Reproductive Health

When 'Breast is Best' Is Not Enough

Friday, August 26, 2011

For all the promotion of breastfeeding, U.S. women are not responding well to the "breast is best" message, says Kimberly Seals Allers. It's time to clear the air and talk about all the other factors--beside nutrition--that affect a mother's feeding choice.

(WOMENSENEWS)--It's National Breastfeeding Awareness Month. But rather than celebrating, I'm in questioning mode.

I'm questioning why our natural instincts to nurse have gone askew and why our views about feeding our young are less instinctive and more socially and culturally constructed.

I'm questioning why what should be one of the most natural experiences of motherhood is under cultural fire and even being used as fodder for political grandstanding.

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But mostly, I'm questioning why with all the awareness, information and a preponderance of evidence on the benefits of breastfeeding, breastfeeding education has been essentially ineffectual.

Our unimpressive breastfeeding rates show the full picture. In the United States, only about 13 percent of babies are exclusively breastfed for six months, according to the Centers for Disease Control and Prevention (CDC), based in Atlanta. Meanwhile in South Asia, 44 percent of babies are exclusively breastfed for six months, according to UNICEF.

The solution isn't in more pamphlets or brochures. Or more awareness months, for that matter. The problem is in the invisible external forces not mentioned in those glossy materials that markedly affect a woman's decision to breastfeed and her experience thereafter.

These many forces include: the competitive mommy culture, the media who always love a good fight, aggressive infant formula marketing, the Internet and social media outlets, where the battle between breastfeeders and formula feeders has reached World Wrestling Entertainment proportions, and capitalist interests--because let's face it, breastfeeding is bad for big business.

Perhaps the biggest culprit though is closed-door deals between the pharmaceutical industry and hospitals that wind up with women going home with formula in their goody bags. That sends a deep message that health authorities think formula is really "just as good."

All of these factors create a muddled environment that prevents a woman from clearly choosing based on fact alone.

The biggest losers against this "machine" of forces are newborns, who don't get the best first food possible, and mothers, who lose out on the many health benefits of breastfeeding.

A More Nuanced Message

As a mother who breastfed both of my children for at least 12 months, I know that breastfeeding is marketed as a simple decision. Breast is best, end of story. But breastfeeding is actually more complicated and nuanced than that, and that is where we are losing many women.

The conversation must include existential matters like how connected women are to the experience and how breastfeeding works in the actual context of our lives. We need to address and name the psychological, sociological, economic, political and cultural forces that are undermining our breastfeeding experience.

We must speak to the tremendous pressure mothers are under to optimize every dimension of our child's life. And how that pressure can be polarizing, and then exploited by others, robbing many women of the joy of breastfeeding and deterring others to never even try it.

For decades, moms-to-be and new mothers have fantasized, and at times even romanticized, the act of breastfeeding. From the days when La Leche League International's book "The Womanly Art of Breastfeeding" made us believe that nursing our children was the deepest expression of womanliness to the power of the pump--which allowed us to breastfeed without being tethered to an infant--giving our newborns human milk as their first food has been inextricably linked to our mothering values and our womanhood.

But loving your baby and loving the act of breastfeeding is not the same thing. As mothers, breastfeeding contains all of our awe about motherhood and also some of its ambivalence. So along with the empowerment comes conflict--a deep personal conflict between a mother's desire to give her child what's best and a woman's desire to live a full life.

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Thank you for writing about this important issue. I have heard so many reasons for not breastfeeding: my breasts are sexual organs, I didn't have enough milk, etc. There is not enough education or support for breastfeeding. I did it partly as an act of feminist defiance! Skilled lactation consultants should also be on the list of things we need to promote breastfeeding. When I had a glitch after six months of nursing, the lactation consultant said "pat yourself on the back and buy some formula". I didn't, and I continued to breastfeed for over a year. As a full-time working mother, I found that breastfeeding connected me to my children immediately when we got home from work and daycare in the evening. I was always able to comfort, calm, and put them to sleep with my breast. Their dad did lots of diapers and baths as his part of parenting. Breastfeeding can be the best part of parenting an infant or toddler when you are a type-A feminist. It was for me!

Excellent article. Clearly defines issues mothers have. Need to get out the message of mothers doing what is best for their children and families even if that is not what social media states.
Congrats to mother of the Down's Syndrome infant/child for giving your child what he needed.

Dear Kimberly:
Thank you for getting the word out!! Many of us have worked for decades to get this message across: we need to create an environment in which women are enable to decide to breastfeeding and succeed with it. "Telling" overburdened mothers to do something is not the way. The Carolina Global Breastfeeding Institute is dedicated to addressing the "subtle" issues: community paradigm shift and social marketing, paid maternity leave, reimbursement for support when needed, inclusion in prenatal support, and reducing obstacles in the health and day care systems. We also co-sponsor an annual symposium on breastfeeding and women's realities, now in its 7th year.
Thank you again for this excellent commentary.

Great piece!
We, as women, also need to stand up for ourselves and support each other, especially when nursing in public.
In less than a month, we've got The Milk Truck coming to town in Pittsburgh, PA. Haters, look out!

I have a 4 year old son with Down's and I breast feed him for 3 1/2 years. My goodness, it's difficult to admit sometime. I did it for such a long time for a few reasons, one of them being to help strengthen his muscles in his mouth so that he could speak clearly. The other was because it became difficult to set a boundary for a 3 year old begging for milk. Yes, it was isolating and most of my friends had negative things to say about it. However most of the time I remembered the real reason was for his development. Today I don't want more children because I can't imagine breast feeding and what that entails and I wouldn't think of giving an infant formula. Who knows what that is? Keep up the good work this is very necessary.

I myself am not a breastfeeding mom but if I could have been I would have. I simply didn't produce enough breast milk. While I don't agree with most of what formula companies are spouting these days I can honestly say that it hasn't done any harm to my boys. Both of my children are perfectly healthy. I believe that it's cases like mine that have lead so many mothers to ditch the pump and leap to the can. So many women see the convenience in a sort of grab and go method and in this busy world I can see why. I do wish that more women would breastfeed, I wish that I could have breastfed, but anymore it seems to be a losing battle, especially in America. Lets just hope the companies that make formula are put in their place and start telling the truth about what's actually in their formula. Maybe then more women will choose to breastfeed.

My vision takes this beyond breast vs formula and out into the wider medical and social context here:


I cannot tell you how grateful I am for this excellent article, speaking not only to the importance of breastfeeding but bringing up all the forces that play into a woman's life, consciously or subconsciously influencing the decisions. I am a public health nurse, have lived in Pakistan, Egypt, and the U.S and breastfed 5 babies. The time I had the most difficulty receiving support was giving birth in this country and having nurses tell me it would be too hard. The fight that ensued around trying to insist that my newborn be left in my room was not pretty. Thanks for bringing attention to these "insidious" forces and by doing so helping women think about what is really influencing their decisions.