Posted on
October 14, 2009 by
BirthingBeautifulIdeas
For the past few days, I have been following the spirited discussions and debates spurred by the recent interactions between the bloggers at Nursing Birth and The Fearless Formula Feeder. In a nutshell, at the center of the debate is not only FFF’s critique of NB’s recent interpretation of a study on postpartum depression and bottle-feeding but also the guilt and misinformation that continually swirl around people’s baby-feeding choices.
I’ve reviewed the comments sections on these posts. I’m a regular reader of Nursing Birth, and I have now read all of the posts on the Fearless Formula Reader blog. And for years, I have examined the research on breastfeeding, both for personal purposes and for purposes of this blog. What’s more, I’m a doula, a future lactation educator, and a self-professed “lactivist.”
And given this information about myself, it may be surprising to many people that I think Melissa at Nursing Birth and Suzanne at the Fearless Formula Feeder both offer some excellent insights regarding the sorts of support, information, and research that women need in order to make fearless, guilt-free and informed decisions about they ways they feed their babies.
But being the self-professed lactivist that I am, I needed to read the Fearless Formula Feeder in her own words in order to reach this conclusion. I needed to see why she is dedicated to creating a supportive space for formula-feeding mothers. I needed to see her motivations for proclaiming to be a “fearless” formula feeder. I needed to see her positions on breastfeeding and the research on breastfeeding and formula-feeding.
And even though she and I may disagree in some respects, I think that her commitments are not necessarily antithetical to my own concerns regarding breastfeeding advocacy. They may actually be complementary.
In fact, after reading her post on “Why it’s not Irresponsible to Support Formula Feeding Mothers,” I said this in response:
I think that you will offer a remarkable service to moms who literally cannot breastfeed, or for whom breastfeeding was an overwhelming, demoralizing, or even insurmountable struggle. And those of us who live in societies in which clean water and sterilization techniques are readily available should be eternally grateful that these moms and babies have access to formula! (As someone who needed to feed her son formula for a couple of days while she had emergency surgery at 10 weeks postpartum, I include myself as one of those grateful mothers!)
Hold on a second: a remarkable service?! What kind of lactivist are you, Kristen?
Well, I’m the kind of lactivist who thinks that mothers who have been failed by the current maternity and pediatric care systems in the United States (and possibly/probably other countries)–those mothers who didn’t have a good nurse or doula or midwife help them get that great first latch after birth, who were bombarded by formula samples during pregnancy, in the hospital, or even in the pediatrician’s office, or who may even have been misinformed by their or their child’s care providers–deserve a support network of other non-judgmental mothers who can say, “I know. You are a good mother. You didn’t fail. The system failed you. And you can still raise a healthy, formula-fed child.”
I’m the kind of lactivist who thinks that mothers who need to use formula–those mothers who have medical conditions that preclude successful breastfeeding, or whose infants have health needs that interfere with breastfeeding, or whose past experiences with sexual violence make breastfeeding an insurmountable difficulty–deserve a safe space in which they can discuss their anger or their frustration or their sadness or even their gratefulness over their experiences with formula-feeding.
But I’m also the sort of lactivist who thinks that one should be careful not to gloss over the different experiences of all formula-feeding mothers. And this is why I asked Suzanne from FFF to make the following clarifications in her blog and in her planned book:
…I hope you delineate in your book and on this blog the difference between women who need to use formula and the women who choose to use formula before their babies are even born. Or even the difference between formula-feeding moms who did have good breastfeeding support and formula-feeding moms who did not have good breastfeeding support after their babies were born. Notably, I would never even purport to suggest that any of these groups of mothers should be vilified–and I do concur that some breastfeeding advocates can make claims with very condescending and vilifying tones. In fact, I also think that each one of these groups of mothers should receive the proper emotional support, especially if they are experiencing PPD.
Nonetheless, all mothers also deserve the right sort of informational/educational support regarding why breastfeeding is best (in the right sorts of circumstances, as you acknowledge) so that they can make a truly informed decision about the way they feed their babies. And this may not always be the case, especially for moms who receive misguided information from the media, friends, family, or even from their hospital staff!
Of the many reasons I chose to make these claims, one that stands out in particular is my concern regarding the simple title of the blog: the Fearless Formula Feeder.
Don’t get me wrong: I am glad that Suzanne from FFF’s hope is to create a safe and supportive space for formula-feeding moms. And I am glad that she is fearless in these efforts.
I would also hope that no one would ever make a parenting decision based on fear or guilt. In fact, I think that it is utterly deplorable to use fear-based or guilt-based tactics to scare someone into making any particular decision.
