The folks at the CDC are shocked, shocked that women all across America are ignoring their breastfeeding advice. Perhaps it is because medical professionals have gone beyond the realm of medicine to embrace the dominant mothering ideology, an ideology that is not shared by all women.
According to Racial and Ethnic Differences in Breastfeeding Initiation and Duration, by State:
National estimates for breastfeeding initiation and duration to 6 months and 12 months were 73.4%, 41.7%, and 21.0%, respectively. Breastfeeding estimates varied by race/ethnicity, participation in the WIC supplemental nutrition program, and mother’s age and education.
The folks at the CDC can't resist offering their own opinion in the form of an "editorial note":
Breastfeeding provides a wide range of benefits to the mother, child, and community, and reaching higher prevalence of infant breastfeeding is an important public health goal.
But the reality is that the benefits of breastfeeding, while real, are small and that the dramatic efforts to increase breastfeeding rates reflect the dominant mothering ideology rather than the medical evidence.
In a fascinating PhD thesis Cross-Cultural Framing Strategies of the Breastfeeding Movement and Mothers’ Responses, Harmony Newman explores the philosophical underpinnings of the belief that breastfeeding is critical to infant health and well being. She argues that lactivism (aggressive attempts to promote breastfeeding) can only be understood within the framework of the dominant mothering ideology, intensive mothering. As she explains:... [I]ntensive mothering is a belief system that demands that mothers provide unlimited amounts of care, attention and affection to their children. This dominant discourse of motherhood has been described as one that sees mothers as “selfless” and “sacrificial)". That is, mothers are expected to focus primarily, if not exclusively, on their children’s needs rather than on their own desires and needs. Furthermore, mothers are increasingly being held responsible not only for the health and well being of their children, but also for their cognitive and intellectual development, and their overall short-term and long-term success in life.Lactivism is best understood as a product of this ideology:
Breastfeeding fits within this dominant intensive mothering ideology as it is constructed as the ultimate infant feeding method—the healthiest way to feed a child and one of the best ways for an infant and mother to bond. Breastfeeding very often requires a considerable amount of time from the mother, as she is the only one who can provide the child this sustenance. A breastfeeding (and/or pumping) mother must also have dedication to persevere through the physical struggles that she may encounter. We see activists in the breastfeeding movement draw on this ideology in the construction of their persuasive arguments, encouraging mothers to fear for their children’s future health and possibly even feel responsible for failing to best protect their children if they do not breastfeed.Newman points out that while all mothers are aware of the dominant ideology and most believe in it (hence the fact that it is the dominant ideology), there is wide variation in how rigidly mothers follow the prescriptions that flow from the ideology.
The strictly committed women believed that motherhood could not be understood in any way other than according to the dominant standards. In contrast, other mothers were resistant to the idea that one conception of motherhood should be applied to all women. These women were much more flexible in their ideological commitment to intensive mothering.Those who are rigidly committed to intensive motherhood believe and behave in different ways than those women who have a more flexible commitment.
The women committed to intensive motherhood as ideal had a very particular conceptualization of what “good” motherhood meant. The mothers with a strict commitment described characteristics of good mothers as those who are “selfless” and “present.” ... These women are explicit in their construction of a good mother as someone who puts herself on the backburner, first addressing any needs her children might have. [Some] even [argue] that mothers who do not align with this ideology of selflessness should be considered “bad mothers.”... This perspective—that “good” motherhood requires an unending amount of attention, affection, and selflessness—is a very demanding expectation for mothers. These women strictly believed in the standards of intensive mothering and expected those behaviors (and sacrifices) both from themselves and other mothers.In contrast:
... [W]omen with a flexible commitment to the dominant standards of motherhood tended to agree that there was not one cut-and-dried way to parent. Instead, 65 percent of these women argued that mothers needed to figure out what sort of parenting style worked best for them and their children... These women are critical of the idea that there are ... rigid rules for parenting... [T]hey believe that different parents, children, and situations call for flexibility, and spontaneity in figuring out what the most appropriate response should be.
In other words, the unwillingness of women to follow breastfeeding recommendations and the racial and ethnic differences in breastfeeding rates may reflect the racial and ethnic differences in willingness to embrace the dominant mothering ideology.
