Late Mamageddon Post: the breastfeeding debate

Yes, I know. I am about a week behind to really talk about the whole ‘if 90% of women breastfed to 6months we would save over 900 lives and millions of dollars’ thing. The tweet storm, the blog storm. It be over. And yet, here I am, taking it on anyway.

Truth is that I have tried to write this post about 5 times, only to send drafts to the trash. I hesitate to say anything, because

a) I have this weird love hate relationship with drama, online or otherwise. I see it, have opinions and want to say what I have to say. But I am also a big scardy cat and I shy away from conflict. You know, it is my dual personality acting up.

b) There is nothing I can say that hasn’t already been said. And better.

And yet, I am going to give it a go none the less. What can I say? I am a gluton for punishment. Here I go:

I have a number of issues with the recent study/news cover/mommy blogging reaction to this whole thing.

See, the thing is (in my opinion), a study like that and the spreading the word of that study, is only beneficial to the breastfeeding cause if:

1) a significant portion of the population is not breastfeeding because they believe formula is ‘better’, or at least, are not informed about the ‘risks.’ What I am saying, is from a Mom perspective, if that story would have solved the problem of why I don’t breastfeed, then it would be useful. But, it is my belief, that a very very small percentage of women who do not breastfeed have not heard a study like that before. And even if they haven’t, I don’t think it addresses the issues they experienced or the reasons they made the choice they did. What I am saying (not particularly articulately) is that 99% of Mom’s don’t not breastfeeding because of lack of knowledge about the benefits or breastfeeding. They don’t breastfed because it is hard, they lack support, they don’t have sufficient maternity leave, they don’t have access to a qualified lactation consultant, they had a traumatic birth, they had other health problems, they experienced postpartum depression, they have a personal reason not to, their baby had an untreated tongue tie, ect. ect. ect.

2) if you believe that not breastfeeding is, as it has been suggested online, a ‘public health risk.’ I don’t. Don’t get me wrong. I truly believe that breastfeeding is the best option. But I do not believe my formula fed baby is anything but healthy and thriving. I get that ‘studies have shown..’ but it seems to me that these studies point more to a correlation then a causation between formula feeding and health risks. (Go talk to the Fearless Formula Feeder if you want a good critique of most studies linking formula feeding to significant health risks. I am not getting into it here.)

3) if, by quantifying the impact of higher breastfeeding rates in terms of lives and money (things that get people to listen in our society), it would push the government to take action. This is the one I could maybe buy. This perspective, which was suggested by a commenter on Fearless Formula Feeders blog, was something I had not considered. I had been looking at it from the perspective of a Mom, who is hurt when someone tells her that she is ‘harming her baby with formula’ and not from a political perspective. A political perspective where there needs to be sufficient cause in order to convince a government that an issue is worth attention. The truth is that in both Canada and the US (but far more so in the US), we need our governments to address a number of women’s issues that are very important in their own right, but also happen to be connected with breastfeeding rates.

-longer maternity leaves that women can afford to take

-lowering the c-section rate, supporting women to have natural births and better care in maternity wards

-flexible work schedules

-access to healthy food to lower income parents and their kids (for everyone, really)

And then there are more specifically breastfeeding things like:

-pumping rights for women of all income levels

-better access to qualified and kind lactation consultants

-breastfeeding friendly hospitals (and by breastfeeding friendly, I do not mean formula feeding unfriendly)

We need these things. But if we are going to get them out of our government, the government needs to see that they can justify the money spent on such things…. hence the studies.

A light bulb went off in my head when this commenter suggested this and it did change my perspective somewhat.

The problem with all this is that it is a double edged sword. While maybe the government and its constituency need these studies to convince them of the benefit of policy change, the impact on Mothers is not positive. Why do I say that?

It is my belief that the focus on formula’s risks in the pro-breastfeeding camp is actually hurting breastfeeding rates. How? Think about it this way. Take brand spanking new Mom A and brand spanking new Mom B. Mom A has heard that 900 lives (aka her baby) are at risk from formula feeding. Mom B has heard that breastfeeding is better, but formula fed kids turn out fine. Who do you think is more stressed during those first 8-12 weeks when nearly all new Mom’s encounter some struggles with breastfeeding? That’s right- Mom A. The stakes for Mom A are super high. If she doesn’t succeed at this breastfeeding thing and does end up giving the kid formula then she will be hurting them, possibly worse. I am no breastfeeding expert, but I think a stressed Mom has less of a chance of getting through those struggles then a less stressed Mom. You may not agree, but that is my opinion.

