This week (August 1-7) has been promoted as "
World Breastfeeding Week".
I have mixed feelings about the promotion of weeks like these, but I actually lean towards annoyance. Don't get me wrong-- of course I believe in the benefits of breastfeeding. I'm still going strong in breastfeeding my 7-month-old, who has stayed formula-free since birth and who now is having his nutrition "complemented" with solids which, thankfully, takes the pressure off me a bit as his sole nutritional source. I am a family practice doctor and a perinatal provider, taking care of pregnant and postpartum moms as well as newborns, infants, and kids. I know the medical benefits of breastfeeding, both for infants such as fewer infections, less allergies/eczema, less obesity later in life, and possible even improved IQs, and also for moms (faster postpartum weight loss, decreased risks of breast cancer, heart disease, diabetes, and the like). It would be awesome if all women would be able to successfully and easily breastfeed.
However, I have to agree with the author, Dr. Amy Tuteur in a recent
Time article "
Why I'm Not Celebrating World Breastfeeding Week" in that I feel that public celebrations like these (including the Arcata Plaza "Latch On" last Saturday, where breastfeeding mamas were encouraged to come and simultaneously breastfeed to break a record) are pretty tasteless for their implicit "shaming" of nonbreastfeeders. I feel that breastfeeding (UNLIKE vaccines, a subject on which most readers know my views), is a personal and not a public issue.
I have friends and patients, who, truly, despite every effort on their part and with the intense desire to nurse their children, could not make it work. There are women who have had breast surgery or other medical conditions and don't have the supply (there is a good documentary,
Breastmilk by Dana Ben-Ari, which explores some of these women's stories). Not every woman (or, should I say very few women) has/have the time or employer support to spend 15-30 minutes pumping milk several times throughout the work day or while at home with other kids needing their attention (and I'm not sure if everyone out there knows this, but pumps are much less efficient than actual babies at extracting milk. They really suck [not that well]). If every mom out there had a decent supply and were with their babies 24/7 and had nothing else to do, breastfeeding would be a pretty great option and usually works out. But this is not reality.
"Breastfeeding is free," you'll hear (while formula, of course, costs money). But if you count the
loss of productivity or other sacrifices of time for working moms (or any mom who wants to leave the house alone), breastfeeding isn't really "free." It is a strain on my colleagues and my patients. It is a
strain on my body. Pumping is a real sink on time. Breastfeeding (especially night nursing) makes you so very hungry and tired, and it really
makes you crazy, too. It has made me feel trapped at times, and unable to leave the house (alone) unless the last feed was perfectly timed. This ideal breastfeeding goal makes many women, who opt not to breastfeed or who stop/supplement at some point, out of medical necessity, other necessity, time, or choice, feel bad and guilty for that choice, and this is what bothers me about "Breastfeeding Week."
While I have found breastfeeding to be immensely rewarding, mostly from a bonding perspective and because it is something special that only I could offer my son (while I historically failed miserably at getting him to sleep, and Daddy continues to be far superior at this task!), it has not been a walk in the park, and I've been tempted to quit multiple times. I have had mastitis (which makes you feel AWFUL) and plugged ducts. I have not, in actuality, struggled with supply but I have struggled with the the anxiety and paranoia that comes with constantly worrying about my supply (OH MY GOSH. Iver ate 15 oz while I was at work, and I only pumped 10) and a smaller-than-average baby ("He's in the 13th percentile... does that mean I don't have enough milk??). I have been drinking regular "maintenance/just-in-case" Mother's Milk tea (which doesn't taste good) and taking prophylactic fenugreek capsules, and sometimes spend more time in a day with my pump (which is much more uncomfortable and infinitesimally more annoying than nursing) than my husband or infant, in order to just keep on breastfeeding. I have felt resentful many days.
Having an unpredictable schedule due to home OB call and emergencies (and an unpredictable baby with regards to frequency of nighttime wakes) has made breastfeeding (or breast-milk-feeding) challenging, time-consuming, and stressful. The number of hours I have spent pumping, washing pump parts, putting together pump parts, organizing, labeling, and freezing milk, reorganizing and rotating milk in the freezer, thawing milk (agonizing about not thawing too much so that it isn't wasted) and preparing the pumped bottles are hours which I would have much rather spent doing something I really enjoy (and which are probably better spent playing with my infant and truly focusing on the important parts of mothering, rather than being an all-star milk-making and organizing machine). Being the "breastfeeding" parent has made me seem, at times, like the "more important" parent which is not fair and doesn't give credit to my amazing husband.
