Yesterday's discussion about gender equity and childcare spun off into an interesting discussion both here and Crooked Timber. I thought I would sum up the arguments and start a new thread on this topic.
We here at 11D are firmly committed to the notion that childcare should be, in an ideal world, a 50/50 proposition. Men and women should equally split the responsibilities for the kids, because it is good for both parents, good for the kids, and the only way that women will have the time and the energy to compete in the professional arena.
What does the choice to breastfeed do towards achieving that goal?
Siobhan pointed us to an article in Atlantic Monthly by Hanna Rosin that points out that the research that supports the notion that breastfeeding makes kids smarter and healthier is highly flawed. The benefits are marginal, and it is difficult to tease out the data from socio-economic variables and other factors. She questions the huge advantages of breast feeding the babies.
And when I look around my daughter’s second-grade class, I can’t seem
to pick out the unfortunate ones: “Oh, poor little Sophie, whose mother
couldn’t breast-feed. What dim eyes she has. What a sickly pallor. And
already sprouting acne!”
All that work for a questionable pay-off results in a huge cost to women. Rosen writes, "This is
why, when people say that breast-feeding is “free,” I want to hit them
with a two-by-four. It’s only free if a woman’s time is worth nothing."
Breast feeding has a huge impact on gender equity. Even if you make deals, like he deals with the output, while she deals with the input, things are still off. Every time that baby cries, people declare "he wants the boob" and that kid is in your lap. Breastfeeding is time consuming, painful, and dads lose out on the bonding process.
I would be hesitant to completely disregard the benefits of breastfeeding. When it comes to your kids, I think it is best to hedge your bets. But why can't there be a middle ground? Why do we have to go to extremes in these matters?
Sometimes breast feeding is easier. Sometimes bottle feeding is easier. It is possible to do both. That nipple confusion stuff is bullshit. When our kids were born, they were primarily breast fed except for the 3:00am feeding. Steve administered that feeding with formula. He got to bond and I got to sleep. Pumping is a Middle Age torture device, and after one tearful attempt, I refused to do it. Then we gradually increased formula until month six or seven when we went entirely to formula.
Those first few years are overwhelming. We're thrown into a world of guilt and extremism. The books present a one-dimensional uber-mom that we're all supposed to aspire to, and they fail to prepare us for the realities of combining childcare with other goals like work and shared parenting. And as Harry and others say, they don't prepare us for the realities of C-sections and kids who won't breastfeed and sickly babies.
On the other hand, there's the equally ridiculous backlash literature, which states that kids are resilient and actively encourages us to neglect our kids to pursue our own goals.
There needs to be a middle ground, people. We need to do the right things for our kids, while dividing up the labor correctly and having a life outside the home. One good thing about getting past the baby stage is that you stop reading those books. There are still many pressures that wreck havoc with achieving a good balance, but thankfully the breast police have checked out.
UPDATE: Profgrrrrl shares the really lovely part about breastfeeding. When it works out well, breast feeding is cozy and warm. And check out Wendy's excellent post. She thinks that women are encouraged to stop breastfeeding too quickly; she defends attachment parenting. Mamalooper thinks that the breast is best.
UPDATE 2: Here's Rosin on the Today Show.
UPDATE 3: Tim Burke writes, "What I really want is for us to get to a place where modest incremental
benefits can be argued for using modest incremental rhetoric, where
experts don’t feel the need for overcompensatory alarmism or feel they
have to circle the wagons in order to get attention or bludgeon an
uncooperative public into change."
Apt. 11d 
Speaking of avoiding extremism, I found pumping to be just fine. Not cheap, though — it cost $80/month to rent our pump, while formula feeding exclusively would have cost $40/month.
All this was before I, like harry, cast aside the parenting magazines and did my own review of the medical literature. If we have another kid, it’s formula all the way.
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“That nipple confusion stuff is bullshit.”
We wasted a great deal of worry on that and found no problem switching back and forth.
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I practically ruined my life struggling to breastfeed my twins. They nursed for 7 and 8 months, respectively, before they refused entirely. I never made enough milk for both, despite nursing and then pumping 6 times a day (for SIX MONTHS), and when I look back on all of the time I lost due to pumping, lost time to just enjoy my kids, it makes me shudder. I really wish I could have let go a little bit and accepted that 50/50 breastmilk/formula wouldn’t have killed them. Instead I did everything I could think of to shift that ratio to 75/25, and in the meantime nearly lost my mind.
I did it because I read all of the breastfeeding extremism literature and I bought into it.
I often think about how weird it is that breastfeeding extremists don’t put much energy into worrying about what kids ingest when they start eating solid foods. There is so much energy that goes into arguing about the merits of breastfeeding, but if what we REALLY care about is the child’s health and well being, why aren’t we then getting all worked up over feeding kids non-organic food, and milk with bovine growth hormone, and fast food? Why so much concern over breastfeeding and not the same amount of extreme concern over other foods that the child consumes?
The main reason I can think of is that feeding the child one type of food over another doesn’t have the same effects on a mother’s freedom of movement that breastfeeding has. The debates over breastfeeding are intimately tied to a mother’s role in relationship to family and work. I believe this is a hidden agenda that drives much of the breastfeeding-related vitriol of some groups of people.
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“That nipple confusion stuff is bullshit. When our kids were born, they were primarily breast fed except for the 3:00am feeding.”
Again, this is a question on which one’s mileage varies. I have two children. I gave up on breastfeeding the first, because neither I nor she learned to develop the breastfeeding relationship, and because for both of us it was a steep learning curve. Some babies and moms are better at it than others. For my second, I persevered, and succeeded. I am an example of someone who can successfully breastfeed, but only with encouragement and support (and without 3 AM feedings taken over by others during the new born stage).
Now, I was very aware of the statistics behind the benefits of breastfeeding, and do regard them as vastly exaggerated, when applied to individual children (as I do for any other feeding choice, from organics to milk to meat to . . . ). But, I also think there are public health benefits. a .05% increase in obesity is very small, and can’t be weighted very heavily when making one’s own decision, but when making public health policy, the small benefits are relevant.
(I do, incidentally, believe from my review of the literature that there are small but significant benefits to breastfeeding, when it is not contra-indicated).
Oh, and I think there’s just as much extremism over the other food that children consume.
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“I often think about how weird it is that breastfeeding extremists don’t put much energy into worrying about what kids ingest when they start eating solid foods. There is so much energy that goes into arguing about the merits of breastfeeding, but if what we REALLY care about is the child’s health and well being, why aren’t we then getting all worked up over feeding kids non-organic food, and milk with bovine growth hormone, and fast food? ”
Straw (wo)man. All the “breastfeeding extremists” I know put a lot of energy into thinking/talking about those issues.
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albe, I agree with Wendy — the people who are terrified of formula tend to morph into the people who are terrified that their child will taste refined sugar (or even juice). I think your point still stands, though, as it’s rarely fathers who are expected to monitor every morsel that passes their toddler’s lips.
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I agree that those who are very concerned with breastfeeding are also often concerned with the quality and type of food their kids eat. (I am one of them). What I meant to say, however, was that I haven’t seen the same level of discourse on the latter issue in relationship to mothering. Maybe that’s because my children are smaller and I’ve been more steeped in the breastfeeding debates? But I certainly haven’t seen the same amount of energy or the same levels of vitriol or just the sheer volume of discussion on the types of food children eat versus the breastfeeding debates.
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My wife does set the rules about what our son gets as far as organicness and whatnot. For some foods, it has to be organic or we don’t eat it. For others, it doesn’t matter. As far as sweets go, we held-off (with the exception of the haircut bribe) until after he was two. We did the same for TV. Our pediatrian was very concerned that we didn’t let him watch TV till that age and we only did it once (again, so we could cut his hair).
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I completely agree about the backlash literature (but Rosin is not in that camp at all). My objection is not to breastfeeding but to the message that that is the only thing to do, and you are doing something wrong if you don’t do it. I posed this, I think, in terms of the impact on gender equality, in your original thread. But I realize that some marriages aren’t going to be egalitarian, and that some people don’t want that, and also that other marriages (like mine) can manage to be egalitarian despite breastfeeding.
