What That Doctor Who’s “Not Celebrating World Breastfeeding Week” Needs To Hear

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Way to try raining on our parade with something other than, you know, breast milk — which would’ve been very welcome this week!

There’s a piece circulating on the internet, made popular recently due to the fact that it’s World Breastfeeding Week and August is National Breastfeeding Month (let’s call these WBW).

Many people (even those who aren’t breastfeeding) have been celebrating in different ways. Some haven’t been celebrating because they had no idea it’s a week and month designated to breastfeeding. Or they do know but don’t really care.

And then, some are actively NOT celebrating because they do know and they do care. So much that they publicized their refusal to celebrate. One author who goes by the name of Dr. Amy Tuteur did just that. (Edit: Originally I linked to her full article, but I’m sure it’s received enough clicks at this point).

Now a few quotes from Dr. Amy’s article and what I think she needs to hear in response:

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1). “The moralization of infant feeding is not good for mothers or babies.”

No, no… she must have misheard. It’s normalization, not moralization. Silly.

WBW is about understanding breastfeeding and understanding women, children, and nature — not about the “right” way to be a woman, have children, or follow our natures.

2). “It’s not because I don’t understand the benefits of breastfeeding; I’m an obstetrician… And it’s not sour grapes; I breastfed four children and I enjoyed it.”

I may not have a medical degree, but I have a journalism degree… which means I know half-truths when I see/read them.

Some medical practitioners can recite surprisingly little about the modern recommendations for breastfeeding. In fact, my son’s first pediatrician (a pediatrician!) advised us to switch to cow’s milk at one year because supposedly it’s “more nutritious.” As I hadn’t birthed a calf, this was especially confusing.

It’s also hard to ignore the fact that some medical practitioners receive monetary kickbacks for promoting formula and handing out free samples like Halloween candy.

Regarding those “sour grapes,” I’ll share another anecdote of which I’m reminded. One of my relatives said she breastfed exclusively for half a year (or a year, depending who she told), but the truth is she only breastfed for a few weeks and during that time supplemented with formula.

Keeping in mind that some people round up (a lot), we know that breastfeeding multiple children for a few months each is not the same level of experience as breastfeeding multiple children for, say, a few years each. Nothing wrong with the truth whatever it may be, but it’s these exaggerations that harm new mothers — not the openness of various motherhood realities that is WBW.

Whichever it is, such a claim needs honest clarification before it can be used as evidence of credible “expertise” in this area.

3). “I’m not celebrating because my email inbox is filled with tales of anguish from women who feel guilty because they tried to breastfeed and were not successful.”

They feel anguish, they say. And the chosen reaction is to attempt to guilt those who celebrate the thing they seemed to really want to do?

Shouldn’t an obstetrician respond by helping these women troubleshoot their problems instead of refusing to stand with the rest of their community? What do they tell their clients who want to publicly honor their breastfeeding victories — “sorry-not-sorry, I cannot by my own conscience share in your happiness”?

Surely these guilt-wracked women didn’t spend time writing anguished emails to their obstetrician just to bounce off an ear — no, that kind of email goes to their therapist or counselor. I’ll bet the hopeful intention was for medical help, support, advice… they landed in the inbox of their obstetrician, after all.

Dr. Amy goes on to say 5% of women physically cannot breastfeed. If her inbox is literally filled with women who weren’t able to successfully breastfeed, the number of senders must dip beyond that pool of the 5%. The rest would then be women who were very likely physically capable with the right support, but unfortunately doomed by booby-traps. The system failed them and it is not their fault.

These women are part of why WBW exists.

Did these anguished women claim they received cheers, but ran short on help? Did anyone drop by their houses to release them from some domestic burdens when working on nursing issues, or offer to milk-share in times of need? Did their employers fully comply with the workplace pumping laws that intend to help them meet their feeding goals even when they must go to work? Did their obstetricians provide realistic and attainable solutions when they flooded email inboxes with tales of anguish regarding breastfeeding roadblocks?

Simply refusing to celebrate WBW does nothing to help these women who feel like they’ve failed. It wouldn’t have helped when they felt they were in the process of failing, either. All this does is imply breastfeeding mothers (and perhaps breastfeeding itself) are to blame for these mothers’ feelings of anguish and guilt, when the true culprit is a culture full of booby traps and complacent medical practitioners.

