Public Health Campaigns Shouldn't Shame Moms Who Choose Not to Breastfeed

A still from the simpsons shows a group of moms staring at Marge in horror after she dropped a baby bottle

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.

Mexico city's breastfeeding public health campaign

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.

by Julie Ackerman
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16 Comments Have Been Posted

Thank you

Thank you, thank you, thank you. I had a very similar experience after the birth of my daughter (no supply, no matter what I did or how often I pumped or fed or took magical witchcrafty herbs and ate lactation cookies) and every single time someone asked me if I was breastfeeding my heart would break a little. Even the formula cans reminded me: "Experts recommend breastfeeding". Fucking thanks for twisting the knife.

It took an epiphany moment when I realized I had postpartum depression and nearly all if it related to not being able to breastfeed to make me decide to stop. I also cried on a few shoulders, who fortunately were reasonable and all supported my choice to stop trying to Make Breastfeeding Happen.

After letting go of the pump and starting formula, I couldn't believe how much better I felt. I could sleep for more than two hours at a time. I could leave the house for more than an hour. Nearly all the anxiety about going back to work disappeared. I was no longer depressed, I no longer resented my beautiful child, and I finally felt all those warm snuggly motherhood feelings that everyone else seemed to feel long before I did.

Thanks again for sharing your (our) story.

breast feeding ... the antidote to care share

My boyfriend and me decided against breastfeeding because it made me less flexible as it bound me to the couch, than it already did, and it made it harder for him to take care of the baby.
Not only was he less able to calm our daughter (breast is king!), he simply couldn't feed him for half a year as he was lacking lactation (and don't get me started on the devil's machine, the breast pump, or the inability to drink alcohol, eat hot stuff, onions, milk or certain fruits). There was just no equal way of sharing the care with the breast feeding gig.

Your welcome and thank you

Thank you, Diane, for taking the time to respond. I knew I couldn't be the only one out there, but hearing your story helps me too. We all want to do what's "best" for our children, and not being able to do that first, seemingly basic thing was so hard for someone like me. I'm glad to know my story helped you.

This article is so needed. I

This article is so needed. I have been saying this for 12 years since my daughter was born and I 'failed' at breast feeding. The bottle was by far the best decision for our family. We had a contented baby and her dad was able to share the responsibility, and enjoy feeding her; as were visiting grandparents, aunties and uncles.
I had to deal with the enormous sense of failure I felt at 'letting her down' of course; but that feeling rapidly changed to anger and resentment of the post-natal industry, inc. NHS midwives and health visitors who, it seemed, were only allowed to quote 'the party line' rather than offer true and genuinely helpful support to me.

thanks

Beautifully said. thanks for sharing your experience

whole generations of American

whole generations of American children weren't breastfed and we're ok. I don't understand why there is even so much debating about this. my mom never breastfed, her 4 kids are fine. She even had anesthesia during each delivery! neither of my sister in laws breast fed. their kids are fine. it's just so bizarre that there is shame in either direction on this, and even starts get that there is shame -both- ways. moms can't win.

"[O]f course, any mom should

"[O]f 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."

And why is that? What is it about breastfeeding that makes it appropriate to do in places where other types of infant feeding would not be allowed?

Example: A mother and baby may well be allowed to be inside a furniture store, but I don't think that anyone would argue that the store is not well within their rights to ask mom to stop if she sits down on one of the couches for sale and whips out a bottle of formula to feed to baby. What if formula spills on the merchandise? What if LO spits up?

Many stores do not allow food or drink of any kind on their premises; why should breastfeeding be exempt from that rule?

Instead of making laws that moms are allowed to BF anywhere they are legally allowed to be, I think it would be much better to say that BF is allowed anywhere that feeding babies is allowed. After all, it is just another way of feeding a baby.