Predictably, despite the failure of breastfeeding promotion efforts in raising rates of breastfeeding, the folks at the CDC recommend more of the same:
Breastfeeding should be promoted through comprehensive clinical and social supports starting in pregnancy, and including the birth, delivery, and postpartum periods.
There is no consideration given to exploring the reasons why women ignore the recommendations and the support already provided. There is no awareness that many women simply do not believe that the small medical benefits justify the difficulties and inconveniences of breastfeeding. There is an astounding lack of insight into the fact that many medical groups have far exceeded their medical brief in aggressive promotion of breastfeeding because they are promoting a philosophy of mothering that many women do not share.
The promotion of breastfeeding is a worthwhile goal, but the aggressiveness with which this goal is being pursued cannot be justified by the limited benefits that breastfeeding provides. That aggressiveness reflects a ideological understanding of motherhood, the ideology of intensive mothering. Unless and until medical organizations acknowledge their own philosophical biases, their efforts are doomed to failure.
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What does that have to do with my claim that exaggerating the benefits of breastfeeding is not justified either as medically correct or as effective in increasing breastfeeding rates?
How are women helped by promoting an ideology that insists that there is one and only one way to be a good mother ... an ideology that implies that being professionally successful is incompatible with being a good mother?
What does breastfeeding have to do with being a good mother, anyway?
No, many women feel that it is a nuisance to them. Why do we ignore how these women feel and imply that there is something wrong with them?
Basically, I like what you are saying, that women should not be pressured to parent in any particular way. And I understand that not every woman chooses to breastfeed, and that they have a million reasons.
Obviously formula has been working for quite a long time, and there really isn't a real medical reason for promoting breastfeeding. I don't know why the government has chosen to promote it so strongly, perhaps as a way to save money or to reduce waste from packaging. That being said, breastfeeding also has a risk. Mothers need to live cleanly in order to breastfeed. This includes abstaining from drugs, alcohol, and even prescription medicines that they may need. It also requires the mother to be monogomous with a healthy partner, or use disease prevention measures in their sex life. But any sex life at all does pose a risk, because if a mother becomes infected she can pass that on.
In this way, the government is being irresponsible by using an approach to breastfeeding that says everyone should do it. Obviously, everyone should not.
That being said, many women do enjoy breastfeeding. And they can still do their own thing. That's why there are breast pumps. I have breastfed both my children, but it's something I never had any trouble with and I always enjoyed it. I think it's easier. But it's not for everyone.
That said, however, I do not consider myself a "lactivist" (great word!) and said nothing when my only grandchild, the daughter of a child who breastfed far longer than normal, was given a bottle. I never ever found it "nuisance" and would do it again in a heartbeat, if I were not long past menopause.
I broke ranks with La Leche League because of the lactivism. While I may disagree with you on the benefits of breastfeeding being "minor," I feel it is far, far, far more important to support a new mother and help her be the best mother she can be, no matter how she chooses to feed her child. I would never guilt a mother into breastfeeding or make her feel "less than" for choosing to bottlefeed. By the same token, if a mother wants to breastfeed, I would do all I could to get her past the first awkward days until she can enjoy it.
We live in an era where breastfeeding takes real work, especially since so many mothers must also work (I was fortunate that I was able to stay home with our babies). We also live in an era where there is more stigma about nursing in public than I experienced in the 60s and 70s.
Bottom line is the baby. If it is healthy and happy and the mother feels comfortable with her parenting, how I feel about it, or how I did it is not important.
Amen!!
I breastfed my four children, despite some difficulties, and ultimately enjoyed it a great deal. It was the right thing for me and for my family, but that doesn't mean it's right for everyone.
RSG asked one question...
"Why aren't you fighting for a family friendly society that would make it much easier to women to combine mothering their infants and pursuing their career?"
You "answer" with three.
"What does that have to do with my claim that exaggerating the benefits of breastfeeding is not justified either as medically correct or as effective in increasing breastfeeding rates?
How are women helped by promoting an ideology that insists that there is one and only one way to be a good mother ... an ideology that implies that being professionally successful is incompatible with being a good mother?
What does breastfeeding have to do with being a good mother, anyway?"
One rating. Well done Amy.
Yes, this. We should all be fighting for this.
Let me illustrate how easy it was for me to combine breastfeeding and my career. (And for the record, it was my choice to do it, I wasn't following some "agenda" and I've never heard the phrase "dominant intensive mothering ideology" until just now.)
