Reply turned post, same old song about breastfeeding shame

On my Facebook page, I linked to this article asking the president of Facebook to change its policies on breastfeeding. In case you don’t know, Facebook considers photographs of breastfeeding to be obscene, and deletes them as pornography. Yet, they put underwear advertisements from American Apparel on my homepage.

The letter uses statistics from this recently publicized article from Pediatrics that enumerates the risks of our low breastfeeding rates in the United States in numbers of money spent and lives lost. This is a common way to discuss large scale public health issues. But, as usual, someone wants to hold breastfeeding to a different standard than other health issues.

A former friend of mine, who I thought I had blocked on Facebook, but I guess I hadn’t, replied with this comment:

i’m all for facebook changing its policies, but i don’t think that we need to demonize women who choose not to (or cannot) breastfeed.

*facepalm*

OK, I know the post took the mortality numbers and ran with them. I have to admit, they are startling numbers, and there is something about putting a mortality number on something to really drive home how policies can really affect public health. It’s all theory on the internet when we’re bloviating about whether breastfeeding in public is obscene, or whether being “pro-life” really can be reconciled with being against legal and safe abortion, but numbers of actual deaths per year are a powerful, powerful argument. There is nothing inherently different about breastfeeding that makes it somehow sacrosant, however, and therefore we cannot use our most powerful tools to promote it. There was not ONE word in this article that I thought demonized women who choose not to breastfeed. It acknowledged how breastfeeding successfully, even getting out of the hospital breastfeeding, needs a lot of support and education. It needs all the help it can get, and treating photos of breastfeeding like pornography on the most popular, incredibly pervasive social media outlet in the world may be a factor in the public perception of breastfeeding. Period. It wasn’t this post that linked breastfeeding to preventing almost 1000 deaths a year. It was the researchers who were published in Pediatrics, and then the article was publicized by outlets like CNN.

Here was my reply:

I don’t think that this post does that. It is a letter to the president of Facebook about its policy on breastfeeding photos being obscene, and draws attention to the fact that breastfeeding is important by using real epidemiological statistics on the public health effects of the low breastfeeding rates in the country.

I know that discussing breastfeeding’s very real health benefits may make women who don’t or can’t breastfeed feel bad, and that’s a shame. It’s hardly the most important point, however, as the statistics in the article clearly explain, and isn’t a reason to suppress real public health statistics on its benefits. It’s hard to discuss breastfeeding without talking about the true risks of low breastfeeding rates, and how these low rates may be related to how it is treated by various media sources, including social media.

One journal article on why women choose not to even initiate breastfeeding showed that the most prevalent reason was fear of what others, especially their partners, will think of them. The public shaming of breastfeeding is an important topic, even when discussing why some women choose not to breastfeed.

I didn’t see one line in this piece that said women who don’t or can’t breastfeed are wrong in any way. It’s an important health decision with important health consequences, and when I talk about it as a public health issue, I am not commenting on individual women’s health choices, which, when regarding many aspects of pregnancy, birth and parenting, are complicated and multi factorial. I don’t think this piece was, either.

In fact, in the comment section, I think the author answers this point rather well. Mothers, especially first time mothers, cannot make an informed health decision about breastfeeding when the behavior is shamed socially by prominent, pervasive outlets like Facebook. When mothers who don’t breastfeed have their bottle feeding pictures banned from Facebook for being pornographic, then we are talking about a similar issue. Otherwise, I don’t this article has anything to do with demonizing women who don’t breastfeed, but is rather about shaming women who do.

********************

I want to add, since this is my blog and not Facebook, that this is a major pet peeve of mine, and this person knows it. I hate that almost any internet discussion of breastfeeding is derailed by “Don’t hurt mothers’ FEELINGS!!!” and accuses me of being unsupportive.

