The other day, I read this post on the reasons why women stop breastfeeding over at @phdinparenting ‘s blog. (I seem to have established a pattern of responding to Annie’s posts- they always make me think.) Overall, I agreed with the thesis; that breastfeeding advocacy should focus on the women that want to breastfeed and stop before they achieve their personal goal, rather then the small percentage of women who don’t start breastfeeding. I also agree with the general sentiment that what most women need is greater support.
But I was disheartened by what I perceived as the focus on ‘formula as the issue’ in the post. To be clear, it is not that I don’t accept that formula has an impact. But rather that I believe that the impacts of formula are there because of the lack of knowledge, research and support for women, and not the other way around. I’ll get to what I mean in a minute.
First some background. The post pointed to a Today’s Parent survey about women’s’ breastfeeding experiences. (Oh the irony with the HUGE Simlac advertising banner on the site). The survey identified: “.. three difficulties were roughly twice as prevalent in women who stopped early: low milk supply, low baby weight gain and a baby who seemed uninterested in nursing or nursed ineffectively.”
To me, reading this, I thought of all the challenges I experienced and the hurdles I wasn’t prepared for, that had an impact on all of the above three difficulties. The specific physical (both for the infant and the mother) and emotional challenges.
The post, though, focused on what I see as the secondary results of these challenges. While acknowledging that there are some women will encounter “insurmountable challenges”, Annie suggests that others will encounter “surmountable” challenges in combination with an other contributing factor. Of the contributing factors she lists, five that have to do with being encouraged to use formula, two that have to do with lack of support and one that has to do with social stigmata. I do not disagree that these contributing factors have an impact. I know they do.
But to me, it perpetuates the focus on breastfeeding advocacy in the same, misguided place: against the formula companies and not against the challenges. That is, if the “surmountable” challenges were discussed, researched, communicated, NORMALIZED, then the impact of the sway of formula would be lessened. If the contributing factors had nothing to contribute to…… see what I am saying?
Instead, this continued focus on the impact of formula derails the discussion from the one that we really need to have. The one about how almost every Mom, 9 out of 10 according to Today’s Parent, encounter at least one of the typical struggles. Those struggles are normal. They are to be expected.
From my experience, many breastfeeding advocates try to avoid acknowledging them and talking about them; fearful that they may scare women off. Worried people will think breastfeeding is hard and therefore not worth it. They put them in as an aside, explaining that just small percentage of women experience them- inconsequential. The problem with this of course is that even a small percentage of women is thousands and thousands of people. I have often heard advocates remind women that sometimes we ‘think’ our baby isn’t getting enough milk, but really they are. Which may be true, early motherhood is full of worry- some of it unnecessary. But this fits in with a general pattern of downplaying women’s experiences and making many of us feel like we are being told that it’s all in our head and we just aren’t trying hard enough.*
In my opinion, the formula advertising/sampling/suggestions from health care workers- that’s not the reason women stop breastfeeding. They stop breastfeeding because their told its
a) necessary for a healthy child and you do it if your a ‘good’ Mom
b) easy, pain free, blissful and ideal
c) natural and everyone can do it
and then the reality of their experience doesn’t match up with what they were told. It’s not pain free, it’s not easy and it may be physically possible for the majority of women to do it, but it sure doesn’t seem like that at 2am when your baby is crying.
Is breastfeeding worth it? Yes. I believe it is. But it isn’t easy in a culture of Motherhood where perfection is expected. Where mothers are blamed for anything that goes wrong with their kid. Where real experiences are swept under the rug in favour of talking about the ‘formula conspiracy’.*
Formula is not the reason women stop breastfeeding. Women stop breastfeeding because they feel defeated and alone. That’s what we need to target.
The great tragedy of that first year of motherhood, in my opinion, is that feeling that you are alone. That no one else is experiencing what you are experiencing. That you are a failure while everyone else is thriving. I can’t tell you how many Mom’s I have talked to that have expressed feeling this way. And while infant feeding is not the be all and end all of the reason women feel this way, it is part of the big three triad: feeding, sleeping and crying. What we need to do, more then anything else, is change the culture around motherhood. Admit and accept that it is hard. But it is less hard when you don’t feel alone. When you know that what you are experiencing is normal and to be expected. Where no one down plays your struggles.
So I am going to give you a list of what reasons I believe are the real reasons women stop breastfeeding. These are the things I believe we need to talk about, research, discuss and demystify. (These are taken from my comment over on Annie’s post)
-extreme maternal stress/anxiety/depression and the impact on milk production
-tongue tied infant which can reduce breastfeeding efficiency and have a negative cyclical impact on supply
-infant allergies (either to milk protein or something in the mothers diet), which impacts the health of the child and requires elimination diets that sometimes don’t work
-Poly Cystic Ovarian Syndrome or some other maternal hormonal/endocrine disorder which can impact supply
Since writing this I would also like to add the following:
-blocked milk ducts and mastitis
Feel free to add to this list in the comments. What I would like to see is when we talk about the reasons women stop breastfeeding we talk about the challenges women face first. That is the number one way to render the marketing tactics of formula companies ineffective. It is also the number one way to reduce the “Mommy wars”, come together as a community and start to really support each other.
What do you think?
*Side note: Just to be clear, though I would have liked to see less talk of formula and more talk of challenges in Annie’s post, I know she often advocates against this ‘blame the mother’ culture. She is also a great advocate for more breastfeeding support for mothers. I also do not believe, based on what I have read, that she is in any way down playing women’s experiences or contributing to the ‘its all in your head/you aren’t trying hard enough” approach to breastfeeding advocacy. I just happened to disagree with the focus of this particular post and it happened to get me thinking.
