Category Archives: anger

Support versus advocacy: how finding balance is like keeping a white carpet clean

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I lost a few very dear followers over on the Facebook page recently (and I assume on the blog as well), and I’ve been obsessing over their departure. As too often happens on the FFF community page, we have been visited by a few breastfeeding advocates who have, at times, pushed their agenda to an uncomfortable (and sometimes quite emotionally triggering) point. Tempers flared, statistics and studies were tossed around like grenades, and my failure to wield the “ban stick” resulted in a loss of security for some members. They no longer felt safe around the FFF community; no longer felt like it was a positive and healthy place to heal their postpartum wounds and work through their feelings about infant feeding.

Yeah. Shitty.

What really burns me up about this is that in trying to stay open and neutral, I have singlehandedly sullied a place which I’d built to be the safe haven I personally craved. Even I have felt a pit in my stomach when I’ve gone over there lately, wincing in anticipation for the latest infiltration of misplaced “education” or not-so-thinly-veiled hatred (like a comment the other day that referred to me as the “Bitter Formula Feeder.”) When you don’t want to visit your own page, you know there’s a problem.

Some colleagues have suggested that I haven’t protected my community from the types of voices which have already caused so much hurt in their hearts. I fear this is true – people come to a page called “The Fearless Formula Feeder”, not knowing squat about my blog, and assuming that it will be a safe place to discuss bottle feeding and negative feelings about breastfeeding. Instead, they find acrimonious debates about the dangers of formula and critiques of the way that they are choosing to nourish their children. It ignites anger (quite justifiably) and people lash out, sometimes in the wrong direction. They expect me to come to their defense, and it takes every ounce of my being not to lunge like a bloodthirsty mama lioness, but I usually don’t.

What kind of fearless leader does this make me? Not a very good one, I fear. I completely sympathize with the people who feel betrayed by my allowance of dissenting voices, and encouragement of highly emotional debate. There was a time, not so long ago, that I would have felt the same way.

The problem is, I’m against hypocrisy more than I’m against anything (well, maybe not anything. I mean I’m probably more against human trafficking or the unethical treatment of animals or John Wayne Gacy… but you get the point). It would be agonizingly hypocritical of me to only allow those who agree with me to post on this blog, or on my Facebook page. Now, there’s a fine line between being outright obnoxious and posting things which challenge someone else’s beliefs. In the case of the former, I have no problem wielding my ban stick with a theatrical flourish. But with the latter? Well, I’ve had that happen to me on other anti-formula blogs, just because I politely dissented, and it sucks. I don’t want to be part of the very problem I rage against.

Unfortunately, it’s hard to know where to draw the line. Having someone come and throw the same studies we’ve discussed and (I believe quite fairly) critiqued on this blog in our faces every day can feel rather antagonizing and confrontational. Sometimes, I will attempt to express this – telling the person in question that we are well aware that WHO ranks formula feeding fourth in its hierarchy of feeding, and that breastfeeding contains live blood cells, and that studies have shown that formula feeding leads to SIDS, cancer, and the plague, and the slaughter of innocent lambs at the alter of Enfamil, and so forth. And sometimes they keep pushing. And sometimes it makes me want to stick my head in the oven.

When this happens – when the attempt at “education” or “correcting misinformation” becomes aggressive and contrary to the purpose of my page (which is outlined here, if you’re wondering), people begin to get bitterly angry. I understand this, because I feel the same anger. I have to fight against it, sometimes ranting to Fearless Husband for hours on end to get the rage out. But I have the advantage of having done this for nearly four years, and I’ve heard so much hate, passive aggressive “education”, pity, and condescension that it begins to blur into a nice, easy-to-ignore din. For many of you, the wounds are just too fresh, and these people are pouring salt into a wound, and then pouring on some vinegar for good measure even after you’ve asked them to stop the salt. It sucks, I get that.

At the same time, though, I also notice myself allowing people on “our side” to engage in name calling and, at times, unfair attacks. That’s because, on the most fundamental level, I think we are in the right. It is our territory – a place that is supposed to be free from drama, free from the usual critical voices. If someone wants to come into our house and visit for awhile, I’d appreciate they didn’t stomp around with muddy boots.

The thing is, sometimes the boots aren’t exactly caked in mud – sometimes these guests just have a bit of sand on the bottoms. We’re already so sick of vaccuuming up after rude guests, though, that the tiniest bit of sand is enough to turn us apoplectic. And that is where I get uncomfortable, because I don’t want to stoop to the level of other communities, where the slightest disagreement is treated like a federal offense. If it’s just a little sand, maybe it’s better to just kick it aside, and see if offering the guest a drink of water might just make them sit tight for a minute and stop tracking sand all over the floor.

I get that this can veer into uncomfortable interactions for some people, because hey, when you’ve been treated like freaking Cinderella and forced to clean up someone else’s shit while simultaneously ridiculed and insulted, a tiny bit of sand can be a huge pain in the ass. But I’ve seen the same people who initially came in tracking mud on the floor turn around and ask if they could help mop it up. Sometimes you just need to give someone a chance. Sometimes you catch more flies with honey than with vinegar (a nice reminder for those perpetuating the salt-and-vinegar torture I alluded to above).

