The biggest problem with the breastfeeding discourse has nothing to do with breastfeeding

Sometimes, a cigar is just a cigar. And sometimes, it’s not.

As any journalist, blogger, or parenting-forum moderator can attest, merely mentioning the words “breastfeeding” or “formula feeding” will create controversy – or at least a comment thread that derails within the first three posts. It’s virtually impossible for someone not to feel offended. It happens on both sides of the debate; some breastfeeding advocates see red anytime a person writes favorably about formula, while some formula feeding mothers are guilty of taking it all too personally, and assuming that every positive aspect of breastfeeding is dig at their lack of lactation.

This bugs me, being someone who writes about this topic regularly, because it dilutes the conversation. We lose track of what we’re talking about, and lose the chance to understand, to evolve, to connect.

Of course, this problem is endemic to any hot-button parenting issue. Circumcision, sleep training, working vs. staying at home, vaccinations… But when it comes to breastfeeding, what I’m talking about goes far beyond the mommy war bullshit. We’ve apparently lost the ability to discuss anything to do with breastfeeding and formula without heaping layers of preconceived notions, philosophical ideals, and emotional reactions onto whatever’s being discussed. Even if the conversation takes place in a respected medical journal, the halls of a hospital, or a human rights nonprofit.

With that said, I want to make something clear: this post is not about breastfeeding. It is not about the benefits of breastfeeding. It is not about a woman’s right to breastfeed or formula feed. It is not about you, or me, or your sister-in-law. It’s about language, interpretation, and bias. If it helps, substitute the word “breastfeeding” for something less emotionally loaded. “Drinking coffee”. “Wearing palazzo pants.” Whatever.

In the past month, two stories popped up, buried so deep in the news that only someone who obsessively googles terms like “infant feeding” and “lactation” would have seen them. They were about studies showing negative associations with breastfeeding (see? Didn’t your heart start beating a bit faster? …Negative associations with palazzo pants. That’s better, right?) The first one found that longer durations of breastfeeding (past 12 months) were associated with higher rates of a specific form of breast cancer in Mexican and Mexican-American women. The evidence was based on subject recall of breastfeeding history, in a specific population. All I will say about the study itself is that it is one, isolated result; more research must be done before anyone can make proclamations about whether women of Mexican descent might want to wean after a year.

Which is basically what I say about every infant feeding study. These results do not prove a causal relationship. It would be patently false and extremely irresponsible to have headlines screeching “breastfeeding causes breast cancer!”

Luckily, there were no such headlines. The story didn’t receive much coverage in major news outlets, but here were the headlines I did find:

Breastfeeding May Increase Cancer Risk for Mexican-American Moms (http://www.nbcsandiego.com/news/health/Breastfeeding–Cancer-Rules-May-Not-Apply-to-Some-226050001.html)

Lactation may be linked to aggressive cancer in Mexican women

http://health.ucsd.edu/news/releases/Pages/2013-10-01-lactation-linked-to-cancer-in-Mexican-women.aspx

Women of Mexican descent more likely to be diagnosed with aggressive form of breast cancer http://www.news-medical.net/news/20131002/Women-of-Mexican-descent-more-likely-to-be-diagnosed-with-aggressive-form-of-breast-cancer.aspx

Mexican Women’s Breast Cancer Risk Tied to Breast-Feeding? http://healthcare.utah.edu/womenshealth/healthlibrary/doc.php?type=6&id=680757

Notice all the qualifiers. May be linked. More likely. And my favorite example, the question mark at the end of the last headline.

Now, let’s compare these measured, accurate headlines with those that stemmed from similar studies (self-reported data, specific populations, single studies rather than meta-analyses) that showed a positive effect of breastfeeding:

Breastfeeding reduces cancer risk http://www.dailymail.co.uk/news/article-88785/Breast-feeding-reduces-cancer-risk.html

Breastfeeding Cuts Breast Cancer Risk http://www.webmd.com/breast-cancer/news/20070417/breastfeeding-cuts-breast-cancer-risk

Study: Breastfeeding Decreases Cancer Risk http://www.npr.org/templates/story/story.php?storyId=9656285

Breastfeeding Protects Against Breast Cancer http://www.reuters.com/article/2009/08/10/us-breastfeeding-cancer-idUSTRE5795CZ20090810

Not one qualifier to be found.

