I’m heading in the direction of slightly warmer weather this week and will be bringing you a few guest posts from authors and activists whose voices and work I adore. First up is breastfeeding advocate Emma Kwasnica talking about the continued harassment of breastfeeding women by facebook staff (which I first wrote about more than three years ago).  Protests at facebook offices around the world are being planned for February 6, 2012. Please welcome Emma with a message about the importance of seeing breastfeeding and a personal challenge to you.

Montréal Breastfeeding Challenge 2009 "in the park". Torrential downpour for the event, but that didn't stop us. I am 42 weeks pregnant with Chloë *to the day* in this photo; Sophie (2.5 years old) nursing on cue for the official latch-on at 11am. (Photo courtesy of Rowan Smith)

Why SEEING breastfeeding on Facebook, and in real life, is important:
My personal challenge to you

I’d just like to talk a bit about the bigger picture here. When Facebook takes this stance against breastfeeding images, it stigmatizes breastfeeding women, and shames women into thinking that their breasts are much, much less than the amazing life-giving source they are. Nipplephobia has reached epic proportions here in North America, and this is to the supreme detriment of babies everywhere.

Just think for one moment, how many more women would breastfeed, or for how much longer, if only we rid society of the harmful practice of over-sexualizing women’s breasts! And how much this, in turn, could benefit the BABIES.

I’ve said this before, and I’ll say it again: as a childbirth professional, but also as a woman, in general, it is absolutely crucial that one support ALL women to breastfeed their young.

Quite simply, this is about re-normalizing breastfeeding.

The more we hide it away, classify it as obscene, shame mothers into covering up while feeding, and encourage women to retire to “private” rooms in order to breastfeed the baby, the less we see of it in public, and the less and less people are comfortable with the very idea of nursing in public. This is the sad reality of this pathologically hyper-sexualized (yet sexually repressed…) North American culture of ours.

The solution seems quite simple to me; breastfeeding (and/or images of breastfeeding) need to be seen every day. I am convinced that SEEING more breastfeeding, wherever possible, is what will change our breastfeeding culture. Re-normalize it. There is no law prohibiting women from breastfeeding in public. And so women should do it. And they should feel completely free to do it. Lots of it. As much as possible.

Did those words sound familiar? I first wrote a version of these words in 2009  after my account had been disabled for the 4th time for sharing breastfeeding images. It’s two years later, and it is still happening. Daily. To women all over the globe. It happened to me three weeks ago and I have, quite simply, had enough.

When I wrote this blog post in 2009 I ended with a challenge to all of you personally to encourage women who breastfeed in public, and to get out there and breastfeed your own child in public.

Today I’m bringing it back around to Facebook. I am challenging you to get involved. If you live in a city that is holding a nurse-in, a peaceful protest, a “boob-out” as my friends in Australia are calling it, on February 6th, I urge you to take the time to attend. Even if you’re not breastfeeding anymore. If you are a mother, a daughter, a wife, a husband, a father, an employer… come out and show your support for breastfeeding women and their right to share their joy and pride in breastfeeding with their friends and family, or with the world if they chose, on Facebook.

If you can’t attend, I challenge you to take action on February 6th. Change your profile picture. Upload breastfeeding photos. Come to our Facebook support page and share out the photos and videos and words of the people attending the nurse-ins around the world. Make joyful noise and tell everyone you know on Facebook that you want them to stop harassing breastfeeding mothers who are only trying to do the best by their children –and by humanity. Tell Facebook to leave breastfeeding images alone.

Will you commit to doing this, today? Again, I challenge you.

Warm regards,
Emma Kwasnica

Emma Kwasnica is a birth and breastfeeding activist and mum to three daughters. She is also the founder of Human Milk 4 Human Babies Global Network and spends her days passionately advocating for “informed choice” for all childbearing/-rearing women.

In November, Michelle Hickman was harassed and humiliated by Target staff for breastfeeding her baby in one of their stores in Houston, Texas. Yesterday, breastfeeding moms across the United States (and even a few in Edmonton, Alberta, Canada), headed out to Target stores for a nurse-in. In the end, there were moms at more than 100 different Target locations and the participation ranged from one mom and baby pair, all the way up to 40+ moms with babies. Some were nursing one baby, some were tandem nursing an infant and a toddler, and some were former nursing moms or partners of nursing moms who came out to support them.

Here is a video that I put together with photos from some of the nurse-in locations set to music from Moorea Malatt’s “Whip It Out: Songs for Breastfeeding”.

Here are some pictures of some of my blogging friends at the nurse-ins. On the left is Heather from The Bee In Your Bonnet tandem nursing and on the right is Amanda from Mommies Are Light nursing her newborn.

Was the nurse-in a success? That depends. It did bring out a lot of moms and babies and got a lot of media coverage about the rights of breastfeeding mothers. That is certainly positive. However, Target’s breastfeeding policy still leaves a lot to be desired. In particular, the requirement for moms to be “discreet” (Why? By whose definition? What about the not-so-discreet pictures of women in their underwear hanging up in the stores?), when we know that whether and how much to cover should be up to each mom. Read Heather’s great post on the problems with the policy for more detail. Also, Target still hasn’t apologized directly to Hickman for the treatment that she received.

Ultimately, I think that we need more moms and babies breastfeeding in public, including at Target, every single day. We also need more moms breastfeeding on television, in movies, in magazines, and on websites. Once that happens, breastfeeding in public won’t be a big deal or something that people need to be educated about, because it will simply be regarded as normal.

Congratulations to all the Target Nurse-In moms for taking a stand and being part of the positive normalization of breastfeeding.