But I also think that there are real mother and baby health issues. The studies (which I distrust) focus on physical health. But emotional health and development are at least as important (more important once some threshold of physical health is reasonably secure). Breastfeeding is VERY stressful for some mothers, and the feeling that one must persist despite any difficulties may contribute to a descent into depression (I’m convinced I’ve seen that happen a couple of times) that is bad for the mother and for the baby, especially if the baby is being cared for mostly by the mother. This possibility is not discussed at all in the parenting books/magazines I read during #s 1 and 2 (didn’t bother to read anything for #3, maybe that’s why he is so happy and energetic and hard to deal with), and often gets left out of these discussions.
Wendy may think that albe is constructing a straw man, and albe may be, but albe’s own story is quite familiar to me, and there’s no question that numerous smart well-educated women who are confident in other areas cede to the experts on this question rather than acting on what would be their own judgment, taking into account their own emotional needs, as well as those of their babies. (Even non-twins sometimes seem not to get enough food).
As for breastfeeding being a well-evolved system that must be better for all children — well, that might be true for all children whose mothers wouldn’t, in nature, have died in childbirth, but my first was born by emergency C-section, and the second would have been if she hadn’t been scheduled for a C-section. Nature would have rendered them motherless, and I don’t see that nature has a mechanism for making breastfeeding the best thing for children whose mothers it tried to kill.
Next post – C-sections.
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Straw (wo)man. All the “breastfeeding extremists” I know put a lot of energy into thinking/talking about those issues.
Not straw. I personally know an LLL member who BF her son until past age 2. Said 4-year-old now only consumes protein in the form of chicken strips from chik-fil-a.
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“My objection is not to breastfeeding but to the message that that is the only thing to do, and you are doing something wrong if you don’t do it.”
See, I don’t think the “breast is best” manthra says, that, though some who say it certainly mean that. But then, those are the same people who would object to my kids eating ice cream before dinner.
There’s a lot of practical pressure *not* to breastfeed, because it takes practice to get it to work, because it requires the mother (preventing outsourcing of care), because it’s more difficult to measure success, . . . . The social pressure to breastfeed is designed to counteract that practical pressure to use formula.
So, I think it’s an important public health policy initiative to tell people that breastfeeding is better (when it is — and although I distrust the overblown conclusions, I don’t distrust the individual studies). I would never apply that to an individual person’s decision about how they feed their child, though. It’s not grounds for taking someone’s child away, or throwing them in jail. It’s not even grounds for shunning.
What are some grounds for shunning? I’ll put one on the able that will annoy many people. I am distressed when people do not vaccinate their children, enough that I would consider, though probably only if it were convenient, shunning them.
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I personally know an LLL member who BF her son until past age 2. Said 4-year-old now only consumes protein in the form of chicken strips from chik-fil-a.
Our you alleging a causal relationship here, or just dinging a passionate defender of breastfeeding for turing out to be a lazy parent when it comes to subsequent nutrition issues? If the former, I don’t see the connection. If the latter, well, lots of people who support good causes are inconsistent and foolish in matters related to, but not the same as, their original cause–that’s not an argument against their point.
There are, I think, very reasonable (egalitarian and otherwise) arguments that can be made against the advice of an LLL wingnut who is convinced that all American mothers should breastfeed their children for 25+ months. But make them on the merits, not by sniping.
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One good thing about getting past the baby stage is that you stop reading those books.
Yes!
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Forget what the kid eats. I want to go to chik-fil-a.
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Our you alleging a causal relationship here, or just dinging a passionate defender of breastfeeding for turing out to be a lazy parent when it comes to subsequent nutrition issues?
Neither. I’m defending albe from the charge of posing a straw man.
I also observe that a lot of energy and attention goes into the solid foods this particular child eats — foods in plastic containers are toted to restaurants and other events, special meals get cooked at home, etc — so I’d hardly call the parenting ‘lazy’. In this particular case the stated rationale is ‘pickiness’ rather than health/organics. I’m sympathetic–you never know what someone else’s parenting experience is–but it is still a (single) anecote that backs up albe’s generalization.
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Hey, I nursed my baby while working — velcro on breasfeeding pillow, hands over the baby and on the keyboard. I guess I’m an extremist. Hold on while a steal a pringle from my 4 year-old.
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bj, shunning! Wow! I have never considered what would cause me to shun another but I find it an oddly compelling idea!
Although this doesn’t go to the level of shunning, I will confess to actively avoiding La Leche zealots. (“La Leche, you say? Interesting! Waddayaknow, looks like I need to refill my wineglass …”)
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First, the basic principle that kids are resilient needs to come back into force big-time. I completely agree with this. I think the post-boomers have become incredibly fussy, overworried parents who overthink almost everything and are inclined to overattribute life results for their children to isolated dimensions of parenting.
Breastfeeding is one of those things that gets overanalyzed in this way. We agreed that it seemed a good thing to do in general. Then at our parenting classes, they allowed a La Leche representative to come in when almost everyone in the class was getting close to term. She was, to put it mildly, a fanatic who basically made the rest of the health system out to be full of villainous plotters who would do anything to corrupt our pure determined will to breastfeed children. She explicitly told people in the class not to trust anything a doctor said about formula, not to deviate ever from breastfeeding.
Neither of us cared for that. And yet, it got under our skin some in those days after my daughter was born, when you’re confused and tired and worried about every little thing. We were both surprised at how difficult it is for babies and mothers to learn how to breastfeed. So about two weeks in, when we were all tired and it was difficult, I finally said, “Screw it, we’re going to do at least one night feeding as formula, so I can do it, you can get some sleep, and we’re sure she’s getting a good meal”. This turned out to be totally sensible: breastfeeding supplemented by formula worked, it allowed me to take on a greater share of the feeding responsibility, it helped us both get some sleep, etc.
Breastfeeding extremism is not a “straw woman”. We both encountered it in person, and it’s real, if as all extremism, not the same as the more sensible advice that other people give. The most sensible thing someone could tell a new parent, however, is “go with what works, use your own judgment, evolve your own style as a parent in relation to the kind of person your child is, and above all, don’t overthink this and don’t act as if every small decision is a battleground on which your child’s ultimate future might be completely determined”.
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We’ve had twins, and just recently given breast feeding the flick, and gone solely with bottle.
Whilst mother still does most of the feeding, I enjoy the times I get to have a go; their two heads in my lap, those four eyes looking up at me, the extreme tiredness, the bike tire smell of their burps, and the cuddles before sleep.
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Like breastfeeding, pumping has a learning curve, but isn’t that big of a deal. I have the Avent hospital grade mechanical pump that converts to a pocket-sized hand pump and I can (and do) pump anywhere. It’s a painless, 10-minute routine and the pump cost $219 on Amazon.com.
Bottles are time-consuming: there’s an awful lot of mixing, bottle-scrubbing, heating up and carting around bottles and extra runs to the store. Giving a baby a bottle requires two hands, but I need one or no hands to nurse and can type away on my laptop or monitor e-mail on my phone (ie further my career) at the same time. During the first six months of my son’s life 90% of the writing I did happened while I was breastfeeding.
Also, formula feeding today means feeding your infant a dairy and/or soy product (two major allergens that doctors otherwise recommend against introducing before age one) mixed with corn syrup (known to be contaminated with mercury) in a BPA-containing can that’s possibly also contaminated with melamine. That’s a diaperload of potentially serious health issues.
I had a emergency c-section (placental abruption), a preemie with suck/swallow issues, and I work outside of the home part-time and travel tons. Yet my one-year old has never had a bottle of formula and still nurses frequently. That’s meant some perseverance and a willingness to pump/nurse in some strange places – but nothing heroic, extreme, or medieval. Seriously.
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Tim, I (personally) never said BF extremism is a straw (wo)man. The idea that BF activists are crazed extremists who care only about their kids ingesting breastmilk and nothing about their ingesting other nutritionally deficient food *is* a straw (wo)man, despite the existence of a few anecdotes.
I’ll have to go to my blog for a response to this one (eventually–don’t have the time right now). I’m hardly an extremist, but 5 years after stopping BF, I guess I’ve become more “extreme.” Ftr, I nursed 1 till 11 months, 1 till 14 months, supplemented with formula with both.
I just really find the tenor of many of the responses here and at CT to be pretty offensive. So dismissive and insulting to people who are trying to make BF to seem more like the norm and less like a gross imposition.
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“Pumping is a Middle Age torture device, and after one tearful attempt, I refused to do it.”
