The Least Interesting, Least Controversial Post You’ll Read About That NYT Article

In the 1993 film Groundhog’s Day, a reporter (Bill Murray) gets stuck in an endless time-warping loop, which forces him to repeat the same day over and over again. He’s aware of the constant rewinding, but no one else seems to be; everyone around him repeats the same lines and actions every day, with no knowledge that they did the very same thing the day before.

I’m starting to feel a bit like Bill Murray.

Every year or so, someone (typically a journalist or academic) writes an article for a major news outlet about the breast/bottle issue, and the universe explodes into a toxic cloud of overwrought responses and painfully long comment sections. I’m not casting stones from my glassy little house; I’ve contributed to these explosions many times by posting the catalyst articles on Facebook and Twitter, written my own overwrought responses, and added my unnecessary two cents to comment threads.

But that’s what you do, when you’re caught in a Groundhog’s Day situation. You go through the motions, say what people expect you to say. You play your part.

Here’s what my personal Groundhog’s Day looks like:

An article comes out with a controversial, negative title about breastfeeding, containing one or more of the following points:


-Breastfeeding studies are flawed and therefore can’t be trusted.

-The studies proving that breastfeeding isn’t the cat’s meow are somehow exempt from the same criticism, and can be trusted implicitly

-Everyone trying to help women breastfeed is a bully

-The person writing breastfed, but thinks formula feeding is a perfectly viable option and resents the pressure she couldn’t resist; or, she formula fed, and this is a sad, penitent story about her breastfeeding failure and how hard she tried.

Next,  a response piece comes out, making one (or more) of the following arguments:


-The author of the original piece isn’t an MD or IBCLC, but rather a political or social scientist, so she’s got no business having an opinion on medical issues. (Let’s ignore that some of the most prominent voices in breastfeeding literature are anthropologists.)

-People who speak out against the pressure to breastfeed are anti-breastfeeding, hate breastfeeding mothers, and must be bitter/anti-feminist/in the pocket of Big Formula/uneducated/uninformed.

-There is no such thing as the Mommy Wars, and moms don’t really feel guilty about not breastfeeding, because our 6-month exclusive breastfeeding rates show that they are in the majority, so why would they ever feel bad?

-Because breastfeeding mothers also have problems, that negates the problems of non-breastfeeding parents.

-All of the research cited in the article means nothing, because (add circular argument here about how the AAP and WHO support breastfeeding, based on the same studies that are being questioned).


-Anyone who cares about women and babies should boycott said article and the godforsaken newspaper/website that published it.


Then, a follow up to the follow up will be written, reiterating the points of the first article, and we all act as if any part of this tone-deaf conversation is news. And so on, and so forth, until we find ourselves back at the beginning, ready to start the cycle over.

If this were a movie, I’d make a dramatic, heart-stirring speech, grab a stick, and draw a literal and proverbial line in the sand. On one side, I’d invite the the rational, kind people – regardless of their opinions on breastfeeding, or how they fed their own kids. As long as they respected other people’s points of view, and were willing to listen and have a real conversation, they would be welcome.

On the other side, we’d leave the zealots and judgmental jerks. Then something magical would happen, maybe involving a fairy godmother who’d been disguised as a gruff barkeep for the whole movie, watching and waiting for the protagonist to figure out the Big Lesson. Sparks would fly, and those of us on the “nice” side would miraculously wake up 24 hours later and go on with our lives, while the others would be stuck in that same day, having the same tired arguments. (Don’t feel bad for them. They’re happier that way.)


But there isn’t a fairy godmother, or even a barkeep, so I’m stuck reciting my lines. I’m not going to be poetic about it, because I’ve written the same article like 7000 times already and I would only plagiarize myself (is that possible?), so I’m just going to list some bullet points, in no particular order, which detail my response to the all the articles and responses and responses to responses, in no particular order:

Breastfeeding moms struggle. They deserve help, and resources, and the right to feed their babies anywhere and in any way they see fit.

- Formula feeding parents struggle. They deserve help, and resources, and the right to feed their babies in whatever way they see fit.

- Infant feeding studies are inherently flawed. All of them. The ones that say what you want them to say, and the ones that say what you don’t. The best we have are sibling studies, of which there are approximately three. Those three do show very negligible benefits of breastfeeding. However, just because research can’t prove that breastfeeding guarantees a healthier, smarter child, does not mean it’s not worth supporting. It is still the biological norm, and there are many reasons it is worthwhile and wonderful that have nothing to do with science. (Incidentally, I find it ironic that SCIENCE is what we use to promote breastmilk, while at the same time being seriously pissed off at SCIENCE for making a damn good substitute for it. Those science-y bastards!)

