Category Archives: guilt

Getting a grip on the Strong Mom Empowerment Pledge Controversy

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The latest outrage in the breastfeeding advocacy world doesn’t have to do with dying children in resource poor nations, or bogus “breastfeeding advice” hotlines run with the nefarious goal of undermining a mother’s goals. It’s not even about someone questioning the benefits of breastfeeding, or urging the government to rethink some of its public health messaging.

No, this week’s rage-fest is over a campaign asking women to pledge not to bully one another based on their parenting choices.

Sound silly? Well, according to a handful of well-respected bloggers, it’s about as silly as a car wreck. This is because the campaign is sponsored by Similac, a formula company, which has everything to gain by women feeling “empowered” to use their second-best (or fourth best, if we’re going by the WHO hierarchy) product in a world made less judgmental by a pledge such as this.

On a purely anti-capitalist, anti-marketing level , I understand why some may feel a little queasy about this campaign. I’ve seen some backlash against the Dove Real Beauty ads for the same reason – the message is great, but the fact that it was created by a group of advertising executives rather than a non-profit, purely altruistic group, sullies it. There’s an ad term for what Dove and Similac are doing – the “halo effect” – meaning that when you use the product, you’ll have positive, do-gooder type feelings about it. Coke’s done it, too. (Remember that catchy “I’d like to teach the world to sing” jingle? Halo effect, right there.)

I assume this is what was behind tweets I came across today suggesting that formula companies have no place talking about parenting issues. My counter argument to this is that many of us formula feeders feel abandoned by the parenting gurus (paging Dr. Sears) and in some cases, even our own pediatricians – the message we receive is that if we’re formula feeding, we’re pretty much a lost cause. So while I can’t say I’m thrilled that a formula company stepped up to fill this gap, I think we need to think a little more critically about why the gap was there in the first place.

For the record, with this particular campaign, Similac isn’t giving parenting advice, but rather advocating for an end to mother-to-mother judgment. More of an anti-bullying campaign than anything about parenting issues. Which is probably why they have Michele Borba as one of the spokespeople – she’s a well-known expert on bullying as well as parenting issues, but she barely deals with the infant/toddler set. For that matter, I don’t think babies are mentioned at all in the campaign literature –most of it has to do with embracing your parenting choices and not allowing other people to make you feel less-than.

But I’m not even all that interested in discussing the campaign itself – I’m more concerned with the response to it. Comments I’ve seen; articles I’ve read from some folks I have utmost respect for, but whom I feel really missed the mark on this one. Some of these arguments include: Similac has no right to talk about mommy judgment because formula feeding shouldn’t be a lifestyle choice; the bloggers who came on board to support the campaign are sell-outs or shills for Big Forma; and that the campaign is one big booby trap.

In a thought-provoking and controversial NY Times Motherlode column, KJ Dell’Antonia quotes Kimberly Sears Allers, who maintains that the Strong Moms Empowerment campaign is faulty because formula feeding is a public health issue, not a personal choice:

One centimeter beneath the surface of Similac’s “Strong Moms” Summit and online campaign you will find that framing of infant formula use as a “lifestyle choice” that is not to be judged has been its primary marketing strategy for decades. … And since choices are individual, they have no social consequences; women are therefore relieved of responsibility of considering the broader implications of their decisions. And once I make my choice, no one is to challenge me. We can’t talk about it. And if you do, you are judging me.

Admittedly, I’m taking major poetic license here, but my take-away from Allers’ post was that we can’t not judge other moms for doing something which puts babies at risk. KJ’s own argument is more nuanced and balanced; she suggests that this whole conversation has become too personal, and the “judgment” rhetoric just dilutes the real issues.

