rivka: (baby otter)
rivka ([personal profile] rivka) wrote2006-04-12 01:45 pm

Breastfeeding, formula feeding, and lactivism.

I gave Alex two bottles of organic whole milk today, and she sucked them both down. So, God willing, I've bought my last-ever can of formula.

I've been looking forward to this transition lately, and looking back at her birth and the time that followed. So breastfeeding and formula have been much on my mind, both in general and in terms of our own failure.

I still grieve the loss of our breastfeeding relationship. Not every day, and not always intensely - but reminders do still make me sad. I very much believe that breastfeeding is best for both the mother and the baby, and in our case there were health factors (a strong family history of allergies and Crohn's disease) that especially indicated the importance of breastfeeding. It's what I always imagined doing. It's what my mother did. It's what all my friends do. It is what is considered normal and desirable in my social circle. I thought we were going to breastfeed. I never imagined that we wouldn't.

Sometimes when I read about nursing, my breasts ache.

I don't feel guilty. I look back at our situation: a poor suck, very large nipples, gastric reflux disease, antibiotic-resistant mastitis. No weight gain ever from unsupplemented nursing; eventually, no weight gain even when I supplemented with pumped milk. Significantly below her birth weight at one month old. Before-and-after-nursing weight checks showing an intake of less than half an ounce. A sick and miserable baby. A sick and miserable mother. The real threat that my mastitis would require surgery. The desperate horror with which I approached the baby scale. I don't know how we could have held out any longer. Honestly, I don't know how we held out as long as we did.

My only regret is that I didn't pursue one lactation consultant's suggestion of going to a speech pathologist. At the time, it didn't even make sense; subsequently I've learned that lactation consultants know a lot more about maternal problems with breastfeeding than they do about infant problems, and that speech pathologists do actually diagnose and treat sucking problems. But I don't know. I also remember that, at the time, the process of getting a referral from my pediatrician, convincing my insurance company to accept it, making and keeping appointments, and going through unknown new therapies seemed overwhelming.

My other regret is how ashamed I felt. How pulling out a bottle in public made me want to hide. How I felt obligated to justify myself to every breastfeeding mother I encountered. How I avoided social situations where I thought I would be likely to meet lactivists. How much I still look forward to the day when Alex drinks all of her liquids from a cup, and I can get rid of the damned bottles entirely and leave this whole issue behind me.

I still feel ashamed, although my shame is now mixed with anger. I think about how hard it will be for me to seek breastfeeding support with my next baby, because it will mean exposing myself to the awful, awful things that breastfeeding advocates say about formula and the women who feed it to their babies. And I think that there has to, there has to be a better way to promote and support breastfeeding, a way that doesn't make women like me feel unworthy of being mothers at all.

There has to be.

I'm not even talking about the extreme cases - the strangers in LJ communities shrieking about how formula is child abuse, formula is as bad as cocaine; the woman on mothering.com who posted that she refuses to allow children's books into her home if they have pictures of bottles. I'm talking about discovering, just as I began to supplement with formula, that two of my LJ friends belonged to a community whose userinfo declared that every breastfeeder was a better mother than any formula-feeder. Not "making a better feeding choice" - a better mother. I'm talking about the woman who left a comment in my journal comparing making mothers feel guilty about formula feeding to making them feel guilty about not using a carseat, and who then went back and posted in her own journal about how awful it was that my friends were telling me that Alex would be okay even if I couldn't breastfeed her.

There has to be a better way to promote and support breastfeeding.

Some lactivists are unapologetic about the fact that women like me are the eggs they need to break in order to make an omelet. Others insist that of course they support women who really can't nurse. But always implicit in that support is the right of the lactivist - or anyone, really - to judge whether you tried hard enough. Always implicit in that support is the responsibility of the formula feeder to justify herself, to make her case, to - if necessary, if it looks as though she's going to be found wanting - berate herself for mistakes and admit that she was wrong.

