In the Guardian today, Jessica Valenti wrote an excellent piece about breastfeeding, bottlefeeding and judgement. It was a lovely article, making making points well. But it’s central point – namely that all parents are making the best choices for their families – is flawed. Hang on, before you grit your teeth to prepare to read a bottle-feeding smear article, hear me out.
Choice in infant feeding is a myth
Valenti asks why we clamour to celebrate breastfeeding and why we don’t show the same adoration for bottle feeding. The fact is, breastfeeding is still the underdog. If you doubt that, simply look at the numbers – in Canada only one quarter of infants are exclusively breastfed for the recommended six months. In the United States that number is below one in five. Feeding artificial milk is thus the normalized, if simultaneously derided, ‘choice’ simply by virtue of the numbers.
The real question though, is whether or not bottle-feeding is a choice. Do we think that nearly 70 percent of the mothers who first ‘chose’ breastfeeding simply switch their choice to artificial milk a few weeks later?
In her article, Valenti gives us this beautifully personal and detailed account of how her feeding decisions were made”
In my case, when my daughter Layla was born, nearly three months early and weighing just 2lbs, breastfeeding wasn’t on the table. Instead, she was first fed intravenously and then later by feeding tube with milk I had religiously pumped. But the stress of having a very sick child does not do wonders for milk production and, by the time she came home two months later, I had to supplement breastfeeding with formula to make sure Layla got all the nutrition she needed. I felt like a failure and a terrible mother.
I enlisted the help of a lactation consultant and started pumping 15 minutes every hour (six hours a day!). Even as I cried in pain and was thrown into a horrible depression, I kept it up because I fully believed not only that “breast was best” but that formula was ruinous. It was only when I stopped – in part, because of the legitimate concerns raised by, among others, my extremely worried husband – that I truly bonded with my daughter. I had to give myself permission to be okay with bottle-feeding for nutrition and still breastfed Layla for comfort, for both our sakes.
Valenti sandwiches her story in sentences about her supposed choices, but her words make it incredibly clear that although she certainly made decisions, the circumstances were entirely too constrained to call those decisions choices. When your traumatic premature birth leaves you unable to produce enough food for your baby, you are not ‘choosing’ artificial milk, it’s simply the only feasible option available to you.
A friend and I once co-wrote a blog post about our nearly identical early feeding journeys and their very different ends. Ultimately we both made different feeding decisions, she bottle-fed her beautiful daughter and I’ve gone on to breastfeed both of my children. Did either of us ‘choose’ the diverging routes we took? No. I got adequate professional support for my challenges and Kelly did not, that’s it. In the early days of parenthood, when our bodies are recovering from the intense, and often traumatic, exertion of birth; when we are on a hormonal roller-coaster; when we’re abruptly left without a primary health care provider for either us or our babies; when the care providers we do seek out dole out bad advice on a topic they have absolutely no training in, are we really at liberty to make choices?
Going forward, our feeding decisions continue to face constraint. In Canada, if we are conventionally employed, we enjoy 50 weeks of paid parental leave. But in the US, the number is as low as six weeks and without any financial support. I am as determined a breastfeeder as anyone, but I’ll be the first to admit that I wouldn’t have spent two weeks struggling to get breastfeeding to work if I knew that it would probably go out the window four weeks later anyway. I would have bottle fed and enjoyed my meagre time at home, then left for work free of the stress of finding the time, physical space and bodily ability to eject milk into a whirring machine. It would have been my reality, but certainly not my choice.
Then there is the social treatment of the two feeding methods. It sickens me to hear of bottle-feeding mothers being scorned. It shouldn’t happen, yet we live in a world where we think we can know a person, their history and thoughts from 140 characters or a sepia-toned snapshot. We’re ready to not only form an opinion in an Instagram, but are desperate to voice it. But here again, breastfeeding women are still at a disadvantage. Not only is their feeding method critiqued, those critiques are often encased in an additional and disgusting layer of sexualized commentary. Anywhere from comments about the size, shape or desirability of the breasts, to accusing the woman of an act akin to public masturbation. I have often heard women name anxiety about such harassment among their reasons for bottle feeding and if their inner sphere of family and friends isn’t supportive enough to counter this, it becomes a serious factor. If fear of sex-based harassment is a motivator for a decision, that decision cannot truly be called a choice.
The myth of choice leaves us with no one to blame but each other
The crux of Valenti’s article is to beg us all to accept each other and the choices we make. Her final sentence is one of support for parents “making the choices that are right for them and their children”. I fully support the sentiment, but I firmly believe that the real solution is in repositioning the discussion. We do need to fully support every parent for the decisions that are necessary for them and their children, but we need to stop masking the external influences on those decisions under the guise of choice. Those of us who ‘succeed’ at breastfeeding need to admit that it was help and luck more than choice that created that success. Those who wanted to breastfeed but switched to bottlefeeding need to feel able to say that it was not their choice, it was the necessary route and that sometimes we do what we must instead of what we wish.
It’s complicated and messy to say in the same breath that artificial milk is not optimal but that it’s certainly preferable to starving and that using it gratefully doesn’t preclude us from using it with a degree of sorrow. It’s hard to say that babies who are fed formula are going to be OK but we need to fight for good and accessible breastfeeding supports so that fewer of them need to be given formula. It’s a lot easier to say “This was my choice so back off!”. But that conversation keeps the focus on our internal debate about who is a better mother, and stops us from working together for the things that all mothers need. After all who wants to talk honestly about the risks inherent in using artificial milk if we’re asserting that those who use it are doing so by choice? The theme of choice is what leads us to deny the fact that affiliations between healthcare providers and formula manufacturers creates an obscene conflict of interest that lowers breastfeeding rates.
If we don’t start having the messy complicated discussion, then we’ll keep writing articles asking why Olivia Wilde gets more praise than a bottle feeding mother, when we should be asking why some women get paid to breastfeed their babies in couture when other women are too busy worrying about how they’ll stretch their minimum wage to pay back the exorbitant hospital bill from the birth, especially after missing six weeks of pay, to have much time or energy left for worrying about making the feeding ‘choices’ that are right for them. If we don’t start having that discussion and writing those articles, then we’ll keep having this blame war instead of lining up collectively to make a better reality for us and our babies. And choice will continue to be a myth, rather than becoming a reality.