I agree with KJ, actually – it’s a point I’ve made myself, in my own somewhat pissy rants about how the only anti-breastfeeding-promotion opinions we hear come in the form of personal stories (which are important in their own right – don’t get me wrong – but hardly a match against scientific studies and “fact”-driven articles). But making things “less personal” doesn’t just mean that every blog post discussing breastfeeding must stop devolving into a who-had-it-harder string of comments. The onus can’t purely be on those whose choices are being questioned to buck up and be “strong”. If we’re going to make it less personal, than breastfeeding advocates cannot be in charge of conducting research on infant feeding. We need to ensure that voices from both sides are heard, so that formula feeding mothers don’t need to sit in awkward, shameful silence while the food that so beautifully nourishes their infants is compared to tobacco, lest they be accused of “taking things so personally”.  And outlets like the New York Times need to post intellectually-driven or research-based pieces from the “other” perspective, rather than just personal stories of breastfeeding failure, so that the conversation isn’t so one-sided.

But I think, in some ways, KJ’s point gets convoluted by Allers’ quote. It can’t not be personal, when a woman’s decision to formula feed is being equated to a public health issue. This is where the misinterpretation of risk within the breastfeeding canon is problematic; it is where people like Joan Wolf are so vitally important. And yet, Joan Wolf can’t participate in the conversation because it has become so personal: her assessment of the literature is brushed off as anti-breastfeeding, lost in the fervor of those who fear that discussing breastmilk as anything less than a miraculous and perfect substance, and breastfeeding as anything less than a moral imperative, will negate their admirable efforts to normalize what should be a human right.

The other common refrain in the past few days is that formula feeding mothers should be offended by this campaign. I’m crying foul. First of all, I take issue with breastfeeding advocates speaking for me – someone who felt completely ousted, chastised, and disenfranchised from their community, and their ideal of good mothering. Just like I will never know the hot rage felt by a nursing mom who is asked to leave a restaurant, someone who has a fundamental belief that breast is best will never know what it feels like to be told that your maternal instinct is faulty, due to susceptibility to marketing, stupidity, selfishness, or some combination of the three.  To hear a company which created a product that nurtured my babies echoing the same sentiments I’ve been preaching for years – that the judgment must stop; that moms need to stop fighting each other and work together for better parenting rights; that women need to stop engaging in sorority-level hazing in order to wear the label of “Good Mommy/Good Radical Feminist/Strong Woman – makes me happy. I don’t feel preyed upon; I am well aware that they are hoping to sell more formula, and you know what? If I had to decide between a brand that is marketing to breastfeeding moms and one that is finally trying to appeal to its actual audience, I’d probably choose the latter.

Someone commented on the NYT article that it would’ve been nice if this campaign came from an individual or group without profit-driven motives. Spoiler alert: that would be me. That would be Bottle Babies. We’re out there, doing this. But most people aren’t aware of us – we each top out at about 3k Facebook followers, opposed to the popular breastfeeding blogger-activists, who are all in the 200k range or higher (some of whom, incidentally, could benefit from a pledge not to bully other moms. Just sayin’.)  We have nothing behind us – no advertising, no sponsors. No money. It’s slow going, trying to make a dent, attempting to create change in a positive and real and measured way. We waste a lot of time defending ourselves against accusations of working for the formula companies; of being anti-breastfeeding; of being uninformed and defensive.  And trying to run our ad-free websites and blogs and attend conference on our own dime and BE HEARD when there are so many more powerful, louder people out there. I realize this sounds like a whiny me-me-me rant, but I’m trying to paint a picture here – because it helps explains why I’m okay with the Similac campaign. Until the indie, unsponsored voices are able to reach the masses, I’m just happy that someone can. I’m happy that women who are feeling judged and guilty and embarrassed about their choices, who are forced to read “Breast is Best” every time they see a formula ad, or open a can of food for their baby, can finally have an opportunity to feel good about the product they are using. That for once, we can feel like part of the sorority – part of the “empowered” group – even if it’s all manufactured and for profit, even if it’s bullshit.  It’s not even about the cheesy “empowerment” pledge – it’s about seeing a formula company treat formula feeding as something matter-a-fact, rather than constantly comparing itself to breastmilk, and in a more subtle and unintentional way, comparing formula feeding mothers to breastfeeding mothers. It’s about being able to feel okay about the way a formula company is operating, rather than cringing at how they are sending free samples to moms intending on breastfeeding (rather than those of us who’ve filled out the damn internet form 300 times and never received a single coupon, but I digress) or marketing some asinine product (like the company in question, with its new “formula for supplementation”. Jesus, Similac. I’m wasting time defending you and then you pull something like this? For real?)

