Should breastfeeding be “goal-oriented”?

When you hear the term “goal-oriented”, what word associations does it bring to mind? Marathoners; job interviews; Type A personalities. Nurturing, love, and parenting? Not so much.
And yet, today’s headlines announced that more than two thirds of women “aren’t meeting their breastfeeding goals”. This is apparently a problem, presumably because breastfeeding has been deemed so inherently important to raising healthy, happy kids, and not because falling short of these goals is particularly heartbreaking to most women (although, as anyone who reads the Fearless Friday posts knows, it is heartbreaking).
The headlines were referring to a study in this month’s issue of Pediatrics, which followed over 3,000 women through their pregnancies and first year, between 2005-2007. While 60% of these women had stated on surveys that they intended on exclusively breastfeeding for anywhere between a few weeks to a year, only 32% achieved these goals. Now, I could drone on about the flaws in the study itself (the fact that it was based on self-reported data from women in one of the most hormonal, impressionable times of their lives, for one) but overall, I think the study’s intentions were good. We should be focused on helping women who want to breastfeed do so successfully. (And for the record, the study authors actually gave a very measured interpretation of their results to MedPageToday, which was misinterpreted by the rest of the media. Most articles stated that avoiding formula and pacifiers in the hospital would help the situation, based on the fact that women in this study who were not exposed to these instruments of doom were less likely to fall short of their goals; however, even the women giving birth in Baby Friendly hospitals weren’t immune to “failure” – only half met their personal goals.  I also have to wonder if the women who were not given these items were more committed to breastfeeding in the first place, and had specifically chosen Baby Friendly hospitals or informed hospital staff that they wanted to adhere to BFHI regulations – considering the data used for the study was based on surveys filled out by the women, it’s hard to know what the realities of their situations were.) I agree that women need better breastfeeding support, and should not be left to figure it all out on their own in those key first weeks.
But I’m not going to talk about the study. I’m going to talk about the fundamental flaw in how it’s being framed in the media, as a study which shows that “women are not meeting their breastfeeding goals.” 
Parenting is not a marathon, nor a job for which you must produce results for an employer. And you don’t have to be Type A to do it well. Why the heck are we talking about goals?
The way we birth, the way we feed our babies, and the way we parent in general, is something that should be fluid, organic, and based on individual needs and situational factors. By setting goals, we are setting ourselves up for failure. Breastfeeding should be approached as something we want to do; it is a method of feeding our children, and quite a miraculous one at that. Making it a regimented, quantifiable process sucks (no pun intended) the joy right out of that act. Why are we not asking women what their breastfeeding hopes are? Their breastfeeding expectations? Their breastfeeding worries? These are things which can be considered and assisted in a more sensitive, nuanced way; goals, on the other hand, are cold and exact. You meet them or you don’t. Succeed or fail.
This morning, a reader over on the FFF Facebook page asked how she could celebrate meeting her breastfeeding goals if people were saying that it didn’t matter if she breastfed or not. I understand where she is coming from – this woman has breastfed for 16 months while being gainfully employed; that’s hard work, and she has ample right to feel proud about achieving something which meant something to her. But this woman should feel proud without having to lean on the plethora of studies stating that breastfeeding is necessary for good health and intelligence. She should feel proud because she is feeding her infant in a manner which feels right to her – not because she has “met a goal”, not because the meme that breast is optimal/best/normal is tattooed on her frontal lobe.
Typically, goals are made for acts which are challenging and daunting, like conquering the Appalachian Trail or losing 30 pounds before bikini season. They are not made for enjoyable things. You don’t make a goal to eat chocolate cake or get a massage. How can we expect women to want to breastfeed, to enjoy breastfeeding, if we are framing it as something so unpalatable?
I know- probably more than most- how challenging breastfeeding can be. But I have also seen it go smoothly and naturally, and in most cases, this happens for the women who go in without expectations or “goals”. It’s the women who want to breastfeed, but go in armed with the reassurance that even if it doesn’t work, their babies will be loved and fed, who tend to fare the best. Until we stop making infant feeding – and motherhood in general – a pass/fail experience, we are going to have a large percentage of women feeling like failures. And that isn’t optimal/best/normal, for anybody.

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.


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39 thoughts on “Should breastfeeding be “goal-oriented”?

