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Monday
Apr082013

Bottled Up by Suzanne Barston (Book Review)

 I just finished reading Bottled Up: How the Way We Feed Babies Has Come to Define Motherhood, and Why It Shouldn't (by Suzanne Barston from Fearless Formula Feeder) and I think every breastfeeding advocate should read it.

Why, you may ask, should breastfeeding advocates read a book that is written by someone whose main goal is to stand up for formula feeders? Well, there are several reasons:

  • First, they should read it so that they can get out of the echo chamber that often exists in the breastfeeding advocacy world and get a fresh and well-researched perspective on some of the things that people in the breastfeeding community often simply accept as gospel. Perhaps some of those the whole truth and nothing but the truth, but  perhaps there are other things we've just repeated so many times that they feel true even though they are not.
  • Second, breastfeeding advocates should read this book to get a more comprehensive understanding of the barriers to breastfeeding -- not just the medical ones, but also the societal, psychological, and socio-economic barriers.
  • Third, the book does an exceptional job of explaining why and how the choice to breastfeed or not truly is individual and personal. 

That said, as I worked my way through the book, I alternated between nodding and shaking my head. In this post, I'll touch on a few of the issues that caught my attention and I'm sure I'll bring others up in future posts too.

Guilt Trips

In the introduction to her book, Barston asks:

Why are we focusing so much energy on convincing women they have to breastfeed rather than offering better help to those who want to, and working to make formula the safest and healthiest alternative that it possibly can be? All of these questions danced seductively in my head, coming together for a big Chorus Line finish, the one singular sensation question that no one seemed willing to answer: Is breastfeeding really so superior that it justifies the guilt trip we heap on all of these women, essentially scaring them into nursing?

The answer to that question, in my mind, is no. We don't need to scare anyone into nursing. We need to provide evidence based information (to help moms decide) and evidence based education and support (to help moms succeed). The problem, from my perspective, is that there is insufficient evidence based support (for breastfeeding or for formula feeding), but there is plenty of propaganda and rhetoric from both formula companies (that have HUGE budgets) and the breastfeeding advocacy community (that have very small budgets, if at all).

If I feel my voice is being drowned out (especially by deceptive corporate advertising campaigns), I'm more likely to yell. I think that is what leads to the "guilt trip" that sometimes comes from lactivists. This is one of the reasons that I support a ban on formula advertising (with appropriate enforcement of the ban). I think that if less money and effort was spent on wooing moms on both sides, it would be a much less emotionally charged issue and resources could be put towards supporting moms instead of selling to them.

Feminism and Breastfeeding

There is a difference, to me, between understanding the fact that women and men have not achieved equality in the home or in the workplace and accepting that disparity. Barston brings up examples of workplace barriers to breastfeeding and, as I've discussed on the blog, also raises the issue of inequality within couples. She quotes her friend Megan, who was exclusively breastfeeding her four month old:

I keep hearing these things about how if you're in a truly feminist, truly 'modern' marriage, then breastfeeding shouldn't lead to an unfair division of labor...and I have to say, it's a load of crap.

Personally, I don't think that creating a fair division of labour in parenting, or in relationships in general, is something that just happens by accident. Traditional gender roles, our own upbringing, wage disparity, and many other issues reinforce the woman's role as the primary parent and primary housekeeper. Assuming that there is a solution to inequality at the bottom of a can of formula is naive, in my opinion.  A truly equal partnership will find a way to remain equal in the face of breastfeeding and formula will not create equality in a partnership where it didn't already exist.

The same is true of a workplace, I think. In an environment where woman are empowered and trusted, they will be able to find a way to pump at work. In an environment where women are not empowered and trusted, not being able to pump at work is likely just one of the many workplace issues they are facing.

All that to say, I don't think we should just accept the status quo. I think we should continue trying to create a society where more relationships are respectful and equal and where more workplaces trust and empower their employees. We shouldn't do this for the sake of breastfeeding, but if it allows more women to breastfeed if they want to then great. While we work on that, we need to accept that each woman will need to come to terms with her own situation and make the feeding decision that is best for her (without projecting her situation on everyone else).

Shifting the Breaking Point

One of the most interesting questions for me is why do women give up on breastfeeding? I mean, I know the reported reasons and the unreported but documented contributing factors, but I want to know how to shift the breaking point. In her book, Barston gives the example of Norway:

Although the six-month breastfeeding rate in Norway is an impressive 80 percent,  this still means that 20 percent aren’t breastfeeding to the “required” six-month mark— in a culture where, as one Norwegian woman told the New York Times, “Women who are not able to [nurse] are very, very sad. … They feel like failures if they cannot breast-feed.”  If there are no social constraints, no formula advertising or hospital freebies, and women don’t have to return to work, why are 20 percent “failing”? Even within the first month, 12.9 percent of women in a large Norwegian cohort suffered from breastfeeding problems so severe that they required medical intervention.  Chances are that not all of these women were suffering from primary lactation failure, but obviously there are issues here that “ideal conditions” cannot wipe out, and a significant number of women— and their babies— are suffering the consequences.

