How do privileged mothers display their status if they can’t breastfeed?

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Breastfeeding is a signifier of social status.

In every society the privileged attempt to distance themselves from those less fortunate. Privileged women adopt status displays that are costly, and therefore difficult for less privileged women to emulate.

For example, when poor people were thin because they didn’t have enough to eat, being overweight was a status display. When economics change, status displays change. Now when achieving and maintaining a thin, muscular body requires access to healthy food and gym memberships, being thin is a status display.

European formula and donor breastmilk allow privileged women who can’t breastfeed to still display their status.

Infant feeding is no different.

It is not a coincidence that in wealthy, industrialized countries breastfeeding is more common among those with higher socio-economic status because it requires the leisure time to do it. Women either need a partner to support them so they can stay home and breastfeed or a high paying, high status job that allows them time to pump and access to places where they can pump.

In contrast, in poor countries, where many women lack the financial resources to purchase formula, formula feeding is a status display and breastfeeding is a sign of poverty.

So what happens when privileged women cannot or do not wish to breastfeed?

There are two status displays being marketed directly to them: European formula and donor breastmilk.

Both, of course, are prohibitively expensive.

According to Yahoo Finance, domestic infant formula costs range from 9-32 cents per ounce. But that’s a fraction of the cost of domestic organic brands at $1.15 per ounce.

But those seeking status displays have turned to Europe for extraordinarily expensive formula that — in a status bonus — is difficult to access. European formulas, at $1.75 per ounce, are designer formulas.

A recent story on Parents explains:

To access European formula, American parents either need to know someone traveling overseas or order through a formula dealer.

Sure, you may be formula feeding, but by importing Holle or HiPP, you can distinguish yourself from those using Similac or, worse, the truly unfortunate mothers who must make do with store-brand formula.

Is European formula any better for babies? Not by any pediatric metric. It’s just more expensive and that is the point. It’s a status display because poor women have neither the money nor the time to access it.

But the best status display always costs the most. By that measure, sourcing and purchasing donor breastmilk truly sets you apart. It’s the bespoke equivalent.

Critically ill infants and premature babies get priority at most milk banks, but many will sell surplus milk to families whose babies aren’t hospitalized. However, it’s expensive and not always covered by insurance. For example, some milk from the Mid-Atlantic Mothers’ Milk Bank costs $4.50 per ounce, which adds up fast when babies eat as often as every two hours.

Yet there is no evidence that donor breastmilk provides ANY benefits for term babies.

The average baby drinks approximately 9000 ounces of milk in his or her first year.

Store-branded formula at 9 cents/ounce costs $820 for one year.
High end domestic formula at 32 cents/ounce costs $2,880 for one year.
Organic domestic formula at $1.15/ounce costs $10,350 for one year.
European formula t $1.75/ounce costs $15,750 for one year.
Donor breastmilk from a milk bank at $4.50/ounce costs $40,500 for one year.

There’s a price point for a broad range of status displays. Why pay $15,750 to import European infant formula for one year when you could pay $820 and get the exact same result? To display your status!

Infant feeding isn’t really about what’s best for babies; it’s about mothers and the curated image they present to their friends and on social media. Commiserating with other high status mothers over the laboriousness of importing European formula or accessing donor breastmilk is like fretting over the difficulty of finding good servants. It distinguishes you from those who are less well off and that is the point.

  • Heidi

    Has anyone noticed that formula feeding is also being made more complicated than need be? I do think it’s pretty straightforward and easy. But I’ve noticed claims that you need to boil water, only feed expensive RTF the first few months, sterilize bottles specialized feeding techniques, etc. When I was growing up, you made a bottle according to the instructions with tap water, washed the bottles like you would any other dish, and you let the baby eat until they quit at the pace they wanted. That’s the way I did it too. Pediatrician never mentioned staying with RTF so as soon as we ran out of the bottles the hospital provided we went to powder. I used our city’s potable tap water. I either threw the bottles in the dishwasher or handwashed them with hot tap water and regular dish liquid.

