Breastfeeding Medicine

Physicians blogging about breastfeeding

Stop the Madness

with 39 comments

For the second time in 8 days, the New York Times is running an opinion piece criticizing “polarizing messages” about breastfeeding and questioning the evidence linking breastfeeding with differences in health outcomes for mother and child.

Neither writer interviewed an epidemiologist or a scientist who has studied associations between breastfeeding and health outcomes, and neither writer acknowledged evidence-based reviews of the literature by the US Agency for Healthcare Research and Quality or the World Health Organization. Instead, they quote a retired physician who authors a controversial blog and journalist who wrote a piece on breastfeeding in 2009, and they conclude that breastfeeding isn’t that important after all.

Both Alissa Quart and Jane Brody go on to suggest that it’s unrealistic to recommend 6 months of exclusive breastfeeding, because too many women encounter insurmountable barriers that make these recommendations impossible to achieve.

And yet, for the second time in 8 days, a New York Times writer has chosen to ignore the major public health strategies currently in place to address these barriers:

These documents do not make mothers feel guilty or berate them to try harder – rather, they outline specific policy recommendations that would address the very obstacles that Quart and Brody suggest make breastfeeding too difficult. But these documents are conspicuously absent from their critiques of current breastfeeding policy.

I appreciate that 6 months of exclusive breastfeeding is a lofty goal. I see mothers in my practice who struggle with breastfeeding, and we talk a great deal about the gap between what is recommended under ideal circumstances, and what is possible for this particular mom and baby.  Sometimes, breastfeeding does not work.

But the answer is not to cast aspersions on the evidence and say breastfeeding doesn’t matter.  Lactation is a normal part of human reproductive physiology. When this physiology is disrupted, the best evidence that we have indicates that risks increase for mothers and for infants. The fact that so many mothers and babies run aground reflects our failures as a society – and it underscores the urgent need to address those failures.

We need to make sure that mothers get accurate and evidence-based information during pregnancy so they can make an informed decision about infant feeding. We need to educate health care providers so that they can support that decision, both before and after birth. We need maternity hospitals to discontinue practices that undermine mothers and babies in the first days of life.  We need paid maternity leave, on-site daycare, policies for babies-at-work, and barring those options, access to pumps so that mothers do not have to choose between earning a living and nurturing their children.

And we need journalists writing about breastfeeding to treat it as a real public health issue, not another round in the media-generated “mommy wars.”  An essay reviewing the evidence on heart disease would source the science with a clinician-scientist, not a controversial blogger or a journalist.  A commentary on management of hypertension would reference national recommendations for screening and treatment. But when it comes to breastfeeding, it appears that personal anecdote and armchair observations about “underlying issues” is sufficient to get published in the New York Times.

There are real, actionable policies that would enable more women to achieve their breastfeeding goals.  As Regina Benjamin wrote in the Surgeon General’s Call to Action to Support Breastfeeding:

 The time has come to set forth the important roles and responsibilities of clinicians, employers, communities, researchers, and government leaders 
and to urge us all to take on a commitment to enable mothers to meet their personal goals for breastfeeding.

The time has come to stop the madness. We have work to do.

Alison Stuebe, MD, MSc, is a maternal-fetal medicine physician, breastfeeding researcher, and assistant professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine. She is a member of the board of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by astuebe

July 23, 2012 at 7:37 pm

39 Responses

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  1. Thank you so much for this excellent response to a poorly-written piece in the NY Times!

  2. Dr. Stuebe, you are one of my personal heroes! You were so kind to me when I saw you at UNC two years ago, and your work is so important. Keep up the good work and keep speaking out, please!!

    Jessica M. Dandona, Ph.D.

    July 23, 2012 at 9:57 pm

    • Why all of the sudden? What is happening that the NYT would suddenly “take a side”? Could it be that we are finally making a difference? Weren’t we all expecting push-back?

      lizabeth Berkeley, MPH, IBCLC

      July 23, 2012 at 10:17 pm

      • It happens every year before World Breastfeeding Week, the first week in August.