  1. “But I have also seen it go smoothly and naturally, and in most cases, this happens for the women who go in without expectations or “goals”. It's the women who want to breastfeed, but go in armed with the reassurance that even if it doesn't work, their babies will be loved and fed, who tend to fare the best. “

    Amen, FFF. This was certainly the case for me with Danica (2nd child). With my first, although I didn't have a specific goal in terms of time frame, I went in with the expectation that I WOULD breastfeed. Thinking about it, I did possibly say “at least for 6 months” so perhaps I did have a goal after all! There, see? It's so insidious that I didn't even realise it until now…

    Anyway, fast forward to baby 2, and I really tried to have the attitude of “If it works, for any period of time, great. Otherwise, at least I know what I'm doing with bottles ;)”. And I got lucky – a baby who breastfeeds.

    At the end of the day though, I'm still just feeding my baby. It doesn't make me proud, because I know she isn't smiling and cooing at me and her Daddy and her sister because I breastfeed her. She's doing it because she feels safe and loved – which has nothing to do with what milk she is getting 🙂

  2. I did notice that in the article you linked on facebook one of the variables that apparently increased the likelihood of not meeting your goal was having a longer time period as a goal. That struck me because I wonder if some of the “failure” is mental. That those women who are the most committed to exclusive breastfeeding for a really long time are also the ones most likely to take it hard, take it personally, etc. if they hit roadblocks along the way. I feel like I would have been much better equipped emotionally to handle my own breastfeeding “failure” if I hadn't felt like it was such an immensely huge deal. And not just that breastfeeding was a huge deal (because I still think that breastfeeding is super-awesome and plan to do it with any future kiddos) but that *exclusive* breastfeeding is a huge deal. I have a feeling it was the moms who were practical and realistic about their situations and said”well, I did have a breast reduction when I was 20, so I'm worried there might be some issues with my supply, but we'll see how it goes” or “well, I'm going back to work when the baby is 3 months old, so I'm hoping to exclusively breastfeed that long and then if we have to use some formula or donor milk or whatever we'll do that.”

  3. Wow, I ended that in the middle of a bad run-on sentence — how embarrassing! Anyway, what I was saying is that I think the women who were practical and realistic and knew that they might not meet their “goals” or that the goal might change along the way were probably better equipped to handle any roadblocks that presented themselves. And they were probably more likely to be pleasantly surprised if they were able to keep going for longer.

  4. Pumping is no fun, I agree – but I really enjoy nursing my baby. And you may actually be able to combo feed – some formula when you are at work and still nurse exclusively on the weekends. 🙂 Also – don't worry about nursing in public! Chances are that you are worrying about it way more than anyone is noticing you!

  5. As usual, this is a great post. I saw these articles too today and though this might be grossely naive, I took them as more of a positive… that it's being acknowledged and recognized that it's really difficult for women to meet their own goals let alone the ridiculous recommendations made by the AAP et al. The article I read (msn.com I think) did call out formula supplementation in the hospital as the only remaining significant variable in not meeting goals after adjustment (the pacifier relationship went away, as well as a few others but can't recall them off the top of my head). Interestingly enough, this particular article also reported that after adjustment, overweight, lower socio econ status, diabetic, etc. mothers, despite setting goals to exclusively breastfeed for x amount of time, were also less likely than normal weight, healthier women to meet their goals. Um, confounders anyone? Could this be the other end of what we're seeing/reverse causality in the numerous “bf'ing reduces obesity, bf'ing reduces diabetes, etc. etc. etc.? Maybe it's because overweight, diabetic, “insert ailment here” mothers aren't successful breastfeeding in the first place? (I am in NO way intending to insult ANYONE, just stating facts from this article, besides I've been as much as 40lbs overweight in the past so I'd be a pot calling a kettle black) So is it really the lack of breastfeeding or is it characterisitics of the population who isn't succeeding in breastfeeding? Maybe there's something about being severely overweight or diabetic or whatever that's making breastfeeding difficult and IT'S NOT REALLY THE BREASTFEEDING OR LACK THEREOF THAT'S CONFERING OR DENYING ALL OF THESE SUPPOSED BENEFITS! I know this elephant in the room flaw for all of these studies has been discussed at length but just couldn't help adding that here because that part of the article really struck me as interesting…