The American Association of Pediatrics acknowledges barriers to “initiation and continuation of breastfeeding” that include:

Insufficient prenatal education about breastfeeding;

Disruptive hospital policies and practices;

Inappropriate interruption of breastfeeding;

Early hospital discharge in some populations;

Lack of timely routine follow-up care and postpartum home health visits;

Maternal employment (especially in the absence of workplace facilities and support for breastfeeding);

Lack of family and broad societal support; media portrayal of bottle feeding as normative;

Commercial promotion of infant formula through distribution of hospital discharge packs, coupons for free or discounted formula, and some television and general magazine advertising;

Misinformation;

Lack of guidance and encouragement from health care professionals.”

WBW is not just about the cheering and “Rah rah rah, breastfeeding”!

It’s about recognizing that new motherhood was always meant to come as a package deal with a tribe of experienced, helpful people interested in helping mothers draw real meaning from their baby-feeding journeys. It’s about actually helping — especially when they reach out for it.

4). “…it has been drilled into them that ‘breast is best,’ and, therefore, they are harming their beloved babies by formula feeding.”

If “breast is best” is declared too much, how about any number of the things declared by formula companies?

Formula companies want you to believe that formula is “basically the same” as breast milk. They equate their products to breast milk and use the advantages of breastfeeding to serve as foundation for their own campaigns. Breastfeeding has no appropriate place in formula marketing except to remind that “breast is best” (without attempting to demonstrate how the artificial product is really, kinda, pretty much almost-best).

Focusing solely on the benefits of breastfeeding can make it seem like breast milk is “extra good” instead of normal. Women deserve informed choice, and to shove all that under the rug is irresponsible.

Formula feeding and breastfeeding are not equal just because they are both methods of infant feeding. To perpetuate this dangerous myth is negligent and attempts to undo all the progress we’ve made in society and the medical community in recognizing the importance of breastfeeding, breast milk, or at the very least, keeping babies close to their mothers’ bodies for as long as possible.

Truly, there is no comparison between breastfeeding and formula. They aren’t an equivalent or similar type of feeding, they are two separate, different types. Just like apples and oranges — not like two brands of apples or two varieties of oranges, just two unrelated fruits.

This is a problem for formula-feeders because it defaults formula as the “lesser option,” thereby insinuating that formula users are inferior parents. It’s a different option — only when compared to breast milk is it truly lesser, and this is how formula companies work to pit mothers against mothers. It effectively widens the divide between families and garners more support for companies rather than each other. Even the Fearless Formula Feeder is irked by ads like the one for Gerber Good Start.

One study asked people whether they agreed that breast milk offered many health benefits to babies — most answered yes. Then the same people who agreed with that statement were asked whether they believed that formula feeding carried health risks — most said no. So, breast is best, but formula isn’t bad. You see, it doesn’t hurt formula companies to declare “breast is best” just like everyone else. This is a trick.

Learn about how this kind of language has permeated and changed our culture. Read this post “Watch Your Language” by Diane Wiessinger, MS, IBCLC, and watch this video:

This is another reason why we need WBW. Because breast is NOT “best.” It’s the biological norm. It’s normal. It’s the standard. “Best” is a sales pitch, a marketing tool, verbiage that ultimately undermines all efforts of re-normalization of breastfeeding.

WBW is not about “best” — it’s about acceptance and acknowledgement of a reality that has been greatly misunderstood and unappreciated since the advent of factory milks.

5). “…the benefits are trivial, a few less colds and diarrheal illnesses across the population in the first year of life. Research on other potential benefits of breastfeeding is weak, conflicted and plagued by confounding variables.”

Many highly-regarded health advisers and organizations will disagree with Dr. Amy. And science… science disagrees, too. It’s not only impassioned “lactivists” who note the disadvantages of alternative feeding methods.

Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers” – The World Health Organization (WHO) and UNICEF

From “Global Strategy for Infant and Young Child Feeding,” WHO (emphasis mine):

The vast majority of mothers can and should breastfeed, just as the vast majority of infants can and should be breastfed. Only under exceptional circumstances can a mother’s milk be considered unsuitable for her infant. For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances.

…For infants who do not receive breast milk, feeding with a suitable breast-milk substitute…should be demonstrated only by health workers, or other community workers if necessary, and only to the mothers and other family members who need to use it; and the information given should include adequate instructions for appropriate preparation and the health hazards of inappropriate preparation and use. Infants who are not breastfed, for whatever reason, should receive special attention from the health and social welfare system since they constitute a risk group.”

See more recommendations by health authorities here, and a list of facts about breastfed babies and nursing mothers here.

Do you really know what’s in breast milk? Do you know what’s so good about breastfeeding beyond just the milk? Read up: What’s in Breast Milk? and Special Components in Breast Milk.

