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Breastfeeding Advocacy: It's a Movement, Not a War

In another swing of the media-driven “Mommy Wars” pendulum, author and mom Alissa Quart wrote a New York Times opinion piece this past Sunday about an issue that was brought to a head by the recent (will we ever hear the end of it?) TIME Magazine cover depicting a toddler standing on a chair to nurse, along with the headline “Are You Mom Enough?”. Quart dubs this particularly formidable mom-divide, as well as the title of her piece, The Milk Wars. She opens with a cringe-inducing account of her delivery hospital’s doctor decrying formula as “evil” when – in the face of MIA colostrum and a newborn dropping weight – Quart’s husband inquired, hesitantly, after the possibility of supplementing with something other than breast milk.

Quart writes, “however worthwhile nursing may be, the heightened pressure to breast-feed creates shame in those who don’t manage to do it, and today’s lactation rhetoric erroneously implies that nursing is the most crucial thing you can do for your infant’s welfare.” Now, Quart makes a few good points in her piece, but framing pro-breastfeeding efforts and emphasis as “pressure” and saying point blank that it “creates shame in those who don’t manage to do it,” is too sweeping a generalization to capture the nuances of American moms’ experiences. Her own encounter with that unprofessional, clearly not-helpful doctor is -- as your comments following this post I wrote on the question of hospital formula swag bags reflect -- shared in some form by many, but countless other moms (many of whom wish to breastfeed exclusively and experience initial challenges) have had near-opposite experiences. There’s a broad spectrum when it comes to the availability of breastfeeding support, as well as the presence of pressures, and it’s important to recognize this spectrum (and acknowledge that our experiences all land us somewhere along it) before calling the whole thing a war.

Quart herself recognizes – whether she realizes it or not – that many women also experience pressure not to breastfeed, and these experiences often take place on a larger, more culturally-consistent scale. Despite the AAP’s recent recommendation that infants receive breast milk exclusively for at least six months (ideally continuing to nurse for an additional six after that), Quart writes, “fewer than half of American babies are breast-fed for six months. I understand why. Breast-feeding exclusively for the first year is just not feasible for many women, who sometimes get six weeks of paid maternity leave but often get none. Choosing formula as a supplement is reasonable, given this reality.” Sure, I agree with that! But… this is a reality that should be challenged, right? Most moms who breastfeed stop before they intend to because of it. And the recent AAP breastfeeding recommendations overtly identified the systems surrounding moms—pediatricians, workplaces and society at large – as crucial forces that should be held responsible for making breastfeeding more realistically doable. Many organizations, journalists, politicians and, yes, moms themselves are speaking up about this, as well. This is not a war. It’s a movement.

Along with increased cultural awareness of the needs of, and need for, breastfeeding moms, there should also be more awareness of the diversity of experiences women have in breastfeeding; Quart is right on in making this point. For some women, it’s a piece of cake. Other moms really struggle to make it work. Some moms just don’t want to. And many have mixed experiences, along with mixed feelings, and end up taking a mixed approach. I wanted to breastfeed, but had limited success, hobbled along for as long as I could, and definitely utilized other options, including organic formula and donated breast milk. I didn’t feel ashamed that my plans hadn’t panned out (maybe I was too exhausted for that?), but I did feel disappointed, and a little jealous of moms for whom breastfeeding came easily. But I also felt grateful for the sheer availability of options, because I needed them. And while I didn’t have all of the support that I now realize would have likely made at least some positive difference in my lactating longevity (the pumping setup upon returning to work definitely killed my already-meager supply), I also didn’t face judgment from our pediatrician, or other parents, for my choices. Once, many months after stopping breastfeeding, I did receive a nasty comment from a (male!) friend about not breastfeeding for longer, and it hurt. I can sympathize with moms who've endured criticism around their baby-feeding choices, especially if they've struggled to make breastfeeding happen at all. But I don’t think that assuming all people who promote breastfeeding are judging those who don’t do it is either accurate or helpful. Neither is writing breastfeeding off as not-actually-that-awesome-anyway. Which is what Quart does, via the opinions of Dr. Amy Tuteur, who she interviewed for her piece.

Tuteur (in addition to believing home birth to be, basically, a death sentence for those who attempt it… um, not accurate), in Quart’s words, proclaims breastfeeding “is less important than its advocates claim. She cited a 2008 study in the journal Pediatrics, in which the authors concluded there was no ‘evidence of risks or benefits of prolonged and exclusive breast-feeding for child and maternal behavior.’” This may be true, but there definitely is scientific evidence of breastfeeding's benefits for child and maternal health. These benefits aren’t everything – many, many babies thrive on formula, too. But it’s not accurate to defend formula-feeding by denying the facts about breastfeeding. And, as this recent (and more lighthearted than all this mommy-wars-waging business) piece also acknowledged, breastfeeding is NOT a walk in the park. It actually kind of sucks sometimes (so to speak); I certainly didn’t love it... And let’s not even talk about the pump. But, like I did, many moms give it a go because there are proven health benefits for moms and babies alike. The iVillage piece suggests that, despite its drawbacks, breastfeeding is worth trying.

It’s been shown that information about breastfeeding’s benefits results in more moms wanting to do just that, and support once they begin results in greater success rates. The majority of pro-breastfeeding peeps also want to get more moms advocating for themselves – and their children – so that breastfeeding to the benefit of moms and babies is realistic, even in the midst of work and social realities. The more women who push against breastfeeding-at-large when they mean to push against bad doctors and uncompromising zealots, the more difficult this kind of positive social change is to make.

I agree that every mom faces her own challenges, and I stand by Quart’s position that we, as moms, shouldn’t judge one another, ever, over these matters. I also agree with her that “we should be organizing for paid parental leave, subsidized day care and public preschool.” But her ‘milk wars’ are, in reality, less about mom-to-mom ideological combat than they are about fighting for women’s rights to breastfeed publicly, privately, and with the support of their workplaces and communities. These are real parenting issues (Quart's incorrect in insisting they aren't). Let’s not confuse them with petty attitudes, from either side, and let’s ensure they continue to get the attention they deserve.

Do you think the “Milk Wars” are real? Is breastfeeding overrated? Is the increased attention to the issue backfiring by making moms feel guilty if, for whatever reason, breastfeeding doesn’t work for them? Or is it helping more moms and babies breastfeed successfully, and with the support they need?

PS. Did you know that World Breastfeeding Week takes place August 1-7? How will you celebrate?