On Breastfeeding: My Body, My Choice

The shame, punishment and misinformation needs to end now.
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It’s World Breastfeeding Week again, and this time I’ve got something to say. But first, the climate surrounding breastfeeding being what it is, I feel I have to put this caveat up front: I am not against breastfeeding. Every woman who wants to breastfeed should be able to do so, with full medical, legal and social support.

I’ve seen so many articles lately expressing outrage when breastfeeding mothers are shamed for feeding their babies in public, or discriminated against for needing to pump at work. And that is outrageous. But it is also outrageous that many of the same people who so righteously support mothers’ right to breastfeed engage in exactly the same kind of shaming against mothers who choose not to.Legitimate support for breastfeeding mothers does not include pressuring and attacking mothers who choose not to breastfeed. Let me say this as simply as possible:

No woman should be forced, shamed or manipulated into giving another person the use of her body against her will — whether that means sex, pregnancy or breastfeeding.

This is core to feminism, and to human rights in general. It should not be a controversial claim.

“No woman should be forced, shamed or manipulated into giving another person the use of her body against her will — whether that means sex, pregnancy or breastfeeding.”

There are several different lines of attack in the pressure to breastfeed, and the most logical-seeming is the claim that breast milk is best for babies, nutritionally speaking. I will address that set of arguments directly in a moment, because it is based in facts and can actually be refuted.

But there is also something much more subtle and insidious going on here, and it has nothing to do with science and everything to do with the ownership of women’s bodies.

Breastfeeding promotion is not just a public health measure. It is part of the War on Women — a concerted effort to essentialize them as mothers, ground them in their biology, and force them back into the home to be wives and mothers.

Some feminists are lactivists because they see breastfeeding as empowering and body-positive, and it has certainly been a focal point of earth mother-style second-wave feminism. But I would caution my fellow feminists and progressives to look closely at the conservative social agenda being advocated alongside breastfeeding.

Breastfeeding has become the last legitimate “women’s work” — the only argument remaining for a gendered division of labor that argues that women’s place is at home with the children. And in order to fulfill this social agenda, it has been elevated to monumental status in order to fill the gap left by the erosion of other arguments in favor of keeping women out of the workforce.

A huge percentage of lactivist messaging pressures women to abandon or postpone their careers in order to stay home and breastfeed their babies.

And this is no coincidence — pushing women out of the workforce and back into the home has been a core aspiration of breastfeeding advocacy since the very beginning. The La Leche League was founded with the express mission of tying women to their babies through breastfeeding in order to keep them at home, and spoke of breastfeeding as “God’s plan for mothers and babies.” The original 1981 edition of the La Leche League manifesto The Womanly Art of Breastfeeding explicitly states that the only justification for mothers to work is financial necessity, and teaches group leaders to encourage women to leave their jobs and stay home full time.

And although the message has been toned down in the intervening years, it is still alive and thriving practically undiluted in lactivist circles.

In the 2013 edition of The Baby Book, attachment parenting guru Dr. Sears starts off by affirming that you can work and breastfeed at the same time, but quickly adds that the “ideal” is to “minimize time away from [your baby] while working.” And all pretense gets dropped in the chapter titled “Working and Parenting,” which declares:

To write that full-time attachment mothering makes no difference would be dishonest, ignoring what both research and experience have shown and trading truth for popularity.

The rest of the chapter admonishes mothers that “[y]our presence is important to your baby’s development,” and “[w]hile quality time is important, so is the quantity of time.” The chapter continues to argue that “the effects of mother-baby separation… are a lessening of the benefits of mother-infant attachment” and baldly states, “If you are blessed with a high-need baby … full-time mothering for a longer time may be your only real option.”

(Apparently none of this logic applies to fathers, though.)

And I have become increasingly convinced that Dr. Sears’ message is the rule, not the exception. If you look closely, you can see arguments for breastfeeding as proof that motherhood is women’s destiny sprinkled all throughout the breastfeeding literature. For example, the trusted and ubiquitous Dr. Spock’s Baby and Child Care says it this way:

Women who love breast-feeding talk about a unique sense of closeness that comes from nourishing a baby from your own body. I know many women who bottle-feed yet wonder about that feeling or perhaps yearn for it. If you find yourself moved in this direction, then by all means follow your heart.

But what if you find yourself moved in the other direction? Well, then that’s not your heart talking — it’s Big Pharma, or your demanding career, or maybe just your selfishness and vanity, you cold-hearted bitch.

The idea that a woman wouldn’t want to breastfeed is just dismissed as impossible and unnatural. Any real mother wants to breastfeed, obviously.