Laura, are you talking about a cheapo retail pump or a hospital rental? I’ve had one unpleasant experience with a retail pump, and some very nasty gumming episodes, but the hospital pumps were fantastic if the suction was set correctly. I did approximately a year of pumping for each child, which meant that for my first baby, it was quite a while before I actually had much to do with her. My husband gave her a bottle while I ran the pump and listened to books on tape (how else would I ever have gotten around to Madame Bovary?). I’d reformulate your quote to “Babies are a medieval torture device, and after many tearful attempts, I refused to do it.”
It cannot be said too often that pregnant women and new mothers are often CRAZY. It’s nothing personal, it’s just the hormones.
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One more thing: there’s a reason why they invented wet nurses.
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And, as I watch the hurt feelings flare in the comments, I realize, once again, why parenting is such a parlous blogging topic. Breastfeeding may work for one family with one kid; formula feeding may be right for another child in another situation and some combination of the two might work best for another.
You’re not automatically a better parent because you breast or formula feed. You’re not getting a gold star if you use the family bed OR Ferberize. Right? Right.
Of course, what I haven’t touched on in this comment, so far, is how very gendered 95% of the parenting discourse is. It’s all about mothers and how bad they are for doing this or that, at least from what I see. *sigh*
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I actually know something here – or think I do. I did a review of breastfeeding results medical literature in conjunction with a paper on chemical contamination of breast milk (a real problem if the mother has been exposed to contaminants, very big in some of the ‘Stans where pesticide use has been extreme and in Inuit women who eat polar bear and aquatic mammal organs, some problem in Michigan-Minnesota women who eat lots of local fish).
Anyhow: after reading all those papers, there is some positive effect (not huge) on kids who are breast fed up to six months, there’s no particular virtue to exclusive breastfeeding even up to six months, and it’s hard to find effects from feeding from the breast versus other food after six months.
My wife made a fairly big effort to breastfeed all of our kids for first three months, with poor success for the first (who spent his first week in the PICU and never really got the hang of it) and good with the second and third. Some years later, they all seem fine.
We all slept in the same bed when they were infants, so it was really easy for her to take the younger two to the breast at 3 am. I did a fair number of 3 am formula feedings for the first (as did she) and it was more disruptive for both of us, but had some sweet moments.
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Wendy, it could be that we are responding to very different micro-social-environments. Rosin’s comment about the chilly reception she got from saying she would quit was completely familiar to me — having read the “breastfeed only” manuals, and being familiar with people who really do look down on people who don’t. But, of course, I can imagine other environments in which people are very cavalier about things and in which more positive reinforcement of the decision to breastfeed would really be beneficial (well, I don’t have to imagine it, two of my nephews have been raised in such a micro-environment). I don’t think anything you have said has suggested that you are in that camp, and of course not everyone who promotes breastfeeding is. (So, to give concrete examples, all three of my family doctors while I’ve had kids have promoted and supported breastfeeding in exactly the way you think is normal — “do it if you can, stop if it feels wrong to you”…etc). And I don’t want to suggeste there;s anything wrong with doing it, far from it — I think it is fine to do, and probably better for many kids and many mothers, and, in addition, I think that if you enjoy it that is a good reason to do it. But I have witnessed people making what seemed to me unhealthy sacrifices of their mental health because they were led to believe that doing it was far more important for their kid than, I suspect, it really is. And others (and this is autobigoraphical) who have not had the strength of will that Tim had to do what seemed intuitively the right thing (supplementing once or twice a day) because the advice they got was that any bottlefeeding would jeopardise the breast feeding.
Anyway, I apologise (honest) if the tenor of my writing has caused offense. I hope that if we’d been talking in person I’d have managed to avoid causing offense. Its worth talking about these things, but probably only worth doing so if one can do so civilly and collaboratively.
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I used a store model for pumping. I don’t think it was cheap. $100 or so. I just couldn’t do it. But I know others who had no problem with it. This thread really shows that different methods work differently for different people. We all have to be careful about prescribing the one right method. (Myself included.)
I come from a family of midwives. In fact, my aunt was the president of the American Midwife Association a few years ago. She is really skeptical about any hardcore philosophy. In fact, she told me to have a glass of wine every night when I was pregnant, after the first trimester.
Harry b, do that C-Section post. Nature tried to kill me the first time around. I was completely unprepared for that experience after nine months of book reading. (It also took five days for my milk to come in, because my body had been nearly destroyed.) One of my neighbors just had a baby with a serious birth defect and wasn’t adequately prepared for it with all the classes and books.
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A $100 breast pump is a cheap one. The hospital pump cost around $1,000 new, but rents starting from $1 a day.
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It took me five days for my milk to come in also, Laura, and I had a fairly normal delivery. A friend of mine tried to breastfeed for 6 days, still no milk, so that was that. (I don’t recall if she had a C-Section or not.)
When I was pregnant in 2000, I got bombarded with the Breast is Best stuff. “Enough already,” I thought, “I get it. Breastfeed. No problem.”
But when my daughter was two weeks old and the pain from thrush made me cry every time she nursed, I started to understand why that message was delivered so forcefully. It isn’t easy (for some families) and it takes a lot of work to get established (for most families) and there are various social pressures against it in some communities (though that wasn’t true for me). So, as Wendy said, there is a tendency to over-encourage to meet those hurdles.
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Five days is pretty standard for milk coming in.
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So, to give concrete examples, all three of my family doctors while I’ve had kids have promoted and supported breastfeeding in exactly the way you think is normal — “do it if you can, stop if it feels wrong to you”…etc)
I’m not sure who “you” is here. I don’t think telling someone “stop if it feels wrong” is the “normal” thing to do (well, I think it’s is normal, in that it happens regularly, but it’s not the normal, meaning reasonable, thing to tell someone).
Plenty of things feel wrong sometimes. We do them anyway, because eventually it will stop feeling wrong. We have such a low threshold of “wrong” these days, and I think that threshold is somewhat based on misogynist/sexist views of women, parenting, and work.
“I’m not supposed to feel like a cow!” someone might say. Well, actually, yes, you are, at first. It’s ok. The kid will grow up and you’ll stop feeling like a cow. But heaven forbid a woman should feel like a cow for one second! Heaven forbid a woman should look like a cow for one second, or no one will find her attractive/womanly/acceptable!
I’m about to finish up a much longer post at my blog.
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Breastfeeding is great, but I agree that the health and bondedness of children does not have to do with whether or not she was breastfed. I think there’s a definite bias in some circles against using the bottle. As an adoptive mom, I bristle against the notion that my kids are not going to be as smart or healthy because they didn’t get breastmilk. I also think we need to have access to really high quality organic formula. I sometimes think those who are pro-breastfeeding dismiss formula as being “poison” without giving thought to making it better for those of us who need and want to use it, and deserve to have it nourish our children.
Oh, also? My mom breastfed me until I was 3, and I’ve been plagued with weird, random health problems my whole life. Though I am smart.
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I think that Harry B’s “micro-social environments” couple with the personal experience Janice points to to make this an extremely difficult conversation to have in a national context.
When we were expecting (2005, Austin TX), we went to prenatal nursing classes in addition to birthing class. When my daughter couldn’t suck enough, we used the hospital lactation consultant, and hired a private consultant as well. Nothing but a bottle seemed to work, so we switched exclusively to pumping. My wife woke up in the middle of the night to pump while I fed the baby, so neither of us got any sleep, but at last our child started gaining weight. We gave up on nursing after 5 weeks, but did pump-and-bottle for the next four months. My daughter had nothing but mother’s milk for nearly 6 months, since we had a freezer full after we returned the pump.
Once we switched over to formula in defeat, I felt like we’d been had. Everything I’d been told — from the supposed expense to the effects on diapers — turned out to far off base. Formula worked, and was cheap and easy by comparison. The agony of those first couple of weeks, when everyone was afraid to suggest bottles for fear of nipple confusion or somesuch — even while our baby remained below her birthweight — it could have been avoided. If we have another child, we’ll try to breastfeed again, but I can guarantee you we’ll make our decisions differently.
This kind of experience makes it very difficult to have an unemotional conversation with someone whose personal experience was easier, or whose social environment is very different. Obviously, I don’t think my own peer group needs any more influence from “people who are trying to make BF to seem more like the norm”. However, it’s easy to imagine precisely the opposite side — someone who has gotten zero support from their employer or family for their efforts to breastfeed. Or someone who knows people who never bothered trying for silly reasons. But put me in the same anonymous comment box as a person who’s received cutting remarks about nursing in public, and any conversation that departs from the details will probably be impossible. We all have such different baselines, and it takes more caution than I usually possess not to generalize.