I see Fearless Formula Feeder – the site, the Facebook page, and the persona- as standing for infant feeding freedom first and foremost. But FFF also stands for honesty, open-mindedness, respect, and fairness. We have to give people a chance to engage with us if we’re going to make any progress in ending this ridiculous breast vs bottle war. I know, I know – many of us feel like it’s only a war because the “other side” has made it so, and I think there is a lot of truth to that. And I know it feels really sucky to have to be the bigger person and treat others how you want to be treated, especially when they aren’t giving you the same respect.

Don’t get me wrong – this doesn’t mean you can’t fight fire with fire. I love the articulate, targeted way some of you choose to fight back. You fight science with science, studies with studies, anecdotes with anecdotes. That’s the way to do it. Stooping to calling someone a “lactonazi” or making blanket statements about breastfeeding mothers is only perpetuating the belief that all formula feeders are anti-breastfeeding, when I know most of us are the farthest thing from it. I don’t want to feel like a sanctimonious jerk by reminding the community about that. I also don’t want to seem like I am not jumping to the defense of those I care so deeply about defending.

I think the point of this rant is as follows: FFF serves a few purposes – it exists to support mothers who are bottle feeding in a practical manner, both emotionally and with research-based and peer-oriented advice on feeding logistics. It also exists as an advocacy site, to protect the rights of formula feeding, tube feeding, and combo feeding parents. It supports  women in their individual breastfeeding journeys (i.e., helping with encouragement for moms wanting to try again, or moms who are currently struggling but want to continue to breastfeed). And it promotes a conversation between infant feeding activists, mothers, physicians, researchers, and interested parties to try and make some progress so that things aren’t so crappy for future generations of mothers.

Therefore, the Facebook page is sometimes not going to be a safe haven. There are going to be times when someone might say something that hurts you deeply, and I invite you to express that hurt, and strike out in the most powerful way you can – by speaking your truth, being proud of your choices, and knowing that the power of the community is behind you. And my promise to you is that while I will gladly allow the sandy shoed folks to hang around and contribute, I will not stand for people tracking mud all over my living room. Or if they do, they better plan to stick around and Hoover the crap out of the place.

 

Can formula feeding really be “fearless”?

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The lovely KJ Dell’Antonia recently mentioned my book and blog in a Motherlode column she wrote about the recent onslaught of breastfeeding-pressure backlash. There was the refreshing -albeit unfortunately titled- piece by a father in the Atlantic, followed by another excellent Motherlode post by writer Marie C. Baca about “embracing” bottle feeding- these came on the heels of a number of other articles which cropped up over the summer and in the early fall, as a result of Latch On NYC and a few other initiatives that have passed in the United States and abroad. Dell’Antonia observed that in all of these writers’ submissions (including yours truly’s) to the infant feeding discourse, one thing remained consistent:

…What’s striking about Ms. Barston’s and Mr. Kornelis’s stories, and most stories of “fearless formula feeding” is still really how “fearless” they aren’t. In every narrative of not breastfeeding, there is the obligatory note of failure, as though justification were the first order of the day… for most women, not nursing, for whatever reason, remains a troubling topic. As long as women are occupied with the litany of excuses… then the conversation will stay on defending the bottle or breast, and off the more important question of how to ensure that the choice between them is dictated more by health and happiness and less by circumstance.

This struck a nerve with me. Scratch that – it pinched a nerve. Her theory was like a constant, nagging backache, reminding me that it needed attention every time I moved a bit too fast. It took me a few days to untangle what bothered me so much about these assertions; the ensuing discussion on the FFF Facebook page only served to deepen my desire for answers (or a good massage).

All of you made fantastic points about why we so often appear to be defensive about our choices. Some argued that while we may indeed give excuses, this is because we are conditioned to expect judgment. “I think our stories are tinged with defensiveness since before even sharing them we are already preparing to be attacked,” Tara mused. Lisa echoed that sentiment. “For me, it wasn’t inner guilt – it was everyone’s expectation that I SHOULD feel guilty and that I had done something wrong. Frankly, I was outright pissed off by the insinuations and outright accusations that by formula feeding my daughter, I was setting her up to be fat, stupid, and unhealthy. That’s where my defensiveness came from – the need to defend my choice.” And others thoughtfully mentioned that while we may indeed appear defensive, a lot of it may simply be our way of dealing with complex emotions over the inability to do something we wanted very badly to do:   “”I don’t believe that guilt is a simple emotion – I felt guilty because my boobs failed, I also felt guilty that I was happy that formula was working for us. I felt I was letting my daughter and others down. Guilt is often the result of being unable to change a moment in time – it’s not always about what is right or wrong,” wrote Allison.