        Beth

        July 30, 2012 at 7:27 pm

  3. I wish all those crazy pro-lifers fight for the breastfeeding/maternal rights

    Tammy

    July 23, 2012 at 11:30 pm

    • Im a ‘crazy'(more like passionate) pro-lifer and I am also a lactivist who fights for and educates the public on breastfeeding and maternal rights. Not sure what being pro-life has to do with breastfeeding.

      Raquel Newton

      July 25, 2012 at 2:29 pm

  4. Dr. Stuebe, I am a huge fan of your work, and your approach. I think you take lactation science and policy to a higher level and tend to approach the topic with a much-needed sense of perspective. And there are certainly aspects of this post I agree with – first and foremost, that these articles left much to be desired by way of in-depth analysis and nuanced discussion of the issues.

    However, I don’t think this is “madness”; I don’t think we can expect these women to cite all the touted benefits of breastfeeding; and I don’t think it’s fair to ask them to. These pieces are coming out of a place of frustration and rebellion against items like the Bartick piece, the new AAP breastfeeding statement, and a myriad of other articles beating us over the head with the message that not only is breast best, it is a) our civic responsibility to breastfeed and b) the only reason a woman wouldn’t breastfeed was if she was woefully uneducated, misinformed, or mishandled. Until we start listening to these dissenters and their misgivings about the messages that breastfeeding advocates have been sending, no one’s going to get anywhere productive – least of all from a public health perspective.

    Both babies and parents suffer ill effects due to the current state of breastfeeding advocacy – because when many women “fail” at breastfeeding- for whatever avoidable or unavoidable reason – they are left in a precarious spot: filled with guilt, fear, and completely inept at how to safely feed formula. I also think that denying that some women will be unable or unwilling to breastfeed (because for many of us, exclusive or even partial breastfeeding requires tremendous sacrifice in a physical, emotional, financial or social sense) is obtuse. If formula feeding is causing such a major health threat, then I’d challenge those interested in public health to demand better R&D to come up with a better alternative – whether that means more access to milk banks, a breastmilk/formula hybrid, or just a superior formula. THIS is where I think the conversation needs to go; by flinging mud at people’s credentials (the “controversial blogger” you mention happens to be a Harvard-medical school-associated MD, as polarizing as she is) we just end up perpetuating the mommy war. And it IS one, because too many well-meaning breastfeeding advocates get sidetracked by discussions on how nursing improves social/emotional outcomes which are nearly impossible to quantify…. it’s such an odd mix between the idealogical and the scientific. We need to approach breastfeeding advocacy more sensitivity, empathy, and critical thinking that allows for admission that the “backlash” may be coming from an educated, and legitimately frustrated group of parents (and social scientists) who are well aware of the body of literature supporting the superiority of breastmilk as a nutritional substance, but who also know, quite viscerally, that the infant feeding discourse is not a one-size-fits-all, static conversation. Their experiences may indeed be anecdotal, but that doesn’t mean their voices shouldn’t be heard.

    Suzanne Barston
    Author, “Bottled Up: Why How We Feed Babies Has Come to Define Motherhood, and Why It Shouldn’t” (University of California Press, October 2012)

    Suzanne Barston

    July 24, 2012 at 12:26 am

    • Well said!!! I completely agree! I was well educated about how breast was best but that ended up being meaningless when my breasts did not produce enough fast enough for my kids and coupled that with my demanding family meant that something had to give.