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Wendy,
what I meant was that the doctors all were pro-breast-feeding but not fanatically so (which is what you implied was normal — forgive me if I misinterpreted). I should have added that two of them knew my wife very well (still do, one is a family friend), and are good enough doctors to calibrate their advice to her personality. (ie, knew that it would take a lot, perhaps too much, pain and inconvenience for her to stop). Oh, and all were women, the two we know well have several children between them.
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Laura — wendy’s warned me off the C-section post. I’m going to consult a statistician (but not a physician) before doing it. dsquared, perhaps.
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Wendy – Just reading over your past comments and thinking about them. I guess we’re all looking for some balance here between those who say that BF is gross and shouldn’t be done in public and those who make us feel wicked for not going to whole 9 yards.
BF was both a joy and a pain for me. It did make equal parenting more difficult. But there was nothing gross about the experience. In fact, I was very sad when that period of coziness was over. I saw BFing as a cool life experience and I’m glad I got to do it. But if it didn’t work out for me, it would have been okay.
RAF — great comments over at CT on this topic. And congrats on getting the promotion. I meant to leave at comment at your blog.
Harry b — you sure know how to stir up the blogosphere, don’t you?
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Harry, *please* interpolate dsq’s comments into any C-section post that develops! That sounds like pure gold…
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Formula can be absolutely dreadful. If the formulator leaves out an essential vitamin, or if they put in melamine, or if it’s made up with water which gives the kid giardia, game over. If the Nestle rep has given the mom free samples which tide her over until her milk goes away, and then she doesn’t have the money to buy formula and puts the kid on solid food too soon, also a problem. These are mostly 3rd world problems, but they contribute to the general cloud over formula, and to the self-righteousness of the breast milk zealots. There’s been a certain amount of mysticism about special virtues to breast milk which formula cannot match. I’m inclined to think breast feeding is good, if reasonably possible, for the first six months, but my view of ‘reasonably possible’ is not all that demanding, and from my reading in the literature I’m not sold on the idea that exclusive breastfeeding is all that much better than partial – assuming quality formula and safe water, which 1st world types like the readers here have access to.
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Interesting conversation. I think YMMV on this issue and it seems to me that Breastfeeding is the first of many parenting issues about which parents start to feel guilty. Is feeling guilty a good thing for either parent or child? I don’t think so. I had one good and one bad BF experience. In the first, it was primarily because I had to go back to work at 6 weeks (as the family’s only income and because I’d already taken 2 weeks of my time off without pay). I didn’t have *any* support. Neither my mother nor my mother-in-law had BF; my mother was almost as clueless about formula feeding. In another time, I think my mom would have opted for a wet nurse. One friend who’d had a baby 6 months earlier had had to give up BF because her baby wasn’t gaining weight. She was completely distraught over this. Another friend outright refused to BF because she was squeamish about her boobs. Seriously. I’ve seen this happen more than once. We’ve sexualized breasts to such an extent that I’ve seen plenty of women just feel weird about it. So, when BF wasn’t working out for me, I really didn’t have anywhere to turn for help and I was freaking tired and Mr. Geeky was willing to get up in the middle of the night since I was the one who had to harch into work.
The second time around, I found the Internet. Seriously, it was 4 years later, enough time for the Internet to have spawned many more communities than it had in 1995. I joined a BF while working email list and it saved my life. Plus, I was in a different location and surrounded by plenty of other women who’d successfully BF. Ironically, this was in a less “progressive” location, but was completely supportive of mothers BF. And, of course, I was older and wiser and more patient about getting it to work. I had a c-section for this one and Mr. Geeky got up and brought the baby to me. I BF lying down and both me and the baby just drifted off to sleep.
Had it not worked out the second time, I wouldn’t have given it a second thought. I might have been a bit disappointed, but as far as I’m concerned, I have my own needs too. Ignoring them wouldn’t be healthy for either of us.
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I think if you want a straw man in all this, it’s the idea that there’s a strong force out there that’s trying to demonize breastfeeding or make it feel abnormal. Who’s trying to make breastfeeding seem abnormal here or at CT? You’ve got a bunch of people reporting on their own experiences in which they were determined to try and breastfeed, who then found that there were various hybrid or flexible feeding practices which worked better for them. They’re not saying, “Stop all breastfeeding”.
At some point, you take repeated experiences of basically good-willed people seriously and say, “Ok, so there’s an issue here”. One of the repeated themes I see when this question comes up, in fact, is the gap between people’s lived experience of trying to feed infants and the canned, statistical advice they get from medicalized advocates of exclusive breastfeeding. So it’s a bit of a flashback to see the complexities of people’s lived experience waved off as merely anecdotal.
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Tim, I explained my concerns at my blog post. Too long to go into here.
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Just one other thing: I think Harry is right and that our microenvironments have some effect on us. I was living among Long Island’s middle class when I gave birth the first time. Hicksville is not exactly a bastion of BF support.
And that’s the kind of microenvironment that most people in the US live in, fwiw.
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Wendy, I understand the need to support women who choose to breastfeed in unsupportive environments. (I have had to breastfeed on a subway, so I know about those environments.) But isn’t it equally important to tell the truth about breastfeeding, which is that there is no scientific evidence that it helps your kid all that much?
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“I think if you want a straw man in all this, it’s the idea that there’s a strong force out there that’s trying to demonize breastfeeding or make it feel abnormal.”
Back when I was on the big Washington DC mother’s list-serve, there was at least one episode of mothers on the list organizing a “nurse-in” (or whatever you call it) at an establishment after a nursing mother had gotten insensitive treatment at the hands of some clerk. That’s the background. I just turned up this youtube from 2006 about a nurse-in at National Airport in DC that was prompted by a nursing mother’s being kicked off a plane.
http://www.youtube.com/watch?v=ARZbnJgQtew
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I breastfed exclusively, and, being Canadian, I took the full year’s maternity leave. But my husband and son still created a strong bond and at this point (3.5 years in; I’m back to full-time work) I would say we parent equally.
So I’m not really sure, anecdotally, that breastfeeding is to blame for inequal parenting AFTER the first year. Certainly breastfeeding takes a lot of time during the first year, but that’s a short time in the whole life of a child.
I find it interesting the debate turned to just about how to get the baby fed and the question of father bonding fell off the comments.
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“But isn’t it equally important to tell the truth about breastfeeding, which is that there is no scientific evidence that it helps your kid all that much? ”
I’m still just astounded by this. As I said in my blog post, it seems to me that people are taking the word of Hanna Rosin (who obviously has a lot of resentment over BF) over the statement by the AAP (whose job it is to ensure that children grow up healthy). Don’t you think that’s weird?
As long as I’m pissing people off today, I think I’ll write a blog post on how offensive I think it is that women change their names when they get married. Similar issues at stake, believe it or not. And I kind of want to get out of thinking about BF today for reasons that are complicated to go into.
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I’m not really sure why you doubt Rosin. I’ve read those statistics elsewhere, too. Here’s one of the studies that she cites: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1361236
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Laura, that study says “This study provides persuasive evidence of a causal connection between breastfeeding and intelligence.” I’m not quite getting what you’re saying. Rosin’s “evidence” seems to suggest the opposite of what she’s saying.
A friend has posted another friend’s response to the Rosin article (long story, blog-unsavvy Original Author). It’s here.
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the canned, statistical advice they get from medicalized advocates of exclusive breastfeeding
I don’t know if it’s because we’re members of a pretty tight-knit–but pretty mainstreamed, all the same–religious community which dictates many of our social interactions, or if it’s because neither of us ever felt any draw to the innumerable parenting/birthing/whatever classes out there, or if it’s because we’re close enough to our mothers and grandmothers to find in them primary sources of advice, or what, but all I can say is that after checking with my wife, I can confirm: we can’t think, through four children in three different states (Virginia, Arkansas, and Illinois), of ever having anything like a close, intrusive encounter with even a single person who matches this description which Tim gives.
As he says, we should take the “repeated experiences of basically good-willed people seriously,” and hopefully I do. I’ll happily grant that there are LLL wingnuts out there who try to make every new mother who uses a bottle feel like a failure, and I add my voice to those who would argue against them. But if we’re speaking from our respective “micro-environments” here, then here’s ours: we have no personal knowledge whatsoever of the existence or power of a “you must breastfeed” brigade. I don’t think they’re straw men; I mean, hey, we can read, the testimony is out there, they clearly exist. But honestly, I just don’t know where you find them.
