Tuesday, March 31, 2009

She Blinded Me With Science

I was going to write a follow-up post to my last one, detailing some of the perks that have come from weaning, but I got too distracted by this article by Hanna Rosin. Now obviously, just calling something "The Case Against Breastfeeding" is designed to raise both hackles and cheers from respective ends of the breastfeeding-support continuum (let's put La Leche League on one side of that and Nestle on the other). The author's actual intent, however, is to discuss the pressure put on mothers to breastfeed, the sense of guilt they can receive if they don't, and the, in her opinion, overstated benefits of breastmilk.

As the mother of three children (all breastfed, she happens to mention), Rosin is fully entitled to discuss the first two things, but after following the links to her cited sources, I think her refuting of the benefits of breastfeeding is its own overstatement. The fact that breastmilk is inherently better than formula is so obvious that I can't wrap my head around any arguments to the contrary. It takes a lab to prove that a naturally occurring substance, the one that kept the human race alive for our entire existence on the planet up to the last century or so, is superior to something made in a factory from the dried compounds of who-knows-what? Are there ongoing studies comparing orange juice with Tang?

Why do we only buy this argument when it comes to baby food? I don't know anyone who chooses to drink reconstituted dried milk, even though it would be much more "convenient" to keep milk in non-perishable cans in the pantry rather than constantly having to buy it, refrigerate it, worry about the expiration date, stock up on it before looming weather disasters, etc. The fact is, the inconvenience of breastfeeding is what has been overstated. It has been framed as the high-maintenance alternative to formula, instead of the biologically-implicated norm.

So let's just be honest about it, without judging anyone for their choices. Science can't duplicate nature. Not perfectly. Can it come close enough to grow happy, healthy babies? Why yes, yes it certainly can. Especially when they have an entire arsenal of other environmental advantages.

Which brings me to my biggest annoyance with this piece. The author talks about the guilt and even shame that is directed at mothers who cannot or choose not to breastfeed. She references the skinny-jeaned mom-iosos who huddle together at toddler parks and look askance at anyone pulling a powder-filled bottle from their designer diaper bag. Now, I wish nothing but solidarity among all mothers, and I don't discount the isolation that comes from feeling unsupported in your parenting decisions, but when I read about these milk-cliques, I couldn't help thinking, "If this is what breastfeeding propaganda has wrought, so be it."

While the trendy Brooklyn moms are discussing which baby monitors have the smallest carbon footprint, the moms in my neck of the woods are being told by their pediatricians that their 1-day-old babies are starving and need formula because their milk hasn't come in yet. And those are the tiny fraction who even bother to try breastfeeding. The percentage of Memphis mothers exclusively breastfeeding at six months is 9%, half of the national average. And, in what seems hardly coincidental, Memphis has the worst infant mortality rate in the country (which, as a nation, isn't so hot itself). I'm sorry if the PSA with the bull-riding pregnant woman makes a formula-feeding mother feel bad, I really am. I have issues with the execution of that campaign. But if it encourages the overarching public feeling that breastfeeding is worth the hassle every contrary force has declared it to be, and some babies end up healthier for it, then I can live with that.

The one point Rosin makes, maybe accidentally, that I did agree with is that nursing can be presented as the be-all, end-all of parenting, that the decision to nurse overrides all others and takes precedence over every other aspect of the parent-child bond. I think that's true, and it's not always a good thing. I've known mothers who probably would have benefited from some education in ways to balance breastfeeding with the rest of their lives, including the right ways to occasionally alternate with formula that wouldn't be detrimental to their milk supply and nursing relationship. The all-or-nothing ideal can be very overwhelming, and a more realistic approach may have broader appeal and efficacy. Of course, so could giving moms a $35 manual breastpump at the hospital instead of a bag full of formula samples.