First, my company offered a 6 month maternity leave. They didn't pay for it, but you could use vacation time and sick pay, which paid for a good 3 months of it. Then, when I went back to work and brought my baby to the company-subsidized day care (1 block away) I could visit my child and breastfeed during my lunch hour. In addition, my company provided a lactation room (with a cushy chair, refrigerator, and complimentary use of a high-end Medela breast pump) so that I'd have a supply of breast milk to bring to the daycare each morning.
This made it so, so easy for me to breastfeed, and in retrospect I was extremely lucky to have worked for such a great pro-family employer. I ended up nursing both my kids for over a year.
Would have I been able to do it without these supports in place? Probably not. It would have been too stressful for me.
One huge problem is that women are ridiculed, harassed and discriminated against every day because they breastfeed. This cannot be ignored when siting any drop off in nursing. The sexualization of breastfeeding still dominates attitudes in this country and this is a big reason women feel uncomfortable feeding their babies naturally. No own has lost a job, been asked to leave a restaurant, or labeled "disgusting" because they fed their baby formula.
Breastfeeding often is painful, difficult and inconvenient as are many things worth doing - like being a parent - like life in general. However, it is the things we work at, that aren't easy, that we are often most happy we bothered doing.
I did breastfeed. I did stay home more often than not (though due to a transient military life, not choice - we would have been far better off economically if I had a steady source of income), and I did do all sorts of other things the "good moms" did...but I felt that I was never ever going to live up to that high standard.
I realized that when I felt I had to explain why I was allowing my child sprite at a birthday part that I needed to stop the madness and just enjoy my family, even if I did have to turn in my "good mom" membership card.
The CDC estimates that 900 babies die each year because breastfeeding guidelines are not followed. It's estimated that rules against installing your baby's car-seat in front of an airbag save just a handful of lives every year. Yet no one would support a woman's right to choose to do such a thing.
My husband and I were both formula-fed, so I realize that it's not the end of the world. I also know that I suffered a childhood plagued with allergies and asthma, and have food allergies to this day. I guess I really can't understand placing my own convenience over the opportunity to prevent that sort of suffering in my child.
Formula feeding = Freedom of expression
Who wants to be a conformist? Bottle feed, or that's what you are.
The new anti-breastfeeding movement strikes one more blow against breastfeeding. Dear, you don't want to breastfeed. It's way too hard for modern women to do.
Flashbacks to the 60's...
What's in it for you, Amy? Why is it so important to try to convince women not to consider breastfeeding? This is the second Salon article I've seen in a week trying to convince women not to breastfeed.
My central claim is that breastfeeding does not make you a good mother and that being a good mother does not require breastfeeding.
Women who breastfed successfully are reacting with outrage. That's because, for them, breastfeeding is more than an excellent way to feed your baby, it is a sign that they are superior to the women who did not breastfeed. How dare I suggest that they are not better than other mothers?
No, the CDC estimates nothing of the kind. Professional lactivists (like Bartick, the author of the paper that made that claim) like to imagine that babies die for lack of breastfeeding. The truth is that NOT A SINGLE INFANT DEATH has ever been attributed to lack of breastfeeding, let alone 900.
Poorly supported claims like this are a part of a deliberate lactivism strategy: the effort to scare women into breastfeeding.
Newman addresses this in her thesis:
"Through the active construction of formula feeding as a dangerous behavior, breastfeeding activists intend to change mothers’ health beliefs and behaviors such that they feel compelled to breastfeed rather than formula feed their children.."
Specifically:
"[Scare tactics] attempt to increase the urgency with which mothers should accept breastfeeding as the preferred infant feeding method by linking the failure to breastfeed with serious health risks, including the possibility of death (i.e., SIDS)...
Even though these arguments are portrayed as absolute, scientific fact, these arguments are better understood as a rhetorical strategy to persuade mothers of the health threats to their children (c.f., Best’s (1990) work on the construction of the child-victim). In contrast to this absolutist presentation, the evidence is more accurately described as suggestive and inconclusive..."
I strongly support breastfeeding (I breastfed four children) but I don't support disregarding the truth about the scientific evidence, and I certainly don't support the idea that there is one and only one way to be a good mother.