Yeah, I've seen some examples

Yeah, I've seen some examples about people being awful about it, but the Anthropologie case really just seemed like they didn't want someone eating on the merchandise. I don't think they should have told her to go to the bathroom, but they probably wouldn't have been cool with anyone eating in any way on one of their chairs.

Good point

Thanks for that comment. I honestly hadn't considered the point about getting milk or spit up on merchandise or furniture, and that is a valid concern. So I have to say, I agree with you, breast-feeding should be allowed in places where other food and beverages are allowed. Sorry, nursing mommies, I know it can be really inconvenient and awful when your baby is hungry - I know - but Anthropologie doesn't want anyone's food or drink on their merch. It's understandable. However, on a plane, in a parks, in a restaurant, or anywhere else people are EATING, there is no reason a mother shouldn't be able to nurse her child.

See, isn't it great to talk about things, so we can see another point of view?

Thank you for this! A friend

Thank you for this! A friend of mine, who incidentally works two jobs, was simply not producing enough milk. And got so much grief from their midwife about it. Yet their child is perfectly fine, despite being fed on the dreaded formula.

Well, this is true that

Well, this is true that people should think more about how to take care of health in order to healthy in life, and they can overcome all things.

Thanks for this article. I

Thanks for this article. I think it's important for women to be supportive of other women's choices. Our society has a tendency to be so judgmental and we have lost the ability to think that we may not know a stranger's circumstances. For example, I am about to adopt a baby and obviously will not be able to breastfeed. I dread the lectures and looks that I know I will get for using a bottle. I hope articles like this will change the way people act and think.

What a brave and humorous

What a brave and humorous treatment of an issue that is even larger than, "to nurse or not to nurse..."
The parents I know all suffer from varying levels of obsession over whether or not the are good enough parents! Feeding is a real hotbed issue, but so is discipline, working outside the home, screen time...you name it! I love how this essay invites us to look at the big picture; both in our own nuclear families and in our communities. Really well done!

well said

Julie, It is so wonderful to hear the truth about breastfeeding. I remember when I was tempting to breastfed my first son and we were both sitting in the rocker screaming and crying. I was begging my husband to just get him to eat. I felt like I was failing my son and that is a feeling I wish for no one. I believe to each their own because it isn't just about what the American Pediatric Association recommends if the prime caretaker isn't happy. We have to do what we feel is right for our child and that means not just making sure the baby is alright but also mommy. :)

I couldn't agree more :)

I couldn't agree more :)

Many Factors Play a Part

Excellent article Julie! Being involved in the birth world for over 12 years, as a certified birth & postpartum doula, my heart goes out to you and other women who have had challenges breastfeeding. Each woman, baby and birth experience is different and we all must be aware of, and appreciate, that. As mother's we usually do what is best for our baby. As Julie points out so well in her article, once baby is born, often times, what the mother may need or feel, is often overlooked. When a woman is in "pain" while breastfeeding, something is amiss. If all is investigated and the pain persists, it is unfair to ever expect a woman to continue in this way. The decision to breastfeed is something only the woman can or should decide to do. As a birth professional, if a woman chooses to breastfeed, I will do anything I can to help her do so, and that means without pain. If a woman decides not to breastfeed her baby, for whatever reason, it would never occur to me to shame or judge her. As a doula, my heart is for the mother. A woman is at her most vulnerable state when she gives birth to a baby. We must all remember that and do nothing but encourage her in what her choices are. How devastating it would be to carry a baby for 9 months, birth that baby, attempt to breastfeed, meet serious challenges in this attempt and then be reminded over and over again that it did not work out for whatever reason. Acceptance is essential. We need to support one another and realize that we all want the best for our children and as Julie tells us, the main ingredient to achieve that is to have a mentally healthy mommy. To the mother's that did have challenges breastfeeding, please accept it for what it is, an experience, you did what you could and you are no less a mother. You are courageous for even trying. Blessings to you and your little ones. Enjoy every moment with them as they grow up way too fast.

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