As a few of you rightly pointed out, so much comes down to perspective. Unless you have lived through this particular kind of hell, you just can’t understand it. As Misty explained. “I think they mistake bitterness with defensiveness. Unless you’ve suffered the same societal and personal condemnation and guilt tripping that comes with the breast v bottle war, you can’t imagine what kind of damage and pain it causes to a woman’s soul. Obviously, not every woman who tried to nurse but went to formula experiences anguish about it, but many of us do, especially those who had fully embraced the ‘breast is best’ mantra. I still struggle with resentment toward the BFing friends and professionals who, in my opinion, needlessly caused me to suffer terribly as a new mother. I still have sorrow that my first year as a mother was so joyless, because others chose to reinforce my flawed views about BFing (which I’d gotten from them) instead of guiding me compassionately to a more balanced and emotionally healthier way of feeding my child.”

Perspective also plays into the issue of defensiveness in another way: the further away from it you are, the easier it is to approach the “Why I Formula Fed” question dispassionately. I guarantee that for most new mothers, ten years from now- hell, even five – this debate will bore the hell out of them. Other issues will take its place – education, bullying, puberty, safety concerns, etc. However, there are those of us for whom this isn’t just a personal tragedy, but a social problem, a cause which deserves our anger and outrage and yes, defensiveness. I don’t think it’s entirely realistic to hope that we can move away from defensiveness completely, because we are typically reacting to offensiveness.

I think you can be fearless and simultaneously feel the need to defend yourself. All “fearless” formula feeding means to me is that you feel you have made the best choice for your family, for your baby, for you. Fearless doesn’t necessarily mean regret-less, guilt-less, anger-less, resentful-less. It just means you’re not scared of your choice, because you know it is safe, and you know it was right.

But as for what KJ refers to as the “litany of excuses”… I’ve always suspected these are a necessary tool, a ticket to participate in the conversation. By explaining how much you wanted to nurse, and talking about all the struggle you went through to do it, it might help the opposition understand that this is not a matter of lack of education or drive. That it would at least start us on a level playing field, and take down the barricades at the border – I wanted to nurse, you wanted to nurse, we both believe in breastfeeding, so let’s try and discuss this rationally. I have nothing but admiration for women gutsy enough to just come out and say nursing wasn’t for them – I loved Amy Sullivan’s essay in The New Republic, and it was, indeed, the most “fearless” argument for bottle feeding I’ve seen (interestingly, Dell’Antonia felt that Baca’s piece was free from the normal guilt-ridden excuses. I thought it was an excellent piece, on every level – I mean really, really excellent, and quite fearless in a number of important ways – but the fact remains that Baca still mentioned that that she was physically unable to nurse. That gives her a “pass”, in many people’s estimation; it’s still a preemptive strike against condemnation, unconscious as it may have been). But one look at the comment section of Sullivan’s editorial, and you’ll see that it immediately erupted into a hate-fest. Breastfeeding moms took her words as an affront to their method of feeding; breastfeeding advocates told her she was misinformed; judgmental sanctimommies hurled accusations of the usual flavors- Sullivan was selfish, shouldn’t have had kids, etc.

Still, in the past few months, I’ve noticed something: no matter what the writer says, in every online piece I’ve read about formula feeding, the response thread is Exactly. The. Same. The same arguments, the same people, the same facts and studies and name-calling. So while I think we have a right to our emotions – whether these emotions are guilt or regret or anger or pride- we shouldn’t feel the need to state our case in order to create a more peaceful discourse. No matter what you tell them, haters are gonna hate, or whatever that saying is.

Ultimately, I think KJ is right: I’m not sure we can move forward in creating positive change for anyone until we can stop the vicious cycle of guilt-defensiveness-bitterness. I would argue, though, that this is not the responsibility of the women (or men) sharing their stories, but rather that the conversation at large needs to change focus and tone. This might start with media outlets allowing for more nuanced, balanced features on why breastfeeding isn’t working for so many women, rather than coping out with opinion pieces. It might continue with physicians being able to speak out against some of the newest breastfeeding promotion endeavors without risking their careers to do so. It might end with us accepting that changing our society to be more breastfeeding-friendly is far less of a public health issue than it is a question of personal freedom, women’s rights, and trusting our own instincts over what the experts deem is best.

 

 

Nothing changes…

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Lately I’ve been frustrated. Like, mind-numbingly frustrated. It seems that every week there’s a new article on the infant feeding wars, rehashing the same points over and over, with the same battle being waged in the comments section: You’re judgmental. Yeah, well, you’re anti-breastfeeding! No I’m not, and I’m a better parent than you! Oh, really, well, I’m am MD/RN/LC/PhD and I KNOW I’m right, so shut up! You’re a lactofanatic! You’re selfish and misinformed and a threat to breastfeeding moms everywhere! Bloomberg! Hannah Rosin! Bottle! Breast! Bottle! Breast!

Shall I go on?

I’ve been blogging for nearly 3.5 years now, and I’m so damn tired. I’m incredibly grateful and proud of the community which has formed around FFF, but I don’t see anything changing. I want to do more than whine about how unfair the current atmosphere is; I want to change it. I want to make this blog unnecessary, because I’m truly sick of talking this subject to death. And I’m sure you guys are sick of hearing about it. How many times can I pick apart studies which fail to thoroughly consider the most basic notions of correlation and causation? How many ranty essays can I vomit out about the pressure to breastfeed? None of it seems to matter, because nothing changes.

I mean, nothing changes.

