Bottled Up. Suzanne Barston
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better my postpartum experience would have been had there been a book synthesizing all this information, one that lived alongside The Nursing Mother’s Companion and The Womanly Art of Breastfeeding, which would have offered a dose of rational perspective and given me some context in which to make a truly informed decision on how best to feed my child. I couldn’t find that book, so I decided to write it myself.
In the following pages, I’ll present evidence that suggests that the benefits of breastfeeding don’t always outweigh the risks to a woman’s physical, emotional, or financial health, and I’ll advocate a new outlook on infant feeding: one that refuses to embrace a one-size-fits-all strategy. I’ll tell the story of a cultural phenomenon that has touched many arenas—politics, feminism, healthcare, science, and our personal lives; a story about how we view motherhood, how women view each other, how science gets bastardized by bias, and how our choices are not always simple. Each chapter interweaves my own personal journey with informative research, interviews with experts and other mothers, and contextual perspective, in the hope that my travels through the infant-feeding wilderness can personalize an issue that too often degenerates into assumptions and generalizations; that my own struggles and realizations can prevent other women from feeling inadequate based solely on their lack of desire or inability to breastfeed. I’ve chosen to tell this story in a manner that will, I hope, be useful to policymakers, care providers, and researchers but also accessible to the parents who are going to “go make a bottle” and feel terrible because of it.
Most parents are unaware that there is an “other side” to this debate, because the conversation has mostly been relegated to academia, most notably in the fields of sociology and feminism. Joan Wolf eloquently picks apart the breastfeeding science in her 2010 book Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood, arguing that the body of evidence is inherently flawed and used coercively to support the stifling goal of “complete motherhood”; that breastfeeding “sits at the intersection of public discourse on science, health and personal responsibility.” A decade earlier, the book At the Breast detailed the impressive fieldwork of Linda E. Blum. Through interviews with women of different ethnicities and social standings, Blum highlighted the social inequities that put breastfeeding squarely in the purview of feminism. A myriad of academic articles have taken the current state of breastfeeding promotion to task, provoked in part by a 2003 U.S. Department of Health and Human Services/Ad Council campaign that compared not breastfeeding to debauched mechanical bull–riding while pregnant. At the forefront of the infant-feeding debate is the Center for Parenting Culture Studies at the University of Kent, spearheaded by Frank Furedi and Ellie Lee; this notable group has begun challenging how the “moralisation of infant feeding” has contributed to the “belief that ‘parenting’ is a problematic sphere of social life.”1
Yet, most scholars of the infant-feeding debate take a subjective approach, save for a few like the Australian women’s studies scholar Alison Bartlett, whose intimate and fascinating book Breastwork focuses on the sexualization of breasts and the dichotomy this creates for modern mothers. I am eternally grateful for the skilled research and analysis that these pioneers have provided, but I hope to take what they have started one step further: by taking readers through the journey of breastfeeding failure, one step at a time, I hope to show the very human side of this debate. Breast versus bottle is not just a matter of public health discourse or a feminist issue, but a battle that affects women in the most intimate of ways—we cannot possibly understand the toll breastfeeding pressure is taking on women without hearing from the women who have suffered through it. If we leave the women most affected by this battle out of the discussion, by limiting it to the pages of academic journals most of them will never see and discussing it in a theoretical sense rather than a practical one, we may never come to a cease-fire. I hope this hybrid of memoir and reporting will speak for the scores of other women who wanted very badly to do the best for their children and found themselves in conflict about what “the best” truly was.
I begin, in chapter 1 (“Preconceived Notions”), by arguing that the current state of breastfeeding promotion sets women up for failure, framing the “choice” as one that is no choice at all and ignoring the (very real) underlying reasons that make formula feeding the better, or in some cases only, option for some women. I demonstrate how the “good mother/bad mother” dichotomy is manipulated as a way to encourage breastfeeding, by considering the emotionally vulnerable position most women are in when they start thinking about how to feed their babies, and by examining how a now infamous government-sponsored breastfeeding campaign brilliantly capitalized on this vulnerability. Other mothers weigh in on subtle—and not so subtle—forms of pressure and guilt surrounding infant feeding that plagued them during pregnancy.
Prenatal desires notwithstanding, once in the maternity ward, many mothers will find themselves smack in the middle of an inherent conflict between the “natural” discourse surrounding breastfeeding and the medical model that supports the actual practice of nursing our children. In chapter 2, “Lactation Failures,” I show how infant feeding became the purview of the pediatric community, how this shady history resulted in an unstable marriage between breastfeeding advocates and the medical community, with modern mothers caught in the middle. Detailing my own inability to breastfeed successfully in the hospital, I also ponder if, from an evolutionary perspective, we may be evolving—slowly—into a state where breastfeeding is simply not as “natural” as it used to be; hence the need for lactation consultants, breast pumps, supply-boosting drugs, and so forth. We are often told that women in Western culture fail to breastfeed because of societal barriers, but further examination suggests that this interpretation may be limiting our understanding of real, lived experiences.
One of those real, lived experiences is that of postpartum depression (PPD). Recent studies estimate that as many as 20 percent of new mothers experience some form of postpartum mood disorder.2 Chapter 3, “Of Human Bonding,” focuses on women who have struggled with PPD and other psychological disorders (eating disorders, body image issues, and posttraumatic stress from sexual abuse) exacerbated by breastfeeding problems—myself included. I relate stories of women for whom nursing was somehow inexplicably linked to psychological stress, for whom formula feeding was a lifeline, a way back into the light—and I speak with a postpartum mood specialist who weighs in about the detrimental impact of our society’s romantic notion of breastfeeding women, and the number this fantasy can do on the already fragile psyche of a new mom dealing with PPD. I also discuss how medications are determined “safe” for breastfeeding and how the complicated risk-benefit analysis necessary to treat nursing women with clinical depression is muddled by overblown beliefs about the dangers of infant formula.
Chapter 4, “The Dairy Queens,” tackles the convoluted relationships among feminism, women’s rights, and breastfeeding advocacy. Considering that the average American woman has three months maternity leave at the max, most moms have to pump their milk several times a day in order to comply with the American Academy of Pediatrics’ six-month exclusive-breastfeeding mandate. We’ve turned into a nation of dairy queens, with political support for breastfeeding focusing primarily on achieving pumping rights for working women rather than on fighting for better family leave policies that would allow all parents—both male and female—to spend more time with their infants. I speak with a sociologist whose landmark study on white-collar breastfeeding mothers shows how lactation-friendly workplace policies can be a “double-edged sword,” creating a goal-oriented view of parenthood that measures mother love in ounces of breastmilk produced. Through interviews with working women, I argue that even the most progressive lactation policies don’t acknowledge the realities of pumping in the workplace and that a reluctance to supplement with formula is adding a third shift to the already stressful second shift Arlie Hochschild described in her landmark book back in 1989.
This chapter also questions why feminists have either unequivocally embraced or completely ignored the pro-breastfeeding movement. By brushing off the concept of “choice” as a mere construct of the formula companies (as many