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6). “Why are we celebrating World Breastfeeding Week in the U.S? It’s not to educate women since everyone knows that breastfeeding has benefits.”

And how many people know about the disadvantages of alternative feeding methods?

Many breastfeeding mothers give formula to their infants on regular or irregular occasion. This is why exclusive breastfeeding rates are published as inaccurately higher than they are in reality, given that infrequent (and thus perceived as trivial) supplementing often goes undeclared.

[M]any of the mothers counted as breastfeeding were supplementing their infants with formula during the first 6 months of the infant’s life. Although breastfeeding initiation rates have increased steadily since 1990, exclusive breastfeeding initiation rates have shown little or no increase over that same period of time. Similarly, 6 months after birth, the proportion of infants who are exclusively breastfed has increased at a much slower rate than that of infants who receive mixed feedings.” – American Association of Pediatrics

This celebration of breastfeeding is so much more than teaching about the “benefits” of breastfeeding — it’s about creating awareness of the potential problems. It’s about seeing it for what it is behind the mask of myths.

I was a pregnant first-time mother once. I knew breastfeeding was a healthy option and I wanted to try it. But I had NO clue what great point lay beyond it’s nutritional profile. It took even longer for me to realize breast isn’t “best,” it’s normal. You see, not “everyone knows.”

For all that I knew, there was a lot I discovered I didn’t as our nursing relationship evolved. For example, I didn’t know about nursing aversion UNTIL I HAD IT two years after I started breastfeeding. Why didn’t any doctor or an experienced family warn me about it? Was it assumed I “already knew” or was it because the details of breastfeeding are deemed too niche or taboo?

WBW is about education of informed choice. Nursing aversion, balancing breasts with bottles, nipple shields, pumping struggles, recurrent mastitis, milk-sharing, inducing lactation, handling public criticism, etc… these are not easy, delicate tulle-wrapped topics.

There are unsavory sides to every story, whether it runs on mama’s milk or moo milk. Just like women should know what they’re getting into with formula, they deserve to know what they might face with breastfeeding.

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7). “[WBW] hopes for a world where breastfeeding is not the personal choice of the woman who owns the breasts in question but a moral imperative.”

What WBW hopes for is a world where breastfeeding is seen as normal (at the very least) and beautiful (at best) — not a matter of morality or command.

Below is the type of media coverage that runs during WBW. You’ll notice many types of feeding are featured, from nursing at the breast in the home and in public, giving formula and expressed breast milk, using feeding tubes, preemie supplementation, inducing lactation, and so on:

22 Photos That Show Feeding Babies is Beautiful, No Matter How It’s Done

Did you know: If you’re relying upon a combination of breast milk and formula, you can get formula/bottle-feeding advice from La Leche League Leaders that can help preserve your breastfeeding relationship and learn to prepare formula correctly. Certified lactation consultants (LCs) are also well-educated in formula feeding.

Contrarily, formula companies offer “helplines” for supplementers and those who wish to breastfeed, however it’s smart to avoid dialing up Similac, Gerber, etc. for advice about balancing breasts and bottles. The information given may be technically accurate, but it won’t be entirely complete either.

With that in mind, it’s clear where we can find the true unbiased supporters of personal choice.

8). “It echoes ‘a world where marriage of a man and woman is the cultural norm’ and ‘promoting a culture of life,’ statements that reflect the desire of a portion of the population to substitute their personal beliefs for the beliefs of the individuals who are affected.”

That breastfeeding is, by and large, a positive part of our humanity is not a personal belief.

What we’re really talking about is “a world where the censorship of a woman in her maternity is the cultural norm” and “promoting a culture of economy over family” — statements that reflect the desire of a portion of the population to substitute their personal beliefs for the beliefs of the individuals who are affected.

Many people believe women need to throw blankets over their bodies in public (but not in bikinis at the pool… unless they’re breastfeeding). Every week we hear yet another news story about women being asked to leave a restaurant, a plane, a clothing store, a school function, really any place mothers need to go — because she nursed her baby and someone believed it to be offensive.

Sometimes these women are threatened. Shamed publicly on the internet. Called “tasteless” within earshot (my firsthand story). Asked (no, told) to feed their babies on toilets. 

Now, how many non-breastfeeding families have been asked, with all kind of disgust-laden tone of voice, to remove themselves to put a plastic nipple in their baby’s mouth in the nearest (farthest) bathroom stall?

A handful of relatives and I have butted heads and hearts over our need to breastfeed in public. They maintained it was their “personal opinion” that we should hide away to breastfeed, as if this master of puppets-style attempt to control my body with their almighty opinion was in some way excusable. Now, how many families have actually burned bridges over bottles of alternative milk?