P.S. To those who are wondering what happened to the Carnival of Toddlers, it will be continuing soon with posts on sleep, discipline, fun and more.

Some mothers have a specific weaning age in mind when they start nursing their child. Sometimes they change their mind along the way and sometimes they don’t. Other mothers purposely pursue child-led weaning right from the start. Some simply decide to take it one day at a time. Regardless of the approach that you choose, you may one day find yourself nursing a toddler.  After all, the World Health Organization recommends that breastfeeding continue until at least the age of two and anthropologists have pegged the natural age of weaning in humans as being between two and half years and seven years.

Busy Busy Bees

Nursing a toddler isn’t just like nursing a baby. They are busy little people, with lots of places to go, things to explore, toys to play with. They have big emotions and strong opinions. You may start to feel like your breasts are no longer a full service restaurant where your baby takes a long lingering multi-course meal. Instead, you may have a demanding rushed customer looking for a quick snack at the drive through or a round of shots at the bar.

What should you know if you are entering toddlerhood with your nursling?

There are no hard and fast rules about nursing a toddler. Some toddlers are well on their way to weaning, while others are still frequent nursers. So the experience of each mother-toddler pair will be very different.

• Balancing nursing with other sources of nutrition: As your toddler grows, they will, of course, start taking in some new foods. However, for most nursing toddlers, breastfeeding is still an important part of their nutrition. A lot of guidelines for feeding toddlers (how much milk, how many portions, etc.) seem to assume that the toddler isn’t nursing anymore and don’t take the nutrients and calories from nursing into account. So if it seems like your toddler isn’t eating very much compared to what the guidelines suggest or what other children the same age are eating, you probably don’t have to worry as long as they are still growing.

• Get some great photos: I have some great pictures of me nursing my babies and a few of me nursing them as toddlers. But I don’t have as many as I would like and my last nursing picture with each of them is probably about a year before they finally weaned. You’ll cherish the time that you spend nursing your toddler and having some great nursing pictures at that age will help you to remember it and share it with them as they grow. My friend and photographer Sara McConnell does some amazing breastfeeding photography and has some great shots, including some older nurslings and tandem shots. There are also some great shots over at Three Girl Pileup of her older nurslings. Be sure to take some pictures, whether professional or amateur, so that you can remember those times.

• The road to weaning is a windy and sometimes bumpy road: A lot of moms are surprised by toddlers who suddenly start nursing more. They thought they were down to two or three nursing sessions per day and suddenly their toddler wants to nurse all the time, around the clock. That is completely normal. Milestones, sickness, teething, and simple (or complex!) toddler emotions can all have an impact on how much your toddler wants to nurse. Understanding that weaning doesn’t happen on a straight line and that it is normal for there to be ups and downs can make it easier to ride that wave, rather than worry or get frustrated.

• Setting limits is okay: I see breastfeeding a toddler as a two way relationship that requires some give and take. When my toddler would ask to nurse, often I would say yes. However, if it wasn’t convenient (I was in the middle of cooking dinner, talking on the phone, planting flowers), I would say no. I also put “rules” in place about nursing at different stages. For example, I had a “no nursing between dinner and bedtime rule” for a while with my son because I needed the enticement of nursing to lure him into bed. But I also made sure that I offered to nurse my toddler at least as often as I said no. So if I had just finished doing something and was about to sit down, then I would ask her if she wanted to nurse. Or, when we woke up in the morning, before I got out of bed, I would ask if she wanted to nurse first. I didn’t want to use the “don’t offer, don’t refuse” approach to weaning, because I think it puts the entire onus of initiating nursing on the toddler. Rather than nursing being about a toddler demand, I liked seeing it as a relationship.

• Nursing is a great parenting tool: Toddler meltdowns and emotions are sometimes hard to handle. But for breastfeeding toddlers, settling down on mommy’s lap and nursing can be a way to help them calm down and get out of that moment. It gives them a chance to process their emotions while being comforted. Nursing is also a way to get very busy toddlers to settle down for a few minutes every once in a while. If you felt like you were always sitting down nursing when you had a newborn, when you have a toddler you’ll feel like you never get to sit down, so sitting to nurse is sometimes a great relief.

• They will wean: A lot of people seem concerned that if you don’t actively wean your toddler, that they will never give up breastfeeding. That simply isn’t true. Despite British “bitty” skits that show a grown man still breastfeeding as he brings his fiance home to meet his mother, I haven’t heard of any true stories of people breastfeeding into adulthood. Go with the flow, do what feels right for you, but know that regardless of whether you choose child-led weaning or gentle mother-led weaning, your child will eventually wean.

Those are the biggest things that come to mind with regards to nursing toddlers, but of course whole books could be (and have!) been written on the topic. Mostly, my suggestion would be to go with the flow, do what feels right, and talk to other moms with nursing toddlers to get support and share experiences. Enjoy the time because it will be over before you know it.