    I don’t know. It’s almost like we feel guilty it’s not that hard to formula feed so we’re making it that way. Being a parent is hard regardless! Waking up and having to feed a baby at 2am sucks if you formula or breast feed.

    • alongpursuit

      I completely agree! I’ve had the same recommendations about which formula to use and how to prepare it like using RTF at first then only using boiled water for 4 months, sterilize bottles in boiling water (not in the microwave or dishwasher). Ugh! Then toddler sneezes in baby’s face and I wonder why I even bother with all the formula prep rules.

      • Heidi

        I actually never had these recommendations from professionals. I only see it online from other people. I happily went about preparing my formula how I saw people do it online – fill bottle with water, scoop formula in, put nipple on, shake and feed.

        • rational thinker

          Im in the US and the last time I used baby formula was around 14 years ago. I have never heard of all this formula prep bullshit until recently. I think its a tactic to get more moms to breastfeed and its probably working.

          When I had babies I sterilized all of the new bottles and nipples in boiling water. Normally you would do that every once in a while for the first 4 months. I live in a country with clean tap water so I was never told to boil the water to mix with the powder.

          I think all this extra shit is to intentionally confuse new parents about the safety of formula and to make the whole thing sound like breastfeeding would be easier. After all the most common claim I see online is that powder formula is not sterile and breast milk is sterile which is not true. Powdered formula is sterile breast milk is not and the human nipple in the baby’s mouth is definitely not sterile either.

    • Valerie

      I was just thinking this today. In particular I read that you have to boil water (for no more than 1 minute), and then mix it with the formula within half an hour to kill off any bacteria present in the powder. I get that you don’t want to over-boil, which could concentrate impurities like lead, and you don’t want to let hot water gradually cool exposed in your house because it will spend time in the zone where bacteria grow well. However, I’ve worked in labs, so I know that to be sure to kill things, you need to follow a protocol. Eg, be exposed to a certain chemical or a specific temperature for at least a specific amount of time to be sure the thing you mean to kill is dead. There is no way that water boiled within half an hour (what temperature is it when you use it?) takes on magical properties that kills bacteria in formula powder on contact. It doesn’t make any sense.

      • Heidi

        They don’t actually recommend this in the US though. No pediatrician, hospital employee nor the formula can I came across recommended these things.

        • Valerie

          I stand corrected:
          https://www.cdc.gov/features/cronobacter/index.html

          The recommendation is to kill a specific organism that rarely causes problems in immunocompromised and very young babies. This protocol works well enough.

          … But the majority of the time a healthy baby will be drinking formula, it’s not necessary or recommended by the CDC. Good to know where it comes from, though.

      • AnnaPDE

        The point would be to pour it on the powder while the water is still >70C so as to kill bacteria in it? “Within half an hour” is a bit loose for that.

        • Heidi

          No. The point of that is for questionable water, not to kill anything in the powder.

          • AnnaPDE

            That’s the general “boil water first” idea, yes. And usually you’d let it cool afterwards to avoid accidental burns. But the part with “kill bacteria in the powder” is new, and it only works if the water is still hot enough when mixing with the powder.
            It’s not part of the Aussie recommendations, or at least it wasn’t when I had my son 4 years ago. The UK guidelines on the other hand were all over it, and various lactivist pages were very eager to point out the potential evil germs in formula.

          • alongpursuit

            In Quebec, Canada we get a big book about everything pregnancy- and infant-related but I think it’s full of misinformation and impractical instructions. For example, we’re supposed to sterilize bottles until the baby is 4 months old. We’re also supposed to boil water to mix with the powder or concentrated liquid formula until 4 months old: https://www.inspq.qc.ca/en/tiny-tot/feeding-your-child/milk/handling-commercial-infant-formula

            I feel like the province wants to push breastfeeding so badly that they want to make formula feeding seem dangerous somehow.