But FFF, you’re arguing semantics, you say. Perhaps. But how can we argue that subliminal messages that come through the advertising of formula or bottles can so greatly affect a woman’s breastfeeding intention, and then argue that the language used in widely-read headlines doesn’t make an impact?

Not convinced? Let’s go beyond the headlines. The one quote from the lead researcher of the breastfeeding/cancer in Mexican women study used in the media was this:

“Our results are both puzzling and disconcerting because we do not want to give the wrong message about breastfeeding…If you treat breast cancer as one disease, breastfeeding is beneficial to both mother and baby. That should not be dismissed.”

Puzzling? Disconcerting? Science needs to be free of bias. It’s perfectly acceptable to be “surprised” by findings, but “disconcerted”? And as for the point about “breast cancer as one disease“, this is not the sentiment expressed in the quotes from articles reporting a positive effect, many of which proudly extrapolate their specific findings and make sweeping statements about breastfeeding promotion:

Clearly, the researchers conclude, breastfeeding is associated with “multiple health benefits” for both mother and child…”That’s why we need supportive hospital policies, paid maternity leave, and workplace accommodations so that women can meet their breastfeeding goals…” (source: Reuters)

The same double standard popped up a few weeks later, when a study hit the news which found that babies breastfed longer than one year, as well as babies introduced to gluten after 6 months, had an increased risk for celiac disease. Again, hardly any media coverage; the one major outlet (Yahoo News) that covered it used the headline “Parent’s Feeding Choices May Raise Baby’s Risk for Celiac Disease“. Absolutely accurate headline, but no mention of breastfeeding. Granted, there were two findings that came from this study; both of which did involve a feeding “choice”. What I find interesting, though, is that whenever formula is associated with something negative – even if that particular finding is buried in a mess of other data – the headlines make sure to mention it. (Remember the arsenic-in-baby-formula scare of 2012?)

This study had many flaws. (Science of Mom has a great explanation of what these were over on her blog, if you’re interested.) But it didn’t have more flaws than 99% of the formula-is-risky studies which we are subjected to on a weekly basis, none of which are handled with the same degree of intelligence and moderation.

In Bottled Up, I discuss the problem of publication bias, and the professional death knell it is to report or support anything that detracts from the supreme perfection of breastfeeding. This is a bigger problem than one might believe – because if the end goal is to find ways to reduce disease and increase health in populations, we should be striving for information, not propaganda. And this is why I fight so hard to reframe how we discuss and promote breastfeeding – because if we are basing all of our support for the practice on science, then we run the risk of bastardizing – or at least “tweaking” – that science to justify our promotion.

Sometimes, a cigar is just a cigar. But when it comes to infant feeding science, the results are never just the results.

FFF Friday: “I chose to give up breastfeeding my baby.”

Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts and feelings, and I hope we can all give them the space to do so. 

Every so often, it happens: a Facebook thread provokes a divide in our community between those who “tried and failed” to breastfeed and those who made a conscious decision to formula feed without the drama. And every time, I try and make it clear: this community supports educating yourself on your options and making a choice that is right for your family. That’s it. I’m not pro-formula. I’m not pro-breastfeeding. And I’m definitely not pro-formula-as-long-as-you-at-least-gave-it-a-shot. 

But you know, that doesn’t mean each and every one of you has to feel the same way. Inner bias is natural, and it’s naive to assume that we can all just “get along” and always agree with everyone else’s choices. All that I ask is that we listen without judgment. That we acknowledge that our own truths aren’t necessarily someone else’s truths; that we agree that there are all sorts of ways to be a good parent, but there’s a few definite ways to be a good person: Listen. Don’t assume. Open your mind to someone else’s point of view.

Enough lecturing from me. I really enjoyed Corri’s story – it’s refreshing to take a break from reading about heartache and feelings of inadequacy and hear about someone feeling confident in her decisions. I admire Corri’s self awareness, and her ability to make a choice that honored her right to happiness and health – a choice that allowed her to bond with her baby, even if that choice butted heads with what we’ve been told is “necessary” for bonding between mother and child.

Happy Friday, fearless ones,

The FFF

***

Corri’s Story

I‘ve read all the stories about how hard women tried to nurse, and then it didn’t work out and so then they “resorted” to formula. 

