Maternal suffering has always been central to lactivism, but why do babies have to suffer too?

Newborn

I understand why maternal suffering is central to lactivism. It, like other aspects of natural mothering (natural childbirth, attachment parenting) is meant to control women. It was literally designed to subordinate women’s intelligence, talents, needs and desires to the purported “imperatives” of full time mothering.

Women’s needs and desires are therefore rendered invisible and treated as irrelevant. It’s not surprising then that maternal exhaustion is normalized, that maternal pain is ignored, and maternal needs beyond mothering are discounted. Although breastfeeding is typically portrayed with images of blissful mothers nursing milk-drunk babies, the reality is often quite different. No matter. There is literally no amount of maternal suffering — pain, exhaustion, mental anguish — that is not normalized in contemporary breastfeeding discourse.

Does supporting breastfeeding require ridiculing those who worry infants are suffering?

I understand that. What I don’t understand is why babies’ suffering is considered acceptable.

Lucy Ruddle, IBCLC has created the character Enid, an old busybody, to make fun of anyone who dares question aggressive breastfeeding promotion. Enid — Ruddle has acknowledged — is supposed to be me.

Enid incorporates anti-feminist, ageist tropes about older women: dry, desiccated women whose appearance is distasteful, whose experience is dismissed, who should no longer be seen or heard. I expected that. What I did not expect is how Enid is mobilized to normalize infant suffering.

This was the first Enid cartoon:

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This is Enid. Enid formula fed her babies, has no training in supporting breastfeeding, and wouldn’t know a letdown from her elbow. But Enid feels qualified to say you aren’t making enough milk for your baby.

Ruddle fails to explain why you need to understand letdown in order to recognize a starving baby; you don’t. Ruddle also fails to acknowledge that I breastfed four children over many years and am professionally trained both in the physiology of breastfeeding and the physiology of newborns. But what struck me most forcefully about this cartoon is that Enid’s concern that a baby might be suffering is mocked.

Babies ARE suffering as a result of aggressive breastfeeding promotion. In the US, tens of thousands are being re-hospitalized each year for complications of insufficient breastmilk. In the UK, the re-hospitalization rate for complications of breastfeeding is so high that it has significantly raised the overall preventable re-hospitalization rate for all babies.

It’s not a figment of my imagination. And therefore, it is not a figment of Enid’s imagination that a woman intent on exclusively breastfeeding her baby might be inadvertently starving that child. After all, as Academy of Breastfeeding Medicine Board Member Alison Stuebe, MD acknowledges:

… 15% of infants — about 1 in 7 breastfed babies — will have an indication for supplementation.

In other words, there’s a 15% chance that Enid is right, the baby is starving and he or she may end up re-hospitalized if no supplementation is forthcoming. Curiously, Ruddle doesn’t merely discount that possibility, she ignores the very real suffering of babies who are being inadvertently starved. Why? Is infant suffering funny? Is infant suffering unworthy of her concern?

Today’s Enid cartoon continues in the same vein:

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Enid took a casserole to her neighbor who recently had a baby … She also took a dummy [pacifier] because she heard the baby cry during Coronation St.

Imagine that. Dry, desiccated old Enid provided food for the parents because she wanted to be helpful and provided a pacifier for the exact same reason: she thought it might be helpful. Enid knows from experience that it is very hard to hear your own baby cry and new mothers are desperate to soothe their babies. Enid knows, probably from experience, that babies can be soothed with pacifiers, reducing the suffering of both babies and mothers. Enid probably doesn’t know — though I do — that pacifiers reduce the risk of Sudden Infant Death Syndrome (SIDS), the dreaded scourge of contemporary infancy.

There’s no evidence that pacifiers interfere with breastfeeding. Nipple confusion exists almost exclusively in the minds of lactation professionals and nowhere else. Babies have a natural need to suck and are soothed by sucking. Yet Lucy seems to think that babies should be deprived of pacifiers and suffer as a result. Why?

I have lots of other questions for Ruddle about the normalization of infant suffering but I’ll confine myself to this:

Does supporting breastfeeding really require ridiculing those who worry infants are suffering as a result?

  • Shawna Mathieu

    Glad people are learning this. I’m still horrified that my LC that I was “giving in” by feeding my screaming 8 day old son beast milk in a bottle, because “if he’s hungry enough, he’ll latch.”

    She acted like he was some bratty child refusing green beans, not a newborn that is completely dependent on someone else for their food!