In the United States, around 47% of babies were still breastfed at 6 months (16% exclusively) and in Canada 54% were breastfed (14% exclusively), which is dismal considering that over 90% of women in Canada initiate breastfeeding. Women in Canada and the United States are bombarded by formula advertising, hospital formula freebies, formula freebies sent to their home, formula freebies in maternity and baby stores, formula ads in their doctor's office, and so on. Women in the United States have dismal maternity leave, while women in Canada have better leave options (although certainly not perfect). In Bangladesh, 64% of babies are still exclusively breastfed at 6 months and 95% of one year old babies are still being breastfed.

I don't know much about breastfeeding in Norway beyond what I read in Suzanne's book, but even the 80% that they've achieved there seems pretty impressive to me compared with what we see here in Canada and the United States. Perhaps the difference between the 50% mark being reached in Canada and the United States and the 80% reached in Norway is the creation of those "perfect conditions", while the difference between the 80% in Norway and the almost universal breastfeeding in Bangladesh is the affordability and accessibility of infant formula. If women truly do have the best support possible in Norway, but also have the option of being able to buy formula, then maybe 80% is a reasonable goal for developed countries. I think it is entirely possible that there are 20% of women who either cannot or do not want to breastfeed their babies and (in a developed world context), I think that is okay. I'd love for them to be able to be able to access human milk, if they desire, instead of just formula, but 80% sounds like a dream to me right now. 

And...

The word that comes to mind more than any other when I look at the things Barston suggests in her book and compare them with things that I might suggest is "and". We need to normalize breastfeeding by having more moms breastfeed in public AND we need to stop judging moms who take out a bottle in public. We need to ensure that women in developing countries are given adequate breastfeeding education and support AND we need to ensure everyone has access to clean water in case they need or want to prepare formula. We need to be willing to "listen to the myriad of reasons that women may choose not to nurse" AND we need to realize that "just try formula" isn't a welcome or useful solution for someone who feels passionately about nursing her baby and just wants quality support.

At the end of the book, Barston talks about a woman who went through the same breastfeeding struggles that she did, but ended up being able to keep breastfeeding. Barston wrote: "Logic says that I should have found this threatening to my sense of self. I'd been frantically repeating the narrative of I had no choice but to stop breastfeeding to myself and anyone who would listen, and here was someone who had been in an eerily similar situation and persevered. What did that say about the truth I held to be self-evident?" She goes on to say that "as the conversation progressed, she told me how much breastfeeding meant to her, and how relieved she felt that she could still do it despite her son's allergies." That, in a nutshell, is why I do what I do. I want women like her to be empowered, educated, and supported if they want to keep breastfeeding. Barston, on the other hand, does what she does in the hopes that the "mom who wants so badly to quit breastfeeding and finds nothing but fear-and-guilt-inducing literature everywhere she turns" will "be able to make a truly informed decision" and "sit beside her breastfeeding friends, free from insecurity and judgment."

I think we want the same thing. I think we want women to be supported and empowered in their choices. I think our stories, our advocacy, and our approach is closer together than most people would imagine it to be. I think our slightly different yet well thought out and researched perspectives on the same situations can allow us to have the types of conversations that will move the bar forward. Thank you, Suzanne, for your book and for reading and commenting on my blog from time to time. Together, we can make a difference for both breastfeeding moms and formula feeding moms.

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Reader Comments (31)

My problem with Barston's work is that she acts like formula feeders are an oppressed minority, and she quotes a "74% Breastfeeding rate" in America as evidence. But that's all patently false. 74-76% of women Breastfeed at least ONCE in the hospital, and nearly all switch to formula shortly after. Women meeting even the bare minimum of the AAP's recommendations are the minority. Bottle-feeding is ubiquitous. It's almost absurd to have a movement trying to protect the status quo. I support formula feeders - I was one - but I will not pretend that they're an oppressed minority. It's flat out false.

April 9, 2013 | Unregistered CommenterTheFeministBreeder

I'm fascinated by the fact that a subject which is rightly of just as much importance to the lives of the babies who are being fed as it is to the lives of the adults who are making the feeding choices is approached - always, always, always - in such an adult-centric way. This book puts the feelings, rights, quality of life, freedom of adults at the centre of the debate. I can't think of any other issue which affects the lives of children which is treated in this way.