No discernable difference in our IQs. Brother had more ear infections than I did and was colicky, but I ran very, very high fevers whenever I got sick and he did not. Neither had seasonal or major food allergies. Both of us were, though, pretty smart and healthy kids.
Could my brother's ear infections and colic be attributed to formula-feeding? Perhaps. Or perhaps we were just two different children with different constitutions.
And I've certainly known plenty of allergic-to-everything, fussy babies with never-ending ear infections that were exclusively breastfed.
Look, I'm all for nursing your babies. Nearly all of my friends and relatives who are mothers do so at least for a few months. Some of them do so until the children are well into toddlerhood. That's fine and good and they're all really happy with that decision. But if you need medicine to stay out of constant crushing pain (such as my friend with rheumatoid arthritis) or to stay sane (such as another friend with manic depression) or if breastfeeding is severely screwing up your insulin levels (as a diabetic friend of mine had happen) BY ALL MEANS GET A CAN OF SIMILAC AND DON'T FEEL AN OUNCE OF GUILT.
Likewise, if you haven't gotten more than forty-five minutes of uninterrupted sleep in months and you're a walking zombie who's depressed and crying all the time because you just need some damn rest, BUY A CAN OF FORMULA AND LET YOUR HUSBAND GET UP AT 3 AM TO FEED THE BABY.
You aren't a better mother for making yourself miserable.
I myself donated milk for 3 years to a baby unable to tolerate any kind of formula, and who would have died without breastmilk but whose mother was unable to breastfeed.
Like every other statement in this discussion, I think it's not possible to make sweeping definitive statements.
Breastfeeding is such an emotional topic. I don't consider myself better than other women for having breastfed, nor do I consider my daughter-in-law "less than" for choosing not to.
The most important thing is the mothering and giving women the self-confidence in their abilities to make the best decision for themselves and their babies.
I agree. Therefore, it is important to recognize that lactivists have an avowed aim and a favored tactic that are designed to do the opposite. They don't want to promote confidence in mothers; they want to promote doubt. They exaggerate the reliability of existing scientific findings to deliberate scare women into breastfeeding.
I think there is more going on here than simply a desire to promote breastfeeding. Among lactivists there is a desire to promote a specific ideology of motherhood and to proclaim the superiority of that ideology and its followers.
I do think there's a whole, quasi religous view of woman- and mother-hood that my generation kinda spawned in its Femist split between the Gloria Steinem path, and the whole earth mother thing. And out of that has come all the rest of it, from attachment parenting, to make all of your own babyfood etc. Great if you want to, but not required in my view. I feel badly for young mothers these days what with all of the motherhood job requirements presented, lose the baby weight, be a sex goddess and make a great living. And of course, as usual, women are hardest on each other. My sister still scrutinizes my smart, healthy daughter for signs of harm due to my working, not breastfeeding and giving her supermarket cupcakes.
This is a fantastic quote. It totally hits the nail on the head.
Thank you so much for this post (and thanks to Salon for sending two links in the last week to the email list on this topic). I have had it up to my earlobes with lactivism. It's an utterly ridiculous movement. Yes, women should be given all of the information necessary to help them breast feed if they so choose to. If they choose not to, for whatever reason, stop judging them harshly for it.
Obviously we should have a more family friendly society, but that goes both ways. Not all families are the same and this trend of looking at women who either had to, or choose to bottle feed, as though they are bad mothers doesn't help anyone. I wasn't able to breastfeed, but that isn't anybody's business but my own, but I found myself have to defend my situation over and over again. I still find myself having to do it, even though my son is 7-years-old.
Rated.
I have a problem with people implying that formula feeding is just as good as breastfeeding. It isn't. That doesn't mean that it's never a valid choice, or that women who feed formula are bad mothers! I don't think I've ever met anyone who really believes that. Even the most ardent "lactivists" recognize that for some women breastfeeding just doesn't work. I do believe, however, that there are bad reasons to formula feed--like my mother who was pressured into it for social reasons, and regrets it to this day.
i'd just like to say *thank you*, dr tuteur, for contributing this article. the kind of intensity and emotion coming from the moms who are responding negatively is much of the reason i felt like such a failure when i tried and failed *twice* to breastfeed my own children.
