Lately, I've noticed what can only be described as
something of a "breastfeeding backlash" in the media, and among some
mothers. The message of this backlash can best be summed up as
something like this, "the health benefits of breastfeeding have
been wildly exaggerated by a bunch of weird and nasty breastfeeding
zealots who get their kicks from harassing bottle-feeding mothers in an
attempt to make them feel guilty."
There are
variations and nuances on this theme, depending on the medium and
message-bearer, but that pretty much covers all the bases. The most
prominent recent example of the breastfeeding backlash was Hanna
Rosin's much-discussed piece in The Atlantic, provocatively titled, "The Case Against Breastfeeding." Jennifer Block already wrote a definitive and specific rebuttal
to Rosin's piece, so that's not my intent with this particular blog
post. Instead, I want to explore the current reaction to perceived
breastfeeding "zealotry," and offer some context that I think might be
helpful when considering how and why we are seeing this bubble of
contrarian commentary at the moment.
The current
breastfeeding backlash is a reaction to a certain intensity surrounding
the issue of breastfeeding that did indeed gain currency over the past
decade or so. But what today's mothers - the ones who are fueling the
breastfeeding backlash with their criticisms and complaints - don't
appreciate or maybe even realize is that the activism and advocacy they are
slamming was actually an important, grassroots women's health movement that managed
to fundamentally change the way our culture views and treats
breastfeeding within only about ten years (!!!). And any time you have a
movement that erupts out of a sense of frustration and oppression, and manages to turn
that frustration into the kind of power it takes to create meaningful change on a big issue, that movement is going to have to be both pushy and loud.
The
group of people on the leading edge of most social change movements are
often later criticized as "too radical" by the very people benefiting
every single day from that radicalism. Example: 20 and 30-something female executives
who today speak with disdain about those "radical, bra-burning
feminists," without appreciation for the fact that they are trashing
the very women who effectively blasted open the doors of corporate America's steno pool so their daughters and granddaughters could instead take up
residence in the c-suite. So if these younger women are defining
"radical" as "assertive, unrelenting, outspoken, political and
visionary," well then, yeah, I guess the objects of their criticism
qualify for the label. But really, they should be thanking the
feminists who preceded them into the workplace instead of criticizing
them.
Sort of like those women who casually enjoy the obvious fruits of second wave feminists, even as they criticize them, I suspect that many (most?) of today's
mothers of babies and young children are completely unaware of how
different our cultural landscape is when it comes to breastfeeding than
it was only a very brief time ago. They take it for granted that their hospital has a lactation consultant, and that their insurance company will help pay for the breastpump needed to express milk for their premature baby. They can't imagine a world where ALL breastfeeding mothers (and there weren't that many) excused themselves to a cloistered location every time the baby needed to eat, or where the idea of continuing to nurse into toddlerhood was seen as pathologically bizarre. New mothers today can't imagine these things because, before becoming pregnant or having a
baby themselves, they never even thought about the topic of breastfeeding, so their only
context is Right Now, Today. As a result, far too many women fail to appreciate the "zealotry" that gave birth to the readily accessible breastfeeding resources, support, protections, acceptance and
information they now have available; they just don't
get why anyone would feel the need to engage in activism or advocacy on
a topic that seems so mainstream. I meet many current moms who have
this opinion because I, too, am currently the mother of a toddler, just
like them.
But I also happen to be the mother of an
almost-18 year old, a 14 year old, and an 11 year old. So I remember
what it was like when I gave birth to my first baby, in 1991. Things
were very, very different even that recently for mothers in this
country who wanted to breastfeed, which I did. But finding out HOW to
nurse my baby wasn't so easy. Aside from local La Leche League
meetings - which I only knew existed because I happened to see a flier
on a grocery store bulletin board - along with a few boring, well-worn
books that you could only find at the library - I wasn't able to find
any good information about breastfeeding my baby in advance of his
birth.
But I gave it a go anyway, struggling along on my
own. Then, at my very first postpartum pediatric appointment, the baby
doctor looked disgusted and horrified when he came into the exam room
and found me nursing my newborn, and he quickly turned on his heel and
walked out. His nurse then came in, and carefully explained to me
(while averting her eyes) that the doctor would wait until I "finished
doing that" before returning to speak to me or see the baby. When he did
return, he firmly recommended supplemental bottles of formula to "help
with his weight gain," and he told me that the information I'd read
about how pacifiers could cause breastfeeding problems was "complete
nonsense." I did as he instructed. He was the expert, after all.
