The latest in toxic lactivist rhetoric: breastfeeding “goals”

Good Better Best Concept

Fed Is Best is winning!

How do I know? Because lactation professionals keep falling back. The latest effort involves defending their relentless pressure on women by invoking breastfeeding “goals.”

“Breast is best” and the “Baby Friendly” Hospital Initiative represented frontal assaults on women’s psyches. Since at least 1996, lactation professionals have sought to promote breastfeeding by shaming women.

Pious concern for women’s feelings is difficult to take seriously when it comes from the very people who have enshrined pressuring women to breastfeed as a lactivist goal.

Watch Your Language, written in 1996 by lactation consultant Diane Weissinger, set out the terms of engagement:

When we fail to describe the hazards of artificial feeding, we deprive mothers of crucial decision-making information. The mother having difficulty with breastfeeding may not seek help just to achieve a “special bonus”; but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial baby milk just “to get him used to a bottle” if she knows that the contents of that bottle cause harm.

Breastfeeding rhetoric was honed to coerce women and to silence those who refused to cooperate. Lactation professionals were taught to treat women who can’t or don’t want to breastfeed, not as individuals with valid concerns, but as deviants who jeopardize lactivist goals. They were taught to literally ignore the suffering of babies — dehydration, jaundice, hypoglycemia, — in favor of long term “benefits.”

Testimonial silencing — ignoring the experiences of suffering mothers — has been standard practice, but now those mothers are refusing to be ignored and breastfeeding professionals have been forced to respond.

That doesn’t mean that they’ve recognized the error of their ways, though; they have no intention of stopping aggressive breastfeeding promotion. But they have changed their rhetoric to reflect the fact that that direct pressure won’t be tolerated anymore. How? By invoking breastfeeding “goals.”

“Look at us,” they invite. “We’re not pressuring women to breastfeed; we’re helping them meet their goals!

Prof. Amy Brown leads the way with papers like What Do Women Lose if They Are Prevented From Meeting Their Breastfeeding Goals?

Brown could not be clearer that the invocation of breastfeeding goals is an effort to fend off the increasing popularity of “fed is best”:

…[T]he argument that we see played out across the media often centers on the suggestion that there is too much pressure on women to breastfeed, and to protect maternal health we should instead take a more mother-centered approach, promoting all feeding options as equal. The focus should be on ensuring a baby is fed, with the proposition that anything else is just noise, with minimal real impact upon mother and baby. Criticisms have been made of the lactation field, predominantly by those with a social sciences background, with accusations of “militant lactivism” destroying women’s mental health.

How dare those with social sciences backgrounds — psychologists, philosophers, women’s rights advocates — imagine they have anything to offer on the topics of women’s mental health and their right to bodily autonomy?

But this “argument” isn’t just foolish; it’s toxic. To understand why, replace breastfeeding with dieting. Imagine if the fashion and diet industries tried to combat the threat posed by body positivity movements by invoking women’s “weight goals.”

The argument centers on the suggestion that there is too much pressure on women to diet and to protect women’s mental health we should take a more woman-centered approach by promoting all women as good regardless of their weight. The focus should be on ensuring that women are physically healthy and everything else has minimal real impact on women. Criticisms of the fashion and diet industries have been made, predominantly by those with a social science background, insisting pressuring women to achieve a certain dress size is harming women’s mental health.

See? Pressuring women to starve themselves to thinness isn’t harmful; it’s just helping them achieve their “weight goals.”

Ugly

Brown writes:

Questioning why women want to breastfeed is illogical in as far as we do not question why human beings wish to use any other function that their body was designed for. Women describe an urge to breastfeed as something that is instinctual; physically, in that their body produces milk without their choice, and emotionally, in that women often cannot describe why they so strongly want to breastfeed, they just do …

But women were also designed to be thin. That doesn’t make the desire to be thin instinctual just like it doesn’t make women instinctively desire to live in caves. The desire to be thin is socially conditioned. How do we know? Because desires have changed over time. In some cultures, and at times in our own, being overweight (think “Rubenesque”) was valued and being thin was a sign of poverty. Similarly, in 1950’s America, formula feeding was culturally valued as technologically superior and physically easier.

Indeed, Weissinger’s famous paper on breastfeeding rhetoric explicitly set out to change culture.

