My wife flagged this article by Hanna Rosin in The Atlantic entitled The Case Against Breast Feeding. She points out that the medical evidence that breast milk is superior to formula for infants is tenuous and marginal. This is as opposed to the popular literature which suggests that breast milk is the elixir of the Gods and that if you give your kid formula, you might as well be stuffing unfiltered Pall Malls in their gummy little mouths.
After a couple of hours, the basic pattern became obvious: the medical literature looks nothing like the popular literature. It shows that breast-feeding is probably, maybe, a little better; but it is far from the stampede of evidence that Sears describes. More like tiny, unsure baby steps: two forward, two back, with much meandering and bumping into walls.
All things being equal, it’s probably best to breast feed if you can. But not all can, and all things are rarely equal. Amy & I (mostly Amy) are sensitized to this issue because Amy is unable to breast feed because of a medical procedure years ago. (I’m not talking out of school here, she is very open with this bit of information.) On the upside, we were able to observe the social pressure related to breast feeding without being overly affected by it — no options mean no real pressure. New mothers are made to feel guilty in various and sundry ways if they decide not to breast feed, but the medical evidence does not support this level of moral approbation. (That’s right, I know 25-cent words like “approbation” — despite, I might add, being a formula fed child myself — and I’m not afraid to use ’em.)
In any case, it’s an interesting article and worth a read.
A couple of brief observations:
The low number of mothers on medicaid who try breastfeeding is annoying. Breastmilk is free. Why not use the free food?
Almost all of the “baby is gassy”, “baby won’t poop”, “baby’s poop is too hard”, “baby is spitting up with each feed”, “can we switch formulas?” doctor visits are formula-fed babies.
For those who can’t breast-feed, formula is a fine and adequate alternative.
Agree with T.
I couldn’t help but think while reading the first page of the article, “Is this a shill article for Nestle?”, and then the author confesses that sure enough, Nestle formula was her upbringing. So, there’s the basis. Not to shill, but to justify self. Great.
We’re usually on the other side of this, me on the grand western tradition of product sale, and you on the side of government for our own good, but with my wife working to educate Medicaid patients during pre-natal care visits about the benefits of breast feeding, I am too aware of the enormous ad campaign the federal government conducts to encourage the practice, and on the merits of the content, I support it.
For me what stood out about the article is how women like me are made out to be evil villains for even considering giving formula. We’re treated like scum from day one for it. When in reality, the benefits aren’t really all that world changing. Since I’ve had kids, we bottle feeders are pretty much regarded in the same light as child abusers and for the life of me, I can’t figure out why. I also can’t figure out why it’s anyone else’s business how I feed my baby. I’d never dream of walking up to someone and asking them about their breasts, but whip out a bottle and watch the disdain, accusations, and judgments. It’s like they think if you don’t breast feed, YOUR BABY WILL DIE!
My babies got fed. They are happy. And smart. And perfectly bonded with their mother.
Tom – as for the Medicaid people, I’m willing to bet those women don’t have the kinds of jobs that allot time and places to pump, making breast feeding for a working mom very hard. And if you are on Medicaid, you are probably on WIC, so formula is free. What restaurant manager is going to let his waitress run out and pump for half an hour with busy tables?
Most of the young mothers I’m describing don’t have jobs. The formula isn’t free. It’s free to them. That’s my point. I can assure you most of them aren’t waitressing, etc. They’re living with mom, home with the baby.
When I ask if they plan on breastfeeding, they respond like I’m asking if they plan to walk around topless all day, titties bouncing obscenely in their kids’ faces. It’s seriously like, “Why would I do THAT?” The response is as if they’ve been asked once before, but that it’s something they considered for about a second before dismissing it out of hand.
I don’t doubt that you felt pressure to breastfeed. The culture I’m seeing on my end is a multigenerational refusal to even consider doing it.
I didn’t feel “pressured” to breast feed. I was treated like crap because I couldn’t by everyone from the ob nurses at the hospital to strangers on the street.
What should any woman care what anyone else thinks of her choice to breast or bottle feed; both provide the nutrition needed for healthy growth. Commonsense having informed me of that some thirty-seven years ago. I made the choice to bottle feed because I really wanted our baby girl to bond with both her mommy and daddy – most especially during those serene middle of the night feedings. And so it was, daddy having survived the jungles of Southeast Asia came home perfectly trained to wake with her first stirrings and provide her with the nourishment she needed to grow and he the love needed to help heal his soul.
