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.

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Shrinking the Outer World

Despite the many benefits of breastfeeding, the fact remains that it also can considerably shrink your outer world, at least for a while. Stories of women being ousted from cafés, and earlier this month from the Houston Zoo, for breastfeeding in public don't help. Neither do stories about women getting fired for pumping breast milk at work. There needs to be an honest space to explore all of that.

Meanwhile, our post-feminist selves (perhaps foolishly) believed that our marriages would be partnerships with a co-equal dynamic. In reality, even in the best of marriages, the domestic burden often shifts, sometimes in slow ways, onto the woman. Breastfeeding plays a central role in that shift. When the woman alone is in charge of feeding (or even pumping so someone else can feed), it's assumed she naturally knows better how to comfort the child, and then she is a better nurse when the child is sick, and so on. Something happens from an initial breastfeeding decision, and it can sometimes lead to frustration, disappointment and even depression for some mothers.

These forces take a toll on women and their families, not to mention on public health. At a time when U.S. infant mortality rates rank higher than less developed nations like Poland, U.S. maternal mortality rates skyrocket annually and childhood obesity runs rampant, a stronger and more broad-based breastfeeding culture could have a significant impact on the health of infants and mothers.

If 90 percent of new mothers exclusively breastfed their babies for the first six months of their lives, it would save 911 babies and $13 billion each year, according to the CDC. If 80 percent of mothers exclusively breastfed for the first six months, 741 deaths would be prevented and $10.5 billion saved. If the Healthy People 2010 goals were met, which call for 50 percent of mothers to continue breastfeeding for six months, 142 deaths would be prevented annually and $2.2 billion would be saved.

This would be tremendous.

It's time to look past the simplistic marketing and examine the big picture, which includes the entire breastfeeding culture and all its insidious players. Women and infants need this.


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Kimberly Seals Allers is an IATP Food and Community Fellow and a leading voice on the African American motherhood experience. She is the author of "The Mocha Manual to a Fabulous Pregnancy" (Amistad/HarperCollins) and two other Mocha Manual™ books and founder of, a parenting and lifestyle magazine and blog for African American moms. She is a regular commentator for and and is the multicultural mom channel leader for

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Gratitude: Yes, We Are Still Breastfeeding

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.