And make no mistake, lactivism has extremely disturbing race and class implications as well. The women most likely to initiate and maintain breastfeeding are white, middle-class, highly educated, heterosexually partnered and older mothers — in short, the ultra-privileged.

“Breastfeeding is only “free” if you don’t count the mother’s lost wages during ... nursing or pumping — or if you think women’s time is worth nothing.”

There is a particular kind of racism at work when these white ladies and their husbands advocate breastfeeding because it is “natural,” making much of the fact that breastfeeding tends to be the norm in sub-Saharan Africa, the Amazon and other parts of the developing world. But it’s 2016 in Africa too, and admiring African mothers for being “closer to nature” is just the myth of the Noble Savage all over again.

Closer to home, lactivists frequently tout breastfeeding as “free” in order to argue that there is no excuse for poor women not to do it. But this argument ignores the $100 billion dollar industry of breastfeeding paraphernalia, including breast pumps, special storage bags for pumped milk, nipple cream, nursing bras, nursing pads, nursing pillows, herbal supplements (of questionable provenance and efficacy) to increase milk production, etc.

Not to mention, of course, that breastfeeding is only “free” if you don’t count the mother’s lost wages during the significant amount of time that she spends nursing or pumping — or if you think women’s time is worth nothing.

Most mothers don’t have the financial ability to take extended maternity leave, let alone leave the work force altogether even if they wanted to. Most women don’t have private offices where they can pump during conference calls, and pumping time is taken out of hourly employees’ work days so they have to stay longer to make up the lost time. Which should a working-class mother choose — another hour with her baby, or another ounce of breast milk? (Since a lot of arguments about the benefits of breastfeeding hinge on bonding time for mother and baby, this question should give lactivists serious pause.)

Now, some people argue that pressuring women to breastfeed is not about a conservative social agenda, but instead is a legitimate public health measure justified by the overwhelming and obvious advantages of breastfeeding to babies’ health. But the scientific consensus is increasingly clear that the advantages of breastfeeding are relatively modest, and do not at all justify the amount of emphasis being placed on it.

“Admiring African mothers for being “closer to nature” is just the myth of the Noble Savage all over again.”

There are no proven links between breastfeeding and IQ, obesity, behavior problems, parental attachment, food allergies, ADHD or any other of the long-term health indicators lactivists put forward as reasons for referring to breast milk as “liquid gold.” High-quality randomized and sibling studies have produced:

...results suggest[ing] that much of the beneficial long-term effects typically attributed to breastfeeding, per se, may primarily be due to selection pressures into infant feeding practices along key demographic characteristics such as race and socioeconomic status.

The one area where breastfeeding does seem to make a difference is in reducing the incidence of respiratory and gastrointestinal infections in the first few months of life. A major study published in 2010 found that “[e]xclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants.”

This is a real advantage of breastfeeding, and obviously no one wants babies to get sick. But it is important to keep in mind that the risk of coming down with a cold or a stomach bug is a risk that parents reasonably take all the time. Every play-date and trip to the park increases your baby’s risk of contracting exactly these same communicable diseases. Every time mothers and fathers go to work, they run the risk of bringing home an infection they could pass to their babies. But no one is arguing that babies and their parents should be quarantined indoors and away from other people for the first year of life. The emphasis on breastfeeding is completely out of proportion with the way we approach other risk factors for the exact same diseases.

What’s more, there is some evidence that breastfeeding increases some other risks. For example, breastfed babies are at higher risk for iron deficiency (which actually does affect IQ), and exclusive breastfeeding without introducing solid foods after the age of nine months may increase the incidence of serious food allergies. Breastfed children also seem to have higher rates of asthma, and are at greater risk of catastrophic brain hemorrhage if their parents (foolishly) opt out of the Vitamin K shot at birth. But no one is talking about these risks and how they affect the overall importance of breastfeeding.

The science just doesn’t bear out the popular perception of breast milk as a magical panacea, and formula as practically akin to feeding your baby jet fuel. Nor does it support treating low breastfeeding rates as a public health crisis on par with smoking during pregnancy.

All other things being equal, breastfeeding is better for babies’ health than formula. But as Suzanne Barston writes in her book Bottled Up:

The real question is how much better? We should be questioning if it’s better enough to justify the pressure we put on women to do it, even if they don’t want to or can’t; if it’s better enough to excuse poor science and a stupefying dismissal of relative risk.

But because of the belief that good motherhood requires perfection in every aspect of your child’s life, no one is asking these questions. No one is doing a clear-headed cost-benefit analysis.