Suggested Resources

• Nursing After The First Year (Kellymom): Lots of resources on nursing past a year, including “why?”, common concerns, and how to parent your breastfeeding toddler.
• Nutrition for Breastfeeding Toddlers (Kellymom): A great resource to help you figure out how much and what your breastfeeding toddler should be eating. Find out whether that cow’s milk your pediatrician is pushing is really necessary, learn about toddler growth, and get more suggestions for feeding your nursing toddler.
• A different kind of baby-led weaning (PhD in Parenting Blog): I tell the story of how my toddlers transitioned from nursing to sleep to other methods of bedtime comfort.
• Gently Weaning a Preschooler (Kelly Naturally on the Natural Parents Network): A bit past the toddler stage, but may be relevant for many moms of toddlers too, especially if you see your nursing relationship continuing for a while.
• Pros and Cons of Breastfeeding a Toddler (Breastfeeding Moms Unite): One mom’s perspective on the ups and downs of toddler nursing.
• A time to wean? Your opinion, others opinions and how to deal (PhD in Parenting Blog): How to deal with criticism, how to decide when to wean, and how to gently wean your toddler (if you choose to do so).
• Se7en Tandem Nursing Questions Asked and Answered (Se7en Blog): A tandem nursing mom answers some quick questions about tandem nursing and points to some other great resources on the topic. Super helpful for moms who are nursing a toddler and have a newborn on the way.
• Nursing a Toddler in a Ring Sling (PhD in Parenting Blog): If you are on the go with your toddler and can’t sit down to nurse or if you want to nurse your toddler to sleep in a sling, this post will show you how to easily transition from a hip carry to a nursing.

Suggested Books

• My Child Won’t Eat – How To Prevent & Solve the Problem (Carlos González): A La Leche League book for parents who are concerned that their breastfeeding child isn’t eating a lot of solid foods.
• Mothering Your Nursing Toddler (Norma J. Bumgarner): An excellent book about the natural course of breastfeeding and what to expect with nursing children of different ages.
• The Womanly Art of Breastfeeding (Diane Wiessinger, Diana West, and Teresa Pitman): This is a comprehensive resource on breastfeeding and includes a chapter on nursing a toddler that covers what to expect, as well as some great tips.

Toddler Carnival Sponsor

Post contains affiliate links.

Most moms who wanted to breastfeed, but ended up formula feeding, will be able to cite a reason or two. Breastfeeding advocates generally say that most of those hurdles can be overcome most of the time. The divide between these two perspectives — of insurmountable versus surmountable problems — often results in heated discussions and hurt feelings. Moms feel like they are being told that they didn’t try hard enough and breastfeeding advocates are frustrated at the lack of recognition of other contributing factors.

In Canada, around 90% of women initiate breastfeeding, which is great. But things go downhill quickly. The World Health Organization and Health Canada both recommend six months of exclusive breastfeeding, with continued breastfeeding until 2 years or longer. How do the Canadian statistics stack up against that recommendation? At 3 months, 68% of moms are breastfeeding and 51% are exclusively breastfeeding. At 6 months, 54% are breastfeeding and 14% are exclusively breastfeeding.

Or, in other words, by the time a baby is 6 months old:

• 10% will have never been breastfed
• 36% will have been weaned
• 40% will have been supplemented at some point (either with formula or early introduction of solids, other milks, juice, etc)
• 14% will have met the recommended duration of exclusive breastfeeding

Why are so few moms meeting the recommended duration of exclusive breastfeeding?

Reported Reasons

According to a Today’s Parent Survey (by John Hoffman), only 1 in 10 women report “problem-free” breastfeeding. That means that 90% of women who chose to breastfeed have to overcome some sort of hurdle in order to continue breastfeeding. Some of the are able to overcome those hurdles with help or with time. But others are not.

According to the Today’s Parent Survey, three types of breastfeeding problems were particularly prevalent among moms who weaned early:

• Low milk supply
• Low baby weight gain
• Baby who seemed uninterested in nursing or nursed inefficiently

Some other reasons I’ve frequently heard moms moms give for supplementing prior to six months include:

• Wanting or needing to leave baby temporarily (work, date night, weekend away) and not wanting to pump or not being able to pump enough.
• Doctor or parenting book advised them to introduce solids before 6 months.

Contributing Factors

The reasons that moms give for stopping breastfeeding are an outcome — low milk supply, low baby weight gain. There need to be reasons for those outcomes. In a small percentage of women, there are legitimate insurmountable medical reasons for those outcomes. However, for most mothers, it is other contributing factors (likely in combination with difficult but surmountable breastfeeding challenges) that can lead to that result.

Those contributing factors include:

• Formula given to babies in hospital (at least one-third of moms reported that their babies were given formula in the hospital and experts say that is probably lower than the reality, and moms who weaned early were much more likely to say their babies got formula or sugar water in hospital)
• Formula samples handed to moms in hospital (Forty percent of moms leave the hospital with formula and those who do are 3.5 times more likely to be supplementing by two weeks of age)
• Formula samples or coupons sent to moms by formula companies or companies they are partnering with (if they don’t get you at the hospital, don’t worry, there will be a sample in your mailbox soon)
• Formula advertising (moms who recall seeing a formula ad twice as likely to feed their babies formula)
• Doctors who suggest that moms “just try formula” (moms advised by their doctor to try formula were four times as likely to do so than those not advised by their doctor)
• Not enough breastfeeding support (not having access to support when you need it or not being able to afford quality support)
• Poor quality breastfeeding support (getting bad or inconsistent advice, which can lead to more problems instead of resolving the problems, was about twice as prevalent among moms who stopped early than those who continued breastfeeding)
• Ashamed to breastfeed in public (moms who use nursing covers may wean earlier than moms who are comfortable nursing in public without covering up)

Twice as likely, 3.5 times as likely, twice as prevalent, much more likely, four times as likely, and so on — it all adds up.

Moms don’t usually name a formula sample, a not-so-knowledgeable doctor, or a lack of comfort nursing in public as the reason for their low milk supply, but in a lot of cases it probably is a contributing factor. That doesn’t mean that these moms didn’t try hard enough (and really, hard enough is subjective and will be different for each person), but it does mean that these are issues worth tackling. They are hurdles, or barriers or booby traps, or whatever you want to call them. They are silent killers of breastfeeding relationships.