April 9, 2013 | Unregistered CommenterWendy

@Thefeministbreeder - As someone who has been with the FFF since the beginning, I have to say that you are missing something that Suzanne has repeated with regularity, which is that in a certain part of American society, namely upper middle class, urban, white women, there is a breastfeeding culture that exists where women who bottle feed are not the majority. And the pressure to breastfeed in that subset is pretty intense, and even with a fire and chronic illness to contend with, I still felt like I had somehow failed my son by being unable to establish breastfeeding. Ignoring that women are made to feel less-than as mothers is hurting the goal set forth by lactivists. This isn't a movement to protect the status quo, but rather, a movement about respecting choice and that "best" is not black and white.

April 9, 2013 | Unregistered CommenterBrooke

I have to disagree a bit Wendy. As a mother who suffered severe post natal depression and breastfeeding not being the "most natural thing in the world" Iwas promised it was, had I not forced myself to put myself first for a bit I would have been hospitalised for a breakdown and have been of absolutely no use to my child at all causing a lifetime of attachment, resentment and abandonment issues. At some point a mother is allowed to make the choice to do whats right for her, in turn doing whats right forbher child.

April 9, 2013 | Unregistered CommenterDee

Hi Brooke. Thanks for your response. I have no doubt that what Barston and you have experienced is real. I can't speak to that because I don't live in that environment.

However, as an African-American woman who regularly encounters women who have never seen anyone close to them breastfeed and who face monumental barriers to breastfeeding -- including family disapproval and sabotage -- the whole focus on "pressure to breastfeed" smacks of privilege and disregard to all of the women (not just women of color) who would LOVE to have access to even a minute amount of assistance in trying to breastfeed. Those of us out here working for the public health of not-so-upper middle class women (of any race) and their babies who could benefit greatly from breastfeeding find this upper-middle class white female focus on bodily autonomy, guilt and pressure to be rather insensitive to what's going on in the trenches, so to speak, of areas outside higher income coastal areas where breastfeeding is the norm.

Should the health and well-being of women and children not in that privileged subset (not to mention those children dying in the developing world) be sacrificed on the altar of upper middle class white urban female "pressure?"

All that being said, I have not read the book and I will do so before giving an overall review. I'm sure there is much I can learn and it always helps to hear a variety of opinions. But I guess coming from my perspective, approaching a serious public health issue from a "protect the feelings of upper middle class urban white women" angle really bothers me.

April 9, 2013 | Unregistered CommenterLisa

I am a breastfeeding advocate and someone, who as a medical professional, supports women in their infant feeding choices and supports them in establishing and maintaining breastfeeding. I have an issue with this statement:

"Second, breastfeeding advocates should read this book to get a more comprehensive understanding of the barriers to breastfeeding -- not just the medical ones, but also the societal, psychological, and socio-economic barriers."

I know it is nit-picky, but it suggests that breastfeeding advocates don't already have a compehensive understanding of the barriers...you can't support women to breastfeed well without an understanding of the societal, psychological and SE barriers. Some advocates and feel the need to "shout" their information BECAUSE of an understanding of these.

April 9, 2013 | Unregistered CommenterKelli

In regards to feeling like a minority, I think some of the discrepancy is that people like me and Suzanne fit into a well-educated affluent demographic which is one that is often conducive to exclusive breastfeeding. I'm in Canada (west suburban area of Ottawa) and had fabulous mat leave and the majority of mothers that I know still breastfeed/breastfed/expressed at 6 months. You feel like a minority when it is the norm where you live. Heck I was breastfed in 1977-1978, around the time that breastfeeding was at an all-time low, so there was basically no question what my choice was going to be. Sadly due to two physical issues both involving my boob tissue it was not going to be exclusive in my case.

Also in the promotional literature there is no doubt that breastfeeding is treated like the only way to feed your child. Formula was barely mentioned anywhere. Sure I knew it existed but before pregnancy I honestly couldn't tell you any brand name. The city of Ottawa's Public Health website not only has a fabulous breastfeeding section, but a formula feeding section - that said the formula feeding section is hidden in the Food Safety and Inspections area, but not in the Healthy Baby and Parenting area like the breastfeeding section.

So what am I getting that - it can feel like the world is looking down at one's formula feeding circumstance, even if in many areas formula feeding is the norm (but not all areas/social circles). Think of it this way, In many places obesity/being overweight is the norm, but there is a lot of shame directed towards those who are, even if they are in fact a majority. Just because people are in a majority doesn't mean they're having it easy either.

I'm more than 6 and a half years into motherhood now and hoping to have another (sadly we have to go to the most expensive ivf/icsi treatments..), and honestly I feel fine with formula feeding my next one, but a lot of that has come from being in my mid-30s and comfortable with my own situation. It really does suck (no pun intended) to be a first-time mom and struggling with breastfeeding with so many people telling you your body is made to do this while you're nursing 24/7 and your child is losing weight and all you want to do is what is best for your child (which in retrospect was to supplement with formula in our case which I did with tears streaming down my face).