      Awesomemom

      July 24, 2012 at 10:16 am

      • Supporting breastfeeding is also about supporting and empowering women in their body’s ability to nourish a baby as well once baby is born as it did when baby was still inside. I believe that you did the best you could with the resources you had available. This really isn’t about guilting women about how they fed their babies. It’s about removing barriers as we move forward. What supports were available to you in your family? Your community? Did your insurance pay for you to see a lactation consultant? Were herbal galactagogs available to you? What about accupuncture? Were any risk factors for low milk supply addressed in a timely fashion by your provider or baby’s provider? Were you encouraged by family or friends to “just give it up”? These are barriers to effective breastfeeding that can effect all women. Removing these barriers for those that come after us, for our sisters and daughters, will result in healthier kids, adults, and communities. And a bonus – stronger, more confident women as well.

        Anne in MN

        July 25, 2012 at 2:23 pm

    • Motherhood goes on for a long time; infancy is fleeting. I have been parenting with the same families in my elementary school community for 8 years now, and I couldn’t tell you who of my best friends breast fed or formula fed. It isn’t an issue for parents anymore. New issues have taken center stage. There is so much more to motherhood than how you fed your infant.

      For a new mother, feeding your infant is in the forefront. The first six weeks after giving birth is an intense time, and everything related to your baby feels personal. New moms are so vulnerable. However, breastfeeding and formula marketing are public health issues, even though seeing them treated as such can be personally hard on some new mothers.

      sarahblain

      July 24, 2012 at 1:24 pm

    • I think Suzanne said it better than I ever could, though I tried to here…

      http://www.confessionsofadrmom.com/2012/07/the-real-problem-with-overzealous-breastfeeding-advocacy/

      This is not “madness”, it’s a larger than you realize population of women who are left feeling marginalized or unsupported in their endeavors to simply feed their babies. And most women actually want to breastfeed. Until we realize that what we say, how we say it, and what we truly know about the obstacles/barriers to breastfeeding we will not increase the numbers of breastfed babies. Also, as a pediatrician and mom with IGT…our goal should not be so short sighted. Yes, we want higher breastfeeding numbers but in the grand scheme of things…we also want healthy and sane Mamas who in turn will lovingly raise healthy babies. Breast/bottle/formula/donor milk…or whatever combination works for that particular mother/parent/child duo.

      confessionsofadrmom

      July 26, 2012 at 2:21 am

  5. Wonderful blog, Alison! Thank you so much.

    elienrouw

    July 24, 2012 at 2:02 am

    • Brilliant post, Alison. As for Suzanne Barston’s comment — I don’t know who you are, but I think you must not have been around very many breastfeeding advocates, or maybe are new to the issue. I strongly disagree that breastfeeding advocacy is responsible for any “ill effects” on mothers and babies. Mothers who fail may feel guilty and fearful, but what they should feel is angry that they didn’t get the support they need, as only a tiny fraction of mothers truly can’t nurse. For those who truly can’t nurse, or who choose not to for personal reasons, I doubt they feel guilty or fearful. And certainly the formula companies are more than happy to teach women how to “safely feed formula” — although I can’t help pointing out that the phrase itself is an oxymoron, as there isn’t any way to safely feed formula. As for calling for more milk banks and for better formula for those babies who aren’t going to get breast milk — I’ve been calling for that since the 1990s, as have many other breastfeeding advocates. See my chapter “Beauty and the Breast” from the book Breastfeeding: Biocultural Perspectives, as well as my 1998 “Skomp Lecture” available from Indiana University. Final point — live birth (vs. egg-laying) and lactation ARE how motherhood is defined for mammals, at least biologically.

