breastfeeding because I never know if a formula feeding mother (or friend of one) is in the room and I don't want to offend anyone. I wish I felt free to talk about how beneficial it is without fear of hurting someone's feelings.
Great post.
I think that breastfeeding vs. formula is simply the very first thing that a mother comes up against. Because whoa. The judging and defensiveness on a wide swatch of topics does not end. Ever. (or so it seems)
For example? Like many folks, I have been trying to talk about our food supply and all of the crap loaded into it. Guess what? I am getting similar reactions as when I tried to talk about formula safety/quality. Well, sorry folks - you may love Kraft Mac n' Cheese, but it is loaded with crap and artificial food colorings NOT allowed in other countries.
Am I trying to talk about food safety so that I make another parent feel bad? No. Absolutely, NO. But I am trying to get the WORD out, to educate. Because people really, genuinely and simply are not AWARE.
I see the very same correlation with formula. There is some scary stuff in formulas and I am so grateful my kid never had any of it.. However, parents simply do not want to hear about the scary stuff in formula. Period.
Wrong or not.
What I find so hard about this whole issue is the perception that *I as a "successful" breastfeeding mother* can make a formula feeding mother / combo feeding mother feel guilty. What I say or do for my child is personal to our family unit. If I say my goal is to let my son self-wean, how can that make someone else feel guilty? If that mom is 100% happy with her decision to use formula, then why would she feel guilty?
Guilt is a personal emotion but the only person who can make me feel guilty is me. No study, no website, only me.
Yeah, that.
You know what's just occurred to me? Whenever a study like this comes out, or whenever the risks of formula are mentioned (and I do think it should be framed that way, as opposed to the "benefits of breastfeeding", since breastfeeding is the biological norm...) discussion inevitably comes down to "you're picking on formula feeding moms!" According to the stats, though, isn't that the vast majority, at least by the age of six months? So, the minority (moms that ebf or nurse past 6 mos -- what was the number, 13%?) is "making" the majority feel guilty? Huh.
I also don't see how it's the minority that is making the majority feel bad. My daughter is only 3 months old and I've already been told to wear a cover when I nurse her even though I nurse her completely discreetly with nothing showing. Many people have come up to me and not even known that she was nursing. But it might make people uncomfortable, so I'm asked to wear a very obvious cover that says "hey everyone I'm nursing here!!" If I was bottle-feeding I"m sure I wouldn't get the same flack, and as she gets older I'm sure I'll just hear it more from people. I want to take these studies and shove them in their faces, but that won't help either...but who is being picked on here?!
Here's a suggested response to "when are you going to start cow's milk?"
When the baby grows horns.
FWIW I'm not anti-cow milk, my children drink it sometimes, but they've never been big fans and being half-Chinese that's probably a good thing - more than 90% of Chinese people are at least somewhat lactose intolerant. I'm anti-focusing-on-any-one-dietary-component-in-what-should-be-a-complex-diet.. you know, after the kid has a full set of teeth and all ;)
Actually, there are legal court documents that have said basically that about breastfeeding mothers - that they're negligent or being physically inappropriate with their nurslings because they're "still" breastfeeding (the "too old" cut-off in the complaint varies greatly). There was even a recent report of a couple who is divorcing while the mother is/was pregnant and the father saying she shouldn't be ALLOWED to breastfeed the new baby AT ALL because she *might* get off on it, because she had a let-down reflex reaction during sexual intercourse with him once after the birth of an earlier child. So, yeah, breastfeeding mothers get that too - and from some really powerfully scary angles. No department of child welfare in the country is going to take formula feeding as the exclusive reason of complaint of "negligence" seriously. There ARE some where a breastfeeding mother (especially one breastfeeding past the child's first birthday) can be investigated and threatened.
I have had people suggest that I'm being negligent by not giving my child anything other than my breastmilk until they get teeth (generally around 6mo but I trust biological cues more than calendar dates). Heck, I had a pediatrician tell me to give my 2wk old rice cereal mixed in with my pumped milk, even tho he wasn't getting ANY bottles and he was gaining weight VERY well, because she thought it would help me get more sleep (he was sleeping in my room, I barely woke to nurse him & get him back into the co-sleeper, I wasn't feeling sleep deprived at all and did not complain). That wasn't even an older doctor, she was probably mid-30s at the time (not quite 6 years ago), so seems like she should have known better than to do something that could so easily undermine the breastfeeding relationship THAT early on! Oh, and my husband is Chinese - would have gone over SOOOO well with my mom-in-law if her first grandchild developed a sensitivity to rice from getting it before his digestive tract was ready for it *rolls eyes* Luckily I trusted my breasts to know what my baby's gut was ready for and didn't follow that doctor's unneeded and unwarrented advice. But heck, the baby sleeping in my room thing would be enough to have some doctors calling CPS on me, for that matter (don't know if I mentioned it to that one, the next doctor we got that we still have I found through a referral from a similar-minded mom so I knew it was OK to be open with the doctor about our family practices).