Yes, it’s not perfect. But it’s a start. And if you think it’s sad that we are so desperate for acceptance and celebration that we are willing to get into bed with a formula company that thinks of us like an easy booty call, I’d recommend taking a long, hard look at yourself: at the comments you make; the Facebook posts you share; the policies you write; the initiatives you implement; the articles you publish.

Because yes, it is sad. It is sad that Similac has been able to capitalize on this need. It is sad that there is the need to capitalize on. And it’s sad that those who have created that need are refusing to see how implicit they are in the development of such a sad situation.

It’s just sad.

 

“Where is the mother in the discussion?” An interview with Walker Karraa on maternal mental health and infant feeding

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Some of you may know Walker Karraa from her comments on our Facebook community page, or from her fantastic posts on Science & Sensibility. But I doubt you’re aware of the full magnitude of her bravery and dedication to issues surrounding maternal mental health. I recently interviewed Walker for a short piece on formula feeding and postpartum adjustment, and was so blown away by her answers – I was only able to use a few of her wise words due to word count constraints, so I’m thrilled she’s agreed to let me post the interview in full here on FFF.

Walker is a doctoral candidate at Sofia University, where she is conducting a study on the transformational dimensions of postpartum depression. She was also the founding President of PATTCh, an organization founded by Penny Simkin dedicated to the prevention and treatment of traumatic childbirth, and is a perinatal mental health contributor for Lamaze International’s Science and Sensibility, Giving Birth With Confidence, and the American College of Nurse-Midwives (ACNM) Midwives Connection. Like that wasn’t enough on her plate, Walker also served as social media manager for the Integral Leadership Review, and has her own social media consulting business, On My High Horse, and is currently working toward co-authoring a book regarding PTSD following childbirth with Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA. 

I’m exhausted just reporting all of that. And did I mention she has two kids and is a breast cancer survivor? Yeah, she’s all that and a bag of reduced fat potato chips.

I hope you guys will appreciate the revolutionary nature of Walker’s discussion here – her opinions, while brilliant, probably seem uncontroversial to those who follow this blog, but they are quite “rogue” in the birth/maternal-child health community. I can’t thank her enough for being a dissenting voice and speaking up for the benefit of all women. 

FFF: Here on FFF, we see stories almost weekly which discuss how a perceived “failure” to breastfeed can lead to depression, anxiety, and self-esteem issues. Do you think the maternal mental health community has recognized how breastfeeding (or lack thereof) can affect the emotional state of new moms?

Walker Karraa

WK: I think that overall breastfeeding is very well addressed in the health psychology, and developmental psychology fields. What’s lacking is the reframe of the research to integrate more qualitative data, and methods, into the consideration of the full range of implications of breastfeeding from multiple perspectives—including the woman’s perspective.

In a 1985 Lancet article on maternal mortality, Allen Rosenfield asked the famous question, “Where is the ‘M’ in MCH (Maternal Child Health)? In the discussions of MCH, it is commonly assumed that what is good for the child is good for the mother.” (Rosenfield & Maine, 1985, p. 83). In many ways this is relevant in the discussion of breastfeeding and maternal mental health. Where is the mother in the discussion? And in what ways do we still assume what is good for the child is good for the mother? For me, this is all about reproductive rights and a deeper issue about our discomfort with women’s sovereignty over their reproductive, physical, and mental health.

The mental health community has responded to the growth in published data regarding infant health and breastfeeding. This has also been the funding stream for a large part of the last 20 years. But maternal mental health has yet to directly address a woman’s infant feeding choice as a part of her reproductive choice, rather than discrete periods of time that occur with as a continuum of events that are inextricably woven through reproductive events—none of which, taken by themselves, gives either the best data on mental health.

FFF: What do you feel needs to change in order for new mothers to be better supported in terms of mental health in general?