  • E

    I moved to Germany when my eldest was 4 months old. I used HiPP. It was half the cost of the generic formula back in the States. Seriously. A box of HiPP was €6 and generic formula when I left was $14. There was also a generic brand in Germany that ran for €3 but I didn’t buy it because I thought I was already getting a deal.

    • E

      I just checked the cost of HiPP today. It costs about 57 US cents per one ounce of powder not yet mixed.

      This is based on the price of 1 kg of HiPP at my local grocery store goes for about €18,32 for non newborns. For newborns and premies it’s €19,98 per kg. Those are not sale prices.

      I get that if you’re ordering from the states, you’ll need to pay shipping which would indeed raise the price, but my point is, HiPP isn’t a fancy formula. It’s just a quality brand at a reasonable price.

      • E

        If my conversions are correct, that makes HiPP about 9.5 US cents per an ounce of prepared formula. So either HiPP has gone up in price or American generic formula has gone down or it’s different by region, etc. but either way, HiPP costs about the same for German parents as the cheapest generic formula in the states according to Amy‘s chart.

        Just saying European formula isn’t fancy whatever that means. But both my kids are fine now in any case.

      • Heidi

        It’s $50 per 900 grams here approximately so it’s significantly more expensive for a quality brand when our US formula is quality too.

  • Felicitasz

    Designer European formula? Oh wow. I am sooooo behind times. 😮

  • Amazed

    One of the things I remember from my childhood is how, in the middle of what happens each time Commies seize power and manage to keep it for over a year, aka a severe economic crisis, doctors taught mothers from the only TV channel we had at the time how to feed their babies without breastmilk and without “artificial milk”. Because, oh wonder, some women could not breastfeed despite trying desperately and there was no formula available on the market save for the one delivered from abroad for the chosen ones. Yes, you heard this right: it was a freaking public effort to teach mothers how to make their own formula because these kids needed to be fed. How much yoghurt, how much water, how much SUGAR, oh the horrorz! should be mixed. Things like this. Burn these doctors at the stake!

    You know what? These kids SURVIVED. They’re healthy and successful adults now. Despite their “formula” being homemade and less than optimal.

    No way am I going to believe that formula prepared specifically for children under expert… well, formula is going to harm anyone.

    It amazes me to see mothers bawling their eyes out that they’re ruining their babies because formula is bad because reasons. First world problems, these ones. Really. I can’t believe women have come to believe a bunch of uneducated fanatics and trust them with their babies’ lives and their own mental health. I can’t believe there are this many doctors and hospitals falling for this. I suggest a crash course in Bulgaria of 1991 for all the leaders of Breastfeeding Academy or whatever their ridiculous institution is called. They wouldn’t survive a week. Doctors from that time are going to rip them apart. Because they did save lives ,these doctors. That was actually their goal. Save lives and not “the breastfeeding relationship”.

    Of course, having said this, I don’t need to add that I find the clamouring for good, better, best formula, save for the cases of real medical needs, slightly ridiculous and a first world problem, Yoghurt, sugar, and water did the trick to keep a now thriving generation alive. I find it hard to believe that a generic vs non-generic formula are THIS different.

    BTW, do I need to say that the very fact of these doctors appearing on the TV kind of proves that the only 5, only 2, or even only 1 percent of women can’t breastfeed is bull? You can believe me that I’ve never seen mothers so determined to breastfeed. Trying so desperately. Because it wasn’t about “formula is suboptimal and my baby is just cluster-feeding”, it was a matter of life and death. Still, there were too many women who could squeeze milk out of a boob just as much as they could squeeze water out of a rock.

    Fuck privilege and fuck those who have chosen pushing breastfeeding as their career. It’s disgusting to brainwash people into creating their own problems.