"Of course, if a woman really can't breastfeed - like if she's had a double mastectomy - " I saw one lactivist post. Another told a story about how she learned not to judge: she and her breastfeeding friends were talking to a new acquaintance at the playground, and when this mother pulled out a bottle, everyone got quiet and looked away. The new mother explained that she was the baby's aunt; the baby's mother had died of cancer shortly after birth; the bottle held donated breastmilk. The lactivist and her friends then realized that they had rushed to judgment. Implicit in this story: if the story had been any less tragic, they would have been perfectly justified in their shunning.

"We shouldn't say that formula is second best. We should say that formula is fourth best, after nursing, pumping and bottle feeding, and using a wet nurse or a milk bank." I tried to post back here about how awful that argument made me feel, but I wasn't really able to articulate why. Since then I've seen it brought out many, many more times, and my thoughts have coalesced.

Here's the thing: I did pump. I pumped ten times a day when I first started formula feeding, and then dropped back to five or six times a day as my mastitis finally cleared. I got up in the middle of the night to pump. And the most milk I ever pumped in one day was eight ounces - about a third of what Alex consumed at that age. Using a hospital-grade pump didn't make any difference. And my milk supply dried up when Alex was four months old.

I've since found out that my situation is far from unusual. Most women can't pump enough to feed their baby pumped milk exclusively, and many of the ones who can are boosting their supply by taking a non-FDA-approved drug illegally shipped in from Canada, which has severe depression as a common side effect. It's particularly unlikely that a woman who had nursing problems from the start, and therefore never established her milk supply, would be able to pump enough to exclusively feed her baby. Most pumpers supplement with formula - or supplement formula with small amounts of breastmilk.

A wet nurse, or milk banks: milk-bank milk is not availble without a prescription, and typically the prescription needs to specify that the baby cannot tolerate formula or has some heightened medical need for breastmilk, such as prematurity. And even then? It costs $3 an ounce. $3 an ounce. The least formula that Alex ever took, when she was exclusively bottle-fed, was 24 ounces a day. She got up to 36 ounces a day before switching over to mostly solid foods. So even if I had been able to get milk bank milk, it would have cost me $72 a day to feed my baby.

So the "formula is fourth best" argument tells women who can't breastfeed that their second- and third-best options are things which, in all likelihood, are completely impossible for them. I've since heard from other women who can't breastfeed that some lactivists include another better-than-formula option in the list: "chimpanzee or other primate milk," which, for Christ's sake, give me a fucking break! As far as I can tell, that one's just down there for extra smugness, to push formula further and further down towards the unacceptable bottom of the mothering barrel.

How do people say shit like this, and live with themselves? I found out. Here's another thing I saw endlessly quoted in lactivist circles: "guilt is a sign of awareness that you're doing the wrong thing." And its corollary: "No one can make you feel guilty unless you know you are wrong." There it is: permission to say the most godawful things imaginable to another mother, secure in the knowledge that if it hurts her, it's her own damned fault.

There has to be a better way to promote and support breastfeeding. There has to be.

[identity profile] fairoriana.livejournal.com 2006-04-12 05:59 pm (UTC)(link)
I very much understand what you're saying, even if I hear it from a different perspective. (And I hope it wasn't hurtful to hear my whining about nursing!)

My daycare is impressed and bemused by my dedication to breast feeding. Most of the mothers there -- the working poor -- don't have $200 breast pumps and quiet private rooms and every-three-hour 15 minute breaks that make pumping possible. My daycare provider notices my healthy, happy, intelligent child, and knows that I bring frozen bags of breast milk. She has decided that my milk is why my boy is who is is. But honestly? I'm much more skeptical. I have no doubt that there are some benefits (otherwise I'm not sure I'd still be pumping) -- he may have gotten sick less often, it might help his growth somewhat, etc. But the core of who he is is genetics and nurture, with nutrition coming in a pale third or fourth, and then at the margins.

Although I admit I once found myself horrified halfway through a lecture (before I was even a mother) when I encountered the coworker whose wife wasn't nursing because it was "gross". But even still, I was out of line. If you think "ew" every time you feed your child, I don't think that's healthy for either of you.