  6. I would love to see the actual survey from this study. Can you imagine admitting you weren't planning on breastfeeding as a new, first-time mom? I can count on one finger the friend I knew who was certain before giving birth that she would never breastfeed. But admit it on a survey? And who isn't going to overestimate the length of breastfeeding. But you're right, to even make such a serious fuss about breastfeeding “goals” is absurd when the research does not justify the overly stringent recommendations not to mention the amount of hostility or guilt induced by “suboptimal breastfeeding.” Personally, if we're hell bent on setting parental goals, I think we should set a few more like raising independent, empathetic and thoughtful children. But then again those intangible assets are so much harder to achieve and assess then merely putting baby to breast for a year.

  7. Brooke – I relate to this completely – because BFing, especially when you have work commitments and a baby who isn't the most laid back, can be a challenge, you have to plan ahead and tell yourself you're doing it because it matters, and you get invested in it, especially emotionally. I didn't think I would care one way or another but I found I did, and I felt really bad about weaning. I think this is true of everyone to some level, and those who BF for long periods and make all kinds of sacrifices to do so often say this is not because they think formula is bad and so on but anything that challenging requires commitment, and that commitment comes from feeling one has to meet a goal. I think FFF is right to question why we treat BFing as a goal, especially from a public health perspective, but it's difficult to avoid seeing it as such when you do pretty much have to plan your life around it if you have any life outside parenting.

  8. Shortly before I had my babies, when I was registering at the hospital, they asked if I intended to BF. This was a reasonable question–they wanted to provide support and instruction, and (as I found out later) they would finger/SNS/syringe feed any infant of a “BFing” mom, that needed supplementing in case of the dreaded nipple confusion.

    Anyway, I didn't understand that I had agreed to “exclusive BFing.” I had always intended to combo feed—having twins, and having to go back to work, my plan was: 1)Try nursing. 2)Regardless of how that goes, pump. 3)Offer bottles (early on) with breast milk and/or formula in. 4)Switch back and forth between nursing and bottles as necessary 5)If not enough breastmilk, oh well, give formula.

    So, my twins were born at 36wk, and though healthy, were quite small. I assumed (correctly) that the hospital staff would want to supplement them immediately, and I was fine with that…but they rigged up this system with syringes and tubing (SNS) and it took 2 helpers for me to feed my babies like this. I thought it was a little ridiculous and couldn't understand why they didn't just give bottles. I figured the babies and I could learn how to nurse when I had some milk to offer. It finally dawned on me that we were going to all this trouble because I said I was a “breastfeeding mom.” So, I kept quiet and made the effort in the hospital, and as soon as we were home, husband and I started preparing bottles. I gave up on the SNS because I didn't have 2 nurses to help me at home, and decided not to try nursing at that point, because I still had no milk.

    Milk did come in, Day 4 pp, but I was afraid that if I tried nursing, the babies wouldn't get enough to eat, and they were already a tad jaundiced as well as tiny. So I tried pumping….supply did increase some, but never enough to supply two babies with 100% breastmilk. After several weeks of wasting hours on the damn pump, constantly plugged ducts and a bout of mastitis, I threw in the towel. I wasn't real broken up about it. But looking back, I see I went in with no goals really, therefore, I had avoided setting myself up for failure. I think that was possible only because I hadn't read any of the literature, blogs, forums, etc, or hold the belief that women that MUST breastfeed or ELSE.

    I suppose one could say I was “uneducated,” at least from the BFing bully perspective, but that POV allowed me to figure out what worked for me and my family wo/feeling crazy pressure to do things only one way.

  9. I just posted an idea over on SOB and thought I'd share it here. The definition of exclusively breastfeeding babies is very restrictive, perhaps the Powers that be could change their definition to primarily breastfeeding (75%+ of nourishment from breastmilk) this in itself would have many more women meet the goal, could include those moms that feed a bottle in the evening..then again that would be saying indirectly that formula isn't the devil 😉

  10. Polly-I just wanted to tell you how much I've been enjoying your blog lately. Like FFF, yours is truly a breath of fresh air amongst the “smog” of this rigid, scare-mongering tone that seems to dominate the parenting community. I do not yet have children and blogs like yours and FFF actually give me hope that it's not one way or no way. Please keep up the good work!