April 9, 2013 | Unregistered CommenterAlison

I'm a huge fan of Suzanne, her book, and her site. But I also love this site. As a blogger, one of my first pieces was my own guest post on Suzanne's site, and I hope that there continues to be more ongoing dialogue. When I first read Suzanne's book and her blog, I literally couldn't believe the relief that I felt that was sort of "bottled up" (sorry) inside me. I know -- as a researcher myself -- that statistically formula feeders are not an "oppressed minority." But it felt that way to me, especially living in Cambridge, MA, where my son was born. It was my emotional experience: to be felt like I was judged and somehow had "failed" because -- for a variety of reasons, including my son's allergies -- I decided to stop breastfeeding. Babies will be okay if they are formula fed; there is no doctor, no medical professional who has ever told me that my son will suffer physically or psychologically because he was. It's a personal decision, granted one made in a social and cultural context. But a feeding choice should not be part of how a woman evaluates herself as a "good mother."

April 9, 2013 | Unregistered CommenterJessica Smock

Great review, Annie. I have learned a lot from reading Suzanne's FFF's blog and Facebook page, and I have her book on my wish list. I especially appreciate Suzanne's passion for supporting moms who formula feed and I know she takes a somewhat dim view of the way formula companies market to breastfeeding mothers, a concern we all share. I

April 9, 2013 | Unregistered CommenterJodine Chase

"Those of us out here working for the public health of not-so-upper middle class women (of any race) and their babies who could benefit greatly from breastfeeding find this upper-middle class white female focus on bodily autonomy, guilt and pressure to be rather insensitive to what's going on in the trenches, so to speak, of areas outside higher income coastal areas where breastfeeding is the norm."

I totally understand where you are coming from here, and I (hope) I was clear in my book that a lot of what I speak about is specific to a certain geographical and socio-economic subset of women. However, while the discussion about guilt and judgment may be one of privilege, I don't think that negates the fact that breastfeeding promotion, as it exists currently, ignores the lived realities and economic/lifestyle challenges faced by underserved, lower income groups (regardless of race) in the United States. I do discuss this in the book - it is a subject I am quite conscious of, although I would never presume to speak for those whose experiences I can't possibly know on a visceral level.

That said - lately my focus has been in the advocacy arena. And surprisingly, the organizations that have come to me with concerns about the way breastfeeding promotion is being handled are actually those that serve low-income minority groups. Not the upper-class Brooklynites that I expected these issues to resonate with. What I'm learning is that while the surface details are quite different, the end result is the same - breastfeeding is being promoted incorrectly, without regard for cultural sensitivity or individual circumstances.

I am NOT advocating for a future where breastfeeding is discouraged or even not promoted, especially to those who may not have supportive communities surrounding them - but rather one in which we provide support and education without the mom-blame and confusing, inflated statistics.

Lastly...regardless of whether or not this is a problem of the intellectual elite or the financially privileged (which I do not in any way believe that it is), the fact is that women are suffering. I do not claim, in my book or elsewhere, that ALL women feel guilty about not breastfeeding, and I would never insinuate that there aren't intense systemic barriers to breastfeeding. But that doesn't make my experience, or the experience of my audience, any less valid.

To the Feminist Breeder - I don't think formula feeders are an oppressed minority. Seems to me you took one sentence out of the free Amazon preview of the book and are judging my entire argument on that, so I'm not sure how much of a productive discussion we can have here. But I do not use that statistic to show that we are a minority. I actually use it to show that most of us are starting out WANTING to breastfeed and then not being able to, for a myriad of reasons - and when we can't... well, that's what discussed in the rest of the 200 pages.

I know we are by far in the majority, numbers-wise. All that means to me is that the MAJORITY of women in this country are not doing something which has come to be the mark of good motherhood. That's an awful lot of women feeling crappy about themselves from the get-go.

April 9, 2013 | Unregistered CommenterFearlessFormulaFeeder

Great review, Annie. As a breastfeeding mom of three who faced many challenges throughout, I can really see where both of you are coming from and I'm glad to see that there is enough common ground to have pleasant discussions AND not beat each other up.

April 9, 2013 | Unregistered CommenterRookieMom Heather

"I am NOT advocating for a future where breastfeeding is discouraged or even not promoted, especially to those who may not have supportive communities surrounding them - but rather one in which we provide support and education without the mom-blame and confusing, inflated statistics."

There is a Canadian breastfeeding promotional ad circulating right now which on the surface is funny and on-subject. http://www.cbc.ca/news/canada/newfoundland-labrador/story/2013/04/07/nl-breastfeeding-council-video-407.html

I watched it, laughed, enjoyed the familiar faces... but it occurred to me that it's yet another example of breastfeeding promotion with little to no information as to HOW. How to start, where to look for info, how to learn what's normal for a newborn (frequent, lengthy nursing sessions, etc). Yet again, telling women "You should. It's best. Go for it!" but the underlying message is "You're on your own if you need help."

