Atlantic Monthly's "Case Against Breastfeeding" Makes the Case for Mothers' Self-Care

Guest post by Meredith Lichtenberg, a post-partum doula. 

Hanna Rosin wrote an article called “The Case Against Breastfeeding” for this month’s Atlantic Monthly. She and I agree on something: women are ill-served by a society that tells them their own needs are irrelevant.

Motherhood is a dance with two partners. Sometimes a baby’s needs predominate. A culture that suggests that a baby’s needs always predominate doesn’t serve women, mothers, or babies. My career is based on helping new mothers learn to take their own needs seriously. This means learning how to evaluate when their needs trump their baby’s needs. But first it means believing that their own needs are legitimate.

After this point, though, Rosin and I part ways.

The reason we part ways, ironically, is that she’s missing her own point. Rosin is enraged that Society told her she should breastfeed because it was healthy for babies. Society told her that her own wishes or needs didn’t factor in.

But instead of saying, “Hey, Society, don’t tell me what I need to do! I’m the mom here, and I’ll decide for myself what’s best for me and my baby!” she succumbed to the “pressure”. Three babies later, she’s really mad. And she thinks that that makes a case against breastfeeding.

Admittedly, my work gives me a bias here, but I think what she needed was a good, facilitated mothers’ group. A discussion among diverse moms in a moderated, respectful forum might have helped her gain the confidence to figure out what, actually, she wanted to do, not just what she thought everyone else thought she should do.

“The Case Against Breastfeeding,” by the way, is an article about choosing to breastfeed or not. It’s not about milk supply issues, breast issues or overcoming obstacles.

What triggered the article was that Rosin did some research about the health benefits of breast-milk for babies. Although she concedes that breast-milk is “best” health-wise, for babies, she’s annoyed to discover that it’s “probably not so much better” than formula.

Rosin isn’t impressed with health benefits to babies from breast-milk. The lawyer in me says, let’s accept her reading of the data her conclusions, and see if it proves her point. She says:

– the medical benefits of breast-milk for babies doesn’t justify “making a mother feel that she is doing psychological harm to her child if she is unable or unwilling to breastfeed.” (I agree, by the way, that trying to make someone feel bad is a lousy way to get things done)

– only four percent of breastfed babies have a reduction in diarrhea.

– lots of studies show only a correlation or only a small improvement in health from breastfeeding.

– the IQ differential for breastfed babies over formula fed babies is only five points. (By the way, if your aim in breastfeeding is solely to get Junior into Harvard by pumping him with a performance enhancing drug, you have other problems).

Even if we agree that this shows breast-milk isn’t so impressive, it’s not much of a case against breastfeeding. People breastfeed, or don’t, for many reasons. People react to the very notion of breastfeeding differently. For some people, using something available naturally has basic, intrinsic appeal. For others, bodily fluids are iffy, imprecise, best replaced with something man-made and measurable.

For some, the thought of baby at the breast is satisfying in a deep metaphoric way. It reflects the incipient connection between mother and baby, the way a mother gives of herself that the baby may grow. For others, the thought of a child hanging off your boob draining away what visually made you woman in the first place is unpleasant or even nasty.

For some people, the fact that breastfeeding is free is inherently appealing, whereas for others, the very notion of paying for something makes it valuable.

(By the way, though, breastfeeding is free. Rosin says that breastfeeding is incompatible with working, so it’s only ‘free’ if a mother’s time is not valuable. But breastfeeding was free, no cost, gratis for her when she pumped and worked, as it is for the many moms I have helped with the transition back to work, as it was for me when I went back to work full-time at a large New York law firm. My time was indeed valuable; I was making enough money to support my family. Buying formula would have cost some of the money I was earning; pumping was cheaper and breastfeeding at home was free. I didn’t say it was easy or simple. I didn’t say that pumping, or figuring out how to balance work and breastfeeding was fun; most people I know who do it, do it despite the inconvenience, not because it’s so enjoyable. But is free. Rosin’s suggestion that it’s impossible to work and breastfeed, and therefore breastfeeding isn’t free is just, well, weird!).

Rosin doesn’t address the health issues for mom at all, though many studies have found that breastfeeding has concrete benefits for mothers including reduced chances of breast cancer and postpartum depression, and quicker physical recovery from birth.

