The issue is not breast vs. bottle but process vs. outcome

SuperMom

Only baby haters don’t breastfeed?

That’s the provocative title of piece in yesterday’s Daily Telegraph:

Only baby-haters don’t breastfeed…or alternatively: Bottle is better and my boobs aren’t round my knees. No other topic divides women as instantly and viciously as breastfeeding

Ask any woman who’s had a baby what her views on breastfeeding are, and you’re likely to get an impassioned defence of, or argument against doing it. Rarely has there been a topic that so instantly divides people, with women of all ages taking up militant stances whenever the subject arises – which is regularly, as supposedly scientific research throws up or debunks yet another fact/myth about its benefits.

So the news that breastfeeding does not, apparently, improve a child’s intelligence will see the battle lines drawn once again.

That’s deeply unfortunate because the truth is that the issue is not breast vs. bottle, but process vs. outcome.

No process, natural childbirth, breastfeeding or attachment parenting, guarantees a healthy, happy, intelligent, successful child.

First the bad news:

There is no process, whether it is natural childbirth, breastfeeding or attachment parenting, that guarantees a healthy, happy, intelligent, successful child.

It doesn’t matter if you have an unmedicated vaginal birth, breastfeed and “baby wear” your child.”

Now the good news:

There is no process, whether it is natural childbirth, breastfeeding or attachment parenting, that guarantees a healthy, happy, intelligent, successful child.

That means that it doesn’t matter if you have every obstetrical intervention possible, bottlefeed and never “baby wear” your child.”

Why?

There is no law of human causation. Human beings are not widgets; we cannot demonstrate with any reliability that certain inputs will produce desired outputs.

That goes double for creating the traits which we admire in the US in the early 21st Century. Human biology evolved to create the fittest people for a hunter gatherer existence. Long term health, individual happiness and the ability to do well on the SATs and earn lots of money, qualities that we prize today, were not relevant for most of humanity for most of the time.

It is nothing short of absurd to insist that breastmilk evolved the ability to prevent obesity or the chronic disease of old age in industrialized countries, heart disease and diabetes. It is nothing short of absurd to claim that breastfeeding is the first and necessary step to getting into an Ivy League University and snagging a coveted place at Goldman Sachs.

The breast vs. bottle debate has nothing to do with babies and what is good for them and everything to do with mothers and how they compete with each other. It takes decades to find out how your children turn out (“the outcome”), but women want to compete with each other in the meantime. Therefore, they compete on “the process” insisting that it predicts the outcome.

They compete on unmedicated childbirth, implying that it contributes to future success of the baby as an adult. They compete on breastfeeding implying that it contributes to future success. These notions are ridiculous. For most of human existence, all children were born vaginally after unmedicated labor (or died in the process). That didn’t ensure that all people were equally intelligent, wealthy or successful. For most of human existence, all children were breastfed (or died of dehydration or malnutrition). That didn’t ensure that all people were equally intelligent, wealthy or successful.

The bottom line is that no matter how much certain people wish it were so, breast milk does not have magical properties that ensure success. It it merely one of two excellent sources of infant nutrition with formula being the other source.

It makes no difference whether or not you breastfeed.

Call us when your child grows up and we can assess the outcome of your parenting process. Don’t fool yourself into believing, or try to convince the rest of us into believing, that the process has anything to do with the outcome.

  • Fabi

    I am so glad I came across to you blog! I so like your clear, no frills,
    honest and well balanced advice. Breastfeeding is something that speaks very
    loudly to me. God knows how much I tried to breastfeed my first-born son. 2
    weeks after he was born, my breasts were completely cut, bleeding and inflamed. But still I persevered. I had lactation consultants coming over to my place to help me with his latch, but nothing worked. Three weeks later, I’ve got mastitis. Even pumping was excruciating. The consultant suggested me to take medicines to get my milk going while I was healing. That I did, even though there was a risk to develop depression as a side effect of the medicine. Soon enough I was able to pump. My consultant advised me to pump 8 times a day, including a shift at 3pm, and put my son on my breast for 10-15mins to stimulate the milk. That I did also, religiously. My Mom couldn’t understand what I was doing. She couldn’t breastfeed us either, not that she didn’t want to, but she had the same issues I was having. “Why can’t you just give formula to your kid?” she would ask me. But for me, that would signify my failure as a mother. Thank goodness, I came to light around 2 months later. I realized that I had missed much of my son’s first 2 months of life, busy with pumping and sterilizing the bottles and pump parts every 3 hours. During that time, I slept little, I was constantly worrying about him, and worst of all, I used to feel guilty for spending so much time pumping and sterilizing. I vowed I would never do this again should I have another child. When my second one came, I knew better. I tried hard, but when the same signs started to appear, I decided I would not take medicines nor spend countless hours in the pump. I enjoyed every single moment I had with my children. I cuddle my newborn, I played with him, burped him, changed all the diaper, and gladly feed him with formula. The pediatrician wasn’t happy, but I do not regret my decision. Both kids are growing up healthy and active. That was 7 years ago. 20 days ago my sister gave birth to a healthy boy, and she too is having issues with breastfeeding. Her pediatrician told her to breastfeed the baby on demand, and to complement with formula in a teaspoon! He didn’t want to take the chance that the child would develop nipple confusion! She was still doing it by week 3. This is crazy! Why all these people are so paranoid? Why so many people think that breastfeeding is something that every single woman is capable of? Well, I am subscribing to your blog, and I thank you very much for your wise advise, and I hope other women who are struggling with all these non-senses may find help here too.

