Wednesday, March 18, 2009

Thoughts?

Atlantic Monthly's "Case Against Breastfeeding" Makes the Case for Mothers' Self-Care

600px-Breastfeeding-icon-med.svg Guest post by Meredith Lichtenberg, a post-partum doula.

Hanna Rosin wrote an article called “The Case Against Breastfeeding” for this month’s Atlantic Monthly. She and I agree on something: women are ill-served by a society that tells them their own needs are irrelevant.

Motherhood is a dance with two partners. Sometimes a baby’s needs predominate. A culture that suggests that a baby’s needs always predominate doesn’t serve women, mothers, or babies. My career is based on helping new mothers learn to take their own needs seriously. This means learning how to evaluate when their needs trump their baby’s needs. But first it means believing that their own needs are legitimate.

After this point, though, Rosin and I part ways.

The reason we part ways, ironically, is that she’s missing her own point. Rosin is enraged that Society told her she should breastfeed because it was healthy for babies. Society told her that her own wishes or needs didn’t factor in.

But instead of saying, “Hey, Society, don’t tell me what I need to do! I’m the mom here, and I’ll decide for myself what’s best for me and my baby!” she succumbed to the “pressure”. Three babies later, she’s really mad. And she thinks that that makes a case against breastfeeding.

Admittedly, my work gives me a bias here, but I think what she needed was a good, facilitated mothers’ group. A discussion among diverse moms in a moderated, respectful forum might have helped her gain the confidence to figure out what, actually, she wanted to do, not just what she thought everyone else thought she should do.

“The Case Against Breastfeeding,” by the way, is an article about choosing to breastfeed or not. It’s not about milk supply issues, breast issues or overcoming obstacles.

What triggered the article was that Rosin did some research about the health benefits of breast-milk for babies. Although she concedes that breast-milk is “best” health-wise, for babies, she’s annoyed to discover that it’s “probably not so much better” than formula.

Rosin isn’t impressed with health benefits to babies from breast-milk. The lawyer in me says, let’s accept her reading of the data her conclusions, and see if it proves her point. She says:

– the medical benefits of breast-milk for babies doesn’t justify “making a mother feel that she is doing psychological harm to her child if she is unable or unwilling to breastfeed.” (I agree, by the way, that trying to make someone feel bad is a lousy way to get things done)

– only four percent of breastfed babies have a reduction in diarrhea.

– lots of studies show only a correlation or only a small improvement in health from breastfeeding.

– the IQ differential for breastfed babies over formula fed babies is only five points. (By the way, if your aim in breastfeeding is solely to get Junior into Harvard by pumping him with a performance enhancing drug, you have other problems).

Even if we agree that this shows breast-milk isn’t so impressive, it’s not much of a case against breastfeeding. People breastfeed, or don’t, for many reasons. People react to the very notion of breastfeeding differently. For some people, using something available naturally has basic, intrinsic appeal. For others, bodily fluids are iffy, imprecise, best replaced with something man-made and measurable.

For some, the thought of baby at the breast is satisfying in a deep metaphoric way. It reflects the incipient connection between mother and baby, the way a mother gives of herself that the baby may grow. For others, the thought of a child hanging off your boob draining away what visually made you woman in the first place is unpleasant or even nasty.

For some people, the fact that breastfeeding is free is inherently appealing, whereas for others, the very notion of paying for something makes it valuable.

(By the way, though, breastfeeding is free. Rosin says that breastfeeding is incompatible with working, so it’s only ‘free’ if a mother’s time is not valuable. But breastfeeding was free, no cost, gratis for her when she pumped and worked, as it is for the many moms I have helped with the transition back to work, as it was for me when I went back to work full-time at a large New York law firm. My time was indeed valuable; I was making enough money to support my family. Buying formula would have cost some of the money I was earning; pumping was cheaper and breastfeeding at home was free. I didn’t say it was easy or simple. I didn’t say that pumping, or figuring out how to balance work and breastfeeding was fun; most people I know who do it, do it despite the inconvenience, not because it’s so enjoyable. But is free. Rosin’s suggestion that it’s impossible to work and breastfeed, and therefore breastfeeding isn’t free is just, well, weird!).

Rosin doesn’t address the health issues for mom at all, though many studies have found that breastfeeding has concrete benefits for mothers including reduced chances of breast cancer and postpartum depression, and quicker physical recovery from birth.

She also doesn’t consider the ways that breastfeeding can affect the relationship between mom and baby. She quotes a researcher saying that the IQ differential in breastfed babies might be because “breast-feeding mothers interact more with their babies.” She uses this quote as evidence that breast-milk itself really isn’t all that great, not as evidence for breastfeeding.