    • KeeperOfTheBooks

      Y’know, I do sometimes, courtesy of the…education…I received about breastfeeding, giving birth, etc, feel really sorry for myself that I had C-sections, couldn’t breastfeed, et all. And I’ll cut myself some slack for some of it, because sometimes that’s PPD talking, and I’m not responsible for the chemicals in my brain deciding to make me crazy for a while post-baby. But, PPD aside, then I read your posts about your childhood in Bulgaria and what went on there, and I am able to say, “y’know what? Suck it, lactivists, I fed my kids to the best of my ability, and they’re happy and healthy, and at the end of the day, THAT’S what matters, not how they got to this point. What would moms back then have given to be in my shoes?!”
      In all seriousness, thanks. 🙂

      • Amazed

        You’re so kind. Frankly, I hesitated before I posted this because I realize that it might come across as dismissing what is, to many women, a very real problemл No one is to blame about how things were here back then. But… well, it does look tiny in comparison – PPD excluded, of course!… Thank God that there are so many children who grew up with different experiences.

        Plus, you know what? You can never appreciate white chocolate the way I do. Simply because I was at the ripe old age of 13 or perhaps 14 when I first saw one.

        • KeeperOfTheBooks

          Oh, white chocolate is a beautiful, beautiful thing. I like to bake in my spare time, and recently made a white chocolate buttercream that went on a chocolate cake with raspberry filling…it was, indeed, a thing of beauty. 😀
          Seriously, though, perspective…it’s important.

  • Hannah

    One of the things I love about you is that you point this stuff out. I live in the UK so use European by default… but over here, there’s still a bunch of classism in formula. Mostly I see it from people who use HiPP Organic, which while it may be better for their kid – some of the mums really get their nose in the air about it. But even the midwives I saw, when I asked if there was a difference in formulas, just shrugged and said ‘not really, standards are so tight they’re basically all the same’. And Son was born mere months after Aldi came out with their own brand, £3 cheaper a tub than all the others. So thanks to you pointing this stuff out, I went on blast the other way. And I became the safe person for other mums to talk to about formula guilt! So thank you for pointing all this out – it’s things I never would have thought of otherwise.

  • Adelaide

    For the sake of not scaring away parents from formula feeding you may want to check your numbers. For some of those formula equations you are using the cost per ounce of powdered formula and multiplying it by the number of ounces of mixed formula. Walmart formula comes in around 7.5 cents/mixed ounce if you buy a 4 pack. Earth’s Best (middle of the road organic) comes in at 12.5 cents/mixed ounce if you shop around. Not sure what the European stuff water/powder ratio is, but the number you are using looks like the powder ounce cost. I’m not bashing….just don’t want anyone thinking about using formula to have sticker shock.

    On a side note, I’ve helped a lot of Moms breastfeed, supplement, and transition to formula and I have found that the organic brands that use milk products instead of corn syrup do help easy the initial parent anxiety in regard to formula feeding in some families. I always tell people nutritionally all formulas are the same, but families that are caught up on “what’s in the formula” are much more likely to be open to supplementing or outright formula feeding thanks to some of organic options, particularly ones without corn syrup. It may be a status symbol for some, but in my experience it has been a bridge to shame free formula feeding for most.

    • rational thinker

      “.just don’t want anyone thinking about using formula to have sticker shock.” -The price is not the reason most women decide to use formula and the article was about how some women use european formula as a status symbol. I have a friend that used it and she absolutely was bragging all the time how it was so much better than what other people feed their kids. Her son was failure to thrive on breast milk so she had to get off her high horse and give him formula so she bought a fancy formula so she could get right back up on that horse.

      • Adelaide

        I’m not defending European formula in any way, and for the record I’m absolutely against donor breastmilk outside of doctors’ recommendations. I know that some women may use these formulas as a status symbol, but the large majority of the women I have encountered are struggling with some type of feeding related shame or are simply worried about what their babies are eating. Shaming them over their formula choice is definitively not helpful. I always try to educate about what is different or the same about different formulas depending on the family’s needs.

