Breastfeeding: how privileged women make privileged choices normative

mother feeding her baby in nature outdoors in the park

Lactivism, like natural childbirth and attachment parenting, is a philosophy of privilege.

Specifically, privileged women shame the less privileged — women of lower socio-economic class and women of color — by insisting that their personal preferences are not merely normative, but actually morally superior.

Lactivism, in other words, is like driving a Volvo.

Sociologist Orit Avishai explores this issue in the chapter Managing the Lactating Body: The Breastfeeding Project in the Age of Anxiety. Avishai immediately gets to the heart of the matter:

Public health campaigns [to promote breastfeeding] are based on two premises: ‘the breast is best’ and breastfeeding as ‘natural’… [T]hese premises are flawed. Like other parenting, reproductive, health and lifestyle choices, breastfeeding is an option framed by access to resources, corporate interests, public policy, competing ideas about science, motherhood and standards of infant care. Drawing on interviews with class-privileged American mothers, this chapter sheds light on how breastfeeding is shaped at the crossroads of moralised motherhood, public health campaigns and grass-roots activism, economic disparities and the commercialised, medicalised and professionalised contexts that characterise contemporary parenting. Specifically, I demonstrate that this group of women constructs the lactating body as a carefully managed site and breastfeeding as a mothering project – a task to be researched, planned, implemented and assessed, with reliance on expert knowledge, professional advice and consumption. The construction of breastfeeding as a maternal project sheds light on breastfeeding disparities (‘successful’ breastfeeders tend to be white, educated, older and heterosexually partnered mothers) and on the fallacy of the ‘breast is best’ and ‘breastfeeding is natural’ slogans.

That goes a long way toward explaining why breastfeeding has been aggressively promoted in public health campaigns despite the fact that it has only trivial benefits. These campaigns have been motivated in large part by privileged white women inscribing and reinforcing their privilege by declaring their personal preferences morally superior to those of poor women and women of color.

It is well established that breastfeeding rates differ markedly by race and class. As Avishai notes:

… [B]reastfeeding has become even more stratified… [I]n Western nations breastfeeding has become a marker of privileged motherhood, where white, middle-class, educated, heterosexually partnered and older mothers are more likely to initiate breastfeeding, continue breastfeeding beyond the first few days and upon return to paid employment and breastfeed exclusively…

These disparities are also a product of racialised and sexualised public discourses. Blum argues that the ‘breast is best’ frame creates a standard of good mothering that faults mothers who cannot comply with this standard or do not wish to comply with it. These mothers are usually poor, uneducated and minority women, some of whom resist what they see as imposition of white, middle class mothering standards.

The heart of Avishai’s argument is that, contrary to the claims of lactivists, breastfeeding as practiced in contemporary America is not natural. Indeed:

…[T]he lactating body [is] a carefully managed site and breastfeeding [is] a ‘project’ – a task to be researched, planned, implemented and assessed. Analysis of the breastfeeding project demonstrates that breastfeeding is far from a natural practice.

Breastsfeeding as a project is promoted in part because of the commercialization of breastfeeding:

… [A] new profession – lactation consulting – emerged in the mid-1980s as an alternative to the free breastfeeding advice offered by La Leche League. Working within a clinical frame, this profession boasts formal training and certification procedures, a vibrant professional association, the International Lactation Consultant Association, and a peer reviewed journal. Breastfeeding is additionally supported by a vast market of goods and services, including lactation classes and books, nursing clothes, bras, pillows, chairs and breast pumps and related paraphernalia. Numerous websites also provide breastfeeding advice, support and merchandise.

What does managing the lactating body involve? Avishai conducted in depth interviews with first-time, educated, workforce- experienced and class-privileged mothers in the San Francisco Bay Area and created this list based on what she learned.

  • Consulting books and asking experts
  • Setting goals and assessing the product
  • Managing the uncooperative lactating body
  • Investing in production facilities

Each stage is mediated by privilege, and most require money. In contrast to the claims of lactivists, breastfeeding is no longer free.

Though most of the women in this study suggested that breast milk is produced by their bodies ‘free of charge’, and contrasted breastfeeding’s ‘simplicity’ with the ‘bagfuls of paraphernalia’ associated with bottle-feeding, many of them were immersed in breastfeeding-related consumption, reflecting broader consumption trends that characterise privileged parenthood. Since the physiology of lactation assumes proper levels of nourishment and rest as well as maternal health – all stratified in the United States – the very construction of breast milk as ‘free’ by mothers and lactation experts masks social inequalities. In addition, … participants in my study embraced the expanding market of nursing gear, gadgets and accessories. They invested in nursing bras (∼ $40), nursing pads, breast pumps and related kits ($200–400), nursing pillows (∼ $40) and nursing chairs (∼$200). Some purchased herbal supplements to enhance their milk supply
or acquired breastfeeding outfits.

Avishai concludes:

Analysis of the mothering project sheds light on the obstacles encountered by women who cannot mobilise such resources, which are no longer considered optional. Viewed in this light, the twin constructs of ‘the breast is best’ and ‘breastfeeding is natural’ are impoverished slogans that do not capture the extent to which both the science and the imagery of breastfeeding are shaped by normative assumptions and middle-class experiences.

Although Avishai describes contemporary lactivism through the lens of sociology, her analysis is nearly indistinguishable from what I have been writing for years:

The benefits of breastfeeding in industrialized countries, while real, are trivial.
The public health campaigns that currently exist are not justified by the empirical benefits of breastfeeding.
Lactivism is the attempt by privileged white women to inscribe and reinforce their privilege by shaming women who are not like them.
Efforts to ban formula gift bags, lock up formula, and make women sign breastfeeding contracts are further signs of privilege and attempts at shaming.
Breastfeeding is NOT best for all mother and babies.

Or to put is in a slightly different way, breastfeeding is equivalent of driving a Volvo. It’s a mark of race and class that provides marginal benefits but serves as a visible sign of privileged status.

  • Amy Tuteur, MD
    • Ash

      Bugs me that ppl keep citing Keefe, M, JOGNN. 1988 (see the link to the PDF “myth” in the Post article). The article is incredibly insubstantial

      21 mother infant dyads
      randomized
      10 to nursery
      11 to rooming-in

      Data collection: self reported estimated number of hours slept,
      self assessment rating quality of sleep on 7 point scale, Comments from each woman

  • Maxgarete

    Hi Dr. Tuteur, could you please give us some links to these studies that suggest breastfeeding has just trivial benefits? I have found one on your blog but it seems there are more than one on th etopic?

  • Mishimoo

    For the first time out of 3 kids, I was asked by a doctor (new to our GPs practice) yesterday if I was still breastfeeding at 14 months. When I explained that he’d selfweaned at 9 months, her response and demeanour suggested that I hadn’t tried hard enough. She conceded the point, but didn’t seem convinced after hearing that he’d screamed at my nipple and deliberately bitten it hard every time it was presented to him, and then happily guzzled a bottle of formula. We’re not going to see her again, and I won’t be recommending her to anyone.

    • Stacy48918

      You should write the office as well so there is documentation of your complaint.

      • Mishimoo

        I want to, I just don’t know how to word it so that it’s constructive.

        • Stacy48918

          To Whom It May Concern,

          On XYZ Date I brought my 14 month old child, Joe, to see Dr. Smug for a routine wellness examination. During the course of the exam, Dr. Smug asked if Joe was still breastfeeding. Upon learning that Joe had self-weaned at 9 months of age, Dr. Smug said ABC [as close to word for word as you can].

          Dr. Smug’s comments insinuated that I hadn’t tried hard enough to breastfeed my child longer. I felt hurt and ashamed at the implication that I did not do what was best for my child. My priority as a parent is to ensure that my child is fed, healthy and happy. The specific method of administering his food is not important if those first priorities are not met.

          As a mother that cares for her child, I simply wanted to express my dissatisfaction with the treatment that I received. I do not wish to have my child seen by Dr. Smug again. I will not be recommending her to anyone I know.

          If there are any questions I can answer for you, please feel free to contact me at the information below. Thank you for your consideration.

          Sincerely,
          Mishimoo

          • Mishimoo

            Thank you! That’s absolutely perfect, I really appreciate it.

          • Stacy48918

            You’re welcome. 🙂
            I hope you receive a constructive response.

    • Siri

      When visiting my mum (my kids’ mormor) in Norway, I saw her neighbour looking extremely thin and tired, while her hefty, healthy 14 month old played energetically next to her. Problem? Said giant boy still breastfeed on demand day AND night while poor mum is back at work and running a household. Not enjoying breastfeeding any more; not enjoying anything much. Her Norwegian health visitor told her to keep it up for another year!! Her neighbour’s UK health visitor daughter told her to wean him that.night.pronto. She did. She is now wondering why she didn’t do it sooner, but with advice like that, what choice did she really have?

      • Young CC Prof

        Breastfeeding promotion is founded on the Big Lie that breastfeeding is very important, right up there with keeping your child in a carseat.

        The Big Lie is surrounded by a network of other lies designed to convince women that really problematic breastfeeding relationships are in fact normal and expected.

        So, lie about the reasons to do it, lie about how to do it, lie incessantly about when it’s OK to stop.

        • Siri

          And for two years! In the richest country in the world, where every toddler’s nutritional status is secure and founded on the healthiest foods available to mankind. Plus multivitamins and cod liver oil. I don’t know how Norwegian healthcare professionals can give such ridiculous advice with a straight face. Gro Nylander, the OB credited with turning breastfeeding stats around in Norway, said once that not breastfeeding is akin to letting your 2-year-old cross a motorway by himself – he’ll probably survive, probably be ok, but why risk it?

          • fiftyfifty1

            Gro Nylander. Wow what a jerk.

          • Siri

            Agreed! I used to think she did a lot of good, but in recent years she’s either showing her true colours or becoming intoxicated with her own sense of power to the point of lunacy. Offensive lunacy.

      • Mishimoo

        Oh goodness, the poor mum! I’m so glad she listened to you.

        My intent was to wean at 12 months, at the latest, because then they can go onto cows milk. All 3 had different plans. The first weaned at 7 months, the second at 5.5 months, and the last at 9 months. He’s still on toddler formula because he’s growing so fast compared to his sisters and I want to be sure that he’s getting enough vitamins + minerals.

  • Lisa

    I’m so sick and tired of all of the “Look at Me Mommy” exhibitionism–the constant hovering over children, the total child-centeredness of American middle- and Upper-middle class life where every thing is about MOMMY. “Look how great I am–I juggle X-kids to soccer/swimteam/field hockey/japanese/ basson/whateverclassorsport and make sure they eat only organics and have family dinner EVERY X day and oh, look at me I breastfeed my 4 year old AND my newborn and I’m superfit and I dress like a celebrity and LOOK AT ME I sleep with my kids and I wear my kids and its about ME!!!!!!!!!!

    Not everyone can afford this lifestyle–and that lifestyle DOES include breastfeeding. Not many fast food places, factories, warehouses, call centers or retirement homes (nursing homes–how Ironic) give Moms time to pump. Few families can afford for Mom to take 6 months off just to nurse, let alone longer.

    When will women just SHUT UP about what great Moms they are and SUPPORT EACH OTHER regardless of choices???

  • Bessie T

    This is slightly insane. Not only this ridiculous article but also the commenting section. Cruising through the internet just to find information of the benefits of breastfeeding, and I come across someone who compares a breastfeeding woman to a privileged white ‘lactivist’ who exercises class over the weak. Really? Are you really comparing feeding a child breast milk to classism and privilege? Well here’s your privilege, lower middle-class military wife, having two babies with no support from dad, juggling bills and a part-time job, pumping, and breastfeeding. How about my ob recommended me to consider breastfeeding to be a healthy and nutritious start at life for my twins? What about there is science behind breastfeeding, and many health organizations support it? How about there are women out there who want better for our kids than powered factory mull, made from a different species.

    And another thing, who are you? Are you even a registered physician? Why does your opinion even matter? Anyway, this is just insane. You’re no greater than the La Leche League, just the polar extreme. Some crazy women on the internet ranting and raving about literally the same things over and over, breastfeeding, home births, vaxes, and that’s it…. For how many years now? Get a hobby woman, and stop trying to bring us moms down. As if the world didn’t do that enough!

    I’m having a natural birth, get over it.

    I’m breastfeeding my twins, get over it.

    I’m delaying vaxes that I feel necessary, get over it.

    My kids, my life, my decisions. You can take your ridiculous ill-supported opinion and shove it up where the sun doesn’t shine.

    Goodbye

    • The Bofa, Being of the Sofa

      I’m delaying vaxes that I feel necessary, get over it.My kids, my life, my decisions.

      Your kids, huh?

      So are you going to keep your unvaccinated kids away from everyone else?

      Or are you going to expose everyone else’s kids, including mine, to yours?

      You contradict yourself in two sentences.

      You are an awful person. It’s all about YOU YOU YOU!

      Do you know why you can risk not getting your kids vaccinated? Because people like ME vaccinate mine.

      But it’s all about YOU!!!!!!!!

      So you don’t do much to change the view that folks like you are narcissistic assholes.

      • Bessie T

        Gladly. The last thing on Earth I need is for my children to be around a bunch of stupid judgmental internet moms who don’t have a pot to piss in, and their disgusting little brats. Get the fuck out of my business and mind your own. Capish? Thank you! Have a wonderful day, and a pleasant tommorow

        • Mishimoo

          You came here and aggressively shared your business, you get to have fun with the consequences of that choice.

        • The Bofa, Being of the Sofa

          Get the fuck out of my business and mind your own.

          Since when is your “business” here at Dr Amy’s blog? As far as it being a business, it is HER business, not yours. But again, it’s all about you.

          However, I would like to here this plan of yours for keeping your kids away from mine.

          BTW, I thought you said Goodbye? In most places, that means you are leaving. But hey, why do that when you can get all this great attention, I guess.

        • Amazed

          That would be the same little brats who keep your little disease vectors safe?

          Sorry to break it to your overblown ego but the business you’re trying so hard to make mine, Bofa’s, and everyone else’s isn’t all that interesting. You can keep your boobs for yourself, breastfeed until your kids hit college, formula feed, donate boobs for scientific experiments, we don’t care.

          We, however, care about your overblown self-importance leading you to endanger peope mooching off OUR herd. Our business, unfortunately.

    • Guesteleh

      It’s great you breastfed your twins but you are in a minority of women who can, for a lot of reasons that are physical, emotional and financial. the burden of breastfeeding weighs a lot heavier on a person like you than it does on a stay at home mother with a high-earning husband who has a lot of time and money to devote to the minutiae of parenting. And it’s not surprising that a lot of women calculate the financial, physical and emotional cost of breastfeeding and decide it’s not worth it.

      • Roadstergal

        And in the developed world, when they do decide it’s not worth it, using formula instead has no real long-term negative effects, and almost nothing in the way of short-term risks. Certainly nothing that outweighs having a comfortable and healthy mom to help care for them, and nothing that a woman should feel guilt about.

        Unlike delaying or skipping vaccinations. Which has substantial short-term and long-term risks to both your kids and everyone else they come in contact with.

      • Amazed

        What’s so great about it? Breastfeeding, I mean. Poor little victim had the chance and opportunity, she did it. And she talks about “moms” as if she and her ilk are the only moms who are real moms.

        Fucking narcissist exposes everyone, including you and yours, to the disease vectors she’s breastfeeding and she want us to “get over it”.

        Great?

        • The Bofa, Being of the Sofa

          I didn’t read her post as saying that is currently breastfeeding, but that she will. She WILL have a natural birth, she decrees. Apparently she is having twins. And she plans to breastfeed them. And delay vaccinations based on her great knowledge of immunology, it seems (as SHE sees fit).

