I’m currently winding my way through “is Breast Best?” very dense study but reaching many of the same conclusions. That is to say that a lot of the studies that have been conducted did not exclude “other factors” when discussing the benefits of breastfeeding. As one point, the health claims made for breastmilk over formula do not take into account that many children in the study who were breastfed did not go to day care or have significant exposure to other children.

Made my little heart trill just a little bit.

Aw, man. I was just gonna post about this same thing and you beat me to the punch – and did it so well, I’m not sure I have much else to add. The only thing I can tell you is that I recently interviewed Ellie Lee for the book I’m writing on these very issues, and she is as awesome as she sounds from this brief. It seems that the Brits are leading the charge on this backlash and I wish to god we could follow suit. We need a conference like the ones Dr. Lee and her colleagues have organized, where smart peeps can come together and issue our own collective call to arms. If I had a free arm I’d try and organize it, but since I’ve got a newborn in one arm and a toddler in the other, plus trying to type with my toes to meet my manuscript deadline… oy. You get the point. But maybe someone else will get this together… Joan Wolf??

@Jennifer, actually the numbers don’t suggest otherwise. You are making more assumptions than I am if you’re assuming that the women who are not breastfeeding, either from the get-go or after 6 months etc., are doing so solely for the reasons you stated. It’s more likely that most of them are not breastfeeding for personal reasons which are nonyabizness. Wouldn’t you agree?

Secondly, I don’t buy the “booby trap” argument. I believe there is adequate support available for women who WANT or need breastfeeding support. As many women who say they didn’t breastfeed because of inadequate support (and really, how do we know this is their true reason for quitting), there are just as many who feel that they are bullied into bfing. In other words, nobody has exclusivity to the bfing/ffing boo-hoo-ing.

But hey, I don’t want to called a soshulist so I am unsubscribing from these comments

I don’t want to be called it either. I just wish I knew what it was!

Breastfeeding vs. formula. I breastfed one; formula fed the others (personal reasons not at issue here). The one who was breastfed was the least healthy of the flock. The child developed colds as an infant, ear infections, stomach upsets, allergies, and while the child did grow and gain weight normally, and is perfectly healthy now, such wasn’t the case through infancy and toddler age. However, the others who were fed formula from birth through weaning were the healthiest kids ever. In fact, one of them had a perfect school attendance from Kindergarten through fifth grade — not one absence due to illness! None of them had ear infections or picked up every respiratory infection that came along. They just were never sick. Oh, sure, they had a sniffle here and there, but nothing that a breastfed child wouldn’t pick up being around other kids. My one super-healthy child never had a cold until he was 11 — he didn’t know what a sore throat was and it scared the heck out of him!

Was it because they thrived on the formula or because of something else? Hard to say. Would I breastfeed again, knowing that mother’s milk is supposed to be much healthier, nutritious, etc. etc.? Based on my experiences, I’d stick with the formula…tried and true. If it’s not broke, don’t fix it!

You caught my mistake! My bad! Oh and formula is not tried and true, in fact it is way immature compared to human milk which has nourished babies since the beginning of time until about the 1920s.

Wow, your angry! No I meant immature, it is not fully developed, they are still working on its composition.

You are taking what I am saying out of context, like I said above, I am not anti-formula, I know a lot of formula fed babies who grew into healthy, happy, active kids. I do not think the decision to breastfeed or not is the end all, lifetime parenting decision. But are mothers who choose formula upset by the facts? I think formula is a fine choice for baby nutrition, just not the best choice, ugh, end of story. Like I said I often make sub-par choices for mine and my childrens nutrition, I just try to do my best, and I know that’s what we are all doing here. Yes, I do try and get new mom’s to choose breastfeeding, because it is so easy, and environmentally sound. Breastfeeding made my life so much easier, no bottles, no cost, and no hassel. My only point is that if a mother and baby can get through the hard part, it is truly rewarding.

I wish we as women, and mothers didn’t treat each other this way.