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Well, that study states that that breastfeeding does not decrease allergies or obesity — claims we hear all the time. The study and others say that there might be some correlation with IQ but it only 5 points, which a normal variation in any IQ test and can be chalked up different parenting levels for siblings (ie. the first born always get more attention). Like I said, I’ve heard these numbers quietly whispered about. I know a pediatrician who only breastfed for 2 weeks, because she said there was no evidence that there were any benefits for going beyond 2 weeks.
Like I said, I chose to breast feed to hedge my bets and because it was a life experience that I wanted to try. I would never try to argue that one should or shouldn’t breastfeed. I just think that we have acknowledge these studies.
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the canned, statistical advice they get from medicalized advocates of exclusive breastfeeding
Thanks for pulling this quote out, RAF. It reminds me that I just want to point out that I am the LAST person to ever do something because a doctor or other medical professional tells me. They oughta put “AMA” after my name.
4 days before I gave birth:
Midwife: Wendy, your bloodwork just came back, and you have to come in so we can induce childbirth.
Me: ORLY? No.
The day I gave birth, 3 am:
Me: Oh no! My water broke. I’ll dutifully call the midwife.
Midwife: You should come in.
Me: It’s 3 am!
Midwife: Are you having contractions?
Me: No.
Midwife: Oh, ok. Go back to sleep.
The day I gave birth, 8 am:
Phone rings.
Midwife: “The other midwife was ON CRACK! Get in here now!”
Me: ORLY? I’m still not having contractions.
Midwife: YES, RLY!
Me: OK.
The day I gave birth, 12 noon:
Wendy wanders into the hospital. Visits someone else from her childbirth class who had an emergency c-section after an epidural caused fetal distress. Wanders over to L&D.
L&D: OMGWTFBBQ!!!!!
Me: Whatevs. Still not contracting.
L&D: We’ll make you contract!
Me: Well, I don’t want to go all the way back to Hicksville now, so ok.
True story. Gave birth at 11:45 that night.
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You don’t need a pump. You can do it by hand. I never had one and I was able to provide 2 bottles a day for our son, since I went to work and my husband took care of him during the day. Our two children were breast fed until 12 and 14 months respectively. I stayed home with my daughter. She refused a bottle. If I could have it to do all over I would have stayed home with our son, but I didn’t have that luxury. I don’t feel guilty about it, however.
I think breast feeding is best for mother and child — there is a protective effect for breast cancer for mothers who have breast fed, for example. That’s what the scientists tell us. Maybe tomorrow they will tell us something different, but for now, those are the facts. Does that make me a fanatic?
I personally found the literature of the la leche league very helpful. I also had a wonderful boss at work who was very supportive and who had breast-fed herself in the nineteen fifties when almost no one else was doing it and she was proud of it.
People feel guilty? Well, when you have kids you discover very quickly that there are tradeoffs in this life and also that there are aspects of life that are out of your personal control.
Taking care of a baby is very labor intensive and exhausting. It’s expensive in terms of time and lost wages. Our society doesn’t value women and children, or anything without dollar signs attached. Yet, after what I have seen of babysitters and other caregivers (and I’ve lived more than half a century), I think babies are best off with their own mothers, on the whole.
The very best situation, arguably, is when the mother has full-time (or even part-time) help of some kind, although I never did, as it happened.
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Wendy, I’m not sure how your post responds to Timothy Burke’s question.
However, your post, and an earlier comment of yours, suggest that one should breastfeed despite difficulty as a sign of commitment to one’s child. Well, no, not necessarily. Changing my children’s diapers with only one hand is difficult, too, but I don’t think I’d prove much by doing it. In the face of an obvious, significant benefit to a sacrifice or struggle then, yeah, on average I’d agree a parent should suck it up and do it. But not in this case.
And even if breastfeeding were demonstrably superior, as harry b has emphasized over and over again, there’s not much benefit if it comes at a high cost. I can’t be the only one who knows mothers of poor sleepers who are so exhausted by breastfeeding that they are basically too dead during the day to provide the baby with other playtime and stimulation. In an admittedly rare and extreme case, we (distantly) know a couple who divorced because the mother’s obsession with breastfeeding for a year despite low supply left the husband feeling excluded, isolated, and fearing for his child’s health. I don’t know enough about the effect of broken homes on children’s physical and emotional well being to comment on that, but I do know that the cost of supporting two households means there’s less money left over for, say, private school, enrichment activities for the child, etc.
And just to be pedantic, in a non-randomized style, one is not actually “hedging your bets” by going with the treatment that correlates with better outcomes, although it’s a natural assumption to make. For example, this is why really weird and dangerous supplements were originally believed to be safe via observational studies — supplement-heads tend to be pretty fit people, so if you compare them to another group and say “hey, they’re much healthier. I know it’s correlation and not causation, but just to hedge my bets I’m going to take hearty supplements of ephedra” — statistics fail!
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“I’m still just astounded by this. As I said in my blog post, it seems to me that people are taking the word of Hanna Rosin (who obviously has a lot of resentment over BF) over the statement by the AAP (whose job it is to ensure that children grow up healthy). Don’t you think that’s weird?”
I’m also astounded by this, because I’ve actually read many articles on breastfeeding, with a critical mind, and a scientist’s eye (though I am not an epidemiologist), and my conclusion is that there is a small but significant effect.
Rosin’s conclusions on the scientific data sounded like post-hoc justifications for her choice, that stretched what we don’t know to include everything. This is the classic problem I have with global warming apologists, or ID folks. In each of these cases, they take areas of known scientific doubt and use them to undermine all conclusions drawn in the field. The motivation is that they’re countering the exaggerated claims of others (and indeed, on global warming and breastfeeding, I think that exaggerated claims are rampant — not so much on evolution). The fact that advocates exaggerate a position does not mean that there’s no science in the position to start out with. It’s likely that there are differences between breastfeeding and formula feeding — and that the differences will favor breastfeeding. It’s unlikely that the differences will be dramatic, or potentially, even more significant than many other food choices that can be made.
(And, there’s just no way that a study from 1985 could be authoritative on breastfeeding).
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Siobhan, I can’t really tell what Tim’s question is, to be honest, other than “Hey, we’re nice people, we’re the good guys!” Yes, you are. I agree. But I will explain where I’m coming from to try to interrogate the gut support everyone seems to have for Rosin’s article.
I get that it’s “easier” to feed formula in many cases. I think we should question why that is.
And I still do not understand why everyone dismisses the AAP recommendations!
Within the next few hours I will likely disappear for most of the weekend. Heading to NY for my sister’s 40th birthday party. Just so you know I’m not cowering over in the corner over, well, anything. 😉
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Well,my kid, hardly had any breast feeding. I have a regular 9 to 5 job and breast feeding wasn’t possible always.We gradually shifted her to formula. This is alice from Israeli Uncensored News
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Let’s talk about the AAP. And this is coming from the midwife auntie. The AAP is purposely overstating the claims of breastfeeding, because they want to reach the women who put soda in the baby bottles. They want to scare them enough to feed their kids better. They also want to reach the women mix in oatmeal into the formula for newborns, because they think that the baby will sleep longer. It is not aimed at middle class parents who read the directions on the back of the Similac box. That is also why they say that pregnant women should not have one drop of booze. Another lie, BTW.
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Have fun, Wendy!
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The 2005 sibling article cited by Rossin is nice, and also publicly available:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1361236
They do a nice job of discussing their own study and it’s limitations and reviewing the literature.
The correlation with their measure of cognitive ability was robust, and can’t be ignored given the context of the specific study, though, notably, they discuss potential confounds for this correlation as well. They also discuss the limits of their study, notably the small sample of discordant feeding (n=approx 500), and the low incidence of certain outcomes (diabetes, for example), which decrease their ability to detect small but significant effects.
But, the study is quite nice.
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Rosin’s conclusions on the scientific data sounded like post-hoc justifications for her choice
But her choice was to breastfeed anyway!
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Rosin (and this blog and commentators) are ignoring the health benefits to the breastfeeding mothers: less risk of breast, endometrial, and ovarian cancer; less osteoporosis and rheumatoid arthritis; weight loss etc.