She also doesn’t consider the ways that breastfeeding can affect the relationship between mom and baby. She quotes a researcher saying that the IQ differential in breastfed babies might be because “breast-feeding mothers interact more with their babies.” She uses this quote as evidence that breast-milk itself really isn’t all that great, not as evidence for breastfeeding.

Did I just provoke you with that idea? Are you getting your back up, thinking I am saying formula feeding mothers don’t connect w/ their babies? I am not. I am saying that Rosin’s argument wrongly assumes that the only good thing about breastfeeding is breast-milk, and that if breast-milk isn’t so much better than formula, breastfeeding is useless. But the quality of the milk is only one part of breastfeeding.

Let’s look at the alternative for a minute. Rosin, somehow, ignores the marketing juggernaut of the formula industry. What informed adult doesn’t take a critical eye to someone with a profit motive – in any area? In this country, new and potential mothers are flooded with advertising about formula. It’s illegal for formula companies to say that their product is as good as breast-milk. So they take another approach. They suggest that while “breast is best,” perhaps your particular body isn’t quite up to the task at hand. Or, lately, they suggest that “best” is too perfectionist a standard – liberal, freethinking women don’t need to be goody-goodies; it’s so June Cleaver. Women who believe in “choice” should be liberated from Society’s Pressures.

They don’t suggest these things because they care about the plight of women. They do it because they think it will convince more women to buy their product.

If Rosin has stock in Enfamil, she’s right on to suggest that the nutritive quality of breast-milk is the only thing that matters. If not, she’s been duped into thinking she has a feminist argument against breastfeeding, when really she’s bought into a recent trend where some of the best language and ideals of liberal, educated women have been co-opted and turned on their ear.

When you are traveling with a small child on an airplane, you are told that in an emergency you should put on your own oxygen mask before you put on your child’s. We need to be told this because the instinct is not always automatic. But it is essential that we learn to look at the mom, that we not forget her, whether she is nursing that baby or not nursing that baby. We need to see her as a person, not only a vehicle to support the baby’s health or IQ.

But Rosen herself ignores the importance of each individual mom discovering her own best path! She says that even if breastfeeding has health benefits for the baby, there are “modesty, independence, career, sanity” on the negative side. Now who’s trying to tell all moms how to feel?

Let’s take modesty. She describes nursing her third child in a doctor’s office as being “half-naked.” It simply defies credulity to think that a mother on her third baby literally took off half her clothes to nurse in a doctor’s waiting room. So, she’s exaggerating. But still, her idea is that nursing in public is, must be, horrifyingly immodest for any woman. This is an antiquated notion – that no part of the female body can even be discreetly acknowledged in the public sphere without titillating the surrounding masses.

Rosin is entitled to her modesty. But she is not entitled to claim that her Victorian ideas extend to every other woman. (By the way, for moms who are concerned about whether breastfeeding can be done modestly in public – and it is a legitimate question – the logistical and emotional issues can be sensibly, and respectfully, and compassionately addressed. More than anything, reading this article, I find it a shame that the author seems only to have encountered the most strident and least helpful people, and has generalized that that is all there is out there.)

The same applies to independence, career and sanity. Who does not value independence, career and sanity? Breastfeeding need not come at the cost of sacrificing these. It is valid and important for women to take their own independence, career and sanity seriously. More women should do so. But it has nothing to do with breastfeeding.

Rosin’s clincher is the end of the article where she talks about husbands. I lead discussion groups for new mothers every week, and I know how quickly a discussion about what your husband does or doesn’t do can devolve into an unproductive gripe session about what Neanderthals they all are and how they don’t turn out to be equal partners after all. This is the part of Rosin’s article where we’re all supposed to groan and agree. You know what, though? No marriage is perfect, and when you have kids and there’s less of everything to go around, there’s going to be some stress. Toss in that you’re learning new roles, new identities, that there’s crying and sleep interruption, and you can have a lousy time for a while.

That’s reality. But I will not, and you must not, buy into the idea that the person with milky boobs is the only one who can take care of the baby. And if she does end up taking care of the baby most of the time, to say it’s her breasts’ fault is preposterous.

Mom can breastfeed. If there is another parent, he or she can do everything else. If you have a baby, go home and try that out for a few weeks. Yes – I said everything else. Mom lies in bed eating ice cream between nursing sessions and Dad does all the childcare.