Back to nipples for a sec: Many social media platforms frequently receive reports of “graphic nudity” or “explicit/sexual content” on breastfeeding photos. Some social media platforms continue to ban all photos that include female areolas even if they’re actively breastfeeding. The internet does not, never has, and never will blur out photos of nipples on formula-filled bottles.

So who’s most affected by unfair personal beliefs here?

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9). “…while it is natural for women to bear children; the idea that all women should have children is a cultural norm, a norm that is harmful for women who don’t want children.”

Presumably this was meant to demonstrate that breastfeeding is a cultural norm, however in the U.S. it’s actually not if the majority of mothers today are formula feeding.

The number of women who initiate breastfeeding on their own after birth is very high with a national average of 79.2%. This suggests most new mothers choose breastfeeding and want to do it. Unfortunately the numbers drop off sharply: only a self-reported 40% are still breastfeeding exclusively at 3 months and 18.8% at 6 months (with Minnesota as low as 10% – CDC Breastfeeding Report Card 2014).

1 out of 5 breastfed infants receive formula in the hospital before 2 days of age, a “medical culture norm” known to throw a wrench in breast milk production.

In this poll, 15% of women said they chose to formula feed due to potential embarrassment of breastfeeding. It also asked why women chose to breastfeed; only 4% said they breastfed due to social pressure.

So it seems that the most harmful cultural norms in regard to infant feeding are the beliefs that:

…all women should breastfeed at home (“Why can’t you just pump milk before you leave the house? Why don’t you just stay home if you knew the baby was going to be hungry?”)

…that all women should cover up (“What’s so hard about covering up? A selfish display for attention!”)

…that all women should fear harassment (“Stay away from this-or-that place, they’re not breastfeeding-friendly… They don’t understand breastfeeding so don’t provoke them…”)

…that all women can’t balance breastfeeding and a career (“Asking for pumping breaks is unacceptable if you’re here to work, not to mother”).

“Bressure” we may surely see and feel, but it’s also a current pressure in the U.S. for women to pursue careers, achieve high economical status, and remain independent for life; so prevalent it is that the importance of families has taken a backseat** to the detriment of women who do want to care for their them.

(**The U.S. recently dropped to the 33rd best place to be a mother, according to Save the Children’s State of the World’s Mothers Index, which takes into account the facts that the U.S. has the highest maternal death rate in the developed world and is home to the most dangerous city to be born in the developed world. The U.S. also comes in last place in paid maternity leave, according to a 2014 survey by the United Nation’s labor agency of 185 countries).

Now let’s mind the women who don’t want children but end up pregnant anyway because, you know, it happens. Do we forget about them? Or do we support them, arm them with options to be able to raise their children or connect them with others who would be happy to do it for them? I hope our instinct is to respect them rather than kick them to the curb.

So then what about women who need to feed their babies, don’t really like the idea of breastfeeding, but know it’s healthiest? Do we support them? Educate them? Help them? I hope our instinct isn’t to tell them it doesn’t matter what they do. Mothers want to feel like their hopes and goals and efforts matter.

Now me, I was sure I’d hate breastfeeding. I figured it’d feel, well, gross. And I tried it, though no one said I should. And it worked. So here I am now, doing something I didn’t even know myself that I wanted. It was a sad cultural norm that convinced me I probably shouldn’t want this, or enjoy this.

So, all women indeed?

10). “Up to 5% of mothers cannot produce enough breast milk to fully meet a baby’s needs.”

In other words, upwards of 95% of mothers can produce more than enough breast milk for their babies.

In our Western society where mother-baby separation, early solids, pacifiers, and scheduled feedings are the norm, insufficient milk supply is incredibly common and understandably so. This should be required first-time reading for all mothers who want to breastfeed: “Perceived Insufficient Milk” by Diana Cassar-Uhl, MPH, IBCLC.

Dr. Amy goes on to explain how babies with rare anatomical anomalies or weak muscle tone may not be able to readily breastfeed, and thus are at risk of dehydration or death (but is this really the case in the developed world unless they also cannot feed from a bottle, which could be filled with donor breast milk or formula?).

Formula was invented for the specific purpose of the subset within this 5% of mothers whose babies also cannot drink donor milk (such as babies affected by the extremely rare condition called Galactosemia). When prepared correctly in a safe, clean environment and fed by caregivers who are educated in infant bottle-feeding, commercial formula is largely safe, nutritious, and as originally intended, it can be a life-saving food.