WK: I think one of the first calls to action must be for maternal care providers to get support in knowing that perinatal mood and anxiety disorders are common and create the conditions for morbidity and mortality for mother and children. This is starting to happen, but still very slow. I think new models of medical care such as Dr. Michael C Lu’s life course model, which places the woman at the center of care, not the doctor. And, she is treated across the lifespan, not merely when she is pregnant. This facilitates better reproductive health in preconception and interconception, and uses a reproductive life plan for women and families from an early age. At puberty, to have a conversation with medical, nutritional, mental health providers as to planning one’s reproduction (girls and boys) would be ideal.

FFF: Many women struggle with the decision of whether to treat postpartum or prenatal depression/anxiety with psycho-pharmaceuticals, especially when they are breastfeeding. Why is there such mixed information and messaging about what drugs are safe, and what the relative risks are (ie, breastfeeding without meds vs breastfeeding on meds vs formula feeding and taking the meds)?

WK: Not having good information is a barrier to care for everyone involved. The OB/GYN or midwife, the social worker, the woman, her partner and family—when we don’t have good information, we cannot make informed choices. And for women in poverty, the risk is twofold. Specifically regarding breastfeeding, but also education across the board regarding psychopharmacology, pregnancy, and lactation. With organizations such as OTIS (Organization of Teratology Information Specialists) and Motherisk, there really is no excuse for not having current evidence-based data regarding risk and benefit of untreated depression and anxiety, as well as risks and benefits of medications used to treat them.

Byatt et al. (2012) did a wonderful grounded theory study regarding community mental health provider reluctance to providing psycho-pharmacotherapy. 28 obstetric care providers (nurses, OB/Gyns, etc.) shared how they perceive community mental health practitioners as obstacles to psychopharmacology for perinatal women. The participants felt community mental health providers “99% of the time” discontinued a patients’ medication, and put women at risk of relapse. Secondly, Byatt et al., (2012) reported that participants perceived a lack of collaboration and communication between community mental health care providers and OB/Gyn providers, and that pharmacists also “further impede or delay depression treatment by not filling needed psychotropic prescriptions, often exacerbating women’s mental health symptoms” (p. 3).

FFF: Why do you think so many women express grief, guilt, and feelings of failure around the subject of infant feeding?

WK: Because that is their experience! And I attribute all of it to social constructs that are completely ingrained in medical, social, and mental health systems that have been made for and by men. The intentions of those men is not necessarily nefarious, and not really the point. It is that the constructs we have to measure ourselves (abilities and weaknesses) are made by men. We tell women from the get-go that they need us to be good mothers. They need our insight, knowledge, treatment, book, video, technique, services, product to be taught how to mother. This is so ironic, because so many of the birth movements have evolved from a call to empower women. But to empower, we have just made more systems of knowledge that mimic the ones we refute. That is not very popular to say, but it is true. The messages still given to women is that if they “know” something analytically, they are devoid of femininity, and if they “know” something inter-subjectively, they are devoid of ration.

Shame is a powerful force for women. And at no time in her life is a woman more susceptible to shame than early motherhood. If they are lucky enough to find a safe space to share their feelings without judgment, such as your blog, they are given the gift of voice. They can speak their truths.

FFF: Any tips for a mom who is having a tough time reconciling her use of formula?

WK: You know, when I was a doula, I had clients ask me to go buy formula for them so they wouldn’t be seen in public. When I was diagnosed with breast cancer shortly after the birth of my second, I underwent two mastectomies before she had turned one. I learned that my body parts have nothing to do with my inherent ability to love her. My breasts were gone—off of my body, one in one hospital and another at a hospital down the road. I fed, nurtured, attached with, loved, and parented without them…and still do! So my advice is to write down on a piece of paper: My breasts have nothing to do with my love for my child. And keep it where you can see it. Memorize it, know it.

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.

 

 

The more things change, the more they… change.