Are you rolling your eyes at this? If you are, your eye rolling has nothing, zero, zilch, nada – NOTHING! – to do with breastfeeding. It is so unusual to see a Dad taking that kind of role with his baby that when I float the idea when I’m teaching, the class bursts out laughing. This is not because breastfeeding infects the family in some insidious way, making us fall into 1950s stereotypes, but because those stereotypes continue to pervade our culture, even though most women in the 1950s didn’t breastfeed at all.

How about a more moderate notion – mom and dad (or mom and other mom who isn’t nursing) find some intricately personal, complex and creative balance, sharing care of their baby, and the boob tasks are done by the one who’s lactating.

This is not something that exists only in La La Land; it’s the result of willing partners who work creatively and flexibly together to find something that leaves them feeling like they’re in it together.

Rosin suggests that breastfeeding causes moms to succumb, slowly, into the stereotype of ‘doing it all’ with dad as the occasional special guest star. Is she an ad exec for some organization for Caveman-Dads? Talk about a marketing scheme – let’s take a bunch of husbands who don’t have a clue and say it’s not their fault – their choices, their interests, their priorities have nothing to do with it. The reason they’re so unavailable and non-participatory is, is is … well, it’s the mom’s breasts that are at fault!

No, ma’am. Your breasts are not responsible for the fact that your husband doesn’t change any diapers.

In the end, Rosin confesses, she is still nursing (and also giving formula), but not “slavishly.” Good for her. Not because she’s still nursing or because she’s giving formula but because, after 3 kids, she has found she can do something without feeling like a slave. You see, this is the goal.

Rosin says that breastfeeding, “contains all of my awe about motherhood, and also my ambivalence.” That is as it should be. Mothers feel both awe and ambivalence. Mothers feel the tug of their babies toward them and the pull of the world of adults as well. We need to see ourselves not only in the supporting roles, but as real, full women, with needs and desires and ambivalence and drive.

Rosin ends by telling us how, now, having thrown off the mantle of the pressuring society, she can experience breastfeeding as “intimate and elemental.” But that intimate, elemental side of breastfeeding was always there, was always a way she could choose to see it. It was she who was preoccupied with the other, “facts and numbers” side of the matter. This isn’t a case against breastfeeding at all. It’s a case against looking at breastfeeding only one way.

Comments

[Rebecca]

Sounds to me as if Rosin is tired. Three kids can make you cranky whether you breast feed or not. Her assertion that because a mom breast feeds she is totally in charge of a baby is nonsense. Meredith is absolutely right -- Dad is capable of many other aspects of caring for their baby (note the their). There are adamant people on both sides of this issue. Ultimately it should be up to a mom as to whether she wants to breast feed or not. Great if she does, but no shame if she doesn't and people on either side should not be pointing fingers. I breast fed. Yes it sometimes interfered with the rest of my life, it was sometimes difficult and there were times when I wished I didn't have to, but in the end it was an emotionally rewarding experience and now that that part of my life is long gone, I am happy to have done it.

[Micaela L. Ward, RN]

So sorry this woman felt victimized by the breastfeeding nazis, but she really doesn't make her case. I am a labor & delivery and post-partum nurse. Informed choice is the key,and when someone chooses not to breastfeed, having weighed the actual evidence, it's still my job, as well as my personal obligation, to support a mother's choice. A guilt-ridden backlash is not the answer to a complex issue.

I breastfed both of my children. When my first child was born, 17yrs ago,I had no support with breastfeeding from hospital staff until the day I brought my son home and was sent on my way with a week's supply of formula. When I went back to work six weeks later, my workplace had no accommodations for nursing mothers. I sat on a bathroom floor and expressed my milk by hand because I was determined not to lose that bond with my child over a lack of support. It was my choice.

I once criticized someone to my mother for not breastfeeding, and she immediately put me in my place. This was long ago, and I have learned to respect the choices women have to make, for whatever reason. I cannot know what it feels like to walk in another woman's moccassins. Women and families have myriad reasons for the choices they make. Those reasons may not always jive with the evidence that breast *is* best, but it *is* still their choice.

Interestingly, the author did not mention any of the reasons women are sometimes unable to breastfeed, other than her own angst. There can be physiological and genetic reasons for a woman to not even be able to produce milk. No one in my field, or La Leche League, for that matter, would shame a woman in that position. Furthermore, many women have ambiguous or even repulsive feelings about their own body image, sometimes stemming from societal pressures, but often as a result of sexual abuse. These victims deserve our sympathy, support and care more than most. Far be it from me to say that she should have to breastfeed and 'get over it.' There, but for the grace of god, goes me and everywoman.