I would love to see more promotion focussing less on why it's great (that's still important) and more on "Here's how easy it is to access help" and "here's how a normal newborn feeds". It would serve two purposes - less of a reminder for moms who had trouble establishing bf-ing and turned to formula to feed their babies that they are doing "less than best", and might actually HELP someone.

April 9, 2013 | Unregistered CommenterJuliette

The other day a women posted online somewhere that she was supplementing with formula and she wondered what brand to choose and what other women might know. As someone with a poor supply who ended up formula feeding I wanted to answer but the truth is I don't know what brand is best. I tried to do research on different formulas to make sure I was doing the best I could for my baby, but the information isn't out there. When I was searching for it I found myself angry with breastfeeding advocates. The lack of information made me feel like more of a failure at one of my worst times.
I don't know what the balance is, but I wish we could find one.

April 9, 2013 | Unregistered CommenterAmy

As a feminist, and a PhD--I wanted to offer my support to the legitimacy, import, and academic accuracy of Suzie Barston's work. I, too, reviewed her book for Science and Sensibility http://www.scienceandsensibility.org/?p=5564. I also took the time to speak with her, interview her on the phone and in writing, and did my homework as a researcher before merely sharing opinion.

The push back against the author of the book in this thread is thinly veiled internalized misogyny in its finest form: misguided, mislabeled, misused constructs of feminism used as a way to oppress other women. I see right through it, and directly to the courage, intelligence and depth to which Ms. Barston goes to actually help other women--using evidence based medicine, solid journalistic skill, and unwavering commitment to throw the covers back on a social construct of women that needs to be just as scrutinized as any other. I think the FFF site is an example of the future of feminism, and I am glad for it.

April 9, 2013 | Unregistered CommenterWalker Karraa, PhDc

Thank you for the review and all of the great comments. For once, it is nice to read actual, well-thought out discussion. I agree that we should be offering support and information. Most importantly, women need to know what to expect when breastfeeding and have access to resources. There ar sm nay obstacles different women in our culture, and around the globe, face - often without the help and support they need.

April 9, 2013 | Unregistered CommenterCarolyn

@Wendy

I have trouble thinking of very many child rearing issues that are not frequently approached from an adult-centric point of view. Where the baby sleeps, whether to let the baby cry to sleep or not, whether the baby goes to daycare or not, and so on are almost always about what the adults need/want (or at least one side of the debate is).

Even with older children this is true. The entire public education system is set up primarily for the convenience of adults, not the benefit of children. A child centric education model would look very, very different.

I think infant feeding is one area where people often do put the child's needs first, almost to the point of forgetting that there is woman attached to those breasts who has feelings, needs and wants too.

April 9, 2013 | Registered Commenterphdinparenting

Kelli:

I didn't mean to suggest that most breastfeeding advocates don't already have an understanding of the barriers. I do think there are some, however, who demonstrate ignorance of those barriers or are dismissive of them. But even among those who know the barriers very well (as I would say that I do), I think Barston's book provides additional context and stories to help further that understanding.

April 9, 2013 | Registered Commenterphdinparenting

Lisa:

Thank you so much for your comment.

"Should the health and well-being of women and children not in that privileged subset (not to mention those children dying in the developing world) be sacrificed on the altar of upper middle class white urban female "pressure?""

I think that is a fabulous question and is something that often frustrates me, both as it relates to breastfeeding and as it relates to any other type of advocacy or social change. I wrote about that previously in a post that asked "Is shame a barrier to social change?"

http://www.phdinparenting.com/blog/2011/9/15/is-shame-a-barrier-to-social-change.html

April 9, 2013 | Registered Commenterphdinparenting

I also read Suzanne's book (and owe a very, very overdue review) and found it hit home very seriously for me. My son is almost 11 months old now and we were never able to successfully breastfeed despite 5 grueling weeks of trying. We saw 4 lactation consultants, all of which eventually dismissed us because our issues were too complex. Eventually I went to exclusively pumping with formula supplementation because I was also under producing. I've failed at breastfeeding and it was one of the biggest struggles I've faced.

I think that what the initial commenter misunderstands is that in some circles where breastfeeding is very prevalent, education on formula is poor. For example, I took a breastfeeding class before my son was born, where I learned about how often and long to feed my son on each breast, different holds for feeding, etc and got information from my OB and at the hospital. But when we needed to use formula because I couldn't keep up, and even to an extent with pumping, I had NO idea how much he should be eating, what type of bottle was best, what type of formula was best, how to best mix formula, etc., because that information was not readily available at my "baby friendly" hospital. It's not that formula feeders are necessarily a minority, it's that we've pushed hard for breastfeeding education, which is GREAT, but we've lagged on formula feeding education in that push. And if the goal is for every baby to be fed and thrive, we need to educate all mothers, not just those who are able or choose to breastfeed.

