Winning the Breastfeeding Culture War

Every week there seems to be some new sensational story about breastfeeding in the media.  Everyone is weighing in on the breastfeeding debate.  First there was that now notorious Time Magazine cover with a strange and over-sexualized image of a young (beautiful) mother nursing an older toddler.  More recently, we’ve seen breastfeeding fedishized on reality television and headlines peppered with stories about nurse-ins or nursing mothers being scolded or kicked out of business establishments for breastfeeding in public (despite legal protections). At the same time, as the public health rhetoric has shifted to encourage more mothers to breastfeed, women talk about feeling ashamed or criminalized for needing to use or choosing to use formula to feed their babies.

When I look at this picture, I wonder:  Who is winning the breastfeeding culture war anyway?  The answer:  The media, for one and probably the formula companies are a close second.  Sadly, the biggest losers in the the “mommy war” debacle are the moms.   While moms are busy defending their choices or criticizing others’ decisions, we are losing site of the real battle–working for a culture that provides real supports for families, allows for choices and encourages the health and wellness of future generations.

Let’s take a second to breathe and get some perspective on this. Humans, as all other animals on the planet fall neatly into their own family and species classifcation.  We are mammals.  Mammals are set apart from other animal species by the way in which they reproduce and nurture their young.  Mammals have mammary glands which provide all of the nourishment (via species-specific milk) that babies need to grow and thrive.  Rabbits make the perfect milk to help baby rabbits survive unattended in a burrow for long  periods of time.  Cows specifically make milk that help calves grow big and strong so that they can follow its herd independently.  In contrast, humans make precisely formulated milk for immature babies to help their brains grow, their immune system to develop, and their bodies to grow and develop over a relatively long period of time. This means that breastfeeding is the biologically normal way to feed an infant for all mammals. (See:  Morbacher, N. Breastfeeding Made Simple)

Historically speaking, as we became increasingly more technology dependent and simultaneously more socially independent from traditional family and community structures, mothers began to seek out other feeding methods for their babies.  For women of another era, formula was the key to independence–to career advancement and other freedoms (and indeed was a saving grace for women for whom work outside the home was not a choice, but a necessity).  This change was great for the dairy industry and formula companies, but maybe not so great for the health of future generations.

Fast forward to 2012 and we can all acknowledge that here in the U.S. we are mired in a complex health care crises and find ourselves standing at the precipice of major change to our health care system.  Did we get into this mess simply because  a few generations of mothers didn’t breastfeed?  Of course not.  However, as we learn more and more about the risks of feeding babies non-human milk (and therefore, the reciprocal benefits of breastfeeding), we have to acknowledge that breastfeeding will play a pivotal role in bringing us back to a healthier center.

Babies who are fed formula are far more likely to get pneumonia, diarrhea and ear infections.  Moreover, they are more likely to develop allergies, asthma, diabetes and become obese.  Women who breastfeed are more protected from breast and ovarian cancer and actually have a net gain in bone density after breastfeeding.  With these kinds of potential protections in a time of health care crises for so many, it’s no wonder that the U.S. Surgeon General and the American Academy of Pediatrics are now championing breastfeeding as a matter of public health.

Assessing risk is a funny business.  We take risks all of the time.  We choose to travel in motor vehicles, take medications, use exercise equipment or any number of things that we take for granted, but are not risk-free.  Earlier this week an opinion piece in the New York Times titled “The Milk Wars” argues that as a risk oriented society, pushing exclusive breastfeeding is “…part of a collective dream of reducing all danger to nil.” While I can appreciate her feeling that it may be unreasonable to remove all danger from the world (especially in the short term), I also think it’s important not to rationalize away the potential risks to the overall population of not breastfeeding.

What we are dealing with here is culture change.  Anyone who has ever worked in a human care or services industry knows all about culture change in the work place setting.  Culture change is the process of learning from new available information and changing practice in response.  This isn’t like enforcing a new rule or policy.  It’s a matter of valuing people’s wellbeing and re-envisioning what is possible.  Unfortunately, lasting change does not happen instantly.  It requires a shift in people’s awareness about the issue.  At the same time it requires flexibility and and sense of realism about where we actually are on the culture change spectrum.  Mothers didn’t stop breastfeeding at once.  It’s unreasonable to think we’ll be able to get all new mothers breastfeeding to 1 year and beyond all at once either.

