Archive for September, 2010

Tits on a bull…

Yet another can of worms has been opened, this time in the form of a call from a Doctor of Midwifery to ban baby formula except on prescription in Australia. http://www.abc.net.au/news/stories/2010/09/23/3020386.htm?section=justin This has incited near rioting from feminists, demanding women (rightly) have access to free choice, and on the other side, loud chants of “Hear! Hear!” from the so-called “breastfeeding nazi” brigade. Ultimately, though, this polarization benefits none of us as women, being divisive in nature and smothering any chance of civil discussion about breastfeeding in general and also the mothering choices women have.

Yes, women have a right NOT to choose breastfeeding. Likewise they have a right TO breastfeed. The medical literature does support breastfeeding – in the simplified breast milk versus formula comparison –  in the manner of lifetime benefits of lower incidence of diabetes and obesity, and a statistically lower risk of illness and hospitalization of babies in their first year. That’s all well and good, but women themselves – as human beings with their own needs – are largely absent from the medical discussion. What motivates a woman to breastfeed? What discourages them?

From my own experience, breastfeeding was no picnic, especially in the early stages. It was excruciatingly painful (I lived on ibuprofen for a couple of months) from a latch issue as well as a candidiasis issue caused by the antibiotics I was given in hospital during her birth. Negotiating the social bias against breastfeeding – especially in public – in the area where I live was also tough. There was no support in the way of hospital lactation consultants, and my daughter’s pediatrician was completely clueless, as was my obstetrician.  I relied on telephoned advice from friends who were experienced,  internet research, and my training as a nurse. My daughter point blank refused any kind of bottle (one memorable desperate day I did get 4oz of formula into her via a bottle, which took over an hour, and then she promptly and spectacularly threw up every ounce all over herself and me in a gushing fountain), leaving me no option but to be the sole source of nutrition for her for at least for the first six months. Coupled with waking every two hours every night until she turned one year, it was a pure living hell.  I get why so many women give up, I really do. I persisted, however, because I felt it was a healthier option for her. Looking back, I remember absolutely no discussion whatsoever from anyone about the challenges or downsides of breastfeeding. Taking all of that into consideration, though, there is no reason why we should throw the baby out with the proverbial bathwater and have to choose sides in the debate. Breastfeeding does have advantages as well. The problem is that there is no informed consent in regard to breastfeeding – without all the information, there can be no true consent. Without informed consent, there is no point in having to get a prescription for formula.

I came across this article http://www.cannold.com/media/2000-06-03/ in reference to breastfeeding choice, as well as this article http://www.cannold.com/media/2008-01-27/ which hurls ire at hospitals for introducing “Breastfeeding Friendly Hospital” policies. From the point of view of someone who is choosing not to breastfeed, sure, those policies might be somewhat of an intrusive nuisance at best, and a guilt-inducing angst-ridden nightmare at worst. But what about those mothers who DO want to breastfeed? Their choices are undermined on a daily basis by hospitals who do not have the breastfeeding friendly policies in place (of which there are many – I found a spectacular example when I had my daughter) and freely hand out formula samples. Breastfeeding IS the healthier choice for the child, hands down. Formula is not equal to breast milk and never will be.  However, it should never be a situation of either/or if we want the choice to be legitimate and take into account the needs of the mother as well as the child. The stark reality is that very few doctors or nurses are taught properly about lactation in their basic tertiary education, and many are ill equipped to help a new mother who is having any kind of breastfeeding issues unless they have attended extra training in the area, leading to a vicious cycle of breastfeeding problems with a lack of good advice leading to failure to thrive, leading to cessation of breastfeeding and ultimately (undue) guilt on the part of the already stressed mother. Until every single nurse, pediatrician, and obstetrician have the extra training in lactation issues, there absolutely is no place for a prescription only availability for infant formula.

Perhaps this should-formula-be-prescription-available-only debate is a metaphor for the bigger underlying  issue. Women are extremely adept at judging one other. Perhaps this is symptomatic of an underlying unease or insecurity about such personal issues as breastfeeding and what defines Right Motherhood in this age of parenting tomes and abundant internet preaching. Who has the Right Answers? What is the Perfect Mother? We seem to attack each other rather than support each other’s choices. Let’s face it, the job of motherhood is hard enough as it is without adding the judgment from each other.  Women are faced with a damned-if-you-do, damned-if-you-don’t situation as long as this judgment keeps happening. There also seems to have been somewhat of a puritanical backlash since the heady days of the Women’s Movement in the 1960s and 70s – evidenced by the polarization of women into the two camps of Working and Stay Home, each – on the surface – acknowledging each other, and – behind closed doors – whispering subtly worded deadly daggers in the direction of the Other Side’s backs, demonizing their choices. The return to the ideals of what is a good stay home parent come straight off the set of Leave It To Beaver, with self-sacrifice on the part of the mother at its epicenter.  I have personally been witness to the glazing over of eyes and rapidly diminishing conversation that occurs when you tell someone you are a full time parent, the assumption being you have no knowledge of anything beyond diapers and teething and only wish to speak of how completely fulfilled you are by motherhood, and have also heard the sniping comments of other stay home mothers who say things along the lines of “Why bother having children if you’re going to have someone else bring them up?” in reference to mothers who choose to continue their careers.

So what would be helpful to glean from this current debate? It is clear that there are many barriers to breastfeeding – lack of time/place in a work environment for breast milk pumping, lack of social support, pain from incorrect latch issues, and hormonal issues. Let’s not also forget that some women just don’t want to breastfeed as a personal preference. What we need is for the information both for and against breastfeeding and formula feeding to be readily and easily accessible, and for women to support each other’s choices and recognize that we can never truly walk in another person’s shoes. We need to start the discussion on how we can return to a more shared experience of motherhood, instead of the isolationist approach we have in our society, which ultimately plays a large role in the divisiveness of contemporary motherhood and the rise in postpartum depression. We can address some of the barriers to breastfeeding instead of blanket bans of formula. We can also stop pretending breastfeeding is a breezy picnic (“if only you could just get  it right”) when it really isn’t for a lot of mothers.  If we supported more women properly, perhaps more would breastfeed.  In short, we need a kinder, gentler approach from everyone. We need to stop judging and sniping at each other with righteous outrage and come together to recognize that motherhood is, frankly, a bloody hard task for anyone who attempts it, and that divisiveness ultimately benefits none of us  and is as useful as the proverbial tits on a bull.


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