- We do NOT have solid evidence that breastfeeding is the panacea (at least in western society) that organizations like WHO and UNICEF make it out to be. But remember that WHO and UNICEF are worldwide organizations, and in many parts of the world, not breastfeeding really can be a death sentence. So that might cause a bit of understandable zealotry on the subject.

- It is unfortunate that the only people speaking up about these issues are political scientists and bloggers (one exception: Dr. Amy Tuteur, who has a book coming out very soon which tackles this topic). Consider, though, that it’s basically career suicide for anyone in the medical profession to speak out against breastfeeding pressure.  Until we can have more balanced discussions that don’t result in knee-jerk responses and accusations, I don’t see many practicing MDs volunteering to lead the charge. (There’s a really long discussion on this form of innate censorship in my book, not that anyone has read the damn thing. Because, you know, it’s Groundhog’s Day, and it doesn’t exist in this alternate reality. Or any reality, really, looking at my book sales. Sigh.)

- Infant feeding politics are greatly affected by region, race, class, and social group. What happens to one patient in one hospital doesn’t have much bearing on another patient in another hospital, even one down the street, let alone in a different part of the country. Some people live in breastfeeding-friendly communities where they really are the only person reaching for a bottle. The fact that their statewide statistics show that 50% of the people in their state are also reaching for bottles means nothing, unless those 50% hang out in their neighborhood, with their social circle.

- What happens in Baby Friendly Hospitals is not uniform. What Baby Friendly says in its literature can easily get lost in translation. Many, many parents report feeling bullied and pressured, and left without any resources or support once they chose to formula feed. Telling them that this isn’t happening just because it isn’t happening at the hospital YOU work at, is gaslighting, pure and simple.

- Likewise, just because you were treated like a criminal for asking to supplement, doesn’t mean someone else is lying when they say their child was given formula without reason or consent. Some hospitals are very breastfeeding unfriendly.

- Speaking of which, the whole reason for the huge push with breastfeeding is that for a long time, formula was the norm, and breastfeeding was discouraged. That said…I actually think a case could be made that the truly anti-breastfeeding period was about 2 decades, or about 25 years (50s-mid 70′s). Formula feeding became the norm in the 50′s, and that’s when pediatricians started telling women it was “better” to use commercial formula than their own milk. The pendulum swung the other direction in the mid-70′s (post Nestle disaster) and breastfeeding has been the “right” choice ever since. As it is currently 2015, and the pendulum has been way over on the breastfeeding side from around the early 90s, that means we’ve been pro-breast longer than we were anti-breast. This might be the reason for all the recent backlash – it’s time for another pendulum swing, this time (hopefully) towards the middle.

- Instead of questioning the quality of the breastfeeding research, why aren’t we questioning why we’re still doing meaningless observational studies which do nothing but frame infant feeding (and therefore, necessarily, women’s bodies) as the only element in childhood health and development? Instead, we could be using the money, time and energy finding better alternatives for those who can’t make breastfeeding work, or finding ways to support breastfeeding without harming the psyches of new mothers or marginalizing new dads or adoptive parents. Even studies which look at the chemical composition of breastmilk would be helpful and interesting. But we know that observational studies on the long-term effects of breastfeeding are bullshit, so why do we keep doing them? Seems like an exercise in frustration, to me.

- Breastfeeding supporters (IBCLCs. CLCs, nurses) are not the enemy. I think there are fundamental flaws in the training programs and governing boards that oversee these credentials, things that make it difficult for care providers to do their jobs with empathy and sensitivity. For example, the way IBCLCs are restricted by their code of conduct makes it hard to truly support formula feeding parents, in my opinion. But for those who want to breastfeed, these professionals are a GODSEND. And many do stray from the party line and help parents feed their babies, however that may happen, end of story. Stereotyping is stereotyping, no matter which way you cut it.

- The previous point does not negate the fact that many women have been mistreated and hurt in the name of breastfeeding. The individuals and organizations that perpetuate this behavior must be held accountable, just as much as the formula companies need to be held accountable for their marketing tactics, past and present.

- Speaking of marketing, formula companies have done some god-awful things. But we must be careful not to confuse their modern, generic capitalist behavior with the sins of the past. Sending a formula sample (which can be donated to a food bank or burned at the stake, you choose) is not quite the same thing as sending fake nurses into a resource-poor nation and creating conditions that killed hundred of babies.

- The experiences of formula feeding parents are just as real, valid, and important as the experiences of breastfeeding mothers, and vice versa.

- Listen to those experiences: breastfeeding mothers talk about shame around feeding in public, attitudes towards extended breastfeeding, and a lack of practical support at the hospital. Formula feeding parents talk about shame around the entire first year of feeding, being made to feel like they are harming their children, being chastised by care providers, and having a lack of practical support at the hospital. There are problems and gaps and room for improvement on both sides. It’s not a pissing contest.

