A group of moms on The Simpsons responded in horror to Marge's revelation that she doesn't breastfeed.
National Breastfeeding Month just finished and let me say that, of course, any mom should be able to nurse their baby, comfortably, in Barnes and Noble, Starbucks, Southwest Airlines, and every other place on this planet. That is still a surprisingly radical concept: This past month, moms staged a “nurse in” at an Anthropologie in Beverly Hills that recently told a customer she couldn’t breastfeed in the store. More power to them. There is so much work to be done to combat the sitigma against breastfeeding in public. But one issue that gets lost in the movement to promote breastfeeding is that not everyone can breastfeed. Some moms, like me, make ourselves miserable trying to breastfeed—and we shouldn’t be shamed for making the necessary choice to use formula.
Four years ago, aglow with purpose and estrogen, I attended the breastfeeding class at the birth center where I would deliver my first child.
“What are the reasons that breast is better than bottle?” asked the instructor. The group called out answers: “It’s free.” “It’s natural.” “It’s full of antibodies.” “It’s better for your baby.” We didn’t need any convincing. Breast was best, of course. One of the benefits of delivering at a birth center is the support of powerful midwives who encourage breastfeeding from the start. They place the newborn directly onto you for skin-to-skin contact, your child is born drug free, and therefore alert, able to find his way when he is ready, right to your breast. You are left alone to find your own rhythm, unless you need help, then it is provided. Yes, my son and I had everything we needed to make an ideal breastfeeding team.
But after three weeks and hundreds of feedings, I realized it still hurt every time he ate, which was eight times a day. I hired a lactation consultant. We went to a breastfeeding support group, together, because remember, when exclusively nursing, you are pretty much chained to your bundle of joy. They thought I overproduced milk, which might have caused his crankiness. I tried all their suggestions, but it still hurt when he ate. He still cried. I exchanged more emails and phone calls with the lactation consultant. We visited doctors and specialists and had the frenulum under his tongue clipped. Twice. It still hurt every feeding, eight times a day. He still cried, all the time. I watched how-to videos on Kellymom.com. I read every article I could find, tried every hold, used the horrible milking machine to try to get some time away. It didn’t help. I sank into a dark and hopeless place, where it felt like all I did was try to feed this creature who had bottomless needs that I could not satisfy. And I had to nurse, because breast was best.
Finally, when I found myself screaming at my infant son to “shut the fuck up,” I knew I had reached a scary place. With help from the midwives and my husband, I found myself at the Postpartum Stress Center, pouring out my story to a psychologist. She recommended I consider weaning. My son was only five months old. I gasped. “What about breast is best?” I asked. She looked me in the eye and said, “What about what is best for you?”
I had no answer to her question. What was best for me, with respect to nursing, or motherhood, had not crossed my mind. I know now, without a doubt, that no child with thrive with a miserable mother, no matter how well breastfed he is. Which makes me wonder, if the demands of exclusive nursing are too much for many of us, why are we doing it? And why is the media not talking about this more?
Often, discussions of breastfeeding as being the best for all families leave out the economic realities that impact babies’ health and parents’ ability to breastfeed. A recent Ohio State University study found that much of the research on breastfeeding has potentially overstated the benefits of breastfeeding compared to bottle-feeding babies, because the many studies don’t take economic factors into account. “Many previous studies suffer from selection bias. They either do not or cannot statistically control for factors such as race, age, family income, mother’s employment—things we know that can affect both breastfeeding and health outcomes,” said Cynthia Colen, an assistant professor of sociology at The Ohio State University who is the lead author of the study. “Moms with more resources, with higher levels of education and higher levels of income, and more flexibility in their daily schedules are more likely to breast-feed their children and do so for longer periods of time.”
Back when I was pregnant, everywhere I looked in media about motherhood, everyone agreed that feeding your kid formula was a terrible idea. There was no question, no disagreement. Harvey Karp, author of The Happiest Baby on the Block, writes that the superiority of breast milk is one of the very few areas of medicine where there is absolutely no controversy. The American Pediatric Association recommends six months of exclusive nursing. I can almost, but not quite, laugh at my naiveté when I first had my son, having no idea what a Herculean task six months of nursing is.
Breast milk is rich with antibodies and great nutrients—but that doesn’t mean breastfeeding is the best thing for every family. Most of us don’t get to stay home with our babies, stress free, for the first six months of their lives. Most of us don’t get to sleep when the baby sleeps, much as we may want to. Even if you don’t have the problems I had with nursing, most moms have pain for the first few weeks. Many moms have some kind of problems, and need support, or even the help of a lactation consultant. Many give up, feeling like a failure.