I guess what I am saying is that I understand why the pro-breastfeeding camp wants to retweet and talk up and tell everyone about these studies. It is an important issue. I do think there are benefits to breastfeeding. Anyone who knows me can tell you I tend to prefer the ‘natural’ option. The problem is that the issue is highly emotionally charged and there is a whole bunch of us (Even with Canada’s higher breastfeeding rates, 46% have supplemented with formula by the time baby is 6 months) who just don’t like being told that our choice is a public health risk, or that our choice is causing harm to our child. We. Don’t. Especially because most of us have at least some emotional scars about having to do it in the first place. And, as I have said, I don’t think that message is helping the Mom’s who are struggling to make breastfeeding work either. And I think that those talking up these studies should be more sensitive to that. There has got to be a better argument we can use to get the government to change its policies.


15 responses to “Late Mamageddon Post: the breastfeeding debate

  1. Bree April 10, 2010 at 12:49 pm

    I am of the opinion that the cultural environment matters most. Stats like this help women who struggle to breastfeed (ie they do but it is difficult) feel reassured that the trouble they endure is worthwhile. It props up the breastfeeding lobby, but I doubt numbers do much to sway the new mom struggling (and failing) to nurse a new baby.

    On the other hand I disagree that the majority of formula feeders made their choice because they really couldn’t nurse. Or how would our species have survived in pre-formula days?! There are very good studies that show drastically higher formula uptake when women are sent home from the hospital with free samples (vs not). I’m convinced Canada’s higher bf rates are due to our mat leave policies. This is all to say that social/cultural/situational factors are more likely the reason than physiological issues preventing breastfeeding. I often wonder whether having close friends or family members nursing nearby positively impact bf rates … I imagine that it’s much harder if you’ve rarely witnessed it

    • amoment2think April 10, 2010 at 1:15 pm

      I would totally agree with you that I think the main factors are societal/cultural. And I totally agree that Canada’s better mat leave policies have a big impact on our higher numbers. My argument is that those societal factors aren’t lack of awareness of formula feeding risks. And that many many women try and fail, for a whole bunch of reasons. Very few of which are because someone thinks formula is a better, or even an equal, option. Although I hear what you are saying on it giving a Mom reassurance that her struggle is worth it……… but I think there are better ways to provide reassurance then the fear of formula.

      But I should also recognize that I am bias on the issue. Being someone who did experience physiological issue breastfeeding (at least mostly… along with some societal ones as well), most of the people I encounter also had physiological or psychological reasons. Anyway, I am just saying that my experience has certainly impacted my perspective on this issue.

    • Perpetua April 10, 2010 at 7:39 pm

      *raises hand* didn’t breastfeed because I couldn’t, not because I didn’t want to.

      There are a lot of us out here, and trust me, it sucks to be us.

  2. Ginger April 10, 2010 at 1:08 pm

    I think the cultural thing can’t be overstated enough. I live in California, where breastfeeding is the norm, there are a ton of laws in place to help breastfeeding/pumping moms, and we are given a bit of financial help by the state with maternity leave (it’s still not long enough, or $ enough, but it’s better than nothing). IMO, this study does next to nothing in California but fuel the fire for the judgment on formula feeding (which I disagree with vehemently, even though I BF).

    My cousin who lives in Louisiana on the other hand, which I think has one of the lowest breastfeeding rates in the country? This study might help there. It might help public policy, hospital policy, and public perception of breastfeeding.

    I don’t know. I BF and I kind of think this study is rubbish in it’s methodology. I worry that it will end up doing more harm than good for lots of moms. But maybe in a public policy way there will be something good to come from it.

  3. Fearless Formula Feeder April 10, 2010 at 1:43 pm

    First of all, I second what Ginger said. I think it really does matter where you are – I have a very distinctive POV living in CA. I’m aware that in Minnesota, this is a different animal altogether.