I have a very good friend who had an awful struggle with breastfeeding who eventually had to give up and use formula, another who had to stop due to allergies that led to constant GI bleeding and anemia in her child, and a few cousin Susans who didn’t breastfeed after the first feeding or two in the hospital. I was a doula to a mother with MS that couldn’t breastfeed because she wanted to go back on her medications. I find it really insulting to be told that I am not supportive of mothers, since it is something I take very seriously. I have wiped tears off of a mother’s breast while helping her tape tubing of an supplemental lactation system to her breast, and I doubt any of these people who have accused me of that have ever been that supportive of mothers trying to breastfeed without judging them. And, I think crying “FOUL!” any time the subject comes up allows people to have an excuse to not consider the true risks to not breastfeeding, and casts it as a lifestyle decision rather than a health decision. And, I think this recasting of breastfeeding is a major reason why women choose not to do it.

44 Comments

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44 responses to “Reply turned post, same old song about breastfeeding shame

  1. Maureen

    I absolutely agree with you.

    • MomTFH

      Thanks. I used to face this nonargument a lot when I spent more time on parenting sites. I haven’t had it rear its ugly head in a while, and it really ticked me off.

  2. Thank you. I want to sing this all from the rooftops. I am so frustrated that every time I “go there” (take on society’s maltreatment of breastfeeding mothers), I get slammed with at least one very angry person who accuses me of judging/blaming/being mean to mothers who don’t/won’t/can’t breastfeed when that is the last thing I intend to do. So thank you.

  3. My post on this topic covers a lot of this territory too. It is so frustrating when people get all “OMG, don’t you understand that there are a lot of things that prevent mothers from breastfeeding?” Really? Funny, in public health we usually just blame individuals and ignore structural factors. Guess we should get to work on that.

    • MomTFH

      Right. Or, as seen below, they say – you know, there are other factors involved in SIDS, like smoking. Right, because you as a lay person can figure out that, but we researchers are rendered completely mystified at the concept of multiple risk factors. It is almost always addressed clearly in the studies they haven’t read but are criticizing.

      • SERIOUSLY. “Maybe mothers who breastfeed are also different in other ways!” Gosh, really? I cannot believe that when I did a project on breastfeeding duration last semester, I did not think to control for income, geographic location, race, education, etc. etc. What are they teaching me in those schools? (Wow, this topic brings out my sarcasm.)

        I will say, we can control for everything we can think of, but can we control for some impossible-to-measure X factor difference between breastfeeders vs. not, if it does in fact exist? No, and I think that’s going to be the inherent methodological flaw in every breastfeeding study until you find a sufficient sample size of women willing to be randomized to breastfeeding or formula feeding (like home vs. hospital birth, this will be never.) But demanding that (like demanding an RCT of home vs. hospital) before being willing to say breastfeeding makes a difference is (to me) a moving-the-goalposts of the first order.

        • MomTFH

          Breastfeeding studies are still easily designed to be high quality if we use large cohorts of people. Prospective cohort studies with large enough numbers, which can be done out of centers with high delivery numbers, can and are accomplished.

          Many research topics surrounding pregnancy and parenting cannot be randomly assigned in more traditional ways. But, people can be assigned to having a doula vs. current standard of care, or to having a lactation consultant, or to being treated with a defined standard of care, such as following Baby Friendly Hospital protocols.

          Prospective studies are better for controlling for confounders, and larger studies are better for finding associations with power for statistical significance for subgroups. There are some studies of siblings that compare one that is breastfed to one that is not that can answer some types of confounders.

          • Oh, agreed! And I think the PROBIT study is a great model for RCTs that don’t do the assignation on an individual level (communities w/ baby-friendly hospitals vs. not). Sibling comparisons are helpful too, in trying to control for unquantifiable X factors. It’s not that I think there aren’t good models for high quality BFing research – it’s just that people seem to be demanding an impossibly high standard (individuals assigned in RCTs) before making any concessions to the idea that (gasp) something other than the physiological norm might have health risks. Sigh.