- When a new voice arises on the infant feeding debate scene, don’t immediately dismiss it. Maybe there’s a reason for all these articles – maybe there are some real issues going on here, and if we solved them, the articles would stop.


I could say more, but I’m boring myself. I hope you’re bored, too; bored of the constant back and forth, bored of defending yourself and your point of view; bored of fighting. It won’t change until the people in real positions of power – physicians, members of the AAP and WHO and numerous other medical organizations, government officials, parenting “experts” – decide to take a long, hard look at what this “debate” is doing to parents and babies, and realize that if the end goal is a happier, healthier generation, they are failing miserably.

All we can do in the meantime is take care of ourselves and those around us; to tell our stories and talk to those who are willing to listen, and explain why breastfeeding is not, and never will be, the same sort of public health issue as obesity or smoking. Some will put their hands over their ears and refuse to listen, but that’s okay. Keep talking. Force it to be a dialog instead of a lecture. Read the articles you agree with, and the ones you don’t agree with. Find people who support you, and pay it forward by supporting others.

And one day, if we’re lucky, we will all wake up in our beds and find that it’s February 3rd.





City of Ottawa Public Health Unit’s “Informed Consent” webpage: A case study in (un)informed consent

An anonymous FFF reader has allowed me to publish the following letter, which she sent to her local Public Health unit in Ottawa. I visited the site that caused her so much consternation, and I was equally incensed. Please click here to see what she and I are talking about:

Make an informed decision about feeding your baby

My thoughts on the Ottawa website follow this letter. I’d also encourage you to check out the letter sent by the blogger at Awaiting Juno. And, if you’re feeling inspired to do so and happen to be a citizen of Ottawa (or even if you just feel like giving them your opinion), feel free to write your own letter and send it to


Dear City of Ottawa Public Health Unit,

I discovered the following webpage on Informed Consent and was utterly dismayed at what I had read.

I had my daughter seven years ago and am hoping to have another child within the next two years. When I was pregnant with her I knew I was going to breastfeed her. I felt that formula was vastly inferior. Unfortunately having breast hypoplasia (something that none of the literature of had prepared me for), made exclusive breastfeeding an impossibility. My daughter went from losing weight on my breasts alone (I did have a postpartum nurse who was very concerned about my breasts due to their shape and spacing, but I dismissed it as an unsupportive nurse, not as her giving me relevant information on my situation), to thriving on formula.

That page isn’t giving informed consent, it is scaring women into breastfeeding by bringing up scary words like “obesity”, “SIDS” and “Cancer”, without mentioning any potential  drawbacks for breastfeeding (including not being able to take certain medication and that it can be a physically and emotionally draining experience for some) and without making any positives about formula. It also doesn’t mention that formula prepared properly is a valid feeding method and choosing it doesn’t mean that a child will end up toothless, obese, diagnosed with cancer, or dead. From what I have seen about the research the main risks are a higher rate of gastrointestinal viruses and ear infections (which my daughter did get, when she was 5 and a half years old). For a woman who might be already sad that breastfeeding isn’t working out with them, such phrasing of information without perspective or actual risk amounts could contribute to postpartum depression. I should know- seeing that kind of information online (it exists all over the internet) after switching to formula was a contributing factor to my own depression.

You mention on the first page that the Baby Friendly designation includes supporting women’s feeding choices, but I do not see how that supports a formula feeding woman at all and could increase the stigma and isolation about using a product that is in fact very safe to use in our city.

I encourage you to take that “Informed Consent” page down and rework it so that it does not demonize formula. The benefits of breastfeeding in all honestly should be able to stand on its own without resorting to demonizing formula. Furthermore, I am more than willing to help with any rewording to help formula feeding moms feel more supported in their choice.

As a taxpayer, mother and a woman who felt intense guilt for 2 years for using a product that nourished my daughter where I couldn’t (I also have the perspective that she is a very healthy, active 7 year old), I urge you to reconsider your approach.

Yours truly,



Before I return to my Pad See-Ew, which is currently getting cold (yet another reason to be annoyed at the city of Ottawa – they are ruining my damn dinner), I want to add a few of my own thoughts to Anonymous’s letter.

The document on the Ottawa Dept. of Health website is coercive and factually inaccurate, starting with the first sentence. They state:

Deciding how you are going to feed your baby is one of the most important decisions you will make as a parent.

What the “most important decisions” you’ll make as a parent are is entirely subjective.

Next, they state:

Making an informed decision means you have all of the information you need to help you decide what is best for your family.

