“Case Against Breastfeeding” Overlooks Big Dirty Secret
Posted March 17th, 2009 by Bettina ForbesHere’s what Hanna Rosin is missing in “The Case Against Breastfeeding”: Moms are being urged to breastfeed but set up to fail.
Ms. Rosin finds that breastfeeding no longer works in her life and doesn’t want to be made to feel guilty about not breastfeeding her third child. Unfortunately, instead of examining why it doesn’t work, and why something that can be so easy, pleasurable and beneficial is being made so difficult, Ms. Rosin conducts a selective, cursory review of the scientific literature, concluding that the evidence is “thin” in favor of breastfeeding, a point of view that was furthered on the Today Show.
We all agree that mothers should not be made to feel guilty, whether they choose to breastfeed or not. What would be far more helpful, though, is to ensure that expecting parents have the best, evidence-based information to make their decisions on how to feed their babies, and that they can actually carry out that decision without constant interference. For the 74% of mothers who want to breastfeed, that is simply not the case. Many women throw in the towel before they want to—according to CDC data, 60% do not meet their personal breastfeeding goals, and only 11% meet the minimum six months of exclusive breastfeeding recommended by the American Academy of Pediatrics (AAP). They unfairly blame themselves and lash out at other mothers, instead of at the “booby traps”—the cultural and institutional barriers that are tripping them up at every turn.
As soon as an expecting woman tells her doctor that she plans to breastfeed, she starts receiving formula samples and coupons in the mail—coupons and samples which her friends who checked off that they do not plan to breastfeed will not get. She will probably have taken a childbirth education class, while a breastfeeding class is optional at best. She’ll expect to receive breastfeeding support in the hospital; she won’t know that in fact, “most hospitals perform poorly on breastfeeding support”. She won’t know that only 3% of the 3,000 maternity centers in the U.S. are designated “baby friendly” and follow a protocol proven to result in breastfeeding success.
While in the hospital, 25% of babies will be supplemented with food other than breastmilk, whether or not there is medical indication and often irrespective of parental request. Mom and baby will leave the hospital before the mother’s milk has fully come in and before breastfeeding is established. 70% of mothers will receive a diaper bag filled with more formula samples and coupons—a practice known to be highly effective in undermining breastfeeding duration. At home, the new mother will be subject to disapproval from family, peers and a society that normalizes bottle-feeding.
Having received insufficient support in the hospital, the mother will probably need to find a lactation counselor to address unnecessary breastfeeding complications. Unfortunately, professional help is not only scarce in some areas, but often not covered by health insurance. While the American College of Obstetricians and Gynecologists and the AAP both recommend exclusive breastfeeding for a minimum of six months, it seems that neither organization requires that doctors be trained in even the basics of breastfeeding support (such as latching in the first hour, or referring patients to lactation counselors or support groups as needed). Finally, if moms manage to make it through the gauntlet of the first few weeks, they face discrimination in public, and from stores, restaurants, airports, and employers. The U.S. has the worst maternity leave policy of any industrialized nation, despite evidence that breastfeeding benefits employers.
No wonder women like Rosin and her friends are ticked off (although their anger is misplaced); breastfeeding has become a lot harder than it is supposed to be! Worse, too many have a miserable experience breastfeeding. The longer we let women suffer through unnecessarily difficult nursing experiences without removing these barriers or “booby traps,” the more disgruntled they will become, the more likely they will be turned off by the nursing experience altogether, judge each other, and miss what can be a wonderful part of motherhood.
As for the scientific debate, Tanya Lieberman, IBCLC does a great job listing the facts, and I’m sure the Academy of Breastfeeding Medicine has more to say.
I do find it hard to believe that the World Health Organization, Unicef, the AAP, hundreds of respected scientists and doctors as well as every other medical and scientific body would go so far to promote breastfeeding if the evidence were as marginal as Ms. Rosin asserts. Consider that there is no financial gain to be had for promoting breastfeeding, there are no kick backs to be had, funding for a hospital’s NICU, or charitable donations for “causes” that breastfeeding actually protects against. The converse can not be said to be true, the deep pockets and lobbying power of the formula industry and the pharmaceutical companies that own them are well-known.
Instead of ending the mommy wars, it seems that Ms. Rosin has only added fuel to the fire. We hope it’s an opportunity to put heat on the barriers that are undermining us all.
