This post was inevitable on a board dedicated to issues of motherhood, so I am going to get to it right now. This past fall I met an amazing woman doing research on the politics of breastfeeding and when I heard a talk she gave and read some articles that her website directed me to, I felt a wave of gratitude and motivation to share my story. My first thought specifically was, I wish someone had told me this before my daughter was born. I'm not going to rehearse her arguments here, but her thesis is that many claims about the medical benefits of breastfeeding are based on irresponsible research practices, and the reluctance to criticize them is based on a politics of "hyper-maternalism." Her most important argument, I think, is that in the research that finds benefits to breastfeeding over formula feeding, researchers fail to control for some pretty obvious variables--specifically, if a woman chooses to breastfeed her child based on health benefits, she is most likely to make many other parenting choices based on health benefits. What I want to do here is to tell my story and to express why I felt so grateful for this professor's research, which I think every mother needs to hear.
Before I even got pregnant, I decided to breastfeed my child. I read article after article, book after book, took a class, visited a lactation consultant, all of which further convinced me of my choice. I expected a struggle because I had never even seen a woman breastfeed, and I had no one to go to for help and advice. And I was right-it was hard at first, but I found assistance at my doctor's office and in online communities that helped get me through that learning process. Things were going great! I knew that I was protecting my daughter from ear infections, allergies, and respiratory illnesses, and that her I.Q. would be 8 points higher because of my magic milk! At four months old, she had her first ear infection. By the time she was one year old that number had reached seven or eight or nine--I lost count! At six months old, she was hospitalized with pneumonia for three days, and I was terrified. It's the hardest thing I've gone through as a parent, watching my child struggle to breathe. Breastfeeding, I believed (and still do in a lot of ways) , was the most important parenting choice that I had made, and I was wholly committed to it. When I worked I pumped faithfully so that my daughter never had a drop of formula. My understanding of myself as a parent was wrapped up inextricably in breastfeeding, so that every time my child gained weight it was my personal achievement. And every time she got sick, it was my personal failure. I wasn't doing it right--maybe because I was pumping--she needed more time at my breast. Maybe I wasn't eating the proper foods myself--it's hard to work and care for an infant and also take care of myself at the same time. Why was she sick with exactly the illnesses that my milk was supposed to protect her from? The feelings are still so strong that I feel myself tearing up as I type this.
As I sat in the hospital room with my little baby hooked up to machines, I felt duped. I wanted to yell, "All of you told me this wasn't going to happen! I am doing everything I was told to do! What am I doing wrong?" I finally came to the understanding that breastfeeding was not the guarantee that literature on the subject promised, and that it was not the most important part of caring for my child. There were so many other things that I did for her that were also essential to her health and development. And it was not my fault that she was sick. I had to rethink all my reasons for breastfeeding and decide whether or not to continue.
I realized that when I removed the anxiety and the frustration of watching her get sick over and over, I really loved feeding her. When my baby was at my breast, we were the only two people in the world, and the love and connection between us was profound and unbreakable. I loved nursing my child. So I decided to continue, but for totally different reasons than when I started. I had learned to enjoy the experience of nursing and the bonding that came with it, with the anxiety of preventing illness removed. Her health became a separate concern, and I no longer felt as if I had failed her somehow.
So what I want to say to other mothers and those who want to be mothers is that breastfeeding is wonderful and rewarding. If I have another child, I will breastfeed him or her, too. But it is not a guarantee against illness. It is not essential to being a good mother. If you choose to bottle-feed, you are not a bad mother and should not feel guilty. And if you choose to breastfeed, you should understand that the science is not perfect--in fact, it is definitely flawed in a lot of ways. The decision should be one that is satisfying to the mother and the child and should not be based on guilt or unreasonable expectations.
Edited to add:
For reading on this issue, see Jules Law, "The Politics of Breastfeeding: Assessing Risk, Dividing Labor," Signs 25.2 (Winter 2000): 407-450.
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6 comments:
Hi Sarah, I had a totally different experience. I breastfed for 11.5 months and my son only had 1 ear infection. Yes,he got colds but I had every expectation that he would. Breastmilk is good but it doesn't cover the child with a bubble.
I believe that there are great health benefits to breastfeeding both for mother and for child but like everything else, sometimes, it is not the be all and end all. There are exceptions. Perhaps if my DS had more illnesses in infancy I would have felt betrayed by the "sale" but that didn't happen to me so I can't really say. I loved breastfeeding, from the very beginning, for a a lot of reasons. It was EASY, it was cheap, it was no fuss no muss. It was great for me. I saw the results of breastfeeding on my body and it made me feel like a mother and it bonded me to my baby and it made me feel like I had really accomplished something tremendous.
I also feel that having the freedom to not have to pump played a significant part in the success of my breastfeeding relationship. It was never a hardship. It was never a chore.
I am cynical enough to believe that perhaps the health benefits are overplayed to sell it to people who would not try to breastfeed otherwise.
All I can say is that for me, the health issues and benefits were important those benefits and issues didn't closed the deal for me.
Great post Sarah. I love to read your thoughts.
Hi Sarah -
My daughter has had colds and ear infections and rotavirus but I don't for a second feel I was duped.