When
I developed a not-unexpected case of mastitis two weeks later - mostly
because, at my pediatrician's recommendation, I wasn't nursing my now
partially-bottlefed baby often enough - the doctor I then went to see
(at the urging of my worried grandmother,
who kept insisting I'd developed something she rather charmingly
referred to as "childbed fever") immediately hospitalized me for three
days for a course of IV antibiotics. The doctor told me that I needed
to pump and dump my "infected breastmilk," and that my baby could not
come to the hospital to see me.
Yes, this is a true story. I was hospitalized and separated from my newborn for several days because I had...MASTITIS. And this was in 1991, not 1951.
Fast forward to 2009. Today, American women have access to a huge volume of excellent and accurate information about the hows and whys of breastfeeding. State laws
support the right to breastfeed in public, and businesses offer
lactation rooms and support. Today's pediatricians are far better
informed about how to help mothers successfully nurse their babies, and
hospitals/medical organizations are beginning to take a hard look at
the ethics of their relationships with infant formula manufacturers. We
still have a long way to go in all of these areas, but the significant
changes that have taken place just since I gave birth in 1991 are
pretty remarkable.
As my personal story illustrates
anecdotally, today's wealth of information and support for
breastfeeding is actually still quite a new development, even though
the seminal feminist health organization otherwise known as La Leche League
had been conducting a tireless crusade to educate women and doctors
since the 50s. LLL's work was groundbreaking, and its importance can't
be overstated, but breastfeeding still really hadn't really "gone
mainstream" when the 1990s dawned. Sure, many women at that time did
nurse their babies for at least a short period, and certainly among
some specific demographic groups, breastfeeding was more common.
However, the situation for the majority of American women was one in
which information was faulty or absent, and support was almost
non-existent.
Enter the "zealots" who are now the subject of the breastfeeding backlash.
Beginning
in the early-to-mid 90s, La Leche League finally got reinforcements for
their tireless, yet always gentle and polite campaign. The help came in
the form of large scale, cross-demographic, mother-powered organizing
and information-sharing, made possible for the very first time by the
advent of the Web. Suddenly, mothers could for the first time ever,
quickly and easily ask OTHER MOTHERS about breastfeeding issues
and concerns! And as mothers talked to each other online, and gained
access to information we had never had access to before, we realized
how much flat-out erroneous info was being propagated by the healthcare
establishment at that time. We got a clearer picture of the
longstanding advertising practices of the infant formula industry, and
gained an understanding of the impact those practices had on women's
infant feeding choices in our country, and all over the world. We were
able to educate ourselves in a way our doctors could not or
would not - using the medical libraries and peer-reviewed journals that
we could now access online. We learned about the health risks for
babies who are not breastfed, and the health benefits to women that
come with nursing our children. Lactation consultants, often isolated
as the only person doing their job in a particular community or
hospital, could for the first time easily communicate with one another in a setting that allowed case sharing and professional development.
Wow! Talk about radicalizing!
There
was certainly a period, during the second half of the 90s and the early
part of this decade, when the discourse regarding breastfeeding was
somewhat reactionary. What I mean is that after many decades of
information suppression and misrepresentation, a lot of women were,
well - for lack of a better way to put it - kind of pissed off when we realized that as a group, we'd been misinformed, manipulated, dismissed and even lied to regarding this important and meaningful element of infant-maternal health.
We
were really irritated to find out that, despite what we, our mothers
and grandmothers before us had been told by the "experts," we actually
COULD breastfeed our babies successfully, and that we DID make "enough
milk." We found out that infant formula ISN'T "just like" human milk,
and that women all over the world DO nurse beyond infancy. (That was a
real eye opener.) In short, we discovered that the medical profession
we trusted, along with infant formula manufacturers and marketers, had
sold us a bill of goods about something that really mattered to us, and
to our children.
Our generational response to this
discovery came in the form of an unprecedented tidal wave of new
articles, books, websites, online communities, organizations, and
academic/medical research on the topic of breastfeeding, all within a
period of only one decade. Our frustration became consciousness
raising, which became empowerment and productivity, and I think it's
fair to say that those of us who were among that particular group of
"lactivist" moms fundamentally and forever changed the dialogue on
breastfeeding in America.
Some of us played a role as writers, while others of us were Web developers, doctors, nurses, academics, midwives, peer counselors, lactation consultants and activists.
In the course of only about one decade, this group of women - early
adopters and very effective users of what is now called social media -
built on the pioneering work of La Leche League and others - and
in doing so, we successfully reclaimed an important part of motherhood
for ourselves, and for our daughters. We changed laws, we changed
workplaces, and we sparked a process of significant and ongoing change
in the way medical practitioners learn about breastfeeding. (Hells yeah, we did!)
