I talk a lot about breastfeeding, mainly because I’ve spent the past year plus of my life nursing my daughter 6-12 times a day, so I end up thinking about it a lot. Which means I’ve read a lot of articles about breastfeeding, I’ve watched all the documentaries and I belong to several virtual and real life breastfeeding support groups. And of course anyone who is paying attention to trending blog posts and media discussions will see that one of the issues at the crux of the “mommy wars” is breastfeeding vs formula feeding. For the sake of this blog post let’s put aside the moms who decide in advance that breastfeeding isn’t for them and they aren’t interested in trying.
What we have left are moms who exclusively breastfeed, exclusively pump, pump and breastfeed, breastfeed and supplement with formula, and moms who tried to breastfeed but ended up exclusively feeding their babies formula. Often moms who have exclusively fed their infants breast milk know that bad information early in the breastfeeding relationship can totally derail breastfeeding and negatively affect milk supply. As a result, when another mom says she is sad that she “just doesn’t make enough” and needs to either supplement or switch to exclusively formula feeding, a bunch of other moms jump in to see if she is drinking enough water, eating enough calories, feeding on demand, power pumping, getting a good latch, seeing a lactation consultant… etc etc until the message that mom starts to hear in her head is “this is your fault, you could be doing something different and succeed”. And the truth is that according to research, a very small percentage of women biologically and medically cannot produce enough milk to feed their babies.
However, I would posit that a more important truth is that new mothers who want to breastfeed get either very little information, bad information, or tons of conflicting information before and immediately after their babies are born. We’ll start with my personal experience and then examine some of the feedback I’ve heard from other moms directly. I was relatively prepared before my daughter was born. My mother breastfed and promised to be a resource to me. I took a birthing class that covered breastfeeding. I watched two breastfeeding documentaries, one while pregnant, the other a few weeks postpartum. My obstetrician asked me if I intended to breastfeed once, I said yes, she literally never talked to me about it again.
My obstetrician asked me if I intended to breastfeed once, I said yes, she literally never talked to me about it again.
That’s right. The doctor who is supposed to be trained in all things women’s health and baby birthing never discussed the potential issues I might face and where to find good/vetted information. She verified that I had good intentions and then left me to sort through the information I encountered from other moms, nurses, Dr. Google, and well-meaning strangers on my own. Then my daughter was born and she was immediately whisked to the NICU. So now I had three lactation consultants and four postpartum nurses coming in every four hours or so giving me different instructions on how often I should pump, what flange size I should use, and how to care for my nipples. Thankfully I knew enough to ignore some of the bad advice I received in those first three days postpartum. Fast forward a week and my little girl is discharged from the hospital (hurray!) we go home, she gains weight, everyone says, “great job!”. Meanwhile I feel like my nipples are going to fall off and I’m using every healing treatment I can find to keep that from happening because I’m so determined that I won’t let anything derail us from breastfeeding a full year. Finally, I have a full on breakdown around four weeks postpartum and I look online for a local lactation consultant to come and help me.
The first woman who comes to my house is clearly nervous and she’s making me nervous and she’s making my daughter nervous. She goes through her weight checks and watches us nurse and makes a few suggestions, but at the end of the visit says, “Hmm, I’m really not sure what’s wrong.” I was NOT a happy camper. Finally, I ask my pediatrician for a lactation consultant recommendation and I get Lisa. Oh, what a difference Lisa makes. It doesn’t take her long to identify a tongue and lip tie, and soon we have schedule a procedure to get it corrected, and while I still had issues for another 6 months, it was enough to get us to one year!
Now, let’s take what other moms have going on. They have daycare providers who are imposing formula guidelines on them because they don’t understand how breastfeeding is different. They have pediatricians who don’t understand much about breastfeeding and give them terrible advice. They have postpartum nurses who are trying to formula feed their babies against their wishes. They have mothers and aunts who never breastfed and don’t support it and work against them at every turn. They have husbands/partners who see their breasts as sexual and want them to stop because they seem to have this wrong idea in their head that as the partner they “own” these breasts.
Some of the most harmful misinformation is coming from medical professionals. When a mom receives bad advice from a medical professional she is put in a position of going “rogue” and going against the advice she receives in order to do what she feels may be best for her and her baby. Now she feels like she’s taking a risk and the truth is that if motherhood does anything to a woman, it makes her risk averse. Especially when it comes to her brand new baby.
So, what’s the more important truth here? The more important truth is that moms haven’t failed to breastfeed, we have a system that has failed to support them in their breastfeeding goals. We have told them that “breast is best” and they should strive to exclusively breastfeed. But then we haven’t educated our obstetricians, our pediatricians, our nurses, all of our medical professionals about how to help a woman succeed in lactation. We’ve set a goal for moms and we have failed to give them adequate support. On one hand we are supposed to be able to trust the medical advice given to us by those who have spent their lives studying how our bodies work and how to care for them. On the other hand if you talk to breastfeeding moms you’ll know they’ve had to ignore all kinds of advice from medical experts in order to successfully breastfeed. And then when they don’t meet that goal, with often really good intentions to help, we’ve essentially told them they are to blame. We’ve set moms up to fail, and then we put this crushing pressure and guilt on them to make up for the major flaws of our maternal health system.
Let’s eliminate guilt from our conversations about maternal health. It’s not helping. It’s always hurting. And then let’s focus all the good, constructive energy we have to make the maternal health system better and stop nitpicking our friends, coworkers, relatives about their mothering choices.