          • Amazed

            Good luck on her. And good luck on society. ‘Cause you know she’s gonna benefit and pride herself on her selective vaxxing while you and your children pay the price for her mommy badge.

          • Amazed

            At rereading her post, yes, you’re quite right, Bofa. My point still stands but you’re right.

          • The Bofa, Being of the Sofa

            Of course, that makes it all the more rich. Yes, good luck on her. But what are that chances that if she discovers that breastfeeding twins, born by emergency c-section, isn’t quite as easy as she thought it would be, and they needed supplementing, that she will come back here and admit it?

            Not good, I’d say.

        • Bessie T

          Yes, my poor little victims. If that’s what you have to tell yourself to excuse the filthy little cunt of a ‘person’ you are and your ravenous judgmental attitude, go ahead. My poor little victim children, who’s mother busts her ass for them working part-time, pumping, and doing it all by myself without daddy. Who is going to answer screaming babies in the night, with no help. Who’s going to start working two jobs pretty soon to put them in private school and the best daycare I can find, who’s carried the burden of parenthood almost all alone, the swollen feet, weeks of sickness and vomiting, and research to try to do the best I can for them, that’s your ‘narcissistic mom’, twat. And what do you do? Bash other women, while shoving powdered factory meal down your children’s throats, ignoring the health consequences for doing so. You are pathetic, and you can do yourself a favor go to hell.

          Boy did that feel good! Ok, I have to go. I’ve see how terrible these threads can get, so I have no desire to talk to disgusting people this low to the Earth. Goodbye and good riddance. Talk about me all you want, it only shows what type of women you all are; the stupid kind who takes advice from a unlicensed quack while dismissing the advice of recognized health organizations Oh, and the type who call expectant mothers ‘fucking narcissists’. Bravo! Maybe you’ll stomp on kittens and spit on the blind tomorrow.

          Enjoy your life of bashing people on the internet and accusing them of being judgmental and rude, while being judgmental and rude to fellow mothers. Hopefully you’ll learn how to grow the hell up, get a life, and tend to your miserable children, instead of spending so much time arguing and cursing at strangers on the internet.

          Peace, my darlings!

          • Amazed

            Ah, Bessie! Poor little you! You didn’t make the choice to be a mother, I guess? All those inconveniences you pride yourself on, you didn’t choose them?

            Keep whining, my darling. Keep feeling heroic. It isn’t as any other expectant mother has suffered swollen ankles. They just don’t pride themselves on it because that’s a part of their choice.

            Amazing, they also don’t consider that as something giving them the right to freeload on the sacrifice of others, unleashing disease vectors on them.

            Peace, Unique Mommy!

          • Roadstergal

            With all of that work, when will you ever find time to teach your kids to call women who disagree with them ‘cunts,’ just like mommy does?

            Or is that what private school is for?

          • Amazed

            Bessie T: Hi, children. Today, we’re going to learn how to use others and howl that they don’t put up with us.

          • The Bofa, Being of the Sofa

            What really goes on at a Montesseri school, right?

    • Amazed

      “I’m delaying vaxes that I feel necessary, get over it.”

      Get over it? No way. You’re gorging yourself on other people vaccinating and you dare say “get over it”? Because our disapproval hurts your tiny little feelings?

      You get over it, you damned narcissist, you. Because I don’t expect you’d be as thoughtful as keep your little disease vectors home, preferably latched onto your mommy breast. No, you let them free ride over vulnerable people, I am sure.

      You’re fair game. Ungrateful privileged assholes are.

    • fiftyfifty1

      “powered factory mull”

      Hmmm. Sounds interesting.

      • Bombshellrisa

        Not just factory mull, it’s “from another species”. Unfortunately, the first thing that comes to mind is that I eat fish, cow, pig and chicken and insisting something is wrong because it comes from another species gives me no choice but to become a Cannibal.

      • Siri

        I’m not sure, but I think mull is the technical term for straw horse droppings.

        • fiftyfifty1

          Even better! It’s as if the factory is a beast, and the formula is its droppings. But not just any droppings, POWERed droppings. It’s like the Incredible Hulk.

          It’s so Mythic sounding. Poetic even. The writer must be some sort of genius. Crazy genius, but genius. I hope to hell that this phrase wasn’t just some auto-correct randomness. Oh darn! I see below that it actually was–she corrects it to “powDered factory mEAL” below. BOR-ing!!!!!

    • Bombshellrisa

      Hahaha you do realized that Dr Amy had natural births and breastfed her babies? It wouldn’t be the worst thing in the world to have adequate pain relief during labor, it might make the experience quite amazing and joyful.
      It wouldn’t be the worst thing in the world for you to have two healthy twin babies who thrive because they were fed properly, and if what they were fed happened to be formula.
      It sounds like you have some tremendous life challenges, making one part of your life a little easier by choosing supplementation or formula feeding may help you. I have found that most OBs talk about breast feeding early on and support it tremendously. Because it can be so absolutely difficult at first!

  • jeniy

    Formula for a year is still more expensive then breastfeeding….even if you do need all the breastfeeding “stuff”.

    • Elizabeth A

      Formula feeding is, however, a considerable savings over breast feeding if you work and pump.

      When my son was small, I made $26 an hour, and did not get paid for two half-hour pumping breaks per day. Since daycare was quite inflexible about their hours, breast milk cost me $26 per working day. That makes formula look cheap.

      • RKD314

        It amazes me how some people refuse to acknowledge this. The response is usually something along the lines of “But there’s a law! They have to let you pump at work!” Yeah, if your job falls under the provenance of that law. And guess what, they don’t have to *pay* you for the pumping breaks.

    • The Bofa, Being of the Sofa

      Depends. How much is your time worth?

      See Elizabeth’s case below.

      How many days was my wife able to work when our kids were born because we were able to use formula? With our first, she couldn’t pump enough to use EBM only. With our younger, he wouldn’t touch breast milk from a bottle.

      When she was making $350 – $400 a day, and able to work 2 days a week, you do the math and tell me, what is more expensive? Feeding our kids formula and working (and paying for daycare for two!), or staying home and breastfeeding all the time?

      (hint: it’s not even close)

    • Jessica

      This is your privilege showing. Already two people have posted explaining how breastfeeding carried with it a real cost – lost time at work – that made formula the more rational economic choice. Without better workplace protections for breastfeeding/pumping, it’s just not going to be universally true that formula is more expensive than breastfeeding.

      I’ve often said that one of the things that made breastfeeding/pumping possible for me was an extremely flexible and accommodating job. I have a private office, was salaried, made my own schedule for the most part, and had the support of my partners (all men) to set aside three 20 minute pumping sessions per day.

      • The Bofa, Being of the Sofa

        Shoot, it’s not that my wife couldn’t pump at work – she did! But it still didn’t matter, because 1) with our older, she couldn’t pump enough to keep up with what he was eating at home while she was gone (or should I have just rationed the milk, and let him go hungry?), and 2) with our younger, he wouldn’t drink ANY breastmilk from a bottle, only straight from the tap.

        The only way we could have avoided formula was for her not to work at all. In working only 2 days a week, she covered all of the formula costs for the year in the first week, even after accounting for the cost of daycare.

    • Sara N.

      Not for me.

      -Hospital grade breast pump rental: $720 ($60/month)
      -Lactation consultant fees: $350
      -Nursing bras: $120
      -Domperidone: $1,060 (max dose)

      That’s an annual cost of $2,250, and doesn’t even count nursing tops, all the supplements that didn’t work, extra pump parts/bottles, storage bottles, etc., doctors visit to get a minor tongue tie clipped, books about breastfeeding and increasing supply, and most importantly, time away from work ($20 PER DAY for me x 5 days per week x 47 weeks per year = $4,700 per year). Plus I STILL had to buy formula to supplement with.

      I gave up after 4 months and over $2K in the hole.

      Cost of formula for 1 year: $1,260 (name brand through amazon subscription). 16 bottles: $64. Total: $1,324.

      • Crystal

        But why on Earth would you waste all that money on things you don’t need? I worked and went to school and was still able to nurse my son for 8 months and I know it was much less expensive than buying $15 cans of formula every few days. One big problem is lack of encouragement, this kind of discouragement and lack of resources and education.
        Most insurance companies will cover the cost of breast pumps. And if you can get a used one, buying the parts that the milk actually touches is fairly cheap.
        Read an journal article online or get free information from your pediatrician.
        Don’t buy unnecessary nursing accessories that you probably won’t use anyway and supplements that are neither proven to work nor supported by the APA or FDA.

        • fiftyfifty1

          So do you think that what Sara’s problem was was “lack of encouragement”? Or are you saying her problem was “discouragement”, or do you mean to say that in her case it was “lack of resources and education”? I’m totally confused here, because it seems to me that Sara had plenty of encouragement, resources and education and kept going for months despite a very discouraging situation of low supply.

          And speaking of low supply, you tell her she shouldn’t have used the meds she did to try to increase her supply. Fair enough. But what’s YOUR solution then?

        • Elizabeth A

          Which nursing accessories on Sara’s list were not used? Which stuff wasn’t needed?

          My breast pump was covered by insurance, for my first baby (who had a trivial case of newborn jaundice). By the time my second baby came around, the nurse’s told me that the rules had changed because “everybody qualified for a breast pump on the old system”, and there was considerable paperwork to arrange a covered rental even though my baby was in the NICU. Used pumps are hard to come by and questionably clean – pumps that are available retail are not meant for multiple users.

          “Read an online journal article or get free information from your pediatrician.” The reason I don’t just run google searches and read online is that the good articles are often behind paywalls. Are you under the impression that speaking to my pediatrician is free? Her billing office begs to differ. My insurance covered well-child visits on a certain schedule, and sick visits. If the baby isn’t sick and it’s not a scheduled WCV, move along or pay out of pocket. And the pediatrician’s office books her for 15 minutes per appointment, tops. If we had a nursing problem we couldn’t solve in 15 minutes, she would recommend a lactation consultant. Or formula.

          I couldn’t wear underwire bras while nursing, but all my pre-baby bras were underwires. Given I didn’t plan to wean until at least 1 year, I needed a good set of bras I could wear for at least that long. Cue nursing bras, to the tune of about $150, and at that, I got off lightly (bras that fit my non-nursing breasts run about $40 each).

          Domperidone – well, either Sara paid for it, or she went straight to paying $15 a can as often as necessary. I’m not a fan of not FDA-approved uses of that drug, but if a woman gets as far as using it, it’s not because the baby is gaining weight beautifully and meeting all milestones, and there’s a stash of milk in the freezer for emergencies.

        • MaineJen

          I am sick of this attitude. Just sick. Here is this woman bending over backwards to breastfeed, doing what she is SUPPOSED to be doing (according to you!) and it’s STILL not good enough. She is supposed to somehow work full time and still be able to put her baby on the breast every 2-3 hours. I’m sorry, but no.
          Here’s a little reality: most women who work will have to pump if they want to breastfeed. Pumping is a pain in the ass, takes time away from work that IS noticed by your coworkers and boss, and is often minimally productive. You have to take at least 3 breaks a day of 15-20 minutes each to make it even a little bit worth it, and unless you want to skip lunch every day and you have a very, very accommodating workplace…you have to be very committed to breastfeeding to make a go of it. And here you are telling her, NO, you still did the wrong thing and spent too much money. You breastfed but you didn’t to it RIGHT, somehow.
          A couple more points. Insurance will only cover the cost of a pump if your baby has to stay in the hospital longer than you do. (A little trick I learned from a lactation consultant at my hospital) If that’s not the case, it’s a huge up-front, out of pocket expense that is out of reach for a lot of people. (And BTW, you are not supposed to re-use those pumps. At all. You can only re-use the hospital grade ones, and those are so expensive it’s more economical to rent one, which is exactly what the OP DID). Buying formula every week may still be cheaper in the long run in this case. And certainly less of a headache.
          You think the problem is lack of education. Let me tell you. There is NO ONE who has recently had a baby in America who has not had the ‘breast is best’ message pounded into their head. The problem is not lack of education, the problem is logistics, and the fact that many moms have to return to work at 6 weeks postpartum. I think that you, *berating* the choice to buy a pump and breastfeeding paraphernalia, are part of the problem.

          • Cobalt

            The new health care laws require coverage for pumps now, how cooperative your insurance company is may vary. My double electric pump was free as long as I ordered it within a certain time frame, check with your insurance company to see what they cover and when.

            And breastfeeding and working away from the baby is logistically complicated even in a good scenario. When I did it, I switched to formula during away feeds pretty quickly. I would pump over lunch for relief, but pumping enough to avoid formula was really not worthwhile.

            And avoiding lactation supplements sounds like an easy decision. If you don’t have supply issues. Those of us who were dairy cows in a past life may be able to skip a lot of the breastfeeding expenses, but that doesn’t mean every woman has it so easy.

        • Stacy48918

          Well good for your that your breasts are spigots. Some of us have some difficulty FYI. What journal article should have I read that would have magically increased my supply?

        • Amy

          Sorry Charlie, no amount of information, education, support, etc. was going to make nursing work for my daughter and I. Stop assuming that mothers who use formula are simply uneducated.

        • RKD314

          Wow, just in shock that it never, ever even occurs to you that she spent money on those things bc she wouldn’t have been able to breastfeed without them.

          No one takes domperidone and hooks themselves up to a hospital-grade pump (which makes you feel like a dairy cow) for the fun of it. People do that when they have serious supply problems. And no one sees sanctimonious, unhelpful LCs for the fun of it either. Again, it’s because there is a problem.

          Now, let’s imagine that a mom has no supply problems, so she doesn’t need domperidone, she doesn’t care about nursing bras, so she doesn’t need those, she and her baby “got” nursing right out of the gate, so she doesn’t need an LC, and again, no supply problems, so she can get by with a less efficient pump.

          You STILL totally missed the point. The point is that even if THAT were the case, since she WORKS, and she has to give up $4.7k/year in lost wages to pump milk during her WORK hours, FORMULA IS STILL ABOUT 3.5 TIMES CHEAPER FOR HER.

  • yentavegan

    My decision to stay home and lactate was indeed rooted in privilege. Guilty as charged.

    • Renee Kazmar

      Mine, too. I could be a SAHM because my husband has a good job. I knew it then and I know it now.

  • guest

    Sidney Harper (Author of the Fraser Health Authority response to criticism about the ‘contract’)

    Project Development Nurse, Baby Friendly Initiative

    Sidney Harper is a public health nurse and is part of Fraser Health’s Baby Friendly Initiative.

    She is also a lactation consultant @ Latch on Lactation Consultants Inc….

    Their standard ‘breastfeeding package’ fee is $300….
    http://latchonlc.com/services/

    I wish I was joking.

  • Anna T

    As to “breastfeeding is no longer free”… well, there are people who will try to make money on just about anything and everything. A sensible person will discern between what is needed, and what is not. Just as I figured I can give birth with my “natural equipment”, without needing to pay for a doula and a VIP room, so I figured I don’t need to buy a nursing pillow, nursing chair, nursing bras, or any breastfeeding accessories at all. Breast and baby are all that is basically needed (for consulting in case of a problem, there are public health nurses where we live) and anyone who tries to complicate the simple is a fraud.

    • the wingless one

      I had to go back to work and therefore needed a pump. I leaked like crazy so needed breast pads (or I guess I could have just made all my mostly male cowokers extremely uncomfortable). Maybe I didn’t strictly need the handsfree pumping bra but pumping sucks and you really do have to take the little things that can make it suck less even if it costs you $40. Sure for some women (100% of whom I’d venture to guess are SAHMs) breastfeeding is as easy and simple as breast and baby. BUT for a lot of us out there, breastfeeding is nowhere near as easy and simple as you make it out to be.