I wrote a book, one that took nearly three years of heavy research, interviews, and soul-sucking rewrites, hoping that it would help me reach a larger audience, and get people talking on a more nuanced level about this debate. But no one wants nuance.

And nothing changes.

I sit here at my computer, hiding behind the safety of our little community, preaching to the choir, holding myself up as fearless while I wallow in fear; the fear that people will judge me, criticize me; the fear that I will disappoint you.

And nothing changes.

Recently, an opportunity came up that might allow me to effect change in one tiny arena of this circus of insanity. It would allow me to meet with some other people who are uneasy with the way formula is being vilified. It would give me the ability to spread the message that we need better education and guidance for bottle-feeders. It might give me access to people willing to listen to ideas about tempering the Baby Friendly Hospital Initiative to be a little more palatable to those of us who must, or choose to, formula feed.

The problem is that this opportunity necessitates my associating with a formula company. They are the ones with the means to bring me to the table, to have these conversations. It makes sense that they contacted me; they have a vested interest in protecting infant feeding “choice”, and so do I. But theirs is financial, and mine is personal. I’m not naive; I know they aren’t doing this out of the kindness of their hearts.

Formula companies- like all major corporations- are out to make money. Some of the ways they go about this do not bother me – for example, I see no harm in them advertising their product. I view formula as a healthy substitute for breastmilk – certainly not perfect, not without room for improvement (because I always suspect manufactured substances always have room for improvement – that’s just the capitalist in me), and as I explain in Bottled Up, not a competitor to breastmilk. Just another option. Considering the only industry that has major restrictions on advertising is Big Tobacco, to say formula companies shouldn’t be allowed to advertise is to compare them with the manufacturers of cigarettes- a completely unfounded, ridiculous, and irresponsible comparison, in my opinion. I don’t like when they bring breastmilk into the marketing message – lines like “closest to breastmilk” should be left on the cutting room floor- but at the same time, how can we really blame them? If we are spending so much time and effort convincing society that breastmilk is the gold standard, why wouldn’t specific formulas want to be seen as coming closer to matching this liquid gold than their competitors?

But there are other ways that formula companies handle themselves that provoke a disturbing, fundamental mistrust in my gut. They want to increase their sales; therefore, it’s in their best interest if women do not breastfeed. This is a fact that’s impossible to ignore, when we see them sponsoring breastfeeding “help” hotlines and guides. I can’t help siding with breastfeeding advocates on this one: the LAST people who should be giving breastfeeding advice are the folks with a vested interest in having women turn to the alternative.

This is the point in my ongoing internal debate where I start getting all angst-ridden. Formula marketing execs need to take a long, hard look at how they are handling their accounts. They have an incredibly smart, media-savvy audience in this country-not all moms are Little Red Riding Hoods; many of us know there’s a wolf hiding behind that grandmotherly lactation consultant. Even if the breastfeeding information they are doling out is 100% useful, encouraging, and evidence-based, it is not going to be received as such.

What I find so frustrating is that formula companies are so busy trying to market to breastfeeding moms, when they have a willing and ready market base just sitting here, waving our arms to get their attention. Ban The Bags doesn’t want them hawking their wares to mothers attempting to breastfeed? Fine. More for us. Why not urge hospitals to keep the bags on hand, to be distributed only to parents who request them? Or even better, give parents the option of signing up on a website to receive the samples in the mail. Seems like a no-brainer that most moderate people could accept as a compromise.

Likewise, why should formula companies distribute pamphlets on breastfeeding when formula advice is so needed? If you’re going to spend money sending formula samples in the mail, the literature accompanying it should be about formula feeding. Not breastfeeding. Leave that to Medela or Lansinoh.

I have plenty of ideas on how formula companies could better serve us, their true customer base, and perhaps shift the cultural opinion of formula feeding away from a “competitor” to breastmilk and towards a more moderate point of view, where it is merely seen as an option for women who cannot or choose not to breastfeed. Tough distinction, but worth making. And there’s a hopeful part of me which thinks that maybe, just maybe, the formula companies also want to protect their customer base – even if it is for entirely selfish reasons.The formula companies don’t want their customers feeling ashamed to buy their products; they want us to be proudly bragging about how great our kids did on Enfasimistart. They don’t want us improperly using the stuff and then suing them later.

If I’ve learned anything in the past few years, it’s this: breastfeeding moms have a tough time in this world. But they also have a lot of respected, smart, noble individuals fighting their fight. No one believes that formula feeders need defending, so we are left to our own devices. The only folks who have a vested interested in our well-being is the formula companies, and they haven’t really done us many favors.

I’ve been thinking that maybe I can change that, though. If I can’t make headway with the breastfeeding organizations, maybe I can at least provoke some change in the companies who are making and marketing the products that feed our babies. Maybe if they hear from us – their customers – they can put some of their considerable resources and influences to good use, rather than simply pissing off breastfeeding advocates and giving them more fodder to hate on formula, formula makers, and by association, formula feeders.