You've done a terrific job of being a mother to Alex. She's a beautiful, wonderful girl. I wouldn't let any guilt or anxiety cloud that. You've done a terrific job.
ailbhe: (Default)

[personal profile] ailbhe 2006-04-12 06:02 pm (UTC)(link)
I'm sure there is. I don't know what it is. I'm trying to find it.

Part of what I do to try to achieve that is partake in communities of which I do not actually approve, because, well, the idea of everyone asking for advice in there getting it from the crazy mother-eating lunatics frightens me.

I'm afraid I might be a crazy mother-eating lunatic.

I HATE the guilt thing. I don't have the strength to contradict it every time I see it, but I do hate it.

I don't know how much of what I wrote back then you read. You weren't the only mother I knew who desperately tried to breastfeed and couldn't, of course... but you were the only one on LJ. And the only one who could afford a lactation consultant. I assumed you'd be filtering me out. But at some stage, I'd like your opinions on those pieces. Because, you know, it was easy for me. I want to know how to help the people it's not easy for - not necessarily how to help them breastfeed, but how to help them cope. And how to encourage the 1/3 of all women who never even try, once.

I'm a bit afraid of your opinions, mind you. I have no idea how nasty what I'm saying is.

[identity profile] kcobweb.livejournal.com 2006-04-12 06:11 pm (UTC)(link)
I'm right there with you, in that fight. I was ready too, every time I whipped out a bottle in public, to *defend* myself and my horrible choices (the rant began with "have *you* read her medical charts? Then why are you giving me advice?"), but I never actually had to use it.

Guilt is not always a sign that you're doing the wrong thing. You might be doing the very right-est thing, and be guilty because everyone around you thinks you're wrong and is judging you for it.

Our daughters are happy and healthy. Formula is not poison, formula saved their fucking lives. And I'll be damned if I let anyone make me feel bad about that.

[identity profile] wiredferret.livejournal.com 2006-04-12 06:13 pm (UTC)(link)
My girlfriend just stopped nursing, at 3 weeks, because it was making her crazy, because the baby was doing only okay, because she hated and feared feeding times. I think that's an okay reason to quit.

I am feeling guilty because I wasn't there. I wasn't local to talk her through the first couple weeks, which totally suck even if you have no problems. I wasn't around to just be another woman who nursed. Because it feels lonely, sometimes, and she didn't have a nursing peer group.

Now I'm happy for that, because I know she'll catch less grief. I don't think her baby's health will suffer, and I think it's probably better for her, mentally, not to have that chain. I know how liberated I feel when I wean.

I'd like it if lactivists talked more about the social and economic costs of what they are demanding, how literally crazy nursing can make anyone. Like childbirth classes that discuss both vaginal and c-section births, as things with plusses and minuses.

I wonder how much of pre-formula infant mortality was due to inability to nurse/failure to thrive.

You're a good mommy, Rivka, and I hope you have always known I think so.
ext_6283: Brush the wandering hedgehog by the fire (Spiny sea urchin)

[identity profile] oursin.livejournal.com 2006-04-12 06:15 pm (UTC)(link)
there has to be a better way to promote and support breastfeeding, a way that doesn't make women like me feel unworthy of being mothers at all.

This is such a sad and awful phenomenon, the way people switch into this messianic mode where everyone who is not part of their One True Way is on the side of Evil. That not doing it Their Way is not just not-as-good but seriously doubleplus bad. (Paging Melanie Klein and her concept of the Good and Bad Breast and its relationship to the paranoid-schizoid position, perhaps.) Promoting one thing shouldn't mean persecuting those who do other things. People have to work from where they are with the options available to them. They do the best they can. Haranguing and stigmatising them for necessary choices is not going to win any converts.

[identity profile] pixel.livejournal.com 2006-04-12 06:15 pm (UTC)(link)
"Man, that is messed up beyond belief. There has got to be a better way.

I am reminded of my girlfriend PG being told by someone that her children didn't have souls because they were both C-sections.

This is also why, dispite the fact I don't ever want kids and hate the idea of being a parent, I will never ever call myself 'childfree'. Because there is way to large a percentage of that group that are full blown nuts."