      • NoLongerCrunching

        Just a tip for others: to make a free hands-free setup, take an old bra or tight tshirt and cut slits for the pump apparatus.

    • Stacy48918

      I will echo wingless’ comments. “Breast and baby are all that is basically needed” if you get to stay home and have no trouble breastfeeding at all. For those of us that need to work or have any difficulties, we do need supplies. There are people that live lives different from yours and those that make products to help them aren’t frauds.

    • Kate

      Yeah…my son refuses to latch, even after multiple attempts, LC visits, breast shields, etc., and trying to get him to do so results in him screaming so hard he can barely breathe. So I exclusively pump. I wish all we needed was breast and baby.

      • Anna T

        Kate, I correct myself: since the benefits of breastfeeding are indeed trivial, if it’s so difficult perhaps it’s just not worth it. That is what I meant by saying “only breast and baby are needed”. If it is not so, formula is a readily available and acceptable alternative. At least it would be so for me. Other women, of course, may make other choices.

    • RKD314

      This is only true if you have no breastfeeding issues and don’t work outside the home. If you do, then you can expect to pay for some or all of the following: lactation consultant, pump, domperidone, herbal supplements, nipple shields, getting your LO’s tongue tie snipped, loss of hours due to taking pumping breaks. My personal cost, in supplies, for BF for 4 months:

      Lactation consultant: $375, insurance paid 90% = $37.5
      Domperidone for a week, just before giving up: $15
      Herbal supplements: $20
      Rental of a hospital grade pump for 6 weeks: $180, insurance paid 90% = $18
      Nipple shields: $20
      Hand pump that I used after I returned the hospital grade one: $85

      That comes to almost $200. On top of that, all of that effort allowed me to produce only 1/2 of what my baby needed. The other 1/2 came from 1 can of formula every 2 weeks. 2 cans a month. Do you know how much those 2 cans cost me? $30.

      Again, just accounting for the (for me) necessary equipment, ~400 mL of breastmilk cost me $50 a month. The same amount of formula cost me $30 a month. That does not include the *time* I had to spend pumping, as the only way to get BM into my baby was through a bottle.

      Sometimes people try to “complicate the simple” because it IS NOT SO SIMPLE for them.

  • TsuDhoNimh

    “These campaigns have been motivated in large part by privileged white
    women inscribing and reinforcing their privilege by declaring their
    personal preferences morally superior to —- whatever —-r.”

    It has a long tradition: the WCTU, the “Visiting Societies” of Victorian England checking up on the housekeeping habits of the poor, the anti-Suffrage groups, the societies for rescuing fallen women … all propelled by well-to-do women with an agenda.

  • lucy logan

    the consumerism is less a big deal than the conspicuous consumption of time.

  • Ob in OZ

    Good blog. Saw a pregnant patient today. Looked at chart. Readmitted last pregnancy 5 days post parting for breast feeding issues. 2 days in hospital by which time she is wanting to leave. From notes pt keeps saying she is happy to supplement with bottle. Advised to pump more, position change, the usual stuff. Had to ask what she did when she got home. Answered she immediately supplemented and helped significantly. Still pumped for 3 months, miserable doing it and finally stopped when nothing was coming out anyway. Asked her what she planned this time. Bottle feeding. She almost cried when I said sounds reasonable instead of reading her the riot act. After talking about strategies of dealing with the inevitable bullying that will come her way, I still said that each time is different and if it was more baby than her she might give it a go. She agreed, but now I realise I’m as brainwashed as most in that I still felt obliged to suggest breast feeding again. What have I become?

    • Michelle

      Hopefully you’ve become a good person. I think it’s valid to still suggest persevering and giving it another try even if only initially and it’s not bullying to do that provided that it is accepted that bottle feeding is likely to be the preferred option as you did with no pressure and adequate discussion of what issues might be faced there.

      I think with this article though, it’s important to keep in mind that generally there is more support for mothers elsewhere than the US like generous leave provisions and some of all of it paid. In the US I’ve been reading many don’t even have provision for paid sick leave, so it really is a class based thing. This does make a significant difference having most with access to that Volvo instead of one lot with a battered old Holden and another with a much better car.

      “…public policies in the United States that privatise childrearing responsibilities offer little support to mothers whose short maternity leaves, inflexible schedules and work environments interfere with breastfeeding routines and are inhospitable to establishing pumping as an alternative. Mothers who take longer maternity leaves, work part time or on a flexible schedule and pump their breasts regularly while separated from their infants are able to breastfeed their infants longer (Avishai 2004).

      Countries that offer more generous support to new mothers such as New Zealand, Australia and Canada, exhibit higher breastfeeding rates across the population and less significant racial and socio-economic disparities.”

    • NoLongerCrunching

      I would have said the same thing. Then I would ask the mom how she felt about exclusive FFing. If she said “great!” then end of discussion. If she said part of her wished she could bf, I’d suggest ways to either start out bf and make a realistic plan for the first sign of trouble, or ways to combo feed from the get-go. You can do anything from a couple squirts of breastmilk into each formula bottle, to using the breast as a pacifier or dessert and formula for the main food, or do something more breastmilk-intensive, like half breast, half bottle.

    • Stacy48918

      I don’t think you’re brainwashed. If mom stuck with it so long before, I would assume she had some level of desire to breastfeed….it just didn’t work out and then she felt obligated to continue to the point of exasperation. She might genuinely wish she could have continued, even if she recognizes that it didn’t work out. Offering to help her try again – if SHE wants – makes you a compassionate care provider. But so does letting her know that it’s OK to choose formula. You’re doing the right thing. 🙂

    • SGuest

      I would say the same thing completely! It is as much about the baby as the Mother. My first sounds similar, my second popped out and latched on. I always tell people to think through last time and how they felt, make a mental list (or write it down if you like!) of ‘lines in the sand’ where you give yourself permission to let it go, and don’t be bullied into doing something that you’re not comfortable with.

      Good advice OB in OZ, wish you were my OB!

  • Sad lady

    I doubt it. A Haitian woman spontaneously lactated 3 weeks after birth, she was given formula straight from the hospital…she’d never even given colostrum. Had she mixed the formula with with dirty earthquake water or salvaged diet cokes the baby could have died. It doesn’t get less privileged then a Haitian earthquake survivor. Apparently she felt the let down in extreme sorrow listening to her baby cry. The argument that breast feeding isn’t better technically is only valid if there is no natural disaster and it’s not a 3rd world country. It’s clearly the better choice where the water is bad, ie in underprivileged communities. Therefore I think formula egalitarianism occurs in countries like the USA with potable water. Except Toledo Ohio. During that water contamination crisis I read a story and the mom was saying , “how am I supposed to feed my baby?”… Yeah…. Um… Lactate? People aren’t even aware of these other fringe benefits.

    • Sad lady

      Ugh I meant to indicate the story about the Haitian lady was of course during the earthquake…I saw it on cnn she was self reporting to the journalist. My bad… Preggy brain…

    • KarenJJ

      You doubt what? That breastfeeding in the developed world has only marginal benefits over formula?

      I think you are stating exactly what we are all saying about the differences between formula feeding in countries with secure water supply and countries without.

      “During that water contamination crisis I read a story and the mom was saying , “how am I supposed to feed my baby?”… Yeah…. Um… Lactate? People aren’t even aware of these other fringe benefits.”

      In those cases, surely bottled water/pre-pepared infant formula would be better then trying to suddenly lactate – especially if the issue that necessitated formula feeding was one of the many reasons why formula is needed (eg poor suck from the baby, medication issues, low supply, masectomy due to breast cancer etc etc).

      • Sadlady

        I doubt that lactivism is for the privileged *pokes title*. Because breastfeeding most benefits the underprivileged.

        • KarenJJ

          Then why has lactivism been focusing trivialities such as formula samples in western hospitals, providing breastpumps and raising breastfeeding rates in places like the US with the BFHI. Why even waste time and resources to encourage breastfeeding in the US, if the benefits in countries with poor quality water supplies is where the need is the greatest?

          • Sadlady

            Because straight from the hospital is the critical time. Milk doesn’t come in immediately and new moms are given misinformation that the baby is immediately hungry and must eat now. I am pretty sure let down is supposed to happen when baby needs it and not when a random nurse wishes you would feed the baby. Plus instant formula from the hospital might lead to nipple confusion as with a paci. It’s not for moms who a pretty sure they’d like to try breast feeding. This could make or break someone on the fence. The reverse isn’t true of formula feeding, you cannot hurt the formula feeding relationship by “trying” breast feeding in the hospital, nor reduce it’s supply. There isn’t a critical window for formula feeding. You can always have it.

          • KarenJJ

            But why is it important to recruit mothers on the fence with regards to breastfeeding in a place like the US?

          • Sarah

            Yes, this. To be sarcastic and crude about it, why does Team Tit work so hard to get all the cool moms on their side? If the long term benefits are nigh on indistinguishable, why is it so very, very important? And why does Team Formula have to engage in ritual weeping and gnashing of teeth over not being on the team?

          • Young CC Prof

            “misinformation that the baby is immediately hungry and must eat now.”

            Except sometimes it isn’t misinformation. If I had supplemented formula more aggressively in the first few days of my baby’s life, he wouldn’t have been readmitted to the hospital and separated from me, and we might have wound up successfully breastfeeding after all. The research evidence is clear–supplementing as needed during the first few days of life improves outcomes including duration of breastfeeding.

          • toni

            I gave my son a couple of bottles of formula on our second and third night out of the hospital because my nipples were so raw and I was losing it a little bit. He gobbled it up and slept soundly. We resumed exclusively breastfeeding after my short respite and we haven’t stopped since. (He’s 1 and a half now). Thank you ready-made emergency similac

          • toni

            *ready made emergency similac given to me by the lovely maternity ward nurse, I should add

          • lawyer jane

            You’re wrong. A recent study showed that formula supplementation in the first week actually helped maintain a long term breastfeeding relationship for babies that had lost a lot of weight. Plus, nature is not a perfect system -there is a lot of wastage. Reliance on lactation only by all means would result in some dead babies, a lot of failure to thrive babies, and negative impacts on mother and other children in the family.

          • NoLongerCrunching

            YeS. Before formula, those babies would have been seen as weak and sickly, and probably fed some animal milk or gruel to supplement mother’s milk.

          • Carolyn the Red

            Sorry, my daughter got formula for the first week because she was hypoglycemic. Once her blood sugar was stable (she got a glucose IV for a couple days).

          • NoLongerCrunching

            Preach it. What ever happened to respecting a mother’s instinct about what her baby needs?

          • VeritasLiberat

            Nipple confusion is a myth. Either that or my babies were just unusually bright.

          • S

            I would be really interested to see the evidence behind nipple confusion being an actual thing (as opposed to some babies preferring the bottle because they’re unable to suck efficiently).

            After i had my first, i came across a few other women whose babies would not take a bottle — we were the ones running out the door as soon as the event/rehearsal/whatever was over because we knew our babies were hungry!

          • S

            I’m agreeing with you, by the way. I think i don’t always make that clear. =)

          • guest

            I know way many more babies who refused bottles, but I did have one friend who EBF till 6 weeks, offered 1st bottle, and he never nursed again. She was pretty sad about it, but was able to pump for awhile and then transitioned to formula just fine.

          • Kelly

            I have claimed that my child had nipple confusion but I just realized after reading your comment that my child did have a poor suck. Once we got her on the bottle, she would chug it in ten minutes instead of falling asleep and waking up ten minutes later starving while nursing.

          • Young CC Prof

            Nothing “confused” about a baby who prefers eating to not eating, that’s totally logical.

          • Kelly

            Yeah. Now that I am far away and have absolutely no guilt about my decisions, it makes perfect sense. During that time though, I thought I had caused the problem with giving her a bottle.

          • Jessica

            But you can hurt a baby if your insistence on breastfeeding at all costs ignores big red flags that things are not going well.

            Supplementation (first donor milk, then formula, then my own expressed milk) kept my son from losing too much weight until he figured out nursing. He breastfed for 19 months. Neither the bottle nor the pacifier negatively interfered with that relationship.

          • TsuDhoNimh

            “lead to nipple confusion”

            Having seen nieces and nephews that were both breast and formula fed … they knew EXACTLY who was responsible for breast milk and who handed out formula.

            The one thing my sisters and SILs couldn’t do was bottle feed their own baby … but any other adult could do it.

            Is that considered “nipple confusion” or is that a baby that has figured things out?

          • sankoji

            Along these lines, I’ve always wondered whether nipple confusion really exists, or whether it’s a further attempt at keeping kids away from a bottle. We started our son on a pacifier and one bottle of pumped milk per day when he was a happily breastfeeding one month old, and he never had any issues distinguishing the breast from either. Letting my husband handle one nighttime feeding with the bottle was crucial to giving me a better night’s sleep, which made me function better as a new mother. My son is now a still-breastfeeding toddler, and I can assure you that he still has no problems identifying “boobie!”

            When I think back on it, I don’t know of anyone who has had first-hand experience with nipple confusion. The first link on “nipple confusion” on Google is Dr. Sears’ site, which truthfully makes me question whether it’s legitimate or is a ploy to keep moms attached, breastfeeding and at home. Anyone in the medical field care to weigh in?

          • NoLongerCrunching

            I am a hospital based LC. You are right that some mothers erroneously believe they do not have enough colostrum. But a good chunk of mothers truly do not have enough. If you dont supplement, there are serious consequences, one of which is a lethargic baby who cannot stimulate the breasts enough to bring in a full supply, leading to permanently lowered milk supply. Yes, judicious early supplementation can sometimes save breastfeeding. Maybe stop talking about the way you think things should be, and learn how things actually are.

          • FormerPhysicist

            No one could get my exclusively breast-fed baby to take a bottle after she went her first 8 weeks without. She would go all day at daycare without a drop, unless it was spooned or syringed into her. It’s MUCH easier to give a baby a bottle earlier and get them used to it.

          • The Bofa, Being of the Sofa

            Good one.

            We INSISTED that our guys figure out how to use a bottle, and, with our younger, we tried lots of and lots of different options (nipples and formula) to find something he would take. But he had to do it.

          • MaineJen

            “…new moms are given misinformation that the baby is immediately hungry and must eat now”
            So which is it? Do babies need to breastfeed an hour after birth or the whole thing is ruined, or can they just hang out for a few days until mom’s milk decides to come in?

          • fiftyfifty1

            Why both of course! Because that way there are 2 different ways that you can be Doing It Wrong!

          • Cobalt

            I really don’t think breastfeeding can be ‘ruined’ in the first few days, other than making it so aggravating and stressful that the mom gives up on it. At that stage, a baby will latch onto anything it physically can, and milk production is almost totally hormone driven.

            Issues arising in the first few days are inherent, there isn’t any choice or action on the mom’s part that would cause or prevent them.

        • Young CC Prof

          OK, let’s make one thing clear. Pushing breast at all costs on women in rich countries by lying about the health benefits is lactivism. Promoting breastfeeding in areas without reliable clean water isn’t lactivism, it’s common sense.

          Breastfeeding provides no benefits to the child of a poor woman in the USA who has to go back to working as a nurse or waitress or on a factory floor 2 months or less after birth, and for her to NOT return to work may endanger the family’s long-term financial stability, which would have catastrophic lifelong consequences for the child.

  • Theoneandonly

    I just heard a mother today refer to her 2 1/2 year olds near constant breast feeding as ‘natural term feeding’. What does that even mean?!

    • KarenJJ

      My guess is nothing. People come up with all sorts of terms to make something sound more legitimate and technical then it actually is. Especially with baby care. It makes things like eating, sleeping and pooping sound more like rocket science and fits into the priveleged “educated mother” role Dr Amy discusses above.