  • SporkParade

    It takes decades to find out how your children turn out (“the outcome”), but women want to compete with each other in the meantime. Therefore, they compete on “the process” insisting that it predicts the outcome.

    I know the outcome. Formula means that my baby is getting adequate nutrition and sleeping well on a full stomach.

  • Every mother and every family needs to make the choice that best supports their needs in order to have the best outcome. For some, it will be breastfeeding – others, bottle feeding. For some, having a stay at home parent – others, having both parents work outside of the home. Supporting a different choice, does not require you to make the same choice – it requires you to understand that people make different choices for a variety of reasons. The only thing that is universal – is the need to protect your children and provide for their needs as best you can. “Do Not Neglect” – it is as simple as that – but equating some of these choices with neglect is simply ignorant and cruel.

  • Medwife

    OT: nicely done, very nicely explained study on the impact of gluten-free, casein free diets on autistic kids. So no, I will not be tormenting my kid by taking away any of the already limited types of food he happily eats, thank you very much kind strangers.

    https://www.autismspeaks.org/science/science-news/study-glutencasein-free-diet-doesn’t-improve-autism-symptoms?utm_source=social-media&utm_medium=text-link&utm_campaign=espeaks

    • RMY

      I think parents who fall for that are doing so out of desperation. They’d probably amputate their left hand if there was enough information about doing that curing autism in children.

    • austisticchick

      Wow, Autism Speaks actually information that wasn’t fear-mongering? hell must have frozen over. I’m an adult with “mild” autism and loathe them for saying I have a disease that needs to be cured. So it pleases me that maybe they are finally getting the message and changing their message as well. Do they still think vaccines cause autism? That was their last stance that I knew of.

      • Medwife

        Oh no, they are definitely not in the Jenny McCarthy camp. I wouldn’t have touched the link otherwise. I know Autism Speaks is controversial for the disease model position, but I do appreciate their resources on early intervention. I have never personally walked away from their site feeling that my son has been pathologized.

  • Ellen Mary

    And my mother was a very solid mother, yet one of my brothers is facing a 5 year jail sentence if he can’t successfully rehab from mental illness & addiction. She didn’t cause that, it just is.

    • Gatita

      Yes, we put too much praise and blame on moms for how kids turn out. The kids themselves have a lot to do with it too.

      • Kelly

        One of my friends has great parents and some of her siblings have done some really stupid things. Even the judge at one point asked how the child could be so stupid since he had a good home life. She said that her Mom is convinced more than ever that kids come with their own personalities and that she did not have as much influence as she once thought.

    • RMY

      I’m so sorry. I hope your brother is able to get the help he needs. My brother-in-law is serving 11-to-life, and my wife blamed herself for it, as she was the one constant in his life as they were growing up. It’s very hard.

  • Nick Sanders

    So, a pro-vaccine group I’m in posted this screenshot:

    https://www.facebook.com/656716804343725/photos/a.660980460584026.1073741827.656716804343725/1177325302282870/?type=3&theater

    How do people come up with this nonsense?

    • Chi

      I thought jaundice was caused by EXCESSIVE bilirubin? What the heck is happening to science education and critical thinking?

      I. Just. Can’t. Even.

      • Nick Sanders

        That was pointed out in the comment that accompanied the photo, but I don’t know how, or even if, I can embed the whole thing.

      • Mattie

        Yes, excess bilirubin but LESS Billy-Ruben, Billy Ruben is the mean dude that causes jaundice =P he’s immunocompromised so scared of unvaccinated children #logic

        • Sue

          You people are SO disrepectful. It;s WILLIAM Ruben to you!

    • Azuran

      But this change everything!!! I have to get my boss to buy a new blood test machine to measure this new and innovative Billy-Ruben parameter. I can’t believe we are still only measuring stupid old bilirubin as a way to evaluate jaundice.

    • Daleth

      But Billy Ruben lives in Iowa, and I don’t even know him. How could it possibly affect him if my child gets a Vitamin K shot? I don’t understand.

      https://www.linkedin.com/pub/billy-ruben/23/101/562

      • Megan

        Poor Billy is probably wondering why he’s suddenly had a hundred or so profile views… 😉

    • Roadstergal

      Is this Billy-Ruben as in The Three Billy Rubens Gruff, or the sandwich?

    • Rosalind Dalefield

      Mr and Mrs Rubin’s icteric son Billy.

  • Sue

    “The issue is not breast vs. bottle but process vs. outcome.”

    You have neatly summarised exactly what frustrates me most about current risk-averse, hospital medicine.

    Thank you.

    • Nick Sanders

      Risk-averse medicine, as opposed to what?

      • Tiffany Aching

        I would be very scared of risk-friendly medicine…

        • Sue

          It’s about degree, TIffany.

          Modern, dumbed down “risk management” is about reducing the risk for the provider, not the customer, by changing process without measuring whether the outcome improves.

          IN obstetrics, the process-over-outcome leads to such phenomena as “baby friendly” and calls to reduce the Cesarean rate without examining the outcomes. IN this case, it is ideologically-motivated.

          In my own specialty of emergency medicine, where risk is everywhere, we are doing so much testing and hospital admission, in an attempt to minimise risk, that we end up creating more risk of harm from the testing than from the disease.

          This has nothing to do with the anti-medicine attitudes of radical NCBers.It’s about a tendency in modern societies to over-regulate to show that they are “doing something” – ie process over outcome.

          • Who?