Not trying to be confrontational, just pointing out that there are actually documented experiences that are different from what you've encountered - just like you've likely never encountered knowingly someone who had SERIOUS negative consequences directly attributed to formula feeding (I know I haven't). Being rare or infrequent doesn't mean that majorly devastating events like either of those aren't happening.
The best post I've ever seen on breastfeeding discrimination is this one: http://hoydenabouttown.com/20090625.5497/gone-too-far/" rel="nofollow">Gone too far?
Lenore's article is appalling but not surprising. I was a fervent reader of her blog until I began to suspect that the "motivation" for the free range ideas was laziness. I quit reading after a long post about how she requires her kids to entertain themselves and stay out of her hair even if it means they are glued to the television or video games ALL DAY... cause that is FREE Range.. to allow them to do whatever they want as long as they aren't bothering her.
Now she blogs about how formula feeding is more convenient and its such HARD WORK to breastfeed... yep and why o why should moms feel bad who choose convenience over the health of their child... free range is code for lazy parent.... or so I am beginning to suspect.
Excellent point. I totally agree.
Wow. This may be the first time we (sorta) agree on something!
As a vehicle for pushing health care reform in a certain direction (i.e., towards longer paid maternity leave, better breastfeeding support, pumping stations in the workplace etc.), this study does what it's supposed to do - and that's what I understand Dr. Bartick was aiming at,according to what she's saying in interviews. As a vehicle for guilting more women into breastfeeding (i.e., if you really think that 911 more babies born in 2005 would be alive today and would use this study to pummel women over the head with this fact)...notsomuch.
I'm pretty sure the benefits of driving my kids around in the car outweigh the associated risks. Some women will continue to choose artificial nutrition for their babies at one point or another and that's their business provided they haven't been misled about the possible drawbacks of that decision.
Maybe I'm super naive but I thought the mothers who weren't medically able to breastfeed would also like this study. It would seem to be a good argument for funding milk banks. Let's give a choice to the mamas who didn't really have one.
Yes, I read that... enraging! And if you look on Redbook's "Mom and Kids" page, THREE of the six featured stories are about how breastfeeding isn't really important. Just sickening to read those articles. Uggh.
The car anaolgy is rediculous, esp when you consider that the children who sadly die in car accidents, when buckled into a car seat are most likely sitting in a car seat incorrectly installed. I have to say I stopped paying attention at that point because the whole analogy died! I know this is totally off the point but I hate it when bloggers and journalists don't get their facts straight!
But back on the point I should add that breastfeeding should be normalised and so should other parenting behaviours that have fallen by the wayside in our western culture, including baby wearing, co sleeping, infant massage and so on. These types of parenting acts are normal in indigenous cultures the world over and are not of a particular 'tribe' but more a natural human parenting act. Parents in the western world should not be made to feel abnormal for choosing to parent their child/children in a way that is natural to the human race.
I disagree, i think part of the problem is that in many cases the decision to breastfeed or formula does NOT involve "days or weeks of pain and frustration and guilt" anymore, even though i agree with you that is should, and that is part of the problem is because there is a lack of education about what is being missed when breastfeeding is passed over because of the increasingly growing opinion that formula is just as good as breastmilk, and i now hear things like it being more convenient because you can feed anywhere and helps babies sleep better at night - arguments that are hard to ignore for new moms!!
Don't people think that if formula really is as good as breastmilk that the formula companies would be all over that! Even they admit in their own ads that breast is best.
Moms need to be given as much help as possible from the state, because society would crumble without them.
Don't Pat The Belly: Yes, that's it *exactly*. Thank you. If we start interpreting scientific research as a personal attack on people who don't like the results, where does that stop? Do we have to stop researching methods of abortion because that might offend some people? Evolution? Any other hot topics while we're at it? That would be a really scary road to go down.
As promised, I've been working on a post looking (in part) at this issue, and delving a little more into the reasons *why* women react this way, and have finally got it posted at http://goodenoughmummy.typepad.com/good_enough_mum/2010/04/the-bartick-study-and-breastfeeding-disclaimer-syndrome.html. I'd love any comments that anyone could make on it.
Oh, Annie, meant to add: The link you've put in to her post is actually the link to the front page of her website, and needs to be changed to the archived link.
Thanks again for letting me know about the ones that were wrong in my post. ;-)
Thanks. When the post was on the front page, I couldn't figure out how to get the link for just the post.