[identity profile] kalmn.livejournal.com 2006-04-12 06:20 pm (UTC)(link)
Our daughters are happy and healthy. Formula is not poison, formula saved their fucking lives. And I'll be damned if I let anyone make me feel bad about that.

yes.

yes, that.

a crucial signpost on the way to being a good parent is *not letting your child starve to death*.

i can't figure out what to say here that isn't either trite or flip, but i am nodding fiercely in agreement.

[identity profile] saoba.livejournal.com 2006-04-12 06:28 pm (UTC)(link)
You struggled so hard and you got dealt a truly spectacular set of obstacles. And I hate that the whole subject of breastfeeding has become so polarized that people say hurtful, stupid things.

The thing that makes me crazy is, formula is not the Anti-Christ. Once upon a time we didn't have formula, and most mothers could not afford wet nurses. Their babies either died or were profoundly malnourished on substitutes. Oh, and wet nurses? A lot of the time they didn't have enough milk production to feed the client's baby and their own well, so their own child was not well-fed.


Not every woman can nurse easily and well enough to support her child's needs. Hellfire, it varies from child to child, depending on the various factors in the woman's life and health. And suggesting that it is somehow evil/wrong/bad mothering to be physically unable to nurse or to be financially unable to afford to provide a child with breast milk strikes me as smug and entitled.

The frenzy around 'you must breastfeed' makes me angry and tired. I've seen too many women I care about hurt by this particular skirmish in the Mommy Wars to have any patience or charity for the fanatics.
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[identity profile] therealjae.livejournal.com 2006-04-12 06:35 pm (UTC)(link)
This is a wonderful, wonderful post, and I love you for it. I hope lots of people read it, and think about it.

-J
ext_2918: (Default)

[identity profile] therealjae.livejournal.com 2006-04-12 06:44 pm (UTC)(link)
This is also why, dispite the fact I don't ever want kids and hate the idea of being a parent, I will never ever call myself 'childfree'. Because there is way to large a percentage of that group that are full blown nuts.

This reminds me an awful lot of the gay men who refuse to call themselves gay, even though they've only had sex with people of the same sex and only would ever want to, because they don't want to lump themselves in with people who march naked in pride parades and call each other by women's names. 'Childfree' is a very useful word that means no more and no less than "someone who's made a decision not to have children (for whatever reason)." Abandoning this useful word because some of the people who use it to describe themselves are batshit crazy doesn't do anybody any favours.

-J

[identity profile] geekymary.livejournal.com 2006-04-12 06:48 pm (UTC)(link)
*hug*

Thank you SO much for posting this! I hated breastfeeding (because of all the guilt): I hated pumping, I never had enough supply and so we supplemented with formula.

The "all or nothing" attitude of boob nazis/lactivists is really self-defeating. They're marginalizing themselves as weirdo fanatics. I mentioned as much on an LJ community one time and was met with an icy response.

If I had time to get that master's in Women's studies, this habit of turning on each other in competition that women tend to have is something I'd be interested in writing a thesis on.

[identity profile] pixel.livejournal.com 2006-04-12 06:51 pm (UTC)(link)
"I consider my choice to have kids or not have kids as only relevant to myself and the people I enter into relationships with. So I don't feel a strong need to seek out a label for myself to express that to the rest of the world. I would prolly slap the 'childfree' label on myself, except the peopel who use it piss me the hell off. And I don't want to be, even for a second associated with those people. So I don't."

[identity profile] pixel.livejournal.com 2006-04-12 06:52 pm (UTC)(link)
"So to clarify, abandoning it does me the favor of not being lumped in with the loonies. There are other valid labels I also refuse to wear for the same reson."
ext_2918: (Default)

[identity profile] therealjae.livejournal.com 2006-04-12 06:56 pm (UTC)(link)
That's your right, of course. It bothers me, though, for the reasons I stated. I don't *want* the crazies to be the only ones owning that word--it's a useful way to distinguish between people who happen to not have children, and people who have made a conscious decision not to have them at all. And the more people there are who refuse to use the term in a more casual way than an entire lifestyle, the more uphill that battle will be.