    • Young CC Prof

      It’s a lactivist thing, I think. Their latest idea is to refuse to even define typical infant feeding, so the mother of a baby old enough to walk who’s still feeding every 2 hours around the clock thinks what she’s going through is normal and that trying to cut down the night feedings would be child abuse.

      • Theoneandonly

        Indeed. It was in a discussion about teeth rotting issues in toddlers, and someone brought up a mother who breastfed her older child so frequently it caused decay issues. Of course this woman got defensive – even though she herself had in past mentioned her child was having alignment issues more commonly seen in extended thumb suckers.

        • Jessica

          Ugh. A friend of mine is still nursing her two year old (which doesn’t bother me). She recently posted a meme on Facebook about night nursing not being linked to dental caries and her husband responded with, “Good thing, because our kids’ teeth are pretty bad.” From the rest of the conversation I gather that their child’s dentist told her to stop nursing at night, but she doesn’t agree that the nursing is the cause of the decay.

          If my child had decay issues at the age of two, I would be pretty aggressive in not trying to exacerbate the problem, and night weaning would be one of the first things I’d try.

          • Young CC Prof

            But the party line says breast milk can’t possibly contribute to tooth decay, and only a terrible mother would limit her child’s eating frequency just because he’s old enough to grow teeth.

          • FormerPhysicist

            I couldn’t night wean. I had to just wean. And I weaned earlier for each kid – because of dental issues.

  • auntbea

    Writing like this is why people roll their eyes at academia.

    • fiftyfifty1

      Oh, but it gets so much worse than this.

      • auntbea

        Does it? I got to “crossroads” and bailed, so I don’t have much material to compare. (Note to academics: never use the word “crossroads”)

  • Maria

    Last week was Black breastfeeding week, a week created and promoted BY black women to help their community (as part of a greater month of breastfeeding). The hatred that I saw from white women offended that there was a push for black women to breastfeed really cracked open the facade of natural/ap parenting. It’s okay for them to shame formula moms and talk about all the issues that they (White women) overcome, but when faced with some black women trying to address the situation in their circumstances, they took it like an insult. Well some of the more vocal ones anyway. I am sure most women don’t really care one way or the other.
    Sigh, since when was mothering such a clusterfk??

    • Guesteleh

      I googled Black Lactivists and found this: Dear White Women: Top 5 Reasons Why We Need a Black Breastfeeding Week. Really eye-opening.

      • DiomedesV

        Looks to me like the problem was that Black Breastfeeding Week detracted from the “all breastfeeding mothers are victims, even the upper middle class white ones” tone that seems to appeal to so many lactivists.

  • Dr. W
  • Guesteleh

    Breastfeeding initiation rates by race and ethnicity: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a1.htm

    From 2000 to 2008, breastfeeding initiation increased overall from 70.3% to 74.6% (Table). Initiation increased from 71.8% to 75.2% among whites (p<0.01) and from 47.4% to 58.9% among blacks (p<0.01), but remained unchanged among Hispanics (77.6% to 80.0%, p=0.2). Breastfeeding duration at 6 months increased overall from 34.5% to 44.4%. Duration at 6 months increased from 38.2% to 46.6% among whites, 16.9% to 30.1% among blacks, and 34.6% to 45.2% among Hispanics (all p<0.01). Breastfeeding duration at 12 months increased overall from 16.0% to 23.4%. Duration at 12 months increased from 17.1% to 24.3% among whites (p<0.01), 6.3% to 12.5% among blacks (p<0.01), and 18.2% to 26.3% among Hispanics (p<0.01) (Table).

    For each of the 2000–2008 birth years, breastfeeding initiation and duration prevalences were significantly lower among black infants compared with white and Hispanic infants. However, the gap between black and white breastfeeding initiation narrowed from 24.4 percentage points in 2000 to 16.3 percentage points in 2008 (Table).

    The percentage of infants breastfeeding increased from 2000 to 2008. However, despite increases in the prevalence of infants ever breastfed and breastfeeding for 6 and 12 months, only a small percentage of infants were breastfed for the recommended minimum breastfeeding duration of 12 months, indicating that mothers might need support to continue breastfeeding. The prevalence of breastfeeding among black infants remains below that for whites and Hispanics, suggesting that black mothers might face unique barriers to meeting breastfeeding goals and might need additional support to start and continue breastfeeding.

  • Ellen Mary

    Or ideas that BF is an activity only available to a certain type of mother affect maternity care practices in a way that discourage other women from participating . . .

    The idea that BF is only for white women ignores the experience of a whole IDK, continent of women.

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6333a2.htm?mobile=nocontent&s_cid=mm6333a2_w

    • fiftyfifty1

      Dr. Amy is not claiming that breastfeeding is only for rich white women. What she IS pointing out is that rich white women are using breastfeeding (and not just any breastfeeding, EXCLUSIVE breastfeeding without any formula) like a litmus test. Basically, privileged white women are saying “If a mom is REALLY a loving devoted mom, she will find a way to 100% breast feed like I can”.
      This ignores that a big part of what makes her ABLE to breastfeed is all the support she gets: usually a husband, frequently family support, lactation consultants, expensive pumps, a breastfeeding friendly peer group, protective laws. These are benefits that many women are not lucky enough to have.

      • ngozi

        Maids to do the housework and cooking…

    • Stacy48918

      Anyone without an axe to grind recognizes that the culture of lactivism is confined to the western world. It is that culture that Dr. Amy is addressing.

      But if you just want her to be wrong you try to make her comments apply worldwide, which of course completely misses the point.

  • ash

    I dissagree and it bothers me that you say these breastfeeding products “arent optional” anymore. I am a super broke, 21 year old mother of 3 and I have successfully breastfed all of my kids, and the only one of these products I have felt the need to buy were nursing bras. I bought 2 of them for 50 bucks. Waaaay cheaper than having three kids on formula back to back to back. I’m way too broke for that! 🙂 Oh and up until shortly before my third was born I woked FT as a nanny and was in school, so yeah. I feel like if you set your mind to it it can be done and it really CAN save you money if you want it to. But with that being said, different people have different goals, priorities, and ways of life and there is no need for breastfeeding moms to get judgy about another women’s choices. But also, it is not just formula feeding mothers who get put down. Moms who breastfeed have to put up with tons of crap too on a regualr basis. from friends, formula feeding moms, family, and everyone around them.

    • Stacy48918

      I set my mind to it and still couldn’t EBF my second child. I resent the implication that if I’d just tried harder it would have worked.

    • auntbea

      Since we’re swapping anecdotes, let me chime in to say that not only did I never get crap for breastfeeding from ANYONE, let alone everyone, I also know no one IRL who got crap for it.

      • Mishimoo

        I did get some crap from family members “Are you STILL breastfeeding that baby?!” (6 month old), and I once had an elderly couple angrily storm out of McDonalds because I was discreetly breastfeeding in a booth with a cover, but the vast majority of my experiences with breastfeeding have been overwhelmingly positive.

        • Sad lady

          Lol mcdonalds eaters to classy for you. Derp. Go eat your mcchicken somewhere else! Kudos.

      • Zakiya Ramos

        I have gotten crap for it 3 times in 4 kids from strangers in public despite the fact that I cover also but my experiences have been overwhelmingly positive. I have two friends that had very serious incidents one of which made the news. They also happen to also be black women one is a married SAHM and the other is a student and works PT-married, both middle class

        • The Bofa, Being of the Sofa

          I have gotten crap for it 3 times in 4 kids from strangers in public
          despite the fact that I cover also but my experiences have been
          overwhelmingly positive.

          Um, if you got crap only 3 times for 4 kids I’d say, you damn straight it is “overwhelmingly positive.”

          Think about it this way: how many people didn’t pay attention to it to get those 3 crap comments? Probably hundreds and hundreds of people saw you breastfeeding and went on their merry way.

          Now, unless you are looking for a cookie (and I don’t think you are) those are all perfectly fine, positive experiences. But if one person gives you grief, that is what you notice.

          So let’s see…hundreds of perfectly fine interactions, 3 bad ones. Yeah, that’s “overwhelmingly positive.”

      • ash

        Well, I personally have gotten crap for it on multiple occasions.Once at a playdate, my friend’s sister asked me to go in her bedroom, isolated from everyone, to feed my daughter because their family is weird about breastfeeding. I have a few memebers of my extended family that have done this to me at gatherings as well. My grandma has rudely asked me when I will stop breastfeeding a couple of times. My husbands grandparents are weird about breastfeeding and once abruptly left the table when they realized I was about to feed my newborn at golden corral. Ive had a group of teenagers laugh as me as I nursed in public once. A rude women at my postpartum dr apptmt who dramatically covered her sons face as I nursed in the waiting room (with a cover). A mother and daughter whispering about how im nasty for breastfeeding in the mall playplace as I watched my kids play, among a handful of other negative experiences. So yes, it definitely happens, trust me. But I am glad you didnt have to deal with any negative feedback from people, thats great! 🙂

        • auntbea

          Oh…so then you *don’t* agree that one person having a successful experience means that everyone will have one? Your experience with breastfeeding doesn’t mean anyone can do it any more than the fact that I never got crap for breastfeeding means no one does.

          ETA: Your experiences do sound quite unpleasant. I’m sorry you were treated that way.

        • Guest

          Do people ask nursing mothers to stop or change place even if nursing with a cover!? (I’m not from US)

          • Poogles

            Unfortunately, yes. It seems to be a much more common occurance in the south and some parts of the midwest, where the stigma of breastfeeding (as something semi-sexual and something only people who can’t afford fomula do) has lingered longer than most other places in the US.

    • ngozi

      If you live in the US you can get formula for free through the WIC program.

      • Cobalt

        If you’re poor enough. There is a definite gap between qualified for WIC and able to afford formula. And WIC doesn’t necessarily cover all the formula a baby needs. It helps, but not everyone who might need help to make formula feeding work.

      • ash

        Yepp. but not evreryone who needs it actually qualifies for wic and also they wont give you all of the formula you need, but they do give you some. I was on wic at one point too, but got food for breastfeeding.

    • S

      We’ve gone over this in other discussion threads; if you didn’t need to buy any products to breastfeed, then you were just lucky, that’s all.

      I did not pay for a single thing except a few extra bottles (hand-me-down pump and bras), so don’t think i have an axe to grind.

      • Sad lady

        I don’t think paying for a nursing bra means anything. Bras cost the same nursing or not. And you are supposed to get new bras every 6 months to a year. Pregnancy is 9 months. So… That’s you regular bra budget. You were gonna have a bra anyway.

        • Young CC Prof

          I had a permanent size change, which meant I threw out a dozen perfectly usable bras and had to buy new ones that cost three times as much. No “regular bra budget,” that was a straight-on additional cost.

          • me

            Mine changed in size from pregnancy. That would have happened had I bf or not. Hell, I just considered myself fortunate that I didn’t have to buy a whole new wardrobe. Many women find that even after they lose the baby weight, their bodies have changed in shape so that their pre-preg clothes won’t fit anymore, and have to start from scratch.

            A half dozen bras doesn’t really compare…

        • S

          I learn so much here. Out of curiosity, why are you supposed to get a new bra every year? (I have very small breasts, and i wear a bra for modesty, not support.)

          • Amy M

            They wear out–the elastic will get all stretched, and the bra won’t be as supportive anymore. When I find that I have to fasten my bra on the inside-most hooks, it’s time to get a new one. Also, the shoulder strap adjuster things tend to slide down more (rather than staying put where you set them) on older bras. Another tip is if the back fastening part of the bra is riding up between your shoulder blades, you are probably wearing a size too wide. But with older bras, the tendency is to keep tightening the shoulder straps to retain support, and that will cause the bra to ride up also. The bottom of the bra should be on the same level all the way around your body.

          • S

            Thank you! Figured it was a support thing.

          • toni

            I have bras that have lasted me 4 or so years without stretching very much, I’m not small busted either but I think it helps that I always get the band size closest to my actual rib cage measurement so the band takes most of the weight and not the straps. A lot of women esp in the states wear bras a good 6-8 inches too big in the band, it’s nuts. They get hardly any support and the straps are doing all the lifting and giving them shoulder pain and, as you say, making the band ride up. I worked in nordstroms for a little while and the number of ladies who were thin (size 4/6) with full busts wearing 38 inch bands was incredible. They were in like 38DD when they probably needed a 32FF/G. It’s not their fault though most lingerie stores here don’t go below a 32 band (even lucky to find that outside of the juniors dept) or over a DDD size. Stocking a very small range of sizes and leading us to believe we must have strange bodies if we don’t fit into something they sell. gr.

          • Belle

            You are so right! I wore the wrong size bra for years until a friend who sells lingerie correctly fitted me.. she measured me under my breasts around the rib cage for the band size, then right over the nipple line for the cup size. Each inch over the band size counts as a cup size. My band size is 38″ and bust measurement is 44″ so my correct bra size is a 38 F.. she also said that if you wear underwire, the underwire should sit flat against your chest between your breasts and should come up toward your armpit on the other side. So many ads show women “pouring” over the underwire, and that’s not how it’s supposed to fit. I now wear bras that actually lift and support my breasts and are flattering.. no more sagging..

          • toni

            Yes I had a lady come in a similar size to you but of course she was wearing something like a 44D or whatever the ‘biggest’ size is in VS/Macy’s. We had I think a 38ff for her which was a vast improvement but not perfect (and not very pretty!) so I suggested a 38G and told her to get on bravissimo/nordstrom website and order a few on there. I think it’s shitty to sell an ill fitting bra just to make a sale. She came back in a little while later in a Freya Deco or Panache Cleo (one of the classics) and was just beaming. She looked fab and her clothes fit so much better. It’s pretty easy once you know the basics and let go of the idea that a D is HUGE so a G must be record breaking. a D is not necessarily even that big it totally depends on the band size that goes with it. http://fullerfigurefullerbust.com/2012/08/16/bra-sizes-do-not-exist-without-back-sizes/

            It’s a problem for small ladies too. Many would feel better in a 28C or similar but are put in a 34A that does them no favours. Even teeny little middle schoolers would be wearing 34 bands. I’d say look, I’m about 30lbs heavier than you and I’m not even 34 inches under the bust

          • Belle

            It is indeed very shitty to sell an ill-fitting bra to make a sale! Unfortunately, most stores don’t even sell the so-called larger cup sizes, which are actually the “correct” cup sizes for the majority of women! Not understanding that.. And, many sales women have no idea how to correctly measure for bra size. I think I wore a 42D for years and couldn’t understand why everything sagged!

          • Kelly

            Yeah, I finally got the right size at a specialty shop and found out I was a 30 H instead of a 34 DDD. I had gone to Nordstrom but they did not measure me right. It made me look so much smaller and made my clothes fit better. Also, I have gone through so many bras because I have to go through two different sizes for when I am pregnant, a non-underwire bra for nursing, and another set for afterwards. I am so glad that I am able to buy these bras because it makes me feel so much less frumpy and I could actually fit into some of my pre-pregnancy shirts. My husband stopped gasping at the cost once he realized how much my self-esteem went up.

        • FormerPhysicist

          My nursing bras were about 4x the cost of a regular bra. I needed them, assuming need means that it was painful to breastfeed without a nursing bra, or to just be without proper support even at the times the baby wasn’t at my breast.

          • Ellen Mary

            I’ve been nursing almost 9 years solid and I have purchased ONE fancy bra . . . I bought it with my HSA card from a lactation store, because it is IMO a medical supply. Shhhhh! But the author overstates her case that we are all engaged in this type of consumerism. My pump was paid for by the Affordable Care Act, I really got it to celebrate the new law and for the sense of freedom it provides, I don’t really have time with three to use it.