And what is the value of their opinions, to you? If what they have to say doesn’t apply to you (your breasts don’t work, end of discussion), then it doesn’t apply to you.
OB nurses in cities, or in rural areas for that matter, deal with a population that, on average, could do better in the “caring for baby” department. The women smoked in pregnancy. They dropped out of school rather than studying hard as if the future welfare of their yet-unborn children depended on it. They ate poorly. Didn’t exercise. Chose poor, unsupportive and financially unstable mates. They showed up for delivery with no prenatal care, even though they needed only to go file for medicaid and they would have gotten it. From my past life delivering babies, I could have pulled five charts from each of the above categories with ease–and I wasn’t that busy. So now, by default, these new mothers are preparing to give their babies formula that offers no advantage, may be marginally inferior, and that they can’t afford. The nurses helpfully chime in that there’s a nearly inexhaustable food supply hanging ten inches under mommy’s chin. It’s a perfectly reasonable thing for them to do. It’s as sensible as saying, “If you see five dollars lying on the sidewalk, pick it up.”
The message clearly didn’t apply to you. So your options are to tell them to fuck off, or explain it, or volunteer that it’s none of their business, or wish them a nice day.
I would also say that, in general, instructions given in hospitals are given as if you have a eighth-grade education and short-term memory problems. If you are college-educated–or simply get the message the first time it is given– it can be frustrating, I’m sure. They also would be assuming functional, not post-operative, breasts. Although that info is in your chart and nurses should know it, shifts change, people get busy, and that info isn’t all that vital except to not annoy you about breastfeeding.
And what is the value of their opinions, to you? If what they have to say doesn’t apply to you (your breasts don’t work, end of discussion), then it doesn’t apply to you.
It’s easy in the abstract to disregard other people being vilified, but it’s much more difficult to ignore if everyone in your peer group believes that you have the mothering skills of an uneducated hick.
And I’m not exaggerating about zealous people are about breastfeeding; for a lot of people – especially in the college educated upper middle class demographic – it’s very much like a religion or cult.
Right on Peter. You took the words right out of my mouth.
I hired a Doula for Harper’s birth and I can’t tell you how many articles and emails she sent me regarding how I really could breastfeed. Because someone who had a breast reduction somewhere did it! So I could too! Our situations must be exactly the same! This was after I told her on our initial meeting that I was not able to do it.
I’m not saying women shouldn’t be encouraged to breast feed. I’m just saying that the hyper mass hysteria over it is inconsistent with the actual benefits and vilifying women who bottle feed, for whatever reason, is inappropriate.
Oh, sure, I totally concur. Hire a different doula and educate your peer group or enforce some kind of order on it.
I was just explaining why it is handled the way it is in a hospital setting.
People tell me I’m going to hell due to my being an atheist. There’s less evidence for that than there is for breastfeeding. What are you going to do? People will have their notions despite whatever efforts we take to dispel them of them. It would be nice to be able to say, “I’ve noted your concerns. I’ve come to a different conclusion. Now let’s speak no more of this.” Oh, if only!
There are no shortage of new mothers who really do need a kind of heavy, repetitive message on breastfeeding, though. The ones who say, “You mean I can’t smoke?” If the level of ignorance is that great, the health care provider who takes their job seriously has to beat certain messages like a drum.
I’ve really enjoyed your responses here, T. What was your ‘past life’ role regarding delivery of babies?
I’m a family physician. In residency and the first couple of years in private practice, I delivered about a hundred babies. When our small town got an obstetrician, I stopped delivering babies. I was starting to have less than a delivery per month, which I didn’t feel was enough to maintain proficiency or justify the malpractice expense. I still attend c-sections to care for the newborn, so I still get to participate in what is usually a pretty cool life event.
It occurs to me that some of the breastfeeding cultists that Amy has encountered are very similar to the “So you just brought your baby home. Congratulations and when are you having another one?” cultists. When I would say we were only having one, they would laugh and then say, “No, seriously, when are you having number 2?”
They would then go on and on about how awful their own lives would have been without siblings, etc. It really was bizarre.
I agree with the others who have said that if you can’t breastfeed for medical reasons, then there is nothing wrong with using formula.
And of course, I always figure “To each his own”. It’s not really my place to say if someone is right or wrong for choosing one or the other.
But I breastfed all 3 of my babies (not all at once of course) because it felt safer. I know what I take into my body, and so I know my milk isn’t tainted with rocket fuel.