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I had an interesting conversation the other day with someone who read the galleys of my book.  This woman breastfed two children successfully in the late 80′s and 90′s when this feeding method was certainly not the norm; breastfeeding rates didn’t start really going up until the past decade, when campaigns like the log-rolling, mechanical bull-riding DHHS one began to to kick things into high gear.

Anyway, she had a good experience breastfeeding; she told me she never really experienced much pressure in either direction, and while she was aware that breastfeeding had become far more of an issue in society, she had no clue that formula feeding had become so vilified.  Her exact words were “I had no idea how bad it had gotten.”

I know it sounds ridiculous, but this comment provoked a tremendous revelation for me. Imagine a cartoon image of the FFF (imaginary-draw me with a better figure and less wrinkles, will you?) being hit with a lightening bolt, next to the caption “Doh!“

Of course this person didn’t know how bad it had gotten. She hadn’t given birth in the last 5 years, when the pressure to breastfeed has gotten so ridiculously out of control. And neither have the vast majority of big-time breastfeeding advocates or policy makers, let alone the folks reading the various newspaper editorials and commenting on the heated threads of media-reported breastfeeding studies.

See where I’m going with that “Doh”?

I have had two kids in the past four years, and honestly, I saw a marked difference in the amount of breastfeeding pressure I experienced from one baby to the next. In 2008, it was tough to end up in the formula feeding category; still, most of the vitriol I encountered was the online variety, save for a few  overbearing physicians and mommy-and-me instructors. By the time I delivered Fearlette in the end of 2010, even my childless, motorcycle-driving, gun-wielding neighbor threw me a look when he saw my bottle. And since I have my eyes on what’s happening in the breast/bottle scene, I can say without a doubt that things are just getting worse.  I don’t know if these changes were spurred by Hannah Rosin taking a stand, or Joan Wolf questioning the science, or the Call to Action announced by the US government - but one thing is clear: infant feeding has become part of the national dialogue, and gone far beyond a trivial mommy war.

Mary wore the hairshirt, sans the “F”. Source: Wikipedia.org

If you were a breastfeeding advocate who’d had children before this new front blew in, you might think my pleas for a ceasefire are nonsensical. Kind of like when my mom complains she’s cold on a temperate, 78 degree day. But then again, my mom happens to be super-skinny (like 85 pounds soaking wet), and those without any padding can have issues with temperature regulation. Likewise, women giving birth today have been stripped of the padding when it comes to breastfeeding pressure; no longer are we cushioned by “encouragement” to breastfeed, but rather thrown out onto a cold street with a hairshirt labeled with a big, scarlet “F” should we fail to meet expectations; if we end up being “suboptimal” in our feeding methods.

If you’d been a new parent in a different, not-so-long-ago time, you might think things aren’t so bad. You might brush off feelings like guilt, saying that “no one can make you feel guilty”. That’s easy to say when no one has told a 3-day postpartum You that your inability to breastfeed, or your choice not to, is damning your child to a life of poor health and low intellect. (It’s also easy to say when you’re someone who has never been through this kind of hell, or when you have a penis rather than a vagina and are therefore of the non-lactating persuasion.)

If you’d been a new parent back in, say, the 1970′s or early 80′s, when breastfeeding rates were at an all-time low, it might be easy to laugh at the stories we tell on this blog. Because nobody’s really telling formula feeders they are bad parents. It’s being a breastfeeding mom that’s hard. (Which don’t get me wrong, it can be. I think you’re damned if you do, damned if you don’t, in this regard. But that doesn’t mean formula feeders have it any easier- it’s just that our challenges come in different flavors. My platform is that we can’t protect one group of parents by shaming or neglecting the other – we all need to be supported in feeding our babies in the way that works best for our given situation.)

If you’d been a new parent even ten years ago, when breastfeeding began to be more popular, but three months was considered medically sufficient, and six months was considered ideal, you might not fully comprehend what this breast/bottle debate is all about. You might think hey, it wasn’t so hard to breastfeed, not realizing that by today’s standards, the fact that you stopped after 4 months and had been giving relief bottles every now and then would be considered abject failure by many respected experts.

