The insistence on idealizing breastfeeding makes lactivists appear heartless

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I recently wrote about the way that lactivists, including lactation professionals, invoke “lack of support” as a rationale for ignoring women who can’t or don’t want to breastfeed.

Tell lactivists that you don’t want to breastfeed and they’ll insist that you would want to breastfeed if only you received support.

Tell lactivists that breastfeeding is painful and they’ll insist that it wouldn’t be painful if you had received support.

Tell lactivists that you don’t produce enough breastmilk and they’ll tell you that is a misperception due to lack of support or, alternatively, that you would be producing enough if only you had the correct support.

That explains why lactation professionals feel perfectly justified in ignoring both women who have breastfeeding difficulties and the infant disabilities and death that result in ignoring those difficulties.

In the best case scenario they are deluded; in the worst case scenario, they are lying.

But that doesn’t explain why lactation professionals feel justified in ignoring and vilifying me. Consider this recent Twitter exchange.

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I had been taking Prof. Amy Brown to task in the wake of baby Landon’s death from dehydration due to insufficient breastmilk. Although Brown was willing to acknowledge that breastfeeding can be deadly, she refused to acknowledge just how often insufficient breastmilk occurs. The incidence is not rare; it is common. Brown didn’t give a small number; she knew I would ask for proof and she wouldn’t be able to provide any. She refused to give any number at all.

Pediatrician Dan Flanders parachuted in to offer what he presumably thought was a witty response:

I consider it an honor to be the target of Amy’s trollery.

Trollery?

Not to put to fine a point on it, but my academic credentials are likely superior to either those of Dr. Flanders or Prof. Brown. Moreover, since I breastfed my own four children I probably have as much or more experience breastfeeding as Prof. Brown and infinitely more than Dr. Flanders. Neither knows more about breastfeeding than I know, yet they feel free to dismiss my writing and my warnings.

Why? Because like most lactivists they are ideologues and the fundamental tenet of their ideology is that breastfeeding is perfect. How dare I point out that not only is breastfeeding imperfect like any other bodily function, but that it has real risks of injury and even death?

In many ways professional lactivists like Prof. Brown and Dr. Flanders undermine their own cause. Pretending that there are no risks to breastfeeding is like pretending there are no risks to pregnancy. No matter how much they want to believe in the Tinkerbell theory of childbirth and breastfeeding — you can only be successfully if you believe — no amount of believing prevents miscarriage. Similarly, no amount of believing increases milk supply.

In the best case scenario they are deluded; in the worst case scenario, they are lying. In either case, they demonstrate themselves to be untrustworthy, not to mention heartlessly cruel. Baby Landon is dead because lactation professionals insisted that everything was going well when Landon’s mother told them she thought he was starving. Rather than address that issue, both Brown and Flanders prefer to whine about me.

Sadly, they are recapitulating the behavior of an earlier generation of physicians whom they presumably despise. Those physicians believed that formula was the perfect food because it was “scientific.” They discouraged women from breastfeeding as a result. They were wrong, but they had the best of intentions. They truly believed what they said and that their paternalism was thereby justified.

Similarly, professional lactivists like Prof. Brown and Dr. Flanders sincerely believe that breastmilk is the perfect food because it is natural. They discourage formula feeding as a result and feel it necessary to demean anyone, no matter how personally and professional qualified, who dares to disagree with them. They are wrong, even though they appear to have the best of intentions. They truly believe what they say, but their paternalism is just as ugly as that of the generation of providers who promoted formula.

Let me speak directly to Prof. Brown and Dr. Flanders:

Breastfeeding is NOT perfect!

Believing breastfeeding is perfect is NOT the key to successful breastfeeding.

Informing women of the risks of breastfeeding does not undermine breastfeeding.

Idealization of breastfeeding harms, indeed kills, babies and mothers.

To the extent that you ridicule anyone who disagrees with you, you aren’t merely acting like heartless fools. You are harming both babies and mothers.

And that’s not funny.

  • My daughter got TONS of support. After successfully feeding with EBM (she has truly impossible nipples but makes gallons of milk) two children, this time she was just totally overwhelmed. 2 small kids, working in a family business which meant she needed to go into the office at least a few hours a week (maternity leave’s a luxury for the self-employed), a family crisis on her husband’s side of the family, a colicky baby, no time to pump let alone feed — she turned to me in despair. “I just can’t manage, there aren’t enough hours in the day, but I feel bad about the baby not getting BF for the same length of time the others did”. My support consisted of having the baby sleep over with me two nights a week, so my daughter could get some rest, and slowly weaning granddaughter onto formula (big possibility she’s lactose-intolerant). My daughter was so exhausted that she dried up within 48 hours despite previously pumping almost a liter a day. The “support” she needed was rest and reassurance. We’re all fine now.

