You have my permission to stop breastfeeding

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I’ve heard from quite a few women that they initially found my website when they were googling “am I a bad mother for not breastfeeding?” or something similar. They write with gratitude that I reassured them that breastfeeding has nothing to do with it, that the benefits of breastfeeding have been exaggerated, and that their pain, suffering and mental health are worthy of consideration, too. As a result, they realize that it is okay to supplement their breastfed babies with formula, or give up breastfeeding altogether.

So today I want to make it official: you have my permission to stop breastfeeding!

You have my permission to stop breastfeeding (or supplement) if your baby seems frantic with hunger even after nursing repeatedly for long periods of time. His comfort is more important than what any lactation consultant has to say.

There is nothing in breastmilk that your baby needs more than your continued mental health.

You have my permission to stop breastfeeding (or supplement) if your baby is not growing well, or worse, continues to lose weight after the first few days. The health of her brain is more important than your Facebook friends’ satisfaction that you are mirroring their own choices back to them.

You have my permission to stop breastfeeding (or supplement) if breastfeeding has become excruciating because of cracked, bleeding nipples, infections or no particular reason that you can identify. You are part of the much vaunted mother-baby dyad and your comfort matters, too.

You have my permission stop breastfeeding (or supplement) if you’ve been told you must subject your baby to the pain of tongue tie surgery if you want to breastfeed successfully and you can’t bear to do it.

You have my permission to stop breastfeeding (or supplement) if waking multiple times each night to nurse has left you incapacitated by exhaustion. Sleep deprivation is a risk factor for postpartum depression and you should to do everything you can to avoid that.

You have my permission to stop breastfeeding (or supplement) if you think you may be suffering from postpartum depression or postpartum anxiety. There is nothing in breastmilk that your baby needs more than your continued mental health … absolutely, positively NOTHING.

You have my permission to stop breastfeeding (or supplement) if you feel that breastfeeding is blighting your relationship with your infant. If you are beginning to resent your baby for being the source of your pain or if you simply can’t enjoy your baby because breastfeeding worries and attempts are occupying every spare moment, you can cut back or end breastfeeding altogether.

You have my permission to stop breastfeeding (or supplement) because in industrialized countries the benefits of breastfeeding term babies are so trivial as to be undetectable in the population. I would never give permission for anything that might harm your baby like refusing vaccines, but I know it makes no difference whether your baby gets breastmilk or formula.

You have my permission to stop breastfeeding (or supplement) because the risks of breastfeeding with insufficient breastmilk are not trivial: hypernatremic dehydration, hypoglycemia, kernicterus (severe jaundice), brain injuries and deaths. Indeed, exclusive breastfeeding at hospital discharge is probably the greatest risk factor for readmission.

You have my permission to stop breastfeeding (or supplement) because while breastfeeding may reduce the incidence of SIDS, pacifier use reduces it even more.

You have my permission to stop breastfeeding (or supplement) because NONE of the claims about breastfeeding and the microbiome have been substantiated.

You have my permission to stop breastfeeding (or supplement) because anger at formula manufacturers has led major professional societies to say and do nearly anything to discourage formula feeding even though it is an excellent option.

You have my permission to stop breastfeeding (or supplement) because the truth is that breastfeeding is a class signifier, not a health choice. Almost all the purported benefits of breastfeeding are actually benefits of the higher education level and socio-economic class of those who breastfeed, not breastfeeding itself. That’s why intending to breastfeed provides the same benefits as actually breastfeeding.

You have my permission to use or supplement with formula because buying someone else’s breastmilk is a waste of money better spent on saving for your child’s college education. It has NEVER been shown that donor breastmilk has any benefits for term babies.

You have my permission to never start breastfeeding in the first place. It’s your baby and your breasts. It should be your decision and no one else’s.

Who am I that my permission ought to matter? A medical professional recently complained that people only listen to me because of my Harvard education and training. If that’s the case, I won’t hesitate to take advantage of it. I am a Harvard educated, Harvard trained obstetrician-gynecologist who happily and successfully breastfed my own four children. That’s how I know it doesn’t make me a better mother than someone who formula feeds.

Of course you don’t need my permission at all. You could give yourself permission, but I recognize that some mothers, mired in the exhaustion of new motherhood and buffetted by the dire warnings of everyone from lactation consultants to Facebook friends, wouldn’t dare give themselves permission to ignore middle and upper middle class mothering norms. If you won’t give yourself permission, I hereby give you permission.

Just the fact that you’ve been consumed with worry about “am I a good mother?” means you already are!

  • alongpursuit

    Thank you, Dr. Amy (and those who express support in the comments). This post really speaks to me.