Thank goodness formula exists because it can certainly help fix what’s broken. However, it also has the power to break what was never broken…

11). “Formula is as safe as houses and just as much of a lifesaver.”

What does this even mean? I suppose I have lived in some pretty crummy apartments, but…

Anyway, moving on.

Dr. Amy doesn’t mention that formula feeding-related deaths are an epidemic in non-industrialized countries wherein breastfeeding is not promoted and families cannot afford adequate amounts of formula so they must dilute it, thus unknowingly sustaining their babies on a nutritionally watered-down factory product that provides no natural antibodies or anti-viral agents that third world children especially need. It’s also important to note that clean, potable water isn’t consistently available in impoverished or rural areas in third world countries.

When it comes to natural disasters, emergencies, reduction of toxins in our ultra-polluted world, contamination concerns, availability, safety regulations, and hygiene concerns… breastfeeding has proven time and again to be safer for more babies than the rare cases in which alternative formula is medically required. (Read more about all of those here).

12). “I’d happily celebrate World Infant Feeding Week. For some babies that would mean breastfeeding, for others formula feeding.”

The prospect of “World Infant Feeding Week” (let’s call it WIFW) couldn’t work for several reasons.

For one, breastfeeding awareness gets a big push in hospitals during WBW with educational and support-driven events. In the reality of WIFW, formula would also be promoted in these same hospitals, which would violate the WHO Code on Infant Formula Marketing.

Brushing up on the WHO Code:

WHO was so worried about the dangerous effects of formula marketing on global health outcomes that it instated the International Code of Marketing of Breast-Milk Substitutes in 1981.

This Code prohibits the promotion of formula and milk substitutes in hospitals and related facilities, no free samples/supplies, no gifts to health care workers, no words/images idealizing artificial feeding, all labels should explicitly inform about the risks of formula-feeding (some feel it’s akin to the skull-and-crossbones sticker on cigarettes — though BookishMama opines here about why this is a crappy comparison), and more stipulations. The United States is one country that remains exempt from this code, which is why this type of marketing is perfectly legal stateside.

Does that make it okay for the thousands of mothers were sick of being preyed upon for the contents of their wallets at the expense of their children (breastfeeders and formula-feeders alike)?

Thanks to movements like WBW, nowadays we see more pro-breastfeeding billboards and informational advertising than ever before. However WBW is not about SELLING breastfeeding, in the way that WIFW would be as it would continue to normalize the alternative option: a marketed product that we’re already used to seeing fill up an entire aisle in grocery stores, or advertised on hospital discharge bags and magazine inserts, or in the form of free samples in our mailboxes. There are no free breast milk samples delivered to my door. And Lanolin coupons won’t feed my baby, you know?

I myself would celebrate an “All Infant Feeding” movement standing on its own feet, but not in attempt to overshadow or erase the positive breastfeeding climate that is still being fought to maintain by tooth and nail, and milk, sweat and tears.

A different perspective from a commenter on the TIME article:

“Next up: marathon runners should not be celebrated, as they are clearly moralizing running and using their athletic abiliies to shame all of us. Their accomplishments do not matter, as I have not seen any studies on benefits of running, so therefore they do not have a right to celebrate their journey because that hurts my feelings. (sarcasm)”

Also, WIFW isn’t actually a thing, but World Black Breastfeeding Week is a thing. WBBW was created without needing to censor its sister celebration, WBW, because we know minimizing the experiences of minority groups doesn’t equalize the playing field. WBBW matters and it’s necessary in ways that “World White Breastfeeding Week,” if it were a thing, would not be. I wonder if Dr. Amy would be so bold as to claim a refusal-to-celebrate stance on this race-specific leg of the big breastfeeding awareness party?

So, WBW is ALREADY about infant feeding awareness … many breastfeeding mothers don’t only nurse at the breast, they also use formula, pump milk, milk share and donate, feed solids, etc. And they feed differently based on geographical location, race, unique family circumstances, etc, not restricting themselves to the black-and-white labels of “celebratory/anguished breastfeeding mother” or “celebratory/anguished formula feeder.”

WBW gives all mothers (sometimes celebratory, sometimes anguished baby-feeders) an equal chance to learn. An equal chance to teach. An equal chance to be heard.

13). “I can’t celebrate anything that lauds some mothers while shaming others.”

Isn’t this thought process essentially shaming breastfeeding mothers and their supporters for celebrating this thing that grows our babies, makes them happy, gives newfound confidence to many mothers, strengthens bonds between women, and sets a positive example for, well, everyone?

So please, Dr. Amy, if you’re not even celebrating your own intention… let us have the cake. We will celebrate with or without you.

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