        All that being said I live in a rural relatively poor area, and regularly encounter moms that are absolutely concerned about the cost of formula. Sometimes they are the same uninsured moms who turned down an epidural because they were worried about how much it cost. These issues are not immediately apparent because most families will not talk about them openly, but gently broaching the topic can offer some surprising insight. Even in families that cost is not a significant player in the decision making process the continued “breastfeeding saves you so much money,” is still pervasive.

        As I said before, some of the numbers above are wrong as best as I can tell. From what I’ve seen this blog values accuracy (which is great) and I was only trying to help in that regard.

        • rational thinker

          Maybe the prices just vary from state to state. When I had my oldest child almost 18 years ago I was friends with a a small group of moms and we all had babies within a few months of each other. All of us in that group formula fed. I remember a couple of the moms used Enfamil the rest of us used carnation good start formula. Even back then I remember the ones using Enfamil would constantly go on about how they are using “only the best” formula and those of us using the Carnation good start were somehow not properly caring for our children and if you were using the store brand you should just have CPS called on you. I guess some women will use any parenting choice to put down other mothers.

          So I guess the new thing is expensive european formula if you are not or cant breastfeed. Mostly I notice its the women who were breastfeeding but it did not work out that buy the imported formulas. It certainly was the case with my friend. When I told her one day that I have never breastfed my kids her first response was “why did you have kids then”.

          Its wonderful that you can help moms with all types of feeding. I really wish being a lactation consultant can one day be an extinct job title. What new moms and families really need is a feeding consultant to help make sure that babies simply get fed in whatever way is best for each individual baby.

          • Adelaide

            I double checked the online prices. The organic numbers and European numbers above looked right around the cost per powdered formula ounce. The low end formula price of 9 cents/ounce is close enough to the 7.5ish cents/ounce I found for walmart brand in bulk that I suspect that is reasonably accurate for inexpensive mixed formula. The 32 cents/ounce is definitely per liquid ounce as well. There are a few super premium ones on the market (enfamil enspire and comes to mind) that are almost that expensive. If we are really being honest here I think that that price is in the same cost bracket as the European brands. Just to be clear I have never recommended either one of these as there are other things on the market that are cheaper and that allay most families concerns. The real place we see major expense is in the premixed ready to use bottles. These can easily top the $1/ounce mark although many are much cheaper. That being said these have their place in certain settings where a shelf stable, perfectly mixed, or quick feeding solution is needed.

          • rational thinker

            The ready to feed stuff is probably the most expensive along with the concentrated liquid that you mix with water. Powder is most likely the cheapest way to go.

    • Heidi

      Non-organic brands don’t use corn syrup either if they aren’t lactose-free varieties. They use lactose as the sugar source.

  • Sarah

    I wasn’t aware parents in North America were using European imported formula. Is it because of the high EU food standard requirements that they think it’s better?

    • KeeperOfTheBooks

      Yep. There’s the “European=fancier/classier” mentality mixed with the “oh noes, the GMOs” mentality.

    • Daleth

      Yes. Your definition of organic is more stringent than ours.

      • Sarah

        Guess I’d best make the most of it then!

  • The Bofa on the Sofa

    Yet there is no evidence that donor breastmilk provides ANY benefits for term babies.

    I always find it funny that one of the supposed great benefits of breastfeeding is that “your milk changes with the needs of your babies” but somehow it is still ok to use donor breastmilk.

  • Marie

    It’s not just in the Western world. In the airport duty free stores in New Zealand there were displays of infant formula with signage entirely in Chinese, aimed at wealthy tourists. I was told by someone who had worked on a farm in New Zealand that NZ dairy is seen as “pure” and more safe than Asian alternatives. By my calculations, the price, even at duty free, was several times higher than what I payed for formula in Canada, definitely a status purchase.

    • Sarah

      It’s not just status in China though, it’s also fear. After the melamine scandal we had a big uptick in buyers from China getting NZ formula.

      • Sarah

        I do see why people in China might be less likely to trust domestic products than those from the EU.