  11. I'm sorry but how is it news that things don't go as planned, after you actually have a baby. Everyone I know has these idealistic plans for life post baby, and yeah it never turns out that way.

    But I actually think the whole push breastfeeding at all costs is starting to get completely out of control. If a doctor or nurse is telling you to supplement, I think that moms should feel OK about listening to that advice. Its more important that you child is fed or jaundice is resolved than meeting some arbitrary goal of EBF for six months. It seems to me that the breastfeed at all costs is more about 'certain' moms & health officials, than the needs of the baby or family.

  12. Not to mention why we're obsessing over this goal in the first place when we have children who are being abused, including starved. Or the fact that no amount of breastfeeding is going to eradicate deaths due to water-borne disease in some parts of the world.

    Breastfeeding or not may mean the world to individual moms and that's their right. But on the macro level, researchers spend an inordinate amount of time chasing their tails, focusing on some idealistic world that doesn't exist (the idea that 100% breastfeeding could be achieved if we just shoved it down peoples' throats hard enough) when there are real problems to solve. Those real problems could be anything from how to properly support moms who would like to breastfeed but are grappling with a history of sexual assault, to how to get proper obstetrical and post-natal health care to pregnant women in parts of the world that totally lack even the infrastructure to provide it. But another hand-wringing survey that probably will be used by breastfeeding advocacy orgs to kick around the “eeeeevil formula company booby trap” football doesn't strike me as really productive.

    We already know plenty of women don't end up breastfeeding, despite wanting to, despite all the “breast is best” and blaming and shaming campaigns, despite the Baby Friendly Initiative and WHO code and deliberate withholding of any information about bottles or formula, even when these are medically required.

  13. Hmm, Great question. I'm not sure what the answer is.

    As some of the other posters suggested, I think breastfeeding goals (if set at all) should be flexible.

    I also like that the study focuses on meeting individuals mom's goals and not those set by an organization like the AAP or WHO.

  14. I agree! I (possibly naively) took this from a positive angle and liked how it seemed to stress INDIVIDUAL vs. institutional goals. If anything, I thought the tone of the articles I read acknowledged and maybe even slightly chastised the AAP et al goals as unrealistic and unattainable for many. The more that message gets out, the better for all women (breastfeeding or not).

    Here's to hoping…

  15. “By setting goals, we are setting ourselves up for failure”

    Can't disagree more. In fact, research has shown that women who set breastfeeding goals are more likely to breastfeed for longer. I'm writing about it at the moment. (Sources will be in my article).

  16. “why are we not asking women what their breastfeeding hopes are? Their breastfeeding expectations? Their breastfeeding worries?”

    Because that's negative talk, and pessimism has a significant impact on breastfeeding success. Even using the word “hope” implies anticipated failure.

  17. I'm not going to dispute anything in your 2 posts here because my opinion on the whole goal setting leading to success in breastfeeding or not is fairly neutral. Plus, as I've admitted in previous posts, I do not have personal experience with this or anything parenting related.

    What about if the discussion were framed as-
    Doctor/Nurse/Healthcare provider: “Do you plan to breastfeed?”
    Mother: “Yes”
    D/N/HC: “Are you aware of the current AAP (insert relevant medical org's name here) recomendations regarding breastfeeding?”
    Mother: “Yes” or “No”
    D/N/HC: Depending on the mother's response, inform her of the recomendations or if she is aware of them- “What are your personal breastfeeding goals?” or “What do you want to accomplish regarding breastfeeding?”

    I think the above sample dialog removes any negative talk, allows for an informed discussion (ensuring she is aware of the official recomendations) and opens up the conversation to discussing her goals and what is important to her to accomplish. This also provides an opportunity to address benefits and difficulties of combo feeding/pumping, as it seems many providers assume breastfeeding means exclusive breastfeeding with no supplementing/pumping. It would be nice to not have that be a default assumption as the reality is not many moms do absolutes when it comes to feeding-but that's for another discussion entirely.

  18. Cool nature decided that this Jack Newmam reading/ don't give me any bottles because i am going to EBF person wouldnt be able to provide enough for her daughter to gain weight (she kept losing).

    Awesome.