It is this group of women, the ones who instigated such
a powerful, fundamental and important change for the benefit of all
American mothers, who are the "zealots" now being criticized.. And I
can't deny that as we got our movement to create this big, messy social
change underway, we might have sometimes come across as excessively
outspoken or a wee bit hyperbolic. Let me be clear that I am
absolutely, 100% opposed to anyone at any time being rude to, or
questioning any individual mother about her individual feeding choices.
To wit: it's not okay to offer one's unsolicited view directly to a bottle-feeding mother that she should have "tried harder" to breastfeed, and it's also not okay to tell a breastfeeding mom that she needs to leave a public place and find a more private one in order to feed her child.
Unfortunately, I am now unhappily aware that on occasion, in years past, my own outspoken activism on behalf of a public health topic about which I remain very
passionate did sometimes, completely unintentionally come across as personally rude or
intolerant to individual women. If, for example I responded to a new mother who mentioned to me in an offhand way that breastfeeding "has been really tough" with something like, "I'd be happy to hook you up with a local lactation consultant!" - without being ASKED to help that person find a lactation consultant - my intent might have been to be helpful, but I have come to realize that the recipient of this "helpful" suggestion probably heard it as intrusive, judgmental and rude. And when a discussion among neighbors about a magazine article I was writing on the ethics of the infant formula industry was held within earshot of a mother who was quietly bottle-feeding her 4 month old nearby, I wasn't sensitive enough to realize that the discussion I believed to be totally impersonal, and not in any way directed at her, could be perceived as unkind, thoughtless and hurtful. I have - over time, and after talking to many women who have shared their experiences with feeling judged and criticized for their decision (or need) to bottle-feed - come to appreciate the imperative to be EXTRA careful never to allow public health activism at the 30,000 foot level to create the perception in any individual woman that I am judging or second guessing HER, personally. But I know I screwed that up sometimes in the past, and for that, I want to offer a genuine and
heartfelt mea culpa. I hope any woman whom I ever hurt in this way - no matter how unintentionally - can forgive me.
But
if I did manage to step on some toes (again, I am truly sorry) via stridency on this issue, I
also know - because I hear it from people all the time by email, through my blog
and in person - that the book and the numerous articles I wrote about
topics related to breastfeeding between about 1996 and 2002 helped a lot of women decide
to breastfeed, and to keep breastfeeding. Knowing that I truly made a difference to more than a few women in this way is an accomplishment that means a lot to me. And I also feel proud when I hear from a medical student
that he took something I had published on this topic to his obstetrics department head as "ammunition" to ask for more evidence-based teaching on
human lactation. I feel like I made a difference when a state legislator tells me that
something I wrote inspired her to introduce a bill to protect
breastfeeding mothers from harassment or discrimination. And I feel honored
to have been part of a grassroots, mother-led public health
campaign that will mean healthier babies and women for the generations
that follow.
Why am I so passionate about
breastfeeding? Well, because despite some of the criticisms about
"exaggerated health benefits" now being made as part of this whole
breastfeeding backlash, the amount of well-accepted, peer-reviewed
evidence that breastfeeding is one of the most important factors
affecting infant mortality and morbidity continues to grow. It's also
becoming clearer that breastfeeding provides some level of risk
reduction (a level some researchers believe could turn out to be quite
significant) against breast and ovarian cancer in mothers.
And breastfeeding is emerging as an important environmental issue, as well. Last, I believe the tactics of the infant formula industry, and the way they have continued to influence the health care profession, the WIC program, and the entertainment industry on this issue, represent one of the most egregiously unethical situations in the history of American business. It's bad stuff, and is beyond worthy of assertive and outspoken activism.
Sure,
there have been some faulty studies among the many hundreds that now
exist on the topic. And yes, sometimes evidence has been twisted to
exaggerate what some individual study actually says (I would argue
that's mostly been done by the mainstream media, however, and not by
the lactation science or breastfeeding advocacy community- you know, us
"zealots.) Yes, some individual breastfed babies are sicker than some
individual bottle-fed babies, and yes, I know that your mother
bottle-fed you and you "turned out just fine." Breastfed babies can't
jump higher or run faster, and no, your breastfed baby will not grow
up to have x-ray vision or ESP. Finally, it is certainly true that the
risks from not breastfeeding are far, far lower for a
formula-fed baby living with his lawyer-parents in Brooklyn than they
are for a formula-fed baby living with his low-income mother in inner
city New Orleans, or in a refugee camp in the Middle East.