    • AnnaPDE

      In this case it’s more the trust in NZ, Australian and similar countries‘ regulations and enforcement of health related laws. Quality matters, and quite a few Cuinese people who live in, say, Australia, make some extra income by buying local formula and sending it back home with a big markup.

    • Christine O’Hare

      I know a Chinese woman that said she specifically bought American formula when her son was a baby as it was also seen as better than Chinese formula.

      • AnnaPDE

        Pretty much everything that you can trust not to be stretched with melamine will be seen as better than Chinese formula, at this stage.

  • fiftyfifty1

    Yep. There have been a lot of interviews in the press lately with Amy Schumer where she talks about why breastfeeding didn’t work, why she finally gave up on pumping, and what brand of formula she uses. Aparently she started on a regular commercial brand, but Serena Williams got her to switch:

    ““We were giving him Similac and then actually Serena Williams kind of yelled at me and was like, ‘There’s a lot of sugar in that.’ Even though it was great and he was meeting his milestones on Similac, we switched him to Holle,” she shared of the German brand of baby formula.”

    Some observations:
    1. Women still need to justify their decision to quit breastfeeding
    2. Trying to make it work with pumping long-term is a hoop women need to jump through before their decision to quit will be considered justified.
    3. Even incredibly accomplished women are expected to prove their worth when it comes to reproductive choices like breastfeeding.
    4. Name dropping another high status woman who uses formula may help.
    5. Expensive European formulas bring status
    6. People don’t know the first thing about nutrition beyond myths like Sugar=Unhealthy.

    • EmbraceYourInnerCrone

      Why didn’t she ask her pediatrician instead of taking feeding advice from someone who while a great athlete, they are not an expert in what a newborn needs nutritionally (hint breastmilk has a lot of sugar in it!) …I mean if you look at the ingredients list for both Similac and Holle, the biggest difference is Holle uses the word “organic” about a dozen times (eyeroll):

      Biodynamic Skimmed Milk, Organic Whey Powder (Partly Demineralized), Organic Vegetable Oils [Organic Palm Oil, Organic Rapeseed Oil, Organic Sunflower Oil], Organic Maltodextrin, Biodynamic Organic Milk Powder, Calcium Carbonate, Potassium Chloride, Sodium Chloride, Vitamin C, Vitamin E, Ferrous Lactate, Zinc Sulphate

      • AnnaPDE

        I can kind of see the „organic“ thing for someone who is concerned about, say, pesticide residues in milk products. But Holle isn’t just about farming according to EU standards for the „organic“ designation, it’s made by Demeter, the farming association of the somewhat cult-like anthroposophic movement. As in, Rudolf Steiner of Steiner-school fame, who made up a bunch of woo-nonsense on the spot (eg energising soil with stuff buried in cow skulls and similar), when one of his somewhat gullible followers asked him to give advice on improving the yields in industrial agriculture (the irony!).
        It’s not even particularly popular in its home market. Most people who aren’t using one of the cheaper brands (the Aldi one in particular) tend to try Hipp at some point, because it has a reputation that their probiotic formula agrees with some colicky tummies. It’s still a normal-price-range, local brand though.

        • rational thinker

          I didnt know the company name is Demeter. It must be named after the greek goddess Demeter. She is goddess of the harvest an is a god form of mother earth. If a company wants to be seen as natural, healthy or organic friendly its a clever name choice/ marketing choice.

          • AnnaPDE

            It’s absolutely referring to that goddess, but this company (or rather, coop) was established in the late 1920s, long before organic was cool, or really even a thing. Their esoteric method called “biodynamic farming” is pretty out there… just have a look at the links to it and then Steiner’s ”anthroposophy” in Demeter’s wiki article:
            https://en.m.wikipedia.org/wiki/Demeter_International
            It’s not even marketing, they really mean the woo.

      • Alia

        Not to mention it contains palm oil – which would make me cross it out of the list of possibilities as soon as I saw it.