Wednesday, June 21, 2006

The breastfeeding middle ground

I've been reading posts from various blogs, across the political and lifestyle spectrum, reacting to the recently-ended breastfeeding PR campaign. These are posts from thoughtful people, making good points. I've read the posts and tried to move on, but inside my head, there is this voice that just won't shut the hell up. There are some points, in my opinion, to be made.

[First, I feel strongly that the commercials, as described, are pretty ridiculous. As a caveat, I haven't actually seen the commercials because I have Tivo and never watch commercials, and even if I did, I don't think they were broadcast during NCAA basketball games. Which are, of course, the only thing I watch on TV. Clearly, drawing an analogy between mechanical-bull-riding and formula-feeding is extreme. Whoever approved those ads conceptually just wasted a ton of money producing them - women who already want to breastfeed will still want to, and women who were on the fence or were planning to formula feed will feel more justified in not breastfeeding. So, let me go on record as thinking that the ads are both dumb and counterproductive.

However, some of the reactions are just as off-base, in my opinion. I hear the terms "breastfeeding mafia" and "breastfeeding nazis" far too often for my taste. Because you know, really, women who choose to breastfeed their children and who think that others should also be supported if they try to breastfeed should absolutely be compared to monsters who kill at will and attempt to undermine a law-based society. Completely logical comparison, and definitely promotes reasoned debate. So let's put that extreme aside for now, also.]

I think there are two main points that often get obscured for the people in the middle, who are genuinely trying to figure out what to do for their children and what will work best for their family:
  1. Breastmilk is, in fact, better for babies than formula. This is not actually in dispute, although if you get your information from reading pregnancy message boards, you might be confused. Yes, I know that you formula-fed your child and s/he never had an ear infection, while your next-door-neighbor breastfed and her child had to have tubes. This does not, in fact, change the truth that breastmilk is better. There are clear health benefits and if you're trying to mitigate risk, it's something to consider, but not a guarantee of perfect health.
  2. This is the main one for me: as parents, we do not make choices for our children in isolation. We will all make choices that are not "best" in some way, but that do make sense in the larger scheme. Two days this week, I've come home with the kids and turned on Blue's Clues so that they would be distracted and I could cook dinner. Am I proud that my 10-month-old was mesmerized by the TV? No, of course not. For me, it was balanced out by the fact that I could then cook a healthier and cheaper meal for my family than we would have if we went out. I made that choice, and as a big girl, I'm prepared to live with the negative consequences as well as the positive ones. The AAP wouldn't approve of what I did, either. To me, the feeding debate boils down to the same thing. There are many reasons why breastfeeding might not work for a family: mom is unable to breastfeed, she has no support for pumping when she goes back to work, she has PPD that is exacerbated by being tied to feeding the baby, she's on medication that are contraindicated while nursing, the list is probably endless. The point is, as a parent, you have to be able to look at the whole picture, make the decision that is right for your family, take responsibility for the fact that there might be downsides, and move on. Controversies like this won't end once your kid starts table food. This is a good time to practice and get used to the fact that not everyone is going to approve of everything you do. Make your decision in good conscience, using good information, then let yourself be.

As someone who works in public health, I do get immensely frustrated with our lack of cultural support for breastfeeding. It is completely acceptable, culturally, for women not even to try to breastfeed. It is completely acceptable, culturally, to give a nursing mom dirty looks on an airplane when she's trying to discreetly feed her child. It is completely acceptable to look amazed that a 12-month-old is still nursing. It is acceptable to use the lactation rooms in a building for naps, acceptable to suggest that a mom feed her child while sitting in a bathroom stall, acceptable to resent the time a mom needs to pump while back at work, acceptable to expect a mom to pump in her car in a parking lot in 90-degree heat. The real problem with the ads is that they don't change any of those perceptions. Instead of promoting breastfeeding, they tear down formula feeding and make everyone more polarized.

Net result: all moms feel unsuported in their choices. Fabulous. Because that, truly, makes for healthy and happy families.

1 comment:

DT said...

What went unsaid is motivation for both the breast-feeding "nazis" who equate formula feeding with poison and the formula -feeding folks who use the term "nazi" in reference to their fellow mothers.

The "nazis" often seem to want to feel "holier-than-thou" for putting in the effort to breast feed. While it is irrefutable that breast feeding is not easy from any of a myriad of perspectives, it is certainly easier for some mothers (e.g. mothers who don't have to return to work quickly, mothers with the wherewithal to buy storage or pump equipment for breast milk, mothers without cultural barriers to breast feed, etc) there are dozens of studies in the literature that point out barriers to breast feeding.

As for the breast-feeder-haters, it seems a certain amount of defensiveness is operating in the more extreme examples. Ruth very eloquently went through how the culture around breast feeding needs to change. My question is how do you change the culture in a way that will not make those mothers who, for any of a myriad of reasons, cannot breast-feed feel guilty?