This is something I want to do; something that I think could actually provoke change in a positive way for both formula feeding parents and breastfeeding moms – because we don’t have to be at cross purposes. I support infant feeding choice – that means ensuring that breastfeeding and formula feeding are equally protected, and parents are appropriately educated about whatever feeding method is right for them. I don’t see any education or protection for formula feeding parents, and no one is willing to change this. It would be great if UNICEF or the Academy of Breastfeeding Medicine wanted to listen to what I have to say, but I’m not waiting by the phone for them to call. I don’t get the impression they’re very interested in what I have to say.

While all of this sounds good in my head, these thoughts are giving me a migraine. I’m well aware that associating with the formula companies opens me up to major criticism. And yet I can’t help think that there is a major difference between being influenced by a formula company, and influencing a formula company. Being influenced by a formula company would mean having them sponsor this blog, or pay me a salary, because then my content would be soiled by bias- whether it be of the financial or subliminal persuasion. We’ve all seen how having ads or sponsors can soil the editorial style of some of our favorite bloggers; I certainly don’t blame them for it, since this blogging thing takes time and a girl’s got to eat. In my case, though, if I don’t have my neutrality, I don’t have sh-t.

But I’m not talking about being influenced – I’m talking about influencing. I’m talking about having them interface with me on MY terms, helping them move in a better direction, and walking away if I feel things are shady. I’m not sure how this is more suspect than a representative of Planned Parenthood meeting with Trojan. The former wants to advocate for safer sex, and knows abstinence is unrealistic; the latter makes condoms; if Trojan can help promote safer sex and sell more condoms due to a halo effect, it’s a win-win for both parties.

I’m opening this up to the community, because your opinions are the only ones I care about. People have been accusing me of being in the pockets of the formula industry since day one; I don’t know if it even matters to them whether I throw molotov cocktails into the lobby of Nestle headquarters, or bathe naked in a vat of Good Start. But I take my responsibility to this community very seriously, and I wouldn’t make a decision like this without your input.  Please think about this, and let me know: is it okay to associate with the formula companies on an advocacy level? Or will this destroy my neutrality, even if I vow not to let it?

Because seriously…. something has to change.

The two headed chimera of infant feeding studies

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It’s been a crazy week here, and I was really hoping to pull some pithy, short post out of the exhausted recesses of my brain. So when a study came across the wire touting extended formula feeding as a risk factor for a certain kind of childhood leukemia, I stuck my fingers in my ears. (Well, I posted about it on the Facebook page, but that’s kind of like the passive aggressive form of social media, isn’t it?) And a day or two later, when the Interwebz started buzzing about the British version of the infamous Burden of Suboptimal Breastfeeding “study”, I shoved a pillow over my head and sang the soundtrack of Beauty and the Beast really loudly (that’s what’s popular with the Fearless Children these days. It’s a great soundtrack and all, but seriously, how many times can a person hear Be Our Guest without going nuts? Although I did recently discover this YouTube gem, which has given Little Town – or, as Fearlette calls it, “Belle Sahwng” – a whole new meaning…).

One is named “Twitter”, the other “Parenting Science”

Unfortunately, I’m realizing that there is far too much inaccuracy and fear mongering going around to ignore. I don’t think I have the mental capacity to write a whole long diatribe, but I do want to address a few memes that are spreading like a California wildfire.

Courtesy of the UNICEF “Preventing disease, saving resources” report, I recently saw a discussion of how in the UK, only 1% of women are breastfeeding exclusively at 6 months. The consensus was that since formula feeders are so obviously in the majority, there is no need for them to feel marginalized.

I was shocked at that 1% statistic, and when I first heard it I was seriously blown away. But let’s look a bit closer at what the report actually says:

“….the proportion of women still breastfeeding at six weeks after birth increased by only a few percentage points between 2000 and 2005 – to just under 50% (Bolling et al, 2007). Rates of exclusive breastfeeding are much lower – only 45% of women reported that they were breastfeeding exclusively at one week after birth; fewer than 1% were still doing so at six months (Bolling et al, 2007). The rapid discontinuation of breastfeeding in the early days and weeks after birth, seen consistently since national surveys began in 1975, has only marginally improved to date, demonstrating that women who start to breastfeed often encounter problems, whether socio-cultural or clinical in nature, and stop. Ninety per cent of women who stop breastfeeding in the first six weeks report that they discontinue breastfeeding before they want to (Bolling et al, 2007). As a consequence, women can feel that they have failed their babies (Lee, 2007), and the great majority of babies in the UK are fed with formula in full or in part at some time during the first six months of life, and by five months of age, 75% of babies in the UK receive no breastmilk at all.” (p. 35)

First things first: notice the amount of 2007s in that paragraph. Yup, the stats they are citing are from a 2007 report, which offered statistics gleaned from a 2005 infant feeding survey. 

Aw, come off it FFF, 2005 wasn’t that long ago.  Things can’t have changed all that much in 7.5 years. 