Being the scientific minded person you are, I am really sort of surprised that you would interpret articles showing statistical advantages for a population and interpret that to mean that breastmilk is a magic elixir for every individual child. The studies tell us that if you take 100 breastfed children and compare them to 100 formula fed children, on average the BF kids will have a higher IQ (all other socioeconomic variables as equal as possible); on average they will have fewer ear infections; fewer allergies; etc. Sure there will always be anomalies in either population -- the FF baby with the immune system of a superhuman... the BF baby who needs tubes because of all the ear infections.
Maybe it's hard to fathom given that your baby get sick quite a bit, but I wonder would it have been worse if you hadn't breastfed? More complications? Dehydration? Slower to recover? Allergies?
You guys did have a bad run of it, but could it have been worse? Certainly. Would it have been worse if you hadn't breastfed? Who knows. I'm glad you BF and didn't have to find out.
And, breastfeeding is more than just a different sort of milk. It is different from bottle feeding in almost every emotional and physical capacity. It promotes physical contact, and emotional interaction, more time together between mother and baby. And that is rarely a bad thing.
Lisa--thanks for your comment.
I am not at all calling breastfeeding a bad thing. As I described, I chose to continue breastfeeding and enjoyed it until my daughter weaned herself at thirteen months old.
I agree that it seems a bit naive to believe in breastfeeding as a magic elixir (besides the teacher at my breastfeeding class and the breastfeeding handbook that I bought actually using the word "magic" in describing its health benefits), but as you can imagine, when my child was so sick and I was so afraid and frustrated, my "scientific mind" was not in charge. The feeling of being "duped" was an emotional reaction to what I later learned had a possible explanation in science.
What I am arguing here is that the studies do not control for certain other maternal behaviors and environmental factors that affect a child's health and may correlate with breastfeeding. I am not arguing against breastfeeding but for better science and better information.
I'm not arguing that the science behind such studies isn't perfect, but I just take two issues with your general stance.
1) That the studies are flawed.
The studies that I have read have often done what I feel is a good job "controlling" for things I feel would often be very impactful on the results, like socioeconomic status, age of the parents, education of the parents, etc. The studies create like populations and thus they can be compared. A study would have a hard time being published if everyone in the 'formula' group were low income whites in West Virginia and all the 'BF' group were educated Hispanics in NYC.
2) That there is a pervading bias to make breastfeeding out to be better than it is.
I work for a pharmaceutical company, so I am mired in the accusations of how studies might be designed or skewed or whatever because of the financial gain involved.
For a pharmaceutical company accused of skewing the results of a study, there is an easy direction to point the finger -- of course the company might want to do whatever it can to get a favorable result from a study, because of the millions and even billions of dollars at stake.
Where do you point the finger when it comes to breastfeeding? Who is making billions of dollars off of breastfeeding? One could argue the companies that seek to profit off the sale of breastfeeding support products, but they aren't the ones funding the studies. La Leche League and similar organizations? Well, OK, they get some money off of sales of books and from membership dues, but they are a not-for-profit.
The fact is, there is a much more powerful contingency to make formula seem like a better option because that is truly where the money's to be made. So that there is this conspiracy in the scientific community to make breastfeeding seem better than it is, well, I just don't buy it.
The message is certainly out there, loud and clear: breastfeeding is best and your baby will do better because of it. Is that a guarantee that a breastfed baby will never fall ill, never have trouble? Of course not. Just like all the warnings against smoking don't mean -- as we all know -- that there aren't people who smoke for 60 years and never suffer an ill effect from it.
Childhood vaccines perhaps are a better comparison. Overall, and for public health and policy, 100% compliance with vaccination is a very good thing, and for most kids, vaccinations work exactly as they should and prevent serious illness. But there are the kids that have bad reactions to the vaccine... or that the vaccine doesn't work for. But that doesn't mean -- and I know I'm preaching to the choir so I will not continue to belabor the point -- that vaccines are bad. (Though there is a small contingency that would disagree with me there.)
Anyway, my point here isn't to try to sway you toward any opinion because I know we are basically of like minds. So! I hope your next baby isn't as much of an "anomaly" and doesn't have anything more than a couple colds in the first couple of years. :)
Here's where the argument gets probably too big for a blog to handle (and I can't take full credit for it--I'm drawing this from other sources). I'm not claiming a conspiracy--it's much more subtle than that and, of course, no one has money to make there--but rather a broader cultural investment in gender polarity. There is literature out there critiquing breastfeeding studies, but that doesn't make it into the books written for expectant mothers. While many different books and articles cite statistics on breastfeeding benefits, many of those are drawn from the same medical study. And studies that suggest less of a difference between BF and FF children are downplayed as unimportant. I remember about a year ago a study came out that claimed that breastfeeding does not decrease the chances of asthma. It was on the Today show, but the whole interview was not paying attention to this piece of information but rather asserting over and over that it is not that important. Strange. And I have yet to see any acknowledgement of this or of other studies that are finding conflicting results with what is generally printed in breastfeeding literature geared toward moms.
Thanks, Lisa, for engaging me and for being nice about it.
It's probably weird to comment months later but still. When your post appeared, I was pregnant and determined to breastfeed. I was amused how much people talked about breast- vs. bottle-feeding. The choice didn't seem to be a matter of politics or ideology to me. Now that I'm facing decreasing milk supply and need to consider giving formula to my 6-months-old, I realized my own anxieties and read it so differently. I appreciate your way of coming to terms with this issue and I like your idea of cultural investment in gender polarity very much.
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