            Thanks for this Sue. Risk can be managed, passed on, or insured against, or so the cannons of the commercial world suggest.

            In the commercial world, risk is being forced ‘down’ the chain-hence contractors (responsible for their own holidays, insurance and training) rather than employees.

            In seems in medicine, this results in too many tests, which leads to cost blowouts for little return. In a risk averse world, doing something looks better than doing nothing, even if it really isn’t.

          • Sue

            “In a risk averse world, doing something looks better than doing nothing, even if it really isn’t.”

            That’s it, “Who”, exactly.

          • Dr Kitty

            Sarah, sort of related…

            If one of my patients comes to me with a cough and dirty spit, I’ll maybe spend 5minutes listening to their chest, and provided it sounds clear, I’ll give them a self care leaflet about viral coughs and MAYBE a deferred script for antibiotics to use if things worsen over the next 72hrs.

            If they choose to attend A&E instead, and have the misfortune to see an F2, they’ll probably have blood tests, a chest X-ray, and spend 6hrs waiting, with the same outcome, except they’ll be told to contact me if they get worse, because A&E doesn’t do deferred scripts…

            I know ED hate seeing GP issues, but sometimes you’d make less work for yourselves if you did less work, and managed GP problems like GPs, if you see what I mean.

          • Sue

            Hi, Kitty

            As an emergency physician, I don’t really distinguish so-called “GP issues” – there is legitimate overlap between all the specialties for a range of acute issues. SOme are simple, some are complex, they are more or less urgent – but the common ground is the episodic illness, as opposed to chronic illness, family medicine etc.

            The problem in hospital practice is the culture that has developed around “missing something.” If that person with the cough and sputum isnt given antibiotics and then later gets a chest xray that supposedly shows pneumonia, the ED person will be crucified by colleagues for “missing the pneumonia”, which teaches them to do more XRays. The potential harm of “missing something” is readily identified, but the (more distant) harms of over-testing are rarely considered. EDs are expected to sort out diagnoses in a short time, in one episode, in patients they don’t know, and in a hectic environment. This leads to over-testing and overdiagnosis, and overall dumbing down of the clinical process.

          • The Computer Ate My Nym

            The PNA that may not have even been there when the patient comes to see you? Hard to avoid missing that one. VIral URIs can, occasionally, lead to pneumonia. I don’t know that there’s any research that says that average risk patients should be given antibiotics to prevent that relatively small risk, but people like taking medications and will get upset if they leave the ED without a prescription.

            As you point out, CXR are not totally benign, especially in young people. There’s a radiation risk, a false positive risk, etc. If the PNA is subtle enough that you can’t tell it’s there by listening and the patient is average risk (no neutropenia, HIV, organ transplant, etc) I don’t see any benefit to xraying them.

            Sorry, I’m not helping, am I?

      • Sue

        Excessively risk-averse medicine, Nick, which leads to harms from over-diagnosis.

        It’s beautifully described by UK GP Iona Heath:
        http://www.abc.net.au/radionational/programs/conversations/dr-iona-heath/6675014

        It’s about the tendency to approach risk with more tests and more policies, instead of recognising the limits of certainty and the harms of over-diagnosis.

  • JJ

    Thanks for this Dr. Amy and your other breastfeeding posts. I have decided along with my OB that breastfeeding my 4th child is not a good idea for me given that it exhausts me which contributes to me getting PPD. I felt so much happiness and relief that I almost cried when my OB was totally supportive of formula and set up a plan for me to get extra postpartum check-ups to make sure I did not start going downhill. I have already had people tell me (that know about my PPD situation) I could “try for 6 weeks”, “pump so my husband can help”, and “try viewing breastfeeding as relaxing instead”. I want to freak out on these people. I know about pumps and trying since I have already spent 4 years of my life nursing babies! I will support and defend any woman who wants to breastfeed but leave me alone!!! I just cannot believe that people think I should risk becoming mentally ill with 4 children to care for so I can breastfeed!

    • Kelly

      Agh, I hate when people say that I could just try and see how it goes. I know how it goes since it has gone awful both times. Formula from the get go has been the best decision. As someone who has had PPD and had to have my meds upped at the end of this pregnancy because of increased anxiety, I have never felt so good in the first two weeks postpartum. Tell them to go suck it. I support you for any decision you make and I hope that formula helps as much as it has helped me.

      • JJ

        Thanks for the support Kelly. I hope that you continue to feel well 🙂

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    • Lizz

      I’m glad your OB is supportive and I hope that the rest of the medical staff at the hospital cooperate with the plan. I love reading these breastfeeding posts because it takes a bit more off of that guilt complex I got from people insisting that maternal mental health and pain are selfish reasons. I pushed to the point of PPP the first time so I’m glad you had more sense then me, they’re babies for such a short time that it’s not worth either not remembering them or crying for months on end.

      Just fair warning if you’re in a super breastfeeding heavy area many women suggest making a door sign reminding them you don’t want to see the lactation consultant. They’re masterful guilt trippers and don’t like to leave sometimes. I resorted to inflating the amount of seroquel I told her I was taking by 3x after she insisted on knowing my medications before I could get one out of my daughter’s room at the NICU. Postpartum is a bad time to have to deal with pushy people so I’ve just been telling everybody because if one person can not have that happen at a vulnerable time it’s enough to make it worth it to tell everyone.

      • Gatita

        That warrants a complaint to the hospital CEO’s office. LC’s should not be overstepping that way. It’s none of their goddamned business what meds you’re taking.