If you haven’t given birth or adopted an infant since before Obama was in office, and don’t plan to again, you might not care that much about infant feeding “wars”. And that’s okay; I get that many things begin to take on graver meaning, like ensuring a good education (we’re facing that now and I swear I’m *this* close to closing down FFF and starting the Fearless Public School Parent in a Really Awful, Underfunded District blog, but then I remember Sandra Tsing Loh beat me to it), drugs, teen sex, and so forth.

But for the breastfeeding advocates, physicians, psychologists, and media pundits out there, whose voices matter in this discourse: please, for the love of god, take a minute to consider that things may have changed dramatically since you were buying Size 1 diapers. This has nothing to do with the benefits of breastfeeding, nor am I belittling your efforts to make the world friendlier for nursing moms (which I appreciate and thank you for), but it is important that you realize this fact. You need to understand what it is to be a mom in 2012, when the internet has all but usurped the “real” world; when Facebook pages are not just about reconnecting with high school flames but are used to discuss parenting styles and form “groups” which simply exist to hate on other peoples’ choices; when a scathing blog post has the power to change the face of advocacy in a disturbingly negative way; when the media has covered stories which state that women who “fail to comply” with breastfeeding recommendations are costing our country innocent lives and billions of dollars.

I know everyone says the more things change, the more they stay the same. In this case that does not hold true. Things are not the same. The sooner society at large realizes this, the sooner this discussion will begin to evolve.

Or at least I hope it will. If it doesn’t, the silver lining is that I think I’d look pretty cool in a hairshirt.

The long-term effects of formula feeding guilt

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You may have noticed a post from a doctoral candidate named Danna over on the Facebook page, asking for help on a study she’s doing.

Danna emailed me and explained that she became interested in looking at the effect of breastfeeding promotion on mothers who end up formula feeding. She says that the studies she’s been reading “all interview the mothers about their bottlefeeding experiences and all mothers seem to be saying the same thing-that they are left to feel guilty and ashamed of their choice…I am curious as to what the outcomes are of moms who experience these guilty feelings, like do they overcompensate their mothering because of their feelings? Or do they hang on to this guilt until their children are adults themselves? Or is there really no difference at all?”

“My bottom line on the study,” she said, “is to get healthcare providers to change their views, or at least include bottlefeeding as a great way to mother despite all the breastfeeding hype. I mean really, breast is best but not for everyone and so we must adjust our teaching and thought processes if we are making moms feel so bad.”

Obviously, I am THRILLED that Danna is examining this issue, so I told her we’d help get her started by talking about this issue here on FFF (I hope you don’t mind me pimping y’all out a little).

After I received her email, I spent some time pondering her question. Did I personally feel like I overcompensated after “failing” to feed FC? (Things were a bit different with Fearlette, as I knew more at that juncture and made an informed choice to feed her formula, and didn’t feel guilty about it – at least from a health standpoint. Mommy guilt is kind of in my blood, being a Jewish mother.)

Thinking about the short term – i.e., the first year of FC’s life – the answer was an obvious YES. I was committed to making him organic baby food; I was afraid to bring him out of the house for the first 2 months because I was convinced he’d have a compromised immune system; every time he reached a milestone ahead of time I would breathe a sigh of relief, but when he was a little slower than his baby BFF to crawl, I was sure it was due to his lack of liquid gold.

In the long term, these feelings of guilt and inadequacy faded… but that is most likely because FC is the healthiest kid in his preschool class, and so smart that is scares me. Even if I didn’t know enough about the quality of breastfeeding research to realize there was nothing that awful to be freaked out about, the blissful anecdotal evidence that is my first child more than justifies my (non-) choice.

