How to support breastfeeding without being a jerk

10 Oct

Last week, there was a FULL OUT FEMINIST BATTLE in the blogosphere over breastfeeding.  I found it, quite frankly, pretty disheartening.  We fight for abortion access for all women, even those who don’t want and won’t have abortions, and we don’t judge women for whether or not they choose to have abortions – and, as activists, I don’t think many of us struggle with this.  So, why can’t we fight to better support nursing mothers, to break down systemic discomfort and misinformation around breastfeeding, while at the same time accepting, without caveat, mothers who formula feed?

All things being equal, yes, medically speaking, breast is best. But here’s the thing: all things are never equal, and frequently circumstances can drastically change what the “best” thing is for mother and baby.  For women and babies for whom nursing goes well (and, yes, both mother and children need to have biology, preference, and temperament on their side), there are quantifiable health benefits to nursing, and many women report really bonding with their baby while they nurse and truly enjoying the experience.  But things are rarely so simple.  For example, blogger Melissa has written extensively about not breastfeeding her twins.  In her post, Breast is Not Best, she writes:

I was a hormonal, terrified mother who had finally given birth to live children and what do you think happened to me when I looked up at the wall where the “breast is best” posters were hung (they were every few feet on the walls in the maternity ward and NICU), and was told by a medical care professional that it was better to continue with the IVs rather than start formula?

We luckily had an excellent neonatologist who knew what was best for our twins, and she stepped in and not only had the nurse reprimanded and removed from the twins’ care, but she explained that while breastfeeding is wonderful, it does not trump getting our twins off IVs so they could learn how to swallow and put on weight.  That to keep to a mantra that does not take into account specific situations is to cause damage.

Even in more typical circumstances, breastfeeding can be a challenge.  It can be painful; it can be impractical; it can be exhausting.  And, most fundamentally – even if none of these reasons existed – there will be some women who just don’t want to.  We cannot make these women feel like second-rate mothers for the way they choose to feed their children.  We must trust women, and we must trust them in this decision.

If we want more women to have access to the choice to breastfeed, we have some work to do as activists.  We need to provide mothers with information not just about the benefits of nursing, but with practical knowledge on how to do it: when and how often, latches and holds, pumps and nursing bras.  We need to combat the stigma women face when nursing in public (remember, women have the right to nurse their baby anywhere they are both legally allowed to go).  We need to make workplaces more breastfeeding-friendly.  When it gets tough, we need to be supportive as friends, colleagues, and partners.  We need to make sure women have accurate information on supplementing and weaning.  Importantly, we need to address those barriers without judging the women who – regardless of why – do not end up breastfeeding.  If you have trouble with this, please follow this chart:

Read more:

The Real Breastfeeding Support Team Every Mom Needs  and why it includes both a breastfeeding drill sergeant and a laissez-faire feeder.

All the Breastfeeding Support Info You Need to be Successful (although, in some cases, all the information in the world just won’t be enough).

Ask the Lactation Consultant anything you want to know about breastfeeding, and get an expert opinion.  She’s on Twitter, too.

Mama Knows Breast, on breastfeeding in the real world.

My favorite books on nursing:

At the Breast: Ideologies of Breastfeedings and Motherhood in the Contemporary United States by Linda Blum (Best non-instructional book on the topic, in my opinion.)

Nursing Mother’s Companion by Kathleen Huggins

Ina May’s Guide to Breastfeeding by Ina May Gaskin

18 Responses to “How to support breastfeeding without being a jerk”

  1. Tanya DeBuff October 10, 2011 at 2:38 pm #

    THANK YOU for this. I also found that whole debate disappointing. I agree wholeheartedly that there needs to be more support for breastfeeding moms, and that we need to work towards it. I am a mom who tried breastfeeding and couldn’t make it work. And I agree with your sentiment: Trust women. Breastfeeding was difficult for me, and it ended up with me feeling chained to the couch. I had to have my perfect set-up. I couldn’t breastfeed on demand, I couldn’t do it anywhere but my couch. By the time I got done feeding my infant, we’d both sleep for an hour or two and then it’d be time to feed her again. I hated that feeling of being chained to the couch, and was so upset by the experience that I formula fed my last 2. Now, if I have another baby, I’d like to try breastfeeding again. ANd I work at home, which one would think would make it easier, but seriously, I already work 15 hours a day at home (with breaks to care for my kids and errands, etc.) Five or 6 hours breastfeeding just wouldn’t work for me, at all. It seems like in this debate no one won.