        • Lizz

          I probably should have but it was hard to put two and two together because I was on a high fever from cellulitis, was on a fair amount of pain medication post-cesarean, had been sleeping in a recliner between cares and a baby who became over stressed from being touched for too long. Add all of that to family telling me that it was normal and even a good thing, I’m sure they meant well but I am the only bottle feeder in my family since the seventies.
          There’s just a lot of variables to recovery that can make coming out or complaining about this kind of thing really difficult especially if you’ve just come through being lectured by other staff repeatedly. I guess I also had a dumb worry that since all she’d have to say is that I gave it consensually because she routinely looked up medicines for women in regards to lactation and she had a big list of psychiatric medications I was on might have used that to say I was just nuts.

          • Gatita

            I totally understand why it’s hard to complain. It’s just intimidating as hell to speak up when you’re vulnerable and in pain. I’m just putting it out there in the event that someone else has a similar experience and feels up to complaining. The hospital administrators definitely want to know if something like this is going on.

          • Medwife

            I think people are hesitant to complain about LCs being pushed on them because it’s the hospital being NICE, giving them a SERVICE (for which they bill of course) so they can breastfeed their babies like all good mothers should do if they have at least one breast. But they should complain. I am under pressure to automatically make LC referrals for my postpartum patient unless they explicitly say they don’t want to see her. Policies like that will change if it affects the patient satisfaction numbers.

          • D/

            Patient satisfaction definitely impacts how care is delivered, but much of the current policy change is being driven by JCAHO. I’m still wrapping my head around JCAHO’s decision to retire the second breastfeeding core measure (on October 1st) which takes into account feeding preferences and factors the mother’s choice to formula feed into the whole picture of exclusive breastfeeding rates.

            Maternal medical exclusions have also been eliminated since they are “unusual and only affect ~ 2% of patients”. All eliminated so resources can be focused on improving rates for exclusive breast milk feeding and not all the data collection challenges related to maternal feeding preferences and medical exclusions.

            ~~~~~~~~~~~
            From the JC Online update:
            “However, because some women do not want to exclusively breast feed despite recommendations, and since The Joint Commission is not accounting for these preferences, The Joint Commission expects that performance on PC-05 will remain well below 100 percent. … Available evidence suggests that a performance rate of 70 percent on PC-05 is an achievable target for hospitals to strive to achieve.”

            http://www.jointcommission.org/assets/1/23/jconline_May_6_2015.pdf
            ~~~~~~~~~~~~~

            Beginning January 2016 all hospitals with >300 deliveries per year (down from 1,100) will be required to report exclusive breastmilk feeding rates.

      • Dr Kitty

        Never mind the door sign.
        Shout “Security! I have a stranger in my room who refuses to leave!” if a LC oversteps.

        • KeeperOfTheBooks

          This made me giggle outrageously.

        • autumn

          My SIL had to do this. The b—- wouldn’t leave, her husband was in the lobby calling relatives to announce the news and so she screamed for security. She said that LC ran for the hills, and security said that she was not the first one to call for forcible removal of the LC. And SIL had a note on her door for the LC to not come in too.

    • Allie

      My standard reply to unsolicited advice is “how nice” (spoken with a sweet smile and subtly condescending head tilt). Stumps people because they don’t really know how to respond, and as a result it tends to be a conversation stopper.

      • KeeperOfTheBooks

        *takes note*
        I am so using this in the future!

        • moto_librarian

          “Well bless your heart!” is also quite effective.

      • Rosalind Dalefield

        You’re so polite. I say calmly ‘Thank you for your unsolicited advice which will now be summarily ignored.’ If they persist, I say ‘What part of ‘summarily ignored ‘ did you not understand?’

    • Tiffany Aching

      I don’t know anything about PPD but I’ve been struggling with clinical depression for many years and the only advice I can give is : don’t feel you have to listen to any advice except those from you psychiatrist (so that means you should definitely feel free to ignore my advice too :)). People who haven’t been there and have no medical knowledge of depression can be incredibly hurtful and useless in such situations.

    • demodocus

      amen. No amount of trying to convince myself that nursing is relaxing actually made it so.

    • Allie P

      Eff those bees. I had an awful time BFing my 1st, am having a grand old time BFing this one, and don’t care how other people feed their babies, as long as the babies get fed. Formula is marvelous, and breast isn’t “best” for many, many moms. Take care of yourself!

    • Cartman36

      Good for you making the best choice for you and your new baby. I wish you the best.

      Next time some hater encourages you to “just try” remind them to just try not being an a**hole. 🙂

  • Bugsy

    Hands down one of my favorite posts. Thanks so much, Dr. Amy. 🙂

  • Blue Chocobo

    Breastfeeding, competitive? No way! Of course it’s all about the baby! Pay no attention to this meme Breastfeeding Mama Talk shared this morning on Facebook…It’s about “celebrating” not icky shaming.

    • Amy M

      It should be a bra—like a glittery bra, a brass bra, etc.

      • Alexicographer

        “We” don’t need no stinkin’ bras! Bouncing (and sagging) are natural 😉 !

    • Roadstergal

      DIAMOND BOOBS WITH JADE CRYSTALS AND DIAMOND NIPPLES.

      I can’t even start with the ridiculous. I guess I can try to start with being that breast-obsessed and still having to call them boobs… but of course, crystals. Always crystals.

      If you really want crystals on your tits, get your nipples pierced.