What is Missing?

We can compare the statistics on actual breastfeeding duration with the recommended duration and see that Canadian mothers come up short. But that doesn’t tell the whole story. The key information that is missing from these statistics is information on women’s breastfeeding goals. We need a long-term study that asks pregnant women how long they plan to breastfeed exclusively and when they plan to wean and that compares that with what actually happens. Is there a gap? If so, how big is it? What reasons do the moms give for the gap? What other contributing factors came into play? A comparison between the recommended duration of breastfeeding (6 months exclusive, continued nursing for 2 years or more), women’s own breastfeeding goals, and actual length of breastfeeding is essential to a full understanding of where and how things break down.

More Data, But What Else?

Yes, we need more data. That said, there is already some evidence that a lot of women stop breastfeeding earlier than they planned to. According to the Today’s Parent survey, at least 1/3 of breastfeeding moms stopped earlier than they had planned and the numbers are probably higher for first time moms.

In the meantime, however, we need to keep working on breaking down the barriers and tackling those contributing factors. They should be eradicated wherever possible. Or, where that isn’t (yet) possible, we need to at least make moms aware of the danger so that they can protect themselves and their breastfeeding relationship.

Breastfeeding advocacy doesn’t really need to focus on the 10% of women who choose not to breastfeed. It needs to focus on the large numbers of women want to breastfeed and are devastated when things don’t go the way they wanted them to. Breastfeeding advocates need to create awareness among those women (before it is too late) and help them to navigate the minefield.

What do you think should be the first priority in tackling those contributing factors?

Advertising is a tricky subject. People claim it is necessary to inform us about the choices we have as consumers. People say that putting restrictions on it goes against the principles of free speech. People claim that we are smart and we can see past the the marketing spin. To say otherwise, is to call people stupid.

Because, c’mon, who really believed that Nutella was a part of a nutritious breakfast? You didn’t, did you? We’re all smart enough to see past that and read the labels. So the mom who did believe it, she must be the one who is stupid. Smart people don’t fall for ads. So despite the German courts  ruling that Nutella’s nutrition claims are misleading, the problem isn’t so much with the manipulative ads, but with stupid people who believe them. If we could get rid stupid people, manipulative ads would totally be okay.

The advertisers are smart though. They know that ads work. They know that either smart people do fall for ads often enough or that there are enough stupid people out there to make them worthwhile. They don’t need a study to prove that. They have years and years of first hand experience. They know that everyone has moments of weakness and gaps in knowledge and they know that those are opportunities to influence.

But some people may need a study to convince them of this. Some people believe that formula ads don’t influence a woman’s choice of how to feed her baby. The ads simply inform mothers who have chosen formula about the products that are available. That might, arguably, be useful to some women if the claims made by formula companies were accurate (but the Canadian government says they are not).  But that isn’t the extent of the problem. You see, formula ads do actually influence how a mother chooses to feed her baby.

A study by six researchers from the World Health Organization, that was published in the Social Science and Medicine Journal, found that both formula ads and doctors suggestions to use formula did influence mothers feeding choices:

According to their findings, 59.1 percent of the mothers recalled an infant formula advertisement message and one-sixth reported a doctor recommended using formula. Those who recalled an ad message were twice as likely to feed their babies infant formula, while whose advised by a doctor where four times as likely to do so.

Twice as likely. Yes, moms who saw a formula ad were twice as likely to feed their babies formula. And with regards to the doctors, when Dr. Brian Goldman, host of White Coat, Black Art on CBC Radio 1, suggested that more doctors need to tell moms to try formula, I responded over at Best for Babes with a post called Is “Try Formula” the Answer to Breastfeeding Guilt, where I concluded that:

There is a big gaping hole between “Thou Shalt Breastfeed” and “Try Formula”. The gaping hole needs to be filled with affordable, accessible, quality breastfeeding support. Instead, that hole is too frequently filled with pressure and guilt, from society and from within.

I don’t think that mothers need to be told that they must breastfeed and I also don’t think that mothers need to be told that they must try formula. What would happen if, instead of feeling the need to TELL mothers what to, health professionals simply asked: “How can I support you in your feeding decision?” From there, the conversation needs to combine compassion and knowledge, supporting the mother while also answering her questions and educating her without judgement or pressure.

Back to the formula ads. Yes, infant formula ads on articles and websites about infant feeding bother me. Not because I think women are stupid, but because I know that humans are human. They are vulnerable and emotional and get drawn into things that are shiny and pretty and helpful and easy and supposedly good for us. I know this because I am human too and while I resisted the allure of formula ads, there are other ads that do draw me in and cause me to make purchases that I wish I hadn’t . But maybe I’m just weak or stupid.

So for the weak or stupid people out there (or for the humans), I would support a legislated ban of infant formula advertising as recommended by the World Health Organization. But in the absence of a law, I would also support publishers and broadcasters who are willing to take a stand and not allow infant formula advertising or, at the very least, not allow infant formula advertising on websites and publications that are aimed specifically at the mothers of babies. Not because formula is evil, but because moms who have chosen to breastfeed deserve a fighting chance and shouldn’t be bombarded with booby traps every time they turn around.

Image credit: M J M on flickr

I am away at the Blissdom Canada conference this week. After an interesting discussion with Karen Bayne (@karenebayne) on twitter last week, I asked her if she would be willing to expand on her thoughts in a blog post. Luckily she agreed and here it is. Please welcome Karen to the blog.