And this is why I appreciate Suzanne from FFF’s response to my comments:
The book I’m working on is an examination of this debate from a social perspective – looking at media and interviewing moms on both sides, to see where we are going wrong – but I am also making sure to talk to the authors of these studies (and especially the meta-studies) when possible to get a clearer idea of what they mean. As for the blog, it’s where I allow myself to express personal (emotional) opinions and offer a place for others like me to vent and feel supported – basically so I can get it all out here and keep the book balanced and rational!
Nevertheless, I also think that it would be more than unfortunate if someone carelessly interpreted the FFF blog and its content to mean that there are no legitimate reasons to be concerned about choosing formula-feeding over breastfeeding.
That statement is not meant to make mothers who want or need to use formula feel guilty. Rather, it is meant to point out that there are scientifically researched and documented risks of formula formula-feeding/benefits of breastfeeding. And this information should be widely and transparently and accurately available to pregnant women so that they can make an informed decision about whether or not to breastfeed their babies. And I’m under no impression that this is universally the case.
As I have cited numerous times on this blog, one of the best resources that I have found on this very topic is the study, “Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries.”
This study, which “screened over 9,000 abstracts, forty-three primary studies on infant health outcomes, 43 primary studies on maternal health outcomes, and 29 systematic reviews or meta-analyses that covered approximately 400 individual studies,” arrives at the following conclusions:
We found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. There was no relationship between breastfeeding in term infants and cognitive performance.
The relationship between breastfeeding and cardiovascular diseases was unclear. Similarly, it was also unclear concerning the relationship between breastfeeding and infant mortality in developed countries.
For maternal outcomes, a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer. Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression. There was no relationship between a history of lactation and the risk of osteoporosis. The effect of breastfeeding in mothers on return-to-pre-pregnancy weight was negligible, and the effect of breastfeeding on postpartum weight loss was unclear.
Notably, this study points out the extolled benefits of breastfeeding that are supported by the research and the ones that are not. And to those who quickly point out that this thereby reveals the “thinness” of the benefits of breastfeeding, I offer the following analogy (that I used in my response to Hanna Rosin’s infamous article):
…while this might make the benefits of breastfeeding thinner than they were thought to be, this does not make them thin. To use an analogy (one that avoids thinness, for fat’s sake!), if I were to estimate that a California redwood was 300 feet tall only to discover that it was actually 250 feet tall, this would mean that the redwood was, in fact, shorter than my estimate. But it wouldn’t really mean that the tree was short, now, would it?!
But perhaps I digress.
Because for the moment, I am keenly interested in dissecting this culture of shame and fear and guilt that Suzanne from FFF refers to in her blog. And while I am under no impression that I can adequately dissect this issue in one blog post (though lord knows I have the verbosity to do it), I do want to end with two thoughts.
The first?
When I first perused the FFF’s blog, one passage in particular (from her post “Why this blog exists“) stood out to me:
Hospital maternity wards plaster posters screaming that breast is best. Headlines announce new studies weekly about the superiority of children who are nursed. The politics of pumping becomes a feminist issue, making any self-respecting NOW member want to burn her bra for entirely different reasons.
Initially, my reaction was to scream, “NO! NO! That’s not what’s going on AT ALL! Can’t you see?!”
But then I took the proverbial step back and thought to myself, “You know, I think it’s just a matter of perspective. It’s a matter of what our own investments and emotions and commitments ‘allow’ us to see.”
Because as a mother who breastfed her children, and as a breastfeeding advocate, what I often see is a society that kicks nursing mothers off airplanes or out of restaurants, that offers disjointed and sometimes misinformed lactation support, and that literally pushes formula-feeding through advertising and free samples.
But a formula-feeding mother may instead see a society that celebrates the benefits of breastfeeding without sometimes mentioning the instances in which women need to use formula, or that assumes that women who choose to formula-feed are simply “uninformed” or “didn’t try hard enough.”
And we both need to make efforts to, at the very least, take into consideration each other’s point of view without painting ourselves as the victims and without painting the other as the oppressor.
And that brings me to my second thought on the culture of shame, fear, and guilt that seems to have a stranglehold on many parents’ perceptions of birthing options, baby-feeding options, sleep options, etc. And it’s a thought that I will again take directly from a previous post:
What really deserves our careful attention and critique are the socio-cultural representations of women’s relationships with one another. Put less academically?
Ladies, we need to refuse the catty images of woman-to-woman relationships that are served up to us in every single media we encounter. We gotta stop allowing guilt, shame, and back-biting competition to enter the ways in which we relate to one another. I hate it when I see it on the playgrounds I frequent with my children today, and I hated it when I saw it on the playgrounds I frequented when I was a child. And if we can get to a place where we can avoid these modes of relating to one another, maybe we can get to a place where a woman’s profoundly personal choice about whether to breastfeed or formula-feed her child can be made not only after reflecting on accurate and transparent information and evidence but also with the assurance that her decision will be respected–whether on the playground or in her own mind.
And I hope that’s something that breastfeeding and formula-feeding moms can agree on.
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