Yep. Exactly. You deserve accurate, dispassionate information so that YOU can decide what is best for YOUR family. This document does the polar opposite. It confuses correlation and causation (I only see two uses of the important qualifier “may” in the lists of benefits and risks – for example, they claim that breastfeeding “helps to protect against cancer of the breast and ovary.” It would be accurate to say that breastfeeding “may help to protect…” or “has been associated with a lower risk of…”, but the way they pronounce this benefit makes it sound proven without a doubt. This is simply not true); it does not mention any of the potential downsides of breastfeeding, nor the benefits of formula feeding (even if they’d just said “the ability to feed your child when breastfeeding isn’t working or there isn’t a mom in the picture”, it would have sufficed); and most importantly, it does not leave the reader with any choice other than to breastfeed, or feel like an inadequate, terrible human being. And before someone starts misquoting Eleanor Roosevelt to me, let me stop you: yes, people CAN make you feel guilty without your consent. Or if you can’t agree with me on that, let’s forget about guilt – how about embarrassed or judged? Can people make you feel that way without your consent? And what if you’re not in any emotional place to give that consent? Like when you are a hormonal pregnant or newly postpartum parent, and it’s your city government posting a bunch of fear-inducing drivel under the headline “the benefits or breastfeeding for the baby, mother, family and the community”? How about then?

The document’s piece de resistance is this half-assed suggestion at the bottom of the page:

If you have made the informed decision to formula feed and need information on how to prepare it safely, please visit Ottawa Public Health’s Food safety page.

Ah, I see. So if you’ve made a decision to do something that causes nothing but inconvenience, pain, and suffering for you and your child (and your community- can’t forfet your community!) based on this “information”, you should just go to a different department, because we’re freaking OVER you. Notice that when the link for more information on breastfeeding follows this taxonomy:

Residents>>Public health>>Pregnancy and babies>>Healthy baby and parenting>>Feeding your baby>>Breastfeeding

There is NOTHING about formula in this “Feeding your baby” section. Instead, formula feeding monsters, er, mothers are directed to:

Residents>>Public health>>Food safety and inspections>>Baby Formula

Apparently, healthy babies and parenting only has to do with breastfeeding. Formula feeding is on par with selling hot dogs at softball games.

I don’t even know what to say, except to all the soon-to-be moms and currently formula-feeding or combo-feeding mothers in Ottawa, I am so, so sorry. Your city health department sucks donkey balls. And if I were you, I’d start the angry tweets and emails right. Freaking. NOW.

Twitter: @ottawacity




Of nanny states and nonsense

This is why I hate politics.

Earlier today, Jennifer Doverspike’s scathing indictment of Latch On NYC popped up on the Federalist website. By this evening, Amanda Marcotte had written a similarly scathing indictment of Jennifer’s piece on Slate. Both talked about hospital policies, formula feeder paranoia, and boobs. But in the end, what should have been a smart point-counterpoint between two passionate, intelligent women turned into a steaming pile of another bodily substance.

Yep, I’m talking about shit. 

Look, guys, I’m sorry for the language, but I’m done being classy, at least for tonight. Tonight, my Boston-bred, townie self is coming out, because I. Have. Flipping. HAD IT.


Doverspike’s piece does veer into political territory, mostly from the use of the term “nanny state”, a phrase that is undoubtably evocative (and apparently intoxicating) in today’s partisan climate. There were portions of her article that made me (a self-proclaimed, sole member of the Turtle party – our platform is that we just hide our heads in our shells whenever political issues arise. Anyone’s welcome to join!) a little uncomfortable, mostly because I worried that her important message would get lost by those on the Left. But I naively thought (us Turtles are naive about such things, considering we start singing “Mary Had a Little Lamb” whenever someone brings up Congress and prefer to our news from the Colbert Report) that she’d covered these bases with her final paragraph:


There are, of course, many laws the government issues for our protection and those of our children. Seatbelt laws, child car seat booster requirements, bans on drop side cribs and helmet laws. Regardless of whether or not these encompass valid risks (many do, some don’t), they do not encroach on personal freedom the way laws regarding parenting methods do. And don’t get me wrong; this goes in all directions. Infant feeding, and the personal freedoms associated with it, is not a liberal or conservative issue.


Apparently, it is a liberal or conservative issue, at least according to Marcotte, whose response to Doverspike felt far nastier than necessary. Marcotte accuses Doverspike of not doing her homework regarding the implementation of the WHO Code, for example:


What Doverspike fails to mention is why the WHO wrote out these regulations in the first place, something a quick Google search reveals. As reported at the time by theNew York Times, researchers had discovered that poor parents were stretching out formula by watering it down, which was leading to malnutrition in infants. In addition, places that lack clean drinking water are places where formula feeding is downright dangerous. There are substantial benefits, particularly worldwide, to creating a culture where breast-feeding is the go-to way to feed children, and formula is only viewed as a supplement for cases where breast-feeding isn’t working. Of course, that does cut into formula company profits, so if that’s your priority, by all means, bash the WHO’s efforts to keep babies healthy some more.


