books had suggested. I already felt a deep sense of anxiety and insecurity about motherhood; two miscarriages and a problematic pregnancy had rendered me unsure about my body’s innate maternal abilities, and I was determined to at least get the retail aspect of the job done right.
There was a woman next to me, shoving several packages of disposable bottle liners (both environmentally and maternally irresponsible, I thought) into her shopping cart. She had two older children who were shoving each other, fighting over a push pop; her infant daughter was sitting unrestrained in the cart.
Next to her, a glowing, tall, blonde pregnant woman was conversing with her husband. “Grab those ones—the ones that say breastmilk storage bags?” she instructed him, as he reached for something on the top shelf of the display. “I’ve heard those are the best for pumped milk—no BPA!”16
I smiled at the blonde woman, my kindred spirit, as the bottle-feeding mom’s baby started wailing.
Message received.
• • •
My old college roommate is Catholic, and we have a longstanding debate on who owns the monopoly on guilt—her team or mine. I’m the product of a long line of Jewish mothers; she has original sin hanging over her head. There has never been a clear-cut winner in this battle, until now. Now I am a mother. Game over.
The guilt starts early. You get five minutes of unadulterated, blissful excitement when the pee stick turns positive, but then it begins. What about those five glasses of Sangria you had a few nights back? Is your baby going to have fetal alcohol syndrome? Maybe you haven’t been taking your prenatal vitamins as religiously as you should have been. Plus you opted for the generic brand over the fancy Whole Foods ones your sister-in-law recommended. Bad, bad mommy. We’ll know who’s to blame when your kid comes out with scurvy.
For the past decade, no conversation about breastfeeding promotion can escape the legend of the 2003 U.S. Department of Health and Human Services Office on Women’s Health/Advertising Council breastfeeding campaign. The campaign most famously featured a thirty-second public service announcement showing a massively pregnant, attractive African-American woman in her thirties riding a mechanical bull. She falls off; the bar patrons watching are appropriately horrified. And the words flash on the screen, ominously: “You wouldn’t take risks before your baby is born. Why start after? Breastfeed exclusively for 6 months.” Another similar spot relayed the same message with an expectant mother engaging in a log-rolling contest.
By appealing to mothers’ propensity to guilt and fear, the PSA assumed a few things: first, that the target audience was committed to a healthy pregnancy and a healthy baby; second, that they were committed to the nutrition of their children; and third, that they were committed to being the best parents possible. So we’re starting with a group of women who are already nervous, probably overloaded with information (my living room was a veritable obstacle course of pregnancy and parenting books), and the host of a ton of pesky hormones that make us cry at something as innocuous as a rerun of Saved by the Bell. The campaign’s creators were well aware of the impact these ads would have; one member of the AAP’s breastfeeding committee claimed the campaign signified “a change to promote breast-feeding as a public health issue rather than simply as a personal parenting choice.”17 Even the slogan used in the campaign—“Babies are born to be breastfed,” rather than the well-known adage “breast is best”—was significant. The Department of Health and Human Services (DHHS) intended the slogan to address its growing concern that breastfeeding should not be seen as the “ideal,” but rather that formula should be framed as risky.18
Even if one were to accept the general premise that babies were, indeed, sprung from the womb with a breastmilk birthright, where was the mother in the scenario presented by this slogan? Rebecca Kukla, professor of philosophy and internal medicine at the University of South Florida, voiced these concerns in a 2006 paper examining the campaign. Rather than addressing the real reasons women don’t breastfeed—reasons that range from histories of sexual abuse and body image issues to economic and physical constraints—the campaign “portrays anything short of exclusive breastfeeding … as a sign of moral corruption and bad character. … We can only conclude that DHHS believes that women can choose to breastfeed yet are failing to do so, not because there are any impediments to their voluntarily making this choice, but rather because they simply aren’t willing to do the best thing for their babies unless more pressure is exerted.”19
There was a ton of controversy surrounding these ads, which were pulled shortly after their launch (but not before they scared millions of potential, current, and future moms, I’ll bet). They even caused dissension within the American Academy of Pediatrics. On a 2003 episode of CBS’s Early Show, Dr. Carden Johnston, the AAP’s president at the time, claimed that he was absolutely in favor of a campaign to promote breastfeeding but worried about the tone of this particular campaign. “We want women to be able to choose to breastfeed and do that for positive reasons and not feel intimidated or scared,” he said on air. “We are for the breastfeeding campaign and we want to encourage it and support it and we want it to be accurate and credible. … Pediatricians raise their children and support their families with positive nurturing experiences, not with scare tactics.”20 A rational and considerate point of view, to be sure; unfortunately, Johnston and others who shared his concerns were accused of being in the pockets of the formula industry by some on the other side of the debate, and these cautious, balanced voices were silenced.
• • •
The DHHS/Ad Council campaign marked a significant change for the AAP. Although it had come out with statements supporting breastfeeding in the past, the organization had been cautious not to alienate the parents it served. At the time the bull-riding/log-rolling ads were released, the AAP was still relying on documents from the 1980s that, according to one breastfeeding activist, simply “encouraged breastfeeding and acknowledged the superiority of human milk.”21 Then in 2005, “Breastfeeding and the Use of Human Milk,” now used as the go-to for AAP breast-feeding policy, was released; it was profoundly different in tone, saying in no uncertain terms that “human milk is uniquely superior for infant feeding” and recommending that infants be breastfed for at least a year.22
It seems likely that the new, unequivocal tone was at least partly inspired by the dissent in the AAP’s ranks over the DHHS ads—especially when you consider that this statement was written by members of the 2003 AAP Section on Breastfeeding, the same group that cried foul when its parent organization, led by Dr. Johnston, pulled the plug on the DHHS campaign.
An older Southern gentleman with a slow drawl and kindly demeanor, Dr. Carden Johnston is like the poster child for a homey, warm, idealistic view of pediatrics; quite a contrast to how the defenders of the DHHS campaign had portrayed him in the press. In the kindest light they shone on him, he was a daft industry pawn; in the harshest, a slick political animal willing to throw the baby out with the formula water. “Dr. Johnston … developed this sudden and seemingly urgent interest in this issue not via a last minute clinical review of the scientific literature, or even after consulting with the AAP’s own recognized lactation science experts … his concern came immediately after aggressive, personal lobbying by representatives of one of the AAP’s biggest financial contributors, the $3 billion U.S. infant formula industry,” wrote lactivist Katie Allison Granju in “The Milky Way of Doing Business,” a rebuttal to the AAP’s actions regarding the campaign. “Johnston hurled the considerable credibility and persuasive impact of the esteemed American Academy of Pediatrics into an explicit effort to stifle the most ambitious initiative ever undertaken to promote breastfeeding in the United States.”23
When I met with Johnston seven years later, his recollection of the events was less dramatic. “I found out that there was pressure to have an advertising campaign come out of the Office on Women’s Health,