April 9, 2013 | Unregistered CommenterKatie

Amy:

All brands of formula have to follow strict requirements in terms of their ingredients and composition. Other than in cases of allergies or other special needs, I don't know that there is a "best" formula. If I had to supplement, I would probably choose an organic brand like PC Organics or Baby's Only.

April 10, 2013 | Registered Commenterphdinparenting

Katie, non baby friendly hospitals don't educate about formula feeding. They give you whatever brand gave them freebies. I gave a little nurser bottle whenever my son seemed hungry, staff wasnt involved. I guess if they saw a mom fumbling theyd help her learn to hold a bottle but they would do that too at a baby friendly hospital if you needed help with the bottle. Your pediatrician would be the one to go to about feeding advice or the formula recommendations if the hospital giveaway bag kind is causing problems. I don't think even drs know about the pros and cons of different bottle brands. I've been to both kinds of hospitals and I've been both a ff and a bf. Guess which hospital went with which baby.

April 10, 2013 | Unregistered CommenterHAF

Thank you, PhD for your thoughtful review. I totally agree that we breastfeeding advocates are in an echo chamber that would benefit from listening to voices such as Suzanne Barston. We need to respond and not simply react to information we don't want to hear. This is particularly necessary because Barston's book is not the only voice challenging efforts to promote and support breastfeeding. Joan Wolf's book in 2011" Is Breast Best" published by NYU is even more in depth and goes farther in saying that public health and the medical community shouldn't even promote breastfeeding. Now there is a new book "Birth, Boobs and Bad Advice" presumably reaching a different demographic. There is enough momentum in the messages found in Barston's book and elsewhere that Jane Brody of the NYT refers to "concern is mounting that the “breast is best” dogma is creating undeserved guilt and serious hardships" Other websites like Spiked are taking the more reasoned arguments of Wolf and Barston and using terms like "hectoring" and "pseudoscience". What is the response of breastfeeding advocates?

April 10, 2013 | Unregistered CommenterLaura Berger

Walker:

I'm curious which comments you see as "thinly veiled internalized misogyny". Would you care to elaborate?

April 10, 2013 | Unregistered Commenterphdinparenting

Laura:

I have a lot more respect for Barston's work than I do for that of Joan Wolf (or others like Hanna Rosin for that matter). Some people are more likely than others to cherry pick studies or quote things out of context than others.

April 10, 2013 | Registered Commenterphdinparenting

Annie- I just realized I never thanked you in my response above for writing this. I so appreciate your taking the time to think about the book, and to write such an in-depth review.

We both know that these issues are volatile to both our audiences, for different reasons. It says a lot about your approach and your character that you'd consider another POV and respond to it with sensitivity.

It feels weird to comment further on a review of my own book so I will leave it at that - but please know that I appreciate what you did here. :)

April 10, 2013 | Unregistered CommenterFearlessFormulaFeeder

I have not read the book yet, though I am looking forward to doing so, but one of the things I think is missed in the conversation is the idea that "failed" breastfeeding is a solely modern phenomenon. Yes, the inability to breastfeed is completely affected by our lack of cultural memory and community support (from hospitals, to families, to work places), but there have been women who have not been able to provide enough nourishment for their children in this way for eternity. It is one of the reasons wet nurses have existed throughout history - not just when higher class society thought feeding your wailing infant from your body degrading.

It seems that in any other time or place I would have been one of those wet nurses because I had the problem breastfeeding that no one wants to acknowledge - over production. A problem which may actually force me to choose formula.

My breasts would only have been healthy had I had a child attached to each breast 24 hours a day. Yes, this is not what women who struggle with production want to hear and the first response is "donate!" but taking more out only produces more and my production caused almost daily incredibly painful plugged ducts and multiple bouts of mastitis.

I had everything a breastfeeding mother should have to be successful: an incredibly supportive community (including a husband who did all of the housework and baby care so that I could feed, pump, massage, make herbal tinctures, whatever I could to bring my production under control), access to a team of lactation consultants, an incredibly supportive workplace that let me fit five pumping sessions into my schedule when I returned after a 6 month leave, and yet I was in constant pain or fear of it.

My struggle finally ended when my son was 11 months old and a combined bout of recurrent mastitis, blebs and thrush completely shut down my left breast. I am currently 6 months pregnant and while I plan to try and breastfeed again, I do not plan to struggle through the year of pain that I experienced previously. If I cannot bring my production under control then I will turn to formula because my children will do better to have a healthy mother who can interact with them than one who cannot hug them because it brings her to tears from pain.

April 10, 2013 | Unregistered CommenterStephanie

(I’m sorry, this got long…)

"We need to be willing to "listen to the myriad of reasons that women may choose not to nurse" AND we need to realize that "just try formula" isn't a welcome or useful solution for someone who feels passionately about nursing her baby and just wants quality support."