I
freely concede all of these points, but I am frustrated when they are
trotted out by the breastfeeding backlash brigade as meaningful
evidence that in general, breastfeeding doesn't really matter that much
to infant-maternal well-being. These individual points are being used
as red herrings and distractions by the anti-breastfeeding campaign.
And if you don't believe that such a campaign exists (and that many
doctors and mothers unknowingly have their views and opinions and
actions with regard to infant feeding choices manipulated by this
campaign), you are dead wrong.
The appropriate way to consider whether breastfeeding matters as a
public health and societal issue, and to understand why activism in
support of breastfeeding matters, is to consider it from an
epidemiological, population-wide perspective, not by looking at
individual babies, or by picking out individual pieces of the whole
picture. When you put on that wide angle lens, the view is both clear
and dramatic. It also becomes clear why some "zealotry" was both
necessary and acceptable from the women on the leading edge of an
important movement.
So here's my proposal to the
mainstream media, and to bloggers and writers and individual mothers
who have fueled this little breastfeeding backlash we have going on at
the moment. How about this week, maybe in honor of World Breastfeeding
Month, you take a minute to look around, and survey the landscape,
circa 2009. Look at that entire row of great books on breastfeeding
that now sit on your favorite book store's shelf. Be grateful for the
huge amount of informative and accurate information on breastfeeding
that is now easily available to women online. Check out that mom
happily breastfeeding her baby on the park bench without anyone batting
an eye. Take a look at that lawyer striding down Wall Street carrying
her breastpump in her briefcase. Consider making a donation to one of
the new human milk banks
that are saving premature American babies every single day. Or how
about sending a little cash to UNICEF so they can counter the massive advertising by infant formula companies
in the less-developed world, where whether or not a baby receives
breastmilk literally means the difference between life and death on a
daily basis.
Once you do those things, maybe you will
be a little less likely to criticize, and a little more likely to
praise the activists and advocates who got the issue of breastfeeding
to where it is today in such a short period of time.
As
for me, if you had tried to tell me back in 1991 that breastfeeding
would be so mainstream by 2009 that it could possibly even generate its own
"backlash," well, I wouldn't have believed you. It would be like if I tried to tell a new, first time mom today that within ten years, there would be a "backlash" against all the mainstream cultural pressure to do what's considered best, and have a homebirth. But the fact that 1991-me would be wrong in my prediction makes this breastfeeding zealot pretty happy.
La Leche League's great work of the past half-century can be viewed as "first wave" breastfeeding
activism, while the second wave
movement (those damn zealots!) - got us to where we are today. And now, I see this current cultural breastfeeding backlash as a sign that American women
are at an important crossroads with this issue. We are experiencing a sort of group cognitive dissonance as we attempt to deal with being simultaneously shoved in the direction of breastfeeding our babies, while at the same time jerked back by miserably inadequate maternity leave, along with continued bombardment with the marketing of breastmilk substitutes. It isn't surprising that this schizophrenic, "damned if you do, damned if you don't" place in which we now find ourselves has spawned a desire to blame someone for the conflicts we mothers are feeling. Unfortunately, however, the blame is being directed at the activist women who have worked to support and inform breastfeeding mothers, instead of where it really belongs: in the direction of our business and political leaders, at big pharma, at some (not all) healthcare institutions and organizations, and at the relentless marketing campaigns that continue undermine breastfeeding success for so many of us. The current irritation, even anger directed at the breastfeeding advocates whose intentions are very honorable - even if they sometimes accidentally offend in their eagerness to help - is completely misplaced, and pointless to boot. When we spend our energy worrying about individual instances where someone said something rude to an individual bottle-feeding mother, it dilutes and diverts the community energy we should be directing at systemic and institutional problems.
So this is where we find ourselves in 2009. And now, the challenge for the third wave of breastfeeding advocacy is to find a way to continue to be clear, frank and unapologetic in the message that breastfeeding really does matter - and that
the breastmilk vs.formula decision isn't simply a neutral lifestyle choice, akin to picking a nursery color - while accepting and respecting the choices that individual women make as right for them, and for their babies. To paraphrase this very smart blogger's take on this, we need to work together toward a breastfeeding culture, instead of worrying so much about how any single mother decides to feed her own baby. But while we must be sensitive, kind and respectful of individual choices, we can't let that sensitivity and common courtesy impede big-picture advocacy. It's a tricky balance, and one we have not yet achieved. But I am an optimist, and I think we can figure this out, together.
FOLLOW KATIE'S BLOGGING ON TWITTER OR FACEBOOK
READ MORE OF KATIE'S BABBLE BLOGGING
VISIT KATIE'S PERSONAL BLOG