      • Angharad

        Uh, you can’t pierce diamond, der. /s

        • Roadstergal

          I’m still giggling like an eight-year-old. Glitter boobs. Ruby boobs! Click your boobs together three times and say, “There’s no food like BM! There’s no food like BM!”

          • Angharad

            Ruby Boob and the Glitter Nips sounds like a great band name.

          • The Bofa on the Sofa

            Ruby Boob and the Glitter Nips sounds like a great band name.

            Right up there with

            “Block and Tackle”

            and

            “Lovin’ Spoonful”

          • demodocus

            rofl, bm means bowel movement to me.

          • Roadstergal

            I went to Bryn Mawr. :

    • Angharad

      Surely I can’t be the only one whose mind doesn’t jump straight to nourishing babies when I hear “glitter boobs”?
      This whole thing is giving me bizarre mental images.

      • Blue Chocobo

        The only acceptable reaction is “yay breastfeeding mamas”. All other reactions are sexualizing or bashing, regardless of logic, intent, or actual word choice.

        But this is totally NOT contest. The awards are for participation, not icky “winning”.

        • Angharad

          Obviously your brass participation award is totally equal to my diamond, jade, and platinum award. No value judgment here!

        • Jenny_from_da_Bloc

          The whole award system is petty and childish, not to mention demeaning. It’demeans the time and effort women put into motherhood and their children. That’s why people make fun of and disrespect breastfeeding mothers in public. It contributes to the unfair presumption that women who bottle feed are not as good as mother who breastfeed. Awards are given because someone has performed better than everyone else or somebody has done something outstanding and worthy of recognition. Breastfeeding is just one of many ways to feed an infant, nothing really special because most women who give birth, lactate; it’s a normal biological process. This meme makes it a contest between woman who breastfeed and those who bottle feed and even those who breastfeed the longer are better. It’s not funny or cute, it’s offensive and contributes negatively to breastfeeding, formula feeding and motherhood in general. I’m not easily offended at all, but this offends me. And anybody who is breastfeeding their 48 month old, also know as a 4 year old is just doing it to stoke their own ego and is not doing it to benefit their kid but doing it for attention.

          • Blue Chocobo

            “That’s why people make fun of and disrespect breastfeeding mothers in public”

            Lactivism is why I stopped breastfeeding in public.

      • FrequentFlyer

        A real champion breastfeeder should have no problem tandem feeding a toddler and an infant while working the stripper pole, right?

    • Sarah

      I’m just glad they managed to leave pearls out of it.

      • The Bofa on the Sofa

        I’m just glad they managed to leave pearls out of it.

        Nicely done. 🙂

        • Sarah

          Thank you. I’m here all week…

    • guest

      I have silver boobs with brass nipples! Or do I have to give back the nipples because after seven months I said fuck it and switched to formula for personal preference alone? I wouldn’t mind giving them back – silver and brass clash with each other.

      • Roadstergal

        I think you are now entitled to sing ‘silver boobs’ to the tune of ‘silver bells.’

        • Sarah

          Fancy breast pumps, painful boob bumps
          Nighttime feedings for hours,
          On my shirt I can see some more leaking.
          Constant switching
          Baby pitching
          High pitched screams to the air
          But at least my new trophy will be

          Silver boobs
          Silver boobs
          Look at that poor mom with bottles
          Silver boobs
          Silver boobs
          This will be worth it one day

          • AirPlant

            Marry me.

          • Dr Kitty

            I love you.

          • Roadstergal

            Please accept, with our gratitude, one Internet.

          • Sarah

            It just goes to show that you can still win internetz even if you were formula fed as an infant!

          • Rosalind Dalefield

            Could you do another chapter with some reference to the scent of sour breastmilk?

    • AirPlant

      So just asking. The duration of nursing is supposed to be dictated by the child, right? LIke you nurse on demand until the kid decides that they don’t want to any more and then it stops and that is supposed to take anywhere from 2 to 7 years. So just going with that as an assumed fact why would you get extra accolades for extra time? Are you supposed to force the kid to keep at it so you can get you diamond nipples? What is better about self weaning occuring at 4 years instead of three?

      • Chi

        In my opinion, extended nursing is less about any real nutritional needs of the child (cos let’s face it, they should be well and truly onto solid foods by 2 years, barring developmental delays) and more about:

        1) the mother being unable to let go of the ‘breastfeeding relationship’, especially if they struggled to initially.

        2) the mother wanting ‘bragging rights’ with all her other rabid breastfeeding buddies.
        3) Rubbing it in the faces of all those ‘bad, lazy’ etc mothers who switched to formula for whatever reason.

        So REALLY, it’s all about the mother. Once again, the child is relegated to the position of ‘prop’.

        And I quite personally agree with the comment above that anyone who feels the need to make up a prize/ranking system for how long they breastfed, MUST suffer from either extreme narcissism (cos who the hell really CARES how long they breastfed for, other than other lactivists?) or extremely poor self-esteem. Most likely a combination of both, as they are narcissistic enough to think it matters, while lashing out at anyone else who made different choices because to them and their poor ego, the choices of others somehow invalidate they choices THEY made. If that makes sense.

        Mothers need to stop using their children as status symbols. They need to realize that there is no one definition that defines a ‘perfect’ parent and that at the end of the day, it matters a hell of a lot more that their child is adequately nourished (by whatever means) and loved than any of the other nonsense that NCBers, attachment parenting proponents and lactivists spout.

        • Blue Chocobo

          Extended nursing can be about the kid; just like a pacifier or a blankie, some kids aren’t ready to give it up easily and their parents choose to wait for whatever reason.