I do not believe that my philosophy of tolerance and compassion is unique. Perhaps the author should choose better company than those new suburban housewives in tight jeans and shades. They seem, to me, to be the root of her distress, rather than the medical and helping professions, who truly are operating under the standards of evidence-based care.

[diverlisa]

Wow, your commentary, while it makes good points, totally misrepresents Hannah Rosin's real point. Rosin is not opposed to breastfeeding - she's opposed to it being treated as the only acceptable choice of responsible mothers. Her point is that mothers who choose not to breastfeed are treated as irresponsible parents by society - be it peers, friends, or some folks in the medical establishment. I know in Northern California, where I live, the choice not to breastfeed leads to one being treated as a negligent parent, if not nearly an abuser. Rosin's point is that the medical benefits of breastfeeding do not warrant this treatment. Choosing not to breastfeed is a medically acceptable choice, and it should be a socially acceptable one.

With both my sons, the transition to breastfeeding was extremely difficult. We had latching problems and yeast infections, and I wound up in way too much pain to nurse or pump. My young boys had supplemental formula while we worked out our nursing difficulties. Thank god for the wonderful women of La Leche, who helped me work through these challenges. I was so afraid of judgment when I sought their help - afraid I'd be made to feel even worse for not being able to nurse my children. I got total, loving support, and it was clear the support would continue if I chose to stop nursing.

Sadly, this attitude of loving support and nonjudgmentalism, while not unique, is hardly universal.

My (now former) pediatrician started pressuring me to give up breastfeeding when my son was 6 months old. I was glared at for daring to nurse in public, and sometimes faced nasty "sotto voice" comments. I saw the same happen with my little sister when she chose to bottle-feed her infant daughter.

I'd really like to see the day where women are provided with unbiased information about the costs and benefits of both alternatives, and can choose without guilt. And I'd really like to be able to see us feed our babies in public - whether by breast or bottle - without our fitness as parents being judged.

[LetsGetHonest]

I managed to streamline some office work, and with the first child, took my work home, and she was nursed into pregnancy with the 2nd, and was a very healthy smart young lady to. She just got into UC Berkeley (and I hope isn't reading me comment about this here). Formula cost was an issue for us, but I also wasn't impressed with all the stuff in it.

As 2nd pregnancy, the (male, who else) older Oby/gyn doctor said, of course you must immediately STOP that because you are pregnant. AT the time, I was also being for the first time assaulted by my husband, pretty bad stuff. I checked with a LaLeche friend I'd gone to high school with (she had 5 kids, I figure that might be a good ref!) and was told, so long as you have enough nourishment. As my ex didn't believe anything coming from a woman, we "snuck-nursed" occasionally, before bed as I recall ("are you guys done in there yet.....").

The second daughter, i think because by then our lives were so volatile and probably this affected things, she was done with nursing much earlier. I was able to make her formula from an Adele Davis recipe. It may have been better, because I'm sure the violence and associated stress hormones would've affected the milk

Going back a generation, I am one of 3, and the youngest. I was told that my mother heeded "Dr. Spock" and didn't breastfeed me, but did my sisters. It may be entirely unrelated, but it seems that throughout life, and now carrying into all of us being middle aged/old, I never bonded with my mother; moreover, if there is ever a family split, it goes along the 2 - 1 divide; she sides with the older 2. Who knows why, but sometimes I wonder. This is also a hard thing, as our Dad is now gone, several decades.

I found breastfeeding discretely in public the least of my worries as a mother, by far. it's just not that big a deal, depending on the clothes you choose. Another health benefit to the Mom is that she more quickly returns to pre-pregnant weight. It does seem to be a good thing -- but like all good things, not if it's a dogma.

The other thing about nursing is it gives you an excuse to STOP -- however briefly-- and pay attention. We need it, I think.

However it be, HOLDING a baby closely and nurturing it is a wonderful thing, it's just part of that relationship when they are so young. What a great start to life if they get enough of it.

I think the fact is that society is fascinated with children & babies, and as such, if you have one, draw attention (or fire, or unwanted advice, or pressure), I think that's a comment on society, as though having kids was abnormal.