“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 2:22 pm by AnonymousI am a nursing mom and plan to contiure nursing for at least a year. I had good support in the hospital, from my doula, and my family, especially my husband. My son also recieves formula supplement, because I was not able to keep up with him by pumping. I believe that if I were able to stay at home with him, I could have nursed him exclusively for the first year, but that is another discussion. The choice to start supplementing him was a very difficult decision. I felt as though some how I was failing him. Then I realized that what is equally as important it that nursing should be source of comfort and joy to us BOTH, not a source of stress and anxiety. Once I made the choice to supplement and started fenugreek to help improve my pumping, things got a lot better. Now that he is starting solids, we have been able to reduce the amount of formula he consumes and will hopefully eliminate it altogether soon. Parents are some of the most competative people, myself included sadly. The simple fact of the matter is that you know what is best for your child yourself and your family, though everyone else may think they do. While we do need better support for breastfeeding mothers, we have no right to judge the choice that other parents make. We are not their positions and do not have all the information that lead them to that point. The most important thing is that we all raise happy healthy children. Perhaps we shoudl devote our energy to that and not to judgement.
P.S. I was breastfed and my husband was formula fed and we both ended up as healthy, intelligent, well adjusted individuals.
[Reply]
March 19, 2009 at 10:38 am by AnonymousI wish I had lived in the world that some of you are describing-people pushing formula and its convenience on you at every turn.
When I found out I was pregnant with my daughter in 2001, I was cornered at a holiday party and told I had to breastfeed (and this was by a father!). I was out shopping with a childless friend of mine and she said something along the lines of “of course, you are going to breastfeed.” My doctors told me constantly that I needed to breastfeed. My mother-in-law breastfed my husband until he was at least three- She cried when I told her I wasn’t planning on breastfeeding and that I had never wanted to breastfeed. She kept sending me books about it. I overheard her telling my infant daughter that she wished she (my MIL) was able to breastfeed her (my daughter).
Almost all of my friends breastfed- I never heard anyone complain about the “seduction of the formula companies”. In fact they would just send me their coupons, which I could use with my coupons (yes- formula feeding moms are also barraged with coupons, it’s not just a trick used on breastfeeders).
I hope everyone is as comfortable with how they choose to feed their children as I have been. I have never once regretted my decision to exclusively formula feed. And, like the author said in the original article in the Atlantic, I don’t think you could pick out which kids in the first grade were breastfed and which weren’t.
[Reply]
March 19, 2009 at 1:02 pm by TheFeministBreederYou also can’t pick out which women are going to develop breast cancer just by looking at them, but we know for a fact that breastfeeding helps reduce the risk of breastcancer in women. It also greatly reduces the risk of coronary heart disease.
I can’t tell you by looking at a room full of men which ones are going to drop dead of a heart attack by 45, but their lifestyle leading up to that point will certainly be some indication.
Formula feeding, just like with any other unhealthy eating habits, sets us up for future health issues. The mountains of medical evidence proves it. Whether or not you want to take that risk is up to you, but it is wrong to say that it doesn’t exist. We know better.
[Reply]
March 19, 2009 at 9:47 am by TriciaI am all for breastfeeding, but though I have never given my 1-year-old formula, I have resolved to never look at others who formula feed as “doing wrong.” Those of us who choose to breastfeed should not criticize those who don’t or are unable to breastfeed. Certain women (and one man) I have spoken with look down on those who formula-feed. In my humble opinion, THAT IS JUST WRONG. If we breastfeeding mothers/activists want to increase the percentage of breastfeeding vs. formula-feeding, how about a little gentle encouragement, information, and breastfeeding support for those who are on the fence? If I had not taken the initiative to educate myself, or had not had family to gently encourage me, I may have chosen the formula route as well. Let’s just get rid of the criticism.
[Reply]
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 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 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]
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 12:32 pm by TheFeministBreederI believe that all I did was sign up for American Baby Magazine (for free) and your name gets put on some sort of mailing list. You’ll get all kinds of coupons in the mail. I’m quite sure I never visited the Enfamil or Nestle websites, and I certainly didn’t sign up for anything from them because I never planned on using their products. Hope that helps.
[Reply]
March 19, 2009 at 9:52 am by AnonymousSign up at Enfamil.com or Similac.com for formula samples and coupons. Be sure to check the box that say you will be breastfeeding!!!
[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 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 10:04 pm by AnonymousI think it is not true that most women “have” to work nowadays. It is certainly not impossible to live off one salary. My husband makes about 35K (before taxes) and I am still able to stay home with our two children. It is a lifestyle choice – we make sacrifices so I can stay home, but we certainly can afford the basics like housing and food.
There are women who *do* need to work, don’t get me wrong – single moms, moms whose husbands have no health insurance through their employers, moms whose husbands are disabled… but these are not the majority of women.