My story with my second son is different.

With my eldest, I tried to breastfeed.  Unfortunately I ended up back in the hospital a day after discharge with sky high blood pressure.  After a 4 day hospital stay, a magnesium treatment, and blood pressure meds we threw in the towel on breastfeeding.  He was formula fed while I was in the hospital and was very angry when I tried to breastfeed him upon my return.

With my second son, I didn’t have preeclampsia or the lingering blood pressure issues that had prevented me from nursing my first son.  I was hoping it would work out this time, and I’d be able to do “the best thing” for my baby.

Sure, I produced enough milk.  The lactation consultant who burst into my room and started fondling me before I knew her name was very excited to see how much I was producing even on that first day.  Lucky me!  My baby was a champion eater (still is as a toddler!) and latched with no issues.  On paper we were a breastfeeding dream!

Turns out I hated it.  I hated breastfeeding.  I didn’t feel bonded to my son, I felt trapped every time he cried.  He would cry because he was hungry and I would cry because I knew I’d have to feed him.  I found myself wishing it would be over as soon as possible – I found myself wishing my child would stop eating as soon as possible.  I started to resent my husband and his freedom and ability to leave the house (as much as I’d like to be, I’m not a “whip a boob out in public” kinda gal) whenever he wanted, or his ability to not have to drop everything since he was the baby’s only food source.  I wanted to sleep and let him take advantage of his paternity leave and get up with the baby during the night once in awhile.

I just felt trapped.

So I made a choice – I CHOSE to give up breastfeeding my baby despite my good production and my champion eater and a complete lack of physical obstacles in our way.  I chose to feed my baby formula, and the day I made that choice I became a better mom to him and his brother.  I bonded with my baby in a much more significant way feeding him with a bottle than I did breastfeeding him.  I was able to pay more attention to my older son, and help him adjust to his new brother because I wasn’t constantly attached at the boob to his new brother. My husband was able to bond with his new son, since feeding a newborn is basically the only real interaction you have with them.  Even at only 18 months, my eldest was able to help feed his brother and he LOVED it.  We all bonded with the newest member of our family in ways made possible by my choice to formula feed.

I think that part of what makes FFF what it is is respecting a mom’s CHOICE in what she feeds her baby.  I wasn’t “unable” to breastfeed – I just didn’t want to.  That was my choice, and it was what was best for me and my family.  To me, that’s what FFF is all about – respecting the choices other moms make.

***

Feel like sharing your story? Email it to me at formulafeeders@gmail.com. 

First World Problems: Fill the Gap and #FeedWithLove

Yesterday was one of those days. Overslept. Kid peed the bed. Bad hair day. Traffic. Drama at work. Husband had to work late, again. House a mess. Feeling fat. Zit popped up on my chin. You know. First world problems.

http://www.stickycomics.com/first-world-problems/

http://www.stickycomics.com/first-world-problems/

 

Here’s a dirty little secret: I hate that phrase. Because we live in our own realities. No matter how much of a selfless world-view we attempt to hold, or how fully we own our privilege, we’re human. You can feel depressed about a zit while realizing how insignificant your plight is in the grand scheme. One doesn’t need to cancel out the other. I’d even argue that people who are inherently empathetic typically feel all things deeply – a news report about a displaced deer will affect them more than most, but so will a breakup or a bad day at work. Emotions are emotions – and I don’t think controlling them because of some innate sense of privileged-woman’s-burden is healthy.

 

But here’s the other the reason I hate the phase “first world problems”: there are some majorly screwed up things going on right here in the first world. First world problems are nothing to scoff at. Kim Simon, my #ISupportYou cofounder (along with Jamie Lynn Grumet), has been thinking about one of the most warped aspects of our decidedly first world nation. In the midst of our government shutdown, Kim had started worrying about the people affected by furloughs at WIC programs  – breastfeeding moms who receive extra food to ensure they have the caloric load necessary to produce milk without it taking a toll on their bodies, and formula feeding moms who obtain the powder necessary to nourish their babies from WIC. She realized that aside from emotional support for moms, there’s another kind of practical support we haven’t really discussed. As she writes for Huffington Post and her own blog, Mama by the Bay:

When Suzanne BarstonJamie Lynne Grumet and I joined together to create “I Support You“, we realized that support begins with basic care.  Basic care for many of the mothers in this country means that they need to have access to healthy food for their families.  Breastfeeding mothers don’t always need a lactation consultant or a quiet place to nurse.  Sometimes they need breakfast.  I am nursing a four month old, and I usually eat two dinners.  I am hungry all.the.time.  But I have a full pantry cupboard and a refrigerator that I frequently have to clean out.  Many mothers don’t.  Formula feeding moms don’t always need the newest bottles or the support to feed their babies proudly.  Sometimes they need enough powder left in the can to get them through until their next paycheck, so they don’t have to water each bottle down.