  4. natalie

    I have to admit that I have been guilty of this. Mostly, to me, it’s in the delivery. For instance a woman on PhD in Parenting’s FB the other day said “women who don’t breastfeed SHOULD feel guilty.” This set me off. We all know the issue is more complicated than that – the structural factors, the cultural factors, maternity leave policies, hospital policies, birth practices, etc. So when the message is delivered in a judgmental way, yeah, I get het up.

    In sum, it might be a bit repetitive and boring but I think it’s important to always think about how we word things and be sure that valuable messages about the benefits of breastfeeding are not lost because they turn women off.

  5. natalie

    *because they are delivered in a manner that turns women off*

    • MomTFH

      Natalie, I think it is completely valid to expect people to have a respectful, kind, nuanced conversation. I do not think women who choose not to breastfeed should feel guilty. Any more than I think someone who chooses not to get chemotherapy should feel like their decision was somehow morally wrong. Should is a tough word.

      As I said, these are health decisions, and they are multifactorial. Barring all other factors, and there are a LOT of other factors, breastfeeding is a health decision with lots of benefits for mothers and babies, and the low breastfeeding rates in our country has many well researched negative health outcomes. This does not mean every single woman who does not breastfeed is demonized.

      The very real, very painful emotions surrounding the judgment of women for many things, including their breastfeeding choices, are important. They are just not relevant to every conversation about breastfeeding and public health.

      I feel guilt about being obese and not making the time to exercise enough. But, every time I see someone writing about the “epidemic of obesity” and/or talking about the benefits of exercise, I don’t wail “but some people don’t have time or have depression or have a disability or can’t afford a gym membership and how DARE you make us feel bad!” One out of ten times that obese people like me are characterized as couch potatoes who only eat fast food I may point out that characterizations like that are often inaccurate and are pretty hurtful. And, as for the times I read or hear that we don’t deserve health insurance, or should never be caught wearing something at all revealing, or that we are terrible parents who set a dangerous example for our children, or should be disgusted when we look in the mirror….

      You see where I’m going, right?

      Nuance and kindness are a good thing when we are talking about the intersection between public health and individual health decisions. They are not more important than research and facts in public health, but are more important when it comes to individuals.

      And they aren’t mutually exclusive. I like to think that we can have factual and kind conversations.

  6. Yeah, I think there are lots of things that are known to be beneficial to health that people can’t or won’t do for any number of reasons, including structural/systemic ones. The key seems to be working to address those structural/systemic issues, not to shut down all discussion of whatever beneficial thing. If some people can’t eat healthy food because it’s unaffordable, I wouldn’t think the solution would be to never talk about what food is healthy.

  7. “And, I think crying “FOUL!” any time the subject comes up allows people to have an excuse to not consider the true risks to not breastfeeding, and casts it as a lifestyle decision rather than a health decision.”

    HUZZAH!!!!

    • MomTFH

      Thanks! That is the main focus of my breastfeeding support. Treat it like a health decision, not a lifestyle or emotional decision. Yes, there are lots of social factors involved, like any health decision.

  8. Great blog post, and you are so right! I had my firstborn (now 15) in Germany. I didn’t even consider the idea of breastfeeding because of the less accepting culture that I grew up in (America). When the nurse brought him to me, I asked for a bottle and she was puzzled … as was I, when she lifted my gown and proceeded to latch him on while I sat stunned in my hospital bed.

    And…she came back every hour to make sure that it was working out.

    Not at least attempting to breastfeed wasn’t even an option.

    I went from being the mom embarrassed by breastfeeding to that mom…the one who nursed her babies into toddlerhood.

    The only time the breastfeeding thing has really hurt me was after the birth of my youngest. I had cancer and chemotherapy during my pregnancy with her and radiation following her early delivery. She was in the NICU for 5 weeks. My milk never came in. I was such a dedicated breastfeeder. I bought the most expensive pump and tried (in vain) to get something…anything. I gobbled Reglan hoping that the side-effect of lactation would take place. Still nothing.

    I cried many tears over this … and then one day in the NICU when she had lost weight yet again and was continuing not to take her bottle feeds, a nurse actually came up to me and said “it’s because she wants breast milk. Breast is best.”