            I also find it ironic that the ONE place I am not privileged enough to be is academia . . . If I left the home, the only place I could afford to be is a job where I offset (not cover, just offset) the cost of daycare. Even though I was awarded a full scholarship a few years back, I would have had to borrow $8000 a year to cover the cost of daycare for ONE child, now I have three.

            The basic realities have not changed, IMO. TRULY high income, historically high income mothers have *careers* that make it lucrative and rewarding to be outside of the home. They can even afford things like Nannies. Low income mothers get formula paid for through the WIC program & daycare subsidy. They often also get tuition subsidy. But even if they do not, they can *take home* much of the income from a lower paying job, instead of spending it before they earn it on lower quality daycare.

            The mothers who BF in the US are largely are precisely the ones who it makes economic sense for: those who can’t get WIC subsidy for formula, who would have to actually part with $120 of family income a month for formula. If you are staying at home, breastfeeding is a way you can create $120 of family income every month, provided it is going smoothly . . .

            And middle income mothers are those who would have to pay for their own daycare, but without glamorous & rewarding careers to justify paying for daycare on a philosophical or economic level.

            Do I need to mention the author has to be privileged to have access to academia? She is just trying to stir up class warfare between low income and middle income women, as is popular in academia these days.

          • moto_librarian

            Let me educate you a bit on the realities of academia, Ellen Mary. I hold two Masters degrees and am employed at a R1 institution as an academic librarian. I do not have tenure, nor promotion. Roughly 30% of new faculty positions are tenure track these days – contingent work as an adjunct is now the norm, particularly in the humanities. I am fortunate in that I do enjoy what I do, but there is nothing lucrative about it. I bring home enough to pay for daycare. I also carry the insurance for our children, and I continue to save towards retirement. Academia still beats the hell out of an hourly job in retail or food service, but you really don’t get it.

            Staying in the workforce was a choice that I made because of the long-term benefit. There is no short term financial benefit, but at least I won’t have a five year gap in my resume. I think that you fail to grasp that this is the norm for most women.

          • Ellen Mary

            I was saying that it makes *sense* to trade childcare for economic or professional success, or if you have free daycare or relative care. It doesn’t however make sense to take loans for daycare or trade childcare for a hourly job or something that is neither professionally NOR financially fulfilling. My point is that most women are doing what makes sense for them, given their situation in life. But by all means, don’t let that distract you from railing against Breastfeeding Priveledge. I would LOVE a professionally challenging job in academia in any capacity. Unfortunately, I was not willing to both borrow money AND use childcare to get there. I would not trade Breastfeeing for a job unless I had to, but I would gladly, at this point, trade Breastfeeding for a career.

          • fiftyfifty1

            “The mothers who BF in the US are largely are precisely the ones who it makes economic sense for: those who can’t get WIC subsidy for formula, who would have to actually part with $120 of family income a month for formula. ”

            Actually statistics don’t bear this out. The mothers who are most likely to breastfeed in this country are older, well educated women. These are women for whom breastfeeding makes no economic sense–women who are able to command a high wage and who accept a huge financial penalty when they lose productivity to breastfeeding.

          • S

            My friend switched to more expensive nursing bras after hers started breaking.

          • Mishimoo

            I ended up living in nursing tanktops because I couldn’t find comfortable, durable bras in my size.

        • fiftyfifty1

          “And you are supposed to get new bras every 6 months to a year.”

          Or so says the American Council of Undergarment Manufacturers

        • Cobalt

          You can also convert some regular bras to nursing bras. The clips can be bought at many sewing stores or online for less than 5 dollars for a pack of several pairs. Cut the straps just above the cups and sew in the clips, add a ribbon or strip of soft durable fabric from above the clip to the band so your strap doesn’t go flying behind you when unclipped.

          You have to be selective when choosing a bra to use, the straps can’t be wider than the clips you bought and some fabrics are less forgiving. But if you’re crafty, you can expand the size range of available nursing bras and have something that fits you better without having to buy it from a maternity shop.

    • MaineJen

      …so you had a full time job to which you could bring your babies. That is rare. Most of us who work full time cannot have our children with us and have to pump if we want to breastfeed. You got very lucky in your situation (lack of money notwithstanding), that is all. Try not to assume that “everyone can do it if they really want to;” actually no, we really can’t.

      • ash

        Well, when I was pregnant with my first I was 16 and in public high school and working at an ice cream shop. I wanted so bad to be able to be with my son and breastfeed him exclusively so during my pregnancy I searched and searched until I found a job that would align with my goal. And as for school I found a program where I could do the majority of my work at home and come in to class just twice a week for a few hours, I deffinitely had to time things just right so that my son wouldnt get hungry while I was at school. I ended up earning my diploma when my second son was 3 weeks old. 🙂 Also, I didnt mention that when my 1rst son was 6 months old I also got a part time job at mcdonalds for about a year in addition to my nanny job. He was still nursing every 4 hours at that point so I let my boss know I could only work 4 hour shifts till he was about 1 and had started to cut back a little. Oh and before anyone tries to jump to “yeah well I bet you lived with your parents and they helped support you!” Yes, initially they did help but they kicked me out when my 1rst was an infant and I was just 17 and I was doing it on my own ever since! (Until I got married anyway!) I fought every obstacle I faced because it was something I really wanted to do. I would hardly call that “luck”. So while im not trying to say it is always easy I do think that in the majority of cases if someone is REALLY set on breastfeeding they can find a way to make it happen. (Notice I did say majority, not 100%)But as I said every woman has a different set of goals for herself and her children and if a mother wants to formula feed, then that is her choice as it should be! I think breasfeeding is awesome but I am not into judging other mommies descisions!

        • Amy

          Congratulations on finding ways to overcome your obstacles. While you didn’t feel the need to buy all the accessories which are now required for breastfeeding, it seems as though you did exchange financially lucrative work in order to breastfeed. And it’s fine, it was your decision and you seem happy with it. But it’s as if you see breastfeeding as one of the ways to overcome financial strain instead of one of the causes.

    • Michele

      > I bought 2 of them for 50 bucks.
      Not everyone is bra-size privileged like that 😉

  • Guest
  • Junebug

    “explaining why breastfeeding has been aggressively promoted in public health campaigns despite the fact that it has only trivial benefits. These campaigns have been motivated in large part by privileged white women inscribing and reinforcing their privilege by declaring their personal preferences morally superior”

    Wouldn’t the obvious explanation behind gov public health campaigns championing breastfeeding over formula be the government economic incentive to reduce how many millions of dollars in formula they have to pay for?

    • AllieFoyle

      I don’t think it’s an economic incentive that’s driving this. Women on WIC can get free food (and possibly other breastfeeding supplies and help) instead of formula.

      • ngozi

        You get extra food if you are a breastfeeding mother (at least in Mississippi).

        • Kate

          I’m on WIC in ND, and I get WAY more food because I am exclusively breastfeeding. Even supplementing with formula cuts down your food package.

          • Stacy48918

            How do they know you are EBF?

          • Zakiya Ramos

            You just tell them you are and you dont get formula from them. A mom isn’t going to say shes EBF and then pay for formula out of pocket because the cost of the formula ismore than shes getting in food packages. If fraud takes place it is more likely to be an EBF or a partially BF mom saying she is EFF to get a formula package and sell formula. I have seen that happen. I have seen a woman claim she needed special formula and get an RX and then sell the special formula. I don’t know what she fed her baby I am assuming she breastfed or gave her baby homemade formula perhaps.

          • I was fascinated to discover, when my BF-ing daughter resumed going to Weight Watchers, that her permitted number of “points” went from 20 to 35 per day, and she is still losing weight. I remember being told, in nursing school, that “the most expensive way to feed a baby is to nurse” since the mother needs to eat an expanded diet, but even so…dietary requirements nearly double!

          • Young CC Prof

            I spend $2-3 per day on formula for the baby. If I had a really restricted food budget, I could maybe buy enough extra food for myself for less than that, but in practice I’d probably be spending more.

          • Kate

            I’d believe it. I lost all 30 lbs of pregnancy weight by 3 weeks postpartum while still eating like a beast.

        • Stacy48918

          In my state you have to be “exclusively breastfeeding”. I wonder how exactly the mother proves that anyway? Does one bottle of formula a day negate the mother’s need for additional calories?

          • Kate

            Technically, by EBF, they just mean not requesting formula. So if you paid for it out of pocket rather than taking it from WIC, they would still give you the “fully breastfeeding” package. At least, that’s how it works in ND.

            Don’t know why a WIC recipient would want to do that, though. My food package is maybe $70 worth per month, and I think one can of formula alone is $15-20.

      • Junebug

        Well, the conclusion of a report done by institute for women’s policy research? (iirc) basically just said increasing BF rates would save WIC money (or could expand allocated resources to more people).

        They have the 0-6 month package prices at 60-63$ a month for exclusive formula and $48 for exclusive BF.

        The report said if everyone switched over to BF for 1 year in the ‘worst case scenario’ price it would cost more, but that based on trends that wasn’t likely to happen so emphasizing getting people to BF for the first six months would save a lot money.

        $15 a person isn’t much, but it adds up over 1.2 million WIC users.

      • Cobalt

        It’s not that much food. If all you ate was what WIC gives you, you would only eat a few days a month. The full formula package covers more meals.

    • auntbea

      Well the CDC and WIC are not connected in any way, so it seems unlikely.

      • June bug

        The cdc isn’t the only government agency promoting breastfeeding.

  • Amy Tuteur, MD

    What a coincidence! The Onion makes the same argument about breastfeeding:

    http://www.theonion.com/articles/new-study-finds-link-between-breastfeeding-always,36823/

    • yarnbarf

      I actually saw the Onion article first, and thought you were riffing on that today!

  • Renee Martin

    No wonder BF went so well for me! I am white, educated, usually middle class, heterosexually married, and older.

    Just being able to be with your baby all day, every day, is privilege these days.

  • b

    I’m a physician. I chose to formula feed my daughter as breast feeding was not possible for her. I have no guilt, no sense of shame, no regret, and most of all, I do have a healthy daughter. I deeply resent the guilt trips that were aimed at me as a new mother, by lactation consultants, after my daughter was born, and thankfully I was not afraid to tell them where to get off. PS I got waaaay more sleep at night too. Happy Mother, happy child. We all win.

  • Guesteleh

    Have you seen this? Childhood diet habits set in infancy. I’d love to see the actual study and how they controlled for confounders because going off just the news article, it seems obvious that children in affluent households in general will have more access to fruits and vegetables at all ages. So the fact that kids who get veggies in infancy also prefer veggies as older children may not have a damned thing to do with “setting taste preferences” in infancy.

    • Amy M

      That didn’t even work in my house. My children got lots of veggies, and happily ate them until about age 2.5 or 3. It’s pretty much impossible to get veggies into them now, and I hope they’ll change their minds again when they are a little older. (they are 5.5 now)

      • Guesteleh

        Same here. My son was practically a vegetarian until 2.5, refused to eat any meat and then suddenly made a 180. He’s 7 and we are reduced to sneaking veggies into baked goods just to make sure he’s getting some in his diet.

      • Renee Martin

        If you can, let them cook with you. I found that my kid would eat, or at least try, anything he helped cook. It is a real PITA though, so it may not be worth it. But I love to cook, so it worked great for us.

        • Amy M

          Tried that. No dice.

        • Cobalt

          Cooking with the kid to encourage veggie eating has led to some interesting meals at my house. My older son loved scrambled eggs or oatmeal with diced veggies in them. And we’ve put some unusual veggies through the meat grinder and added to spaghetti sauce. Works great with mushrooms and squash-type stuff, good with carrots if you don’t overdo it. Horrible with chick peas.

        • DiomedesV

          Yeah. Planning for, shopping for, and preparing a well-rounded meal for dinner most nights of the week is already difficult (but doable, with properly low standards). Adding a toddler to that makes it harder. So far we don’t have a terribly picky eater, but I would be pretty reluctant to make “cooking” with a toddler on weeknights a regular thing.

      • DiomedesV

        It is my understanding that many children go through a second “picky” phase when they’re about 5. Ie, most go through a picky phase at about 1-1.5, and then again around 5. They’ll eat them again when they’re older, don’t worry.

      • Elizabeth A

        My mom swears by frozen peas as a vegetable for kids. Otherwise, it’s all about carrot sticks and pepper strips at my house. If I allow them to use salad dressing, I can sometimes convince them to eat lettuce, provided it’s not homemade salad dressing.

        • KarenJJ

          I love frozen peas. Even now I’ll grab a cup on a hot day for a snack.

    • Ash

      full text is free for this article

    • antigone23

      All I can say is I WISH childhood diet habits were set in infancy. Infants are soooo much less picky than older toddlers or preschoolers. No doubt that what foods parents choose to introduce has an impact, but I have an extremely picky almost 4 year old who ate anything and everything that she could gum down when she was 1.

      • Elizabeth A

        Same! When my son was one and a half, my parents took him to a local restaurant, where he ordered my favorite thing off the menu (mushroom pizza), and ate it. Happily.

        Now that he’s seven, if you so much as say the word “mushroom” in conjunction with dinner, he’s not touching it. Even if the mushrooms are a side dish that never ever so much as sat on the same plate as his chicken nuggets.

        • The Bofa, Being of the Sofa

          See, he figured it out.

          Mushrooms are evil.

          • Elizabeth A

            They are evil.

            Sometimes evil is really tasty. Especially when sauteed in butter and served with a nice taleggio on a crispy, thin crust…

          • The Bofa, Being of the Sofa

            No, I have it on the authority of my brother, who always liked mushrooms, that “they don’t taste like anything and you can’t even tell they are there.”

          • Hannah

            Yeah, my husband keeps telling me that. It’s a lie. They have a taste, and that taste is slime. Combine that with their texture and they are in fact evil.

          • S

            I like mushrooms, but that made me laugh.

          • Who?

            You are buying the wrong mushrooms.

          • The Bofa, Being of the Sofa

            I ain’t buying no mushrooms.

            But tell it to my brother (and Hannah’s husband). THEY are the ones claiming they don’t taste like anything and you can’t even tell they are there.

    • Who?

      My two insanely fussy eaters were both cured by adolescence. The growth spurt hit, and down went the food previously rejected.

      • KarenJJ

        My fussy eating brother was cured by going out with a girl from a different culture, thereby encouraging him to try all manner of foods he refused to try previously 🙂

        • Who?

          And also not wanting to look like a prima donna at the dinner table at her parents’ house. Peer pressure is powerful.

          All good outcomes though. Only issue is the ‘reformed smoker’ effect, being disparaging of others who won’t try/eat particular things.

          Ah well, there’s only so much one can accomplish at once with the silver screwdriver…

          • KarenJJ

            The way to a man’s stomach is through his heart, apparently.

          • Who?

            The heart, or some other organ…

  • Zornorph

    What makes me laugh is how the breast feeding advocates always describe formula feeding as this huge pain in the ass. I found it very easy – my son didn’t require the bottles to be warm and I bought a dozen of them so I always had some that were clean even after a busy day or two. Water->formula->shake and you’re ready to go – if I didn’t already have on in the fridge pre-made (as he liked it cold, too).

    • Amy M

      I found the same. The only pain in the ass was the cost, but we mitigated that to some degree by buying in bulk from BJs.

      • Zornorph

        Formula is cheaper in the Bahamas than the US, so that wasn’t much of an issue, either. $18 for the large Similac container and that just lasted over a week.

        • Amy M

          I was also feeding twins, so everything cost double. 🙂

          • Zornorph

            Ah, that would have been an issue. I only transferred one embryo to avoid that risk, but for a few days they thought it might have divided as the initial Beta number was so high and I spend a week or so worrying how I was going to manage two at the same time.