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As a Canadian with reasonably generous mat leave policies who wishes WE were like the Scandinavians (now THEY are supportive of families), I see this whole “scientific benefits of breastfeeding” debate such a strawperson argument.
For me, net net, it’s about questioning a culture that does not support parents and families. It’s about questioning the CrAzYmAkInG conflation of breastfeeding=good mom with “but we won’t give you any mat leave to do it”. In other words, the bar is this high but we will do whatever we can to make sure that you will never reach it. You know, unless you are independently wealthy or can risk losing your paid work.
And whoever said parenting would be equal from day one? Maybe over a lifetime or a number of years but in the first year?
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“That is also why they say that pregnant women should not have one drop of booze. Another lie, BTW.”
Fair enough. I never listened to that recommendation. I was in France at 6 months pregnant, and damn it, I was going to have a glass of wine in a cafe on the Left Bank.
“Have fun, Wendy!”
Don’t let the door hit my ass on the way out? 😉
I’ll have to try to refocus myself because I don’t really want this discussion lurking in the back of my mind while I’m in NY, because it will lead to family arguments. And this is weird, but I’m actually too embarrassed for Jim Cramer to watch the entire interview with Jon Stewart. I’ll just focus on the happy that was last night’s ER (and if you were an old-school ER fan and you missed it, you MUST use whatever means, legal or illegal, to watch it! It was absolutely wonderful). (Yay, Hulu comes through!)
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“Let’s talk about the AAP. And this is coming from the midwife auntie. The AAP is purposely overstating the claims of breastfeeding, because they want to reach the women who put soda in the baby bottles. They want to scare them enough to feed their kids better. They also want to reach the women mix in oatmeal into the formula for newborns, because they think that the baby will sleep longer. It is not aimed at middle class parents who read the directions on the back of the Similac box.”
If that’s true, that’s terrible reasoning. The sort of person who does all that stuff is very unlikely to manage breastfeeding. It makes a lot more sense to encourage them to use something truly dummy-proof like ready-made liquid formula.
I’m also concerned that a painful breastfeeding experience may cause marginal mothers to dislike or lash out at their babies.
Vicki Iovine says:
“…that first month can hurt so badly that you see stars and break out in a sweat whenever your baby looks at you hungrily. I recently went to lunch with eight of my mommy Girlfriends, and after the champagne had flowed for about an hour, I started a game sort of like Truth or Dare. The single most shocking and guilt-lifting bit of truth shared by nearly all the mothers was that we hoarded our prescription pain medication, no matter how badly our “privates” ached, and saved them up for the critical half hour before it was time to nurse. Yes, I am confessing what you think I am confessing: I took the drugs those first couple of weeks simply to endure the pain of breastfeeding.”
“My Girlfriend Lori said that even with her third baby, she would sit in her bed and start weeping silently when she heard the little darling start to stir and awaken in her bassinet.”
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Hey Wendy — I’ve been suddenly asked to lead a discussion on Frost/Nixon, but I haven’t seen the movie yet. Where’s that special sneaky place on the intertubes where I can watch it.
And you know I love a good debate. If you hadn’t taken the contrary position, I might have.
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Bingo!
They don’t give women any leave and they give only tepid support if you want to breast feed. Sure they bring you the baby in the hospital — but they’ve already fed it a bottle, “just in case”, don’tchaknow?
Then they say a two-income family and a huge mortgage are necessities (so you can access a more or less segregated school, with few undesirables), and you’re a failure if you don’t have a prestigious and remunerative career, but there is no good childcare to be had anywhere on the horizon.
And if you’re looking for a scapegoat to blame for this — don’t look at the way our society is set up — Oh, no, it’s those damned latte-drinking hippie extremists, again.
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I find the AAP recommendation careful and measured (and, incidentally, also publicly available): http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B115/2/496 (well cited, too).
After reading the recommendation, I realized what bothered me about the Rossin article. I see it as example of a certain type of parent, who, on being told that they are making a less than perfect decision (and not breast-feeding would qualify, because the AAP’s recommendation is clear), feel a need to destroy the recommendation, rather than admit to making imperfect choices themselves. I make lots of imperfect choices for my own children (including the decision not to breastfeed the first). I am comfortable with imperfection, and do not care whether others “judge” me for it. I also recognize their right to think that I should have tried harder — I think that’s their right — as long as they don’t try to legally oblige me to make the same choices, it’s fine for them to believe that I’ve made the wrong choice. I think we have to come to terms with this as parents — not try to argue that everyone else should parent exactly the way that we do. That’s the mistake the breast-feeding zealots are making, and the one we join in when we say that they shouldn’t judge us for our choices.
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Inflexible hours or Why women don’t go into the sciences:
http://www.eurekalert.org/pub_releases/2009-03/cu-woo031309.php
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But she didn’t, in fact, make the “less than perfect decision”. She continued to breastfeed. And enjoyed it.
(I’m a vegetarian, and I sometimes tease other vegetarians, and meat-eaters, that its because I don’t like animals and don’t want farmers to have an excuse for producing more of them. I thought the article was much more teasing than strident).
I’ll post about Gods Harvard before I dare to tackle C-sections….
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“This time around, nirvana did not describe my state of mind; . . . Being stuck at home breast-feeding as he walked out the door for work just made me unreasonably furious, at him and everyone else.”
“Still, despite my stint as the postpartum playground crank, I could not bring myself to stop breast-feeding—too many years of Sears’s conditioning, too many playground spies. So I was left feeling trapped, like many women before me, in the middle-class mother’s prison of vague discontent”
She’s upset because she *wants* to make the less than perfect choice. And, my answer is, who cares? I have no desire to demand that she do anything with her body, and I, personally, wouldn’t shun her in the playground, but don’t see why she needs to demand that the “playground spies” accept her choice. They’re not going to report her to the authorities. They’re just going to think less of her. Get over it. Or, as my wise daughter actually said to me “If the other mothers laugh at you, you should find a new group of mothers to hang out with.”
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Well, whether you breast feed or bottle feed, get used to it — it’s going to be no more personal time for the next ten years or so. And probably no more uninterrupted sleep for the next five. No matter what anyone says of thinks on the playground. And if you’re already out on the playground with your kid, you’re not going to be breast-feeding much longer. And guess what? Before you know it, its over and they’re grown up and in college. Welcome to life.
Our second son died at at birth so we didn’t take our third one for granted. We didn’t begrudge her our lost personal time, sleepless nights, messed up sex life, colic — or anything like that. We were just so glad to have her. I used to just wake up in the night to check that she was still there — and her father felt the same way.
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This is hilarious. I was recently reading an article from the 1930s about how baby care had changed since the 1890s. The only thing that hadn’t changed was that one shouldn’t let babies eat diaper pins. It’s a wonder any of us had parents and grandparents what with the wretched childrearing advice back then.
Basically, it’s all about guilt tripping mom using the baby as the lever. As a female friend explained to me, men reproduce by having sex, but women reproduce by budding, another person separates from her body. That makes for a very powerful emotional lever and this discussion reads like the crowbar roundup in Popular Carpentry.
Everyone loves to guilt trip mothers. It starts with pregnancy and goes on from there. Look at the rules of eating during pregnancy. The one thing that EVERY culture agrees on is that women shouldn’t eat whatever they get a craving for, and pregnant women in different cultures get all sorts of weird food cravings.
Does breast feeding make all that much of a difference? It wasn’t in vogue back in the 50s and 60s, so you’d think we’d pick up a signature in American baby boomers. If there is one, it is pretty weak. Still, someone has to make the choice, and that should be the woman who is expected to produce the milk, and she should be able to choose for any damned reason she wishes, at least until there is some compelling reason to do otherwise. Sorry, the evidence for breast feeding isn’t there.
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I find the AAP website deceiving at best. Outright lies at worst.
Breast cancer. The website says that one of the benefits of breast feeding is the decreased risk of breast cancer. Yeah… by how much? The number one cause of breast cancer is genetics. Something like 90% of the women who get breast cancer have some sort of family history. The breast cancer websites never say anything about the benefits of breast feeding. My guess is that the studies that have found these benefits are either questionable or have found microscopic benefits. The AAP website doesn’t say that.
Let’s take another claim. Breast feeding reduces the chances for obesity. Ha! The best way to prevent your kid from getting fat is to stop feeding him at McDonald’s. The number one predictor of obesity is maternal weight. If you’re fat because you don’t value exercise, eat a lot of fatty foods, and have a slow metabolism, you’re kid is going to be fat, too. No amount of breast feeding is going to change that fate.