          The “wait for more emotional maturity in the toddler” group, and the “platinum boobies” group are probably not overlapping much, though, and you won’t hear much from the former.

        • Allie

          I went to 23 months and it had nothing to do with 1, 2 or 3 above. It’s just the way it was for us. My daughter loved nursing so much. Every time she saw me she’d say “I want to mum-mum”. Also, she was a terrible sleeper. Always was, still is in some ways, but up until almost 22 months she was up every two hours like clockwork, and I didn’t know how else to cope. Nursing was the best and easiest way to get her back to sleep. So, nursing was a bit of a crutch, but never something I didn’t let go of. When she started sleeping through the night, I was finally able to stop and I never looked back. I never planned to breastfeed that long, and I didn’t particularly enjoy it, but it did have its pluses (never having to fuss with a lot of washing and sterilizing being a big one). Do I deserve a ridiculous, made up award for feeding my baby in the way that suited us best? Of course not. Although I think I deserve a sparkly, golden, ruby encrusted pillow for not smothering my husband to death in his sleep during all those long months of interrupted sleep : )

          • Inmara

            It was the same with my sister-in-law – nursing every 2 hours day and night from the beginning until 20 months. Then her husband got fed up, kicked her out of bedroom and made their toddler to sleep through the night in very short time – without scent of milk and her boob in close proximity it was doable.

          • Allie

            We thought about trying that option, Immara, but my husband is a sudden and deep sleeper. Honestly, it’s like he has narcolepsy or something. He’ll even fall into a deep sleep in mid conversation sometimes, so I didn’t feel comfortable trying it. I don’t know what I would have done if the constant waking had continued much longer, but thankfully it resolved on its own. For the weaning, I used an aversion technique that involved the application of garlic oil and lemon juice directly to the nipple. It worked like a charm, although she ran around the house yelling “yucky, yucky, yucky” for a while. About a month later, though, she was sick and upset and crying a bit and she said “I want yucky”. That broke my heart a little, but I’m glad I weaned her and we have moved on and found new ways to relate.

          • Inmara

            It’s great that you found out what works best for your family – as everyone should, despite opinionated people in internet who may insist that something is right and something is wrong for everyone. And apparently all parents sometimes have to stick to some tough measures in order to maintain good sleeping or eating habits in children.

        • anotheramy

          I’m not so sure about that. For myself and 3 other extended nursing moms I know, we didn’t plan to nurse as long as we did (and we’re kind of embarrassed), but it was the only way to get our kids to sleep or nap. My second child really liked the comfort of nursing and it was hard for him to give it up. He could be really persistent with his crying. I was told “just wait a bit longer till he’s ready” but he was just never was “ready”. I eventually realized he wasn’t gonna cooperate with weaning, and I had to be tough about it, despite what the books said.
          When the topic of nursing comes up (which isn’t often) I underestimate how long I nursed, since I am embarrassed he didn’t wean sooner.

          • Chi

            Sorry, perhaps I should have been a bit more clear. Women who feel the need to make up those stupid, self-presented awards for extended breastfeeding and then proceed to pat themselves on the back and brag about it. They are the ones I was referencing in my 3 points.

            I understand there are other reasons for extended nursing, usually relating to the emotional immaturity of the child and in that case, if that’s what works for the mother and child, then that’s what works. I didn’t mean to come across all judgey on mothers who legitimately choose that because it’s what works for them and their child.

            The problem is, the MAJORITY of extended nursers that I’ve come into contact come into 1, 2, or 3. Until this blog I’d never heard stories like yours. All the other stories were ALL about the mothers and their rights to go ‘look at me for having my 4 year old hanging off my tits, aren’t I awesome?’

            So sorry, limited scope. Plus I’m an evil evil formula feeder so I COULDN’T have done the extended nursing thing, even if I had wanted to.

          • Blue Chocobo

            The reason you don’t know about the mothers around you that did extended breastfeeding to meet their toddler’s needs is because they aren’t interested in drawing attention to it. They’re doing it for the kid, not the publicity, and bragging about it would be as odd as bragging about your toddler still using a pacifier, bottle, lovey, or any other comfort object. It’s mundane, not award-worthy.

        • Wren

          Honestly, I nursed to 35 months with my second because it was easy, not for any accolades. The last feed to go was late at night, when she would get up and come to my bed, latch on, then put herself back to bed. It was easier than dealing with her elder brother’s request for a drunk of water in the night at the same age really.

        • Amy M

          Eh, maybe for some. I have a good friend who technically breastfed until her daughter was almost 3. The child used nursing as comfort, and would usually only go to nurse if 1)she was upset or 2)before falling asleep at night. My friend was not especially proud of this and rarely brought it up. She was very tired and annoyed that this kid wouldn’t stop on her own. She didn’t love it, but it was also a surefire way to calm the kid, so she didn’t force the issue for a while.

      • Bugsy

        …because according to the bible of breastfeeding (“The Womanly Art of Breastfeeding”), you’re supposed to follow the kid’s lead on everything except if they want to stop before your breastfeeding circles believe it’s appropriate. If the kid wants to wean earlier than you do, the kid obviously just doesn’t know what’s best.

        The sad part is that from my first-hand experience, the longer you can force the kid to continue nursing, the more awesome of a parent you appear to be in certain circles.

        • JJ

          Yes to this!