Did I just provoke you with that idea? Are you getting your back up, thinking I am saying formula feeding mothers don’t connect w/ their babies? I am not. I am saying that Rosin’s argument wrongly assumes that the only good thing about breastfeeding is breast-milk, and that if breast-milk isn’t so much better than formula, breastfeeding is useless. But the quality of the milk is only one part of breastfeeding.

Let’s look at the alternative for a minute. Rosin, somehow, ignores the marketing juggernaut of the formula industry. What informed adult doesn’t take a critical eye to someone with a profit motive – in any area? In this country, new and potential mothers are flooded with advertising about formula. It’s illegal for formula companies to say that their product is as good as breast-milk. So they take another approach. They suggest that while “breast is best,” perhaps your particular body isn’t quite up to the task at hand. Or, lately, they suggest that “best” is too perfectionist a standard – liberal, freethinking women don’t need to be goody-goodies; it’s so June Cleaver. Women who believe in “choice” should be liberated from Society’s Pressures.

They don’t suggest these things because they care about the plight of women. They do it because they think it will convince more women to buy their product.

If Rosin has stock in Enfamil, she’s right on to suggest that the nutritive quality of breast-milk is the only thing that matters. If not, she’s been duped into thinking she has a feminist argument against breastfeeding, when really she’s bought into a recent trend where some of the best language and ideals of liberal, educated women have been co-opted and turned on their ear.

When you are traveling with a small child on an airplane, you are told that in an emergency you should put on your own oxygen mask before you put on your child’s. We need to be told this because the instinct is not always automatic. But it is essential that we learn to look at the mom, that we not forget her, whether she is nursing that baby or not nursing that baby. We need to see her as a person, not only a vehicle to support the baby’s health or IQ.

But Rosen herself ignores the importance of each individual mom discovering her own best path! She says that even if breastfeeding has health benefits for the baby, there are “modesty, independence, career, sanity” on the negative side. Now who’s trying to tell all moms how to feel?

Let’s take modesty. She describes nursing her third child in a doctor’s office as being “half-naked.” It simply defies credulity to think that a mother on her third baby literally took off half her clothes to nurse in a doctor’s waiting room. So, she’s exaggerating. But still, her idea is that nursing in public is, must be, horrifyingly immodest for any woman. This is an antiquated notion – that no part of the female body can even be discreetly acknowledged in the public sphere without titillating the surrounding masses.

Rosin is entitled to her modesty. But she is not entitled to claim that her Victorian ideas extend to every other woman. (By the way, for moms who are concerned about whether breastfeeding can be done modestly in public – and it is a legitimate question – the logistical and emotional issues can be sensibly, and respectfully, and compassionately addressed. More than anything, reading this article, I find it a shame that the author seems only to have encountered the most strident and least helpful people, and has generalized that that is all there is out there.)

The same applies to independence, career and sanity. Who does not value independence, career and sanity? Breastfeeding need not come at the cost of sacrificing these. It is valid and important for women to take their own independence, career and sanity seriously. More women should do so. But it has nothing to do with breastfeeding.

Rosin’s clincher is the end of the article where she talks about husbands. I lead discussion groups for new mothers every week, and I know how quickly a discussion about what your husband does or doesn’t do can devolve into an unproductive gripe session about what Neanderthals they all are and how they don’t turn out to be equal partners after all. This is the part of Rosin’s article where we’re all supposed to groan and agree. You know what, though? No marriage is perfect, and when you have kids and there’s less of everything to go around, there’s going to be some stress. Toss in that you’re learning new roles, new identities, that there’s crying and sleep interruption, and you can have a lousy time for a while.

That’s reality. But I will not, and you must not, buy into the idea that the person with milky boobs is the only one who can take care of the baby. And if she does end up taking care of the baby most of the time, to say it’s her breasts’ fault is preposterous.

Mom can breastfeed. If there is another parent, he or she can do everything else. If you have a baby, go home and try that out for a few weeks. Yes – I said everything else. Mom lies in bed eating ice cream between nursing sessions and Dad does all the childcare.

Are you rolling your eyes at this? If you are, your eye rolling has nothing, zero, zilch, nada – NOTHING! – to do with breastfeeding. It is so unusual to see a Dad taking that kind of role with his baby that when I float the idea when I’m teaching, the class bursts out laughing. This is not because breastfeeding infects the family in some insidious way, making us fall into 1950s stereotypes, but because those stereotypes continue to pervade our culture, even though most women in the 1950s didn’t breastfeed at all.