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I need to forget about this blog and have a life this weekend, so I just want to wrap up the discussion. I’ll leave the comments open, because people need to vent. But I’m not going read anything until Sunday night.
Monarda, I am very sorry about the loss of your child. I really admire people who are able to pick themselves up after that kind of loss and continue to enjoy life. You added a lot of perspective to this debate.
One commonality among everyone in this comment section is that we love our kids. We may have different experiences about feeding them, but it’s all good, because raising kids involves more than just those first few months. It is a life long process. We’ve all got so many opinions on this topic, because our kids are a central part of our lives. There’s something very life-affirming about this debate.
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Let’s talk about the AAP. And this is coming from the midwife auntie. The AAP is purposely overstating the claims of breastfeeding, because they want to reach the women who put soda in the baby bottles.
This might be true of the AAP in general, but is not true of the AAP committee on breastfeeding. The head of the committee is… we’ll charitably call it zealous.
Among the people who put a lot of stock in the AAP guidelines, there tends to be a selective deference to them. On a mothering board I visit, they’re whipped out at the slightest hint of breastfeeding dissent, yet 40+ pound pregnancy weight gain is excused away as no big thing.
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“This is hilarious. I was recently reading an article from the 1930s about how baby care had changed since the 1890s. The only thing that hadn’t changed was that one shouldn’t let babies eat diaper pins. It’s a wonder any of us had parents and grandparents what with the wretched childrearing advice back then.”
I love Lileks’s “Mommy Knows Worst: Highlights from the Golden Age of Bad Parenting Advice,” because it illustrates this really well. I gave away my copy, but how can one forget such details as laudanum being used in the good old days when baby just won’t stop crying? (As Matthew Sweet demonstrates in “Inventing the Victorians,” our forebears had a very casual attitude toward narcotics.)
Even over the past few years, I’ve gotten whiplash from all the shifts in expert advice. It does seem like practically the only constant is that it’s really important to listen to the experts.
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“The relative risk of breast cancer decreased by 4.3% (95% CI 2.9-5.8; p<0.0001) for every 12 months of breastfeeding in addition to a decrease of 7.0% (5.0-9.0; p<0.0001) for each birth." (Lancet. 2002 Jul 20;360(9328):187-95.).
In other words, a small but significant effect. I don't think the AAP article promised anything more.
on the other hand,
"Having a family history or family member with breast cancer, does not play a large role in most women's chances of developing breast cancer. Women with a family history of breast cancer make up only 5 to 7 percent of all women with breast cancer. " (Though Laura's 90% can be interpreted in different ways).
Interesting that Siobhan reports that the head of the workgroup on BF at the AAP is a zealot. How are these reports signed? I do think that kind of zealotry can influence these workgroups, though it should be detectable. I see it in two instances of zealotry in the AAP discussion 1) in the discussion of HIV & BF as a contraindication to BF and 2) in how long exclusive BF should occur — and the disagreement between the committee on nutrition.
(And Siobhan — you didn't mention the AAP recommendation on co-sleeping, which is universally hated by the BF zealots. I, personally find both measured and useful and appreciate having the information available, and still make my own decision based on the summaries, and following up on the literature)
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Nice to meet all of you.
I am a mom of three boys– 6, 4, and 2. All of them nursed for a year or more. With the first, I had every complication known to BFing (seriously), and I had a baby with colic and reflux (but who gained weight very well, go figure). It was often miserable. Around 10 months, my supply dwindled and he got the occasional bottle of formula when I couldn’t pump enough at work. And I did feel like a failure– but that’s as much about me being type A as the BF zealots. Given his reflux, I was more scared to give him something harder to digest as a newborn, so I stuck with it. As an attorney, I was able to pump when I needed to.
The BFing relationship with my other two was much easier. And much more fulfilling. My third, though, didn’t take a cup or bottle or solid foods until nearly 9 months (not that I didn’t try and try and try –he just wanted me home!). That was a challenging several months. But as someone else has already pointed out, these boys will always take a lot of my time if I take parenting seriously (and I DON’T mean driving to every activity known to young boys; I mean teaching values and– this’ll piss someone off– discipline). I actually expect my children to do what they are told. Crazy, isn’t it? And, no, I didn’t vote for McCain. And yes I am pro-choice (sort of).
There are a lot of things I thought I could do as a mom before I had kids. Right now, though, this is all I can handle. Yes, that is because I had a very demanding job and my husband is a physician with a good amount of call. We can’t share the responsibility equally– part-time cardiology isn’t available (we took a “lfestyle” job with less pay so that he could be home some). So, yes, I am rather disgruntled at times– I would love to share it more equally. But once they are all in school, life will be different.
As many have pointed out, BFing isn’t really the issue here. It is how individual v. family needs. And I am constantly tryinng to balance what I want and need with what my family wants and needs. Sometimes it ain’t pretty. But when one of mine whines that he didn’t get to go to a birthday party for one of his 15 clasmates, I tell him weekends are pretty mucch family time. Sometmes we don’t get what we want, we get what we need. BFing did teach me about sacrificing and limits on what I could do. But I have come to the conclusion that it isn’t a bad lesson to learn. And with three boys so close in age, my kids might actually learn it a little younger than I did.
These thoughts are not completely clear. My apologies. I was up last night with a sick– but weaned– child.
I guess the point is that I have come to realize that every stage of life has its ups and downs. Its challenges and new responsibilities. And there are no clear answers to most of them– we all have to find our own way.
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bj, I’m appreciating your comments, especially the comparison to the global warming deniers and the folks who don’t believe in evolution. Just as they do, she found holes in certain studies and used those to pretend that the voluminous data was all uncertain. It would probably seriously displease Rosin to be lumped in with them.
Another problem I had with her analysis is that she discounted the research data because it failed to distinguish between the ACT of breastfeeding (holding your child close for several hours a day) and the milk itself. But if she wants to free women from those hours of baby duty, why does it matter which aspect of breastfeeding is beneficial? The fact is that the baby loses both if the mother stops.
She’s just not being an adult about this. In her mind, this is unfair; it puts too many burdens on women; it shouldn’t be true. And then, magically, it isn’t true! Well, the universe never promised you that everything you’d want would come without a price.
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From Adam Gopnik — How to write a bedtime story:
http://www.newyorker.com/online/blogs/books/2009/03/how-to-write-a.html
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The big difference with the global warming fantasists and the IDers is that whereas they are denying some macro-level phenomenon, what she is disputing is NOT that breastfeeding is sometimes, or often, all things considered better than bottle feeding, but that it always is (and, I suppose, that outsiders are sufficiently well-informed about individual circumstances to make that judgment well).
Part of the disagreement here is about the existence of breastfeeding extremists. Some people claim to have experienced them directly (Tim, my friend whose story I told in the CT post, me) and claim, further, that extremism is echoed in the parenting books we’ve read (not just Sears). Wendy seems sometimes to deny either that they exist or that they have influence. Do those of you who are more or less on Wendy’s side of this agree with my main point, which is not that breastfeeding is always or even usually worse than bottle-feeding, but that, all things considered, bottle feeding can be better often enough that some people (eg those who endure a considerable amount of difficulty breastfeeding over a pretty long period) should be more open to doing it? And do you agree with Tim’s observation that openness to mixing the breast and the bottle is sometimes best.
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“(eg those who endure a considerable amount of difficulty breastfeeding over a pretty long period)”
I’m not in your target group, but I have to question the meaning of “long” in this context. If the baby has lost 12% of birth-weight in a couple of days, that’s plenty long. Or if the mother is being subjected to what would in any other context count as torture, even several days could feel like years.
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Amy P — thanks. Yes, “long” is context relative here.
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I really don’t think I’m saying what you’re saying I’m saying, Harry, which may be my failure to communicate, but given the context of strong emotions over parenting choices, I’m not really sure. However, I’ll go back and check.
I think for one thing we disagree with a definition of “extremism”: the AAP are not extremists. I contend that people should be treating breastfeeding as normal and formula feeding as a technology, but instead formula feeding is seen as the norm and breastfeeding as the weird backwards thing that people only do if they’re upper-middle class *and* it’s easy or if they are KEE-RAZEE enough to SUFFER.
bj also has said many good things, most interestingly pointing out that 90% of the problem is women giving a fuck what other people think about their parenting choices. But a lot of that ties into sexism.