    Not to mention, he’d had his blood sugar tank after birth, made him too tired to eat, which made him more tired, etc. until he got a glucose drip. It didn’t normalize until just before I was released. Now that he’s awake and perky enough to eat, I’m supposed to NOT feed him?

  • I’m a little late to the conversation, but I see the second Enid comic and I’m like, that’s nice and thoughtful! On both points. Even if the new parents don’t want to use dummies/pacifiers, it was nice of Enid to bring one over, and if the parents decide later to give it a try, now they have one.

    The only way one can assume that the second point is negative is to already decide that dummies are a problem, and … they just aren’t. Ruddle is making Enid look very good, which I’m fairly certain wasn’t her goal.

  • rational thinker

    I found a list of bullshit. Its a list of 18 things to naturally increase your milk supply. https://www.verywellfamily.com/naturally-increase-your-breast-milk-supply-431842 The whole site had some bad advice.In another article they said it is normal for a breastfed newborn to lose 10% of birth weight in the first week of life so dont worry until baby has lost 11%. At 10% that baby needs to go to the damn NICU!

    • fiftyfifty1

      Most babies with 10% wt loss do not need the NICU. But they should be evaluated and supplemented.

      • rational thinker

        Your’e right maybe they don’t all need the NICU but they should defenitly be seen by a pediatrician and not a lactation consultant.

  • fiftyfifty1

    I feel about Enid the way I feel about Ruth Bader Ginsburg. Love.

  • Sue

    What a misogynistic portrayal of an older woman!

    How about “Enid is a retired pediatrician whose husband formula-fed four babies while she practiced as a medical specialist, saving the lives of babies and children. She is aware of the evidence for baby-feeding and pacifiers and she is aware that feeding methods had negligible effect on her own four daughters, who are now enjoying careers in cancer medicine, aeronautical engineering, education and family law. She normally has a smile on her face but can appear cranky when interacting with lactivists.”

    FTFY.

  • Melanie Staneva

    New mothers are typically exhausted, regardless of feeding method. As a society we’re not very good at supporting mothers. Im confused as to why natural childbirth is oppressive? Or breastfeeding? Aren’t we meant to have choices available? It makes sense that a lactation consultant would focus on breastfeeding on her page, although i agree its unfair if the cartoons are a specific person. But as a breastfeeding mum (who supplemented at first), i had so much pressure to bottle feed. If my baby cried i was often told hes hungry, and my milk supply was questioned. If he fed too often, i was told i mustnt have enough milk. So thats probably where shes coming from. On my second baby, ive learned that many hcps arent adequately trained in breastfeeding support. This time, i knew to seek help immediately because I was in pain. Pain shouldnt be normalised. It can take a bit to adjust to breastfeeding but people in pain need to seek qualified help.

    • Cartman36

      Natural childbirth and breastfeeding aren’t oppressive if mothers choice them without undue influence. I have lots of friends who had natural childbirths because that is what they wanted. Dr. Amy is making the point (through the breadth of her blog posts) that medical professionals, health organizations, and online busy bodies (i.e. baby center forums, facebook, etc) are often using cohersion to force women to choose natural birth and breastfeeding by overselling or outright lying about the benefits and covering up the risks.

      Any woman who wants to breastfeed absolutely should get help from a qualified professional (although I am not sure that an IBCLC is really qualified without additional medical training (i.e. an RN IBCLC)) but woman should not be pressured to do these things because they are “best” or because the implication is made that their baby will be less healthy or at most risk if they don’t.

      Women can only make a free decision if they are given ALL the facts and right now they are not.

      • Melanie Staneva

        Indeed. I agree about informed decisions and pressure. But thats not what the article says in the first paragraph.

        • Cartman36

          She isn’t talking about the act of natural childbirth. She is talking about natural childbirth movement in general is used to try to keep women in the home. I would suggest reading her book (Push Back). She goes into a lot of detail about the origins of the Natural Childbirth movement.

          • Melanie Staneva

            The origins would surely be similar to all mammels? Saying the movement makes more sense, although i still disagree.