the first time i could never get my son to latch, but pumped for him for a year. the second time i tried nipple shields and smearing my breasts with formula to encourage my infant twins to latch. my pediatrician's advice? "try offering the breast every hour or two, even at night." i called the hospital's lactation consultant the next morning after trying all night to get my girls to nurse blithering and hysterical, just knowing i would fail again and get that superior attitude from my breast-feeding friends who'd see me giving my girls a bottle. many of the comments here remind me of that humiliation. within two weeks of their birth, my girls were diagnosed with 'failure to thrive' and i was strongly recommended to discontinue attempts at breastfeeding. i kept pumping for 4 months and supplementing with formula. i did the best i could, but i will always wonder why i couldn't do this simple, basic task of mothering and others thought less of me because of it.
from my perspective, the point of the article was effectively to say that not every birthing mom fits the mold cast for her by the authorities that tell you you're 'less than' by not breastfeeding. i'm grateful that dr tuteur would dare to stand up for those of us that don't breastfeed, for whatever reason, but strive daily to parent to the best of our abilities.
Yes, and it's wrong.
It is based on nothing more than fanciful "estimates" of theoretical costs. It is utterly reliant on pretending that correlation in breastfeeding rates with disease rates means that breastfeeding causes or prevents diseases.
Breastfeeding rates rise in concert with income and education. So does infant health. It is irresponsible to claim that breastfeeding itself, as opposed to the confounding factors associated with increased maternal education and income, is wholly responsible for differences in death and disease.
The "costs" are in large part absurd. Not a single infant death has been definitively linked to failure to breastfeed, yet the authors insist that 911 deaths each year can be attributed to failure to breastfeed. The putative "lost wages" of these unfortunate infants do not represent any type of cost saving at all. Society does not lose money when an infant dies, so claiming that we would save more than $9 billion dollars (out of a total savings of $13 billion) is ridiculous, and renders the authors' entire argument suspect.
But mostly, I think focusing on the putative loss to society in dollars is amazingly callous when we're talking about 911 babies' lives.
Anyone who grew up on or near a farm knows that not every cow/ sow/ ewe/ mare/ pussycat/ nanny goat etc. will be able to nurse every single one of her babies without a hitch. A baby animal that won't or can't nurse and has to be formula-fed if it's going to survive, or a mother animal who does not make enough milk or who finds nursing so painful that she refuses to suckle her young is not unusual at all. And these are animals we're talking about. They don't have jobs and families and their own identities outside of being mothers to worry about. They don't really have to do anything post-partum but lay there and be milk-machines.
Breastfeeding is great for mothers and babies. And formula is a wonderful invention for when breastfeeding just isn't feasible.
Thanks Dr Amy.
I woul
That represents a profound misunderstanding of the role of peer review journals. Being published in a peer reviewed journal does NOT mean that the study is true, merely that it is worthy of being included in the scientific discussion.
You say that nursing can be terribly difficult to juggle with a demanding job even if you have an understanding employer. The point I was trying to make was that if more companies instituted these kinds of pro-family policies, it would make it a heck of a lot EASIER for most women. This is what we should strive for.
What you ARE doing is taking a sober and unemotional look at how the claims and pressures measure up against the science, and concluding that the intensity of support for breastfeeding is disproportionate to its benefits.
Rejecting a largely emotional, cultural, passionate but not entirely necessary mindset makes you less womanly? That would mean that logic is not feminine, and screaming at people who challenge you is.
How sad for women.
Bravo, Dr.
PS: Mandatory disclaimer: I breastfed exclusively for a few months, and had to supplement when pumping at work went poorly. I was devastated to have to give up "EBF" before I hit the 6 month mark. It turned out to make no difference at all and I know that I was just scared to fail my child and fail the endurance test prescribed by the AAP.
"Why aren't you fighting for a family friendly society that would make it much easier to women to combine mothering their infants and pursuing their career?"
and I also wonder if you aren't getting a lot of payola from formula manufacturers, Dr. Tuteur, or declining into some dotage where you don't check your scientific facts thoroughly. There have been multiple studies–– as you well ought to know in your position ( unless you are disingenuous)–– demonstrating the superiority of breast-feeding for both the baby and mother. For the mother there is the clear and ofttimes demonstrated benefit in staving off breast cancer. More European studies have covered this than American, but still-- ought you not to be using your medical platform to be advocating for the most healthy avenues for people to pursue, rather than lying?