Huh. See, that’s odd, because I clearly remember reading something in Doverspike’s piece about this very issue… let’s see… ah, right:


Unlike the city of New York, the WHO  has valid reasons to be concerned with breastfeeding rates worldwide. After all, in less developed countries not breastfeeding may mean instead using cow’s milk for infants. When formula is used, the risks of it being prepared incorrectly and using contaminated water is rather high…The WHO should focus being on how to educate and support women in developing countries regarding the dangers of cow’s milk, the benefits of breastfeeding, and the importance of correctly mixing formula. Unfortunately, the WHO Code saves most of its energy in marginalizing formula companies, requiring hospitals to under no circumstances allow formula advertising and requiring that product samples only be given for research at the institutional level — “In no case,” it stipulates, “should these samples be passed on to mothers.” The WHO is also requiring labels stating the superiority of breastfeeding and warning to not use the product until consulting with a health professional.

True, she didn’t delve into the issues surrounding formula use in developing nations as deeply as she could have, but Marcotte’s take on the subject wasn’t exactly accurate, either. The Nestle controversy which she alludes to involved corporate subterfuge (women dressed as nurses convincing new mothers to use formula; these “health workers” then packed up and left, abandoning the moms with no established milk supply, no resources to procure more formula, and dirty water to use for what formula they did have), and this was what drove well-meaning individuals to create the WHO Code… but the problems that exist which lead women in these same countries away from breastfeeding are so much more complex than our Western understanding of “unethical marketing”. And to compare the risks of not breastfeeding in these countries to the risks in countries which are debating baby-friendly initiatives isn’t fair nor useful. These are two entirely separate issues.

Marcotte also dismisses Doverspike’s concerns that under Latch On, formula ”must be guarded and distributed with roughly the same precautions as addictive and harmful narcotics” by citing a “sober-minded assessment” that she claims “shows that no such things are happening”. This “sober-minded assessment” is a CNN option piece from writer Taylor Newman, who repeatedly brings up her own breastfeeding experience in a hospital with piss-poor support. Newman engages in some of the most immature name-calling I’ve seen in a respected news source – those who disagree with her opinion of Latch On are “obnoxious”, “unhinged” they write “badly-written” posts that are just ‘kicking up dust”. (If this is sober-minded, hand over the vodka. This is mean-girl, bitchy, completely anti-feminist bullshit, is what it is. If a man called a fellow woman writer “unhinged” or accused her of being hysterical, I bet we’d see plenty of backlash from Slate. ) She also makes the fatal mistake so many reporters, pundits and advocates have made in this tiresome debate: she’s only seeing it through the lens of her own experience. It may not seem like a huge deal to someone who wanted to breastfeed (and ultimately did, successfully) that new moms will have to ask for formula each time a baby needs to eat, or that they will have to endure a lecture on the risks and intense questioning of their decision. But try living through that experience as, say, a single mom who was molested as a child. Imagine you don’t have anyone around to defend you, to demand that the nurses treat your decision not to use your body in a particular manner with respect. Imagine that you don’t feel like reliving your abuse and telling a total stranger – repeatedly – why the idea of letting a baby suck on your breasts makes you want to throw up.

I know I’m digressing here, and again, I’m sorry to be throwing my usual I-Support-You, let’s all hold hands and braid each other’s hair Pollyanna-esque, evolved FFF persona out the window. This is old school FFF, the angry one, the one whose claws come out when I see that women are being told their voices don’t matter, their concerns don’t matter, their choices don’t matter. The one who refuses to allow an important discussion – a women’s rights discussion, not a political one – get bogged down in right vs. left rhetoric.

Marquette’s choice of image to go along with her article is a baby holding a bottle with the caption “Freedom Fighters”. Again, I have to ask – really? Fine, be mad that the Libertarian Federalist invoked the Nanny State and beat up on poor old Bloomberg. Rage against that. But to belittle those of us who care about this issue is petty and cruel. And to ignore – once again – that what Latch On’s PR machine told the press was quite different from what was written in the actual materials used to implement the program; to ignore that no one has actually done a follow-up story since the initiative was announced which reports actual accounts from actual women who actually delivered in actual Latch On hospitals and used actual formula – this is just poor journalism.

Feminists, journalists, bloggers – I belong to all of your clubs, and I’m sure you’re about to revoke my membership, but I have to ask: Why are we rehashing the same arguments over and over, instead of discussing how we could come to a more beneficial, neutral ground? For example – couldn’t women be counseled on the benefits of breastfeeding before they enter the emotional sauna of the postpartum ward? Yes, I realize that not all women have access to prenatal care, but for those who do, this seems like a practical and  beneficial adjustment. If these issues are discussed beforehand, at least a mom who knows from the start that she doesn’t want to nurse can sign whatever documentation is necessary to tell the state s has been fully informed of the “risks” and “still insists” (Latch On’s term, not mine) on formula feeding. For those who change their minds while in the maternity ward – well, couldn’t we just agree that she gets one lecture on why it’s a bad decision, and then receives the education, support and materials she needs to feed her baby safely, rather than having to go through the whole rigamarole every time her infant begins rooting?