-J

[identity profile] going-not-gone.livejournal.com 2006-04-12 07:10 pm (UTC)(link)
I was lucky; breastfeeding worked well for me and my kids. I know I was lucky, just as I was lucky to have uncomplicated pregnancies and healthy babies. I'm certainly not in any position to look down on people who haven't had the same good fortune. It's like looking down on somebody who's carrying more debt than I am because they were unemployed for a year, because after all, debt is bad.

I despise people who think "I did this, therefore it is the ONE TRUE WAY," and are insanely judgmental about anyone who does things differently.

And also, I was bottlefed, and I am both intelligent and healthy. So the lactivists can bite me.

[identity profile] going-not-gone.livejournal.com 2006-04-12 07:11 pm (UTC)(link)
And also? I had a terrific milk supply but I couldn't pump. Never ever managed to get much out of them unless it was going directly into a kid.

[identity profile] chargirlgenius.livejournal.com 2006-04-12 07:19 pm (UTC)(link)
I hear you. I've felt many of these things, though I also admit, I'm sometimes guilty of being too judgemental. I try to reserve that for people who don't even try, but I know even that isn't helpful, I know.

In addition to the bottle-feeding, I've run into this from the sleeping end of things. It's rough.

Congrats on getting her to drink milk! I know a lot of parents who have trouble with this.
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[identity profile] therealjae.livejournal.com 2006-04-12 07:19 pm (UTC)(link)
I thought I didn't have anything else to say, but it turns out I did.

Here's another thing I saw endlessly quoted in lactivist circles: "guilt is a sign of awareness that you're doing the wrong thing." And its corollary: "No one can make you feel guilty unless you know you are wrong." There it is: permission to say the most godawful things imaginable to another mother, secure in the knowledge that if it hurts her, it's her own damned fault.

As you might imagine, this line of reasoning drives me utterly looney. Saying hurtful things is hurtful--period. And even if you *don't* feel guilty about something, even if you know, fully and completely, that it's not your fault, it can still be extraordinarily painful to hear someone you care about telling you that you *should* feel guilty about it.

-J

[identity profile] ratphooey.livejournal.com 2006-04-12 07:26 pm (UTC)(link)
Ack. This issue. I hate it.

I hate that I had trouble breastfeeding. I hate that each lactation consultant I spoke with gave me different advice. I hate that I was so caught in post-partum depression that I could barely breathe. I hate that I was so intimidated by the boob nazis that I stopped posting about the issue in my own damn journal (even the people who meant well sometimes veered too far into hurtful criticism, like the person who described a friend's truly Herculean efforts to avoid formula as if anything less were too little).

But even though I gave up after a month, during which time my son consumed mostly formula anyway despite his and my best efforts, I have a happy, healthy, intelligent child.

I was adopted as an infant, and formula-fed from the get-go. Yet I'm happy and healthy and intelligent, too (if I do say so, myself).

My husband, who breastfed til he was nearly four, has asthma and Crohn's high blood pressure and gets cluster headaches.

I hate that women can be so hard on each other, so judgmental. Where does that come from? Why is it okay?
Answer: It's not.

I'm proud of you for coming through all that with the best possible result: a happy and healthy child. I'm proud of myself, too. We should be.

[identity profile] journeywoman.livejournal.com 2006-04-12 07:28 pm (UTC)(link)
it's a useful way to distinguish between people who happen to not have children, and people who have made a conscious decision not to have them at all.

I don't think it's quite as simple as that. The nutcases are choosing to use the term childfree rather than something like childless. The first term implies that children are a burden; the second term implies that children are an asset. When someone chooses one or the other of these terms to describe his/her situation, I'd say that a value judgment is being made.

[identity profile] redbird23.livejournal.com 2006-04-12 07:32 pm (UTC)(link)
Thank you for this post. I hope you don't mind me commenting here. I found your journal through several mutual friends and have very much enjoyed your posts about parenting and your experiences as a mother.

I'm pregnant with my first, very wanted, child. I'm finding pregnancy to be wonderful and terrifying all at the same time. I go back and forth between being absolutely amazed that this process is taking place inside me, that my baby is currently a part of me, and being slightly disturbed by that very fact.