I’d like to add another reason that I came to understand from personal experience: you just want your body back. As women, we are asked to take on a huge project (some might say burden) in childbearing. Our bodies are put through a lot during pregnancy and childbirth, and breastfeeding is just another physical task we’re asking of it. For me, I got to the point where I just wanted a break. That mindset probably falls into the category of “insurmountable obstacles” because the only way to give oneself a break is to stop breastfeeding.
I’m sure this will be considered selfish by some, but there are plenty of things that we as women choose to do and not to do in order to protect our bodies. My daughter’s survival did not hinge on my ability to provide her breastmilk, thus I didn’t feel it was dangerous or selfish to put my own needs at the same priority levels as hers.
I really like this:
“Formula is not the reason women stop breastfeeding. Women stop breastfeeding because they feel defeated and alone. That’s what we need to target.”
I completely agree that women stop breastfeeding because they feel defeated and alone. While formula isn’t the reason that women stop breastfeeding, it is ever-present in that gap that should be filled with breastfeeding support.
Let me give you some examples:
- Mother leaves the hospital 1 or 2 days after he baby is born feeling nervous and unsure and instead of being given the phone numbers for LLL and IBCLCs, she is pushed out the door with a bag full of formula samples.
- Mother goes to the doctor because she’s having breastfeeding problems. Instead of giving her a referral to an IBCLC, the doctor says “why don’t you just try formula?”
- Mother goes online in search of breastfeeding help and finds inaccurate or superficial articles flanked on both sides by formula ads.
- Mother needs of wants to go back to work and instead of being given support in the workplace and at her baby’s daycare for pumping/feeding breastmilk, she faces roadblocks every step of the way, but the formula company sends her a case of 24 cans of formula and a stack of coupons.
So I think it is a combination of the two. Support is lacking and formula is always there when it is lacking.
I almost stopped breastfeeding because everyone told me it wasn’t supposed to hurt, and it hurt like a SOB. I thought that it must be ME….I must be doing something wrong. I worried and fretted, visited LC after LC, and spent a lot of time on the internet, trying to “fix” the problem. The real problem was that I didn’t understand that breastfeeding DOES hurt for many women, even when everything is fine with the latch and the baby’s weight gain. I think it’s ridiculous that we’re taught to tell women that “if it hurts, something’s wrong.” Here’s my post on that topic! http://thechickadeetweet.blogspot.com/2011/01/things-were-not-allowed-to-say.html
This post beautifully alludes to my number one problem with the “breast is best” campaign. The problems that often arise are not discussed enough ahead of time then, when you ask about those problems, because they probably will happen to you at some point, it is easily glossed over with “that is normal, don’t worry about it.” But you do worry about it, and you feel like a crazy person, and you feel alone/unsupported. That is the pervasive problem that leads to women cracking open that first can of formula in desperation for some peace of mind. It is not formula ad campaigns or doctors who push the evil poison, it is the fact that sometimes women feel like they have nowhere else to turn for help when it is not easy, natural and pleasant. Add in that I think the numbers of people who do have genuine physiological barriers to success (hormone issues, low supply, challenging anatomy for mom or baby etc.) are vastly under-reported (it is much easier to lump those women in to the category “not trying hard enough”) and one does wonder if the current approach is really that helpful for women.
I would add to the list some variant of “lifestyle not conducive to breastfeeding success.” The idea that anyone can do it if they just try hard enough overlooks the fact that not everyone can just stay at home and work it out for as long as it takes. This is a whole sociological/political/economic aspect that rarely gets discussed. Far too complicated to fully explain here, but in a nutshell unless you have a certain level of affluence, it can be very hard to get the resources you need for success.
I will be more blatant than Shasta (commenter #1), some women, myself included, just hate it. I hated breast-feeding for the full 7 months I breast-fed. An extreme version of wanting my body back, I guess and since my baby’s survival didn’t hinge on it, I ultimately stopped.
You don’t need to “target” anyone.
Sometimes it just doesnt work. And that’s okay.
My wife pumped for nearly a year because she and my sons couldnt get the latch going. She was a hero for what she did and damn anyone who tries to “target” her or moms like her.
http://www.dad-camp.com/2010/09/breast-is-best-but/
Hello Buzz,
I hear where your coming from. I tried everything I could to breastfeeding my daughter and ended up stopping at about 4 1/2 months. My goal though, was to breastfeed her for at least a year.
So when I say “Target” I don’t mean “target” like : go after, make feel bad, or “fix”. I mean support, help to feel not alone and provide better care to. The other thing I am referencing is that much breastfeeding advocacy focuses on convincing women who don’t breastfeed at all to consider it and in doing so often hammer on the “evils” of formula. However, given the number of women who really want to breastfeed, but stop shy of their goals, if we want the rates of feeding to increase, focusing on them (with more support) is more likely to be effective and have a positive impact.
So I feel you may have misunderstood me.
For me it was ultimately the struggle to pump at work. As a teacher with no flexibility in my schedule, no hot water in my classroom and no private place to pump it was just too hard. I kept it up for a month but couldn’t stand it after that.
Also, I had thrush for over two moths in the beginning and it was the WORST experience. I can’t even tell you how horrible the LCs were about it, telling me it would never go away and I’d have to endure it for the duration of my BF experience. It hurt so bad for so long, I put so much crap on my nipples that I eventually got a weeping contact dermatitis. Imagine a baby sucking on a weeping rash for a week. Yeah that.
I did not like BFing much. Maybe next time will be better but I think the main reason I didn’t like it was that I was told over and over that my problem weren’t that bad, that they were somehow very common and yet out of the ordinary – that BFing was so easy and natural and yet everyone struggled. It just all seemed like a lie and I hated being fed the BS over and over again. It really bothered me.