      Kathy Dettwyler

      July 24, 2012 at 7:23 am

      • “For those who truly can’t nurse, or who choose not to for personal reasons, I doubt they feel guilty or fearful.” “there isn’t any way to safely feed formula. ” Do you not see how that attitude causes the very doubt and fear you claim doesn’t or shouldn’t exist? Formula was created to save the lives of infants who were not getting proper nutrition from breastmilk whatever the reason. Before formula we resorted to home made brews which have always been tricky, and downright dangerous; and some women have returned to that due to the fear spread about formula. There have always women who could not breastfeed due to biological or social reasons. History is rife with stories of wet nursing or infants who starved because a wet nurse could not be found or afforded. And as an anthropologist, I would expect you to know of various cultures where one woman nurses multiple children while the rest return to work in the fields. Working in a veterinary office exposed me to plenty of mammals who were incapable of providing adequate nutrition to their young through nursing whom we kept alive with formula. Formula saves lives, and is not dangerous except in areas with inadequate water sanitation. Moreover, when used properly, formula can help preserve and extend the breastfeeding relationship for mothers suffering difficulties. As a LLL leader, WIC breastfeeding peer counselor, and mother of two still nursing children, I am appalled and your assertions of the dangers of formula. This is the very form of “advocacy” being referred to in Barstons comment. It is not advocacy at all, but an attack. I used to admire you. Your comment today has caused me to lose a significant amount of respect for you.

        crunchym0m

        July 24, 2012 at 8:39 am

      • Directly below Suzanne’s comment it says, “Author, “Bottled Up: Why How We Feed Babies Has Come to Define Motherhood, and Why It Shouldn’t” (University of California Press, October 2012)”.

        She also has a blog http://www.fearlessformulafeeder.com/

        I think it would be an understatement to say she has been around “many” breastfeeding advocates, and she is certainly not new to the issue.

        Poogles

        July 24, 2012 at 10:21 am

      • I had not heard of Suzanne either but just searched for her and found this at http://www.ucpress.edu/book.php?isbn=9780520270237

        “As the subject of a popular web reality series, Suzanne Barston and her husband Steve became a romantic, ethereal model for new parenthood. Called “A Parent is Born,” the program’s tagline was “The journey to parenthood . . . from pregnancy to delivery and beyond.” Barston valiantly surmounted the problems of pregnancy and delivery. It was the “beyond” that threw her for a loop when she found that, despite every effort, she couldn’t breastfeed her son, Leo. This difficult encounter with nursing—combined with the overwhelming public attitude that breast is not only best, it is the yardstick by which parenting prowess is measured—drove Barston to explore the silenced, minority position that breastfeeding is not always the right choice for every mother and every child.

        Part memoir, part popular science, and part social commentary, Bottled Up probes breastfeeding politics through the lens of Barston’s own experiences as well as those of the women she has met through her popular blog, The Fearless Formula Feeder. Incorporating expert opinions, medical literature, and popular media into a pithy, often wry narrative, Barston offers a corrective to our infatuation with the breast. Impassioned, well-reasoned, and thoroughly researched, Bottled Up asks us to think with more nuance and compassion about whether breastfeeding should remain the holy grail of good parenthood.”

      • “Mothers who fail may feel guilty and fearful, but what they should feel is angry that they didn’t get the support they need, as only a tiny fraction of mothers truly can’t nurse. For those who truly can’t nurse, or who choose not to for personal reasons, I doubt they feel guilty or fearful. ”

        I failed. The milk in my right breast never came in properly, and I never found breastfeeding anything but painful and stressful. Pumping I just found humiliating, and although policies were part of that in the form of not having an appropriate and private place available for the purpose in my workplace, frankly being hooked up to the pump made me feel like a cow attached to a milking machine. I stuck it out for four weeks and then pumped until I dried up completely because I felt like I’d be a failure if I gave in, and because I was being bombarded with messages about what a horrible mother I would be if I bottle-fed my baby. In the end, I count myself as one who chose not to breastfeed long-term “for personal reasons”, as you put it. And I count myself as one who failed. I would thank you not to tell me what I “should” feel about that, or make assumptions about what I do feel. I did feel incredibly guilty, but I just. Couldn’t. Do it anymore.

        I recognize that I could have had better support. I knew where to go for it, and I didn’t. I made a conscious and informed choice about how to feed my child. A lot of time, thought, soul-searching, and yes, information went into that decision, and I do not appreciate having that sense of personal responsibility for my child’s welfare blithely marginalized by the assertation that women like me just need a little support and should be upset because other people did us wrong.