You know what though? I didn't feel passionately about nursing my baby when I had my first child, that came much later. So I’d argue that in hospital, “just try formula” is not useful for any new mother. I was going to bf "if I could" and not “beat myself up" about it if it didn't work. And I was absolutely going to wean to formula at 6 months because “that's what people do”. So when I had problems, though no one expressly said "just try formula", they *did* say he'd be fine if I couldn't bf (while not directing me to help to continue doing so). It wasn't a stretch for me to go out and buy bottles and formula, since I planned to do that eventually anyway, and no one, not the medical community, not family (my mom ff from the start), not friends (all of them either weaned to formula or strictly ff), was making me feel bad about it. And yet I felt bad. Fortunately, bf did work out, but I think I had a small glimpse of what women who wanted to bf but could not might feel like. And I believe as a result that a lot of the guilt women feel is internal--valid, yes! Absolutely. I’m not trying to minimize those feelings. I just have doubts about where that guilt comes from. And having been through the bad hospital advice, the lack of knowledge and support, I know there are many, many systematic reasons why so many women don't meet their goals, and by no means do they deserve to be shamed as a result. It’s the system that needs to change. I also know that even if we eliminated the "booby traps", there would still be some women who simply can't bf, and some who choose not to, and they don't deserve to be shamed either.

But I have to agree with the FeministBreeder that currently, ff is done at least in part by the vast majority of North American women--so who is doing this supposed guilt-tripping? I can honestly say the only women, other than myself, that I know who did not use formula at some point are moms I met via the internet *because* I couldn't find anyone IRL who was doing what I was doing. And I think I'd be included in the "class" of women referred to in some of these comments: I'm white, urban, educated, professional, had generous mat leave. The women like me that I know? They ff, at least part of the time. All of them. Because of bad advice, because of supposed convenience, because of whatever, that really doesn’t matter. And I know this about all of them because it's not something that is considered shameful or strange (I’m not saying it should be). These women certainly aren’t going around giving the stink-eye to bottlefeeding moms in the mall. Yet, I bet these same women would be shocked that I not only never used formula, I bf my children for 2.5 and 3 years. I know for a fact I’ve been gossiped about by those that do know (and that was for bf past 3 MONTHS).

So yes, when I'm living in a bottle-culture, surrounded by ff mothers, where pregnant women who plan to bf are given bottles as gifts and the advice that ff is “just as good if you can’t bf” before they’ve even given bf a try, it is a bit hard for me to believe women are being guilted or scared into bf by others, or that there is judgment of moms that bottlefeed in public. Facebook doesn’t take down pictures of bottlefeeding. You can’t find teenagers posting about how “gross” ff is on Twitter on any given day. Bottlefeeding moms don’t get asked to leave public places on a regular basis. I'm not saying any of this *should* happen, btw, just that bottlefeeding/ff is the norm.

April 12, 2013 | Unregistered CommenterAndrea

Something interesting to consider in the breast feeding debates:

1. The issue on this motion is overnight access. The petitioner’s position is that there should be no overnight access while she is breastfeeding. The petitioner’s child rearing philosophy gleaned from the Internet and other sources is to breastfeed until the mother and child mutually agree to stop. The respondent’s position is that the petitioner is using breastfeeding solely for the purpose of defeating his access to the child.

2. The respondent has been actively involved in the child’s daily schedule since birth. The respondent prior to separation regularly bathed the child at night, fed the child and spent time with the child. Despite this involvement the petitioner after separation was reluctant to allow the respondent to have access to the child. The petitioner and respondent have been through two mediations and two court orders with a psychological assessment pending over the issue of access. When the petitioner has to leave the child at daycare or for access the parting is a 10-minute to 30-minute ordeal. The petitioner submits that access is stressful for the child. On these facts the source of the stress in my opinion is an over protective petitioner.

3. The petitioner may have an honestly held and well-intentioned theory on breastfeeding. This breastfeeding however must come to an end at some point. The petitioner in an earlier affidavit indicated that she intended to breastfeed until at least the child was two years of age. Dr. Newman’s letter indicates that pediatrics recommend breastfeeding for at least a year with no upper limit. The petitioner will have breastfed for two years beyond the minimum recommended. This child is not an appendage of the petitioner. The child will very shortly have to leave the petitioner for day care, junior kindergarten and other outside relationships. It is important for the child’s good that she learn to adapt outside of the petitioner’s constant attention. The petitioner should therefore end breastfeeding over the next four months and the child should then experience overnight access with the respondent."

http://canlii.ca/en/on/onsc/doc/2003/2003canlii2121/2003canlii2121.html

April 23, 2013 | Unregistered CommenterSexism In Media

Excellent observation from Walker Karraa, PhDc which deserves a repeat so it can be better responded to:

"The push back against the author of the book in this thread is thinly veiled internalized misogyny in its finest form: misguided, mislabeled, misused constructs of feminism used as a way to oppress other women. I see right through it, and directly to the courage, intelligence and depth to which Ms. Barston goes to actually help other women--using evidence based medicine, solid journalistic skill, and unwavering commitment to throw the covers back on a social construct of women that needs to be just as scrutinized as any other."