Candace, I agree with most of what you said, except your first point, which made my Libertarian spidey-senses start to twitch…

Candace said: There is a vast difference between legislation designed to protect the rights of breastfeeding moms (and infants) or to encourage breastfeeding as a matter of public policy versus trying to “legislate” that choice.

Actually, there is little difference, IMO, between legislating something and incorporating it into an official “public policy”. It’s semantics and this is exactly why people who value freedom need to be on guard and remain skeptical.

Furthermore, this “public policy” has consequences by creating barriers to valuable education for women who want to formula feed and arm themselves with information about formula differences, how much to feed, colic, protein breakdown from credible sources.

Support for breastfeeding moms should be readily accessible and available, I’m not denying anybody that benefit, but not at the expense of manipulating the reputation of infant formula as a whole and pressuring moms into doing something they don’t want to do, if indeed that is the case.

From Wikipedia:

Public policy as government action is generally the principled guide to action taken by the administrative or executive branches of the state with regard to a class of issues in a manner consistent with law and institutional customs. In general, the foundation is the pertinent national and subnational constitutional law and implementing legislation such as the US Federal code. Further substrates include both judicial interpretations and regulations which are generally authorized by legislation. [1] Other scholars define it as a system of “courses of action, regulatory measures, laws, and funding priorities concerning a given topic promulgated by a governmental entity or its representatives.”[2] Public policy is commonly embodied “in constitutions, legislative acts, and judicial decisions.” [3]

I breastfed my first child for over a year and my second for one single month for personal reasons. I can see both sides. Breastfeeding mothers experience opposition trying to breastfeed in public and finding adequate facilities for pumping at work and support when breastfeeding doesn’t come easily or naturally. I sat on the floor of a public womens restroom breastfeeding my 6 week old little girl because I was too shy and uncoordinated to do it in public. I survived teaching myself and my child to breastfeed(she started in the NICU taking breastmilk through a bottle)because my sister down the street had experience and helped me and the hospital had an excellent lactation consultant. Mothers who choose to formula feed get guilt trips by breastfeeding mothers and some policy makers who force their agendas on others. Every formula can is made to rub it in saying “breast is best.” The most important thing is that children get enough to eat and get the love and attention they need. With all the more serious issues, it seems silly to argue over something so inessential as how a baby gets fed. Every new mother needs a lot of support and understanding; forcing an agenda either way can just make the mothers who feel forced or unsupported bitter and frustrated. Feeding your baby should be a good bonding experience.

I did not see those ads but I don’t think scare tactics are a good way to go about public health campaigns. I am particularly riled up about the current efforts to demonize co-sleeping.

Personally, I don’t really care whether an individual mom breastfeeds or formula feeds or pumps or what have you. It is and should remain a personal choice. And frankly, I don’t see anything threatening that.

And no one should feel they have the right to intervene in any non-abusive parenting practices. What and how you feed your child is none of my business.

I don’t think the samples are such a scape goat as there are studies to show that they do influence moms. Yes, we don’t lose our brain-power when we give birth. However, it is a particularly emotional and vulnerable time and we can be more susceptible to messaging. And the messaging throughout society is that bottle-feeding is the norm. The pictures, the nursery decoration, the tv shows, etc…. bottlefeeding is shown as the norm. Now, what’s in that bottle could be pumped milk or formula… but we’ve very much “normalized” bottlefeeding as the way to feed infants in our culture.

You speak of statistics–but that’s sort of my point. Few of those 75% of mothers will continue to breastfeed.

And most mothers will at least supplement with formula at some point during their child’s first year.

So, if you are using the 75% initiation rate to say that breastfeeding awareness is alive and well, I would counter that the 30% exclusively feeding by 3 months and the 10% exclusively breastfeeding by 6 months and the 40% doing ANY breastfeeding at 6 months would argue both that women are struggling to maintain the breastfeeding relationship AND that there is widespread use of formula.

Doctors receive very little training in breastfeeding. That is just factual. They receive tons of well-packaged information about formula, though.

