Wednesday, 5 October 2011

Another screed on breastfeeding & guilt – this time with cussing!

Oh, this comes at a great time. This comes at a PERFECT time. I was literally in the middle of writing a conference proposal for a presentation on breastfeeding as a reproductive right, and I check my e-mail. My friend (thanks for loving Internet drama, Beth!) had forwarded me the following links on breastfeeding and baby-friendly:

The first was from a feminist blog called the F Word, by a guest blogger named Laurie Hearts, "Baby friendly - but is it woman friendly?":

Manchester's largest maternity unit, St Mary's, is set to become a Unicef-approved 'Baby Friendly' hospital by ceasing to provide free formula milk to the women who give birth there. ... Women who choose to formula feed at St Mary's will have to bring their own ready prepared milk in cartons from this November; powdered milk will be banned for health and safety reasons. ...

In an era when many feminists are (in my opinion rightly) dismayed by the suggestion that a woman's right to an abortion should be subject to conditions, I have been shocked by the high level of acceptance when it comes to the notion that women who formula feed should be forced to justify their choice, not only to medical staff, but to pro-breastfeeding women. While I have never seen anyone claim that formula is better than - or even equal to - breast milk, a large number of women are vociferously and uncompromisingly against a woman's right to choose formula milk. I have witnessed a sizeable number of women, some of whom are self-declared feminists, debating on one another's social media profiles and calling for formula to be made illegal.


The second was from Jessica Valenti's blog:

[F]or me, formula feeding was absolutely, 100% better than breastfeeding. Like, life changing better... refusing to give mothers access to formula is not "baby friendly or helpful - it’s shaming and in some cases could be very dangerous. Enough already.


I usually don’t swear very much on my blog (real life is a different story) but like all good screeds, this was written while I was feeling just a little riled up. So: Holy shit. Let’s just make this clear: baby-friendly is not about preventing you from formula feeding. I work in a hospital that is pursuing baby-friendly certification. Most women at our hospital plan to breastfeed. Some women plan to formula feed. A fairly significant percentage of the breastfeeders choose to use formula at some point. The straight-up formula feeders never hear a word about breastfeeding from us. You told us on admission you planned to formula feed, here are your bottles. The breastfeeders who need to use formula for medical reasons – and they are very clearly outlined, including hypoglycemia (low blood sugar) and excessive weight loss – get formula too (and we are very fortunate to be able to offer them the option of donor milk if they are not comfortable with formula.) The breastfeeders who ask to use formula – this happens not infrequently, often because “I think I don’t have enough milk” – get education and discussion, sign a consent form, and then are given formula too. (No, we don’t have them bring in their own formula like the hospital profiled; we can debate whether that’s any different from making them bring their own baby clothes, but I think there’s a legitimate debate there.)

However, while I have a lot of respect for Jessica Valenti, she and the other blogger are completely mischaracterizing the issue here. Baby-friendly is not part of the mommy wars, and I honestly think it is irresponsible to do so. What makes hospitals baby-friendly is not preventing women from choosing formula feeding, or refusing to give them formula when their babies need it. Baby-friendly is not about forcing mothers to do anything. Baby-friendly is about preventing HOSPITALS from shoving bottles and pacifiers into breastfed babies’ mouths and then sending their unknowing mothers home with a screaming, nipple-confused baby who won’t latch. Baby-friendly is about preventing HOSPITALS from accepting “free” formula and gift bags and samples from formula companies, turning the hospital into a shill for a for-profit company, and engaging in practices that research has shown make it less likely for women to reach their own breastfeeding goals. Baby-friendly is about forcing HOSPITALS to offer regular breastfeeding education to all their staff, including nurses and doctors, so they can help mothers and not give them crap advice. Baby-friendly is not about the mommy wars. It is not about trying to force any mother to breastfeed. It is about changing HOSPITAL practice, and whether or not you realize it, most hospitals in the U.S. have a long, long way to go. Baby-friendly is about offering evidence-based care to promote health.