          • MaineJen

            Look up hyena birth, if you’re feeling brave…

          • Amazed

            We are literally the only species that has a natural childbirth cult. The only one. Telling a mother who had a 30weeker that she should do it all naturally once the baby comes home at 4.5 pounder is thoughtless and cruel. Informing her that you have collected some expressed milk of your own so this baby, now almost a year old, can have “at least some of the good stuff”, although you have expressed for a much younger baby after she has TOLD you that she was totally fine with her baby never having a drop of breastmilk (lifesaving drugs incompatible with initiating breastfeeding which was the reason for getting the kid out at 30 weeks in the first place) is just stupid and cruel. I’ve witnessed this done to my best friend by her SIL – a kindergarten teacher who champions gentle mothering and tutoring and is mothering the most insufferable kid I’ve ever seen. The family drools at him in awed adoration as he beats other kids and family members and insists that other people should keep their babies safe from him. That’s “natural, positive mothering” according to them. But hey, she starved him happily until her milk came in and he was breastfed, so according to them it’s all fine.

            It IS a cult.

          • rational thinker

            I forget where I read it but I read a story about a woman who was pumping at work and keeping the breast milk in a shared fridge at work. Well a co worker also had a baby but a low or no supply so for several months she was stealing the breast milk and replacing what she took with water or cows milk so no one would notice and brought it home to give to her own baby. These people are idolizing a body fluid.

          • Amazed

            I hope the bitch got the pants sued off her crazy ass. This is disgusting and yes, fetishizing a body fluid.

            I remember a story hailing shared milk. A family watched their kid starve until one evening Dad dramatically cried out, “WE NEED MIRANDA! NOW!” Miranda was a NEW friend. With their kid hanging on the boob of their new friend, they rushed to gush in the newspapers.

          • rational thinker

            It is messed up how the newspapers publish all these stories about “milk sharing” and “milk siblings” and the supposedly heroic friend that runs over to your house to nurse your starving baby.

            Some may call me cruel but if I was a journalist and someone wanted me to write a story about how their baby was starving and suffering from hunger while his parents could only stand by and watch. Then their heroic friend showed up to nurse him from her own breast giving him much needed lifesaving food.

            What I would do if I was the journalist is interview everyone to make sure I have the whole story exactly how it happened, then I would call CPS immediately and report these assholes for neglect. Not write an article praising them and their wet nurse friend.

            If you let your baby starve when infant formula is easily available on the altar of “breast is best and formula is poison so its okay to let the baby starve while we search for breast milk from any source” then maybe you should not be the caregiver of a child in the first place.

          • Amazed

            Some may call you cruel and they’re welcome to call me this as well. I would do the exact same thing.

            The Little Book Lady who was born at 30 weeks at the glorious weight of almost 3 pounds never got the loving contact of staring in her mom’s eyes while mom fed her formula. In the NICU, they had taught her to go about business from the changing table, so her mom continued the tradition. Kid knew that eating was eating time and not bonding time. And she is as attached to her mom as any EBF kid I know. Amazing, I know. Looks like Mom managed to compensate by bonding in every other hour. How she did it, I can’t fathom.

          • KeeperOfTheBooks

            I believe Cartman36 was referring to the movement that happened in the mid/late 20th century, courtesy of Lamaze, Ina May Gaskin, et all.

    • KeeperOfTheBooks

      Neither natural childbirth nor breastfeeding is oppressive per se. I’m sorry you had the experiences you did; becoming a mom is hard enough without people telling you constantly that you’re doing it wrong, whatever “it” might be!
      If your babies were fine on breastmilk–i.e., were gaining weight normally, were hydrated, good pees and poops, et all–then good on you for recognizing that, and for continuing to breastfeed despite what others might say, because it sounds like it was the right choice for you and for your babies.
      The problem, at least here in the States (from your syntax I’m guessing you to be in the UK/former British territory), is that the pendulum has swung from one extreme, where 50+ years ago women were drugged out of their minds during delivery and were told by society not to breastfeed, over to the other extreme, where there is, it seems, never any excuse good enough to have had a C-section, or an epidural, or to feed your baby formula. This line of thought permeates much of the health care industry. 50 years ago, one size (ie, drug moms, exclude dads from delivery rooms, nearly force to bottle feed) didn’t fit all, and today it doesn’t, either. It’s just as wrong to harass a mom who’s breastfeeding about how her baby might not be getting enough (provided, naturally, that he is) as it is to constantly tell a mom, as happens here, that dehydration, severe weight loss, et all are either normal, aren’t happening (outright lying about numbers), or are her fault for not trying harder, even if she can’t possibly try harder. In the US, it’s now near-impossible to get any help with the baby in most hospitals; after my C-sections, even though I was at one point hallucinating from a medicine combination, they wouldn’t take them for more than an hour or two. That’s as wrong, and possibly more so, as refusing to let a mom see her baby for more than a couple of hours per day in the hospital.