Women face enormous pressure to breastfeed, even in situations where it clearly makes no sense. Any woman who chooses not to breastfeed is forced to come up with excuse after excuse, and continues to face bullying and criticism no matter what she says or does. Harassment of formula feeding mothers is rampant, both on social media and IRL, and it is actively encouraged by breastfeeding advocacy organizations like the La Leche League in the guise of “education.”

“When hospital lactation consultants pressure cancer survivors with double mastectomies to breastfeed, can we all please agree that lactivism has jumped the shark?”

The La Leche League has openly advocated using guilt to pressure women to breastfeed, even suggesting that “using artificial baby milk could, and maybe should, be considered reckless endangerment because it increases risks to a baby’s life and health, just like parental smoking and failure to use a car seat.”

Reckless endangerment? Really?

When hospital lactation consultants pressure cancer survivors with double mastectomies to breastfeed, can we all please agree that lactivism has jumped the shark?

Worse, this bullying comes not only from individuals and advocacy organizations, but also from government and medical authorities. As Courtney Jung notes in her 2015 book Lactivism:

Not one of the breast-feeding initiatives launched since 1995 seems directed toward supporting women’s own preferences and choices.

Instead, the fanatical devotion to breastfeeding has driven programs and strategies that not only harm women, but endanger babies’ lives and health. Hospitals and medical professionals intentionally withhold information about formula feeding from new parents in order to pressure them to breastfeed exclusively (a strategy that strongly resembles anti-abortion laws requiring doctors to lie to their patients).

The Baby Friendly Hospitals Initiative measures and rewards hospitals based on how difficult they make it for new mothers to get access to formula. The University of Bradford’s Midwifery Society (in England) actually scheduled a panel about formula feeding, but the event was cancelled because the hospital was “unable to show support for anything to do with artificial feeding” for fear of losing its Baby-Friendly accreditation. This took place in England, where 25% of babies are exclusively formula-fed from birth, and over 50% of babies older than 2 months receive only formula. It is not only not “baby-friendly,” but grossly negligent to refuse parents official medical education about the way most of them will be feeding their babies within eight weeks of when they leave the hospital.

Even worse, WIC actually punishes poor women who don’t breastfeed by giving them less nutritious food for their babies, even after they are eating solid food and no longer need either breast milk or formula. Most egregious of all, the World Health Organization encourages HIV-positive mothers in the developing world to breastfeed, despite the significant risk that they will pass the virus to their babies through their milk.

The United Arab Emirates recently passed a law requiring women to breastfeed for two years, and allowing their husbands to sue them or the government to punish them if they don’t. Is this really the company we want to be in? (Well yes, if you ask some prominent American lactivists who have argued there should be a law requiring women to breastfeed for six months.)

“Lactivism — like other strategies of the War on Women — promotes the belief that women’s pain should be minimized, disbelieved and ultimately ignored.”

There is nothing in the scientific literature to justify such a scorched-earth strategy aimed at making mothers breastfeed at any cost and using any means.

The pressure to breastfeed is woven into every piece of messaging a young mother receives, and securely entrenched in the culture. You cannot talk about parenting and babies without running full-tilt into a heavy dose of breastfeeding pressure and unabashed gender essentialism.

Just look at the manipulative strategies designed to pressure mothers to breastfeed in mainstream parenting books — the books your pediatrician will recommend, providing the most basic, vital information that all parents need.

The famous What to Expect: The First Year devotes a full 10 pages to the glories of breastfeeding, with a 12-point list of (questionable) benefits for babies and a nine-point list of (even more questionable) benefits for parents. No other topic gets anywhere close to this aggressive a pitch — not sleep, education, or even the importance of never shaking a baby.

And if the hard sell on breastfeeding didn’t convince you, What to Expect has a chapter titled “Your Feelings,” which begins:

Maybe you’re convinced by the facts, but nagging doubts are still keeping you on the breastfeeding fence. Here’s how to work through a few common negative feelings about breastfeeding.

In other words, if you are not convinced by our arguments so far, we think you are just being all weird and emotional and irrational.

This is classic gas-lighting — a devastatingly effective strategy for tricking women out of insisting on their right to bodily autonomy by convincing them that they are being irrational and crazy.

“Oh honey, you’re being silly. Just give it a try, you’ll like it, trust me.”

Imagine how we would react if it were sex being pushed this way, instead of breastfeeding.

