This post originally appeared on RH Reality Check - news, information and analysis for reproductive health.
I had my son when I was thirty years old, ten years ago, and as green as one can be when it came to any and all things parenting related. While pregnant, I thirstily drank in every word of the handbook for hip-mothers everywhere - The Hip Mama Survival Guide - with its list of cool songs to which to breastfeed, and 18 ways to "chill out" when your screaming baby is making you crazy. I was also given a copy of What to Expect When You're Expecting and read through it somewhat suspicious of its overly chipper yet authoritarian tone ("don't eat too many of those tasty treats!"). I perused the books of Dr. Sears and Dr. Spock for advice on breastfeeding and parenting with their practical and no-nonsense information. The Internet provided nowhere near the well of resources or communities on motherhood as one finds now so I satisfied my need for as much information as I could possibly consume mostly by way of books like these.
And with the information collected stamped into my brain, I set to work on crafting the postpartum world in which I knew my baby, my husband and I would blissfully reside. It was a perfect world to be sure (though I didn't realize this at the time - thinking simply it was what all women experienced, right?). It was a vision that would of course be preceded by an all-natural childbirth with a loving midwife and husband at my side, and blissful days and nights of breastfeeding my newborn baby in the new, wooden rocking chair currently residing in what was to be his bedroom. What could go "wrong"?
You know where this is going, don't you? The truth is that nothing turned out the way I thought it would. My "perfect" all natural childbirth morphed into a natural childbirth riddled with medical interventions. The days and nights following were a blur of breastfeeding trauma that included near breakdowns of anxiety and sadness over why my son would simply not feed, preferring to fall asleep upon immediate contact with my breast instead; why it sounded to me like lactation consultants were telling me one thing about how to breastfeed him, my midwife telling me another and the experienced, older women in my life yet another. I was exhausted, confused, frustrated and felt completely out of control.
The short of it: after two weeks, I ended up on medication, feeding my son formula and setting out on a path towards motherhood that worked and felt best for myself, my husband, and my child. Feeding my son a bottle, we bonded beautifully and I often experienced the authentic joy and contentment I imagined in my "perfect" vision.
But my breastfeeding vs. formula journey was far from over. In my "first weeks" mothers' group, the other mothers - with their discussions of shared breastfeeding difficulties and woes - seemed to look at me with a mixture of pity and contempt when I pulled out the bottle to feed my baby. The leader of the group took me aside one day and let me know it would be okay if "you don't come to those meetings where we talk about breastfeeding challenges since it isn't an issue for you."
Some experiences were not so obviously ostracizing. Taking a walk one day in my neighborhood, I passed a neighbor's house. When my son started crying she asked (and then practically begged) me to come in to nurse him so he'd stop crying before we made the rest of the walk home. I was too embarrassed to tell her I wasn't nursing him, mumbled an excuse and power-walked back to my house where I could give him the (horror!) bottle that he so loved.
By the time my daughter came along, the clarity I experienced around childbirth and breastfeeding took me down a wholly different path. My daughter came into this world with the strength and relative ease I had always envisioned, and almost immediately nursed voraciously straight through until she was three years old (and she would have nursed longer than that had I not decided the time had come for us to bond in ways that felt less "udderly" invasive by then). Nursing her was often wonderful though, for a long time. It was a bonding experience different, though not "better," than what my son and I had experienced, and we both loved it. Of course, the looks I received in public while nursing her openly as a baby and then as a toddler were equally as ostracizing and judgmental at times, just as when giving my son his bottle.
These memories come flooding back with the current public discussion around breastfeeding in both the media and among new mothers. The dialogue centers on the emotional, health and even mental benefits of breastfeeding for mother and child. Breastfeeding your baby promotes "better bonding". Breastfed babies may have higher IQs. Mothers who breastfeed may have a lower risk for diabetes, high blood pressure and cardiovascular disease. And while some of this information is not necessarily new it is eliciting much more attention as of late. The spotlight has also created a springboard for many mothers, who don't want to breastfeed, can't breastfeed exclusively, had or have difficulties breastfeeding or who have breastfed and simply don't buy all of the "hype" to speak up.
With my own history of breastfeeding, one might assume that I'd be strongly rooted on one side of the emerging "breastfeeding wars" or the other. Don't breastfeed; your baby will be perfectly healthy and happy without it! Or, nurse until your child is twelve years old - it's the only certain way to bond, ensure your offspring's brilliance and protect against disease for yourself.
But here's the thing. I'm not on either side of that fence. I've made very different choices with each child and I can tell you, as with any and all women's reproductive health experiences, there are as many different ways to experience these situations, as there are women in the world. And while exclusive breastfeeding certainly has a multitude of benefits, not the least of which is that it's free, when it's possible it's possible. When it's doable, it's doable. And when it's not, there are (thankfully and gratefully) other satisfying, excellent options for women in this country.
