In certain overachieving circles, breast-feeding is no longer a choice—it’s a no-exceptions requirement, the ultimate badge of responsible parenting. Yet the actual health benefits of breast-feeding are surprisingly thin, far thinner than most popular literature indicates. Is breast-feeding right for every family? Or is it this generation’s vacuum cleaner—an instrument of misery that mostly just keeps women down?
Oh Baby! There is a real war out there about Mother's Milk, and it's a pretty heated one.
And it's not as simple as, "Breast is best, do it for the health of your child." This is an emotional political, cultural, social, economic, psychological, physical and medical debate. I think I'm finally understanding its complexity--and bottom line: You've gotta do what you've gotta do. We all try to do the best we can for our children--but everyone's experiences are different.
Back in the late 70's & early 80's when I breastfed there weren't the piles of research out there to convince you of the benefits of breast milk. Any support I got in my effort to breast-feed came from books & phone calls to the mostly unknown Le Leche League. Back then, breast-feeding was more about bonding with your baby, the thought that maybe human milk was better for human babies, and the reality that it was so darn easy & convenient once you got the hang of it.
It was only years later that I read the research that confirmed what I suspected--there were benefits to breast-feeding, both to the baby & to the mother. But, medical research or not, it was a warm wonderful magical experience that by its very nature "forced me" me into hours of eye-gazing cuddling time with my babies every day. I didn't have to think about skin-on-skin cuddle time--it was a built-in part of the experience. The breast was instant comfort to crying upset babies--like magic--it was a powerful experience--and guess what--it had nothing to do with the milk.
And fortunately or not, breast pumps weren't viable options back then. For better or worse the breast pump is what's fueling a much of today's debate. Now it's all about the medicalization of the milk--not that much about the mother. With breast pumps, you can get right back to work, and still do right by your baby. That breast milk can be given in a bottle--by anyone. Not just mom. Huh? What about longer paid maternity leaves, not breast pumps? And since hardly anyone can afford to not work these days, and hardly any employers can afford to give away 6 months of paid maternity leave, this debate isn't going away anytime soon.
Here's the recap of the recent Breast-feeding Wars:
1997: The American Academy of Pediatrics advises women to exclusively breast feed for six months, followed by six more months of partial breast-feeding, supplemented with other foods.
August 2008: "Most Moms Give Up on Breast-Feeding", this NYT story reports on the research published in the August 2008 issue of the Journal of Lactation. According to the article, three out of four new moms try breast-feeding over the bottle, but most of them have quit by the time the baby reaches six months. The report from Brigham Young University shows only 36 percent of babies are breast-fed through six months.
Why are women giving up? According to Dr. Renata Forste, the lead study author from Brigham Young University:
"We're also a culture that is focused much more on bottle-feeding in terms of support networks. A lot of women have to return to work. They don't have the support in the work environment so they can continue to breast-feed. If you don't have support network around you, if you don't have a partner who is supportive, it's much more difficult to continue."
Here's what I had to say on the subject:
Dr. Forste is absolutely correct--–breastfeeding isn’t easy in the beginning and we’re just not prepared for that.
It really hurts until you toughen up; your milk takes days to come in; you get nervous that your baby isn’t getting enough to eat; breast-fed babies need to nurse every 2 hours in the beginning; you can get breast infections and cracked nipples with all that nursing; and there are lots of people around to encourage you to quit.
But if you can hang in there for 6 weeks, nothing could be easier, healthier, or more rewarding.
My now all grown up kids slept in their own rooms, self-weaned at 2 1/2, and took occasional bottles when I worked (part-time) or went out for the evening.
Your body adapts to the missed nursings. The babies adapt. Pumping was impossible back in the late 70’s & early 80’s, with only cheezy manual Playtex breast pumps available.
My doctor told me at 4 weeks I should stop nursing when I had a breast infection. I called La Leche instead, and took their advice to dose every 2 hours with vitamin C. It did the trick.
The fact that the kids stayed healthy & never had ear infections was a welcome bonus. Once you get over the initial trials, absolutely nothing could be easier.