    • Sarah

      Well done. You all did really well.

  • GiddyUpGo123

    The thing about the whole “you failed because you didn’t have support” argument that just gets to me is that lack of support, for women who truly want it and feel like it will help them, is almost always financial. When I was trying (and failing) to breastfeed, a lactation consultant cost $100 an hour. I am in the middle class and it was still hard to come up with that kind of money given all the other expenses we had at the time. For someone in the lower classes, even one consulting fee would be impossible. And for me personally, clearly the two visits that I did pay for with my last baby weren’t enough since I wasn’t successful at breastfeeding. So how much support is “enough support” and more importantly, exactly how much money does one have to spend in order to attain that utopia of “enough support?” My guess would be that it would be financially impossible for all but the most privileged families to get to that point, even if there was a possibility that “enough support” could actually fix things like low supply.

    • Ken S., As Seen On Watch Lists

      Sounds like the chiropractic scam, where they will, as a rule, claim to be able to do more if you just come again, I’ve gone ahead and scheduled you for next Tuesday at 2:00, does that work for you..?

      They just have higher prices since eventually children stop getting breastfed, but good chiro marks will keep coming until they die.

  • Charybdis

    OT (Sort of). I’ve been scarce lately due to Very Stressful Life Things, but has anyone heard from Erin lately? I know she was having a hell of a time with getting her general anesthetic CS approved and agreed to in advance by TPTB.

    • Dr Kitty

      No, I’m hoping it means she has hands full at present and is doing ok, but I won’t really be content until I see a post.

    • CSN0116

      That’s terrible 🙁 I had two maternal-requested cesareans under general anesthetic. My OB was extremely supportive. I wonder where she’s located that she was struggling? Or perhaps I just got lucky?

      • Charybdis

        She’s in the UK, fighting against the NBA and midwife culture there. She had a shambolic first delivery and was struggling to have her concerns addressed and taken seriously.

    • AnnaPDE

      No, but I was wondering the same thing recently, too. Hope she’s doing well!

  • Cartman36

    Oh, and if I read one more comment that says people shouldn’t have kids if their aren’t willing to BF I might throw my computer out of the window. I sometimes look at the profiles of the people that make these kinds of comments and I would bet that they would not want a random internet stranger to tell them that they shouldn’t have kids because they don’t live in the nicest house, drive the newest and safest car, or whatever the random stranger thinks is “best”. FED is best!

    • sdsures

      IKR? What about those of us who would like to try breastfeeding, and it may or may not work out depending on how our bodies tolerate it, whether we have a lifestyle that makes it possible to be a lactating machine in 24/7 service to the newest member of the family, etc? We ALL want the best for our babies, and formula is a perfectly acceptable form of nutrition.

      • SporkParade

        That’s my position. And the answer is that I’m lucky both my kids were naturals at breastfeeding because there is *no* support for women who want to try breastfeeding but aren’t committed to it. All of the mainstream resources out there have an agenda that women *must* *breastfeed* *exclusively*, and the information they provide reflects that.

        • sdsures

          I don’t think my reply to that kind of pushing would be appropriate for a family-friendly environment. *steam comes out my ears*

    • Mark

      “Shouldn’t have kids if they are not going to breastfeed”

      Wow a new low. I can’t believe anyone would say that.

    • Hannah

      And what about people like me who found out in the second trimester that I wouldn’t be able to breastfeed? What should I do, kill myself as soon as the kid gets here? Have an abortion of a (very wanted) child and never try again? Go off my meds and die so he can get a few months of breastmilk, but never know me? Because those are pretty much my options. These ‘people’ can piss off.

      People like this make me GLAD I can’t breastfeed due to my meds. Because at least they can’t make me feel guilty for it; my meds aren’t safe, I AM doing what is best for him by withholding the boob. (or will be, once he gets here). Formula will be perfectly safe and healthy for him, and as a bonus, my mental health will be better being able to tell these twatwaffles where they can go stick it off the bat

    • CSN0116

      8 out of 10 babies will be fed formula. Not to borrow tired propaganda, but formula feeders are the silent majority. They are the ruling class. They just need to realize it.

    • MI Dawn

      I remember when I was pregnant with my first, and my neighbor across the street was, also. I was planning on breastfeeding until I had to go back to work. She (rather defensively) told me she was going to bottle feed. She was shocked when my reaction was “OK, cool” rather than “OMG you are a horrible person.” But I honestly didn’t care. Her body, her choice.

  • Cartman36

    I think I would also add that in addition to appearing completely heartless, lactivists often seem completely out of touch with the realities of life for many women. I found BF to be painful and inconvenient and I have every advantage (private office, good medical insurance, disposable income). I cannot imagine how infinitely more difficult BF is for women struggling with addiction, incarceration (or the incarceration of their partner), homelessness, hunger or other issues. I think we would all benefit from having more grace for other women who are in situations that we cannot even begin to understand and thus make different choices based on their unique situation.

