The breastfeeding profession has fetishized exclusivity and it’s harming babies and mothers

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There’s nothing wrong with breastfeeding. There’s a tremendous amount wrong with the lactation profession.

How can that be? Aren’t lactation professionals simply promoting breastfeeding?

That was probably how it started out, but they quickly became obsessed with exclusivity; that fetish is harming babies and mothers.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There’s one infant feeding goal that eclipses all others: the baby’s goal to be fully fed.[/pullquote]

I can’t tell you when the obsession started; it certainly didn’t exist when my children were born in the late 1980’s and early 1990’s. But I can tell you when it became codified: 1996 with the publication of Diane Weissinger’s seminal paper Watch Your Language.

Weissinger drew the battle lines:

When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding…

That isn’t quite accurate — breastfeeding is a great, but not the best possible, way to feed babies — but it does highlight a central insight: lactation professionals recognized that when they tell the truth about breastfeeding, many women will choose not to do it.

Therefore, Weissinger encouraged lactation professionals to exaggerate the benefits of breastfeeding and massively exaggerate the “harms” from formula feeding. Her goal — and it became the goal of the profession as a whole — was to give women no choice but to breastfeed.

Why?

Weissinger was startlingly honest:

We cannot expect to create a breastfeeding culture if we do not insist on a breastfeeding model of health in both our language and our literature.

And:

All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances.

Do you see anything there about what’s good for babies and mothers? I don’t. I see an effort to create full employment for lactation professionals.

Lactation professionals did more than merely exaggerate the benefits of breastfeeding and concoct “risks” of formula feeding; they became obsessed with exclusivity.

Prior to the 1990’s the thinking went that if some breastfeeding is good, more breastfeeding is probably better. But that practical position hardened into the fabricated claim that “even one bottle of formula” can harm an infant.

Where was the evidence for that position? There wasn’t any. There wasn’t even a theory; the claims about the microbiome came a generation later.

Indeed, to the extent that research had investigated the issue, it was difficult to find any dose-response relationship for breastfeeding. Some minimum amount of breastfeeding (two months, for example) appeared to convey many of the SAME benefits as longer duration of breastfeeding.

No matter. Exclusivity has been fetishized and that obsession is responsible for the harms of breastfeeding promotion we see to day.

Exclusive breastfeeding is the LEADING risk factor for newborn re-hospitalization. It results in approximately 40,000 preventable newborn hospitalizations a year at a cost of hundreds of millions of dollars. Breastfeeding isn’t the problem; exclusive breastfeeding is.

How can that be? Breastfeeding, like any natural process, has a significant failure rate. Up to 15% of mothers may be unable to produce enough breastmilk to fully nourish a baby, at least in the days immediately following birth. That might sound high until you consider that fully 20% of established pregnancies end in miscarriage. Nature doesn’t do perfection; it does “good enough.”

Imagine how different the experience of breastfeeding could be if lactation professionals didn’t fetishize exclusivity: the benefits — medical, psychological and economic — could be enormous.

No baby would be forced to experience agonizing hunger; any mother who felt her baby needed formula could offer it.

Once home, women could both reduce pressure on themselves and get more sleep by allowing partners and family to feed the baby one or more bottles per day.

Women could more easily return to jobs and careers knowing that they don’t have to pump every two or three hours because the baby sitter or daycare provider can give formula if there is not enough stored breastmilk.

It’s not breastfeeding that is causing dehydration, starvation, maternal exhaustion, maternal guilt and shame; it’s the fetish for exclusive breastfeeding.

But wait! Aren’t lactation professionals merely helping women meet their breastfeeding goals?

Prof. Amy Brown asks What Do Women Lose if They Are Prevented From Meeting Their Breastfeeding Goals?

Many women stop breastfeeding before they are ready, often leading to feelings of anxiety, guilt, and anger. Critics of breastfeeding promotion blame breastfeeding advocates for this impact, claiming that if the focus were merely on feeding the baby, with all methods equally valued and supported, maternal mental health would be protected. Established health impacts of infant feeding aside, this argument fails to account for the importance of maternal breastfeeding goals …

But who made exclusivity a goal? It wasn’t mothers. Prelacteal supplementation is common in cultures around the world. It is lactation professionals who fetishize exclusivity.

But that reality doesn’t stop Brown:

The purpose of this article is to highlight the importance of recognizing and valuing women’s individual breastfeeding goals, and not dismissing or invalidating their experience if they do not meet these by telling them that they do not matter.

Brown seems to have forgotten the most critical goal of all, the one that eclipses ALL other goals: the baby’s goal to be fully fed.

The bottom line is that the obsession with breastfeeding exclusivity is a fetish of lactation professionals. There is very little if any scientific support for it; it is harmful to babies and mothers; and the only ones who appear to benefit from it are lactation professionals themselves.