While that, medically, I am okay if my son gets some formula and believe it is really a nutritious and almost-perfect infant food, I feel so much social pressure about the "benefits of breastfeeding" that I feel like I
*have* to keep doing it (exclusively) and this bothers me. I have come home after a long call day, with Iver asleep (and wanting myself desperately to just go to sleep) or at lunch and him not being in mood to eat "on my schedule," and have felt so frustrated but pressured with guilt to hook myself up to the pump, with tears flowing harder and faster than the milk through the flanges. I have been resistant to Kelvin giving bottles of pumped milk at night so I could get a 4-6 hour stretch of sleep (the first in more than a year... his suggestion!), because somehow I'd have to "make up that feed" with another pumping session, which I detest. However, not sleeping more than 2-3 hours in a row for months really has made me a grouchy person. If I have to go to the hospital to round on my day off, I have to give
up time with Iver to pump so that: a) he has milk in my absence, b) I keep
up my supply, and c) I don't leak onto my shirt. My infant has probably benefited a lot from breast milk; however, my mental health has certainly not. Some days I really want to just be free of the nutritional
responsibility and be a formula-feeding but more relaxed and happier parent... and this
societal pressure to "keep it up" with breastfeeding annoys me.
I am trying to make it to a year of breastfeeding/pumping which is recommended by the AAP (WHO recommends two years). I may breastfeed beyond that but don't think I'm going to be one of those "extended breastfeeding" moms, especially because of how many hours I work and
despite the fact that I live in an extremely breastfeeding-friendly area, where many women breastfeed until their children are two or older (as well as during subsequent pregnancies; some even "tandem nurse" both a toddler and an infant), and where, as I mentioned earlier, we have public "get your latch on" celebrations on the town's main plaza. There are just many more things that are more important in life and in parenting to me than the "food," part (I'm sure no one can pick out the "breastfed" infants from the non-breastfed infants in a kindergarten classroom!), and I want to continue to breastfeed on my own terms, not because society or lactation consultants (no offense to any of you, my friends!) or other judgy moms or other breastfeeding Nazis tell me that I should because "Breast is [always] best."
The following Washington Post article from March,
If you’re not my baby, I don’t want to hear your opinions on breastfeeding, By Emily Kaye Lazzaro, also really captured how I feel, so here it is in its entirety.
"Last week, I took my 5-month-old son to Whole Foods. We bought a few
things (bread flour, a chicken who’d led a happy life). After paying, he
seemed hungry, so I grabbed a seat at a table in the café area to feed
him. A well-meaning older woman walked over and said, “It’s so nice to
see a nursing mother. It’s so important to breastfeed.”
I found this incredibly annoying.
I am (mostly) breastfeeding
my baby, but not for philosophical reasons. I am doing it because it’s
cheaper than formula and more convenient, most of the time. And because
breast milk doesn’t have a million unpronounceable ingredients, like
crypthecodinium cohnii oil, which is in the organic formula in my
pantry. Additionally, I have the luxury of working from home and having
all my parts and my baby’s parts anatomically suited to breastfeeding.
But
listen, lady at Whole Foods: I’m not doing it because I believe very
deeply in the health benefits or because I want to bond with my baby in a
special way or because it’s natural. We do lots of bonding when he’s
not sucking all my body’s nutrients out of me, thanks. Don’t force me
into a conversation in which I must thank you for supporting my lazy
choices.
The next day, an art museum in Boston was offering free
admission. My son and I strolled through for about an hour and then got
ready to go. After retrieving our coats and getting packed up, my son
fussed and I decided to feed him before we went outside in the snow. I
took out a contraption I refer to as my “shame apron" covered myself up, and fed him on a bench near the exit.
About 10 minutes later, an employee of the museum came over to me. “I
think you might be more comfortable doing that in the living room,” she
said. The living room is in a different part of the museum, further
from the entrance.
“That’s okay,” I replied, thinking she was
concerned for my comfort. “We’re just about done.” The woman stalked
away and did an elaborate shrug gesture to somebody I couldn’t see.
That’s when it occurred to me that she might have been suggesting that I
shouldn’t breastfeed on that particular bench.