My husband, who is a doctor, and also versed in Chinese medicine, has shown me endless studies on the benefits to children from breast-feeding. He's also treated many dozens of allergy patients and people with issues from formula feeding as a child.
The implications of treating one's kid as simply a "inconvenience" is monstrous. Indeed, why not put your complaining about fanaticism to use in trying to reform the social rigidity inherent in some structures in the work force so that women could get some back up, get help in easing into what is a huge transformation in their lives without being stressed and pushed in a machine model of culture which is very anti-human as well as anti-mother anti-child and anti-father? Why aren't you helping the women that would like to share in a more person and baby friendly version of child-rearing but can't–– because people make that hard, and due to the profit motive which makes it easier for them to buy substitutes for the mother: bottles, day care, nannies , etc? (!)
I have only run into a few of the so-called "lactivists," you ridicule, in my career, and I think their numbers and their intolerance are exaggerated deliberately by you. Most pro-lactation professionals are very open minded and extremely complimentary of all true motherhood models, whether the mother only "tries" to breast-feed, does for a month, or breast-feeds blissfully for years. They are generally on the side of the woman and the baby.
Whereas you seem to be on the side of nothing good.
When I married the baby's daddy and had more kids--I thought I would go to some La Leche League meetings--which I discovered vary from area to area--the one's I went to were filled with woman who let their 5 year old (still nursing!) girls strip down and run around naked!
I did meet women who seemingly "demonized" women who bottle fed their babies. Ridiculous!
I am a big nursing proponent and the LLL was created to support women in the 50's who sought to nurse...but were going against current medical fads! Funny how we come around and around again and again...
- the CDC embraces breastfeeding more strongly than the medical evidence should suggest,
- which is evidence that the culture supports "intensive mothering" over all over models of parenting
Maybe I'm missing something, but I'm not seeing any actual evidence that anyone other than pockets of annoying mothering.com type parents are "intensive mothering." Even the evidence you site only says that 35% of the mothers Newman interviewed were inflexible, and I don't see any evidence that minority of women she described as "inflexible" have much lasting impact on the larger culture. Anyone who has had a baby knows that the baby fads go like the wind - don't like it, just wait 2 or 3 years.
In general, women stop breastfeeding because they have to work, maternity leaves are short, and pumping is unpleasant and inconvenient. That's an obvious explanation. It's not clear to me why an elusive "intensive mothering dominant ideology" is needed to explain something that seems pretty straightforward to me.
I appreciate the public health efforts to support breastfeeding mothers. Without that, working mothers of babies, and moms having breastfeeding problems likely wouldn't have the half-assed assistance they do get. (breastfeeding rooms, insurance coverage for LCs, the right to feed their babies in public.)
"What you ARE doing is taking a sober and unemotional look at how the claims and pressures measure up against the science, and concluding that the intensity of support for breastfeeding is disproportionate to its benefits."
That's right.
By the way, I recently found your regular blog and really enjoy it.
Whether you call them lactivists, the mommy mafia, whatever, I think most mothers who live in the real world take a more practical approach than these theoretical ladies who blog and accost bottle feeding moms at the playground.
I have supplemented with formula when it made sense because of my work schedule or my son's appetite (which I couldn't satisfy on my own).
The reason I kept on/keep on breastfeeding my babes up to a year or so (depending on the preferences of each kid) is because it is far easier and convenient for me to do so. In the middle of the night, in the middle of a day trip to the farm, in the middle of the zoo-- breastmilk is one less thing I have to think about ahead of time, one less item to pour and mix and keep cold and later wash, one less item to spend money on at the grocery store.
It is difficult at first, during the first month or so, when an infant is learning to latch and nurses slowly and frequently and mastitis/engorgement is more frequent. But a mother should ideally be home for the first six weeks, anyhow-- the ones whose jobs require mothers to return at two or three weeks postpartum really are suffering, aren't they? It is really difficult to work full time when you aren't sleeping very well for weeks and months at a time.
After the initial learning period, the baby gets the hang of it and the mom starts reaping some of the benefits (convenience, comfort, ease, inexpensiveness, caloric burn) of nursing.