Well, let me just say this: I want to see statistics from at least 2010. (They have them, but these 2010 survey results do not include information on duration, just initiation.) I have a gut feeling, from my reading of the research and observations I’ve made from the sheer number of emails I get from our UK sisters, that things have changed. In a Twitter conversation tonight, someone with an adolescent son mused that if social media had been around when she was a new mom, her postpartum experience would have been markedly different. The advent of social media has changed the infant feeding world – yes, it may only be on a sociological level, and we may not yet be seeing huge statistical jumps in breastfeeding rates, but both breastfeeding awareness and pressure have increased since new mothers began spending more time on Twitter and Facebook than in mommy-and-me groups, or with their sisters, friends, or mothers.

Additionally, the last sentence of the paragraph – perhaps the most jarring- carries no citation. If we don’t know what they are basing this on, it’s hard to say if it’s hard fact, or merely an assumption by the authors. (Oh- and that reference to women feeling like they have “failed their babies” rather diminishes its citation, Ellie Lee’s landmark 2007 paper about how morality plays into the infant feeding debate. From what I gathered from her work, these women do feel they failed their babies when they switch to formula because they are MADE to feel that way by society- not because they have an innate sense of wrong-doing. I think this allusion ignores a large piece of the puzzle, and allows the authors to pay lip service to formula feeders while simultaneously perpetuating the cycle of shame. Then again, I’m already ornery, so maybe I’m over-analyzing this.)

What strikes me as odd is that I recently saw this press release, also from Unicef, applauding NHS for achieving a landmark: 8 out of 10 British babies are now breastfed, thanks to the Baby Friendly Initiative. Obviously, this is referring to initiation rates, not duration, so it’s apples and oranges. Any yet, the difference in tone confuses me – if the rates are going up, and it’s a cause for celebration, why the pessimism in this new UNICEF report?

I don’t doubt that UK breastfeeding rates are lower than most Western nations. That’s been the case for awhile. But even in Norway, exclusive breastfeeding rates at 6 months are pretty abysmal. That’s because… wait for it… most babies have received some solids by then. Even before the 6-month “ready for solids” party line started being questioned, most moms were letting their babies try a bit of rice cereal or some veggies between 5-6 months. Exclusive breastfeeding means exactly that – exclusive. As in NOTHING BUT BREASTMILK. This 99% of women not exclusively breastfeeding at 6 months back in 2007 was not necessarily a group of supplementers or early weaners – they could just as well have been people who cheated a bit on the 6-month rule for solids. (And more power to them if they did, considering some experts – and many moms- believe that when to start solids should be an individual thing, and based on a baby’s readiness anytime between 4-6 months).

The thing that scares me is that this paragraph – oh bloody hell, this whole report – is based on the assumption that no journalist or policy maker is going to take the time to dig up every cited study, or to pay attention to where the statistics are coming from. I would say the majority of people (shall we say 99%?) are going to assume that this paragraph translates to only 1% of women nowadays, in 2012, are making it to 6 months without using formula and that, my friends, is simply not the case.

Stupid thing to obsess about, right? Well, it might be, except this kind of confusing rhetoric is used throughout the report. They make a big stink about only using “quality” evidence, stating that the costs to British society would be far greater if they were able to use the plethora of less-conclusive scientific literature which links “not breastfeeding” (the word “not” is italicized every time it appears in this context. Kinda weird…) with things like ovarian cancer, SIDS, adult obesity, and Celiac disease. As it stands, they have calculated the health care costs of treating diseases primarily seen in non-breastfed babies: ear infections, gastrointestinal infections, respiratory disease, and necrotising enterocolitis, as well as breast cancer in mothers.

But what exactly does this “robust evidence” consist of? The authors thoroughly vetted the studies they used to determine the rates of specific diseases – so much so, that the outcomes were often based on one or two studies (like in the case of ear infection), as well as a few used for “corroborative evidence”. This report was not trying to determine the quality of breastfeeding research, nor does it purport to offer new evidence for the correlations they site. Rather, they are simply going through, deciding which studies to use based on specific criteria, and using those outcomes to determine economic savings.

(FYI, the authors admit that they leaned heavily on the Burden of Suboptimal Breastfeeding methodology to calculate their own costs. Please refer to our friend Polly over at MommaData for a good breakdown of why this method is inherently flawed.)

The report, which was distributed to and covered by every major media outlet in the UK, is lengthy and exhaustive – great for researchers, not so great for journalists. I doubt many who reported on this study read all 104 pages, including citations; I doubt many understood that the goal of the report was not to determine whether any of these conditions are actually caused by not breastfeeding versus being a matter of correlation too muddled by confounding factors, but rather it went under the assumption that these diseases/conditions were in fact PROVEN to be directly influenced by suboptimal breastfeeding. Get it? Report= economic case for breastfeeding. This is not a study proving anything new.

I admit that this report is far more palatable than its Yankee counterpart. There is legitimate attention paid to why women aren’t breastfeeding, and it even references studies and literature about the guilt and feelings of failure which occur when women cannot breastfeed (if somewhat incorrectly – see above reference to Ellie Lee). I appreciate that. But just as I worried (justifiably, it seems) with the Burden of Suboptimal Breastfeeding, I fear that this will be adopted into the infant feeding canon, and used incorrectly to support a myriad of other studies. This is how it works, unfortunately.