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Last week there was another firestorm at Babble about breastfeeding – years after I thought we would be done. This time it came through the voice of a personal blogger who told other mothers to “cover up.” She has a one month old baby and is able to breastfeed discreetly.  I am sure you can imagine the comment section. It is full of people who feel judged and rightly so. She called their boobs saggy and informed them that no one wants to be “subjected to them.” She even implied that if women were really only interested in feeding their baby, they should not mind putting on a nursing cover to do so for the sake of others. It is far from a feminist argument as it puts the mother in the position of accommodating her body to the needs of several other interested parties for their comfort. But, she was not trying to make a feminist argument.

Over and over again, we are told there is no need to make such a fuss about public breastfeeding and that we should quiet down and be more reasonable. What I know now that I didn’t know when I was breastfeeding my young is that we will never be done with mommy wars  while society’s misogyny runs rough shod over our bodies, our interests and our voices. Each new generation of mothers discovers mothering for themselves. Each of us awakes and finds herself in a postpartum world that abandons us, asks us to shift for ourselves.

The Babble post revealed to me a new mother who is coping with being in the vice grip of  discomfort with her own newly postpartum body and perhaps even the role her breasts now play in her life. She is not the only mother to feel this way – to want to keep her breasts the sexual body part we are more comfortable hiding (or revealing and displaying) here in western society. No doubt this is shaky ground for many of us. With constraining standards of beauty and womanliness, our bodies in a state of very real flux, and infants needing constant care, we are in fact, trying to row up stream without a paddle when we engage in the small act of kindness towards ourselves. Can I love this postpartum body when there is no one telling me I should? If I am applauded for getting back into my jeans as soon as possible, surely I should hide any bodily evidence to the contrary, right?

I work as a birth and postpartum doula. I am  frequently with very new mothers who are experiencing intense postpartum adjustments. Many feel sad or anxious. Some feel angry, all over angry at everyone and everything. It can often feel more challenging to me to be a helpful support in this circumstance   compared to someone feeling alone, sad or worried.  How do I reach across the divide when someone is lashing out – whether in real life or on the internet?  Usually I spin my wheels a bit until I remember how angry I am that our culture does not do everything in its power to make this adjustment time better for families and mothers. Often times we simply abandon them, telling them they are fine and their babies are fine. Too often what new moms hear bout their emotions and experiences is exactly what this blogger wants the rest of us to do with our boobs:  grow up and cover them up, please.  And we want to do the same – hey lady, keep it to yourself– instead of helping to uncover the internalized oppression, we want to snark back about how awesome our boobs are.

Shame and Synchronized Latch

In the meantime Joanne Weiss wrote an article -  in the part of Slate that tells us what women really think  -in which she slams the lactivist movement for shaming women. I cannot find any specific evidence she has for this but no doubt some women have felt shamed by some parts of the lactivist movement. It is too broad a statement for me to deny – my own personal experience proves it to be true. Anyone familiar with the story of my second baby’s illness will tell you how devastated I felt anytime anyone suggested I took the easy way out by giving him formula. There was nothing easy about our journey.   Weiss suggested everyone just grow up, cover up and become more rational as we had more important grown up things to talk about like maternity leave and paid sick leave. These are indeed excellent causes. I have not seen any evidence to show that I cannot support all of them – especially as having excellent maternity leave would improve my country’s longer-term breastfeeding rates and keep infants healthier. Healthier infants must relate to paid sick leave somehow, right?

I find it objectionable that the author has no issue with lactivists promoting breastfeeding to participants of WIC or women  in vulnerable demographics or countries but portrays promoting and educating white, middle class women about breastfeeding as inherently shaming and, frankly, it seems, down right goofy.

There is a way in which the Slate author is quite right. When women turn our energies against each other we lose sight of the way our society has set us up to fail. This misogyny turned inward is the dark heart of the mommy wars. So, perhaps she felt shamed. I can hear that her piece. And she shamed them right back, those silly lactivists with their breastfeeding t-shirts and synchronized latches! When will they buy a nursing cover so they can sit at the grown up table?

My shiny new glasses

When I think back to my earliest days of mothering,  I remember my own history with judging and being judged. I was a young, somewhat broke, stay at home mother in a community filled with  more well off, older stay at home mothers and much more well off working mothers. I was judged. I appeared to be doing it wrong.  And I judged right back to shore up my own position. We all do this; we learn it as kids. It deflects unwanted attention away from ourselves. Then one day, because I lucked out and had a relatively easy baby and a supportive family,  the ground I stood on was not quite so shaky.  I saw clearly the external pressures I faced – a less than ideal job market, daycare costs that were intimating, jobs that did not have paid sick time and a work force in which my work was not going to be for equal pay. The revelation rocked my world, freed my spirit ; the sun shone everywhere for a few minutes and then I thought, “This sucks.”

My society held me 100% responsible for my situation while not giving me the support I needed to change it. When my eyes were opened to this truth, it was like wearing shiny new glasses. I no longer blamed myself for this conundrum. Nor did I blame other mothers who found their own path through the maze though it might look drastically different than mine. I ended my own mommy wars but not purchasing the premise – that I was in conflict with other mothers. I began to notice my judgments more – not less. I noticed how many of my judgments were based on my culture, my family history, my experiences, and my preferences, as well as the preferences of my particular baby. When I slowed down to notice my judgments, I was able to relieve myself of their burden. I began to ask myself, Why does that bother me? What about her choice is triggering this response in me? How am I buying into the values of my broken society and what do I stay to lose or gain by holding this position?