  2. Kelsey October 10, 2011 at 10:30 pm #

    I feel like the true character of this ‘debate’ is really being lost. The issue that many breast feeding advocates have been focusing on is that formula companies and non-baby friendly hospitals have created a system that handicaps women who want to breastfeed before they even start. Millions of women say they want to breastfeed, but end up running into problems because of lack of support and sabotaging practices like free formula samples. The fact is, the majority of infants end up getting formula — it’s not like there’s a big breastfeeding majority bullying those who end up formula feeding. Breastfeeders are in the minority, face plenty of judgment and challenges, and the health of women and children has been adversely affected as a result. I don’t think acknowledging that truth makes me a jerk.

  3. Gretchen Sisson October 10, 2011 at 11:08 pm #

    Hi Kelsey,

    I absolutely agree with you that that doesn’t make you a jerk! And I’m a proponent of baby friendly hospitals – I don’t believe we need to have formula companies influencing the medical advice and choices available to women. I wholly, 100% support breastfeeding.

    I recognize that among certain racial/ethnic groups breastfeeders are the minority (not all, though). I also recognize that many women who use formula feel no bullying, no stigma attached to that decision — indeed, using formula is the norm in their community. And I do think that’s a problem. I think breastfeeding must be a healthy, supported choice in all communities, and when we look at the huge disparities in both breastfeeding initiation and during, it shows that something is critically off in how we support different mothers. I tried to discuss this when I mentioned the brief and entirely non-comprehensive list of breastfeeding barriers that all feminists should be working to deconstruct. I did not mention the baby-friendly initiative due to oversight rather than intentional omission.

    I do, however, think that for a proportion of moms who use formula, especially those women who identify as feminists, they feel that they are letting down not only their child, not only themselves, but the larger community of feminists who promote breastfeeding when they end up using formula for whatever reason. As a birth doula, I see this too in women who end up having c-sections after laboring for days and days without progress.

    Don’t get me wrong: I think our breastfeeding rates are too low and our c-section rates are too high. But given that the rest of the world has normalized these interventions, I actually see most feminists pretty radically embracing the counterpoint, in a way that really makes sense. And this movement is INCREDIBLY valuable. However, for women within this community who, for whatever reason, can’t achieve the perfect birth or the perfect breastfeeding experience, I think they can be left on the margins of the margins: they don’t want to be part of the mainstream that encourages unnecessary medical intervention and control of women’s bodies, but they recognize that other ideals are not achievable for all women. Where does that leave them?

    I was speaking the to feeling that had been expressed that some new moms felt disappointed and let down by communities that I feel should have supported them. But I don’t think you’re a jerk, Kelsey, and I don’t think there’s really a right or wrong answer here. I think given this emotionally charged issue the stakes are high, and we’re all just trying to figure out how best to support women. Do we support them by addressing the systemic barriers? Do we support them by acknowledging and validating their personal choices? Of course, I think we can do both. I don’t think I’m going too far out on a limb when I say I bet you agree.

    (Also, I admit that the word “jerk” was perhaps not the best, and I will honestly, truly say that I was not referring to any one person in particular when I wrote it, but rather the judgmental mindset that condemns formula-using mothers as somehow less than other mothers.)

  4. Kelsey October 10, 2011 at 11:38 pm #

    I definitely agree with what you’re saying. In my observations of the kerfuffle that’s been going on, and other similar ‘debates’ in the past, there really seemed to be a divide between those who were supporting the baby friendly hospital initiative and those who weren’t.