    Nature can be a cruel bitch. Luckily nature gave us the intelligence to mitigate the damage through our wits and technology

  19. I don't think that terms like hopes and expectations are any more negative than “goals”. Obviously, “worries” is a negative term, but I've talked through these worries with many women prior to them giving birth, and I do believe that working through these concerns and offering legitimate solutions to combat them has done a world of good in preventing problems.

    However, my thinking in this post was that I think it's detrimental to speak of ANY parenting issues in terms of 'goals'. I don't think parenting should be goal-oriented, as that takes all autonomy away from the child. As any parent of a teen will tell you, having goals for your child is a sure way of being disappointed. You need to meet them where they were at, and encourage them to achieve THEIR dreams. I prefer terms like “hopes” and “expectations” because while hopes may not come to fruition, you do not “fail” at hopes. You do not “fail” at expectations – you may not meet them, or those expectations may change, but there is no failure implied in that term. But goals are absolutely about success or failure- there's no way around it. If your goal is to run a marathon and you collapse after 15 miles, you've failed. But if your HOPE was to run a marathon, and your expectation was that you would probably make it 10 miles, than getting to 15 miles would be celebrated.

    It's all semantics, perhaps. I don't doubt that women who set breastfeeding goals end up breastfeeding longer – that is logical. But I wonder how they FEEL about their breastfeeding experiences? Did they enjoy feeding their babies? Did they feel that they met their goals, or did they fall short (even if they breastfed 'longer' than those who didn't set goals). What was the mindset involved? Are these women type A goal-setters in general, who approach motherhood like a career?

    Statistics only tell us so much. This blog is concerned with the lived realities and experiences of individual women. My concern is for the women who “fail” to meet goals, and their emotional fallout, not with raising breastfeeding rates. So I think we are probably coming from perspectives that may set us up for a frustrating impasse on this issue. I appreciate your input though, and look forward to your article.

  20. I would agree. My best friend just had a baby, and she has had the most perfect, blissful experience thus far. Everything is going perfectly and exceeding her expectations. It is wonderful when that happens.

  21. In that case, I would have the D/N/HC ask the woman what SHE means by breastfeeding. If pumping/supplementing are things she expects to do in order to meet her breastfeeding “goal” then it would be helpful if the health care provider knows that and then everyone is on the same page. Furthermore, the HCP can provide information about pumping/supplementing (benefit/risk, info about the necessary supplies, etc). It does no one any good if the HCP assumes that supplementing/pumping are off the table…that's one way women might get discouraged from BFing at all, if they are led to believe that it's EBF or nothing.

    As I mentioned above, I didn't set goals with regards to BFing. However I went in totally expecting to pump and supplement, so if I had set a specific goal, it would have been with that in mind. If I mentioned that to a HCP (this is hypothetical now), or an LC and he/she said it didn't count, I'd be less likely to make the effort. Why do all that work if it doesn't count? In real life, of course it counts. It is not like the occasional bottle of formula is going to cancel out all of the benefits of breastmilk.

  22. I made a goal to nurse my firstborn for a year. When at 3 weeks it was not going to happen (tongue tie, poor latch and two LC's consulted) I was devastated. It did not help that my neighbor (a LLL leader) kept telling me that I should have tried x,y,or z. To be honest, now that both my kids are well past the age for ff or bf'ing, I realize what a total nonissue this was(yup, you heard it here, forumal or breast is miniscule in the grand scheme of parenting – GASP :D). But it took a long time to get there. My much older, wiser self wishes I could go back and tell my first time mom self.

  23. And when it doesn't, what's the fallout? What's the fallout compared to taking a more easygoing approach that recognizes that what's best for each mom/baby may look different from family to family? What's the fallout when people who don't fit your narrow definition of biological norm discover that their biology, or their child's biology, fits a more diverse definition of “normal?” And how does that affect their ability to set expectations for breastfeeding future children?

    Are you comfortable with sacrificing a lot of women and children on the altar of “breast is best” just to make those for whom everything does turn out fine feel better about themselves?

    I personally like to see people as people, not statistics to check off on boxes so public health officials and lactivists like yourself can feel better about themselves.

  24. So…your definition of breastfeeding support is to pretend everything is sunshine and rainbows, that everyone can breastfeed even when we know that's not true, and basically lie to people in the name of stopping “negative talk.” We should let worries metastasize in women's minds, even if those worries are based on the very myths that are called booby traps and never have the chance to have someone tell them the truth. We should deliberately withhold proper medical advice to women–ethics be damned–because they can't handle the truth.