This might sound overly simple. However, the pro-breastfeeding mantra and air of associated judgement has become overbearing and suffocating for many women who don't or can't breastfeed, even for women who both breastfeed and bottlefeed their babies. On the other hand, the fact that more women in this country are not breastfeeding, when they could be (and receiving immense joy and satisfaction from it as well), is a loss as well.
In "The Case Against Breastfeeding" Hannah Rosin writes that while she "dutifully breastfed each of my first two children for the full year that the American Academy of Pediatrics recommends" when she had her third she thought about escaping the "prison" of breastfeeding after becoming convinced of a couple of things. First, that the so-called conclusions about the benefits of breastfeeding were too inconclusive and second, that in fact breastfeeding was not the nirvana that women were being sold:
From the moment a new mother enters the obstetrician's waiting room, she is subjected to the upper-class parents' jingle: "Breast Is Best." Parenting magazines offer "23 Great Nursing Tips," warnings on "Nursing Roadblocks," and advice on how to find your local lactation consultant (note to the childless: yes, this is an actual profession, and it's thriving). Many of the stories are accompanied by suggestions from the ubiquitous parenting guru Dr. William Sears, whose Web site hosts a comprehensive list of the benefits of mother's milk. "Brighter Brains" sits at the top: "I.Q. scores averaging seven to ten points higher!" (Sears knows his audience well.) The list then moves on to the dangers averted, from infancy on up: fewer ear infections, allergies, stomach illnesses; lower rates of obesity, diabetes, heart disease. Then it adds, for good measure, stool with a "buttermilk-like odor" and "nicer skin"--benefits, in short, "more far-reaching than researchers have even dared to imagine."
Rosin might drawing a caricature, but her frustration is clear. She takes issue with what she sees as an unrealistic or incomplete image of what breastfeeding is really like for mothers - the time commitment, the physical toll, the exhausting juggling necessary for working mothers. Though she decides to continue nursing her third child, her reasoning straddles the two sides of this debate with the beauty of the uncertainty and gray areas in which most mothers' decisions are made:
Breast-feeding does not belong in the realm of facts and hard numbers; it is much too intimate and elemental. It contains all of my awe about motherhood, and also my ambivalence. Right now, even part-time, it's a strain. But I also know that this is probably my last chance to feel warm baby skin up against mine, and one day I will miss it.
On the other hand, Jennifer Block, author of Pushed: The Painful Truth about Childbirth and Modern Maternity Care, and a tireless advocate for maternal health writes in her article, "The Backlash to Breast is Best", that while she understands some of Rosin's protestations ("There are some relationships that remain unclear, such as whether breastfeeding makes babies smarter or moms shed pregnancy pounds more quickly") Rosin is offering a careless assessment of the overall clear benefits of breastfeeding:
Rosin is right that the individual risk of formula-feeding her children may be relatively small, but public health is about the collective, and among a population the risks of not breastfeeding are significant. For example, formula fed babies will have more severe diarrhea and respiratory infections. One could argue that such consequences aren't a huge deal if they are born into families with good access to health care (like Rosin and her friends). But however treatable these ailments, they become more serious among poor families in the U.S., and it's clear that in non-industrialized countries they cause babies to die.
The truth is they are both right. And I want more than anything for new mothers to hear this. Sometimes breastfeeding works or works well and sometimes it doesn't. For some women it comes easier than for others and it's okay to live in the beauty of the gray and uncertainty. Embrace the possibilities but "get zen" with what you feel you can realistically do. Yes, breastfeeding is nutritionally wonderful for your baby. It can also be an emotional high; a powerful physical relationship incomparable to anything else. But so can holding your baby in your arms, free from anxiety or exhaustion, gazing into each other's eyes, as you nourish her with a bottle filled with formula.
The real focus should be on creating the societal support necessary for mothers to experience new motherhood as optimally as possible. Do we offer adequate paid family leave for new mothers? Do we allow new mothers respectful and comfortable spaces in which to breastfeed in public if they so choose? Do new mothers, regardless of income level, have access to the information and tools, including free formula if necessary, to make the best decisions for themselves and their babies? Right now, the answer to all of those questions is no. When instead we can answer "yes" to all of those questions, I have no doubt the breastfeeding "debate" will resolve itself to a large degree and the guilt or frustration mothers feel, along with the scrutinizing and judging, will dissipate.
Whether we breastfed our babies, fed them formula, or whipped up our own special combination of both, we are left with a human being with whom we are blessed to be able to walk through life for many years. As mamas, our relationship with our children is ever evolving and most certainly does not rest with this one decision. We have many miles to walk and many choices to make and the journey will rarely be easy, the "right" decisions rarely clear. More likely, we do the best we can with what we've got. If mothers can support each other in our voyages, knowing this is the real beauty of motherhood - doing our best with each individual decision - then the actual choices made become secondary to the love and intention behind them and the support received and accepted for all.