        Let me repeat that: This was my decision, and if there was failure it was mine. Not my doctor’s. Not the hospital’s. Not the government’s. Not breastfeeding advocates’. Not the media’s. Mine. I made this decision. I refuse to be mad at someone else about a decision I made. I refuse to give up either the responsibility of that decision or the power of being able to make it.

        I think you’ve missed the point of Ms. Barston’s comment. What I heard her pointing out was that sure, facts are facts and people need to be made aware of them, but this is also a highly emotional issue, and it pays to take that into account when discussing it. When a breastfeeding advocate makes an extreme statement which demonizes formula and sanctifies breastfeeding, new mothers who are considering bottle-feeding (or are already bottle-feeding)–that is, a large portion of your target audience–will start to feel defensive about their choices and will tune you out. Forget about whether it’s nice or morally correct to denigrate people’s choices like that in the name of promoting public health. This isn’t even a question of empathy or sensitivity yet. It’s just plain bad tactics. Speaking more loudly and more often does not help you if people percieve you as an extremist who is set against their personal choices and will therefore not listen to you.

        I’m not sure why your “final point” was necessary, but it does serve handily to illustrate the shaming that mothers who do not breastfeed are subject to. Would you listen to someone who told you that you weren’t a real mother because of a particular parenting decision they made?

        Star

        July 24, 2012 at 12:13 pm

      • Actually Kathy, I am one of those women who truly can’t nurse and yes I do feel guilty and fearful. It’s best not to make assumptions but thank you for letting me know I can’t “safely formula feed” my daughter

        Tina

        July 24, 2012 at 12:26 pm

      • Wow. Your sentiments, exactly why I wrote my most recent blog post. And to assign mothers who truly can’t breastfeed to only a “tiny fraction” of the population is like saying they don’t matter. These women (myself included) are significantly under recognized and have not even been studied! It’s a larger population than you might think and they absolutely feel guilt and shame. Until breastfeeding advocates acknowledge and become educated on how to diagnose and help these women…your words of advocacy are merely lip service with no real action behind it.

        I don’t even know where to begin about your comment “there isn’t any way to safely feed formula”.

        I thank God for the kind and intelligent IBLC I finally found to help me through my IGT. She gave me hope that there is a right and helpful way to advocate for women in their breastfeeding endeavors.

        confessionsofadrmom

        July 26, 2012 at 2:31 am

      • I am a mother who could not breastfeed my baby, and I felt very guilty for my inability to do so because of people who make comments like you, and others in this thread (“Mothers who fail my feel guilty and fearful, but what they should feel is angry that they didn’t get the support the need,” as an example). Just like Suzanne Barston (whose book you should read before you judge her), I did get help and support. I got help from the nurses at the hospital, a public health nurse, and three different lactation consultants at two different clinics. I exclusively breastfed for over four months, while my son’s weight kept dropping and dropping until he was no longer on the WHO growth chart for weight. For whatever reason my milk did not sufficiently nourish my child (despite the fact that he nursed for hours and hours each day, with a good latch!). Because of this ‘failure’ to breastfeed, I felt incredibly guilty. The culture around breastfeeding is very intense. When I pull out a bottle in the company of breastfeeding mothers I get accusatory glances, even though these other mothers are unaware of my individual experience. I see all of the public health posters at the hospital and dr’s offices that say ‘breast is best’. I get that breastfeeding is beneficial for both mother and baby, but it wasn’t ‘best’ for my baby. So, I am 100% for breast feeding advocacy, but I am not in favour of the way it is currently being advocated for. It does have ill effects on mothers who choose not to breastfeed (which is a legitimate choice), and who can’t breastfeed for whatever reason. This campaign made me feel like I wasn’t doing what was ‘best’ for my baby, despite the fact that my baby had a dangerously low weight on breast milk, and thrived on formula. At the end of the day, my son is well loved and well fed…on formula. When I have another baby, I will try breastfeeding again. If it does not work, I will not hesitate to switch to formula. I think what bottle feeding mothers need is not to be ostracized for their feeding choices. Breast might be best, but the bottle isn’t bad.