When it is easier and makes more sense to bottle feed with formula, a mother should feel comfortable doing so, even if it is right from the beginning (or maybe right after the baby gets a couple of doses of colostrum?)
Formula can't provide all of the benefits of breastmilk, but on the other hand, has a couple of vitamins in it that breastmilk can't provide, and nipple confusion is a myth.
I think it is wonderful you pumped and donated milk to a baby unable to tolerate formula. I think it calls to mind the wet nurses of olden times, prior to the advent of formula. (It is amazing also to think that as recently as the 1940s wet nurses were becoming extinct and parents were bottle feeding their infants evaporated cow's milk!)
But...you donated your milk for THREE YEARS? What, the kid was allergic to... FOOD? DAIRY? WATER? JUICE? EVERYTHING? Some how I doubt he would have died from lack of breastmilk past the age of six months or so, which sort of makes your arguments to Dr. Tuteur that you are not/were not a lactivist ring a bit false.
Dr. Tuteur has a decent point buried in all of that controversial hyperbole and overstatement. She's purposely trying to bait the likes of you, I think!
"...many women feel that it is a nuisance to them."
Redstocking Grandma's (excellent) point is that one of the main reasons breastfeeding is seen as a nuisance at all is that society does not support motherhood.
Breastfeeding is made into a nuisance by, among other things, early mother-baby separation and short maternity leaves. The nuisance is not breastfeeding, the nuisance is the barriers to it.
Almost all of the positive comments here are not from women who didn't WANT to breastfeed, but who COULDN'T. That gives the lie to your theory that women don't want to breastfeed and shouldn't be made to feel guilty about it.
Most of them, IME, want to. Lots of them, also IME, can't. Not, usually, because they are biologically incapable (though that also happens), but more commonly because the environment surrounding birth and early infancy is not supportive.
Dr Bartick, the author of the Pediatrics article mentioned above, also wrote an excellent excellent blog entry on the Huffington Post that describes this truth:
http://www.huffingtonpost.com/melissa-bartick/ipeaceful-revolutioni-mot_b_536659.html
The argument that we should support women who don't want to breastfeed is a total straw man, because most women DO want to breastfeed (73% initiation rates) but have trouble initiating or sustaining it through the early difficult period (only 41% still going at 6 months).
Where's the data for that claim?
A more logical reason for why 75% of women initiate breastfeeding and most stop is because they don't like it, and find that it isn't worth it to them.
"Education" efforts to promote breastfeeding have been a resounding flop. That's because the "educators" refuse to listen to women and pretend that everyone is just like them.
As for Bartick's HuffPo piece, I thought it was awful, just like her paper. She's living in a lactivist fantasy world and only lactivists are listening.
I am 100 thousand percent in favor of breastfeeding IF YOU WANT TO DO IT. I am not in favor of inflating its benefits, exaggerating its risks and pretending that lots of money could be saved if more women breastfed.
Where's the data for that claim?"
Are you serious???
3-month max unpaid FMLA leaves and routine mother-baby separation in hospitals are the data for that claim. Breastfeeding rates are consistently higher in countries with longer paid maternity leaves.
"A more logical reason for why 75% of women initiate breastfeeding and most stop is because they don't like it, and find that it isn't worth it to them."
That's not what you're hearing from the commenters on this thread, is it?
"Education" efforts to promote breastfeeding have been a resounding flop."
Agreed, because the problem is not lack of infornation but lack of practical and logistical support.
"As for Bartick's HuffPo piece, I thought it was awful, just like her paper."
Sorry you didn't like it (why not may I ask?) but it was a devastatingly accurate picture of a typical US hospital birth.
On a related topic: my understanding is that you are not in active practice. Do you still attend births at hospitals, or is that something you no longer do? And how long ago was the last time you attended a birth--not necessarily as a doctor; just as a mom or grandmom or friend or whatever?
Why are we intellectualising this perfectly natural function of a woman's body. Women's breasts were made to feed babies.
Get over it!
Medical reasons excepted, as mothers we either choose to do the best for our babies and breastfeed or we give in to convenience or vanity or both and do the second best thing, ie. bottle feed. Thus it has always been and probably always will be.
"The ideology of intensive mothering?" Are you kidding? It's nothing more than the recommendation to do what comes naturally, because it's best for your baby. You either do it or you don't. It's not an ideology, it's called feeding your baby. Get real!