(Author’s note: Special thanks to Melissa Bartick, M.D., Marsha Walker, RN, IBCLC, and Cindy Turner-Maffei, MA, IBCLC.)
42 Comments
March 19, 2009 at 11:31 am by Bettina@bestforbabes.orgYou story sounds similar to mine–I didn’t want to breastfeed, either and bristled when TOLD what to do. We completely agree that women should neither be pressured or judged. It sounds like you thought it through and decided breastfeeding was not for you and were at a place of acceptance and peace which is why you don’t feel guilty . . . which is wonderful! Our heart-ache is for the 74% of women who WANT to breastfeed, are being prevented from succeeding, and are blaming or guilting themselves unnecessarily. Finally, we encourage everyone not to rely on anecdotes with either the blindingly sophisticated marketing practices of the formula industry or with the scientifically established and respected benefits of breastfeeding. We adults love to talk about how we didn’t wear seatbelts or helmets as kids, but because of scientific evidence and the MARKETING of that evidence, our kids now do!
[Reply]
March 18, 2009 at 12:32 pm by thefeministbreederI’ve been exclusively breastfeeding for 10 months and I got TONS of free formula cans and free formula coupons. During the month of my due date, I think I got a total of 8 free cans of formula, and still, to this day, get formula coupons in the mail.
I donate them to those in need. A woman less committed than myself might have chucked breastfeeding and started using the free goods… but I was simply offended by them.
Besides that, I also knew (from my first son) that they only send big coupons for the first few months, until they get you hooked. Then the $12 off coupons disappear, and you’re lucky to get $1 off here and there. It’s terribly misleading.
[Reply]
March 18, 2009 at 12:27 pm by TheFeministBreederMy biggest problem with her article is that she
A.) said that women who breastfeed “can’t work in any meaningful way.” BULL.
B.) that breastfeeding is so time consuming. BULL.
I work 60-70 hours a week, all while breastfeeding a 10 month old. He’s NEVER had formula.
Formula is far more time consuming – hello? mixing/measuring/heating/washing bottles/driving to story to buy it. How is it not easier to pull up your shirt and stick a baby on your boob? Even pumping doesn’t have to be time consuming if you buy a pumping bra, and complete other tasks while you’re hooked up. I can’t tell you how many papers I’ve written or reports I’ve put together while being milked in the Lactation Room at work.
I responded to these two points in my own blog, but I believe that those two arguments, in themselves, are pure fiction. I think she’s got some hatred toward her situation, and chooses Breastfeeding as the target (or cause) of her anger.
http://thefeministbreeder.typepad.com/the_feminist_breeder/2009/03/my-response-to-the-case-against-breastfeeding.html
Don’t you dare tell me that I “can’t work in any meaningful way” while doing what’s best for my child. Maybe YOU don’t want to work, Ms. Rosin…. but that’s your deal.
[Reply]
March 19, 2009 at 10:46 am by Bettina@bestforbabes.orgHooray for everything you said. We couldn’t agree more, especially on the being gently encouraging, see our website http://www.bestforbabes.org/help-i-dont-want-to-breastfeed/ which is geared especially to the woman on the fence (I would love your feedback on the piece, too.) By the way, I supplemented with formula when my newborn was jaundiced because I had no clue that I had been set up to fail, breastfed him for six months exclusively, and then supplemented after that one bottle a week because I just couldn’t pump anymore. I would have roared at anyone who judged me for that. The judgement and criticism of other moms who are dog-peddling through this is wasted energy that should be spent strategically revealing and removing the barriers that are keeping them down. Thanks for such a helpful comment.
[Reply]
March 20, 2009 at 12:52 am by Todd Wolynn MD, MMM, IBCLC, FAAPI don’t usually “surf” blogs and listserves but in my preparation to respond to The Atlantic piece by Hanna Rosin I discovered this site. Bravo and very cool! The mix of insights and opinions and viewpoints are great.
My group and I are troubled by Hanna Rosin’s attempt to justify not breastfeeding by discrediting the weight of supportive scientific studies. There were other elements of the piece that we also found concerning. The greatest irony of course is that the author and friends represent significant breastfeeding successes (except for the friend with breast pain from nursing/pumping on the podcast who apparently lacked adequate support for what may have likely been a correctable problem).