    Bree, I see what you are saying, but suggesting that these studies might make a mom who is struggling feel that her efforts are “worth it” bothers me as much as it probably bothers a lactivist to hear that she shouldn’t broadcast the benefits of BFing b/c it makes FF feel “guilty”. Both these arguments are understandable and sweet, but I don’t think we should go there in either case. I do not rail against these studies b/c they make me feel guilty; I rail against them b/c more often than not, the results are overstated or misinterpreted, and every time someone suggests this they are shot down as being pro-Big Formula. Hogwash.

    And honestly… that assertion bugs me on a personal level, b/c I was one of those women who went to extremes to BF b/c I’d read all these studies saying how awful formula was. It ended up hurting my relationship with my child, my mental health, and my child’s physical health. So I am REALLY picky about any study that makes such an extreme case against formula or combo-feeding. The results better be INFALLIBLE, otherwise they are doing far more harm than good, IMO.

    amoment2think – great thoughts, as always. I’m so glad you decided to post this. I agree with you that stressing moms out is helping no one. I also agree that we need better support for breastfeeders, and for women in general. I just will never accept that in order to get these things done, we need to vilify formula or formula feeders. Two wrongs do not make a right, you know?

  4. Brooke April 10, 2010 at 1:55 pm

    This line just drives me NUTS: “how would our species have survived in pre-formula days?!”

    It presumes that women have always been able to successfully breastfeed when there are examples throughout history of women needing some other method of feeding, whether through grossly inadequate formula (and here I am referring to formula of the past NOT the formula formulated in the modern era) or through wet nurses. Or babies died. Yes, babies died. Formula has saved lives. Now wouldn’t that be an interesting headline.

  5. Perpetua April 10, 2010 at 7:46 pm

    Good job posting this, K.

    It’s taken me a long time to get over my initial experience (and the way I’m feeling right now is proof that I’m not as “over it” as I thought I was), and I wouldn’t have been able to do it without the help (all via internet) of both formula-feeding moms and breastfeeding moms who were there to say, “it’s okay,” and “we’re not judging you.”

    I’m staying away from this debate. It’s only going to freak me out. So thanks for covering the bases. 🙂

    • amoment2think April 11, 2010 at 1:11 pm

      That is funny. I was thinking that the fact I couldn’t let this one go without posting about it was because I wasn’t as over my experience as I thought I was.

  6. Dr Sarah April 20, 2010 at 2:21 am

    Hi – I came over here to read your blog after you posted on my post about the same topic (thanks for that! I’ll reply to you in the comments of that post as soon as I find time.)

    I’m curious about your views on this point: There is a discussion in breastfeeding advocacy circles (don’t know whether you’ve seen it or not), about whether the differences between breastfeeding and formula should be presented in public health announcements in terms of ‘benefits of breastfeeding’ or ‘harms of formula feeding’. How do the different phrases make you feel? (I’m trying to keep the question as open as possible.)

    • amoment2think April 20, 2010 at 6:09 am

      Personally, when I was struggling to breastfeed and in the nurses and lactation consultants office every week trying to get it work, I was surrounded by posters and pamphlets that spoke to the benefits of breastfeeding. It made me feel horrible because I was struggling and I knew what the alternative was if I was not successful. It stressed me out and made me feel like I was failing. I understand from a public health perspective why those messages were there, but I don’t think they helped me.

      If I had seen posters that spoke to the “harms of formula” I think what I would have felt would have been 100X worse. Messages about the ‘harms of formula’ make the assumption that women don’t breastfeed because they don’t know any better. And while there are certainly societal forces out there that are not friendly to breastfeeding and we need to work to make sure breastfeeding is normal and accepted, I disagree with the assumption that most women don’t know any better. At least here in Canada. We have over a 90% initiation rate, which means women, for the most part, know the benefits of breastfeeding and plan to do just that. But by 6 months the number still breastfeeding is just over half. We didn’t stop because we weren’t informed, we stopped because something got in our way. So, honestly, I would be bothered to see both messages. The message should be “how can we support you?” Spend the money that would have been spend on posters on better maternity wards and more training for lactation consultants.

  7. Dr Sarah April 20, 2010 at 2:41 pm

    Thanks. I really appreciate your opinion.

    The reason I’m asking is because I strongly disagree with the theory that the messages should be phrased in terms of ‘harms of formula’, and would like to write a post about this at some stage, and was hoping to get personal opinions backing mine up, but didn’t want to elicit them with biased questioning. So far, the opinions I’ve got have backed me up.

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