Last week, Beyoncé made headlines when she was photographed breastfeeding her month-old daughter, Blue Ivy, in public. The news sent a wave of encouragement through the “lactivist” movement—people and organizations who champion breastfeeding as the best way to feed infants. Still, the assertion that “breast is best” has come under scrutiny.
Historically, researchers and maternity care professionals have maintained that breastfeeding is the optimal choice for meeting a baby’s nutritional needs. The Academy of American Pediatricians, the Academy of Nutrition and Dietetics, and the World Health Organization all recommend exclusive breastfeeding for the first six months, and the AAP says you should continue at least in part for the first year. Countless studies espouse the benefits to mother and child, ranging from a reduced chance of sudden infant death syndrome, to smarter children, faster weight loss, and reduced chance of breast cancer for moms.
But nursing isn’t always easy. Many mothers have trouble getting started, due to difficulties latching on, inverted or flat nipples, low milk production, and more. Add that to the fact that we live in a society in which women have extensive roles and responsibilities, and breastfeeding becomes as much a choice of lifestyle as of tradition.
Elaine Alexander, director of the postpartum and neonatal intensive care units at Inova Alexandria Hospital, says she’s “very pro-breastfeeding.”
“It’s the best food for newborns. Plus sometimes if you supplement with formula, babies will realize they can get more from a bottle and decide, ‘Hey, you can’t produce enough to feed me,’” she says.
Resources have sprung up over the years to help with the nursing process. There are support groups, breastfeeding aids, and certified lactation consultants available in many hospitals—Inova Alexandria has an entire lactation center. However, support is lacking for mothers who choose the alternative. In fact, mothers who end up bottle-feeding by decision or necessity often attest to being stigmatized or chastised. This, plus a peculiar lack of vigorous debate on breastfeeding, struck Joan Wolf, associate professor of women’s and gender studies at Texas A&M University.
“There’s no sound evidence to suggest all women should be breastfeeding for six months,” Wolf explains. “We have tons of evidence to say that breastfeeding is not for everybody, and makes a lot of women uncomfortable for reasons we shouldn’t judge them on.”
In 2010 Wolf published Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood, which posits that while decades of nursing research has properly established links between healthy outcomes and breastfeeding, the research is largely observational and does a poor job of establishing causation.
One study, for example, concludes that young adults who were breastfed for seven to nine months have higher IQs. But it also notes the correlation between moms with high IQs and smarter children, and states that “it may be that mothers who spend more time breastfeeding during the first year of life also spend more time later interacting with the child.” Other studies point out the inflation in breast milk’s value or explore the potential health risks, including how easily breast milk carries toxins and lead.
• Breast milk contains a mother’s antibodies, and often provides the first immunity a baby gains.
• Most formulas contain iron and vitamin D; exclusively breastfed babies often need supplements for these nutrients.
• Breast milk is cheaper, for obvious reasons.
• For some moms, bottle-feeding (with pumped breast milk or formula) is often more convenient than nursing.
• Breast milk has been shown to improve digestive health in babies without preexisting tummy issues.
• Standard formula is manufactured under sterile conditions, is strictly regulated, and is nutritionally formulated to mimic breast milk as closely as possible.
Wolf, who is also a mother and supports breastfeeding as a beneficial infant-feeding method, says the bottle- or formula-feeding stigma exists because “we expect moms will do anything to provide benefits to child regardless of price, emotional health, or financial health. The stigma comes when moms . . . do something different.”
In other words, when society believes breastfeeding is the non-negotiable ideal, those who deviate are made to feel inferior.
Postpartum unit director Alexander says education is key to alleviating the unhappy feelings moms may feel when breastfeeding goes awry.
“I don’t believe many women are very educated before they get to the hospital. You can’t go into breastfeeding saying, ‘I’ll try,’ and then three days later decide it won’t work,” Alexander explains. “[Moms] come in with this idea of their perfect picture . . . but sometimes you have to work really hard. It’s a learning process.”
While breastfeeding seems to enjoy a better reputation than other infant feeding methods, mothers are also sometimes humiliated for doing so in public. And despite the many pieces of state and federal legislation that make provisions for women who nurse, moms across the country are still having their photos deleted from Facebook, and being kicked off airplanes and out of museums, stores, and even women-only gyms for openly nursing.
“Women should absolutely be able to breastfeed in public and not be relegated to the bathroom,” Wolf says. “[It’s] one of the normal functions of breasts, and children are a normal part of life, so I believe strongly in that right.”
Interestingly, much of the criticism and judgment on all sides of the conversation comes from mothers themselves. Between the vitriol found in just about any parenting forum or comment section and the backlash Babytalk magazine earned for its breastfeeding-close-up cover, you could say moms are both the perpetrators and the emotional casualties of this battle.
Wolf also believes information is key. “Many women are choosing based on erroneous information. All of us need to realize that choices are made in context; how you feed your baby is one of the myriad decisions you will make, and it’s really not the most consequential decision you ever will make.”
Capitol HIll resident and new mom Rachel McGuan agrees. “I think making the information available is appropriate, not dictating how a parent should feed his or her child. It’s a personal decision.”