 

Kim goes on to suggest ways that we can put our money where are mouths are – quite literally – by donating supplies, food, money, and time to mothers in need. Her suggestions are incredibly thoughtful and I urge you to read them, consider them, and put them to use.   But Kim also reminds us that even before the government shutdown, hunger was an issue for many American families – and that it will continue to be after this dumb fight ends and WIC offices are up and running. She’s right: back in 2012, when WIC was fully functional, a study found that 1 in 8 low-income families were watering down formula in order to “stretch” their limited resources – and that “the vast majority of families” in this study were “covered by Medicaid and receive(d) food stamps as well as assistance getting infant formula through… WIC.” (Source: NBC News)

1 in 8 families in this particular study, which was performed in the very first world environment of Cincinnati. 15% of parents already getting aid from government agencies like WIC who are not able to feed their babies adequately.

I can hear the arguments starting already: But that’s why WIC is promoting breastfeeding, FFF! If we could just get these women lactating, they wouldn’t have to put their babies in danger by using diluted formula! And you know what? I agree with you. It would be fabulous if these moms didn’t need to worry about their babies’ next meals, if milk were to flow easily and freely from their breasts. But it would also be fabulous if they weren’t in need. If they had well-paying jobs that allowed them sufficient maternity leave to establish breastfeeding without putting their families at risk. It would be wonderful if they had supportive partners or parents or friends who could stay with them in the early days and take care of their other children while they worked through the breastfeeding learning curve. It would be peachy if we could guarantee that none of them were part of the 5% of women who simply can’t produce milk, or that none of them had ever been victims of sexual assault which made it emotionally complicated for them to nurse, or that none of them had babies who were allergic to milk or soy, because when you’re living with food insecurity, it’s not so simple to go on an intensive elimination diet.

 

We can argue until the cows come home about whether all women in need should or can breastfeed, but once those cows do come home, we need to make sure there’s enough milk. Period. Whether from a can or a breast. We can’t let babies starve or become malnourished while we argue. Because when it comes down to it, arguing over breastfeeding in a theoretical sense  is a first world problem. That is where our privilege will bite us in the overfed ass. No matter what you believe, politically, or about infant formula marketing, or women, or birth, or Santa Claus, we need to address the hunger of our littlest members of first world society. And for now, until issues like maternity leave and adequate prenatal and post-natal care and lactation support and childcare are solved, that means supplying formula – not just whatever brand makes a deal with WIC, but options like hypoallergenic or gentle formula for babies who need it.

 

The breast/bottle mommy war is a “first world problem”. But the solution Kim, Jamie, and I are offering to this war doesn’t have to be. #ISupportYou can support moms in their emotional journeys while also supporting those who don’t have the luxury of worrying about judgment, because they are too busy watching the contents of their Similac can diminish and praying that their babies don’t hit a growth spurt before the next WIC appointment.

 

Privilege isn’t a bad thing. Privilege gives us internet access and time and sometimes (although not always), a little extra cash. I’m asking the FFF community to embrace whatever privilege they have, and begin finding ways to address the issue of hunger in our country. I’ll be reaching out to food banks, shelters, and organizations that serve mothers with young infants to see how we can help, specifically, with formula donations. We have one of the smartest and most educated communities on the internet – I don’t doubt we can come up with ways to fill the gap – nutritionally as well as emotionally – so that all mothers, regardless of feeding method or economic situation, can feed with love.

 

First world problems, here we come.

Want to get involved with #ISupportYou or #FeedWithLove? First, read Kim Simon’s post. Then, post here or there, or email me (formulafeeders@gmail.com), with your ideas, contacts, suggestions, etc. 
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