I was a formula baby. Both of my sisters and all of my cousins were as well. I don't think I was ever exposed to a nursing mother until I was in high school. I certainly never encountered a positive nursing role-model until my friends started having their children. Therefore, nursing is still a bit of a strange idea to me.

I know the benefits.

My plan is to go into it with an open mind. I know I have friends I can call with questions. I know there are resources available. I am looking forward to the closeness my friends have had with their little ones.

But having grown up surrounded by mothers who did not nurse, and having looked up to them as wonderful women and fine mother role-models for all of my life, I doubt that I will feel crushing guilt if I find nursing to be a struggle or something I dread. And I refuse to apologize for that. Formula is better today than what my generation was raised on, and I believe with all my heart that a happy and healthy mom is more important to the health and well-being of the child than whether they are nursed or formula-fed.
ailbhe: (Default)

[personal profile] ailbhe 2006-04-12 07:33 pm (UTC)(link)
achilded?

[identity profile] shelly-rae.livejournal.com 2006-04-12 07:33 pm (UTC)(link)
Unfortunately Rivka, there are thousands of people out there who think they know more & better than you do about raising your child. And they will not hesitate to tell you exactly what you are doing wrong. Breastfeeding/bottle feeding is only the tip of the iceberg.

Not only that, there are people who make vast amounts of money out of making Mom's feel guilty. Just pick up any parenting magazine, you'll find them there. And sometimes, these two groups of folks are in cahoots!

And oy! Chimpanzee milk!? That's just crazy talk! Not to mention the ethics. Sheesh!

Anon
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[identity profile] therealjae.livejournal.com 2006-04-12 07:35 pm (UTC)(link)
I think you're mistaken about the generalization. When I refer to myself as 'childfree' rather than 'childless,' I am trying to make the statement "for me, not having children is a good thing, not a bad thing." I am NOT trying to make that statement about anybody else's choice, or about children in general. When people regard not having children as a lack, they are childless. When people regard not having children as a positive thing, they are childfree. That distinction is precisely what makes the term useful--it says something about how individuals view their individual situations.

-J

[identity profile] casperflea.livejournal.com 2006-04-12 07:36 pm (UTC)(link)
I regularly attend La Leche League meetings, and I breastfed my daughter until age 2 and a half, and I agree with what you say. One of the reasons I attend La Leche League meetings is to be the "bad mommy" there - the mother who works, and so can give you advice about pumping, navigating a hostile work environment for pumping, dealing with caregivers who are squeamish about breast milk, etc.; who can help with advice on getting the baby to sleep better because when you have a full-time job, napping when the baby naps is not an option, and you do have to be relatively awake to function at work; to be the one who says, "well, that's not my experience" when the standard La Leche League comments about natural mothering instincts are trotted out (I happen to have a husband who is far more nurturing by nature than I am).

On the other hand, I think that it's possible that because of the cultural niche you live in, you see the ugly pro-breastfeeding people and don't see the ugly anti-breastfeeding people. Who I am afraid are a far greater percentage of the population as a whole - the "that's disgusting" people, the "it's unnatural (in a sexual way) to nurse beyond 3 months" people, the "it's antifeminist to tie yourself to a child" people. A lot of women stop breastfeeding at 3 or 6 months or a year, or never start, not because they have trouble nursing, but because they are made to feel it's wrong or weird to begin or continue, or their job doesn't allow them time to pump enough to keep their supply up (i.e. my friend the labor and delivery nurse who works 12 hour shifts without reliable breaks, let alone most low-income workers - could you pump in a Wal-Mart break room? What if you had no paid maternity leave and needed to go back to work 3 weeks after your baby was born, before breastfeeding was really established?).

I don't think the lactivist approach is the right way to change the US cultural attitudes against breastfeeding. It's very ill-conceived - it mostly reaches people who don't need to be convinced, and it turns off more of them than it turns on. Unfortunately the lactivist people are the only people promoting breastfeeding right now, and I do agree with them that breastfeeding is, when a choice on more or less equal terms is available, the better choice.

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