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.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There is nothing in breastmilk that your baby needs more than your continued mental health.[/pullquote]

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!