Surveys are useful but I do believe anecdotal information is illuminating of the statistics. I have heard a number of moms discuss their breastfeeding experiences. Often, they start off intending to breastfeed. Soon, however, they are told the baby is not gaining fast enough, isn’t following the curve (although few know that there are separate growth curves for formula and breastfed babies and do not ask if their baby is measured on the right curve), or are told to follow a strict diet to end colic, or perceive or know they are looked down upon for feeding the baby in public. They pump, but they don’t pump enough (because the baby is more efficient than the pump). So, they assume (or are told by the pediatrician) they are not making enough milk. They don’t want to feed in public, they feel like failures at pumping, and eventually they just switch to formula.

I’ve seen this enough times to know it is a pattern. Some women have medical reasons to not breastfeed. Others simply do not wish to. That is their call, entirely. I wish I could wave a magic wand so no woman ever felt guilty about her physiology or her choices. Really and truly I do.

But, again, I do not see anyone restricting anyone’s right to choose formula. I see formula available everywhere. I see positive images of bottlefeeding everywhere. I see information about formula and bottlefeeding everywhere–the tv, online, doctor’s offices.

And as to aggressive marketing–on so many separate occasions I have specifically asked NOT to be given formula coupons and samples. Primarily because I never find the time in the late pregnancy/early postpartum time to donate and then they expire and then I feel guilty about letting food go to waste. And yet, I get signed up anyway.

And honestly, they aren’t targeting the formula feeding moms who already have brand loyalty–why would you switch something so important to your baby if you have a brand that works? They are targeting the “converts”–the only way a formula company can get more customers is to get a breastfeeding mom to start using formula. They do it through paid search engine marketing, through clothing stores that sell nursing bras and accessories, and through pamphlets and coupons at pediatricians offices.

Frankly, if the formula companies would stop targeting breastfeeders, and cities and states would stop trying to prevent moms from breastfeeding in public, I would be 100% done with this issue. I have no desire to infringe on your rights…you won’t see me calling for prescriptions for formula or bullying commercials–I’m just tired of the people who try to infringe on mine.

Bottlefeeding is portrayed as normal because it IS normal. What’s abnormal about it? Plus, you’ll find many examples on bfing moms on television. I always see, on bfing support sites, all the shout outs for so-and-so who was bfing on primetime television or mentioning it etc., and it’s frequent.

The phrase I used was “portrayed as the norm”. The reason everyone remarks on breastfeeding is because it is so very rare to see. This is improving but shouldn’t breastfeeding, which is the biological norm, be portrayed at least as often as bottlefeeding? And not just on primetime as a way to titillate (forgive the pun) and provoke debate…but just as, you know…normal?

I think bottlefeeding is much more commercially appealing in our society because American’s are so modest. It’s the same reason you don’t see Disney actors filming scenes while walking around their house sets in their underwear even though that’s what people do everyday.

But what is immodest about breastfeeding? The perception that it is immodest is a huge part of what I perceive as the “problem”.

Bottlefeeding does not suffer from these perception issues. You claim that these health policies make it seem as if bottlefeeding parents are ignorant, poor, etc. And yet I have only seen one study showing perceptions of infant feeding and that one was on breastfeeding–and the women were perceived as LESS intelligent for breastfeeding (http://psp.sagepub.com/content/early/2011/03/18/0146167211401629.abstract).

Flawed as this study no doubt is, I still say that the cultural perception of bottlefeeding is that “this is how people feed their infants” (rather than, this is ONE way people feed their infants). The perception is often of a dad pitching in or a mom going to work or just going about her day. These are all positive, common images.

But, if mothers aren’t digging bfing past 3 or 6 months, why is that such a big problem? Who cares? It’s not like someone is putting a gun to their head and demanding they stop bfing. If they are calling the hospital or LLL or whatever and they are refusing to help, then there is a problem.

If it were just mothers not wishing to continue, that’s not necessarily a problem–especially for someone like you who does not appear to buy into the inconclusive (but to me still persuasive evidence) that increasing breastfeeding rates would have a positive impact on health in our society.