-- The Healthy Librarian --
January 2009: The New Yorker article by Jill Lepore, Baby Food. If breast is best, why are women bottling their milk? This is a fascinating social political history of breast-feeding and how it fell out of favor in the early 1900's when it was replaced by the modern convenience of the bottle.
Although breast-feeding was resurrected & recommended by the American Academy of Pediatrics in 1997, it's never quite "caught on" because most mothers have to return to work before six months. The 1993 Family Leave Act guarantees only 12 weeks of unpaid maternity--in stark contrast to other industrialized nations.
Jill Lepore's article details the crazy-mixed-up policies that have grown up around this whole U.S. schizophrenia surrounding breast-feeding. Women are supposed to do it, but since they can't afford to stay home with their babies, the brilliant solution is to encourage breast-milk pumping in the workplace. In a "poor excuse for support for breast-feeding" WIC (The Women, Infants, & Children Program) permits the use of food-stamp funds to buy or rent a breast pump. Lactation rooms are now part of the workplace. I used to think Lactation Rooms were for breast-feeding--little did I know that they were for breast-milk pumping.
Bottom Line: "Breast-feeding rates increase with maternal age, education and income."
Lepore finally asks the important question. Is it the mother's milk that's the important part of breast-feeding or the mother?
April 2009: The Atlantic Monthly article by Hanna Rosin, The Case Against Breast-Feeding.
Hanna has three children, she nursed them all, but now with her third she's busy, she's tired & even though she wants to stop, she's sick of having to feel guilty about quitting, and feeling the pressure-of-the-playground moms.
Here's a little of what Ms. Rosin has to say about the subject:
Here's the American Academy of Pediatrics' response to Hanna Rosin's "review of the breast-feeding literature"
Here's a list of conditions where studies have shown positive evidence-based effects for breast-feeding for infants:
Acute Otitis Media
Lower Respiratory Infections
Type 1 & Type 2 Diabetes
Risks of Cardiovascular Diseases
However, Hanna Rosin does a much better job of pleading her Case Against Breast-Feeding in person, than she does in print. I got her point. I actually liked her. She won me over, after I watched her argue her case, along with three of her friends.
After watching it, I was sympathetic to Hanna's situation & her argument, sympathetic to her pediatrician who couldn't breast-feed her fourth child after having a double mastectomy, sympathetic to the Baltimore friend who wasn't able to breast-feed & courageously gave up on pumping her milk, and sympathetic to the New York work-at-home mom who was a breast-feeding booster.
If you have some time to spare, check it out on this YouTube video. It's 4 parts--all worth it--but watch one if you lack the time.
Here's the link to Hanna's compelling argument about breast-feeding. Click here.
April 2, 2009: The New York Times Opinion piece by Judith Warner, Ban the Breast Pump.
Warner's piece is based on Hanna Rosin's Atlantic Monthly article. She's buying into Rosin's argument to "Ban the Breast Pump". She's no fan of the pump--it made her feel like a cow. But she knows how dangerous such a remark can be. Breast-feeding has become sacred among some.
Here's what Warner has to say about Hanna & her buddies' breast-feeding discussion video:
In coming weeks, as the news of their heresy spreads, they will undoubtedly roast in the hellfire of mommy-blog vituperation. *vituperation: abusive language
Here's one of my favorites:
Above all, don’t beat yourself up and do what works for you and your family. Women spend too much time doing this as it is, and it only gets worse when you have kids.
Do I think breastfeeding is best? Well, it’s certainly a important biological mechanism that has been honed over time, and therefore a very important practice that does not deserve to be forgotten.
Is it easy? No. Is it always supported the way it should be? No. Is it for everyone? No, but I wish that choice were easier.
I have no doubt that nutritionally and immunologically it is superior, despite body burden chemicals. We no longer raise our children communally or with wet nurses (well, rarely) in the developed world so there will always be a need for formula, particularly for adoptive parents.
So this is where we are. Not perfect, but moving forward. I guess I find breast-feeding to be a fulcrum for talking about the importance of families and raising children well in a very busy, sometimes indifferent world. How we as women, families, society do that is to me one of the most important conversations we can have. It is important work and as such deserves our best thinking.