One of the most damaging gas-lighting strategies of breastfeeding advocacy has to do with pain. The otherwise progressive The New Basics: A-to-Z Baby & Child Care for the Modern Parent answers the question of pain this way:

Why does it hurt? Simply because it does. It’s not your technique. It’s not [your baby’s] technique. That’s just the way it is. Anyone who tells you differently is just misleading you … Find the position that seems the most comfortable and try to breathe through the pain.

To be clear, we are not talking about slight discomfort here. We are talking about breastfeeding being so painful that mothers have to “try to breathe through the pain.” That is the advice given to marathon runners at mile 20, or for that matter, to women in labor without pain medication. And this doctor — the same one who famously advocates sleep training at eight weeks because it is unreasonable to demand that parents get up for feedings multiple times throughout the night — is telling new mothers that this pain is just a fact of life and they should get over it.

This attitude creates a perfect storm of shame and manipulation for emotionally vulnerable new mothers. You are supposed to love breastfeeding. But if you don’t love it— or if you even hate it — because it is horribly painful, then that must mean there is something wrong with you. You must not be trying hard enough. You must not love your baby enough.

Women are being made to feel that only terrible mothers don’t breastfeed, and as a result they are continuing to do it even when it is is horrifically painful and causing serious trauma and injury. Just look at a few of the comments on a recent Scary Mommy article about breastfeeding pain:

These women are talking about debilitating pain and emotional trauma, sometimes even coupled with long-term injury and disfigurement. And although these reports are anecdotal, studies have found that pain is the number one reason mothers stop breastfeeding. But when they do, they are being told they have failed, because breastfeeding is supposed to be the most natural thing in the world, and it shouldn’t hurt if you are doing it right. They are being told that if they had just tried harder or not been selfish wimps, they would have achieved breastfeeding nirvana like all the good mothers.

Women who give up on breastfeeding because of pain live with crippling guilt for years, honestly believing they have failed their children by giving in to the “selfish” desire not to experience excruciating pain.

This is not even remotely healthy.

Lactivism — like other strategies of the War on Women — promotes the belief that women’s pain should be minimized, disbelieved, and ultimately ignored.

As if women needed one more arena in which other people’s demands on their bodies trump their right to be free from pain and trauma.

In another isolating and manipulative strategy, the breastfeeding advocates also advise mothers to associate only with other people who believe firmly in breastfeeding. Dr. Sears advises the new mother to “seek out those who encourage your feeding choices rather than sabotage your choice of parenting styles … In fact, you are likely to get the most critical advice from mothers who have never breastfed. Surround yourself with supportive friends who inspire confidence and affirm your choices.” The La Leche League also advises breastfeeding mothers not to spend time with people who are “unsupportive” of breastfeeding — most importantly mothers who feed their babies formula.

This kind of isolation is how religious cults enforce their hold on their followers. It is also how abusive boyfriends and husbands maintain control.

Whenever this strategy is employed, it should be greeted with extreme skepticism.

In the 2015 anthology The Feminist Utopia Project, multiple essays imagined schools and restaurants with breastfeeding rooms, mandated pumping time at work, and cozy crafting circles with women “popping babies on and off the breast.”

All of that is great and beautiful and I hope it happens. But not a single author dared to imagine a feminist utopia in which formula has been perfected to be fully equal to human milk, and no mother has to breastfeed unless she really wants to. The issue is not that the authors think a perfect formula is too far-fetched scientifically. They have no problem envisioning time travel, but feed a baby formula? Preposterous!

How did we arrive at such a dogmatic devotion to breastfeeding that even feminist utopian thinkers are unwilling to imagine a mother who doesn’t want to do it?

Whatever happened to the feminist rallying cry of “my body, my choice”?

Feminism requires that we respect and protect women’s choices about their bodies.

Breastfeeding is a valid choice a woman can make about what to do with her body and how to care for her family, and that choice should be fully supported. The same goes for not breastfeeding.

This worship of breastfeeding as the culmination of natural, intensive motherhood is bad for everyone. It is bad for fathers, who are pushed out of parenting because they lack the equipment to breastfeed, and breastfeeding is painted as the key to parent-child bonding. It is bad for mothers, who are driven to depression and anxiety and away from beloved careers on false pretenses. It is bad for all women, whether or not they have children, because it reinforces the subjugation of women’s bodies to the needs and wants of others.

And it is ultimately bad for the children who will grow up drinking “liquid gold,” but in a world where a woman’s body belongs to her father or her husband or her children, but is never her own.

There is no justification for the current regime of shame, punishment and misinformation to force women to breastfeed. None.

It needs to end right now.

This post originally appeared on Medium.com/the-coffeelicious.

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