    I don’t want any woman to feel like less of a mother or less of a feminist for doing what’s best for her or her family, but that doesn’t mean we should be silent about important policy issues because it might make someone feel bad. Pointing out the high c-section rate, our c-section-happy medical establishment, and the high toll it’s taking on women and babies might make some women who had medically necessary (and even some women who had elective) c-sections feel criticized. I don’t want them to feel that way, but I’m not going to stop looking at the issue. Some people might feel like a focus on contraception and sex education is implying that there’s something wrong with abortion. I don’t think so — I define myself as pro-abortion — and it’s not going to stop me from advocating for better contraceptive access. We all bring our personal experiences and baggage to every issue, but at some point, public health trumps anyone’s discomfort.

    I absolutely acknowledge that there are breastfeeding advocates out there that ARE jerks, but I have yet to see one that is any kind of influential feminist and I didn’t really pick up on it in the recent debate (although I obviously didn’t read every blog out there). Maybe it’s because we’re so used to being on the defensive, but sometimes I feel like feminist discourse these days is like a defense-only game, especially when we’re bickering among ourselves. I think we could really benefit from assuming better intentions from our sisters.

  5. freewomyn October 11, 2011 at 3:43 am #

    Thank you for this. My friend really wanted to breastfeed, but she just didn’t produce enough milk to feed her baby. Best laid plans of mice and moms . . . She felt very judged by the folks in the NICU who kept insisting that she needed to be breastfeeding the baby.

    I agree with you – we should support whatever choices women make – we don’t know the whole story.

  6. Steph L October 11, 2011 at 2:02 pm #

    Amazingly I didn’t come across that debate going on last week (probably a good thing). But I’ve seen debates over the subject before and its nothing but annoying. People need to learn to MYOB. Why do you care if someone bottle feeds? Or if they choose a c-section? Mind your own damn business.

    I have to say that breast feeding advocates in my experience have been the most obnoxious. A friend of mine who had a baby was unable to breast feed due to medication she was taking. Once we were in a mall and she gave her baby her bottle, some woman actually had the audacity to tell her to her face that she should be breastfeeding and called her lazy for using formula. I wish I could have punched her.

  7. Amadi October 11, 2011 at 2:29 pm #

    Actually, Kelsey, it was a divide between people who were substantially misrepresenting what UNICEF’s Baby Friendly Hospital Initiative calls for, and people who support it and its goals. And a divide between people who state, generically, that pre-term infants should have breastmilk available to them from donors, if their mothers can’t/don’t wish to nurse and people who have decided that such a declaration is somehow an insult to mothers of preemies who didn’t or couldn’t nurse.

    The chart, though… ugh. As a doula, lactation counselor and someone who, in their course of their avocation, works with mothers toward breastfeeding success, that chart is just more of the “whatever you do it’s okay” namby-pamby non-advocacy that has us in a place where within six months, the vast majority of women who begin to breastfeed, and presumably want to breastfeed, have given up. Advocacy sometimes has to say “this is what to do” unequivocally. Advocacy sometimes has to say “there is more to try.” And advocacy of breastfeeding has to realize that “breast is best” is not only true with all things being equal, it’s true, period. The only question is whether breast is feasible and if we were all trying harder to remove societal barriers (including “whatever you do it’s okay” non-advocacy) , it would more often be.

  8. Kelsey October 11, 2011 at 3:37 pm #

    And breastfeeding moms have plenty of horror stories about being kicked out of public places or having total strangers come up and suggest it’s really time to ween their child. Do mothers and women in general have to deal with a lot of people telling them how to live their lives and what to do with their bodies? Absolutely. People should cut that out and mind their own business. But again, public health policy is a different matter. I would never tell a stranger (or even someone I know well) what they should and shouldn’t eat. But I’m not against the Food Pyramid.