[Reply]
March 18, 2009 at 10:44 am by AnonymousI’d say that this post is kind of off base. In my experience the real barrier to breastfeeding success is forcing women to go back to work only weeks after delivery. In this economy it’s almost impossible to live off of one salary so women don’t really have the option they did maybe 40 years ago of “choosing” to stay home. I know from experience that once I returned to work I couldn’t keep up with pumping. That was pretty much it for me and I dried up. Luckily I was in a position that I could take 6 months paid maternity leave and could exclusively breastfeed during that time but I know if I returned to work earlier I would have given up.
As for the claim that women who say they will breastfeed get free formula samples and coupons in the mail, I’ve never heard of that. I wish the hospital where I delivered gave me free stuff! Especially coupons since formula is damn expensive. I ended up going online and registering on formula sites after I went back to work to get said coupons.
[Reply]
March 18, 2009 at 8:49 pm by BettinaYou are right that employment issues are a huge barrier. And I’ve heard many women say that they didn’t bother trying to breastfeed because they knew they would have to go back to work too soon. However, other studies have found that just taking a prenatal breastfeeding class improves duration, regardless of employment plans. Also, the point of this post is that too many women are not making it through the first few DAYS after giving birth, forget weeks! I didn’t have room to go into more detail, but you wouldn’t believe what a huge difference latching on in the first hour makes to breastfeeding continuation, and how very few hospitals ensure that this happens when possible. It would be great if Ob-Gyns would at least make sure after delivery that the baby latches on or that a lactation counselor on site is there to help. In Baby-Friendly hospitals, 76% of babies are still exclusively breastfeeding at discharge, compared with a national average of 48%, and once again this is irrespective of employment plans. Hopefully, the more women are aware of the barriers the more they will put pressure on employers and other barriers.
[Reply]
March 19, 2009 at 12:22 am by MelodieMaybe one of the reasons I haven’t been able to respond to Rosin’s article yet myself is because there is a huge difference between breastfeeding success rates and health care industries in America and here in Canada. In BC where I live, a woman isn’t allowed to leave the hosppital until the breastfeeding relationship is working. Hospitals have protocol they must follow, one thing being that no formula is to be given without mom’s permission/approval. We get a year of maternity leave. I got one paid year and then one extra year not paid when I asked special permission. Maybe if she did have the luxuries I do up here she wouldn’t feel so challenged.
There’s so much more to it than this, but for the sake of a comment I’ll leave mine there. This is also the best response to her article I have read. Good job!
[Reply]
March 18, 2009 at 7:31 pm by Dr. Andrea DavisThe control of the formula companies upon the maternity wards is atrocious. I watched my newborn perfect niece be denied the opportunity to breastfeed through atrocious misinformation given to her mother and tons of support and free formula for bottlefeeding. They recommended that my sister-in-law “try to nurse” on day 3 after her own extensive medical tests were finished and she could be scheduled to see the lactation nurse. Doomed to failure right there, despite the mother’s strong wish to breastfeed.
Breastfeeding is not inconvenient in the least, it is a wonderful, natural practice that has worked for millenia…..and has been proven to be the best start in life for all infants.
My son nursed for 18 months and my daughter till 30 months (old enough to declare that she never wanted to return to the pharmacy where the pharmacist told me I had to stop because of a breastfeeding-incompatible antibiotic I was prescribed when she was 30 months old…..)
Thank goodness I switched doctors when my daughter was 2 months old and a doctor told me I had to stop breastfeeding due to an antibiotic I was prescribed at that point….the new doctor explained it was safe to continue, in fact the antibiotic was the same one used for infants when needed, and that “stopping breastfeeding will change your relationship completely….” — thank you, Dr. Johnson…..
[Reply]
March 17, 2009 at 8:04 pm by tanya@motherwearblogYou’ve said it all, Bettina. The enemy is not other moms, but the many practices we’ve come to accept as normal that succeed in undermining even the most determined moms.
I’m proud to say that my local Moms Rising group (Moms Rising of the Pioneer Valley) is working to advocate for the hospitals in our region to become Baby Friendly.
Great post!
[Reply]
March 17, 2009 at 6:08 pm by AnonymousWow one of the best articles I have read in regards to breastfeeding and why mothers do not succeed. Bravo, bravo.
[Reply]
March 17, 2009 at 6:04 pm by CoachBRAVO. Let’s face it – babies are not convenient, and especially inconvenient in the USA with its lousy maternity leave, discriminatory practices, and competition for “stomach shares” by the formula companies. If we can’t even support mothers and babies who are doing the biologically normal and natural thing, who DO we support? Maybe the AIG execs could trade in some of their bonuses for paid maternity leave.
Rock on.
[Reply]
Trackbacks
Leave a Comment