Thank-you for bringing forward the concept of "evidence based medicine" for readers to consider. As a lesbian mother who currently shares full joint custody and equal access of a minor child who is being fed breast milk by both parents your wise words are a welcome relief.

In my community I am expected to be a "feminist" but, I strongly feel that the expectations of "feminism" and "parenting" are often miss aligned. The ideas and concepts don't fit well. For a while, by sharing equal responsibility and access of our child I felt that I was some how failing feminism. Research and education has demonstrated that my initial anxieties were just that - unfounded anxieties based on personal fear and not rational thought. I am now a proud shared parent who pumps breast milk, doesn't fret and fear that our child will die if our child's father doesn't feed the child my breast milk when equally residing with him. The biggest obstical for doing this important thing for our child (equal 50-50 access) was truly understanding the gaps in the research and the gaps in the views I had on what defines "feminism". I now advocate for "parantisim" - if you can even use that label.

The father of our child (a gay man) often is often verbally assaulted (ontology my fellow feminists like to miss-use quite often) by over-anxious breastfeeding parents (both men and women) when ever our child is with him in public places. This is during our child's access time with him.

He has been subjected to lectures, literature, and having personal insults hurled at him in public places.

Having done a quick background on your materials posted publicly, it appears that you have a significant background in the understanding of parental anxiety and related subjects (e.g. PTSD).

What I am observing from the feedback I am getting from our child's father is that most of the parents who choose to "confront him" on his use of a bottle is that the people appear to be very anxious.

I can only provide subjective statements third party to the conversation (hearsay) but, it appears that these parents are struggling with some form of parental anxiety and choose to publicly humiliate a perfect stranger to possibly justify their own fears (worries, anxieties, etc...).

As you will note I quoted a well cited publicly posted decision from a senior family law justice in this thread which explicitly identifies the parental concerns (argument presented by the mother) that there should be no over night access. The judge identified the possible root cause of the dispute - an over protective (over anxious) parent influenced by her readings on the internet.

What I am seeing is that there is an ever increasing impact to overall social anxiety being injected into society since the advent of the internet. Even the justice in the above mentioned citing identified this in paragraph 1.

What I am wondering is why there is so little "evidence based medicine" on parental anxiety in general. We as a society seem to think it is "ok" for parents to be overly anxious - to the point that these parents choose to verbally assault other parents for doing something they "feel" is wrong.

These parents that take their advocacy to the public in this manner appear to be crossing the line of "emotional reasoning" with logical possibly like this:

"I feel that breastfeeding is the best therefor you, Mr. Bottlefeeding gay man, by bottle feeding your child is disproving how I feel about myself and making me second guess my choices for my child.

I feel compelled to insult, belittle and spout beliefs unsupported by facts at you to make *me* feel better. Oh... and to protect your child from your horrible, awful and bad parenting."

An specifically to your point:

"misguided, mislabeled, misused constructs of feminism used as a way to oppress other women"

I would expand that statement to remove the gender and suggest that it is a way to oppress other parents whom are gay, transgender and male identified.

Thank-you for your article and perspective.

April 23, 2013 | Unregistered CommenterSexism In Media

I am glad that you have written this review and I am considering checking it out from the library. I have provided a kind, listening ear to new moms who've shown an interest in breastfeeding for a long time now and always try to help in any way I can. Sometimes it seems as if all they want is "permission" to stop trying. If that is what they want (with no rightly authority at all), I give it. I am glad that a few here have expressed a concern that the book seems to frame breastfeeding support as some kind of one size fits all moral mandate. That is so far away from my observations. By far the warmest, kindest, open-minded people I have met are in my breastfeeding circles. I think the book could expand my insight into the "upper middle class" challenges, how the other half lives, so to speak, but I have a difficult time with many of the negative comments here which seem to stem from ideas in the book. I would love to find an online book group of like minded people willing to read and discuss the book without a chorus voices claiming "I'm a supporter of Suzie and you are a misogynist if you don't". Has anyone heard of a place where open-minded people can discuss the book?

January 20, 2014 | Unregistered CommenterAnne G

I applaud you for this post, and for your truly mom-supportive voice in a world where passion and fear often overshadow the good intentions of many.

I became quite passionate about breastfeeding while pregnant, but could easily have gone in another direction if I'd become a mom at an earlier time in my life. And while I'm passionate about breastfeeding, I am also passionate about supporting moms where they are. If more of us can find a way to see past our own perspectives, maybe we truly can achieve better support for moms.

February 28, 2014 | Unregistered CommenterMaitri Mama

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