    • Fallow

      So what I’m getting from this, is that I should have stopped breastfeeding at 5 months. I could have had solid ruby nipples with glitter nipples. That sounds like my style.

      • Fallow

        I meant ruby boobs with glitter nipples. I guess I just like saying “nipples”. :

      • Dr Kitty

        I stopped feeding my daughter somewhere between 14 and 16 months, but five years later I can’t remember exactly how old she was, because….it was five years ago and it doesn’t matter.

        Except, clearly, to the kind of person who cares whether or not her golden boobs have jade nipples.

        • D/

          It’s interesting how fifty plus years (of gravity) has affected my feelings toward my evidently award-winning, platinum-plated silver boobs with tungsten nipples (unpublished, ultra-level award after a never-broke biter). Dragged whatever misplaced bit of pride I might have ever had in them right out … and left them hanging like softballs in tube socks.

      • Tiffany Aching

        Elegant and timeless.

    • Dr Kitty

      Are we nine years old?
      Someone actually sat down and invented lots of meaningless pretty prizes to award themself and their friends.

      Lady, I’m not judging you for breastfeeding your toddler, I’m judging you for awarding yourself an imaginary gemstone prize for doing it, and coming up with a ranking system for said imaginary prizes.

      My take away from that handy chart is that women who would use it are emotionally fragile, immature and possessors of chronically low self esteem.
      I don’t care how long or by what method you fed your child…if having “diamond boobies” genuinely feels like an accomplishment, you’re not winning at life.

      • The Bofa on the Sofa

        As my brother used to say, “What do you want, a cookie? ”

        • demodocus

          While breastfeeding? Heck yeah!

          • Allie P

            What demodocus said. I’m STARVING all the time — way more than when pregnant. And thirsty. Jesus, this kid is sucking the life out of me.

        • Amy M

          My mom always said “You want a medal or a monument?”
          The responses to it were (if you said “medal”): Not enough chest to pin it on.

          And “monument”: Not enough sh*t to build it with.

      • Cartman36

        That is exactly what I though when I saw this. How lame is your life if you have time to do this?

    • Megan

      Can I use Glitter Nipples as my stage name?

      • autumn

        If I can have Jade Nipples 😉 Though my real name already sounds like a stripper name.

    • Bugsy

      So 15+ months has jade nipples. That explains it. My nipples – not to mention the rest of me – were feeling pretty darn jaded by 15 months.

    • Who?

      This woman has no grip on the value of precious metals and gems. If time served equals value spent, ruby should be way at the end not up front.

      Ignorant on so many fronts.

      • demodocus

        especially a good ruby the size of even a small boob

    • Nick Sanders

      I can’t be the only one creeped out that this thing goes past two years, can I?

      • Lizz

        I was thinking I was overly tired and couldn’t being reading 48+ months. Maybe it’s too bad these aren’t actual awards so that these kids could sell them to cover their psychiatrist bills in the future.

      • Allie P

        I think they are talking about multiple kids. Like I have now breasfed for 12 months. They talk about cancer risk reduction for every two years a woman breastfeeds… well, she’s probably not doing it for 6 years except with multiple kids.

        • Nick Sanders

          I rather doubt it. “Extended” breast feeding has it’s own cult…

    • Lizz

      Even if these existed they would be so tacky that no one would want to see them. It’s like those golden penis shaped porn movie awards, the only people who are interested in knowing have entirely too much interest in how other’s use their body parts. As a plus though if I had ruby boobs I could at least pawn them for at least the $80+ I spent on specialty nursing bras.

    • KarenJJ

      No fembot boobs?

  • Sarah

    “The breast vs. bottle debate has nothing to do with babies and what is good for them and everything to do with mothers and how they compete with each other.”

    I don’t understand wanting to compete. I regularly feel like this person when I meet other moms:

    https://www.youtube.com/watch?v=RUFT35S7Jb4

    • Cartman36

      Preach it sister! Dr. Phil said something once about if the point of the competition is to tear down the other person why is that a competition you want to be in. People don’t stand at the finish line of Iron Man and mock competitors that came in behind them. And that is a real accomplishment to brag about, not just a bodily function.

  • Amy M

    Amen. I just saw this concept in action on (where else?) facebook this week. It was a screenshot of a woman (let’s call her Mom A) saying that another woman (Mom B) in her Mom Group was giving up breastfeeding and everyone else in the group were (horrors!) letting her off the hook! Mom A’s opinion was that the best way to do all things baby is the hard way. She claimed that she’d been guilty of “taking the easy way” sometimes, but she felt that mothers should always strive to give their babies the best, even though that meant that the mothers would be uncomfortable.

    She saw no distinction between “difficult and inconvenient” and “best.” Where does this idea come from, that finding a way to accomplish something more efficiently is lazy and harmful? Sure, sometimes people are careless and do things sloppily—things that don’t really matter, like cleaning the floor or making dinner. I would argue that 99% of parents aren’t ever being careless when it comes to their children.

    Then there’s the idea of “best.” There’s no scientific consensus on the best child-rearing philosophy. In this case, the short term “best” outcomes (is the baby fed, warm, given medical care and loved) are pretty universal, but how those things are accomplished (and by whom) is not as important.

    • Kelly

      I had a lady come visit me at home and I know she is a home birthing, organic, no epidural nut. When I was asked about my birth and I answered that I had the best induction with an epidural before I even got the pitocin and how I was formula feeding, I thought her head was going to explode. I have taken things the hard way and it made my labor miserable and it made me a terrible parent. My husband even mentioned to me how sane I am. There are times when the easy way is not the best but if it is not hurting anything, why do they care?