All of us within the profession want breastfeeding to be … the CULTURAL norm … (my emphasis)

Brown’s insistence that the desire to breastfeed is instinctual isn’t merely factually wrong; it disingenuous since Brown acknowledges — in the very same piece — that the “goal” of breastfeeding is a cultural goal.

Brown writes:

Breastfeeding and the concept of maternal identity go hand in hand. Breastfeeding is often part of what women envisage themselves doing as a mother. Women report seeing breastfeeding as a way of identifying with a type of mother they wish to be, to fulfill what they see as a maternal physiological role. It is not simply about milk transfer, but a mothering tool, one helping to enhance bonding and closeness. It is a relationship and an experience, rather than simply a nutritional means …

Why do they feel that way? Because Brown and her colleagues have spent the past two decades telling women that is how they ought to feel.

The invocation of breastfeeding “goals” is gaslighting on steroids.

Women may lose something — may even feel anguish — when they fail to meet their breastfeeding goals, just as they feel anguish when they fail to meet their weight goals. But in both cases the primary problem is not the failure to meet the goals but the goals themselves.

Pious concern for women’s feelings is difficult to take seriously when it comes from the very people — like Amy Brown — who have enshrined pressuring women to breastfeed as a lactivist goal.

  • Allison

    It’d be pretty hard to make a convincing argument that I’m anti-breastfeeding. I breastfed for four years. For the record? I only have the one kid.

    For us, it worked… mostly. We filled in with a little formula when my pump couldn’t keep up with Mr. High Metabolism, and, quite honestly, I was ready to stop long before he was – I just lacked the spine to stop until I caught a fortuitous case of bronchitis just after his 4th birthday and was handed a prescription for prednisone and told not to nurse with it.

    But sometimes… it doesn’t work. Nature cares only about survival of the species – it couldn’t care less about survival of any one individual, and sometimes biology just plain doesn’t work. For goodness sakes, if nature always got it right, there would be no cancer, no chromasomal defects, no congenital heart disease – and we’ve got no shortage of all of the above. And sometimes… lactation doesn’t work. Sometimes, Mom is just too tired or just too overworked. Sometimes Mom is an assault survivor. Sometimes it’s just making Mom miserable, and Baby needs a healthy, happy Mom. No problem. This is why we have formula. If breastfeeding works for a family, awesome! Go for it! If not, for crying out loud FEED THE BABY!

  • Courtney

    And this is why I think Skeptical OB is one of the most important feminists of our time.

    It’s upsetting reading Brown’s quote: “with accusations of “militant lactivism” destroying women’s mental health.”

    Uh, yes it is. Bit of a slap in the face to read when it happened to me.

    So it didn’t happen to me? Oh, ok.

    The diet comparison is a good one.

  • mabelcruet

    Just in case your eyes weren’t rolling far enough back in your head, this piece is doing the rounds:

    https://families.media/what-one-woman-said-to-this-doctor-that-changed-childbirth-forever

    The story of Grantly Dick-Read and how a poor low class Cockney woman showed him the true way of childbirth.

    My favourite bit “the womb of a frightened woman would literally be white with lack of blood and oxygenation” If you can see the actual womb per vaginum during delivery, you’ve got bigger problems than just its colour.

    The orgasmic face of the birth mother is also very impressive!

  • StephanieJR

    ‘Questioning why women want to breastfeed is illogical in as far as we do not question why human beings wish to use any other function that their body was designed for’

    Well, I certainly question some things that people read, watch or listen to.

    • Mel

      My body has been designed to kill me at an early age.

      I needed a ventilator for 14 days after I was born. From that, I blew out both lungs at 2 and 4 days old. Thanks to modern medicine my only two side-effects are two pneumothorax scars that I can feel in my breast tissue and a ban on scuba diving. (Guess which one annoys me?)

      I’ve had enough bacterial infections that I question if I’d be alive without antibiotics.

      My single pregnancy devolved into me teetering on the brink of organ failure at 26 weeks without any signs of labor. I’m naturally an optimist – but I doubt I’d have delivered my son prior to some major organ damage that’d killed me. And he would have died.

      Oh, and then my gallbladder filled with stones, got infected and became gangrenous. And guess what? Gallbladders are f-ing DESIGNED to do that! They just kinda cut off their own blood supply for the hell of it! And we don’t actually NEED them!