Or here’s another idea – take the hyperbole out of the initiative. Stop saying these things are “baby-friendly” or “progressive” or “empowering” because they aren’t necessarily so. And by saying that they are, you get people all riled up, politically. You start hearing terms like “nanny state” because some of us don’t want to be told how we should feel (or how our babies should feel, for that matter. If my mom couldn’t feed me and some nurses weren’t letting me access the next best thing, I’d be hella pissed, and that environment would become decidedly baby unfriendly. Especially when I punched the person refusing my mom the formula in the nose with my tiny baby fist). You start getting feminists shouting about second waves and third waves and whether women should feel empowered by their ladyparts or held down by them. It’s one big mess, is what I’m saying. So can we stop it, now? Can we start writing articles that are balanced reports rather than press releases for a particular administration or cause? Can we stop hurling insults at each other just because we don’t agree on what being a mother should mean?

Can we please, for the love of all things holy, just flipping stop?

Breastfeeding pressure doesn’t care about privilege

I am privileged.

I’m not rich, but I have never gone hungry; never been without a roof over my head; never wanted for anything (well, nothing more pressing than a better body and maybe a date with Ewan MacGregor circa Trainspotting). I don’t know how it feels to be judged by the color of my skin. I’ve been discriminated against, as a Jew and a woman; called names like kyke and jewbeggar and bitch, but I’ve never been racially profiled or held back by a language barrier, or assumed to be suspicious or uneducated because of the way I look.  I have a great husband and amazing friends and ridiculously supportive parents and in laws.

I realize that in the United States, this means I am incredibly lucky. I also realize that this means I have no business assuming things about anyone else’s lived experience. It doesn’t matter how many academic texts I read or people I speak with in a clinical setting – I can’t know how it feels to be dependent on welfare, or in an abusive relationship, or at a dead-end job with a sexually harassing boss.

I often hear that the pressure to breastfeed is a problem plaguing a specific socioeconomic and geographical subset of women; that my assumption that women are being harmed by overzealous breastfeeding promotion is dripping with “privilege-laden assumptions”. The people making these claims insist that poor, minority women think formula is superior (because they’ve all been victims of unscrupulous marketing and social pressure), and do not know the benefits of breastfeeding, and that if anything they feel ostracized if they breastfeed. Formula feeding, they say, is the unfortunate norm – my concerns have no place in these communities.

I don’t deny that I am coming from a certain perspective, and I always acknowledge that things are different depending on where you live, and what your social circles are doing. I also don’t deny that these social and marketing influences are real. But I think it’s just as privileged to assume that all women in lower socioeconomic areas need to be “educated”, and to ignore the fact that the lower a woman’s status in society, the easier it is for her bodily autonomy or emotional well-being to be violated. Ensuring that the rights of these women are protected is more important than raising breastfeeding rates – and the same policies which are worrisome for a privileged white woman are even more deleterious for someone whose voice is already struggling to be heard.

Yesterday morning, I met with two women who work at an organization serving a lower income neighborhood of Manhattan, helping teenage mothers from a variety of cultural backgrounds. These women told me that in some of the ethnic groups they serve, breastfeeding is very much the norm; in others, it is not as culturally accepted. Their organization is extremely pro-breastfeeding – there is no formula available at their office to give to girls in need, and they encourage breastfeeding throughout the prenatal period and beyond. But when I brought up the idea that the girls these women work with are not being affected by the “breastfeeding makes good mothers” philosophy, I was met with disbelief. “The ivory tower ideal is even more of an ideal for someone who is already struggling to fit the definition of a good mother,” one of them explained. They expressed a need for better messaging – encouraging at-risk women to focus on mothering rather than just feeding. Things like promoting skin-to-skin, reading to your baby, eye contact… not putting the emphasis on breastfeeding as the be-all end-all of parenting.

I also learned that the breastfeeding education these girls are given mostly consists of comparisons between formula and breastmilk, and information on how breastfeeding leads to better bonding and healthier kids. There is little instruction on the actual mechanics of breastfeeding, or how to manage the lifestyle barriers that could make exclusive nursing difficult. So while these young women may go into labor wanting very badly to give their babies the best (and they are well aware its the best, as their prenatal education features lectures on the differences between formula fed and breastfed babies), once they leave the maternity ward and have to return to work or school within a few weeks, without successfully establishing breastfeeding, or knowing how to pump, or how to advocate for their right to express in the workplace (if their workplace even falls under the parameters of the latest breastfeeding laws, many end up on formula- without any advice on how to do so safely.