  9. Gretchen Sisson October 11, 2011 at 3:53 pm #

    I’m sorry, Amadi, but I’m not saying “whatever you do is ok.” I’m not advocating you give your newborn a bottle of cafe latte with extra sugar. I’m saying that, when a mother decides to formula feed, it’s important that we respect that. Women need to make their own choices. I’m a big supporter of breastfeeding, and I think we should advocate for policies that make nursing more acceptable. But on an interpersonal level, we cannot judge.

    In my work as a doula, I met a woman who was a victim of sexual assault and, as a result of her trauma, really struggled with the intimacy of breastfeeding (not to mention labor). We discussed the benefits of breastfeeding, she tried it a few times, and each time she ended up in tears. I really don’t believe that breastfeeding was the best choice for her as a new mother. I just don’t. And as a doula, I gave her the information, I supported her in her attempts, and I supported her decision when she confidently made it. Once she made the switch to formula, it was like a weight lifted off her shoulders – she bottle fed, bonded with the baby, and began to really love it. Over the first few weeks she tried nursing again, but the anxiety around it just wasn’t worth it. It just… wasn’t.

    I really think Kelsey said it best: “Do mothers and women in general have to deal with a lot of people telling them how to live their lives and what to do with their bodies? Absolutely. People should cut that out and mind their own business. But again, public health policy is a different matter.” In the article, I hoped to both advocate for those policies AND show the importance of support on that interpersonal level.

  10. Tanya DeBuff October 11, 2011 at 8:18 pm #

    I think the whole debate got off track. I agree that breast is best. That said, it’s not feasible for everyone for lots of reasons, and I think women who weren’t able to or didn’t want to breastfeed should be allowed to be confident in their decisions, too, without being told that we’re poisoning our children with formula (some people’s only choice!). Almost all new mamas want to do best by their babies. I think we all need to be about supporting breastfeeding, which I guess means making it feasible. In the hospital I was barraged by the lactation consultants, and they called me after I got home, but I told them my troubles and they tried to fix them over the phone. It didn’t work, and I didn’t have a vehicle all of the time to go and see them. Home visits would have helped me immensely. But as it was, I was a new mom, knew nothing, and after 2 months of using a nipple shield and not being able to nurse her without it, I got frustrated. I wasn’t bonding with her, and I was tired and frustrated and quite frankly angry. My doctor had said it would be easy–heck, she did the dishes while she breastfed! I didn’t feel like a failure when I quit at 2 months and then pumped for another month. It was a relief to sit down and feed my baby with a bottle of breasmilk, and then formula, because she wasn’t screaming and I wasn’t sobbing. I wasn’t told about any availability of breast pumps, and had to buy my own and figure out how it worked. I would have loved support from the hospital or anyone, and this is what we need to be working towards.

  11. Laura P. October 12, 2011 at 4:20 am #

    Very interesting.

    I consider myself a breastfeeding advocate and try to support all women the best I can. Sometimes this is by listening to their stories of failed attempts at breastfeeding and being quiet. Sometimes this is by sharing breastfeeding facts and busting myths. Sometimes this is by watching their child and making no negative remarks about preparing a bottle of formula. Sometimes this is by breastfeeding my child in front of them. Sometimes this is by offering to share tips on re-lactation if they are ever interested.

    Most of all, I do this by being involved, keeping an open mind, and being myself.

    I think that for too long our society has shunned the responsibility of being a community. We owe it to each other to support each other and be involved.

    Being honest doesn’t mean you have to be a jerk.

  12. Gretchen Sisson October 12, 2011 at 7:39 am #

    Laura, I love that you mention “breastfeeding your child in front of them” as a way of supporting breastfeeding. I think that’s so great! Being open and honest about your choice, and basically opening yourself up for them to ask questions about nursing, how it’s going, what works for you — OF COURSE that’s advocacy. Great point.

    I hope you don’t think I was asserting that being honest makes you a jerk – I just don’t think we have a responsibility within our community to let everyone know our honest opinion, particularly if haven’t asked for it. I agree, as you state, that “we owe it to each other to support each other and be involved”. I think sometimes being supportive means offering advice and expert knowledge (which it sounds like you have), active support, opinions, stories on your own experience… and sometimes it means accepting people making decision different from your own, because their life is different from your own.