I am back from NY but on the drive home started counting up all the hours of work I have to do this week and realized it’s way more than 33. Ugh.
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Still not really here. But let me just say 4.3% is a super tiny benefit and that percentage is not mentioned on the AAP website. Check out the list of breast cancer risks — note that it says nothing about not breast feeding. Really the best way of preventing breast cancer isn’t BF, but having more than 4 kids and starting before you are 25. This study found that BF only had benefits on the least popular form of breast cancer.
I think BF is a nice thing, which may have small benefits for you and your kid. I’m not saying don’t do it. I’m just saying let’s be honest about it. There’s more to raising a smart, healthy kid than just how you feed them for the first couple of months.
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“Really the best way of preventing breast cancer isn’t BF, but having more than 4 kids and starting before you are 25.”
Does it work if you breastfeed one child for four years or two kids for two years each?
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“But let me just say 4.3% is a super tiny benefit and that percentage is not mentioned on the AAP website”
It’s from the study they cite, a Lancet meta-anlysis.
“Does it work if you breastfeed one child for four years or two kids for two years each? ”
The Lancet study calculates effect sizes as a function of breastfeeding duration. The benefits appear to be cumulative (and additive to bearing children). But, they are small. Again, I think they justify a public health initiative, but not post-hoc blame (i.e. a person does not get breast cancer because she did not breastfeed). Other behavioral decisions (diet, weight) clearly also play significant roles in breast cancer risk.
I think the AAP is being honest about the effects (though I detected times when compromises among differing biases were very obvious). I think the breast-feeding public service advertisements (from last year?) were not (and were somewhat ridiculous). But, I think PSAs are usually ridiculous and usually somewhat dishonest, and frequently feel the same way about anti-drug (and anti-smoking ads).
I think there’s actually a broader discussion about that here — both whether “exaggeration” in public health announcements is just morally wrong (on the grounds of dishonesty) and whether it is effective. There’s some evidence that the exaggerated anti-drug advertisements are actually counter-productive. My favorite example of this is the anti-smoking ad in which a girl smokes, and then horrible lesions appear on her face (then, the PSA says, well, that’s what you’re doing to your lungs). That may be true, but, what the ad shows is lesions appearing on your face, which does not occur. A logical conclusion: smoking isn’t actually bad, ’cause it doesn’t do what they showed happening in the ad.
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Wendy, who is is that sees breastfeeding and formula in the way you describe? The passive voice there makes it hard for me to tell who you mean. Do you mean society at large? Do you mean the people in this thread who’ve argued for a kind of adaptive, pragmatic approach to feeding infants? If it’s the former, that’s arguable, but I don’t think it’s the case among educated or middle-class Americans at this point, quite the opposite. If it’s the latter, you’re just plain wrong: there’s no one at all in this thread who has evangelized for formula as normal, breast as a weird backwards thing.
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Thanks bj, for that, which helps me think better about this. There was some item in The Economist awhile ago suggesting that there’s a kind of saturation effect with anti-drug PSAs — ie, that you can drive people away from heroine, or crack, or meth, but you can’t drive them away from all at the same time, and the PSAs lead them to abandon one for another. (It was based on the experience of some very agressive anti-drug marketing in some state to the west of me — Colorado?).
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I’m one of those freaky mothers who breast-fed her kids for two years. My kids never had a drop of formula.
And yet, La Leche League shunned me! You see, I was a working mother and even though I was only apart from my kids for 20 hours/week, the local chapter of La Leche League implied quite strongly that it wasn’t “real” breastfeeding. I arrived at the meeting looking for support but was instantly judged and never went back.
I’m of the “do whatever it takes for you” school of thought when it comes to parenting.
For me, breastfeeding was easy, enjoyable and had a ton of emotional and physical benefits. I believed the literature that it was more nutritionally sound – but only with a grain of salt. My mother had been told the opposite and I’ve seen advice about babies flip flop so many times. Sleep on the stomach! Sleep on the back!
So, when I read the article in question, my dilemma isn’t “breast vs. formula”- it’s more “why can’t we all just get along and make our own decisions” – what’s best for me is obviously not what’s best for you, but we both love our kids ferociously. Can’t we just do our own thing and move on?
Next up: Watch as I serve non-organic ketchup with the bad chemical corn syrup stuff to the organically-raised granola-crunchy kids down the street. Will they ever be allowed back at our house again?
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Great comment, K. Thanks!
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This is an interesting article in light of this discussion.
http://www.babble.com/Would-you-feed-your-child-another-womans-milk-Wet-Nursing-2.0/index.aspx
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That study was interesting, but Rosin misquotes it, doesn’t she? http://usfoodpolicy.blogspot.com/2009/03/oh-really-hanna-rosin-in-atlantic-makes.html
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I hate these conversations. LOATHE THEM. Ick.
I think bj’s analysis of Rosin’s “hook” is spot-on. Why can’t Rosin tell a story about learning to live with the messiness of the choices she makes as a mother? I did the research and came to the same conclusions that bj did.
It cut both ways for me. None of my kids was ever exclusively breastfed. They got tons of formula. My best nursing years? Between the ages of 1 and 3. FANTASTIC. Loved nursing then. Couldn’t speak more highly of extended nursing to age 2 if I tried.
I had triplets. They were in the NICU for three to five weeks. I breastfed and bottle-fed all of them. I pumped, but not so often after they came home. I fed them formula.
My problem was not playground bullies or over-sold research studies. My problem was lack of support: not enough women who shared their strategies for breastfeeding when it was hard. Not enough women who shared their strategies for breastfeeding multiples. Not enough women, period.
I mostly think modern society is better for women. The historical trade-off for having a whole extended clan to help you has been that the whole extended clan was pretty invested in limiting your choices. But there are costs to our more-free societies. A lot of those costs are born by women in the early years of child-rearing.
I’ll pay them in return for the freedoms I’ve gained. But I know they’re there.
We’re all completely ignoring Rosin’s other big selling point: does breastfeeding set up unequal parenting and a mother-centric family life? I’d like to see some studies on correlation. Some of the most traditional gender-role families I know are among the most anti-breastfeeding I know. The parents I know who were committed to equal parenting were often crunchy-granola enough to be committed to breastfeeding, too, and so they worked hard to make both their commitments work.
Rosin had an extremely common experience — post-partum, her partnership wasn’t as equal as she thought it would be — and she decided that breastfeeding was the cause. I’d like to see the proof.
[Finally: Every single damn parenting article that gets published has to have a hook. A reasoned, even-tempered hook doesn’t get you published. When it comes to parenting stories, controversy is everything. Rosin definitely knows how to do her job. Hence….]
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I never wanted to breast feed before I got pregnant, still didn’t want to when I was pregnant, and when my boys were born, guess what, still didn’t want to. I have extremely healthy seven year old boys who were exclusively bottle fed with formula milk – it made them happy and me. I think the breast is best campaign is completely out of kilter – what is best is that the mother is happy and therefore her children. Pregnancy (multiple) is bad enough as it is with the perfect parasites sucking up all goodness for however many months the body can bear it, but to continue giving control to my children to my body afterwards, hell no!!
I too understand why wet nurses were employed. And with 7 year olds I also understand why children are sent to boarding school, I just need to work a little harder…
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Here you go: arrested for breastfeeding!
http://www.thesmokinggun.com/archive/years/2009/0428091badmom1.html
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would not have a random new mother give her breastmilk to my child due to any number of factors like ingested drugs, Hepatitis, HIV or anything else. I’d also really want a vegetarian mother’s milk but I know that sounds a bit nuts! True though!
Would I be opposed to formula if I couldn’t nurse? No, my child would need to eat so I’d be ok with it, but I personally only used breastmilk with my babies. For me and my kids, breast was/is best. But I did use formula once my kids were older and I didn’t see a problem with it. I have some friends who didn’t even attempt to nurse and I have friends who nursed as long as they could. We all do as we see fit.
I also would not allow (unless crucial) any woman to directly breastfeed my child, it would have to be pumped milk. I wonder if any one else feels this way?
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Breast feeding is completely natural therefore I am all for it. How do you think cave women fed their babies?
As for other women breastfeeding my child, no way. It has to be the birth mother… it’s the only natural way!
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I’m amazed that there is still any debate about whether women should breast feed or not. That is so 60’s! I thought were were past that.
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