    • myrewyn

      or just plain having to go back to work. I would say having an office job is a minority.

    • Krystle Dolbow

      Their privilege causes them to not see/understand that. I honestly don’t think they even want to try to understand.

  • 3boyz

    I am convinced that the reason you hear more about breastfeeding making weight loss easy than about it making it hard (even though both scenarios are probably equally common) is because lactivists can’t admit that there can be anything negative about breastfeeding. I am unfortunately in the can’t-lose-weight-while-breastfeeding camp. It hasn’t stopped me from choosing to breastfeed each of my kids for about 2 years, but it was definitely a big shock when I first realized that breastfeeding was the likely culprit for my weight frustrations (I’m also insulin resistant, which doesn’t help matters). And I know so many others who have beaten themselves up over not being able to get the baby weight off, wondering what the hell is wrong with them when “everyone knows” that breastfeeding makes the pounds melt away. I wish this was talked about more. Yes, breastfeeding often aids in weight loss, but it just as frequently hinders weight loss!

    • crazy grad mama

      In my case, I lost weight while breastfeeding, but then gained a bunch of it back when I stopped because my appetite didn’t adjust as fast as my metabolism. (Lactivists would probably just blame me for that, though.)

      And as someone who’s struggled with disordered eating, I find the “breastfeeding is great because you’ll lose weight” cry kind of gross. Why can’t we just let women’s bodies be?

    • Dr Kitty

      It also doesn’t note the women for whom breastfeeding weight loss is not desired.
      I make plenty of milk, but it does seem to come at the expense of me.

      When I went back to work, exclusively BF, six months after my daughter was born I weighed 90Lbs. I did not look well.

      When I got norovirus when my son was 7months old and I was breast feeding, I was 85lbs and miserable at the end of a weekend!of D&V.
      My supply tanked, I supplemented with formula and frankly we haven’t looked back.

      Look- I start pregnancy at 98lbs soaking wet.
      I make plentiful milk.
      Simple thermodynamics dictates that eventually I end up tired and thin and with less milk.

      • Empress of the Iguana People

        *hugs* The only reason why loosing weight wasn’t a problem for me is because I started obese. With all my anti-cravings, I gained 10 pounds with my 8.5 pounder and 6 with my 8.75 pounder. My ob was starting to get a little concerned with how little I gained the 2nd time around, especially when I got sick and lost 9 pounds in the 3rd trimester.

      • MaineJen

        The only time I have ever been “skinny” in my entire life is when I was BFing my very greedy son. When he was about 6 months old I had an auntie take me aside during a family function and ask “Are you OK? …You don’t look healthy.”

        I was hungry AF all the time but could not keep any weight on. Now, of course, I don’t have that problem.

        It messes with your metabolism for sure.

    • CSN0116

      There was a commercial on years ago where a woman bragged about burning 500 calories per day just by breastfeeding…failed to mention that nursing moms also require additional calories and it’s basically a washout.

      • AnnaPDE

        Yeah, I burn those calories but if I don’t eat them too, the milk quickly goes away. It is not made from those bits of fat on my bum and legs that I’d like to use up… Total rip-off.

  • Steph858

    The following is the kind of leaflet/article I imagine a Lactivist might distribute regarding adoption of infants, complete with the language and tone I believe Lactivists would use to address such a sensitive topic:

    You are defective and abnormal. That might sound harsh, but I’m afraid it’s true: you were either unable to conceive, in which case your body is faulty, or you were unwilling to create a new life while so many children already born are desperate for loving parents, in which case your mind and attitude leave something to be desired.

    Whatever the reasons behind your choice to adopt rather than have a child in the normal way, here we are. You are now the mother of your adopted baby. As we all know, breast is best, but therein lies the rub: your breasts are not currently producing the liquid gold your precious little bundle of joy needs to grow up healthily. Some Evil Multinational Corporations – such as Nestle – might suggest you feed your baby formula instead. But that would be the worst thing you could ever do to a child who has already suffered more than his/her fair share of misfortune; you would be feeding them poison! For that is what baby formula is: pure poison.

    Unfortunately, your breasts will not be able to produce milk which is specially tailored to your baby’s needs in the way that a natural mother can because your baby is not really yours. However, even milk from the wrong breasts is infinitely better than formula, so you should still be breastfeeding. Ask your Lactation Consultant to prescribe you a regimen of industrial-strength hormones and hourly pumping which might make it possible for you to feed your child in the way nature intended.

    • sdsures

      Brilliant!

      There was a post I saw once, probably on the FB page, of a lactivist trying to “teach” adoptive mothers how to get their breasts to lactate by eating various foods (which is BS) or badgering their doctors into giving them medications (domperidone? risperidone?) to induce lactation despite the fact of them being adoptive rather than biological parents.