Beautifully written. I got goosebumps when I read your words:
"Let’s focus this energy and anger where it belongs: on the misinformation perpetuated by companies that make money by encouraging breastfeeding moms and formula feeding moms to think they are on opposite teams. When we sit on the same team bench, we hear the truth: “I wanted to breastfeed but…”"
You are so right. So many women who formula feed today have tried to breastfeed and run into problems or complications, and/or faced criticism for breastfeeding. It is truly sad. I hear their stories and am SO thankful I've got supportive family and friends, and that I had some idea what to expect in advance in order to "tough it out" those first two weeks of soreness to get to the point where I can nurse comfortably.
I am also SO thankful to live in Canada where we get a year of maternity leave. I just can't imagine going back to work after 3 months.
Sorry I'm late to the conversation, but I am just caching up on my blog reader!
First of all, a lot of these comments are hitting on a key issue I have with these conversations. Every decision one makes, important or unimportant, affecting others or not, is a "personal" decision, so that's a moot point.
However, here is my favorite explanation of breastfeeding, and it isn't an analogy. Breastfeeding (or switching to the intervention of formula feeding) is a HEALTH DECISION. It's not a lifestyle decision, it's not merely a personal decision (whatever that is supposed to mean - done by a person?), it is a health decision.
Health decisions involve social and cultural aspects, and feelings of guilt, and controversy. But, they also invoke a certain level of scientific conversation and (hopefully!) proper weighing of health benefits and risks along with the discussions of lifestyle, emotions, barriers, etc. Some people may choose to weigh their religion, or some cultural factor when making a health decision, more than the health risks and benefits. That's OK, and it happens. Also, all people are not able to do operate physiologically equally or able to avail themselves of all interventions equally. This doesn't just apply to breastfeeding.
Breastfeeding is a physiological state, like a vaginal delivery, and formula feeding is an intervention, like a cesarean section. (Or breathing without asthma medication, or supplemental oxygen). Sometimes the intervention is necessary. Sometimes the intervention is coerced by caregivers. Sometimes the intervention is chosen for lifestyle or cultural reasons, not health reasons. That doesn't mean the very real health effects are not the key issue. Sometimes people will say hurtful or insensitive things about people who have the intervention, whether they really needed it or not. Sometimes people will look back at when the decision was made, and think the decision was wrong or could have been avoided, and feel regret, or guilt, or judged. Sometimes people who have had the intervention think that no one can talk about the intervention but people who have had it, and when people say it is just that, an intervention with risks and indications, and will say "No, stop talking about those facts, and just listen to what women want to choose, you big meanie!"
It can be a cesarean section, a vaccine, a gastric bypass, circumcision, medication for mental illness (especially during pregnancy or breastfeeding, or behavioral modifying meds for children) etc. Health decisions. Also with major societal and cultural influences. Major gender, misogyny, and other privilege issues tied in there, too. Overblowing of risks to the fetus or baby, but also over exaggerating the strength of the evidence that the intervention is effective and risk free happens, a lot.
So, let it be complicated and nuanced. But don't silence the fact that first, and foremost, it is a health decision, and needs to be discussed with the true risks and benefits to morbidity (health) and mortality (life).
I talked more about this http://momstinfoilhat.wordpress.com/2010/04/07/reply-turned-post-same-old-song-about-breastfeeding-shame/" rel="nofollow">here on my blog, in regards to the Pediatrics study and people trying to use it to get Facebook to loosen up its rules on breastfeeding pictures being pornography.
[...] the only one talking about the recent Pediatrics article on breastfeeding. Well, Annie at PhD in Parenting had a post up about the constant refrain that talking about breastfeeding’s benefits is [...]
[...] moms are saying, “Don’t judge me!” We don’t want to be judged for breastfeeding or bottle feeding, for cloth diapering or using disposables. We don’t want to be judged for homeschooling, [...]
[...] “Well, They should feel guilty for not breastfeeding!” on a blog like PhD in Parenting, on the KellyMom Facebook fan page or somewhere else where breastfeeding advocacy is taking place [...]
I am miffed about the 'everyone is just fine' comments as well. The rates of cancer, diabetes, and obesity in this country are atrocious! Everyone is NOT fine. We are sick, we are fat, and we are disconnected from each other. When kids are started out with food that is nutritionally lacking, it starts them down a path that is tough to change.
Car analogy is particularly funny as lots of parents in other countries (like the UK where I live), get by without a car. So the argument is flawed by a very narrow minded and US-centric viewpoint to begin with. If that's the attitude, that we should accept that we all need cars to do anything with our kids in a time when we are approaching (or have already reached) peak oil, then it's no wonder many are so quick to give in to the pressures to use formula.
[...] going to have to defer to a wonderful article from Annie at PhD in Parenting for this one. The intent of the study is not to pick on moms or to make them feel guilty. The [...]
[...] This study about the costs of not breastfeeding has gotten a lot of attention, although not as much as articles or studies that minimize the impact of breastfeeding seem to receive. Lenore Skenazy says to Quit Picking on Moms Who Don’t Breastfeed. Ph.D. in Parenting explains why It’s Not About Picking on Moms. [...]