Bottle vs. Breast: The New Mommy Wars
Breastfeeding advocates say "breast is best" - but does the movement leave other moms out in the cold?
When we hear the phrase, “a woman’s right to choose,” you’d think we were referring to the hot-button issue of abortion. But journalist and blogger Suzanne Barston says increasingly, the new battle lines are over breastfeeding.
While the United States’ breastfeeding rates are on the rise, Barston says moms are still split fairly evenly between breast-vs.-bottle feeders.
She acknowledges that breastfeeding is good for babies and she doesn’t want to diminish the breastfeeding cause. But she says while public health, political and feminist forces are teaming up to make the case for “breast is best,” they are doing so at the expense of moms who either can’t or don’t want to breastfeed.
Barston explores this debate in her new book, Bottled Up: How the Way We Feed Babies Has Come to Define Motherhood, And Why It Shouldn’t.
Much of what Barston writes about in the book she discovered after she became a first-time mom.
After her first son was born, she wanted to breastfeed and give her son the advantage advocates say mother’s milk provides. But her son couldn’t latch on and, despite what doctors said couldn’t be possible, was allergic to her milk.
Barston tried changing her own diet, to no avail, and finally – reluctantly - resorted to hypoallergenic formula. Her son thrived.
"I never really looked back because once I saw what a difference it was making, it was just clear to me that I had been letting dogma in the way of what was really best for my child," she says.
But that doesn’t mean her decision wasn’t judged. Barston says people pitied her inability to breastfeed.
“People were looking at me like him and me were something that should be felt sorry for,” she says. “That was a very strange experience for me. I do talk in the book about feeling like I had a scarlet letter, like a big “B” on me, or “F,” I guess, for formula feeding.”
Barston says the breastfeeding movement came about after a scandal involving a formula company in the 1970s, in which thousands of babies died.
Researchers began looking at the health effects of formula compared with breastfeeding. Barston says today many of the scientists doing this research are in fact breastfeeding advocates, creating a conflict of interest she says is creating warped results.
Moreover, Barston says the existing studies supporting the health benefits of breastfeeding are only associative. Essentially, scientists can’t ethically blindly assign a group of babies to be fed formula and another to be breastfed to get proper results. Rather, Barston says we only have limited, observational studies, which cannot take into account all of the socioeconomic and other subtle but fundamental differences between babies that could affect outcomes.
Bartson says there are some sibling studies, which eliminate some of these factors by comparing a breastfed child with its formula-fed sibling. These studies do show statistically significant differences in health outcomes, but Barston believes they are often exaggerated by so-called “lactivists,” misinterpreted by intimidated new moms, and aren’t always relevant to mothers with access to clean water and good health care.
"My feeling is if the differences were that clear, we would be seeing it on a population level, we would be seeing it on an individual level, and we're just not. So I just think that we've allowed our exuberance about breastfeeding to sneak into the science." -author Suzanne Barston
Deciding not to breastfeed
Barston says many women simply can’t breastfeed, but are told “time and time again it’s not possible.”
For example, a popular statistic says that only one to five percent of women cannot make enough milk for their babies’ needs. Barston says it’s a number that often gets used to dismiss some women’s problems with producing. But this low percentage still means that tens of thousands of women in the United States suffer from this issue. Moreover, she says this statistic is based on one study – done years ago in Scandinavia.
Other moms can’t breastfed because of latching issues or medications they take. Barston says some women who have experienced sexual abuse find breastfeeding difficult and triggering.
“I’ve heard from women who have said that when they told their care providers that they were sexually abused and they don't feel comfortable breastfeeding, they are told, ‘Well, if you are healed enough that you were able to get pregnant, you should be able to breastfeed,’” she says.
Barston says breastfeeding is increasingly part of the larger cultural conversation about what makes a good mother. While the debate was once about working moms and stay-at-home moms, it has morphed into how mothers feed their babies.
Barston says the broader debate over breastfeeding can make many moms who can’t, or simply don’t want to, breastfeed feel like bad mothers. She admits she herself would have felt guilty had she not been able to use her son’s medical “excuse” to formula feed.
She says the anti-formula and anti-bottle messages bombarding moms take away from their personal empowerment and ability to decide for themselves – a position she finds troubling as a feminist.
Elephant in the room
Barston says possibly the biggest consequence of the national preoccupation with breastfeeding is that no one is talking about how to properly formula feed.
“It’s the elephant in the room,” she says. “I've a feeling that if we actually focused on formula education and helping parents find the right formula for their baby, bottle feeding in a bottle nursing kind of way, learning how to read hunger cues and not overfeeding, all these things that contribute to obesity and ear infections and stomach issues, that's where we can be making some real change.”
She says we do not have to abandon breastfeeding initiatives and should support moms who breastfeed. But she says there are few resources available to moms who choose to bottle feed.
“I hear from moms who said, ‘Well, I called my lactation consultant and said I’ve decided to start supplementing, how do I do this?’” Barston says. “And they basically get told that they can't help them and they are making the wrong choice, instead of that health professional accepting that that parent has made a decision and giving them advice to help them to do it in the safest way possible.”
Barston writes a blog called “Fearless Formula Feeder” to help other moms get accurate information about formula feeding without feeling ashamed, and she gets asked medical questions by readers all the time.
“It's really sad to me that I've become the one go-to for bottle feeding advice,” she says. “I mean, where are these people's pediatricians and nurses and lactation consultants?”
In addition to her new book, Barston is currently working on initiative to help hospitals, breastfeeding centers and mothers groups get information to new moms.
“Ignoring bottle feeding or pretending it doesn't happen doesn't help anybody,” she says.
(This interview originally aired on May 22, 2013.)