        Lindsay

        October 14, 2012 at 3:06 pm

  6. I went back to work after 6 weeks and my work fought me every step of the way on pumping at work. I had to drop the federal law on my HRs desk before they began to comply with the law. I made it 7 months before my milk started drying up and it was a great run. Don’t let the man keep you down, ladies!

    brittany

    July 24, 2012 at 8:24 am

    • You said it exactly. It’s our society. We have the worst maternity leave here in the US. I was lucky enough to have very flexible work hours and I am an OB nurse, so my job was very supportive when I pumped at work. Our society needs to change and support new mothers not only with feeding, but spending time with our babies.

      Tricia

      July 30, 2012 at 4:59 pm

  7. <>

    I have to take issue with this – yes, some moms struggle with breastfeeding. Yes, for a particular mom and baby – it might not be possible. Yes, sometimes breastfeeding just does not work.

    But I don’t know anyone that breastfeeds or breastfed under ideal circumstances, and I don’t believe it is necessary for circumstances to be ideal or that 6 months is a “lofty goal”.

    Catherine

    July 24, 2012 at 8:46 am

  8. I think there is a need for compassion on both sides of the argument breastfeeding moms need respect and support and so do non breast feeding moms. We can’t let media drive a wedge between the two groups because united as mothers is how we can change society and repair the morals of a country that is more forgiving of someone for having a sex tape then they are of a mother breastfeeding in public.

    SMB

    July 24, 2012 at 9:01 am

  9. I was unable to produce enough milk to just breastfeed but I went through hell and high water to do as much as possible. I took a supplement and used an SNS and pumped all the time. When I went back to work I pumped in stinky bathrooms and in the dark after the auto lights shut off. I was only able to have milk for 3 months but I would do it all again. I know my son is healthier for it. Now, that doesn’t mean everyone has to. It’s your choice but if I want to even if other people think I am not getting enough milk that they think its worth it; I can. It’s my choice.

    Liz

    July 24, 2012 at 10:26 am

  10. I am glad I read this post but it is raising my blood pressure. Jane Brody once recommended a diet and fitness regimen so exhausting that a reader wrote in to say, “No thanks, I’d rather die young than live like that,” but she is consistently lukewarm on breastfeeding. I don’t get it. And I can’t believe they’re quoting Amy Tuteur, who has exactly one semester of stats and epidemiology under her belt, as any sort of authority on breastfeeding. She is quoting Michael Kramer’s study on behavioral outcomes, despite the fact that (a) it compares more-breastfed and less-breastfed kids, thus telling us very little about groups of formula-fed kids, and (b) the PROBIT results as a whole provide incredibly compelling evidence for the importance of breastfeeding.

    Jamie

    July 24, 2012 at 11:06 am

  11. WOMEN!!! MOTHERS!!!! For GOD’s SAKE…stop this madness women have all their lives of attacking each other!!!!!!!! MEN don’t do this garbage…What is the matter with us????????????? As difficult as life is for women, still in a man’s world, we need to SUPPORT each other. There are plenty of reasons documented why breastfeeding is best nutrition…so we need lots of education and support to make this possible.
    BUT…when a mother feels she can be a better mother by formula feeding….FOR GOD”S SAKE…SUPPORT HER. STOP THIS MADNESS!!!!!!!!!!!!!

    LINDA WALKER

    July 24, 2012 at 1:11 pm

    • Star – I work with mother in the uncomfortable middle. Those who have problems breastfeeding. I beg to differ with your impression based on the 10,000 women with whom I have worked. ALL mothers are attacked for feeding their babies NO MATTER HOW THEY FEED THEM. That’s right. Breastfeeding mothers get criticized just as much as formula feeding mothers and mothers who are trying to breastfeeding but must use some substitutes for their own milk or must feed from a bottle and pump get the most criticism of all. I have never yet heard a mother complain about being yelled out for bottlefeeding in public nor had her complain about being subjected to downright nasty and perverse comments from women and men alike. So, the issue is that ALL mothers are criticized no matter what.

