children “liquid gold”? Should women with histories of sexual trauma or eating disorders, for whom breastfeeding might feel particularly oppressive or uncomfortable, be forced to bite their lips through six months (or more) of suffering? Is the antiformula culture insensitive to the realities of some parents, including teenage mothers, gay dads, adoptive mothers, or those in any number of other situations that stray from the middle-class norm? Why are we focusing so much energy on convincing women they have to breastfeed rather than offering better help to those who want to, and working to make formula the safest and healthiest alternative that it possibly can be? All of these questions danced seductively in my head, coming together for a big Chorus Line finish, the one singular sensation question that no one seemed willing to answer: Is breastfeeding really so superior that it justifies the guilt trip we heap on all of these women, essentially scaring them into nursing?
It took me two years’ worth of interviews with pediatricians, researchers, academics, sociologists, feminists, statisticians, and fellow moms and countless hours of reading through medical journals, websites, breastfeeding literature, parenting books, and chat room discussions to answer these quandaries. I couldn’t help wondering how much better my postpartum experience would have been had there been a book synthesizing all this information, one that lived alongside The Nursing Mother’s Companion and The Womanly Art of Breastfeeding, which would have offered a dose of rational perspective and given me some context in which to make a truly informed decision on how best to feed my child. I couldn’t find that book, so I decided to write it myself.
In the following pages, I’ll present evidence that suggests that the benefits of breastfeeding don’t always outweigh the risks to a woman’s physical, emotional, or financial health, and I’ll advocate a new outlook on infant feeding: one that refuses to embrace a one-size-fits-all strategy. I’ll tell the story of a cultural phenomenon that has touched many arenas—politics, feminism, healthcare, science, and our personal lives; a story about how we view motherhood, how women view each other, how science gets bastardized by bias, and how our choices are not always simple. Each chapter interweaves my own personal journey with informative research, interviews with experts and other mothers, and contextual perspective, in the hope that my travels through the infant-feeding wilderness can personalize an issue that too often degenerates into assumptions and generalizations; that my own struggles and realizations can prevent other women from feeling inadequate based solely on their lack of desire or inability to breastfeed. I’ve chosen to tell this story in a manner that will, I hope, be useful to policymakers, care providers, and researchers but also accessible to the parents who are going to “go make a bottle” and feel terrible because of it.
Most parents are unaware that there is an “other side” to this debate, because the conversation has mostly been relegated to academia, most notably in the fields of sociology and feminism. Joan Wolf eloquently picks apart the breastfeeding science in her 2010 book Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood, arguing that the body of evidence is inherently flawed and used coercively to support the stifling goal of “complete motherhood”; that breastfeeding “sits at the intersection of public discourse on science, health and personal responsibility.” A decade earlier, the book At the Breast detailed the impressive fieldwork of Linda E. Blum. Through interviews with women of different ethnicities and social standings, Blum highlighted the social inequities that put breastfeeding squarely in the purview of feminism. A myriad of academic articles have taken the current state of breastfeeding promotion to task, provoked in part by a 2003 U.S. Department of Health and Human Services/Ad Council campaign that compared not breastfeeding to debauched mechanical bull–riding while pregnant. At the forefront of the infant-feeding debate is the Center for Parenting Culture Studies at the University of Kent, spearheaded by Frank Furedi and Ellie Lee; this notable group has begun challenging how the “moralisation of infant feeding” has contributed to the “belief that ‘parenting’ is a problematic sphere of social life.”1
Yet, most scholars of the infant-feeding debate take a subjective approach, save for a few like the Australian women’s studies scholar Alison Bartlett, whose intimate and fascinating book Breastwork focuses on the sexualization of breasts and the dichotomy this creates for modern mothers. I am eternally grateful for the skilled research and analysis that these pioneers have provided, but I hope to take what they have started one step further: by taking readers through the journey of breastfeeding failure, one step at a time, I hope to show the very human side of this debate. Breast versus bottle is not just a matter of public health discourse or a feminist issue, but a battle that affects women in the most intimate of ways—we cannot possibly understand the toll breastfeeding pressure is taking on women without hearing from the women who have suffered through it. If we leave the women most affected by this battle out of the discussion, by limiting it to the pages of academic journals most of them will never see and discussing it in a theoretical sense rather than a practical one, we may never come to a cease-fire. I hope this hybrid of memoir and reporting will speak for the scores of other women who wanted very badly to do the best for their children and found themselves in conflict about what “the best” truly was.
I begin, in chapter 1 (“Preconceived Notions”), by arguing that the current state of breastfeeding promotion sets women up for failure, framing the “choice” as one that is no choice at all and ignoring the (very real) underlying reasons that make formula feeding the better, or in some cases only, option for some women. I demonstrate how the “good mother/bad mother” dichotomy is manipulated as a way to encourage breastfeeding, by considering the emotionally vulnerable position most women are in when they start thinking about how to feed their babies, and by examining how a now infamous government-sponsored breastfeeding campaign brilliantly capitalized on this vulnerability. Other mothers weigh in on subtle—and not so subtle—forms of pressure and guilt surrounding infant feeding that plagued them during pregnancy.
Prenatal desires notwithstanding, once in the maternity ward, many mothers will find themselves smack in the middle of an inherent conflict between the “natural” discourse surrounding breastfeeding and the medical model that supports the actual practice of nursing our children. In chapter 2, “Lactation Failures,” I show how infant feeding became the purview of the pediatric community, how this shady history resulted in an unstable marriage between breastfeeding advocates and the medical community, with modern mothers caught in the middle. Detailing my own inability to breastfeed successfully in the hospital, I also ponder if, from an evolutionary perspective, we may be evolving—slowly—into a state where breastfeeding is simply not as “natural” as it used to be; hence the need for lactation consultants, breast pumps, supply-boosting drugs, and so forth. We are often told that women in Western culture fail to breastfeed because of societal barriers, but further examination suggests that this interpretation may be limiting our understanding of real, lived experiences.
One of those real, lived experiences is that of postpartum depression (PPD). Recent studies estimate that as many as 20 percent of new mothers experience some form of postpartum mood disorder.2 Chapter 3, “Of Human Bonding,” focuses on women who have struggled with PPD and other psychological disorders (eating disorders, body image issues, and posttraumatic stress from sexual abuse) exacerbated by breastfeeding problems—myself included. I relate stories of women for whom nursing was somehow inexplicably linked to psychological stress, for whom formula feeding was a lifeline, a way back into the light—and I speak with a postpartum mood specialist who weighs in about the detrimental impact of our society’s romantic notion of breastfeeding women, and the number this fantasy can do on the already fragile psyche of a new mom dealing with PPD. I also discuss how medications are determined “safe” for breastfeeding and how the complicated risk-benefit analysis necessary to treat nursing women with clinical depression is muddled by overblown beliefs about the dangers of infant formula.