We can notice and respect to our own judgment -the decisions we make for ourselves and our families  – and also notice and be responsible for our own judgments  – for example, the feel of discomfort you might experience when you see an infant breastfeeding. We can choose to move  from everyone should  language, which is deliberately shaming and aggressive to here’s what I think  language which is mature, responsible and open for debate. We can notice our reactions and chose whether we use them to shame others or not. We are not in conflict with other mothers. We may often disagree, we may decide very different things but our real conflict is with a world that congratulates us on the good news when we announce our pregnancies and then leaves us on shaky ground the moment we have a babe in arms.

Karen Bayne is a birth doula, postpartum doula and childbirth educator with ICEA. Her goal is to provide wise, compassionate care and information that is evidenced based and respectful to women and their families. She lives in Northampton, MA with her husband and three boys where she is the President of the Green River Doula Network and proud MotherWoman Board member. She blogs at Gentle Balance Birth and Needs New Batteries. You can talk to her more on Twitter and Facebook.

 Photo credit: parcelbrat on flickr

In recent discussions about whether formula companies are a good source of advice on breastfeeding, my emphatic answer was NO! A few people chimed in and asked who could provide objective, evidence-based, judgment free advice on infant feeding. Could it come from a lactation consultant or are they too biased toward breastfeeding? I put the question to local International Board Certified Lactation Consultant (IBCLC) Fleur Bickford who blogs at NurturedChild. Please read what she had to say.

A dad feeds a baby a formula supplement

If you’re a breastfeeding mother and you need help with feeding your baby, a lactation consultant is an obvious choice for information and support. What if you’re a mother who needs, or chooses to use formula? Who do you turn to for accurate information and support? Where are you going to get the information you need to make an informed decision about feeding your child?

Your doctor or nurse might seem like the obvious choice if you have questions about feeding formula, but unfortunately, doctors and nurses receive very little training about infant nutrition. For many doctors, their knowledge of infant formula is limited to the information that they are given by the formula reps who come to visit with their free samples and glossy brochures about why their formula is the closest ever to breastmilk. Hardly an unbiased or complete source of information.

Annie asked me to write a guest post about how I work with moms who need to use formula for whatever reason, or those who choose to combo feed (give some breastmilk, some formula), while also upholding the requirements of my designation as an International Board Certified Lactation Consultant (IBCLC). She wanted to know where moms who need or want to use formula can go to get objective, judgement-free support on feeding their infant, and whether or not an IBCLC is a good place to turn.

How does an International Board Certified Lactation Consultant Work With Moms Who Use Formula?

Many people think that lactation consultants can’t or won’t provide information about formula feeding. They often mistakenly believe that the World Health Organization Code of Marketing Breastmilk Substitutes (WHO code) prevents anyone who upholds it from talking about formula or bottle feeding. This is not the way the WHO Code works. The Code deals only with marketing. As an IBCLC, I can uphold my commitment to the WHO Code and still talk to moms about how to prepare formula, and how to bottle feed, as long as I am not using my practice to market formula or bottle feeding.

As an IBCLC, I am required to work within a framework that is defined by several documents from the International Board of Lactation Consultant Examiners (IBLCE) and the International Lactation Consultant Association (ILCA). In all of these documents, the focus is very much on helping mothers to meet their breastfeeding goals. This means that if a mother’s goal is to feed some breastmilk and some formula, then it is my job to help her do that successfully, while at the same time making sure that her decision is an informed one. There is no getting around the fact that there are risks to feeding your baby something other than breastmilk. The possible consequences of not breastfeeding are well documented by research. Having said that, I do not think formula is evil. I disapprove of the marketing tactics used by formula companies, but if a mother’s own milk or donor milk are not an option for whatever reason, infant formula is an acceptable alternative.

Am I biased towards breastfeeding? Yes, of course I am! I am aware of that bias however, and being a lactation consultant does not mean that I can’t or won’t provide information for parents who need or choose to use formula. Although the vast majority of women want to breastfeed (as evidenced by high breastfeeding initiation rates) we do not yet live in a society that is truly supportive of breastfeeding (in fact I’d argue that our society isn’t supportive of mothers in general, but that’s another post). There are many factors that may play into a mother’s decisions about infant feeding, and I strongly believe that all babies deserve to be fed in a safe and biologically appropriate manner. In order for this to happen, parents need information and support. Unfortunately, with all of the emphasis on “breast is best” it seems that often, care providers are afraid to talk about formula feeding.

As a lactation consultant, I see moms who are having trouble with breastfeeding, and often they are already supplementing with formula by the time I see them. My job is to support a mother to reach her breastfeeding goals, not mine. If a mother wants to supplement or combo feed, who am I to say that is not the right approach for her. I do provide info about supply and demand, how introducing bottles or formula might impact breastfeeding etc., however I also do a lot of teaching about safe formula preparation and how to bottle feed in a manner that respects a baby’s natural biological rhythms, and protects baby’s airway. Often, parents have been told to supplement and have been handed a can of formula, but they haven’t been given any instructions on how to feed it. Whether that is because it’s assumed that everyone knows to bottle feed, or due to a reluctance to talk about formula feeding for fear of seeming unsupportive of breastfeeding, I’m not sure. In many cases it may simply be due to the fact that the doctor/nurse doesn’t know anything about formula/bottle feeding themselves.

When I’m working with breastfeeding families, my concern is more about the experience than the outcome. If a mother chooses to combo feed, or exclusively pump and bottle feed, it may not be what I would have chosen for her, but if she is happy with her decision and happy with her experience with me, then I feel that I have done my job. If a mother comes to me looking for information and leaves feeling like she’s a bad mother for using formula, then I’ve lost that mother for good. If she leaves feeling supported by me and empowered as a mother, no matter what her choices for infant feeding were, then she is far more likely to come back to me down the road for her next baby, and perhaps next time she may be ready to try exclusive breastfeeding.