The New York Times article asks for a balanced look at the issue of breastfeeding. This is absolutely correct. If we want women to be the winners in the breastfeeding debate, we need to stop blaming women for their choices and recognize that women will make different choices if reasonable choices are available to them AND if our culture truly supports breastfeeding as the norm.

According to the CDC, while breastfeeding initiation rates are going up in this country (currently about 74%), only about 14% of moms are still exclusively breastfeeding by 6 months (the age to which the American Academy of Pediatrics agree that babies should only receive breastmilk).  We have a lot of work to do if we want this picture to change.

First, women need positive examples of other breastfeeding mothers.  Very few current mothers (and fathers!) grew up in a household where breastfeeding was taking place.  Breastfeeding will seem more normal if we see it as a daily part of life.  This also means that women need to be supported to breastfeed whenever and wherever their baby is hungry–yes this includes when women are out of the house living life, in public. (Currently, we need to create and/or honor legal protections that give women the right to breastfeed in all places to help this happen.  And for those of you who think that public breastfeeding should happen under a cover–would YOU like to eat your meals under a hot blanket where you can’t see or breathe? Neither do squirmy babies.)

Secondly, many women who do initiate breastfeeding decide to call it quits around six weeks when many women are forced to return to work.  Therefore, longer paid maternity leave and breastfeeding supports from employers (e.g. breaks for pumping, designated pumping stations, flexible scheduling options) would help to sustain breastfeeding efforts for a longer period of time.

Interestingly, as important as the above supports are, research shows that the reason many women choose to end breastfeeding is simply a lack confidence, such as fear that they do not make enough milk to feed their baby (after all you can’t see it or measure it like you can a bottle of formula).  This lack of confidence is no surprise when you listen to women’s stories of the stumbling blocks they encounter when trying to breastfeed.  These stumbling blocks or “booby traps” as they’ve been dubbed by the breastfeeding advocacy organization, Best for Babes,  can come from surprising places:  comments from nurses, doctors, and family members; or free samples and marketing from formula companies, for example.

Changing our overall culture and support for breastfeeding is the only way we will change attitudes about breastfeeding in this country.  In the meantime, no more mommy wars.  Let’s support, advocate, change policy, change hearts and minds and for goodness sake, just feed the baby!

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4 Comments

  1. Amen! Very well said.

    Reply
  2. May it be often repeated until things change!

    Reply
  3. Nice post! The aspect I find the most vexing of this whole debate is the EXTREME emphasis that’s put on the bonding/nutritional value of breastfeeding followed by the nervous breakdowns women put themselves through when they find they can’t effectively breastfeed their babies for one reason or another. I’m a BFer, and it’s very important to me to do that for my kids, but I know several people that get down on themselves pretty hard if they have to formula feed, even for legitimate reasons. I was formula fed, as were most people in our generation, so it’s not like it’s the worst thing in the world. I try to tell them it’s really not that tragic, and you won’t ‘bond’ with your baby any less if you bottle feed. The point is the closeness involved.

    All that aside, I find the Milk Wars in underdeveloped cultures much more interesting (and important) than the petty stuff we argue about here in the US. I’ve read about places in Africa where the women only breastfeed a short time before their husbands make them stop, and with no other food source, the infants die. It’s crazy.

    Reply
    • Exactly! There are so many ways to bond with babies! Cuddles, eye contact and just being responsive to baby’s natural cues all go a long way to help with bonding. My hope is that all women feel supported (both personally and by larger social constructs) to at least try breastfeeding and set their own personal goals around it. We are learning so much about breast milk and breastfeeding all the time that I hope that we will have more ways to help women who want to breastfeed but are finding it challenging.

      You are so right about the specific challenges in developing countries. Besides cultural attitudes that cause breastfeeding to fail, in many of these places, they have problems with water contamination that make formula an extremely dangerous choice. Moreover, formula is expensive and people often add things to it or over-dilute it in order to make it go further, leading to malnutrition and/or infant death. In these places, breastfeeding is SO important. We are lucky to have some options here when exclusive breastfeeding is not the only option for families.

      Reply

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