      • Inmara

        My husband mentioned that he’s glad I’m not fallen into lactivist trap and we started to supplement at 3 weeks when baby definitely was not gaining enough weight. And subtly so did our pediatrician because she has seen babies who still have their birth weight at 1 month appointment but mothers stubbornly breastfeed because nobody has told them that formula is also an appropriate option.

        • Kelly

          My husband had never heard of all this crap until we had children and he is disgusted with it. I am glad your husband supports you.

          • AirPlant

            I explained the BFHI to my mother (who breastfed both of her children btw) and she said that it was nothing short of barbaric.

          • Inmara

            Mine was also blissfully unaware of hottest topics of mommy wars but I have entertained him with it during my pregnancy when I started reading through Internet resources. Also he heard me hissing and pouting under my breath during prenatal classes when midwife managed to rattle off several NCB myths in a matter of 5 minutes.

          • Kelly

            The only reason he knows is because I did the same.

      • sdsures

        “There are times when the easy way is not the best but if it is not hurting anything, why do they care?”

        Because they’re nosy little bastards with no lives.

        • AirPlant

          That’s…. fair.

          • sdsures

            I could call them something else, if you wish.

      • Bugsy

        Because it’s one more opportunity to showcase how your poor choices make theirs look even better. The mom I knew who bought into this took the hard road with everything. The friendship I had with her (since faded) made me absolutely miserable in that her decisions were always couched in smug superiority and with statements such as “this is the _proper_ way to parent.” I quickly learned to stop sharing a damn thing about my own parenting, since it always became a segue into her emphasizing her own awesomeness at parenting. On that type of scorecard, any “easy” decision makes us out to be failures at parenting.

    • Blue Chocobo

      I find “difficult and inconvenient” to be indicators of “needs improvement”, not “best”.

    • AirPlant

      I always thought parenting was about knowing when to make the right compromises. We have probably all read about how too much screen time is no good, but I don’t know a single parent who doesn’t throw an ipad at the problem on occasion. Sure, it would probably be ideal to have a conversation or redirect or use the moment as a life lesson, but at some point it is just easier to let technology calm your monster so you can finish the shopping. Screen time is an easy tool that can solve a lot of difficult problems when used intellegently. That doesn’t mean that it is ideal to let you kid veg for 20 hours a day, and maybe a study will come out that shows conclusively that screen time turns kids into autistic sociopaths and I will have to revise my opinion, but for now I will use electronics in moderation to make my life easier and there is no shame in that. There is no reason that parenting should be a dull, joyless slog just because someone else thinks that is the only way to prove that you care.

      • AirPlant

        Related: The moment I figured out why Saturday Morning was cartoon time on TV was the moment I knew that I had become an adult.

      • Tiffany Aching

        Travelling by train is a much more enjoyable experience since the invention of the ipad and other tablets, in my opinion :).

        • AirPlant

          I live connected to my phone. I really have no place judging a toddler.

          • Tiffany Aching

            This exactly. We expect things from kids that we would never dare expect from adults.

    • Roadstergal

      “Where does this idea come from, that finding a way to accomplish something more efficiently is lazy and harmful?”

      Shouldn’t that be a wonderful object lesson for a child – life hacks that get you to the same place with less effort are a _good_ thing?

      There are some things that are worth doing the long way because the long way is enjoyable and you take pride in it, and that’s also a good life lesson, but that ain’t everything.

    • FrequentFlyer

      Occam’s Razor does apply to a lot of parenting situations, doesn’t it?

    • Megan

      I think there’s research out there somewhere that shows that the harder you work at something, the greater the perception of the benefit of the outcome. I could be wrong about that. I think it has to do with cognitive dissonance. If I worked hard for something, it must be good or I wouldn’t have worked so hard, right?

  • EllenL

    This was in my Facebook feed today:

  • Roadstergal

    Perfect post.

    “Ask any woman who’s had a baby what her views on breastfeeding are, and you’re likely to get an impassioned defence of, or argument against doing it.”

    Actually, for the latter, I usually hear an embarrassed excuse as to why they aren’t BF. I’ve only once in person heard a parent mention formula-feeding her kids in a “no big deal” way.

    • Sarah

      You’re my hero. I still catch myself going “Well, I didn’t produce enough, so…” when it’s really no one’s business and I shouldn’t feel the need to qualify my feeding choices.

      • Inmara

        Whenever someone who’s not my family or close friend will ask about feeding I’m ready to say “Our baby is being fed, thank you!” Or telling that we’re combo feeding in a “no big deal” way because it’s really no big deal.

        • Blue Chocobo

          That’s a great way to help #normalizedecency

        • KeeperOfTheBooks

          I don’t know if you’re familiar with the etiquette columnist Judith Martin, who wrote under the name “Miss Manners,” but the first comment is exactly what she recommends in dealing with nosy people–delivered, naturally, in a gracious-and-polite-but-firm way that brooks no further questions. I used it once myself, when some total stranger walked up to me to ask if I was breastfeeding.
          I do love Miss Manners…

    • DiomedesV

      I just straight up tell people my kids were FF. No beating about the bush. People are generally surprised, given the crowd we surround ourselves with. I’m not even remotely embarrassed. Sometimes I even talk about how awesome I think formula is. But only if I know the other person is likely to be interested. In reality, bottle vs. breast is not a topic I hear a lot of discussion about.

  • Daleth

    You have hit the nail on the head! Thank you.