      • Melanie Staneva

        That sounds incredibly tough and unsafe. My hospital dont take baby either (and we have shared wards of 6+ women and dad cant stay overnight) but if mum was hallucinating i think baby would be moved for safety. My first did lose a lot of weight and i was supported to supplement, learn to pump and a midwife stayed with me for most of a day helping and fought the hospital to allow me back home to sleep. I was taught how to monitor nappies and told to get regular weight checks til he was on track and given details of breastfeeding support groups. But my country has an extremely low breastfeeding rate.

        • AnnaPDE

          Is it the UK? Because no, they don’t take the baby off you even when you’re very very unsafe.
          My sister’s colleague tried to ask the nurse for exactly that, at least help her put the baby in the bassinet because she couldn’t do it alone safely after her emergency CS and long labour, and is falling asleep. She was told that she can’t expect this kind of help, seeing she wouldn’t have it at home either. She went home that morning at less than 24h after CS and not having slept all night, because turns out at home at least her husband and mum were there to care for her.
          Complaining to the hospital afterwards just got them a condescending answer along the lines of “you spoiled Spanish people are so entitled and old-fashioned, here in the UK know that the way we do it is the right one – after all your baby’s still alive, right?”.

          • Melanie Staneva

            Thats horrific. Im in ireland. There aren’t nurseries but i have friends who asked midwives to take baby so they could sleep and they did. Maybe depends on the midwife too. But that’s so wrong 🙁

          • AnnaPDE

            Ikr, it was just a total shitshow. Now my sister is TTC and a bit freaked out where to actually have the baby once it works out.
            On that topic, UK posters, any recommendations for non-crunchy, CS friendly doctors and hospitals in and around Cambridge are much appreciated.

          • KeeperOfTheBooks

            Ayup. My situation was similar, in that I was constantly told that I wouldn’t have help at home, so don’t expect it at the hospital, either. I pointed out that at home, I’d be a few days out from surgery rather than a few hours, and, actually, my husband WOULD take care of the baby so I could sleep for a couple of hours or shower or what-have-you, so why couldn’t they?
            I also pointed out that nurses et all are considered mandatory reporters, which means that if they suspect child abuse, they are required to report it to law enforcement. I said that if I told them I planned on having my newborn cared for by a person who had just had major surgery, couldn’t get out of bed, was on narcotic painkillers, was sleep-deprived and actively hallucinating, then they’d have to call the authorities, and rightly so. Yet, somehow, when that caregiver was me, it was somehow okay? Yeah…no.

          • AnnaPDE

            Yes, it’s such rubbish, isn’t it?
            The whole reason hospitals have wards staffed with nurses, and not just operating theatres, is that these places exist to temporarily take good medical care of people who need it, and are unable to get it done themselves.
            What a moronic argument to say “you wouldn’t have that at home”. Yes, and I don’t have the doctors, emergency equipment and whatnot at home either. If I didn’t need that stuff I wouldn’t come to the hospital to begin with.

            What I do have at home, on the other hand, are people who give a damn about me and my baby being cared for.

    • Cartman36

      There is nothing wrong with natural childbirth or exclusive breastfeeding when that is what the mother wants and it works for her and baby. I just have a massive problem with people who tell vulnerable new mothers who don’t want those things or for whom those things aren’t working, that c-sections and formula make them a less than mother.

      • Melanie Staneva

        Do people actually say that? Or is it more a perception thing? Cos i had incredible pressure against both natural childbirth and breastfeeding. I wonder if its more that people are comment-ey to all mothers and we are at a sensitive time in life?
        But the article specifically states that natural childbirth is meant to control women. Not that pressure to birth in a specific way is controlling.

        • rational thinker

          There is an experiment you can do so you can witness the type of behavior that is discussed in this post.

          Go on one or two of the breastfeeding mommy boards on babycenter or kellymom or the milk meg. Go on there and ask for advice about supplementing with formula cause you are in pain or say you think you have a low supply. When they answer you I promise you only maybe 20% of the replies are going to be nice. They will tell you all the ways you are harming your baby and what they think of you.

          To get a better understanding of this post I would say try this to see it for yourself.

        • Cartman36

          People absolutely say that.