      Now the problem I have is that feeding milk from another species has become the default rather than retaining what used to be the default in the past — wetnursing. This is because of the intense criticism that befell women when male scientists started trying to prove that mother love was dangerous and so was their milk. It was fascinating to read Milk, by Deborah Valenze who looked into how Cow’s milk was viewed. The same reasons for distrusting cow’s milk during Medieval Times and the Renaissance are now the same reasons that are often give for distrusting breastfeeding beyond “a certain age”.

      Susan

      July 24, 2012 at 4:50 pm

  12. Of course we can’t let the media drive a wedge between two groups, but these opinion pieces are not based on solid science. As an nutritionist and an epidemiologist I’ve read filing cabinets full of research on the risks of formula feeding and the research is rock solid. Formula was NOT created to fix problems, it was created to sell a product. Before formula we had wetnursing which, when it is done by a healthy woman, is recognized by the World Health Organization as a safer alternative than formula. When are women going to get real and start realizing that we all should be demanding REAL solutions to the human milk gap, which yes, do involve empathy — but not patronizing platitudes.

    Susan

    July 24, 2012 at 1:24 pm

  13. Tina — as a lactation consultant and as an epidemiologist and nutritionist I want to give you an analogy that may help you come to terms with whatever problems you encountered. If you did NOT have diabetes, no medical practitioner would tell you that injecting insulin was desirable or safe. It would not make sense for you to use insulin. If you had Type II diabetes, health care practitioners would help you modify your diet and exercise and perhaps you might need to use insulin but the goal would be to help you get to the point where you didn’t need it. If you had Type I diabetes you would need to use insulin. In the latter two instances, you would not feel guilty about using insulin. I canNOT truthfully tell you that formula feeding is generally AS safe as breastfeeding, but I CAN tell you how to formula feed in ways that are SAFER and in ways that can ENHANCE bonding. Everything we do in life has risks that need to be weighed and balanced. Stop feeling guilty and call up a lactation consultant to find out how to bottle feed formula like a breastfeeder — that is what we should be offering for women that have insurmountable problems. And if I were queen of the universe and had the money of Bill Gates — it wouldn’t be formula it would be safely screen human milk.

    Susan

    July 24, 2012 at 1:34 pm

  14. I am an IBCLC at Aviano US Air Base in Italy. Our military community is proof that when breastfeeding support is a team effort, moms can and will have successful breastfeeding experiences. Every year we honor our community moms who exclusively breastfed for 6 months with a unique military breastfeeding coin. Next week over 60 moms, 12 of which are Active Duty will be coined. If moms in the Army and Air Force at our base can do it, so can the rest of the country. If anyone cares to examine our program to see how we have done this, email me at jennifer.cooper@aviano.af.mil.

    Jenny

    July 24, 2012 at 2:06 pm

  15. It is very hard to take seriously this sort of comment: “I stuck it out for four weeks and then pumped until I dried up completely because I felt like I’d be a failure if I gave in, and because I was being bombarded with messages about what a horrible mother I would be if I bottle-fed my baby.”

    After 30 years in the breastfeeding advocy field, it just does not ring true to me. It sounds dramatic and exaggerated.

    I know that some mothers are VERY enthusiastic about breastfeeding, and they want to HELP, even if their suggestions seem simplistic or unrealistic, or both. But I just never really hear judgement from such mothers.

    Matter of fact, the only time I really encounter jedgement with regards to breastfeeding, it is directed at the breastfeeding mother who is nursing a child for a longer period of time than others find acceptable.

    But women bombarding others as horrible mothers for not breastfeeding- this is urban legend, in my very informed opinion. Let’s remember who stands to gain if breastfeeding and or breastfeeders gets a bad name?