    This woman had no idea of what my journey was, but it has been 4 years, and … that comment has stayed with me.

    It is ridiculous that breastfeeding could be considered pornographic….Good for you for a wonderful response to facebook.

    Kris

    • MomTFH

      Thanks for sharing your story! Ugh, so sorry about the cancer. I wish health care practitioners would be a lot more careful about people’s personal medical histories before making careless, hurtful statements like that. Especially in sensitive scenarios, such as NICU, or reproductive endocrinology. When I hear of practitioners in those fields making careless comments I think it’s especially bad.

      You are a perfect example of how social opinions and treatment of breastfeeding makes a huge difference. And, of course, the standards of care of the hospital. At the birth center where I trained, breastfeeding was treated as the physiological norm, and formula was a medical intervention. A necessary, but uncommon, intervention. We didn’t even have any formula at the birth center, only at the clinic (which was close by). It is true to institution and its nurses, midwives and physicians can make a huge difference, like it did in your case. But, as you said, you were in Germany, where it is more socially accepted, anyway, and came from America, and you didn’t even consider it, due to our societal treatment of it.

  9. Jen

    As a formula feeding mom, I appreciate your measured tone. Breast is best and we shouldn’t ignore that just to make moms like me “feel better” about our decision to formula feed. However, as a formula feeding mom, I cringe whenever I come across a self-proclaimed “lactivist.” I expect to be lectured, criticized and worst of all, pitied. I’ve fallen into the trap of trying to justify myself and learned that my reasons are never good enough for some women. I’ve been told that I’m “lazy” and “ignorant.” But the worst is when I’m patted patronizingly on the head while they lament my “lack of support.”

    What I want as a formula feeding mom is respect. I wish that “lactivists” would look at me feeding my daughter with a bottle and instead of wondering what I did wrong, assume that I made a reasoned choice to formula feed.

    This study is innocent enough but I do strongly object to the leap to “formula will kill your baby!” I saw a hysterical, and way over the top blog post yesterday from someone who apparently thinks that arguments are won by the person who screams the loudest. In a nutshell, it was formula kills and you’re wrong if you think you can’t breastfed. I don’t understand how screaming at me about how my baby will die helps promote breastfeeding.

    • MomTFH

      I am glad you appreciate the measured tone.

      The Pediatrics journal article discussed in the original post associates about 1000 deaths a year, in the United States, of infants under the age of one due to a lack of breastfeeding. That is hardly a significant risk per individual infant, so one individual woman choosing formula is hardly killing her child. However, most people, and organizations like the department of health, think those 1,000 deaths are unfortunate, and breastfeeding should be promoted to help prevent them.

      • Jen

        I haven’t read the article and probably won’t read it but based on my (admittedly limited) knowledge of the other breastfeeding studies, I remain unconvinced that not breastfeeding is truly responsible for the deaths of almost 1,000 American infants. I agree that breast is best and I think this is proven by several studies that show the benefits of breastfeeding. However, I’ve yet to read a study that demonstrates that there is a real link between breastfeeding and SIDS.

        The cynic in me can’t help but notice that every ‘side’ is all “thumbs up” for studies that reinforce their previously held assumptions and nitpicks every study that disagrees with said assumptions. This study is everywhere in the on-line AP world but that same blogosphere completely disregards research showing that bedsharing is dangerous. (and for the record, I think that you can safely bedshare but acknowledge that there are some bedsharing related deaths that can’t be explained away by smoking or alcohol)

        • In all due respect, if you aren’t familiar with the research in general and you haven’t read the article, it is probably not a good idea to criticize the evidence.

          You may appreciate my measured tone, but you might not understand my point. I think there should be less emotional arguing on the topic, and more discussion of facts.

          I didn’t mention SIDS. SIDS is one of the causes of death that is more associated with lack of breastfeeding, and the evidence on it is good, if you care to read it. However, there are also higher rates of death due to other conditions, like necrotizing enterocolitis, which I mentioned in my post, and pneumonia.