The lead-in to this article is, "In certain overachieving circles, breast-feeding is no longer a choice—it’s a no-exceptions requirement ..." Well, most of us don't live in those overachieving circles. In my work, I constantly met women who were the only ones in their family or social group who were nursing. And I told them all, just wait, the trends eventually drift down here from the coasts (including the northern one), and you'll be just like everyone else. It's disheartening to learn that the trend-setters are already chafing under the mammary mantle, and I fear the pendulum will be pointed toward backlash before those of us here in the barely-achieving circles have even seen an upswing.


Sassy Molassy said...

Put THAT in your bottle and suck it, Ms. Rosin.

I can't wrap my mind around a grown-ass woman making such a huge, life-affecting decision because it's what the cool kids are doing. Grow a pair! If you choose to do whatever it takes for you, individually, to breastfeed just so no one will look askance at you over your Bugaboo on the playground, then that is no one's fault but your own, and at least your baby will benefit from it.

I also take exception to the statement that breastfeeding mothers can't work in "any meaningful way." With three of my four kids, I returned to work ful time when they were six weeks old, yet not one of them ever had a single bottle of formula. And with the other one? I built a business from the ground up and opened its doors when she was four months old.

I understand that my teaching job offers a schedule that is more mom friendly than some jobs, but you know what? We all make our choices in life. There are other things I would enjoy and be good at, but I have periodically weighed those other possibilities against my priorities in life, and this is where we are now. I know I'm lucky to have the choice, but it's not like we're rolling in the dough either. We all make sacrifices as parents.

Stephanie said...

One bit of advice I always give new moms is to avoid the "all or nothing" mentality. You can sub in a bottle of formula a day and still keep nursing, or you can nurse once a day while doing formula the rest- there is no rule that you can only do one or the other. I think that mentality has derailed a lot of mothers' best intentions.

Sweet Sassy Molassy said...

It's true that it need not be all or nothing, but I think mothers need to make that decision with the understanding that some of the immediate helth benefits of breastfeeding, like the reduced risk of ear infections and diarrheal illness, are affected by any amount of formula supplementation. There is plentiful documentation showing that the intestinal flora of a baby who has had one bottle of formula in the past two weeks is dramatically different from that of a breastfed baby.

It seems like there are plenty of moms who are told they can supplement with no ill effects to the nursing relationship (and given a "breastfeeding success kit" that includes a bottle of RTF complete with a nipple), but in my (considerable) experience with new mothers, it rarely goes well for the breastfeeding once supplementation is started.

Sarah Jane said...

Whew, lady! I didn't know this article would bring such a vitriol response when I posted it on facebook. I'm going to bed and will read your blog tomorrow. Good night and until tomorrow.

Stephanie said...

But Kristy, I've seen a ton of moms struggle to pump enough once they get back to work, or stressed because they think the baby is starving, who just give up on breastfeeding altogether because they have the "all-or-nothing" mentality. Sure, exclusive breastfeeding is best, but doesn't just about anything beat giving it up altogether?

Sassy Molassy said...

Sure. I'm not saying it's better to quit than to supplement. I'm saying the decision to supplement should be made with all the facts taken into consideration.

Memphisotan said...

I hope it's clear the vitriol isn't in any way directed towards you, Sarah. I can, in some abstract way, understand what it must be like to feel that sort of peer (and inner) pressure, but it's just so far out of the reality in this part of the world. Down here, we want to throw a parade for every mother who manages to breastfeed past the first doctor's visit where she's informed that the baby is jaundiced or has low blood sugar and needs "something more."

Sassy Molassy said...

Exactly. My point about supplementation advice is really about the fact that it's not at all uncommon for a new mother in Memphis to be told that it's okay to supplement (with no qualifiers or caveats), but it is extremely rare for her to be told that she can breastfeed exclusively with success.

Melissa said...

Wow. Do these essays just spring fully formed from your brain like some child of Zeus? You should submit part of this to the Atlantic's Letters to the Editor. Between the callings for Ms. Rosin's head and the formula fans, this is a very eloquent, levelheaded response. (And I am totally buying next month's issue just to read all the vitriol.)