  13. Laura P. October 13, 2011 at 12:34 am #

    Gretchen, no I didn’t think you meant being = being a jerk. I was trying to make the point that people can be honest in a non-jerky way.

    I like your illustration, but for me the difference lies in the non-action when a new Mom or PG Mom is a friend & has NOT asked for advice. I think it is possible to offer help/advice/personal stories without being a jerk.

    Sometimes people don’t ask for help because they don’t know where to go.

    For example; the other day I ran into my neighbor who had a new baby last month. She brought up the subject of breastfeeding. I offered a small glimpse into my personal experiences (positive), shared the breastfeeding issues my older sister went through (positive and negative) and info about the local LLL group.

    She told me her opinions, her story, and we moved on to gush over her baby.

    My hope is that when I walked away, she now knows I am a source of help/advice if she wants it. If she ever chooses to come to me about breastfeeding, it will be possible because I didn’t keep quiet and I reached out to her.

    Does that make me a jerk? Nosy? Annoying?

    This post has really made me think. So thank you!

  14. Marisa October 13, 2011 at 8:04 am #

    Nice article, Gretchen. There’s so much judgment around this, and it’s sort of a hallmark of the way we judge each other’s parenting as well.
    I wanted to mention another angle – I breastfed my son, who we adopted as an infant, through a combination of induced lactation and a supplementer. I was lucky to have a supportive partner and to find a lactation consultant with experience with induced lactation, though it was still very hard work. Generally, people were either incredibly supportive (sometimes to the point of ridiculousness, like the woman who actually used the phrase “breastfeeding hero), or they tended towards the “ick factor” – one mom actually said to me “I thought getting to skip breastfeeding was one of the bonuses of adopting!” Regardless, I hardly met anyone who didn’t have a strong response, which I think is telling.

  15. Sally McCollum October 13, 2011 at 10:01 pm #

    Great article, Gretchen. Well-written, informative, and I love the “flow” chart. Bottom line: we must give as much information and assistance as new mothers need to make their best decision; then what they do is up to them. That is simply their right, similar to all other personal decisions like whether to have a child in the first place. Choices can be improved through education and support but they can’t be dictated by social policy or political influence. Motorcycle riders must wear helmets, yes, but we can’t force mothers to breast feed.
    Also, why are formula samples necessarily a bad thing, as though infant feeding is either/or? It seems only common sense to get a baby started on both breast milk and formula so that she/he will happily take both. Mom can pump and keep bottles of breast milk in the freezer, but there may still be times when she is not there and that shelf-stable formula kept handy in the diaper bag is literally a life-saver. Or grandpa needs to feed baby and there isn’t enough breast milk available. Mom does not have to be chained to the couch to ensure that baby is fed. (BTW, some breast pumps are hard to use and at first, it can take a while to build up a supply of milk in the freezer. Eventually, I got rid of all my pumps because hand pumping was easier than any of them.)

  16. Kelsey October 14, 2011 at 3:37 pm #

    Sally, introducing formula early in a breastfeeding relationship can sabotage supply and possibly lead to nipple confusion. You’ve listed many reasonable instances where someone might use formula, but if someone truly wants to exclusively breastfeed, it’s far from harmless to give them formula samples, especially without an explanation of the risks. I also think it’s stigmatizing of EBF to talk about supplementing as ‘common sense’ or EBF as chaining women to the couch. If we’re truly supporting all women’s choices, that includes giving women who want to EBF the tools they need to do it and not preparing them to fail before they even start.

  17. Sally McCollum October 17, 2011 at 11:31 pm #

    Kelsey, I’m truly sorry you interpreted my comment as “preparing (women) to fail before they even start.” On the contrary, I was making precisely the opposite point. Personally, I believe trusting women also means respecting them enough to believe they can make the best choice for themselves among all the alternatives and routines, when they’ve been given all the information they need, as I originally said.

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