          I am sure you had your reasons for choosing formula, and you shouldn’t feel guilt about them, as you said. But, choosing not to read the evidence and then denying its results is probably not the best way to make a major health decision, in general. Purposefully not reading the evidence is a perfect way to never see the good studies.

          • In case you do want to judge the quality of the evidence supporting the association between SIDS and breastfeeding, along with “acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis,” it is available. Breastfeeding is actually one of the most extensively researched subjects in the field of pediatrics.

            The Pediatrics article based its analysis on this evidence report by the Agency of Health Care Research and Quality. They “screened over 9,000 abstracts. Forty-three primary studies on infant health outcomes, 43 primary studies on maternal health outcomes, and 29 systematic reviews or meta-analyses that covered approximately 400 individual studies were included in this review.”

            Part of the evidence review process is to look at whether the researchers controlled for what is known as a “confounder”, which would be another reason, like bed sharing, alcohol, or cigarettes, other than the main factor you are examining, like breastfeeding, may be responsible for the outcome you are examining, like infant death.

            Another pet peeve of mine is someone who doesn’t understand research or evidence at all criticizing a study they have not read. I would not walk up to someone studying architecture and criticize plans for a building that I did not see.

          • Jen

            (forgive me for the rambling nature of this response – I have a baby sleeping next to me) Like most formula feeding moms, I didn’t make the decision to use formula after an exhaustive review of medical literature. It was pretty simple, feed the baby or let the baby starve. Was my decision “educated?” Probably not. But my baby was hungry and I was exhausted and recovering from major surgery. I wasn’t in a place to make a major life-changing decision but nonetheless a decision had to made quickly so I did my best.

            It is best to discuss breastfeeding as a public health issue instead of a “bad mom” issue but I’m sensitive to this because I know that most discussions about motherhood are reduced to “bad mom.” Our society cannot rationally discuss public health issues related to pregnancy and motherhood. My theory is that this is because the reality of American family life doesn’t fit our ideals and we take out our anxieties about this on mothers. The majority of moms of very young children work outside of the home but yet we as a society provide no support beyond mandated unpaid 12 week maternity leave. No funding of daycare beyond the measly $5K tax credit (daycare will cost me $12K this year). Our society is set up to support a family that largely doesn’t exist anymore, especially outside of the upper middle class.

            Fundamentally I’m a pessimist about this issue. I don’t foresee any significant increases in long term breastfeeding rates. Most of us work outside of the home and we’re not going back home either because we can’t afford it and/or because we don’t want to. Formula feeding is so much easier and the decision to formula feed is usually made during the most stressful time in a woman’s life. (I will note that I’m very conflicted writing about “easy-ness” in terms of how my child is fed or how I like working outside of the home. It feels like mommy heresy to admit that my needs/wants are important.)

          • Jen

            Okay I admit that I was quick to criticize the study and that it’s wrong to criticize a study I haven’t read but I doubt that most of the people discussing the recent study have read it either. I’ve seen it all over the web with big “thumbs up” and I’ve seen little discussion about the assumptions underlying its conclusions. I found it interesting since the community that is so enthusiastic about this study is often the first to criticize “mainstream” studies, e.g. those that show that bedsharing can be dangerous or that homebirth is dangerous. Note that I’m saying that I think bedsharing (we co-sleep) or homebirths are dangerous, just that there are plenty of news articles in mainstream media that say that they are dangerous.

            Further, while I do not want to sound “anti-intellectual” (I actually despise the cult of anti-intellectualism in our modern political culture), a mom shouldn’t need to read studies to have an opinion about how to raise her kids. I hate to sound ‘woo’ but there’s a lot of wisdom in a mom’s instincts and what she’s learned from the community of moms.

          • MomTFH

            @Jen

            The decision between formula feeding and breastfeeding is not the decision between letting a baby starve or nourishing it. Even for a mother with supply problems, there are ways to support the breastfeeding relationship while providing nourishment, including supplemental lactation systems. Yes, formula can be life saving in situations where a mother truly cannot breastfeed. But, that is a rare occurrence.