I hope my response helps increase awareness of the facts (like many of you have posted) that quality breastfeeding support is often not available, that breastfeeding rates after initiation are terrible and plummet quickly, that Corporate America is rarely breastfeeding-friendly and in the small business world is often down-right unfriendly. Science supports breastfeeding and the use of mother’s milk to feed her baby as the ultimate source of the infant’s nutrition. If a woman can breastfeed –great! As a result a variety of health risks are reduced (not eliminated) for mother and baby. If a woman can’t breastfeed or chooses not to breastfeed some risks are statistically enhanced. So be it. It does not make the mom evil and as pointed out it is sometimes unavoidable.
We should not demonize formula feeding but stick to facts. “Breast” is SCIENTIFICALLY best. If you disagree please donate or contribute to ongoing and future studies researching breastfeeding and breastmilk. Even the most fervent conspiracy theorist among you would have a difficult time accusing the “Breast Industry” from tainting studies or falsifying data to make breasts look better.
Todd Wolynn MD, MMM, IBCLC, FAAP
Breastfeeding Center of Pittsburgh
Executive Director
[Reply]
March 22, 2009 at 6:28 pm by Jill@ModernMommyBlogI couldn’t believe that the Today show had her on. What is the point of this? Let’s keep on feeding America poorly researched information and label it as Fact.
[Reply]
March 18, 2009 at 5:55 pm by AnonymousI’m the poster from above who didn’t get anything for free. How did you get so much? I’m pregnant again and would love to get free formula for when I go back to work. I’m assuming I’ll breastfeed for 6 months again and then have to supplement but we’ll see. My hopstial doesn’t give out formula (or maybe they do but I never asked) and I never got stuff in the mail. Any advice would be appreciated!
[Reply]
March 19, 2009 at 7:46 am by DiWhen I gave birth to my daughter almost 16 years ago, I was lucky enough to have a best friend who encouraged me and helped me through the first weeks with her promise that after 3 weeks, it would feel much more “natural” and smooth. Four days after she was born, with my breasts engorged beyond reason and my daughter constantly crying, I called the lactation consultant at my hospital. She was able to help me over the phone by giving me ideas about how to hold her, how to get her to latch on, etc. But I had to make the call. Some people who don’t have the encouragement get understandably frustrated, think they are failures and succumb to the pressure to just use formula.
I went on to breastfeed both kids, even carting an industrial sized breastpump to work every day. When I switched my daughter to formula at 6 months, we found that she was allergic to every formula except Nutramigen…which is crazy expensive AND smells foul. So, for my son, I did it, including the pumping at work, until he was a year old.
There’s more to it than even the health benefits…there’s a huge cost issue. And I can attest as a Mom who worked full time when her kids were infants, that having that connection after a long day at work was beneficial for both me and my children.
[Reply]
March 19, 2009 at 12:29 pm by TheFeministBreeder#1 – I hate the idea that being a feminist means supporting every other “choice” a woman makes. Lots of women make terrible “choices” that denegrate our society, and I do not think it is my job to support them unconditionally. That’s being nothing more than a sheep. That’s the same as following a religion regardless of whether it encourages 90 yr old men to marry 15 year olds, or allows priests to rape little boys with little consequence. Feminism is not my “religion” – feminism is a political message of equality. In my opinion, formula should be available by prescription only, and mothers should be given far more support to continue breastfeeding to a year. We have mammary glands for a reason. We are women; let’s just learn to work with what we were given instead of trying to theoretically castrate our normal female functions. Let’s embrace our power, instead of using technology to free ourselves from our gender and all its glory.
#2 – my husband and I share ALL parenting duties equally – including breastfeeding. He assists me in every way possible, and I have never had to give my child formula. Having a husband’s involvement, in my opinion, should only support, strengthen, and prolong the breastfeeding relationship; not complicate or negate it. I talk about all the ways my husband and I share breastfeeding here: http://thefeministbreeder.typepad.com/the_feminist_breeder/2009/03/theres-a-name-for-it-equally-shared-parenting.html
Who says that men can’t be nurturing caregivers WHILE supporting breastfeeding? Who said that formula feeding is the only way to co-parent? I think that’s incredibly short-sighted.
[Reply]
March 17, 2009 at 9:10 pm by Emily JonesI love reading all the different views on this article. I have posted before about barriers to bfing success, so I chose to address the general tone of the article in my own post about it. You are spot-on that the issue facing women in America is the abysmal lack of support for breastfeeding. Instead of feeling guilty, women should be feeling angry that the system has de facto removed their right to breastfeed.
[Reply]
Trackbacks
Leave a Comment