So to answer part of Annie’s question, yes, an IBCLC can be a good source of evidence based information about bottle and/or formula feeding. Our clinical competencies require that we are familiar with how to prepare formula safely as outlined by the World Health Organization. We are also required to be able to provide information about the safe and appropriate use of devices that breastfeeding mothers may use, including bottles.

Can an IBCLC Provide Objective, Judgment-Free Support?

The second part of Annie’s question – where can mothers who need or want to use formula go to get objective, judgement-free support on feeding their infant, and is an IBCLC the right choice? – is much harder to answer. All health care professionals are human, and all come with their own individual levels of knowledge, training and continuing education, and also, their own beliefs, perceptions and personals biases. All IBCLCs should be able to provide information about safe formula preparation and bottle feeding. Whether or not that information is provided along with non-judgemental support depends on the individual IBCLC. It can also depend on a mother’s perceptions. It can be very difficult to ensure that a mother has all of the information she needs to make an informed decision about feeding her baby (including information about the risks of formula) without the mother feeling like she is being judged. This is one reason why we should be working to ensure that women have this information before their decisions about infant feeding are made.

So what is a mother to do? As I wrote this post I realized that the available information and support surrounding infant feeding for all mothers, whether breastfeeding, formula feeding, or some combination of the two, leaves a lot to be desired. If you are not finding the information and support you need, keep looking until you find it. It is out there, but sometimes it is necessary to shop around. At the same time, we need to continue to put pressure on health care providers and governments to ensure that our society becomes one that supports all mothers.

Fleur Bickford is the mother of two breastfed children, and an RN and IBCLC working in private practice. She is very active in the Ottawa breastfeeding community, having volunteered as a Le Leche League Leader and Ottawa Breastfeeding Buddy, and she is currently president of Ottawa Valley Lactation Consultants. Fleur blogs as NurturedChild and is on Twitter and Facebook. She also writes for the Best for Babes blog.

Image credit: petitshoo on flickr

The business model and profitability of infant formula companies depends primarily on two myths:

• The first myth is that informal milk sharing is riskier than infant formula.
• The second myth is that breast milk is a scarce commodity.

The first myth is one I’ve tackled before in my post on the risks of informal breastmilk sharing versus formula feeding.  Today, in honour of World Milksharing Week, I’m going to tackle the second myth.

World Milksharing Week

Human Milk 4 Human Babies (HM4HB) is a global milksharing network, a virtual village, comprising thousands of people from over fifty countries. Its mission is to promote the nourishment of babies and children around the world with human milk. It is dedicated to fostering community between local families who have chosen to share breast milk.

Dani Arnold-McKenney, the administrator of a milk sharing network in Southwestern Ontario, explains the way that milk sharing not only nourishes babies, but also creates community:

It’s a myth that we are all about anonymous milk drops in parking lots. Our donors and recipients support each other and learn from each other. We’ve had milk recipients rebuild their own milk supplies and turn around and become donors. I have seen milksharing friendships grow and watched bonds of motherhood bloom between mothers who didn’t know each other a mere few weeks before.

September 24 to 30, 2011 is the inaugural annual World Milk Sharing Week.  There are numerous events happening this week all over the world and online to celebrate. Do you want to participate? Learn how you can get involved and take action as part of this year’s World Milksharing Week.

Is Breast Milk Scarce?

As I mentioned in the introduction, formula companies profit depends on breast milk being scarce. Not every woman is able to make enough breast milk to nourish her babies, either for physical reasons or because she got bad advice or an infection that temporarily impacted her milk supply.

Although I had to pump for my babies, including exclusively pumping for my son who couldn’t latch for the first two months and then pumping for both my children after I returned to work, I was lucky that I never really had to worry about my milk supply. I made enough milk for my son (who was a big eater and a big boy) and I made more than enough for my daughter (which meant that I could stop pumping at work months before she stopped getting breastmilk during the day). There was, however, one period when I was pumping for my son and got a horrible case of mastitis. My milk supply plummeted and  once my small freezer reserve was used up, I did have to give him some formula. I wish there had been human milk banks or good informal milk sharing networks that I could have turned to at the time to get the additional 6 to 8 ounces of breast milk that I needed per day for the couple of weeks it took me to rebuild my supply. But there wasn’t.

In some ways, breastfeeding is like gardening. I grow tomatoes in my garden for part of the year. That means that there are a couple of weeks per year that I am swimming in tomatoes and can happily store extra or share them with friends. The rest of the year, however, I depend on a variety of different distribution systems (from the farmer’s market to the produce section of the grocery store to the canned foods industry) to provide me with the tomatoes that I want to feed my family. There are people in others parts of the world that are lucky enough to have a longer growing season than I have, but I just don’t have the ability to produce all the tomatoes that I need, despite the fact that tomatoes are not a scarce commodity on a global scale.

Breast milk also isn’t a scarce commodity. Breast milk exists in sufficient quantities to feed the world’s babies, but not every mother has all the milk that she needs all the time.  Breast milk is, however, a commodity that doesn’t have advanced distribution channels like other commodities. But why is that? It is perhaps partly because there isn’t a profit to be made in the breast milk industry, since selling of breast milk is illegal in many places like Canada. It is also partly because the infant formula industry exists and many people feel that it sufficiently fills the gap.