The problem is that this is not what these moms are self-reporting. They are self-reporting that they believe their milk is insufficient (most common reason for stopping–and yes, I have a link to the studies), or that their milk is upsetting their baby’s digestion, or that they feel uncomfortable breastfeeding in public because of how they are treated or how they perceive they are treated.

If you go on breastfeeding support boards, you will see thousands of women asking questions about these issues, describing the often terrible advice they have received, and explaining their difficulties finding a lactation consultant.

I suppose this could all be part of the “self-justification” you describe…but I personally find the simpler explanation more compelling. These women are genuinely wanting to breastfeed, are being told they cannot by doctors, are not finding support, and are ultimately stopping as a result.

Isn’t that why we have lactation consultants? Breastfeeding typically isn’t regarded as something that needs medical intervention, is it? In fact, many crunchy, staunch bfing advocates shun the medical establishment, so which is it? Do you want medical intervention or not?

(Plus, I have to say, this hasn’t been my experience at all.)

And here come the stereotypes…why is breastfeeding advocacy only for cruncy, medical establishment-shunning hippies?

Personally, I turn to the Internet for questions that are not disease-related. I chose my ped because my daughter’s cardiologist recommended the office. I don’t mess around when it comes to her heart. I trust the three doctors in the office when it comes down to illnesses. When they say something I believe to be values-based, I am confident enough to ignore it. But the idea that you go to your pediatrician for everything from check-ups, to colds, to advice about discipline and sleep to feeding is still prevalent (though I suspect less so). There are probably huge variations as to who trusts their pediatrician and who does their own research. I haven’t seen a study on this but it makes sense.

We still have doctors telling moms to put cereal in the bottle so the kid will sleep better, to introduce solids to breastfed babies at four months, that maybe if baby is biting it is time to wean, etc.

Pediatricians are more equipped to recommend a change in formula (since they are trained to understand ingredients and childhood allergies) than they are to give advice about breastfeeding. And for at least a significant number of women, the pediatrician is still a major source of trusted advice about infant feeding.

Again, I disagree that the norm is that a bunch of dumb doctors are giving women misinformation because they, themselves have never heard of the benefits of bf. C’mon. Really??

I never said they were unaware of the “benefits” touted–they are unaware of how to deal with common breastfeeding difficulties.

I’m sure there are some women who do get bad information and that’s unfortunate, and if the information was impossible or even difficult to seek, I would have more sympathy, but that isn’t the case at all. How many households have computers these days? People are not so ignorant that they don’t know how to search the AAP and LLL and the like. Point me to sources, outside of formula companies, on the Internet (which are widely read) who are encouraging women to formula feed over bfing.

One thing I am surprised about, when I talk to my local friends, is how non-Internet savvy they really are. After blogging for almost 7 years, I often assume people know just where to look and that they do.

For a large number of women, their sources on infant feeding are pediatricians and their mothers and aunts (who did not breastfeed).

Do a Google search for both baby formula help and breastfeeding help and the first, paid result in both cases is a formula company. Talk about breastfeeding on your blog and the ads that show up are for hotlines sponsored by formula companies.

I don’t know that you’ll find trusted medical sources encouraging formula feeding over breastfeeding–at least I hope not. But you will find plenty of sites that bill themselves as breastfeeding or general infant feeding sites that will give you “solutions” to common breastfeeding problems that will probably just make those problems worse. And that formula branding is right there for when the breastfeeding didn’t work out…because, you know, you aren’t one of those crazy, hippie breastfeeding women anyway, right?

We are in the age of a new technology information era. It’s shaped politics and culture, you can’t and won’t convince me that there’s some sort of conspiracy to hide good information about bfing. I don’t buy it.

And at some point, women need to take responsibility for their own efforts to bf. Not everything is someone elses fault.

I never said it was everyone else’s fault…but your post seems to me to be about this conspiracy against formula feeding? And that’s what I’m just not seeing.