But if mom does establish breastfeeding, and then has to return to work at four or six or eight weeks, here’s what she will need: a breast pump, which costs about $200 (though, thankfully, is now covered by insurance plans); a private, comfortable space at work to pump breast milk, because breast milk will not let down if she’s stressed or uncomfortable; she will need breaks in her day to pump, at least one, maybe two or three. How many work places provide this kind of support? The reality is that buying formula can be more efficient than taking time off work to nurse—especially if they’re working outside the home at a job that’s not child-friendly, or one that makes it hard for women to take breaks to pump their breast milk. Then there’s the time it takes to learn how to nurse, trouble-shooting problems that arise, or the cost to a woman’s career of taking the time necessary to exclusively nurse her children. She will need time at work to pump. She will have less sleep, less help with feedings at home. All of this has a cost and it’s an important one to recognize.
We clearly need to push employers to make workplaces vastly more friendly to breastfeeding moms. But the reality is that right now, six months of exclusive breastfeeding is not an option for many, many American women. It feels like too often, conversations about breastfeeding focus on the idea that moms who don’t breastfeed are betraying their kids. For example, a headline on Huffington Post about how if almost all American moms nursed their kids for six months, we would save 900 lives and billions of dollars a year, makes it seem like not being able to nurse your kids means hurting not just your family, but your whole country. In an extreme example of a public health campaign in Mexico City, the government ads ran saying, “Don’t turn your back, give your breast,” accompanied by photos of women who looked like supermodels, not recently postpartum mothers. This kind of campaign implies that mothers who don’t breastfeed our kids turn our backs on our children. We all want what’s best for our children, but we can’t do it without support.
In many ways, I had an ideal situation for breastfeeding. I had three months at home with my child, I had a partner at home with me for ten weeks and extended family living nearby. Not only that, my health insurance covered the cost of a breast pump and a visit with a lactation consultant. I had friends who nursed their babies, midwives who support the practice. I worked part-time, at an office that provided a private space for pumping. This is about as good as it gets for an American mom. So if someone like me, with every possible advantage, still could not make it to the six month mark, what chance does a mother working a minimum wage job with no benefits and an unfriendly boss have? Some moms who can't breastfeed but don't want to use formula can go to breastmilk banks—but they are few and far between in the United States.
For me, the emotional cost was too steep. I hoped I would enjoy nursing, that I would feel that magic that friends described. But for me, it felt like my son was gnawing on an open wound, eight times a day, for the first three months of his life. Exclusive nursing meant that I was solely responsible for most childcare in those first months. It meant little sleep, it meant pain, it meant military-style planning to be away from my child for even an hour. What this fostered was not attachment, but resentment toward my son for needing so much and toward my husband for not being able to provide it. When my counselor at the postpartum stress counselor asked me what was best for me with respect to breastfeeding, the answer was as clear to me as it was distasteful: for me, bottle was best.
But what about the antibodies? The health benefits? The American Pediatric Association recommendation to exclusively nurse for six months? She pointed out that having a healthy well-adjusted mother was more important to my son’s well-being than any of those objections. Deeply skeptical, I tried one bottle, watching my son as if he might combust. Do you know what happened, when I gave my son the dreaded formula? We all grew happier. Immeasurably. Instantly. Suddenly, I could go out when I wanted to, without being chained to a milk-extraction machine. My husband could feed our son when he wanted to, without any explosions from me about “wasting” the breast milk that was so hard to produce. My son could eat to his heart’s content, without a resentful mother willing him to finish and not gnaw off my nipple in the process. We went from three miserable humans to three pretty happy ones, in the time it took to shake a bottle of formula.
I want other women to know my experience, so they can make informed decisions about how they want to feed their children. There is room for middle ground here, for finding combinations of breastfeeding and formula that works best for each family, taking into account each member of that family, including the mother. I wouldn’t discourage a woman from trying to nurse her child. Some women love it. For some families, it works well, and easily, with few of the problems I describe. Or it’s worth the trouble. But we need to talk about the real costs of breastfeeding and account for the mother’s well-being as an invaluable part of the equation.
The time I spent, miserable, suffering, trying to live up to some “best” ideal that was impossible for me to meet, greatly saddens me. If you work outside the home, or have certain health issues, or don’t want to be with your infant all the time, you won’t be able to exclusively nurse for six months, not without some degree of misery. I wish, so much, that I could tell my younger self, “It’s okay, give him the bottle. He’ll be happier. You’ll all be happier.”
Shout it from the rooftops, friends: only I know what is best for my family. And for me, the bottle is just fine.
Related Reading: Breastfeeding is No Longer Considered "Obscene" on Facebook.
Julie Owsik Ackerman writes about the joys and challenges of parenting, writing, and recovering from perfectionism at Anything for Material. Her first novel, Mexico: A Love Story is really truly almost finished.