      Oy. *eyeroll*

      • Steph858

        Wow. I thought I was being satirically hyperbolic, and now I find out there really ARE lactivists who expect adoptive mothers to breastfeed. The mind boggles …

        • swbarnes2

          Someone posted a story, maybe here, about a woman who did all that jazz to get herself lactating for her new adoptive infant…and then the infant started to look a little darker of hue than the bio mom had indicated the baby would be…so despite all that wonderful breastfeeding bonding…the adopter canceled the adoption.

          • sdsures

            *expletive*

          • kilda

            yeah, I remember that story, it was here. That baby dodged a bullet.

          • MaineJen

            OMG. >:(

        • Monica

          I have a relative who adopted a baby. She started telling me she could have tried to breastfeed, but they chose formula instead, I cut her off and said fed is best. That baby couldn’t be more loved or amazing than he is if he was breastfed, but let me tell you the fact that she thought she had to defend herself hurt me. I mean the amount of stress they went through and this was an open adoption to boot, so they know the mother and family and see them around. They actually had to avoid going places because of fear of running into the mother in the beginning there. No, trying to make yourself lactate when formula is available is not necessary and no explanation needed. Truth be told, I honestly would have been more puzzled if she had attempted to breastfeed. I mean I would have supported her and not questioned her at all for doing it because it’s still up to her and her husband and they don’t need my input in the matter. Sad how far we have come though, isn’t it?

          • sdsures

            Yeah. 🙁

  • Madtowngirl

    Absolutely horrifying behavior from people claiming to be professionals!

  • Poogles

    There appears to be a typo/auto-correct error in the paragraph immediately following the first quote:

    “[…] the infant disabilities and earth that result in ignoring those difficulties.” – I believe “earth” should be “death”?

    • Amy Tuteur, MD

      Thanks! Fixed it.

  • Monica

    I would love Dr. Flanders to come here again to try and “defend” his honor. Perhaps he can explain to me why my pointing out that it’s unprofessional to fist bump on social media and he could learn a thing or two from my own kids ped and actually check in on his patients was reason to mute me. Further showing the level of unprofessionalism he possesses. Every word he utters makes me more and more grateful for the wonderful provider my children have, who to my knowledge does not have a personal Twitter account. And yes, I have looked. I mean I’d be a fool not to see what if anything is discussed by her publicly. Although, I’m really not sure how she’d have the time for social media what with her calling and checking on patients after office hours and even opening up her office on weekends to see patients. I’m amazed any practicing physician has so much time to be keeping up with what’s written here and trying to be so witty on social media.

    • Madtowngirl

      As teachers, we were explicitly told to watch what we put on social media. In the pharmaceutical industry, we were told to watch what we put on social media. I was a peon at my company, but you’d better believe I’d face discipline if I made a joke about the company’s financial downfall or some such thing. The fact that they have 1) time to be on social media and 2) think it’s appropriate to make comments like this where they can publicly viewed, says a great deal about how “professional” they are. I can tell you without a doubt that if I needed breastfeeding support, I would be steering clear of these two.

      • Monica

        Yup, I couldn’t agree more. They are everything that is wrong with breastfeeding today and should start looking in the mirror if they feel they need to “fix” breastfeeding so more women do it and do it longer. This is just not good publicity for themselves personally or professionally and it’s not good publicity for breastfeeding.

    • Roadstergal

      He’s come on the comments section here before, and he acted like the typical lactivist drop-ins – avoiding addressing any actual benefits to term infants, dodging questions, downplaying lactivist harm, and just generally being an asshat.

      I repeat…

      Stupid Flanders.

      • Monica

        He likes to say the right things and I’m so supportive of whatever a woman chooses, but the fact of the matter is he’s every bit the smarmy unprofessional dolt that he shows us on his Twitter feed. I’m not generally one to judge a person on what they post on Twitter because 140 characters is hard to express yourself in, but I’ve had enough run-ins with him outside of Twitter to know him to be unprofessional at the very least. I hope parents of Canada are paying attention and can see him for who and what he is.

        • Amazed

          He only says the right thing here, where his money donors, err, I mean patients’ parents, aren’t likely to see him. He likely thinks it increases his popularity to be seen publicly poking fun at evil unnatural Dr Amy.

          • Monica

            Indeed, talking out of both sides of his mouth. Too bad for him we’re not so easily duped ;).

      • The Bofa on the Sofa

        Stupid Flanders

        Nice! PCM recognition!

      • Guest

        And he comes complete with the holier-than-thou attitude and annoying “Hi-diddly-ho, neighborino!” phrasing

    • sdsures

      I thought I recognized the name. Dr Flanders has been here before, eh?