          • Amy M

            We also only transferred one embryo to avoid the risk of multiples. It didn’t work out as planned. 😉

        • RKD314

          Yeah, I never understood the whole cost thing, bc here in France formula is really, really cheap. An 800 g can, which lasts us something like 1-1.5 weeks, is 11 euro.

          When I calculated how much that costs vs. how much of my time the ~300 mL a day I could pump costs, I knew that the rational choice was to stop.

      • Guest

        When it comes to the cost I just know I would pay my blood to see my babies growing and healthy.

    • fiftyfifty1

      Yes it is interesting how hard they describe it being. It seems to me that it’s pretty easy, certainly easier than fixing my own self a meal, certainly easier than getting a toddler to sit in a high chair, cutting the grapes etc. into non-choking size pieces etc.

      • antigone23

        Formula feeding is hard but women who do it are lazy. Get it?

      • DiomedesV

        Well said. Formula feeding was *much* easier than feeding solids to a baby not interested or getting a toddler to sit down and eat. I mourned weaning from the bottle for that very reason.

    • Smoochagator

      I also found formula feeding to be extremely easy. Before bedtime I would pre-measure the powder into a divided dispenser cup and fill several bottles with water so that all I had to do when the baby woke up was change the diaper and then dump the powder from the dispenser into the bottle and shake. Room temperature water = no need for a warmer. Baby and I were usually back to sleep in under an hour. When leaving the house, it was the same deal.

    • Box of Salt

      Some counterpoint:

      I recall when baby#2 hit 6 mos and started eating food. Part of me was bummed out about it because now I actually had to pack things for that baby to eat (in addition to the toddler food packed for child#1), instead of satisfying baby’s nutritional needs by just nursing.

      While it’s not really a big deal, sorry folks! Life *was* simpler when all baby needed for food could be supplied just by me.

      • Renee Martin

        EBF was so easy for me too, I also dreaded real meals. I found EFF pretty easy too though, so I might have just been lucky.

      • The Bofa, Being of the Sofa

        And then we got to the stage where we didn’t need to pack along a bunch of food for the babies/toddlers, and they could just eat the same things we eat.

        • Box of Salt

          Yes, but I’m still packing snacks to keep them going between school and sports and whatnot….

          • The Bofa, Being of the Sofa

            Yeah, we’ve got those containers of goldfish and cheez-its and what not, too.

            We still lug around a backpack, just because it makes life easier.

          • Box of Salt

            We have to pack them up individually, partly due to different genders = different sports.

      • Young CC Prof

        Formula feeding and breast feeding are both SO much easier than infant solids! You need, bare minimum, spoon, sealed jar and bib, and then there’s major cleanup.

    • ngozi

      Sterilizing and fixing bottles is a lot easier for me than getting a child to latch-on. I never had a problem with supply; I actually had a NICU nurse tell me I made more milk than any mother she had ever seen(she had been a nurse for about 30 years). I have had all sorts of horrors trying to get my children to latch.

      • ngozi

        The only time I found breastfeeding easier was at night, when I had more time to help my baby(ies) latch on.

    • DiomedesV

      We genuinely found FF to be easy once we had a system set up. The system evolved as the baby aged, and we were always tweaking it, but it was just a set of tasks I or my husband had to do every night. We made the formula fresh each night in a carafe, then filled enough bottles to last during the day.

      What was not easy was figuring out what level of sterility was really required in a developed country. The WHO instructions for formula feeding assume a water supply that is not clean, as they should. But for those of us in the developed world, it becomes unclear how much effort you need to make. What about cryptosporidium? Water that is fluorinated by the city? Do the bottles need to be boiled? Does the water need to be boiled? Our pediatrician told us when our kid was 6 months that we didn’t need to sterilize the bottles or boil the water. I certainly wish we had known that when our dishwasher broke.

      With a functioning dishwasher, making formula was only a little bit more difficult than setting up my morning coffee in the coffeemaker.

      • Young CC Prof

        As I understand it, if you have regular city water (not well water) and a baby who does NOT have an impaired immune system, regular washing in hot tap water suffices, and you don’t need to make with boiled water. Some sources, however, suggest ready-to-feed for newborns during the first few weeks.

    • RKD314

      I think that nursing is probably the easiest under very specific circumstances: 1) You have no milk supply problems, 2) there are no latching/nursing ability issues with the baby, 3) the baby is one that eats every 3-4 hours instead of, for example, every 1-2 hours.

      However, if you have to supplement with formula, or the problems with direct breastfeeding are such that you have to bottle feed anyway, then nursing is just one more thing you have to do. But of course, we’re told that “any amount of breastmilk is so good for your baby, even one drop is better than nothing!”

      I have gotten into arguments on the internet (always a bad idea) with lactivists and they way they describe the formula feeding procedure invariably goes something like this:

      1) Wash hands
      2) Sterilize bottle
      3) Boil water and let it cool
      4) Open bottle, while maintaining cleanliness by putting the top on a sterilized surface
      5) Precisely measure water into bottle–be careful! Too much, and your baby will die, but they’ll also die if you use too little!
      6) Precisely measure formula into the bottle–again, be careful! Your baby could die if the scoop isn’t perfectly level!
      7) Mix
      8) Warm the bottle up to the right temperature

      As a scientist I always get a kick out of (5) and (6). Apparently these people have never heard of the concept of uncertainty, and don’t realize that there is a certain tolerance on whatever formula to water ratio your can instructs you to use. But I digress.

      In reality, this has been our FF experience:

      1) In the morning empty the dishwasher, which includes yesterdays bottles. Takes about 2 minutes to put them back together and put them on the counter. Those are the bottles available for the whole day.
      2) When you need a bottle, put some water into it. Regular old unboiled water. Make some effort to put the right amount in, but anywhere within 10 mL is fine with me. Lines are on the bottle. This isn’t rocket science.
      3) Put 1 scoop of formula for every 30 mL of water into the bottle. Since I can read the instructions on the can and can do basic arithmetic, I do not find this step overly taxing. Perhaps this is what poses the problem for lactivists?
      4) Shake and done.

      I think we spend maybe total 10 minutes a day, MAX, on preparation of formula and cleaning of bottles.

      • Amy M

        That’s pretty much how we did it. And no mixing of formula at 3am…we had the overnight bottles prepped at 6 or 9pm, 5-10secs in microwave if the baby won’t take it cold. They make it sound like you have to get up at 3am and prepare a bottle like you list above, and that this will take an hour, while your baby screams, etc. Meanwhile, I have several friends who BFed and they were up at 3am feeding their babies. And at 4am, and 5am….

        • RKD314

          Yep, when ours was new and woke up in the night to feed, we had the formula already prepared in advance in the fridge. Now that she sleeps all night we just make it each time, she only has a bottle 4-5 times a day anyway, and it takes like 30 seconds to make one.

          • KarenJJ

            I used to take the bottles out of the dishwasher in the morning, fill the bottles with water from the kettle to the correct level and leave them in the fridge. When I needed a bottle I’d heat the water in the microwave for 15-20 seconds and then add the formula powder and shake.

            Simple enough. We were warned about using the microwave to heat the milk due to the microwave creating “hot spots”, but I figured a good shake that mixes the formula would likely mix the temperature enough to even out too.

          • theNormalDistribution

            Do you need to put it into the fridge? Seems to me that sterilized water poured into sterilized bottles would be okay on the counter.

          • KarenJJ

            I wasn’t sure and as a bonus the fridge kept them safe from the climbing toddler.

        • The Bofa, Being of the Sofa

          We had one of those steam bottle warmers. It took about a minute.

          Now, we didn’t do it in the middle of the night, but I gave our oldest mixed formula/breast milk when my wife was working (she couldn’t pump enough to give him breast milk neat)

      • Zornorph

        Yeah, I got in an online discussion with a lactavist and she was trying to tell me I was a horrible person because I didn’t boil the water before mixing the formula. I shared a link to the Mayo Clinic (a leading health-care provider in the US) which gave instructions and did not include all that. Her response was to find one other bit of baby advice that the Mayo Clinic gave out that differed with the WHO and ask how I could trust such incompetent people since they clearly didn’t have the same wisdom as the WHO.

        • RKD314

          Yes, how DARE we not all take the same precautions in caring for our babies as we would if we lived in an impoverished country with no running water! I should just assume that running bottles through my dishwasher is effectively equivalent to dunking them in the local well.

          In all seriousness, I think that when lactivists start with the WHO worshipping (and they do that a lot) it just drives home even more how their world view is shaped by privilege. They can’t possibly imagine a situation where the WORLD Health Organization would make a recommendation with something other than developed countries in mind. They effectively show that they do not even realize that there is a separation between the conditions of people in developing/developed countries.

        • The Bofa, Being of the Sofa

          Jeez, if the water is such a concern, just use bottled water.

          That’s perfectly fine in a first world country.

      • Cobalt

        They make formula feeding way more work than it needs to be. As to whether formula feeding or breastfeeding is easier (assuming you can choose do either WITHOUT extraordinary effort), it depends on where you are and what you’re doing at the time. Sitting on the couch with just the baby? Breastfeeding is easier. Driving with another adult in the car? Bottles unless you want to be sitting on the side of the road for a while. Day out and about? Depends on whether you’re more comfortable hauling extra stuff or breastfeeding in public. At work? Formula, hands down. Middle of the night? Cold bottles are easiest, but your baby may not cooperate. Anything involving pumping depends entirely on how you feel about pumping and how much time you have.

        Whatever you’re used to will be easiest once you get a system going. This is, of course, assuming no major barriers to either method.

      • LovleAnjel

        I’ll narrow it down even further: we fill the bottles for the day when we assemble them. Come feeding time:

        1. wash hands
        2. scoop in formula
        3. shake

        All done!

    • theNormalDistribution

      It seems it’s not just breastfeeding advocates. it’s everyone. Last night my spouse and I were chatting with my SIL about baby related things (she was visiting with her 9 month old). Apparently her mother in law “doesn’t do nights”, and would sleep while her husband soothed the baby, changed his or her diaper, and “delivered him to the boob”. I think that’s an awesome division of labour and made the comment that there was no way I could get up with the baby multiple times a night day in and day out, which is essentially what my SIL does while her husband sleeps. My SIL is a doctor and considers herself a skeptic, but she basically went into a rant about it, saying that even if daddy bottle feeds you have to get up to pump, and even if he’s supplementing with formula, you’ll still hear the baby cry and not be able to sleep, and even if you *exclusively* formula feed then you’re still going to have to pump (I’m not sure why) but then you have to basically perform bottle surgery every time you need to feed the baby and you’ll be so busy you’ll never leave the house.

      • Zornorph

        Some people just seem to think that if it’s not hard, you must be doing it wrong. I don’t need to complicate my life just for the sake of it.

  • Zakiya Ramos

    I was a poor black single teen mother who lived in government housing, worked two jobs, and breastfed my son for 15/16 months. Medicaid in my state also pays for natural birth and midwives. My own mother is black, was a single mom of 4 and we lived in the projects while she finished school and worked and she breastfed all of us and my sister and brother when we were living there were breastfed to 18 months and 9 months. She was working, going to school and was one of two moms in the projects who I knew BF because they NIP. This is bull. With the right support which I had any mother outside of medical reasons can breastfeed successfully. Its not about race, wealth, age, or privilege.

    • moto_librarian

      I don’t think that she is saying that only the privileged can breastfeed, but it is definitely easier to do so if you are privileged. Don’t you think that the fact that your mother breastfed four children played a big role in your ability to do so? She could give you advice and help that a lot of women need to pay for (most women my age were formula fed, so they can’t get a lot of help from their mothers or other relatives). I think it’s great that you were able to breast feed successfully, especially while working two jobs, but that scenario presents a lot of obstacles that are not easily surmountable.

      • Zakiya Ramos

        Yes if not for seeing my mother breastfeed I probably would not have. That is why seeing women, especially those who look like you, breastfeed is so important. I was 17, single, poor, and black, odds said I would not do it but I did because my family was supportive and my mother helped me and showed me what to do.

        • The Bofa, Being of the Sofa

          So it sounds like it’s a perfectly good example of what Dr Amy’s post is about.

          • Zakiya Ramos

            No its not. She said bf works for privilege white women. We were neither. We were just moms who believed in BF and wanted to succeed despite obstacles. Being a mom isn’t easy and we all have things in our way. Outside of a medical issue if you want to you will period.

          • Karen in SC

            No she said that white privileged women have made breastfeeding a “project.” And that the extras needed to succeed at this “project” are easier to obtain with privilege. I think your personal experience almost proves her right – as you succeeded and didn’t need all those things. Just a good example and support that came free.

          • The Bofa, Being of the Sofa

            She said bf works for privilege white women.

            I think you missed the point of the post.

          • AllieFoyle

            But your obstacles were really substantial compared to someone in a different situation. It was important to you and you had good family support and made it work — but without consulting LCs and buying a special BFing wardrobe and cushions and pumps and fancy chairs and wearing your child 24/7 and exclusively feeding breastmilk. None of that stuff was necessary or helpful to you — you did it because you wanted to — and I don’t know if we need to be telling women who are trying to balance motherhood with work and/or school that they have to go to great lengths to BF if they don’t want to or don’t feel that they reasonably can.

          • Zakiya Ramos

            None of those things are necessary to bf but I agree its really hard even for a sahm and doubly so when there are obstacles, that’s why I personally never judge bc its not easy and I don’t know what has to be overcome for a mother be it work, school, spouse not supportive, body issues etc

          • Amy Tuteur, MD

            No, Zakiya, that’s not what I said. I said that well off white women have more resources to make breastfeeding work, and refusing to acknowledge that and insisting that breastfeeding is required to be a good mother leads inevitably to the conclusion that women of color and poor women are bad mothers. It’s like insisting that good mothers drive Volvos and women who drive cars with fewer safety features are bad mothers.

            They are effectively making light of what you accomplished by pretending that you didn’t overcome significant barriers to breastfeeding.

          • Zakiya Ramos

            Ok yes that is true there are more resources available to middle class women however I know that in black bf/lactivist circles that is acknowledged. I still disagree that those are the most pervasive barriers for us. Point blank I have seen it largely to be cultural barriers and lack of knowledge. If it were those barriers you mentioned we would have just ashigh ininitiation rates and what you would see are rates drastically dropping at home. We barely even have half of black women trying to begin with. I know youre speaking about all woc but I am speaking specifically about black women becsuse I am black I cant speak to other cultures.

          • Guesteleh

            Zakiya, I want to say that I have a huge amount of respect for the commitment you showed to breastfeeding. What you did was not easy and I don’t think most women could persevere under those circumstances.

    • The Bofa, Being of the Sofa

      With the right support which I had any mother outside of medical reasons can breastfeed successfully. Its not about race, wealth, age, or privilege.

      So why are there such large differences in breastfeeding across races and wealth status?

      • Zakiya Ramos

        In the black community there is a HUGE stigma on breastfeeding. I can only speak yo my experiences. There is an attitued thaf bf is for white women, Africans, and the hippie types. Its just not something that is done but it is getting better and better especially with more seeing other black women breastfeeding.

        • Amy M

          It seems like maybe the attitude of “bf is for white women” is reinforced by the current campaign of lactivism. That campaign is run largely BY white women, and they expect everyone to measure up to their standards. I can understand how the Black community would find that off-putting, and how that could lead to lower BFing rates for them.

    • Amy M

      If you don’t believe that race, wealth and privilege don’t play a role in the disparities seen in breastfeeding populations, then what IS it about? Support? What does that mean? What is the right support?