I live
in Somerville, Mass., a rapidly gentrifying, hip, young area just
outside Boston. Baby-wearing, breastfeeding, and baby-led weaning are
big here. Being shamed for breastfeeding was a completely foreign
concept to me.
Somebody doesn’t want
me to breastfeed? I found myself wanting to do it in defiance, free of
the shame apron, just to spite the museum lady. Then I thought that
maybe my ideas about breastfeeding were offensive to people, maybe I was
too exposed? A friend said that I was completely covered and what she
was asking of me was illegal anyway. But I couldn’t shake the idea that I
was doing something wrong.
The fact that I’ve made it five
months without encountering this sort of thing is an indication that
attitudes about breastfeeding have changed a lot, and that’s probably a
good thing. However, I think the more important takeaway from this is
that people still feel like they need to weigh in on women’s choices,
and that’s not okay.
I was bothered by the museum woman, for
sure, but I was also bothered by the stranger in Whole Foods, telling me
I was doing the right thing. By complimenting me, she was implying that
there’s a wrong choice to make.
She doesn’t know that when my
son refused to take a bottle I quit pumping, because he wasted so much
of my milk. Then we discovered that he would take a sippy cup, and I
gave him formula because that’s what I had on hand. If she had known
that, would she have told me that was the wrong choice for me to make?
But also, and more importantly, I do not care what she thinks. Just
leave me alone!
Leave me alone, everyone! If I want your opinion, I’ll ask for it.
It
seems like there are a lot of parenting philosophies out there, but I
think the best thing to do is make the appropriate choice for your
situation, case by case, day by day. Why is there no middle-of-the-road
parenting philosophy?
Baby sleep-training is a great example of this. If you don’t let your
baby cry it out, you are a wimp. If you do let your baby cry it out,
you are cruel. How about some babies need sleep training and some don’t?
How about let’s just leave everyone alone to figure out their own
lives? I know that if my baby has a mother who is well-rested, his life
is going to be more pleasant. I am a better mother when I have slept.
Take from that what you will.
I’m
not making a political statement by breastfeeding in public. It’s just
something that has to happen if I ever want to leave the house. And I
need to leave the house so I don’t fall into a deep depression. I would love to keep my choices private, but I need to be in the world and I won’t be sequestered.
I
think the reason people feel entitled to comment on mothers’ choices is
because babies are very cute and great and they are our future and
somehow that starts to feel like public domain. (See also: abortion.)
There seems to be some disagreement about when a baby stops being an
extension of the mother. My son still feels sort of like my third arm:
ever-present, part of me and not quite fully necessary, really more of a
hindrance to productivity. But he’s my arm and as long as I’m not
hurting him, I get to do what I choose. Right?
Okay, so one
takeaway here is that everybody is a jerk. But, there is a generous way
to think about this. Maybe everybody is just doing their best.
Whole
Foods woman thinks that breastfeeding makes babies healthier and
happier and maybe she lives in a world where breastfeeding is not
encouraged. She is fighting what is, for her, the good fight. Maybe she
thinks I’m fighting, too, and she wants to fight alongside me. Thanks,
Whole Foods lady. Even though you annoyed me, thanks for the support.
Maybe
museum lady was concerned about the group of middle school students who
walked by me while I was discreetly breastfeeding. Maybe she has a
middle schooler at home and she can see firsthand that everything in the
world is confusing and hormonal for a middle schooler and maybe she was
trying to protect the last dregs of childhood and mystery for that
group of kids for just one more day.
Or maybe her boss told her
to come talk to me and she felt super weird about it. I don’t know that
lady’s story. I’m sorry you were in a weird situation, museum lady. I
don’t know your life, and you don’t know mine.
It’s possible that
Whole Foods lady spends all her time not in Whole Foods shaming her
daughter-in-law for bottle-feeding her baby. And it’s definitely
possible that museum lady thinks boobs are gross and I’m gross for
having them and using them. But we don’t know their lives, so let’s go
ahead and assume they are good people, doing their best to get by in the
world. Maybe we can all just assume the best of each other from now on."
So, in summary, I am not celebrating Breastfeeding Week this week. I am just breastfeeding this week because I feel like it and it's working for now, and I support your choice to do so if it is something you want and can do (or not, for reasons that are really none of my business).