    The hospital where I had my prenatal appointments and where I eventually had my baby is a BFHI hospital. There are posters promoting BFing everywhere there, with many using scare tactics. I absorbed the message that if I want to protect my baby from harm (including cancer and SIDS) I need to BF her. Also, I absorbed that my minimum requirement as a mother was to BF exclusively for 6 months. I remember staring at that “10 Steps” poster from BFHI in my recovery room and while I was waiting for my appointments. Growing up, my father was abusive and my mother was neglectful. I wanted so badly to be a good mom and spare my baby from the pain I had in my childhood. My doctor and my prenatal class didn’t prepare me for BF problems. I thought it was the most natural thing in the world. When I had problems latching my baby from the start I sought help from the nurses in the hospital and later from the LCs. I didn’t recognize that my milk failed to come in because nobody told me that was a real risk. On day 4 when my baby had lost 10% of her birth weight, had no soiled diapers since leaving the hospital and was lethargic I was still convinced I just needed to keep breastfeeding her. Thankfully the public health nurse told me I needed to supplement, but unfortunately she insinuated that it was because I couldn’t latch my baby properly and was “mismanaging” the breastfeeding. My confidence was destroyed and I was convinced I was a shitty mom. This was over 1 year ago and it still brings tears to my eyes thinking about it. I tried desperately for 5 months to exclusively breastfeed my baby, but I realize now that I had next to no milk and the crazy triple-feeding schedule didn’t help at all. I was traumatized by my experience. My doctor let me down by referring me to abusive LCs in the hospital and my boyfriend let me down because he didn’t attend any of the LC appointments that I had where I was shamed and blamed. During that time I went off my antidepressants because a breastfeeding clinic doctor wouldn’t prescribe me domperidone because of a potential drug interaction and the LC shamed me for taking medication while breastfeeding. I’m getting help now, but so much damage was done to my well being because of the incessant breastfeeding promotion and the lack of frank discussion around how often it fails at no fault of the mother.

    Big hugs to this community for normalizing formula feeding and defending the rights of women.

    • rational thinker

      I am sorry this happened to you. It is important to keep telling your story. Most people don’t realize how much mental and physical abuse happens because of aggressive breastfeeding promotion both by individuals and BFHI policies. More women need to tell the public about how they and thier babies suffered needlessly cause of breast is best dogma. I hope you and baby are doing better now. ***Hugs***

  • rational thinker

    A very common symptom among heroin users is weight loss, massive weight loss. Now what does mostly everyone agree should be done before the user wastes away to nothing and possibly dies? Discontinue the heroin use. This is no different than a baby that loses a massive amount of weight by exclusively breastfeeding. Except in this case what is a popular answer people give for this situation? Just keep breastfeeding! When that is the answer mothers receive the heroin addict has a better chance of making it through the week and that is just fucked up.

  • demodocus

    Ah, anxiety. Dem isn’t so sure about your last sentence, because reasons. Then he said “oh, but she’s talking about mothers.” Oh, boyo, it translates to parents of either gender, not just transmen who breastfeed.

  • The Bofa on the Sofa

    You have permission to stop breastfeeding (or supplement) if you feeling obligated to breastfeed is straining the relationship with your partner. The benefits of breastfeeding are not enough to sacrifice your healthy, loving relationship with your partner.

  • rational thinker

    Dr. tuteur, Have you ever written about the breastfeeding laws in the United Arab Emirites. In 2014 a law went into effect that forces all women to breastfeed for the first 2 years of their childs life. If they do not comply they will be punished by law and her husband also has the right to sue her in court. I don’t know if you have ever written about this law I couldn’t find anything on your site.

    • Daleth

      Omg, that’s horrible. Those poor women.

      • rational thinker

        Yes its very sad, its just another way to keep women in their “place” in that part of the world. Apparently it says in the Quran that women should breastfeed until 2 years of age. Also they cite that damn WHO recommendation too for legitimacy.

        • Sarah

          I don’t think they’re actually enforced much, but the fact that the statute is on the books at all is an outrage, one of many there.

          • rational thinker

            I have tried to find out if it was used in court yet but I cant find anything or maybe they don’t make that info available to the public. I have to say for that area of the world I really was not surprised that this law exists.

  • BeatriceC

    I see this in my FB groups at least once a week, and probably more frequently. I may not be a Harvard educated anything, but I find myself saying something like “If you need permission to stop, you have it” far more often than I would have ever anticipated, and it makes me sad that young mothers these days are under this kind of pressure. There was a fair amount of breastfeeding pressure when my babies were little, but it wasn’t anything like it is today.

    • fiftyfifty1

      Agreed. I do this a lot as a doctor.

      • Hannah

        As a psychotherapist, I do this a lot, too. One of my clients said “I wish I could just sit down in my garden and enjoy it like my neighbour does” and I said “Go ahead, enjoy it.” She told me later that this was what had helped her most in her therapy. I was wondering if I really needed more than a decade of education for this (most likely not).

        • fiftyfifty1

          We never know what things people will remember, do we?