“Who are you to decide that breastfeeding promotes health? Formula feeding can be lifesaving!” Hell yes it can. You think I don’t see that? I see that all the time. When women are dealing with a new baby, sleep deprivation, hormone shifts AND feeding issues, you are dealing with a potent cocktail for severe depression – you think I never meet women with serious PPD? You think I don’t see women with intense pain from feeding, or a history of low supply, or a baby who isn’t transferring milk well? You think I don’t see women who are BBAC (breastfeeding baby after challenges), who are having the same issues as their last hellish breastfeeding experience, where we talk through their situation and their emotions and their individual needs and they decide that on balance, formula feeding is the healthiest thing for them and their babies? You think I don’t see women with insufficient glandular tissue to make enough milk, whose babies will starve without supplementation? That I never meet women, like Jessica Valenti, who had life-threatening health issues and premature deliveries, who are pump dependent and struggle to make even a tiny supply? You think that because I work at a baby-friendly hospital I refuse to let any of those women use formula? Of COURSE I do. Of COURSE formula is lifesaving. And it doesn’t NEED to be lifesaving to be OK. I see women who just decide that breastfeeding isn’t for them. They don’t want to breastfeed. Maybe they said they wanted to because they wanted to give it a try, but they’re not that into it. I shrug and move on. As a lactation consultant and public health professional, I would love for more women to choose to breastfeed. The lady in Room 4 doesn’t want to? We gave her the spiel, and it’s her choice.

So “formula-should-be-illegal” Judgy McJudgersons out there (even though I think there are fewer of them out there than their reputation): Shut up. Yup, I said it. You can never know what’s really going on in a woman’s life. When you demand that a woman give you a good reason for not breastfeeding, you have no clue what you’re asking. How about this: “Well, I was sexually abused as a child and I had very frightening flashbacks every time I breastfed.” Is that the reason you need to hear? Women don’t need to justify their feeding choices to you. They don’t need formula to be made illegal “for their own protection”. Because even if a woman doesn’t have a “good”, “morally correct” reason to breastfeed (just like many women do not have “socially approved” reasons for having an abortion), “I just didn’t want to” is reason enough. “But if they were really informed – ” No. I know we don’t do a very good job with breastfeeding education in this country. Please, if you really care about educating women, do not do it by asking nosy questions of your pregnant friends or of the woman with a bottle next to you on a park bench, or post judgy comments on mommy wars-fueling news articles. Lobby our elected officials to stop slashing funding for maternal and child health programs. Volunteer to teach classes at a community center. Write a letter to your local hospitals encouraging them to become (gasp!) baby-friendly.

Finally, let’s stop with the idea that women who tried to breastfeed – who wanted to breastfeed – and couldn’t breastfeed, shouldn’t be sad. Do I think they should feel guilty? That they should feel ashamed? HELL NO. But it’s OK for them to mourn something they had hoped to do, and couldn’t. It’s also OK for them NOT to mourn it, to just accept it and go on, to appreciate the things about formula feeding that are positive for them. Everyone is different. But women who had looked forward to providing milk for their baby, who planned to have a positive nursing relationship with their baby, can feel sad about the loss of those hopes. That does not mean that “boob nazis” made them feel guilty and should just stop it with the baby-friendly bullshit already. It doesn’t mean that formula is supernifty and that we should let formula companies engage in deceptive marketing practices and co-opt hospital staff. It means we should support those women and help them work through their sadness so that they can move forward feeling good about themselves as mothers. It means that we should work harder to offer donor milk so that if those mothers are helped by knowing their baby is still getting breastmilk, they have the option to choose it. It means we should continue to research ways to help women so that they ARE able to reach their breastfeeding goals.

I am just tired of this argument. I’ve said it before, and I’ll say it again: when we hate on breastfeeding initiatives like baby-friendly, we hate on the very things that make it possible for women to breastfeed. An individual woman’s feelings of being judged or of guilt are REAL issues that deserve their own space and time (that’s why I just gave them their own paragraphs). But they are not the same thing. They are different. Different things. The end.

(As I was finishing this up, I saw that Gina at the Feminist Breeder has also written a post prompted by those blogs, "Why I’m a Feminist AND a Lactivist", and I highly encourage you to go and check it out.)