    What if some woman was worried about nursing in public with her I-cup-size breasts, but never told you? Maybe she'll internalize that worry to the point where she gets to the hospital and decides this whole breastfeeding thing isn't for her, instead of having a supportive person address those worries, including telling her about applicable laws, practicing cover-up techniques, or doing whatever it takes to get her more comfortable with her body.

    What if some woman is concerned about whether breastfeeding will flash her back to when she was raped? Would you rather she shut up and never discuss that with a mental health professional, physician or nurse, or support group–because that's “negative talk” and automatically means she won't breastfeed, or she'll discourage others from breastfeeding? Let's just let all the sexual assault survivors flounder on their own, they're not worthy of the truth if it seems like “negative talk” to folks like you, hmm?

    The difference between FFF's approach and yours is that she acknowledges women as adults, whereas you seem to feel women are intellectually and emotionally incapable of making a decision when what you perceive as “negative talk” is involved, thus requiring an authority figure to determine what they are allowed to see and hear–in other words, infantilizing women. Your idea of “negative talk” could very well be someone's definition of “positive talk:” taking the empowering step of asking questions, exploring concerns, figuring out what's going on with your body or your child's, and then coming up with plans to deal with it. That's how adults handle potential problems.

    As anyone who has read the FFF Friday stories around here can easily see, this notion of limiting breastfeeding education in the name of minimizing “negative talk” is a booby trap itself, because it means women do not go into birth armed with appropriate information and tools to troubleshoot what might be going wrong, and figure out what they can do about it. To say it's disempowering is an understatement of heart-wrenching proportions, and points to the fact that often what proves to be the booby trap is no ad or sample bag, but rather, the very people whose patriarchal attitudes become detrimental to the very people they claim to want to help.

  25. Correction: it's what YOU believe to be nature's default. Nature's default, actually, is a tremendous amount of diversity. Nature's default is finding ways around obstacles.

    Tell me, what do you think of people who cannot conceive without medications or treatments like IVF? These women have a uterus, so they're designed to have babies, correct? So we don't need to talk to people about fertility treatments, right? It's ethical to withhold information about fertility to these couples because after all, if they're worried about not conceiving, that's “negative talk” and they just won't keep trying hard enough “the natural way” to have a child, right?

    What do you think of people who need glasses or contact lenses to see? Nature's default, to you, is that if people possess an organ or tissue, that should be enough for it to function properly, yes? So nature's default should be 20/20 vision…except there are a lot of people walking around without 20/20 vision these days. But forget that little inconvenient truth, their bodies were designed to function with 20/20 vision, and it's “negative talk” to be concerned if that isn't happening, right? It's unnatural to do anything about that, isn't it? Why, we should be passing moral judgment on those who just haven't tried hard enough to see properly, correct? They're lazy, uneducated, and selfish to want to use a modern invention to circumvent what is the biological norm–for them–because it's not your definition of biological norm, right?

    I could go on but I'll stop here…

  26. “Because that's negative talk, and pessimism has a significant impact on breastfeeding success. Even using the word “hope” implies anticipated failure.”

    This attitude right here caused me an unbelievable amount of heartbreak in my early months of breastfeeding.

    The hospital breastfeeding class I took prenatally was full of this attitude as well. The whole “it doesn't hurt if you're doing it right,” “no one in the western world who eats healthy has low supply,” “giving your kid cow's milk formula is akin to injecting them with cow's blood,” “now that you've taken my class you won't have problems,” “epidurals negatively affect breastfeeding,” it went on and on, and I TOTALLY BELIEVED HER.

    After realizing we had serious issues, I had a crunchy lactation consultant who took moms giving up personally, didn't acknowledge me as a person and not just a milk machine, and who downplayed the difficulties I was facing following the routine she gave me. I can't believe I followed her advice as long as I did.

    These two lactation consultants and their rosy outlook caused me an undue amount of stress. Looking at Best for Babes' list of “booby traps” just causes my blood to boil. How is being HONEST about what can happen and HONEST about how formula is not a big deal a bad thing? Since when can we, as adults, not handle it? Where's the study that says negative talk has a “significant” impact on breastfeeding success?