  • Helga The Horrible

    My friends have a newborn that wants to breastfeed every hour, day or night. Mother is at her wits end. At a one month check they ask their pediatrician if she thinks it would be a good idea if they give some formula to the baby. The pediatrician asks the mother: “why don’t you want to give your baby breastmilk? ”
    So not only lactivists are guilty of shaming women.
    I personally wasn’t in BFH. My baby refused to breasfeed, and was screaming. Formula was given on the second day. She was drinking exclusively breastmilk from months one to six (it took me a month to build up my flow). I just hate hate hate the militant exlusivist philosophy of any kind.

    • rational thinker

      I would say a new pediatrician is in order. A statement like that shows the doctor cares more about upholding an ideology than the health of the baby.

    • Vast

      I had anxiety-related postpartum psychosis and some of my delusions centered around my breast milk. Breastfeeding had been extra rough prior to the psychosis because my baby would only nurse when I was lying down in odd positions due to my excessive let down (and in addition we both had thrush). After my psychosis episodes my GP was handling my medication – I had pumped and dumped while on Xanax for a few weeks (only way to get the anxiety to stop) as I transitioned to Zoloft but slowly I started to realize that the breastfeeding was very triggering me and I could not take the isolation and trapped feeling of staying home nursing lying down all day and pumping and dumping was enough to show me all the problems with exclusive pumping… so when I got fully on Zoloft I started intentionally reducing my supply and never went back to breastfeeding.

      When I saw my GP for a check in (was supposed to report back on how the Zoloft was working, also I needed better medication for the thrush that would not go away for me… my baby’s thrush cleared up fine with what they originally gave)… anyway, she asked me if I was still breastfeeding. I said no. She looked a little disapproving and said, “You know, you can still breastfeed on Zoloft!” Unbelievable. I have no idea if she remembered that my psychoses involved breastfeeding… didn’t ask her or say anything. I should have. I made the healthiest choice for my entire family.

      • rational thinker

        You did the right thing stopping breastfeeding it was obviously not best for you. A lot of doctors have fallen for this militant lactivism too and its a shame.

        Postpartum psychosis is nothing to fool around with it is very serious and your doctor should have known that. When a woman has postpartum psychosis everyone who lives with her is at risk, especially the baby.

        Postpartum psychosis is what happened with Andrea Yates. She loved her children very much, but it still happened.
        She always had mental issues but the postpartum psychosis is what finally did it.
        It is very serious and it makes me sick that a doctor who should know better would be more concerned about breastmilk than mom’s mental health.

  • mabelcruet

    Has Weissinger ever come back and addressed how her paper has resulted in so much pressure on mothers, and how it has been used to force mothers into breastfeeding destroying their own mental and physical health? Has she ever suggested that she didn’t mean for it to go so far, or didn’t expect that the lactation industry would take it to the extremes that it’s currently at? Has she ever addressed being the starting point for a huge division in maternal and infant health, so much so that there is wide scale bullying and abuse hurled at those who choose different paths, simply because of her initial, profoundly unethical suggestion of exaggeration and deceit to emotionally blackmail mothers into breast feeding? Has she ever apologized for her role in starting, or, if not starting, considerably inflaming the mommy wars?

    • Anna

      Like all lactavists I doubt she gives a crap about the damage she has done. I’d suspect she considers the paper a huge success – it has almost certainly contributed to raising initiation rates. Most major lactavist groups use the risk based language. I don’t think they care that they’re shooting themselves in the feet – its never been about increasing breastfeeding rates. Honestly, if there was some magic wand I could wave that would make everyone magically be able to and want to breastfeed tomorrow would they be happy? No, of course not, because they’d be out of jobs and they wouldn’t be special any more.

  • Azuran

    On day 4 or 5, my 2nd baby had one episode of cluster feeding, the only one he had in fact, and you know what? After 3 hours of constantly feeding him when it was obvious my breasts were empty, I gave him a bottle, he drank it all, then slept for a couple of hours, we both rested, and since then he is also exclusively breastfed, it’s actually the only formula he had.

    Did he absolutely need it? No. I generally had enough milk, it was basically the first time he wasn’t satisfied after feeding. Absolutely nothing dramatic (or even remotely harmful) would have happened if I hadn’t given it to him, he probably would have kept cluster feeding for a couple more hours until everything settled down. But why? What good would have come from letting him be hungry even longer and not allowing myself to sleep for over half the night just so he could be ‘exclusively’ breastfed?

    (also, he’s very very VERY fat, must be because of that 1 formula bottle I guess)

    • mabelcruet

      Just you wait-you’ve totally buggered up the poor boy’s epigenetics, and in 100 years time, his great-great-great grandson is going to go prematurely bald, and it’ll all be your fault, you selfish she-devil, you….

    • PeggySue

      Yes that one bottle MUST have done it!!!! Right. Too bad you hadn’t read Weissinger.

    • rational thinker

      Omg! You have gone and screwed up his microbiome with that one bottle!