            We are not discussing bed sharing or homebirth. I ignored it the first time you brought it up. I would appreciate it if you stuck to the arguments of my writing on my posts. I have no desire to fight someone else’s battles with you.

            As for learning from the community, why do you get to pick which community supported parenting decisions are woo, and which one’s aren’t? And, no, most people don’t do an exhaustive lit review before making a health decision, but then those people probably don’t go onto a researcher’s website and start arguing with them about the quality of the research.

            I wish people either did do the research themselves, or find sources they know are reading good research to consult. Most women have gotten so much contradictory messages from the so called community that they will go crazy if that is their only source of information about parenting a newborn. With resources like Google Scholar, the rest of the internet, and licensed lactation consultants, it is easier than ever to get accurate information on breastfeeding. Unless one is avoiding it purposefully.

            Once more, with all due respect, the only person I know who said they didn’t read the article and then is running to say they are “thumbs up” with an opinion based on their own personal viewpoint here is you. I don’t write a blog to defend other people you have seen on the internet. I am a researcher and I take evidence seriously, and am in even less of a mood to have those discussions that you are, and I think I made that quite clear.

  10. Meghan

    “No one can make you feel inferior without your consent.” Eleanor Roosevelt, 1937. One’s feelings are one’s own responsibility. If being presented with new scientific data makes a woman feel guilty about her choices (whether past, present, or future), then she has not accepted her choice.

    Someone can try to make a woman feel guilty for her choices, such as formula feeding, but one cannot force someone else to feel something.

    Also, decisions have consequences. If a woman decides to formula feed, whether by choice or by inability to breastfeed, the same consequences for that decision exist; namely her child doesn’t receive the benefits of breastfeeding. It is up to the woman to internalize and accept those consequences. Society should not shield her from them.

  11. Liv

    Re: working outside the home and formula feeding being easier…I’ve seen several women bring this up as a reason to not breastfeed, and it’s usually said in absolutist statements, such as the one made above that “formula feeding is so much easier” and that breastfeeding rates won’t go up because women work outside the home. It’s said as if it’s just a given that a working mom can’t/won’t/doesn’t want to breastfeed.

    I just want to point out that it’s not always the case. I can imagine that in some positions/industries/work environments pumping can be a challenge, but I, and every mother I know except two, are working mothers who breastfeed.

    I look at the two moms I know who are formula feeding, and there is no way that it looks easy *to me*. I see the expense, the mixing of bottles, the cleaning, sterilizing, the worrying about bringing enough food on outings, etc. My breastfeeding experience, on the other hand, has been as easy as sleeping.

    Is formula feeding cumbersome for everyone? I’m sure not. And is breastfeeding always easy? I think we all know that’s not the case. I just want to correct that impression that breastfeeding is always hard, that formula feeding is always easy, and the working outside the home automatically equals formula feeding.

    • MomTFH

      Thank you. I would further clarify that pumping may be a burden, but breastfeeding generally is not, once the breastfeeding relationship is established. I agree that buying and preparing formula, and sterilizing and cleaning the supplies, cannot be easier than breastfeeding for most people.

      I pumped and worked full time with both of my children, and know many people who have, also. I know a resident who pumped for twins. It can be done. It is hardly more insurmountable than taking care of an infant, formula fed or breastfed, at night. Or potty training while working full time, for that matter. The structural and societal barriers to breastfeeding are very real, very important, and already clearly acknowledged on this thread.

      Also, with a 30%+ cesarean rate in our country, we cannot write off all post surgery moms as guaranteed formula feeders. Yes, it’s another hurdle, documented in the research, that means these moms need even more support from health care practitioners. (Sorry, but saying some moms need more support may be a pet peeve of some, but it is true.)

      If society was more accepting of breastfeeding, then more women would be less likely to disregard the very real, abundant research on its benefits, and more workplaces would have to accommodate more.