    Susan

    July 24, 2012 at 3:15 pm

    • Susan – I completely agree with your comment about the urban legend of women bombarding other mothers for not breastfeeding. I’m sure it happens, but it’s certainly not the norm. The majority of women understand the limitations of care and support necessary for successful breastfeeding in cultures where we raise families in historically unnatural, isolative ways.

      Here in U.K., majority of bf women are viewed by public as deviant, despite NHS and UNICEF efforts to encourage natural feeding. Ideally, we all (all ages, genders, cultures, etc.) will instinctively accept that natural feeding is just the “finishing off” process from pregnancy to birth…and we will be tolerant of listening and respecting the challenges faced by women while breastfeeding as much we are with issues of uncomfortable and difficult pregnancies, all of which aren’t always successful. And, we will all understand the link between big business profiteering vs. regard to baby’s well-being (i.e. developing better, more natural supplements) and the environmental consequences of bottlefeeding.

      The artificial baby milk and various bottle feeding equipment companies must be laughing at all this discussion and controversy, as it just raises their profile and profits. The “war” isn’t really between natural vs. artificial baby feeding methods but rather between these big companies intent on diminishing a mother’s power to sustain her baby’s life by having convinced recent generations that their products are equal substitute to mother’s milk vs. just to be used an emergency alternative…which were the original intentions.

      Matrioshka

      August 2, 2012 at 8:12 am

  16. It is not by chance the NYT articles and the “controversy” come out right before World Breastfeeding Week!
    Nancy Wight MD, IBCLC, FABM, FAAP
    Mother, Breastfeeding Advocate, Neonatologist

    Nancy Wight MD

    July 25, 2012 at 12:13 pm

  17. Folks: there’s not a parent alive who has done everything they ideally wanted for their children. People do what they have to do, what makes sense for them. So, yes, I breastfed my kids for the recommended amount of time. But now I buy them Fruit Loops and let them play video games. Before I had kids, I swore I’d never do such things. But it happens. For lots of complicated reasons, this is what allowed peace to reign in my household, and while I regret it, I’m not ashamed. It might be useful to look at feeding the same way. Formula isn’t often a mom’s ideal choice in an ideal world, but she did what she needed to do at the time.

    Melissa Bartick

    July 25, 2012 at 2:16 pm

  18. [...] good news comes from Dr. Alison Stuebe, who at the Breastfeeding Medicine blog highlights what’s wrong with both of these pieces (starting with the credentials of the sources [...]

  19. Great response! Keep up the good work!

    Jen S

    July 31, 2012 at 6:42 am

  20. Yes, there are complexities that lead to a woman’s choice to breastfeed or not, and there is a theory out there that basically says people will do/act according to whatever is easiest at the time. But that’s what’s so sad (in my opinion)…breastfeeding used to be the easy and accepted way to go.

    I believe breastfeeding advocates are simply trying so hard to remove barriers for anyone wanting to breastfeed, that others mistake them as zealots, and this should not happen. For every action, there are consequences. We may not yet know the full consequence of deviating from what mother nature has intended, though I believe we are seeing some now (increased childhood obesity and diabetes for starters). As an OB RN and breastfeeding advocate, I always ask my patients what they would do if they delivered their baby on a deserted island, and there was no formula, coconut water, or anything. How would they feed their baby? They respond 100% of the time that “Of course, I would breastfeed…I would never let my baby starve.”

    I believe the plethora of choices we have today have made healthy lifestyles very difficult to live, and using formula over breast milk is no exception. We will never be rid of formula, and that’s a fact we need to let rest. But for those wanting to breastfeed for as long as possible, barriers need to be addressed. Here’s to healthy babies, and healthy mommas!!

    Sarah

    September 22, 2012 at 3:16 pm

  21. Beautifully written. Well done and thank you!

    Julie

    April 28, 2013 at 8:08 am


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