After that meeting, I had lunch with an FFF who lives in Brooklyn. Her story was all too familiar – wanting to breastfeed, finding herself faced with low supply, getting conflicting advice from healthcare providers, balancing her own health and sanity with her (incredibly nuanced) understanding of breastfeeding’s benefits. The same sort of story we often see on this blog, from an educated mom with a supportive partner who had the ability to hire lactation consultants, and knew how to read scientific literature well enough to suss out her own risk/benefit analysis.

Obviously, this woman came from a very different situation than the women represented in the day’s earlier conversation.  But there was a remarkable similarity in what was expressed by everyone I spoke to. There was consensus on what we need: a more balanced, less hysterical, more individualized approach to infant feeding. All agreed that an honest discussion of the challenges of breastfeeding would be helpful, and that education on formula feeding safely and knowledgeably would go a long way in protecting the physical health of babies and the emotional health of mothers, regardless of their socioeconomic or ethnic background.

The stories these women are telling are not about white or black, native or immigrant, poor or rich. This isn’t about politics. It’s about what will be the best choice for an individual woman in her individual circumstances. These are stories with one moral: that we can – we must – support a woman’s right to breastfeed as well as her right to choose not to breastfeed.  This isn’t about doing away with Baby Friendly, because we need to ensure that women are getting a good start to breastfeeding and every opportunity to make it work (and that means switching the focus from vilifying formula to actually helping women initiate and sustain breastfeeding in practical ways). But we need to speak up and insist that there is a way to do this without loading more pressure onto new mothers.

I have a feeling breastfeeding guilt is seen as a problem of the privileged, because we are the ones with the time, resources, and autonomy to speak up about it. That doesn’t mean women of other backgrounds aren’t feeling the same pressure, perhaps manifesting in even more damaging ways. Still, it’s not my place to pretend to understand them, or to put words in their mouths. There’s no way I could, because these women aren’t an aggregate. They are individuals. To speak for the “disenfranchised” or “minority communities” as a sole entity is asinine. My experience is extremely different from other moms in middle-class Los Angeles – that doesn’t make it any less real, or valid.

One-size-fits-all infant feeding policies do not work, because women are not one-size-fits-all. In fact, in both fashion and life, one size usually just fits a lucky few. To label breastfeeding guilt as solely an experience of one type of woman, and paternalistic “education” as necessary for another, is just plain wrong.  It would be nice, instead of arguing about who has the most altruistic motives to help certain groups of moms feel empowered, we just focused on empowering all women to make choices that feel right for them, and to decide how their bodies are utilized.  Because while I would never attempt to speak for anyone, I don’t think it’s a privileged assumption that most of us would appreciate the ability to speak for ourselves.



Public Citizen Jumps on the Ban–the-Bags Bandwagon: Advocacy group forms petition to rid hospitals of formula samples

One time, this potato bug terrorized our stairs for three days straight. Being the anti-violence-against-all-creatures vegetarian I am, I urged it to move on by gently prodding it with a stick. It wouldn’t budge. I finally gave up and decided it was it or me, so I ended up spraying it with all-purpose cleaner. It survived the assault. (All we had was organic cleaner in the house, so for all I know the stuff I used made the bug grow bigger and stronger.) Finally, I had to be all lame and stereotypically female and call my husband to take care of the situation – and he had to stomp on it seven times before it expired.

He was too ugly to live. Forgive me. 

I feel like a broken record, talking about the movement to outlaw formula goodie bags from hospitals, once again… but just like our friend the potato bug, the damn issue just won’t die.

The newest incarnation of the old debate comes from the advocacy group Public Citizen. They have put forth a petition on their website, and have submitted a letter to hospitals that continue to hand out formula samples. According to the letter,

There is overwhelming consensus among all major health professional organizations regarding the health benefits of breastfeeding for mothers and babies and the importance of exclusive breastfeeding for the first six months of life.[1]  Hospital promotion of infant formula through dissemination of these discharge bags contravenes this consensus, needlessly and inexcusably harming babies and families. Moreover, formula feeding imposes a significant burden on the nation’s economy. Breastfeeding saves families and the economy countless dollars….
 When hospitals distribute formula samples…they imply that these products are medically approved and recommended. Yet, there is ample evidence that formula samples reduce breastfeeding duration and exclusivity. Multiple studies have shown that women who receive commercial hospital discharge packs stop breastfeeding sooner than those who do not.[2] Hospitals expend resources to support mothers to breastfeed, but reduce the impact of these efforts by distributing formula samples.  Research shows that bag distribution sends a message more powerful than any verbal messages.[3] New mothers who at first experience difficulty breastfeeding are apt to choose to use free formula samples given to them in discharge bags instead of seeking out assistance with breastfeeding. Aware of these dangers, in 1981 the WHO established the International Code of Marketing of Breast-milk Substitutes.[4] The Code states that healthcare facilities are not to be used for the marketing of infant formula. Hospitals in the U.S. that continue to distribute formula samples are in violation of the WHO Code.