However, if things had been different and Fearlette had been my first child, and ended up with the same problems FC did with breastfeeding, and was formula fed by default… it would have been a very different scenario. Although she has blossomed into a strapping little moppet who more than lives up to her pseudonym, Fearlette’s first 6 months were rough. She was sick. A lot. Fearlette had ear infections, bronchiolitis, and her final sickness at 7.5 months was a freaking UTI. Now, to be fair, the kid also had a developmental delay of the sphincters causing a lot of these things due to reflux in not one but two parts of her body, which had fudge-all to do with formula, but I didn’t know that at the time she was going through all of this. I knew intellectually that she could have had all these problems even as a breastfed kid (just as a point of reference, one of my exclusively breastfeeding friend’s second kid was sick just as often as Fearlette, but the other two of my group who had babies at the same time and breastfed seemed to win the immune system lottery) and it probably had more to do with my irresponsible parenting (like letting her 2 year old, preschool petri dish of a sibling kiss and maul her without washing his hands, or allowing his germy friends play with her toys and not disinfecting them, or taking her to Disneyland at 8 weeks old… but hey. That’s being a second child, right? Humor me and say right, okay?) than what I fed her.

But had things been different and I was parenting her in the midst of breastfeeding “failure” and guilt, it would have been an absolute nightmare. And even though I don’t feel guilty, or think that if she were breastfed she would’ve escaped this fate, I do feel a bit defensive that Fearlette was sick so much, considering what people think about formula fed kids.

This is why I think breastfeeding promotion efforts that focus on how you can damage your child with formula are often punitive. It’s one thing to have a rational conversation with an expectant mom about the real-world meaning of the breastfeeding literature, along with suggestions for bottle-feeding and formula-handling techniques that might mitigate some of the formula-related “risks”; quite another to scream about how formula fed babies are fat, sickly, and dumb from the rooftops where many, many formula feeding parents – many out of necessity rather than choice – can hear you. If those parents happen to be dealing with any number of typical childhood ills (because no matter how we try and prevent it, kids get sick. Unless you are very, very lucky, or make them live in a bubble and never hang out in schools, classes, or playgrounds), they might blame themselves. And god forbid, if their child is suffering from an ill that is not typical – say, cancer – I don’t even want to think about how bad an effect these anti-formula rants could have.

I have noticed that quite a few breastfeeding “bullies” are former formula feeders, and 99% of the time, they say some pretty disparaging things about their formula-fed offspring: the bottle-fed kids were more sickly, less smart, have behavior problems, they feel less bonded to them, etc. I can understand why one would want to blame the formula for these issues rather than blame oneself , God, fate, or the fact that your kid was born under the wrong astrological sign. It’s socially acceptable to blame formula; everyone will feel sorry for you; applaud you as a reformed criminal who can now spread the Good Word about the powers of breastmilk to the masses.

I do wonder though, if the children of these rehabilitated formula feeders hadn’t had any problems, if they’d feel the same zeal. Which speaks to my hypothesis, which is that formula guilt only lasts until children develop well enough for parents to relax a bit about the dangers of infancy. Meaning that the people who will continue to feel guilty, and feel like they need to overcompensate, are the ones whose kids are suffering – whether it be from developmental issues, health issues, or behavioral issues. That worries me, because these parents have enough on their plates without heaping on extraneous guilt.

I believe that health care providers – and especially breastfeeding advocates – need to tone down their approach, if they care at all about children. A neurotic, constantly worried mom isn’t a healthy mom. Even if formula does give kids a statistical edge towards more ear infections, colds, stomach bugs or obesity, these things are fixable, for the most part. They can be treated, counteracted, and kids can easily come through unscathed. But if a child is raised by a mother who is spending so much time dwelling on her inadequacy that she is unable to enjoy motherhood, hurting her own mental and ultimately physical health with stress and guilt… this can have truly lasting effects. Emotional health deserves attention as well as physical health, and the emotional health of mothers who are unable to breastfeed – for whatever reason, because no one should be judging the validity of our reasons – needs to be taken into consideration.

What do you think? How long did your feelings of guilt last, if you had any? Do you think it will affect how you parent in the future? (Another topic for another day might be how these experiences made us better, more sensitive and autonomous parents, because I think that this is a very real silver lining of suffering through formula feeding angst.) Danna wants to hear from you, and so do I… so as my fellow Jewish mother, Linda Richmond (aka Mike Myers) would say, “Talk amongst yourselves…”

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