How about a more moderate notion – mom and dad (or mom and other mom who isn’t nursing) find some intricately personal, complex and creative balance, sharing care of their baby, and the boob tasks are done by the one who’s lactating.

This is not something that exists only in La La Land; it’s the result of willing partners who work creatively and flexibly together to find something that leaves them feeling like they’re in it together.

Rosin suggests that breastfeeding causes moms to succumb, slowly, into the stereotype of ‘doing it all’ with dad as the occasional special guest star. Is she an ad exec for some organization for Caveman-Dads? Talk about a marketing scheme – let’s take a bunch of husbands who don’t have a clue and say it’s not their fault – their choices, their interests, their priorities have nothing to do with it. The reason they’re so unavailable and non-participatory is, is is … well, it’s the mom’s breasts that are at fault!

No, ma’am. Your breasts are not responsible for the fact that your husband doesn’t change any diapers.

In the end, Rosin confesses, she is still nursing (and also giving formula), but not “slavishly.” Good for her. Not because she’s still nursing or because she’s giving formula but because, after 3 kids, she has found she can do something without feeling like a slave. You see, this is the goal.

Rosin says that breastfeeding, “contains all of my awe about motherhood, and also my ambivalence.” That is as it should be. Mothers feel both awe and ambivalence. Mothers feel the tug of their babies toward them and the pull of the world of adults as well. We need to see ourselves not only in the supporting roles, but as real, full women, with needs and desires and ambivalence and drive.

Rosin ends by telling us how, now, having thrown off the mantle of the pressuring society, she can experience breastfeeding as “intimate and elemental.” But that intimate, elemental side of breastfeeding was always there, was always a way she could choose to see it. It was she who was preoccupied with the other, “facts and numbers” side of the matter. This isn’t a case against breastfeeding at all. It’s a case against looking at breastfeeding only one way."

As many of you know, I hated breastfeeding. Every friggin' minute of it. Between lack of milk, my feelings of absolute inadequacy, and the godawful pain, I never had that Hallmark glow mothers rave about. (I still think that my baby wasn't colicky for 4 months - he was simply starving.) That said, this piece was written by a woman I know and I think it's pretty awesome. Curious about what you guys think...

4 comments:

Bern said...

Breastfeeding is a hard, complicated, and emotional job. So is motherhood. Whichever way you choose to feed your child no one will be satisfied until mom's emotional "tanks" are full. Not so easy to accomplish in the blur of the first three months of baby's life, but as the baby gets older and you get more of "you" back, I think figuring out what fills you up (emotionally, spiritually, intellectually, however you want to say it) is critical. It's a cliche, but I think it is true; you can't give what you don't have.

So take good care of yourselves mamas! It is important! Now, I've said my peace!

Hatchet said...

Ali! I'm in NY! Send an email to Eric emk AT law mage dot com, removing sp, most especially btw the law and mage as usual. Then he'll give you his cell phone # and we can hook up from there.

schneptune said...

I had this really long comment typed out, longer even than this one, and then I realized, I have no children, I've never breastfed or used formula, what the heck am I doing campaigning for Miss Pomposity 2009?

Both Rosin and Lichtenberg make good points (especially, Rosin on the difficulty of overcoming peer pressure and prevailing wisdom, and Lichtenberg on the need for parents to balance their own needs with their children's), leaving me hanging on the fence. "Every mother should do the best thing for herself and her child" is a great ideal, but in practice may be about as easy to achieve as "everything in moderation". We're social animals; we tend to bend with social mores, and like Rosin we may not realize for years that the pressure has occurred until we try doing things differently. Especially with something like parenthood, a multifaceted chaos in which, I'm guessing, we need human connection and support more than usual. So while I agree with Lichtenberg that Rosin is not "arguing against breastfeeding" and may be missing her own point, I believe that Rosin's message is important to any woman weighing the pros and cons of breastfeeding versus formula.

That said, it's always best to strive for the ideal: doing what's best for you and your child.

caramama said...

Wow. That was so perfectly written that I'm not really sure I have anything to add! Every time I thought "yeah, but..." or "what about...", she hit on that next.

Personally, breastfeeding was important to me for several reasons. We had some issues, but we overcame them. Not everyone can overcome their issues, nor is breastfeeding important to everyone. But the original article? Was not on point about so many things that I have to agree with Lichtenberg in every way.

For the record, I have one of those great husbands who took on all of the diaper changing for the first two weeks, and the majority there after, and shared the childcare in every other way except nursing. It is possible, and we found it uniting, instead of dividing, to share the care, even while I was the only one to nurse our daughter. I was also able to pump and breastfeed without that aspect of babyhood interferring with work, so for the author of the article to say it does for everyone? Way out of line.