I also want to mention that the lead author of this study is Mary Renfrew, who has been quoted as saying that “women are born to breastfeed”. To me, this rings of bias, which can easily lead to confirmation bias. And when you’re basing a report on the opinions of a few key people as to what is considered “quality” evidence… I wonder if a neutral party would have given this study more gravitas. Good luck finding a neutral party in this field, though…

Moving on. The next hot new thing on my Twitter feed is a study which links childhood leukemia with a longer duration of formula feeding. This study may very well be credible. I have no idea, and neither does anyone else commenting on it – because it isn’t published. It isn’t even peer reviewed. And yet it is flying through the airwaves, causing squeals of “formula feeding causes cancer!!” in a manner that echoes with thinly veiled I-told-you-so’s.

But that’s not even the interesting part. Let’s go under the assumption that this study will come out and be stellar and scientifically sound (because we can’t really do anything in terms of dissecting it until we can see the damn thing, anyway). According to the study, do you know what also carries a comparable risk of childhood cancer development? Later introduction of solids, regardless of infant feeding method. Breastfeeding alone did not have a significant effect, but rather the length of time using formula, and the length of time the child went without solids in their diet.

I haven’t seen one freaking tweet about the solids thing. Not ONE.

I may well be a Defensive Formula Feeder, as one beloved lactivist blogger has knighted me, but here’s what I don’t get: one of these (assumed) correlations supports advocating for an act which often involves major social, emotional, physical, and economical sacrifice on the part of women. (It shouldn’t, but right now, in our society, it often does.) The other correlation just implies that you need to start giving Junior a daily dose of butternut squash around 6 months of age. Why are we so focused on the one that is complicated by socio-biological factors, and not one the one which would be easy for most parents to incorporate into their child-rearing?

I’m not pissed about the studies, people. I’m pissed because THIS is how we’ve arrived at this place. This place where women are being pitted against each other; this place where we are made to feel responsible for the wealth and health of the nation, so that our governments can spend a few bucks pressuring women to breastfeed rather than figuring out real ways to enhance socioeconomic disparities; this place where one can’t question the intentions or quality of a research paper without being accused of being anti-breastfeeding or anti-mother or anti-science.

Speaking of Beauty and the Beast…this game of championing-research-which-can-mislead-and-and-scare-new-parents-before-stopping-to-fully-comprehend-it reminds me of The Mob Song (my son’s favorite). As the townspeople march towards the Beast’s castle with fiery torches, they sing: “We don’t like what we don’t understand- in fact it scares us, and this monster is mysterious at least… here we come, fifty strong, and fifty Frenchmen can’t be wrong…”

Imagine those Frenchmen with Twitter and Facebook accounts, multiply them by about 1000, and you have a great explanation of what’s wrong with social media and parenting science, my own personal two-headed Chimera.

 

 

 

FFF Friday: “Didn’t I have a right to know that I might not be able to breastfeed and why?”

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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 I hope we can all give them the space to do so.


I was in need of a good laugh today, so I thought I’d share this fantastically funny FFF Friday submission by Melissa.  I’m betting you’ll find her writing as witty as I did, but be warned – underneath the humor is a scathing indictment of what often passes for professional breastfeeding help. If you concern yourself with women’s healthcare, this post will likely hit you in the gut: first because you’ll be belly laughing, and second, because you’ll be as angry as Melissa over the sub-par level of care – and lack of honesty – she experienced while trying to breastfeed her daughter.