I’m not going to rehash my feelings about formula samples (if you’re interested in what I think – and trust me, it’s not all that interesting or revolutionary – you can check out this previous post or this one on the same topic) or drone on about WHO Code (like I did here). I simply want to address some of the inaccuracies and (what I feel are) harmful statements in this letter, which is making the rounds in the media and blogosphere.
1. The authors do not give a citation for the statement that “formula feeding imposes a significant burden on the nation’s economy”, but I’ll give them the benefit of the doubt that they meant to cite the Bartick/Reinhold study which claimed that “suboptimal” breastfeeding costs the United States 911 lives and 13 billion dollars per year. Please look to Momma Data’s Polly Palumbo for an astute analysis of this study and form your own opinions about the truth of this statement. I’d also submit that even if you believe Bartick and Reinhold were 100% correct, these results were basically a hypothesis; the study did not give sufficient information to start making such dramatic claims as if it were fact. 

2.  They state that “when hospitals distribute formula samples…they imply that these products are medically approved and recommended.” Well, um…that’s because they are. They are not recommended over breastfeeding (except in some cases) but they are indeed medically approved and recommended as breastmilk substitutes. Like it or not, formula has been deemed a safe alternative to breastmilk by medical authorities. A more accurate statement would have been “when hospitals distribute formula samples, they imply that they are advocating the use of formula over breastmilk.” Now that’s a train upon which I could climb on board. Hell, I’d even be the conductor. I agree that handing parents a bag of formula without asking if they are planning on formula feeding is utter and complete crap. It’s contradictory to the “breast is best/breast is normal” message and very confusing, especially coupled with the typically sub-par, hospital-grade breastfeeding support. (Don’t get excited – I’m not advocating that they do away with these sample bags. I think they should offer two versions – a breastfeeding one and a formula feeding one. Breastfeeding one could be provided by the state, since they are pushing so hard for the citizens to nurse their young. Formula one could be provided by the formula companies, because no one else is going to do it. And while we’re at it, it’s pretty depressing that the literature which comes in these bags is often the only education most parents get on how to safely bottle feed.)

3. Invoking WHO Code is pointless. The United States is notorious for being the only “major” country that doesn’t enforce the WHO Code; in this country, it is not a “law”, but rather a moral code which formula companies are “asked” to respect. It doesn’t matter that distributing these bags is violating the Code; until the government makes it illegal to pass out formula samples, hospitals have a right to do so.

Speaking of making formula bags illegal, the Ban the Bags movement was in the news for a different reason this week, as well.

(Ahem. Before I “go there”, I’m going to ask that we pretty please with a ginormous cherry on top do not let this veer off course into a political argument. This is not about the candidate in question or his political party, but merely some statements made by his camp many years back.)

One of the skeleton’s dragged out of Republican presidential contender Mitt Romney’s closet was his clash with breastfeeding advocates back in 2006. As Governor of my former home state, Massachusetts, he fought against an initiative to legally ban formula sample bags in hospitals.  According to,

Romney’s spokesmen at the time and current campaign advisor Eric Fehrnstrom said the decision was about freedom of choice. “We’re not disputing the health benefits of breast-feeding, but we think that new mothers should make that choice,” Eric Fehrnstrom said. “If they choose to bottle-feed, they should be supported in that decision.”… Romney attacked the decision by the Department of Public Health as an intrusion of big government saying “I’m not enthusiastic about the heavy arm of government coming in and saying, ‘We think we know better than the mothers and we are going to decide that they can’t get free formula when it comes as a welcome home kit from the suppliers of formula with Q-tips, baby lotion and so forth. Let’s let the moms decide.”

Regardless of your political views, I do think it’s interesting that this story came out in the exact same week that Public Citizen released its letter and petition. If I were prone to conspiracy theories, I might say that Big Formula isn’t the only group that can orchestrate clever marketing campaigns. But I’m not prone to conspiracy theories, so I’ll just say this: Romney may or may not have been in cahoots with the formula companies (as was the accusation at the time, obviously), but that doesn’t make what he or his spokesperson said any less true. Let the moms decide.

So: if you really believe that receiving a sample bag hurt your breastfeeding efforts, let your voices be heard. Sign the petition. But please, don’t let this ridiculous battle overshadow the realities of the infant feeding discourse. Fighting for better support, longer paid maternity and paternity leaves, etc., would do far more for actually helping women to meet breastfeeding goals.

Lastly, using coercive tactics to convince the public about the superiority of your product is never okay.
And I’m not just talking to the formula companies.

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