      • Zakiya Ramos

        In my personal experiences as a black woman the barriers to BF had more to do with social stigmas among our race than true barriers. That and the fact that formula was free through wic and food stamps there was just a pervasive attitude of why go through the trouble if you didnt have to. Those of us who did breastfeed just strongly believed in it. Where I lived was the GHETTO, as in government projects and everyone there was on assistance. People would say breastfeeding was nasty, breastfeeding was sexual “baby sucking a tittie” it was just pure ignorance. The support I had was from my mom. Knowing my body was made for it and knowing what to do and what was normal (clusterfeeding, growth spurts etc) knowing what yo do when baby didnt latch etc. Support does not only come from LC. I’ve never been to a lactation consultant ever.

        • Amy M

          Ok. Do you believe that if only all of the black women you grew up with had the same support resource (their mothers or other family members), they would be breastfeeding as successfully as you?

          • Cobalt

            I’ve experienced the cultural pressure in really poor neighborhoods to not breastfed because it’s gross/sexual. And free formula from WIC lets you choose not to, instead you can use something that costs money, an option you don’t have in most areas of your life when you’re poor.

          • Zakiya Ramos

            I have had the same experience. Also there is a belief that since formula costs money its better. The main Barrier thoufh was the belief that its gross, weird, africans do it (think national geographic) it will ruin your body etc. Just a lack of knowledge among poorer groups sadly.

          • yarnbarf

            That was also the pervasive believe in most of society until very recently. I was born in the early ’80s in a very working-class, mostly white community, and breastfeeding was not the norm. The hospital where I was born didn’t know how to deal with a baby who is in NICU and the mother was nursing.

            For as long as water has been safe in most of the US, formula has been seen as more scientific and superior. Like drinking bottled spring water vs. sticking a straw in a puddle.

          • LovleAnjel

            Well, there is need crying out for lactivist help. They work so hard on “normalizing” breastfeeding within their own social circles, but not in low income neighborhoods. Maybe they should stop trying to make formula prescription-only and work for women in underserved communities instead.

          • Zakiya Ramos

            I agree LovleAngel my niece initiated bf and showed wanted to go to LLL meetings and there was NO meetings in her area only phone help was available. She didn’t have a car and I didn’t live near her either. I just wanted so surprised and disappointed that in a metropolitan area the only meetings were in the outskirts in the suburbs. I can only guess its because its volunteer (idk) and the women organize groups in their own neighborhoods? She did breastfeed for 3 months which was such an accomplishment in her circumstance. At the time she was homeless and going from relative to relative home to live.

          • Zakiya Ramos

            I dont know how to edit. I meant to say she wanted not showed wanted

          • Zakiya Ramos

            Yes I believe that if our culture surrounding it changed (which it is is through black lactivism) our rates would go up. Wic is doing a better job of it now too. Sorry I have a new phone andI’m having trouble typing on itI

      • Zakiya Ramos

        Let me say this, I am not saying its not a barrier let me be clear. I was a stay at home mother with my last two babies. BF is MUCH MUCH more accessible when you can stay home and when you can afford a pump for goodness sake. But to say that BF is white privilege is nottrue. It is harder for moms who have to work and don’t have access to help kind of like food deserts they call them breastfeeding deserts but it is still possible and our low rates have more to do with attitudes about BF and the fact that its hard and fomrula is free imo.

        • Amy M

          I think you have an excellent point about culture playing a role. I don’t think this post (or I ) suggest that BF is a white privilege. What IS a white, AND middle-class privilege is access to more help with breastfeeding, ability to buy various accoutrements to make it easier, and often, more ability to pump if away from the baby. The thing is, the lactivists take all of that for granted, and are ignorant of the cultural differences you brought up, and expect that ALL mothers should be able to BF like they do–their target demographic is other white, middle class women. Then, when it doesn’t work, because of cultural stigma or having to work and no way to pump, the lactivists shame those mothers for failing to do what came easily to them. It’s great that you managed to overcome various obstacles, but it seems more woc, and poor white women cannot or do not attempt to, finding formula more conducive to their situations.

    • Guesteleh

      I am a woman of color and I’ve achieved a lot of things that aren’t the norm for most women like me: master’s degree, a high-paying professional job, marriage to a high-income earner. But I don’t extrapolate from my experience to say “race and class are no barrier to attaining a college degree and a high income.” I’m the exception and I’m very aware of the factors in my life that supported me in becoming the exception. You have to be very careful about letting your personal experience blind you to inequities and barriers that exist for other women.

    • Mama

      Indeed. I was thankful for bf when my hubby went bankrupt just as we were starting our family. Cash was tight so formula was not an option. I exclusively bf for 6 months. Living in the UK and having had 2 kids, I noticed I was always the only one in the post natal ward actively breastfeeding.

      • RKD314

        This is a personal question so of course I understand if you don’t want to answer, but I can’t help wondering, did you work during that 6 months?

    • fiftyfifty1

      So if any mother can breastfeed successfully, and it’s not about race, wealth, age, or privilege, what IS it about? I ask that sincerely.

      • Renee Martin

        SOME DO NOT WANT TOO!
        And that is OK too.

        • Guest

          Or the baby doesn’t want to! just like mine.

    • Renee Martin

      You missed the point of the post.

      This post is NOT about who can, or cannot BF. It is about how privilege has created the lactivism of the day, and how privileged women are the ones that both set the rules on mothering, and enforce them with institutional might. There is a reason that middle class white women BF more often *as a group*, and privilege, and all that comes with it, has a lot to do with it.

      Of course WOC, and low income women, BF. No one is saying that none BF, or that they cannot BF if they really want too. But privilege does interfere with their daily reality, as it does in countless other ways.

      After all-
      *That support you say is so important, who exactly has good access to it?*

      Privilege is a group thing, it is NOT about the individual. This is how you can have white men that are homeless, and wealthy black professional women, without there being any dent in white privilege, racism, and sexism.

    • AllieFoyle

      Breastfeeding is physically possible for most women and it does have benefits. The question raised here is whether or not those rather minimal benefits justify the effort and resources that are currently devoted to it. Are lactation consultants and breast-feeding promotion efforts the best use of resources? Is increased breastfeeding such a valuable good that it outweighs other concerns that we might choose to address instead with those same resources? Are we serving all women and babies when we as a society decide that breastfeeding is more important than supporting families in other ways? Are we ignoring the needs of a huge group of women who don’t want to or cannot breastfeed? Are we overvaluing breastfeeding and neglecting the importance of financial stability and the potential cost of breastfeeding to a woman’s career and educational success, or even just her mental health and ability to get adequate sleep? And are we continually allowing the bar to be raised so that just breastfeeding isn’t enough — now you have to breastfeed exclusively, for an extended period of time, while following a specific diet and parenting style, and purchase specialized clothing and accoutrements and consult experts — much of which is unnecessary and also inaccessible to many women.

    • lawyer jane

      Did you and your mom pump when you went back to school/work with an infant? I found pumping while working almost insurmountable, and I only had one child, predictable hours, supportive boss, and private office. I think having to go back to work at places that don’t accommodate breastfeeding, and/or very short or no materinity leaves, must be a big reason for differences in breastfeeding rates.

      • Zakiya Ramos

        I went in the bathroom and pumped in the sink or toilet I did not get pump breaks I just used my bathroom breaks and my baby got formula when I was away. I could not afford a breast pump and I did not have a job where I could pump and he we still made it becsuse I wanted to make it.

        • AllieFoyle

          I hate that you had to do that. I understand that it was your decision and that it was important enough to you to make it work, but I wish we had something more substantive to offer women so that being a mother and working or going to school wasn’t so difficult.

          • Zakiya Ramos

            I didn’t know about laws and there probably weren’t any then. I dont even think my bosses knew I needed to pump it was never discussed. If I knew I could have had a break to pump I would have done that. I worked at a grocery store and then when I took a second job it was at the daycare my son started going to so I could breastfeed a few times a day on break but he also took formula.

          • The Bofa, Being of the Sofa

            If I knew I could have had a break to pump I would have done that.

            Here again you illustrate the point, and this time clearly.

            You faced obstacles that the “privileged women” wouldn’t face.

            See the part in Dr Amy’s post about managing breastfeeding, and, in particular “consulting books and asking experts.” You apparently weren’t doing that, and it made it harder for you as a result.

            “Each stage is mediated by privilege,”

          • AllieFoyle

            You were dealing with obstacles that are hardly addressed at all by these breastfeeding campaigns. Also, part of the reason you were able to make it work was that you did use formula. Lots of moms either choose to or have to do this, but these Breastfeeding Uber Alles campaigns attempt to limit women’s access to formula and make it an all or nothing proposition, even though that would make it impossible for many women to work or go to school.

          • ngozi

            Exactly! All the breastfeeding books I read seem to think every woman has a spouse/partner that is ready and willing to take care of other children, cook, and do laundry while the mother breastfeeds. Many of them seem to think all breastfeeding mothers only have one child, or has a line of family and friends waiting outside the door ready to be personal attendants.

        • DiomedesV

          Wow. I’m sorry that you had to do that but I’m also really impressed that you did.

    • Elizabeth A

      More and more, the standard proposed for breastfeeding is “no formula at all”, and I really don’t think that’s possible for huge numbers of women, because breastfeeding is not, in fact, free. A mother’s time costs something (I didn’t get paid for breaks, and in the jobs you describe yourself having, I don’t imagine you did either). Equipment to pump and store breast milk while you’re away from the baby is not cheap, and is absolutely required if you avoid all formula. While law mandates that breast feeding women must be allowed breaks to pump breast milk, many women report that employer compliance with these laws is poor, and that there are few consequences for non-compliance. If you wait tables, you’re more likely to get fired for requesting pumping accommodations than you are to get the accommodations.

      I think that combination feeding is a far more realistic target to encourage women to aim for – breast feeding is great, and we think that any amount of breast milk is good for infants – and realistically, existing social structures and programs do make combination feeding possible.

      • moto_librarian

        I truly believe that lactivists should be focusing on accommodations for women who want to breast feed. That is an area where they could make a positive contribution.

        • KarenJJ

          I think what makes it difficult is that so many breastfeeding mothers that are also lactivists (especially in the US, because of limited parental leave) are outside the workforce and therefore unable to negotiate these types of arrangements.

          When I negotiated paid leave at my work I was in a very technical, and difficult to recruit for, role (we used to have to source people outside of my country). It gave me the sort of leverage that very few pregnant women have in the workforce – and once they are a mother and breastfeeding there would be even less leverage to change workplace policies.

    • ngozi

      I am a poor, black, married mother. With that being said, I have to point out that you said “with the right support.” Some mothers, even single ones, have more support than I do as a married woman. Some women have little to no support with their new baby or other children in the household, even if they are married. Some people do not live close enough to family members that will help with childcare, or if they do, they may have family members who don’t want to help. I am glad you have the right support, but many mothers do not.

    • LovleAnjel

      Zakiya,

      I just want to say thanks for sharing your lived experience with us.

    • Stacy48918

      “Any mother” implies that you think those that don’t, “give up”.

      Maybe they just don’t want to, or find the accomodations necessary more than they are willing to handle.

      • Zakiya Ramos

        Nothing wring with that.I guess what I should have said was any mother that wants to, outside of a medical reason, can.

  • moto_librarian

    Given that the benefits of breastfeeding healthy term infants in the developed world are vastly overstated, I would like to see the Baby Friendly Hospital Initiative curtailed as soon as possible. As Dr. Amy has said in previous posts, what we really need is a Mother Friendly Hospital Initiative. This is what such an initiative would look like:

    1. Instead of “lactation consultants,” there will be “infant feeding consultants.” They will provide evidence-based information on both breastmilk and formula. If a mother wants to initiate breast feeding, they will provide assistance; if the mother wants to begin formula feeding, they will provide assistance.
    2. Formula will not be locked up. It will not require a “prescription” from a doctor. It will be labeled and treated as food, not medicine.
    3. Rooming-in will not be required. The newborn nursery staff will bring breastfeeding babies to their mothers whenever they require a feeding, but they will also provide a means for all recovering mothers to rest as much as they need prior to being discharged.
    4. If a hospital gives out product samples for breastfeeding, they will also offer samples for formula feeding mothers.

    • Natalie Tindol Youngblood

      There are no benefits to breastfeeding it’s the biological norm.

      • Amy M

        What’s your point?

        • Natalie Tindol Youngblood

          Just saying it’s the biological norm. That’s how nature designed it

          • Guesteleh

            Nature designed a lot of things that aren’t optimal. Did you know that 30% of all fertilized eggs fail to implant or end in an early miscarriage? That’s natural. Nature is a capricious bitch.

          • Natalie Tindol Youngblood

            I didn’t say it was perfect just that nature designed it that way. Mammals have the ability it feed their young with their bodies but it doesn’t always work thr way it should. I actually agree that breastfeeding is somewhat of a white privilege in America but I don’t think we should just say “oh well you’re not white so we’re not even gping to try and help” .

          • Guesteleh

            Here’s my beef with breastfeeding “help”: for the most part, it isn’t evidence-based. There are no studies demonstrating the efficacy of interventions used by lactation consultants. And it puts the entire burden on the individual mothers instead of recognizing that the barriers to breastfeeding are structural. Finally, given how small the benefits of breastfeeding seem to be, why aren’t we investing all of that time and money into interventions that are proven to improve infant health outcomes. For example, black women have much higher rates of miscarriage. Doctors in Detroit seem to have discovered why: it’s because black women are more likely to have an incompetent cervix, which can be treated cheaply and easily with progesterone. If all black women in the U.S. were offered progesterone treatment we could cut the miscarriage rate in half. So why isn’t money going to that instead of all this lactation crap?

          • Natalie Tindol Youngblood

            As I said there are NO benefits to breastfeeding because it’s the biological norm. Mothers that want to breastfed should have help whether you think they should or not.

          • Guesteleh

            So no addressing my bigger point about where we are spending public health dollars? Or the fact that the help that’s out there is shitty and not proven to improve breastfeeding rates? Just IT IS NATURAL LALALA DON’T ASK ME TO USE MY CRITICAL THINKING SKILLS.

          • Natalie Tindol Youngblood

            I’m not trying to argue really I’m not. I’m just saying that the benefits can not be overstated because there are none. WIC pays for 50% of the formula in the US. Couldn’t that public money be better spent on better breastfeeding help and support? Formula is not cheap

          • Renee Martin

            Did you even read the post, or the comment you are replying to?
            Either you cannot read and understand, or you are ignoring what is in the post and the comment.
            I cannot even think of a good reply, you have ignored so much of the related material.

          • LibrarianSarah

            You can have an army of LC’s and other “support” specialists and you still won’t be able to exclusively breastfeed if you have to go back to work a couple weeks after you gave birth and your employer doesn’t allow for pumping breaks or have a room for you pump in.

          • Box of Salt

            Natalie TIndol Youngbloode “WIC pays for 50% of the formula in the US. Couldn’t that public money be better spent on better breastfeeding help and support?”

            No. Unless you’re planning to pay the breastfeeding women a salary to replace the one they lose instead of allowing another caregiver to feed the baby formula while they work.

            “the benefits can not be overstated because there are none”

            If there are no benefits, why are you promoting it?

          • Natalie Tindol Youngblood

            Many women work and breastfed or mix feed. Im not promoting anything I just pointed out that its the biological norm. I formula fed I dont get why yall are so defensive about me calling it what it is!

          • AllieFoyle

            I think no one is sure what point you’re trying to make.

          • fiftyfifty1

            No, I’m pretty sure that this is her message: Formula feeding = unnatural, not normative, not good enough for the Good Mommies Club

          • AllieFoyle

            That’s what I thought at first too, but now I’m just confused.

