Posted on by Mary

On breastfeeding

I don’t intend to post a lot of parenting stuff here, but I wanted to make some notes about breastfeeding activism (‘lactivism’) for the geekosphere, as Brenda Wallace has done in talking about her decision to do mixed feeding.

A couple of preparatory notes:

  • The compulsory Mary notice: I am not looking for advice. I am not lacking personally for professional support for my breastfeeding difficulties. It is easier for me to rely on that support than it is to filter through the advice of millions of onlookers. Thank you for your concern!
  • I am a whole week into parenting and have exclusively breastfed to date. I feel quite committed to continuing such to the recommended six months of age and then continue partial breastfeeding for some time thereafter. But. One whole week. And it’s been really hard, actually, even with a good supply from me and a good suck from him and fairly good institutional support from my hospital. I’ve had a middle-of-the-night visit from a locum already to treat mastitis. One whole week. I’m not here to tell you how easy it is.
  • I do not have personal experience of feeding-related persecution or even hassles. (I’ve hardly left the house, I could be not feeding him at all and no one would hassle me.)
  • I really do not mind about your feeding choices for your infant or child, in the sense of exclusive breastfeeding, mixed feeding or exclusive formula. The hassling in the street goes both ways, and in many areas (especially, I gather, the US) the hassling from medical staff sure runs both ways too. I am generally uninterested in person-to-person shame advocacy. More on this later. It’s demeaning, insulting and counterproductive. Lose, lose, lose. Feed your baby, I’ll feed mine, who am I to tell you how?
  • Purely as a terminology thing, formula feeding is not the same as bottle feeding: you can put human milk in bottles and many people do so. (It’s not functionally equivalent to breastfeeding though, because it’s harder to establish and maintain supply, and the correct handling of the bottles is a nuisance as Brenda notes.)

So, why lactivism, a kind of 101:

Consider areas without safe water supplies, that is, most of the world (and this includes major cities of Western nations in the immediate aftermath of a disaster, New Orleans was an example). Formula feeding, or anything other than extended exclusive breastfeeding, is really really dangerous without a safe water supply. Gastric illness kills babies. Lots and lots and lots of babies, many of whom would not have died if exclusively breastfed. Unless there’s a safe water supply mothers with HIV are currently encouraged to exclusively breastfeed, as the risk of the baby contracting HIV is less than the risk of her or him dying of gastric illness related to substitution.

There are several problems with promotion of formula in such areas, or any economically disadvantaged area, a non-exhaustive list includes:

  1. correct preparation of infant formula, including sterilisation of bottles and correct dosages is not trivial and not always (I suspect, not even often) communicated in a manner appropriate to, for example, illiterate people or even people literate ‘only’ in their local language
  2. correct preparation of infant formula is expensive
  3. weaning to formula creates dependency on the product, or at least on milk substitutes: women can restore their own milk supplies (at least sometimes?) some time after weaning to formula, but it’s not especially easy. Without support they’re stuck with a major hole in the household budget, or with dangerous feeding, ie, watered down formula or homemade milk-ish substances.
  4. Per lauredhel here, for many women exclusive breastfeeding is the only reliable contraceptive they have access to (exclusive breastfeeding on demand is more reliable than you’ve been led to believe as a contraceptive) and the use of formula therefore imposes a potential burden of very closely spaced pregnancies.

Right upfront I’ll note that I am far from the most ethical consumer in the world, I have not a shred of pedestal to proclaim from. But. Formula producers are involved in aggressive marketing in exactly these circumstances, in addition to marketing to new mothers in the Western context who are in the often difficult phase of establishing their desired breastfeeding relationship. I’ll note again that in a Western context and in a proclaimed pro-breastfeeding medical environment, I have found aspects of establishing nursing hard. Really hard. If I’d had formula in the house last night it would have been very likely to have been used. (Again, not that there’s anything wrong with that morally, but as a practical matter supplementing is not exactly helpful in further establishing nursing. Or for that matter in dealing with mastitis.)

So, I support very strong institutional focus on establishing breastfeeding in Western countries, and particularly strongly oppose marketing attempts to establish formula feeding as desirable in developing countries. That is my lactivism.

Now to the horrible shaming mothers thing. This sucks. My take on it is that it is two way, like a lot of Mummy Wars. Damned if you do, damned if you don’t. Telling formula feeding mothers that every breastfeeder [is] a better mother than any formula-feeder? Spew. Using the power of the state against breastfeeding mothers? Unspeakable.

I only wish Chez Miscarriage had left her archives up about (some) reproductive choices: no kids? selfish non-Mummy. biological kids? selfish narcissistic eco-raider Mummy. ART biological kids? selfish rich narcissistic eco-raider Mummy. adopted kids? selfish, also rich, Mummy. etc. (Incidentally, re reproductive choice, go be challenged, you’ll gain more there than here.) None of that is the argument I want to have or the people I want to have it with.