However, more and more mothers want to be able to feed their babies exclusively breast milk and want to avoid infant formula for health, financial and ethical reasons. This is where informal milk sharing networks come in. According to Emma Kwasnica, founder of the Human Milk 4 Human Babies Global Network:

Breast milk is not a scarce commodity, it’s a free-flowing resource. With the advance of social media, women who are willing to share their breast milk can now easily connect with families who need milk for their children. We at HM4HB are thrilled to see women and families asserting their autonomy to do what is healthy, normal and ecological. Families are making informed choices to share breast milk and babies everywhere are thriving as a result.

I firmly believe that parents should have the choice to feed their babies however they want to. However, the perceived scarcity of breastmilk has taken that choice away from many women over the years. I am happy to see networks like HM4HB helping to create distribution channels and fill the gap so that more families have a truly free choice in how to feed their babies.

An Experiment Takes an Amazing Turn

Some of you may have read earlier this week about a man who was going to try to live on breast milk alone. When Emma Waverman wrote about it on her blog Embrace the Chaos, he was on Day 3 of the experiment and was documenting it on a blog called Don’t Have a Cow (the blog is currently down and apparently will not be resurrected).

Reactions to the experiment were mixed. Some people were fascinated, some people were disgusted (which further underscores how ridiculous our thoughts on breast milk are – we drink the breast milk of COWS), and some people were upset that the milk was being wasted when it could go to babies in need. The family had, apparently, tried to donate the thousands of ounces of breast milk that they have, but were unable to find a donor.

This story has a wonderful ending. After talking with Emma Kwasnica of HM4HB, the family has now been connected with a mom in California who gave birth to quad babies in June of this year. Katie, the mom with all the extra breast milk, will be handing over several thousands of ounces of breast milk to the four babies. An amazing story of sharing the wealth and the warmth of breast milk.

This is just one example of how a family with extra breast milk can help a family in need. The continued advocacy and support of informal milk sharing provides great promise for helping families provide exclusive breast milk for their babies and creating community and support for breastfeeding moms.

Happy World Milksharing Week!

I’d like to wish all of you a Happy World Milksharing Week. If you have a milksharing story or if you have thoughts on milksharing, I’d love for you to leave a comment. The more discussion we have of the amazing possibilities of milk sharing, the more families that can be helped.

I’ve had a lot of interesting conversations over the past few days about shame, guilt, and social change. Without going into excruciating detail, I heard a lot of people say that calls for formula marketing to be restricted makes formula feeding moms feel shamed because if formula marketing needs to be restricted, then that means that formula is bad, which means that formula feeding moms are doing something wrong.

Some people believe that if you feel shame or guilt that it is your own fault because no one can make you feel guilty except you. While I do think a lot of guilt comes from within, I also know that societal norms and expectations are contributors to feelings of guilt and shame.

We want the world to change. We need the world to change. That means, sometimes, criticizing the way that things are done now and advocating for a better way of doing them. Is that possible though, without making people feel guilt and shame?

• If we advocate for more support for breastfeeding mothers, does that equate to shaming every mother who used formula?
• If we advocate for more midwives and other conditions that will increase the natural birth rate, does that equate to shaming every mother who had a c-section?
• If we advocate for easier and more affordable access to healthy foods, does that equate to shaming every person who ever indulges in junk food or fast food?
• If we advocate for improved public transportation, does that equate to shaming people who drive their cars to work?
• If we say that chocolate bars should not be available for purchase in schools, does that amount to shaming every parent who every put a piece of chocolate in their child’s lunch?
• If we advocate for an end to wars, does that equate to shaming everyone who has ever served in the armed forces?
• If we advocate for better treatment of animals, does that equate to shaming everyone who ever ate factory farmed meat?
• If we advocate for improved educational opportunities, does that equate to shaming everyone who didn’t graduate from high school?
• If we advocate for better maternity leave, does that equate to judging every woman who went back to work?
• If we advocate for better prevention of teen pregnancy, does that equate to shaming everyone who did get pregnant as a teenager?

We live in an imperfect world. We all make choices, on a daily basis, with imperfect information and in imperfect conditions. Every single day, I make choices that I wish I didn’t have to make. Every single day, I try to make better choices. It is a balancing act between progress and reality. No one is perfect. No one should be expected to be perfect. No one needs to feel guilt or shame for being imperfect.

Ultimately, at the end of a conversation that I was finding very frustrating, one in which I raised many of the examples that I listed above, I concluded:

Because, really, any time we argue for better societal conditions, it means that we are saying HOW MUCH WE ALL SUCK. Let’s judge ourselves.

Is that really the world we want to live in? One where we are afraid to advocate for change because it makes us feel guilt and shame?

Ultimately, on the breastfeeding issue, I think the problem at the moment is that there is too much pressure to breastfeed and not enough support for breastfeeding. Moms are told that they must breastfeed. More than 90% of moms in Canada initiate breastfeeding (either because they wanted to or because they felt forced into it). But most of them do not meet their own breastfeeding goals. I think there are enough messages out there telling moms how important it is to breastfeed. Perhaps even too many. However, there is too little real breastfeeding support. Women who want to breastfeed are still undermined every day by the many societal barriers to breastfeeding or the “booby traps”.

But how do we get there? How do we get to a place where we can ask the world to change without making the people who live in that world feel shame?

Image credit: ToastyKen on flickr

Do you ever poke around on flickr? Most of the pictures I use for posts on this blog are from flickr creative commons photos. I love the beautiful imagery that people make available for public use. In particular, because I think the world needs more breastfeeding imagery, I always like to find beautiful breastfeeding pictures to go along with my content. So today, I’ll share a few just because. Enjoy.

Source: various brennemans on flickr

Source: Tareq Salahuddin on flickr

Source: Ben Klocek on flickr

Source: Christy Scherrer on flickr