      I’m on Team Modern Medicine, thanks.

      • mabelcruet

        Did they put a chest drain in via your ‘potential future breast’ area? We were always taught to put chest drains in at the sides or round the back because its recognised placing them through the front of the chest in females can affect breast development.

        But yes, human anatomy, physiology and biochemistry can turn on you and maim or kill in an instant. We’re built with reserve capacity-we have way more lung tissue, liver tissue and kidneys than we need, we have two gonads when we could manage with one (and many people do, given the number of torted testicles I get sent in pathology every month), we’ve got many more inches of bowel than we actually need, all because we need some spare in case things stop working. Just because you have breasts, doesn’t mean to say they will actually do what they are supposed to, same as any other tissue. The only real difference is that we don’t automatically lop off the non-functioning bits-if you have a non-functional kidney it could act as a focus of infection and cause problems, so scarred or cystic kidneys are commonly removed, but we don’t generally do that with non-milk producing breasts

        • Mel

          I hate prepositions. The scar tissue is on the skin, but above the breast tissue.

          Based on pictures and how I remember the scars moving over time, the tubes were placed on the side of my chest and perhaps slightly farther to the front than back. By the time I was elementary school age, the scars had migrated to just in front of my armpit; I could sometimes see them when I was wearing an A-tank outside of the strap and just above the line of the side piece. As my breasts grew in, the scars moved forward towards my lateral curve of the breast and have pretty much settled right at where my breast joins the chest cavity.

          When I had my first mammogram to confirm that a lump that appeared in my breast was fat necrosis associated with an injury caused by a certain toddler’s pointy knee bearing all his weight pressing down then twisting, the nurse practitioner could feel the scars on the skin when I showed her where they were but there was no damage visible on the mammogram from the pneumothorax scars – which was fine by me. Oh, and a confirmed diagnosis of fat necrosis which was also fine by me.

    • AnnaPDE

      On the other hand this is a distraction anyway because people don’t question why women would want to breastfeed. They question what gets them to be obsessed enough with exclusive breastfeeding to even ignore what they can very clearly see and physically feel and let their baby cry and lose weight, instead of just saying “oh well, that’s a plan that didn’t work” as they would with most other wants, and getting on with their lives and a happily fed baby.
      That’s the question that’s being asked, and Brown is trying to dodge it by misdirection.

      • JDM

        Yes, the phrase “Questioning why women want to breastfeed is illogical…” is a classic logical fallacy, the strawman.

  • Emilie Bishop

    This is among my least favorite rhetoric. When my son was readmitted, I was asked if my goal was still exclusive breastfeeding. Having been conditioned that this was what “good” moms did, I said yes. They said triple feeding was the way we’d get there, so I set off. The first night of it in the hospital was terrible, but I was reminded of my stated “goal” and told to keep at it. They had no trouble taking our time and money for LC appts to help me meet my “goal,” and in their response to my first complaint letter, they quoted said “goal” as their reason for continuing to offer their “support.” But no one told me my goal was impossible because I had IGT. NO. ONE. So yeah, it’s nothing but another shame tactic.

    • EmbraceYourInnerCrone

      Troubling that they don’t seem to care that exclusive breastfeeding was not what was best for your baby..even in the face of the fact that he had to be admitted to the hospital. Aren’t they supposed to be the healthcare providers, not the breastfeeding cheerleading providers?

      • Emilie Bishop

        Right? BFHI facilities=breastfeeding cheerleaders

        • EmbraceYourInnerCrone

          I had my one kid before in 1994, most of the BFHI initiative really got going (I think BFHI started around 1991) but even in the Catholic inner city hospital I gave birth at they were pushing Lamaze pretty hard and they were really “encouraging” breastfeeding. To the point that “nice Catholic girl” me resorted to the “sure I want to try breastfeeding” even though I really didn’t just so they would shut up about it. Thankfully at that time they still had a well baby nursery even though they insisted on rooming in during the day and the still had the ready to feed nursettes in the bassinet. Which my almost 9 pound kid would have starved without because my milk did not come in for 3 days…

          • Emilie Bishop

            Mine was born in 2015 at the first US hospital to obtain Baby-Friendly certification. L&D was great, but the rest was a shitshow. We can’t have more bio kids, but before that became the case, we’d decided to change ob practices and hospital systems if baby #2 should materialize.