          • LibrarianSarah

            In conversation there is text and subtext. Yes the text what you said is obviously true and innocuous. Breastfeeding is the biological norm. However, nobody here said that breastfeeding isn’t the biological norm and we weren’t talking about whether or not breastfeeding was a biological norm. The text in this context makes no sense on it’s own. People don’t generally pop in and state the obvious.

            This leads people to look for a subtext. Are you saying that biological norms are preferable? What is the purpose of you pointing that out? Do you really think that we don’t know that?

            “Candy is bad for you” is also a pretty obvious and innocuous statement. However, if you walked up to an overweight person and said “candy is bad for you” that person would rightfully be quite cross with you.

          • The Bofa, Being of the Sofa

            If there are no benefits, why are you promoting it?

            She’s playing a stupid semantic game. See, there are no BENEFITS to breastfeeding, because that is the default state. Formula feeding instead, however, comes with costs, because it is an unnatural.

            See?

          • Box of Salt

            Bofa: “because that is the default state”
            As is, apparently, a lack of understanding.

            Thinking before making statements is unnatural.

          • RKD314

            Alas, as I have learned from my time on the internet, that is unfortunately not the case for all people.

          • Zakiya Ramos

            Most of mothers on assistance work but growing up a lot of the ones I saw did not. I managed to work and go to school and keep BF because it meant a lot to me. I was gone from 7 am to 8 pm due to work and school and could not afford a pump so I hand expressed in the bathroom sink to kewp my supply up and gave formula (WIC) when baby was at the sitter and BF when we were together and weekends. I know people who when they are almost due get on WIC for the fee formula with absolutely no intention of even trying to BF becsuse formula is free and what WIC dont cover food stamps will. I know people who even lie about income to get free formula. They say they are seperated or the dad who lives with them doesn’t.

          • Amy M

            “Couldn’t that public money be better spent on better breastfeeding help and support?”

            No, not if there are no benefits. That money would be better spent on helping mothers in other ways, especially those low on the SES scale. Of course women who want to breastfeed should get the help and support they need, but there seems no good reason to convince or pressure every mother to breastfeed.

          • ngozi

            I work in my local school district, and I don’t know about where you live, but here critical thinking skills are lacking pretty badly. This is true even for adults.

          • Renee Martin

            And I am sure we all agree with this. But how is it relevant to the post?

          • Natalie Tindol Youngblood

            I was replying to a comment. Really I’m just saying breastfeeding is the biological norm just like breathing oxygen. I don’t know why yall have to get all crazy because I’m saying exactly what it is.

          • Renee Martin

            And if you had put it that way, I am sure no one would have even commented on it.

          • Natalie Tindol Youngblood

            Good lord! Yall would have thought I said formula was thr devil! All I said was it was the biological norm and even said…wait for it….it doesn’t always work!

          • The Bofa, Being of the Sofa

            Um, ok. So what’s your point?

            Breastfeeding is a natural bodily function. So is pooping. But given the number of laxative commercials I see, a lot of people apparently have problems with the latter.

            You can tell constipated people that pooping is a biological normal way to eliminate waste. True, but then what?

          • Natalie Tindol Youngblood

            Good lord! Yall would have thought I said formula was thr devil! All I said was it was the biological norm and even said…wait for it….it doesn’t always work!

          • The Bofa, Being of the Sofa

            OK.

            And?

            So breastfeeding is the biological “norm.” So what?

            As I asked earlier, what difference does that make? You apparently think the fact that it is the “biological norm” must be important, or you wouldn’t be repeating it over and over again. So what is the point?

          • Renee Martin

            I think that offering the progesterone would be a great things and would add more health to the population than if all of those moms EBF for 2 years.

          • Smoochagator

            “oh well you’re not white so we’re not even gping to try and help”
            That’s really not what anyone here is saying. We’re saying that in the US, Canada, and many other developed countries, white privilege extends even to infant feeding, allowing affluent white moms to make different decisions about breastfeeding that may not be an option for poorer women and/or women of color.

          • Renee Martin

            Where did ANYONE say anything even remotely like:
            “oh well you’re not white so we’re not even going to try and help”

            Reading comprehension FAIL.
            Pointing out the problem is in no way negating a solution.

            When we rebut your ode to nature, it’s only because we do not agree that natural is better. Yes, nature did “design” mammals in a way that we can nurse our young. And it was good enough to work, and would still be good enough even now, if all we cared about was base survival of the species.

          • Box of Salt

            Nature does not design.

            It just happens.

          • Natalie Tindol Youngblood

            Most things that “just happen” in nature happen for a reason.

          • Box of Salt

            Wrong, Natalie Tindol Youngblood.
            “Most things that “just happen” in nature happen for a reason.”

            The “reason” is that particular part of nature survived long enough to reproduce.

          • Natalie Tindol Youngblood

            There’s your reason right there…

          • Box of Salt

            I will repeat for you, Natalie Tindol Youngblood, because I don’t think you understand:

            Nature does not design.

          • Natalie Tindol Youngblood

            “The “reason” is that particular part of nature survived long enough to reproduce.”
            that’s the reason

          • attitude devant

            So my breasts don’t produce enough milk. So my kids should just die and that’s ok with you? Wow.

          • Natalie Tindol Youngblood

            Saying that it’s the biological norm because of nature doesn’t not in anyway imply that you should let your baby starve

          • The Bofa, Being of the Sofa

            So what is the significance of “it’s the biological norm”?

          • LibrarianSarah

            Saying that “Most things that “just happen” in nature happen for a reason” implies that there is a good reason babies starve in nature and that it is therefore preferable for that to happen.

            If you didn’t think the reason was good than your whole argument devolves into essentially “most effects have causes” which is bordering on a nonsensical tautology.

          • LibrarianSarah

            By that logic we should let our elderly, disabled, and sick die off because nature “designed” them to die for a reason.

          • DaisyGrrl

            The biological norm also involves infant mortality rates that we would never accept in today’s society. Why should we accept the biological norm when we can improve on it?

          • LibrarianSarah

            Nature doesn’t have agency. It doesn’t “design” anything.

          • Renee Martin

            And nature designed lots of things that are imperfect! So what if nature made it, nature makes all kinds of messed up stuff.

          • Amy M

            So what? What does that have to do with how breastfeeding in the Western world has a lot to do with race, class and privilege?

            We all know that female MAMMals have MAMMARY glands in order to feed their young. And for many reasons, often revolving around race/class/privilege, breastfeeding is not ideal (or possible sometimes impossible)for some women and thankfully, humans have developed a healthy alternative.

            If we could break down the barriers of race/class/privilege, perhaps breastfeeding would be easier for more women. But, since that is not likely any time soon, maybe we can reject the white, middle-class, privileged ideal as the be-all, end-all and accept that some women can breastfeed, some can’t/don’t want to/have insurmountable obstacles preventing them and that’s fine. Currently, there are government agencies promoting breastfeeding, BFH initiatives in hospitals that promote it, and of course, lactivists all over the internet, just shouting about awesome BFing is and how awful you are if you don’t. There’s no good reason for that.

            You yourself, say that there is no benefit, science suggests there is a small, short-term benefit—if either of those two statements is true, why are we allowing the privileged white women and all of the organizations they influence, to make such a big deal of it? It’s not like BFing will cure cancer, turn straw into gold or solve poverty.

            Women who want to breastfeed should get the support they need. If they try and it doesn’t work out, then they should move on to formula wo/a backward glance.

          • Renee Martin

            If I could like this one 100x I would.

      • Guesteleh

        So is dying before you reach menopause. You sure the “biological norm” is always best?

        • Natalie Tindol Youngblood

          In most cases yes breastfeeding is the best…is it always achievable unfortunately no.

          • Guesteleh

            Breastfeeding benefits appear to be overstated, according to study of sibilings: http://researchnews.osu.edu/archive/sibbreast.htm

            A new study comparing siblings who were fed differently during infancy suggests that breast-feeding might be no more beneficial than bottle-feeding for 10 of 11 long-term health and well-being outcomes in children age 4 to 14.

            The outlier was asthma, which was associated more with breast-feeding than with bottle-feeding.
            ….
            “Many previous studies suffer from selection bias. They either do not or cannot statistically control for factors such as race, age, family income, mother’s employment – things we know that can affect both breast-feeding and health outcomes,” said Cynthia Colen, assistant professor of sociology at The Ohio State University and lead author of the study. “Moms with more resources, with higher levels of education and higher levels of income, and more flexibility in their daily schedules are more likely to breast-feed their children and do so for longer periods of time.”

          • Guesteleh

            More from the authors:

            “If breast-feeding doesn’t have the impact that we think it will have on long-term childhood outcomes, then even though it is very important in the short-term we really need to focus on other things,” she said. “We need to look at school quality, adequate housing and the type of employment parents have when their kids are growing up.

            “We need to take a much more careful look at what happens past that first year of life and understand that breast-feeding might be very difficult, even untenable, for certain groups of women. Rather than placing the blame at their feet, let’s be more realistic about what breast-feeding does and doesn’t do.”

        • Therese

          That’s not even true. Humans are one of the only animals where the females live a significant length of time past reaching menopause. It’s theorized that this is because having older females around gives offspring a survival advantage due to having the other extra help to care for them. If it was the biological norm to die before you reach menopause then evolution would have never been able to select for longer living humans and people would still die young, even with all the medical care in the world.

          • The Bofa, Being of the Sofa

            Humans are one of the only animals where the females live a significant length of time past reaching menopause.

            Now we do.

            If it was the biological norm to die before you reach menopause then evolution would have never been able to select for longer living humans and people would still die young, even with all the medical care in the world.

            This doesn’t follow at all.

            No one has claimed that evolution selects for longer living beings. It is that because we developed the brains to figure out how not to die pre-menopause. We developed better abilities to protect ourselves and our elders, and the sympathy to want to do it.

          • Therese

            Are you arguing that lifespan has no genetic component??

            Google “Grandmother hypothesis” or “Grandmother effect” for more information about the theory, it’s not just something I made up.

          • The Bofa, Being of the Sofa

            Are you arguing that lifespan has no genetic component??

            No, I’m arguing that people dying before menopause not a function of their “lifespan” but due to other things. Disease, predator, malnutrition, childbirth or other similar things.

          • Therese

            Yes, true, dying before menopause used to be much more common. I just disagree with saying it is the biological norm to die before menopause because that to me implies it is within the normal genetic lifespan of a human. Which if that was the case we would not see humans living so long past menopause today even with the best medical care, just like you’ll never see a dog living to be 60 or 70 no matter how well you take care of them because that is well outside the biological norm for a dog. Maybe it’s just an issue of semantics though.

          • AllieFoyle

            That theory is pretty speculative though. Maybe there’s something to is, maybe not really.

            And living beyond menopause doesn’t have to have been specifically selected for. In a more hostile environment, living long enough to maximize your reproduce potential is optimal, but living beyond it now doesn’t necessarily represent anything other than a safer environment. Overshooting the mark, biologically. And what’s the life expectancy of a woman in Afghanistan now? Mid-forties or something?

          • Guesteleh

            I just looked it up and it’s fascinating. http://www.unicef.org/infobycountry/afghanistan_statistics.html

            Life expectancy, 1970: 36.7
            Life expectancy, 1990: 48.6
            Life expectancy, 2012: 60.5

            This isn’t broken down by gender but holy damn, look at the differences in just a few decades!

          • AllieFoyle

            Wow, that is a huge increase!

      • fiftyfifty1

        “There are no benefits to breastfeeding it’s the biological norm.”

        Yes, this is a perfect example of what Dr. Amy is talking about in this post: the way privileged women take their own choices (in this case breastfeeding) and make them “normative” To make something normative means to use social sanctions to enforce/coerce a certain agreed-upon code of behavior. Privileged groups choose something and agree that it will be the test by which others are judged- it may be a Prada purse, it may be organic food, it may be exclusive breastfeeding. Then if others don’t measure up to this standard they are shamed. Being told you or your choices are, in effect, UNnatural is a form of shaming that is currently really in vogue.

        • atmtx

          THANK YOU!! It drives me nuts how my ap friends are all “I am not judging you. I do what I do because it’s what comes naturally to me.” Then all those choices are painted as morally superior through verbage like “why would you leave a baby to cry alone in a cage, knowing that mom and dad aren’t there for them?”
          This moralization of parenting drives me bonkers. Thank you for breaking it down so succinctly!

          • The Bofa, Being of the Sofa

            Then all those choices are painted as morally superior through verbage like “why would you leave a baby to cry alone in a cage, knowing that mom and dad aren’t there for them?”

            And what do they say when you respond, “Because it comes naturally to me”?

            I’ve said this many times before. I really don’t like the advice “follow your instincts, they are usually right.” It’s not that it is wrong, it’s that far too many people think it means “…and other ways are wrong.”

            I see nothing wrong with “there are lots of ways to do things; here are a few you can try, see if something works for you” but when it gets turned into “this is the way I do it, and you should do it that way, too” then it is not right

          • atmtx

            Usually with an exasperated sigh and a dizzying eye roll. I then follow with more or less what you said: “I’m fine with people doing things differently, but don’t make it out to be morally superior. Do what you want, but don’t judge me.” The only parenting decision I judge is people who don’t vaccinate. Open season on those fools. Otherwise, meh, but lay off me and my decisions.

          • The Bofa, Being of the Sofa

            The only parenting decision I judge is people who don’t vaccinate.

            Yeah, but that is because vaccination comes around on you.

            I didn’t become all that vocal about anti-vax until I had kids of my own. At that point, someone else’s decision to not vaccinate affected me, and more importantly, mine.

            Vaccination is a community health concern. CIO is not.

          • atmtx

            Exactly. I always thought not vaccinating to be idiotic, now it utterly pisses me off because MY kiddos are at risk.
            Other parenting decisions only affect the kid it’s being applied to, excluding of course actual abuse, which harms on a much larger scale. And I mean real abuse, not using a stroller/formula feeding/CIO/crib sleeping. People who see that as abusive need a huge reality check.

      • Renee Martin

        Biological “norm” is also dying by the time you are 35-40yrs old, losing most of your babies in infancy, losing a good % of moms in childbirth, dying from infection of small wounds, etc.

        Biological norm? LOL. AS IF we modern humans have anything to do with biological norms. Our entire existence has been a struggle against nature! And I am glad for it. I will listen to this argument when you go live a life of “biological norms”- oh, that would mean no internet!

        And I do not wanna hear anyone evoke evolution. It only makes people that are “good enough”, and allows for a LOT of wastage (aka deaths) in the process.

        That not all moms make enough milk, not all babies can successfully latch, there are vitamin deficiencies in EBF babies (even now), and B milk does not protect against brain bleeds like formula does, is proof enough for me the bio norm is not ideal.

        TRY AGAIN

        • The Bofa, Being of the Sofa

          Biological “norm” is also dying by the time you are 35-40yrs old, losing most of your babies in infancy

          Not quite most – the norm is losing something like 3/8, so “most” survive. But not by a lot

      • Amy M

        Ok then, since you are saying below that we should take this at face value, yippee! It’s the biological norm.
        And if there are no benefits, then why all the hype? I have no problems being outside the biological norm, and neither do most other people, from what I can tell.

        Incidentally, there are several factors about my family and me that are outside the biological norm—we are all below the biologically normal height for age/sex for example. Aside from having to stand on a chair to reach the high shelf and hem pants, this has no affect on our lives.

      • Sadlady

        That’s true. Normal. No benefit to normal. Maybe detriments occur otherwise.

    • KarenJJ

      Information on formula feeding, expressing, breastfeeding will not be limited in order to coerce mothers in one direction or another.

      A mother’s recovery from childbirth and mental health is a priority as much as a baby’s health his.

    • Belle

      Love this… I’d like to see it called the Family Friendly Hospital Initiative, adding:
      5. All private rooms with accommodations for fathers/significant others and siblings.