  12. Meghan

    @ Liv. Why shouldn’t new moms (or better yet pregnant women) check out the studies concerning feeding their children? You can get the studies through your local library if you don’t have journal subscriptions (which most of us don’t unfortunately), and the librarians can help with reading the study if you are not used to scientific literature.

    Parents spend hours and hours researching the best crib, car seat, neighborhood, schools, etc. for their children. How is their earliest form of nutrition not an equal, or greater concern?

    I think part of it is our overall lack of respect for food. If people eat what is basically easiest and assume that since they aren’t getting sick from what they eat, and they aren’t hungry, then everything is ok. If someone has no respect for what they feed themselves, then why would we expect them to care about formula vs. breast milk for their baby? The kid is eating, right? Hopefully most people care about what they eat, and respect their food and bodies, but there many of society who do not.

  13. Meghan

    Sorry that should have been @Jen, not Liv.

  14. MomTFH

    @Meghan, I agree with what you say about food not being properly valued in this society. Well, even more, that the right things about food are not valued. I am a fan of the slow food movement, and am not the only one who has made an association between slow food and breastfeeding.

    I have to disagree with your assertion that people have no respect for what they eat or what they feed their children. I think that is crossing the line to blaming people for disagreeing with you.

  15. Allison

    I just wanted to weigh in with my story. I had a breast reduction where my nipples were relocated 6 1/2 years ago. When I decided to have the surgery I asked (at the ripe age of 22) would I still be able to breastfeed. My surgeon could not predict but told me I had a good shot at it.

    My son is 3 months old now and we are breast feeding. I have been doing everything I can to increase my supply, reglan, fenugreek oat meal etc. and we still supplement. But I got myself hooked up with a breastfeeding group, a lactation consultant and pumped up to 8x a day while I was home on maternity leave.

    Unfortunately due an outbreak of thrush and going back to work, I am exclusively pumping and giving him breast milk in bottles because he won’t latch. I surrounded myself with as much support for breastfeeding as I could find and we still aren’t nursing – although he is still getting my milk. I firmly believe if I could have stayed home with him longer he would still be nursing. I just happen to have a smart baby who realized hey, I am in control here and if I don’t nurse I get one bottle that comes out fast.

    If I could have stayed home with him longer I would have been able to keep nursing longer, and I really do miss the close time with him. I have other friends who had babies around me and did seek out as much help as I did and breastfeeding is tough for them. I am loving every minute of it even though it is hard work because it is great time spent wtih my son. And I know it will benefit him and its only for a short time while he is small I think its a small price to pay.

    I wish I didn’t have to give him formula at all because breastmilk is always with me and its free, but I’m sure glad I have easy access to it because in our case its needed. I am glad I put the time into trying to breastfeed but I can understand the need for formula too. I don’t feel any shame giving him a bottle – I am taking care of my son! I would never let anyone make me feel bad for giving him formula because the breast milk he does get is so hard won!

    • MomTFH

      Thanks for sharing your story! These are the more bittersweet of the breastfeeding stories, and you are the type of person I most worry about when people make sweeping statements. You have trouble with supply, for good reason, and you are still working with breastfeeding advocates and the community, and it seems like you are really happy with the community who supports you.

      I had less serious breastfeeding issues (latch problems, mastitis, thrush) and had to return to work. Many of us fall somewhere on this spectrum. There aren’t two groups: breastfeeders who are homogenous, group think advocates of all things AP, had vaginal deliveries and are stay at home moms, and formula feeders are people who had cesareans, who eat fast food, go back to work and won’t read any research. We are a wide spectrum of people with different experiences, and the more we can do to speak honestly with each other, the better.

  16. Allison

    That is true, but I worked hard to find my community. No one came to my door asking if I needed help, I looked for it. I feel the same way, I hear some of my friends stories and think gee if you had more help or someone to just tell you if you didn’t have enough milk you could supplement instead of weaning completely and using formula. I think people like me do kind of fall in the cracks when people get extreme in both directions about pressuring people to exclusively breastfeed and the opposite end of giving people a hard time when using formula.