Happy Friday, fearless ones…

The FFF
***
My daughter was due November 8, 2011, so naturally being her father’s daughter, I arrived at the hospital on November 21st for an induction. I spent the first day (8 hours!) on pitocin (and nothing else) and…. nothing happened.
I’m trying really hard right now to keep this to my boobies and not write about everything else that happened and that still angers me about my birth experience. Let’s just say that the last thing a CNM should say to a lady who has been on pitocin for 8 hours without an epidural is to question whether said lady actually wants to have this baby and tell her she needs to visualize having the baby and think about what is emotionally blocking her from giving birth to the baby, as though one can think POOF! World Peace!
Ahem. Fast forward, the next morning, I was again on pitocin until I called uncle around 1 PM and got an epidural. Then things got exciting.
By 9 PM, I was ready to push.
By 10 PM, pushing had done nothing.
By 11 PM, baby’s heart rate was doing a weird dance with every push.
By 12 PM the drugs were off and I was being prepped for a C-section.
At 2:03 AM, November 23rd, little E finally made her grand entrance into this world.
By 2:15 AM, Mommy had proceeded to completely lose her shit over things the doctor said while putting her back together, and someone was kind enough to drug her up well and good such that she thought she was in New Orleans on Mardi Gras when she woke up in recovery….
E figured out the latch thing immediately, and I thought we were cruising. Sure, it hurt like hell and someone probably should have brought me a nipple shield before she turned the left nipple into a bloody mess, but I was expecting all this. I was okay with all this. I was patiently waiting for the milk to come in, feeding her every 2-3 hours, loving watching her sweet little face and hands at such a close distance… And everyone said that it takes longer for your milk to come in after a c-section, so I wasn’t worried when I had no milk by day 2. I figured I had colostrum, she’d eat that, and the (still the same size as before I was pregnant) boobies would do their thing.
By day 3, the nurses had taken to checking in with us every half hour to see if E had peed yet (she hadn’t). And she was rather orange, even to my untrained eye… By then I’d started pumping between feeds on the lactation consultant’s (number 1!) advice, you know, to speed things along because my milk was totally coming… E was angry, screaming, and sucked away on my breasts like there was no tomorrow. She’s more efficient than a pump, they said, so when she fell asleep on the boob that must have meant she got something to eat first, right?
Then the nurses started in with the jaundice talk and someone said she might just need to stay an extra day after I was discharged, you know, if she was still yellow. And that was a wake-up call, because after two days on pitocin without an epidural and an unexpected c-section, I’ll be damned if I’m leaving the hospital without my trophy-baby to show for it. I think we called up the nurse right then and there and brought in a bottle of formula. E sucked it down like she had been starving. Because, you know, she was. By this point she’d lost a full pound of her 7 pound 12 ounces weight.
We left the hospital the next day with E and a hospital grade pump. I pumped. And pumped. And pumped. I hired a new set of lactation consultants (number 2!) who came to my house, weighed E, put her to boobie (she latched on, perfect), then weighed her after 45 minutes on each boobie (no change in her weight at all). They looked at me. They looked at boobies. They made notes. They discussed. They mentioned words to each other that I’ve never heard of, like “IGT” and “tubular” and “one is significantly larger than the other”… and never once did they mention that this might mean I wouldn’t ever get enough supply to feed my baby.
I kept on with the pumping, because new lactation consultants thought it would increase supply. I bought supplements. I drank massive amounts of water in hopes it would clear up massive c-section swelling (did I mention, I still couldn’t bend my knees?). Finally, on day 6 after the birth of my daughter, I got something resembling milk from one boobie… and on day 7, something resembling milk from the other boobie. Success!
Except, my boobs were still the same size. They never got bigger. And I continued to pump and pump and pump and pump… and nothing changed. New lactation consultants (number 3!) were called. Lactation consultant number 2 texted me questions to see how it was going, and when I told her I was pumping every time after she nursed, and still getting just trickles, she offered things like a clear plastic tube attached to a syringe to supplement with the formula I was already giving E. Or to come let me rent her scale for a weekend. Or to come back and do a weight check. Or double check the latch. Or something.
By week 2, I was a mess and my supply had not increased.
By week 3, E had gone on strike agains the boobies, refusing to latch on at any time other than 4 AM after our longest stretch of sleep (when they were most likely to have gotten enough stored up for her to be happy for a little bit). So I pumped and pumped… By the end of Week 3, I was pumping every three hours and E was eating 90% formula and 10% what I made.
By week 4, that had changed to 95% formula and 5% what I made.
By the end of week 4, I had an allergic reaction to the supplements and stopped them cold turkey. My “supply” tanked – I went from making a total of 3-4 ounces a day to less than 15 ml. a day.
At that point, I’d had it. I was tired, I wasn’t enjoying my daughter, and I found myself on Christmas morning strapped to a pump in our living room while my husband made silly noises over our baby and drank his coffee. I stopped cold turkey a few days before New Years, and dried up almost immediately. No pain, and boobies were still the same size as before I got pregnant. I was sad, but resigned, figured it was the long labor or c-section, or all of those things that had made breast feeding not work.
Then I started researching.. and I figured out what IGT was. What tubular breasts were. What those words the lactation consultants had mentioned to one another meant. That I might never have gotten enough supply in, even had I not had a c-section or been swollen beyond recognition. Even if I had woken up that extra hour early during our one 4-5 hour sleep stretch every day. Even if I hadn’t supplemented with nasty formula in the hospital. And every single one of the warning signs listed for IGT, I had in spades. My boobs have always been different sizes, with the left larger than the right. Yes, they are tubular, not that I knew that but I had always known they weren’t a full as the Barbie-like ones I saw on TV. And they didn’t change size at all during pregnancy. Boy, was that a warning…
And then I was angry. Because these ladies I had hired to help me breast feed, every single one of the three different consultants I hired, they either knew or should have known, and didn’t I have a right to know that I might not be able to breast feed and why?  How dare they not tell me. How dare they assure me that these steps I was taking would increase my supply, just keep trying, keep doing, keep putting her to breast even when she is screaming-hungry.
I look back on those first few weeks with regret; if I had known that my boobs were tubular, that the lack of growth during pregnancy (and after birth!) might mean something regarding supply, that never feeling engorged, or feeling really much of anything, might indicate the milk just wasn’t there and wasn’t going to be there, would I have wasted so much time with the pump instead of spending it sleeping or cuddling my daughter or recovering from major surgery? Would I have spent so much time feeling guilty and debating stopping the crazy pumping schedule? Would I have felt so guilty when I decided enough is enough?
E is almost 5 months old now. She’s hitting every one of her milestones early; she’s been in daycare since mid-February and has had precisely one cold, and she barely noticed it. She’s the happiest, sweetest little girl, and she’s 85th percentile in height and weight. And most importantly, she’s a good eater, a good sleeper, and she’s healthy.

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