        • AnnaPDE

          I had IBCLCs who were also RNs working on a maternity ward routinely dismiss my very clearly hungry baby’s hunger cues, record half a drop of colostrum as “good supply”, pretend to see good milk transfer while refusing access to a scale, and withhold formula, all in the name of pretending that exclusive breastfeeding is going well. Even on follow up hospital visits, which were necessary in the first place because he wasn’t gaining weight.
          In reality my son had a massive tongue tie making it almost impossible to transfer milk, constantly hungry, and almost went lethargic on us – the only feeds that actually worked were when my husband or my mum basically hand-expressed into his mouth. But oooooh no don’t ever use formula! When the LC found out at the last visit that the sudden great weight gain wasn’t because of her “advice” but due to supplementation, she was like “oh well, pity you’ve given up after all”. (With the tongue fixed and combo feeding, little guy worked my breasts back up to a full supply in about 4 months.)
          The pressure to breastfeed and not supplement is real.

          And so is the pressure to VB. Not necessarily by doctors, but by the general public. I wanted an elective CS, and the number of times random acquaintances urged me to “at least try” for a VB was ridiculous. During the actual CS, I joked with my obstetrician that it was “too nice” – she’d just been on the radio a couple of weeks earlier talking about the “gentle” and maternal assisted CS she’s willing to do, and her practice’s Facebook page was still flooded with complaints from people who wanted her to immediately put an end to this. With the argument that if a CS is nice for the mother, she won’t want a VB and that’s just unacceptable.

        • MainlyMom

          Oh people definitely say it. I heard from multiple homebirthers that my c-sections weren’t “real” births.

        • Alia

          You may have a point in that when you are expecting or have a baby, people generally seem to feel entitled to tell you that you are doing this or that wrong and that you should be doing something differently. And these are not only your family or friends but sometimes people like neighbours or random people in a shop.
          Over here there’s a sentence that has become a kind of meme, as it sums this attitude perfectly: “But where’s his cap?” Meaning that regardless of the weather and temperature, some people, especially elderly, believe a baby should always, at all times, wear a cap and would criticise any woman whose baby is not wearing one.

          • KeeperOfTheBooks

            Here it seems to be socks. Me, I think baby toes are cute, and that one of the few perks of it being 90+ degrees in temperature and 90+ percent humidity is that one can show off Junior’s cute toes, but every so often you get someone sure that Junior will get frostbite (in August, in the subtropical northern hemisphere…) if he isn’t wearing socks.

        • MaineJen

          The article states that because it’s literally true. Grantly Dick-Read, founder of the natural childbirth movement, promoted the idea that women of the “better classes” weren’t having enough babies and, worse, were venturing out of the home to work. He promoted natural childbirth as a way to steer women back into their “natural” roles as wife and mother. https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2028507

          Similarly, La Leche League was founded by catholic housewives who advised women thusly: “The 1981 edition of “The Womanly Art of Breastfeeding” summed up the group’s opposition to working motherhood: “Our plea to any mother who is thinking about taking an outside job is, ‘if at all possible, don’t.’ ” ” https://www.nytimes.com/2008/12/28/magazine/28froelich-t.html

          As a feminist, I’m deeply suspicious of both natural childbirth and LLL, for the above reasons.

        • FormerPhysicist

          You are asking if people really say that, quite dismissively, while claiming it couldn’t happen because other people said other things to you. Please go think on that a long while.

  • Cristina B

    I exclusively formula fed both of my babies, so, no, I wouldn’t know how to solve breastfeeding issues, but I do know what content, well-fed babies look like.

  • Man, your satire really fails when your central figure of fun is a caring, helpful woman–not to mention the ageism in the cartoons.

    • Sue

      “Lucy Ruddle, IBCLC has created the character Enid, an old busybody, to make fun of anyone who dares question aggressive breastfeeding promotion. Enid — Ruddle has acknowledged — is supposed to be me.”

      Perhaps you missed that bit.

      • Nope. I just note that in spite of Ruddle’s attempts to create what is clearly meant to be a mockable sourpuss ignoramus, she fails miserably because Enid is actually presented as helpful.

        • fiftyfifty1

          Yes exactly. Enid is presented as helpful, thoughtful, kind, generous and down to earth. With enemies like that, who needs friends?

          Clone Enid please and send her out to all postpartum women who could use a little help!

      • Sue

        My apologies, Heidi – I thought you were referring to Amy’s satire.