    It wasn't until I found a well-regarded and rational lactation consultant that I hit my stride. She gave me “permission” to supplement, “permission” to take time for me, and my God, it was what I needed. We supplemented a small amount for a week and a half, to ultimately breastfeed for well over a year. Formula doesn't destroy breastfeeding, rather it can save it and I'll always defend formula and be grateful that it was there for me and my child.

  27. Agree 100%. As long as the woman/patient is aware of the recomendations (informed decision), then the focus of the D/N/HC should be to help her meet HER goals, whatever they are. Forcing recomendations down someone's throat helps no one.

  28. Aside from the excellent points Teri has made regarding the flaws in that statement, what the hell does that have to do with helping a woman meet HER goals regarding breastfeeding after she has made an informed decision?

    If that informed decision means NOT exclusively breastfeeding, despite recomendations, assuming EBF as a default does not help anyone meet any goals. It's a complete disconnect between the mother and the D/N/HC.

  29. My experience of it was different, actually – received zero information about challenges of BFing at different stages and how to prepare for them and deal with them, which made it more frustrating to be faced with the challenges. I think education about the reality of BFing is important if you want more people to BF. If you know in advance that some babies may cluster-feed, feeds might take an hour or longer the first six weeks and so on, you might be better able to arrange your life or your expectations so you aren't gobsmacked by the reality of the challenge (and perhaps you wouldn't throw in the towel so quickly). I feel quite strongly that discussing hopes, expectations and worries can be helpful in countering the baseless fears/worries and preparing people to have realistic expectations of BFing. And treating women like adults rather than fragile creatures who can't overcome negative thoughts is a good thing too, in my book.

  30. It is very easy to say that when you have successfully breastfed. For me, setting realistic expectations was extremely important. I just gave birth to my third child last week, and I was unable to ebf my first 2 due to IGT. Setting realistic expectations has made this a much more positive experience. You might see a problem with the word “hope”, but I think it's much worse to imply that all problems can be overcome. I think the conversation needs to be realistic. I am unable to ebf, and I know there are many others like me. I realize I am not part of the majority, but I exist, and my experience should not be disregarded as the “less than 1%” statistic that is always thrown around.

  31. I dunno, I'm not sure I agree with the premise here about goals. I don't think that “goals” has to refer only to disagreeable things. Having a goal to run a marathon… yeah, it's hard, but you feel pretty good about yourself once you do it! (Or so I hear. I have no interest in running a marathon, personally, but for those who do, it is something they do because they want to but that doesn't mean it isn't hard sometimes.) You could set a goal to learn to play the cello, or to repaint your house, or to breastfeed for six months, or lots of things, and there would be elements with each where sometimes you are frustrated or sometimes it doesn't end up working out the way you'd wanted because of factors that are somewhat or mostly or entirely out of your control or sometimes you change your mind and decide it isn't really worth the hassle after all. But I don't think a “goal” has to be something negative. I had a breastfeeding goal but realized it was possible I might not meet it and that it was okay if I changed my mind… I think the recognizing that it might not happen and recognizing that it's okay to change goals is an important piece here. Which I think we agree on and so this is mostly just a semantic debate.

    I'm too lazy to track it down but I found a post where another blogger pointed out about, I think, this same study, that they did a bunch of speculating on why women didn't reach their “goals” and what would have helped them but never bothered to actually ASK THE WOMEN THEMSELVES what would have helped, and that was stupid of them.

  32. It has been interesting reading these posts. I found this because I was googling helping women meet their breastfeeding goals. I am a Nurse Midwife and am a advocate for breastfeeding. I do agree that many go over board with pushing breastfeeding. Breastfeeding bulling comes from health care providers, etc, who want women to meet health care providers and organizational goals. What I care about are women’s goals, or hopes, or intentions, or whatever words are choosen to describe it. Then I will stand on my head, do the splits, take a 2 in the morning phone call to help a woman get through the tough spots so she can get to the good spots. If she changes her mind about what she wants, fine. If she gives up in tears because nobody was their to help her when she needed help or because she was set up for failure in the midst of a health care system that failed to provider her with the needed tools, criminal. I think that is where goals are important. Not so we can grade a mother…pass or fail, but so we can help the woman who wants, hopes, longs to breastfeed realize her wants, hopes, longings, and goals.

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