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  18. I had an experience very close to Allison’s with my first child, sans the breast reduction surgery. I’m not sure what the issue was, but my supply was so low, even with every intervention and supplement that I, lactation specialists and Le Leche League could think of, that pumping 8x a day only yielded at most 6 oz. at a time. He wouldn’t latch, even after “bottle strikes” for days. To make everything worse, it was intensely painful to even pump, let alone bf.

    With my second son (who loooooved to breastfeed, and took a lot of my guilt away), I also had intense pain. But this time, I was referred to a doctor who took it seriously. Turns out, I had staph in both nipples. I bf him until he self-weened at 8 months, with some supplementation because of supply issues (again).

    I really think we should be listening to each other on these issues, but I also think more research should be done on how to diagnose and resolve issues of supply, pain, fatigue and all of the other things that disincentivise (not a real word, I know) a woman from starting and continuing breastfeeding. Many of us don’t need convincing so much as solid strategies. Not every pain issue can be traced to an improper latch. Not every supply issue can be traced to not pumping or “trying hard enough”.

    That’s all I got. :)

    • Jen

      “I really think we should be listening to each other on these issues, but I also think more research should be done on how to diagnose and resolve issues of supply, pain, fatigue and all of the other things that disincentivise (not a real word, I know) a woman from starting and continuing breastfeeding.”

      This kind of research would definitely have been helpful to me.

      Sorry for barging in here and sorry for bringing up other topics. I wasn’t trying to pick a fight.

      • MomTFH

        That’s OK.

        I think that kind of research is very valuable. It is a good topic for qualitative research, and probably should involved lactation consultants, like IBCLC certified ones. They are probably the best type of support for those types of problems.

        • See, this whole topic has got me thinking and remembering and doing some lit searching, so thank you for that. One last thing I’d like to see to make it easier for folks – more bf’ing education for physicians and PA’s.

          This site (http://life.familyeducation.com/nursing/postpartum/36050.html?page=5) has a perfect description of what happens to a lot of women who go to their doctor for pain when breastfeeding:

          “Unfortunately, relatively few obstetricians, pediatricians, or family physicians are familiar with the problem, which is seldom mentioned in traditional medical textbooks. An awkward situation often arises when a lactation consultant suggests the diagnosis, and the mother’s physician is reluctant to prescribe treatment since he or she is unfamiliar with the condition. Some dermatologists will diagnose and treat yeast nipple infections.”

          I’ve been there myself, as have many of my friends. I’ve been misdiagnosed, too. Given how much of an impact this has on both mother and baby, I’m wondering why we student physicians aren’t getting adequate training in breastfeeding issues.

          Thanks for putting up with the discussion!

          • MomTFH

            Me too. I had severe pain, especially the first time. I had latch problems in the beginning, but they were resolved by a lactation consultant. When I returned, months later, with a rash on my nipples and pain inside the breasts when nursing, she didn’t know what to do.

            I had a horrible family practitioner who misdiagnosed me (as an annoying hypochondriac). I think it was due to a severe candida infection. That’s what a more experienced lactation consultant thought.

            I also had a flare up of inverse psoriasis at the time, which didn’t get diagnosed. I don’t know if that was related to the rash on my nipples or not. I didn’t figure out I had that (it was aggravated by both pregnancies) until I was in medical school.

  19. Allison

    I totally agree that more research and more knowledge would be key to helping women. I know that the breastfeeding group I went to at a hospital led by a nurse and IBCLC was so very helpful for me to learn the science behind breastfeeding with a normal supply. It helped me to learn how my body would have worked had I not had the surgery and also how my body might work for future children. I know I will feel much more confident if I have a second because I learned so much about the process, even things that didn’t apply to my situation.

    I think the support goes to the shame issue too, if we all knew more about breastfeeding and how it worked we wouldn’t feel shameful about it. It becomes second nature.

  20. Pingback: Reply turned post, did someone say breastfeeding « Mom’s Tinfoil Hat

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