of human functions.
In one oddly worded article, Dr. Jack Newman, author of The Ultimate Breastfeeding Book of Answers, writes that the concept of mother guilt is just another ploy of breastfeeding detractors; that we should not stop promoting breastfeeding just because it makes women feel guilty. “Who does feel guilty about breastfeeding?” he asks. “Not the women who make an informed choice to bottle feed. It is the woman who wanted to breastfeed, who tried, but was unable to breastfeed who feels guilt.”34
Awkward phrasing and intention aside, those last two sentences are the truest things I’ve ever read about breastfeeding. I didn’t find this article until I was six months postpartum, but I wish I had come across it during those rosy, innocent prenatal wanderings through the World Wide Web. Maybe it would’ve given me some warning about what was to come.
• • •
I had been writing for a popular health and wellness website prior to my son’s birth, and the founder of the site had lent me a few books on the psychology of newborns. One had described how, if an infant is placed on the mother’s belly immediately after birth, he will instinctively claw his way up to her breasts and latch right on. It seemed so primal, this preprogrammed knowledge, an instinct to both forage for food and seek comfort. I couldn’t wait to see it in action.
To my obvious pleasure and relief, my first moments with my son Leo went exactly as the book described. His tiny movements up the outside of my stomach were like reverse echoes of what he had been doing on the inside for the past months. Familiar but hyperreal; I couldn’t reconcile this small being on my skin as the same creature that had been cohabitating with my internal organs. It was disconcerting. His big eyes looked up at me as he pushed his damp head into my rib cage; the nurse shoved him roughly up toward my nipple and he found his target. It was exhilarating. The books hadn’t lied. The nurse told me Leo was a nursing pro, that we were doing just great. I believed her.
Later, I was wheeled up to the maternity ward. There was a bassinet in our room with a baby in it. My long-awaited, desperately wanted, beautiful, healthy baby. He was a good baby—quiet, alert, an “old soul,” according to my father.
He was perfect. For about three hours.
And then he got hungry.
TWO
Lactation Failures
There’s a startling disjunction between how breastfeeding is presented—as a natural, instinctual act that is seldom sullied by physical or emotional impediments—and the actual lived reality of most early breastfeeding experiences. This has created a breeding ground for serious problems, where lactation “failure” is mishandled, misdiagnosed, and misinterpreted. The true failure, however, may be on the part of well-meaning but dogmatic care providers who refuse to acknowledge that legitimate lactation problems can and do exist.
Like many women, my initiation into breastfeeding was exceedingly technical, supervised, and regimented. During our time in the hospital, I was visited by three different lactation professionals (a mammary-centric version of the three wise men—instead of frankincense and myrrh, this holy trinity brought lanolin and breast pads), all of whom approached our breastfeeding “dyad” as if it were not a living, breathing mother and child, but rather two disembodied nipples and a free-floating tiny mouth. I welcomed these clinical ministrations, though, because despite a brilliant opening-night performance, our breastfeeding relationship had quickly deteriorated. If breastfeeding was a dance, Leo seemed to have forgotten his steps and I had two left feet. Or at least one left breast that functioned, and a right one that refused to cooperate—I apparently had some vague form of “nerve damage” that caused severe pain to shoot through the right side of my body whenever Leo would suck. Adding insult to (literal) injury, my infant son refused to latch on to the “good” breast, repeatedly pulling off of it and screaming as if someone had stolen his puppy.
None of the lactation consultants could get my son to successfully latch. The excuses ranged from a kind but vague “he’s just sleepy, give him time,” to the snippier proclamation that my new babe was “a slow learner.” And although no one solved our problem sufficiently to make an actual feeding possible, every two hours, a clipboard-wielding nurse would march in and demand notification of how long Leo had fed and on which breast, and how many diapers he’d soiled. (I realize these nurses were just doing their job, but at the time I could have killed them all, even if it meant ripping out all my stitches to get out of bed and bash them over the head with one of those stupid clipboards.)
Considering how overtly medicalized the breastfeeding experience has become for most of us, it’s ironic that the discourse around infant feeding so often coincides with an anti-interventionist approach to childbirth. Aside from the Nestlé scandal, a large part of the resurgence of breastfeeding in the late twentieth century can be credited to the women’s health movement of the 1960s and 1970s, which raged against how the current medical system was taking motherhood out of the hands of mothers.1 At the time, breastfeeding was a radical, subversive act; now, it is professionally monitored to a greater extent than most pregnancies.
Breastfeeding has been politicized for a long time—most historians credit the eighteenth-century French philosopher Jean-Jacques Rousseau with framing breastfeeding as a civic duty, a way for women to support the health and moral character of the nation2—but it wasn’t until the nineteenth century that medicalization of nursing and childbirth really became a significant phenomenon, thanks to a confluence of events. The industrial revolution changed the dynamics of American society: women, especially poorer women, were joining the workforce in droves, making it difficult to balance breastfeeding with employment. Wet nursing fell out of favor in the United States; although it was still a viable option for the very wealthy, it was not for the majority of working-class women. Infant mortality rates rose as families began to feed babies unpasteurized milk or other inappropriate substances. At the same time, pediatricians grew fed up with their specialty being considered a “lesser” sort of medicine than that of their peers, and sought ways to become more relevant as physicians. By taking charge of formerly domestic issues like infant feeding and childcare, they were able to kill two birds with one stone—they could reduce infant death and illness rates while boosting their professional cred.3
By the twentieth century, infant-feeding practices were the domain of primarily male doctors, who worried that the “highly developed nervous systems” of their middle-class female clients were not conducive to breastfeeding. In response, they began prescribing rigid routines and dietary restrictions for new mothers, and standardizing “well baby” visits and regular weight checks to ensure that babies were adequately gaining weight.4
At the same time all this was going on, infant formula was becoming a mainstream phenomenon. Pediatricians often designed their own versions of breastmilk substitutes to give to patients when breastfeeding wasn’t working—not working perhaps, as medical historians like Rima Apple have argued, because of the bad advice and birthing practices perpetuated by these same doctors5—and, slowly but surely, capitalism took over. A few companies began marketing infant formulas to the pediatric community, which would prescribe these products to patients as supplemental “relief bottles” or complete replacements for breastmilk.6 Women were increasingly reliant on physician expertise as the century progressed, and formula was seen as easy, modern, and possibly even better than breastmilk in an age in which progress and science ruled. (For proof of this, peruse any women’s magazine from the 1950s. The ads come straight out of The Jetsons.)
Needless to say, the advent of medicalized childbirth and pediatric oversight of maternal duties, coupled with the commercialization of infant formula, is universally blamed for the dramatic fall in breastfeeding rates in the late twentieth century. But Linda Blum, sociologist and author