There’s no conspiracy against breastfeeding–there are aggressive marketing tactics, heavily funded, designed to provide every opportunity to switch to formula along the way. There is a concerted effort to make sure that the easiest to find sources on infant feeding and even breastfeeding in specific, are branded by formula companies.

Well, that’s the thing about companies, they’re always trying to make a profit and I’m not being facetious. Companies with stakeholders typically aren’t known for their humanitarian efforts. Of course they’re targeting the converts because as I suggested before, for many women, they don’t like bfing and the formula companies are the vultures ready to capitalize on it. If Enfamil didn’t, Similac would and they want to establish themselves for those converts. That’s what companies do. It’s not their responsibility to make sure all women bf for a year.

What would you think of a legal opt-out system? Like the phone marketing opt out system? I haven’t had a marketing call in years and years and years because I placed myself on that service. If the government made that a legal requirement, wouldn’t that be sufficient? Give the formula samples and coupons to those who are not offended by it and choose to remain on their list. Would you object to that?

Again, free market capitalist libertarian here…I’ve disagreed with some of my fellow, so-called “lactivists” many a time. I am against spam, misleading advertising, etc. I’m not against reasonable marketing of a safe product.

I cannot tell you how many times I have specifically asked NOT to be placed on the list, only to receive an argument from the salesperson, and to be placed on the list anyway. One time I was buying a nursing bra while nursing my 18 month old. I even told her that as a reason I was not interested in signing up. I STILL got the mailings from that store with the newborn diaper and formula samples. What 18 month old needs formula?

Just out of curiosity, which states currently outlaw bfing in public?

It has gotten a lot better in the last couple of years. I didn’t even realize this but we are now down to three states that don’t exempt breastfeeding from public nudity/indecency laws. Only 8 states have laws with any teeth (a remedy), a number of cities still have ordinances against breastfeeding or are passing them (one in Georgia was recently in the news), and women are still turned out of public establishments…but, yeah, there has been an improvement over the last 3-4 years. I think this is due to all those crazy hippie activists and my hat’s off to them (if I wore one).

Tell me when they start pushing bottlefeeding parents out of establishments or when a city passes a law against bottlefeeding in public…and I promise I will be right there to defend their rights.

And again, this is not about a shame and blame Olympics…it is about this idea that bottlefeeding parents’ rigths are being impinged. When I see it, I’ll be plenty indignant…but I just don’t see it.

I agree that in certain areas, certain circles, there is a condescension…although I strongly suspect, just based on statistics, some of those snobs go home and feed their baby a bottle after making the other mom feel guilty. To me, though, that just means you need new friends. Just like I got new friends when, pregnant with #2, I heard a bunch of women in my playgroup talking about how “gross” breastfeeding was. Most of my friends still are those who bottlefeed their infants…but at least they have the manners not to talk about someone else’s feeding method as “gross”.

I will start by saying that I breastfed my first child for two years & I’m currently breastfeeding my newborn. It is recommended to breastfeed for two years, and formula feed only for the first year (if you are formula feeding). I have friends who tried nursing & it didn’t work, and I also have friends who had no desire to breastfeed- period. I will say that as a breastfeeding mom I met a lot of opposition, but so did the women who chose formula. I love that you are trying to empower women in your blog to make their own decisions, but you should realize that the norm is to bottle feed & so by criticizing the breast feeders you are slamming the minorities. As women we are so often judged- and this only increases with motherhood. If you truly want to empower women to make choices for themselves try to do so without putting down the mothers who chose other paths. I also found your article on breast ins frustrating, it is far more acceptable to give a child a bottle in public then to nurse. I’m completely capable of nursing & keeping it all hidden- but you should see people scanning & doing everything they can to try & spot some nipple once they realize. Also, people don’t usually tell bottle feeding moms they can’t feed their babies in certain places, or to feed them in a bathroom, but imagine they did & maybe you will better understand a breast in.

Thank you Steve.

Thank you so much! I linked to your post in one of my posts today about the connection between grief, guilt, ppd, BFing dogma, etc. I am so glad that someone was able to spit out and put to paper what I have been trying to say in 4 years of supporting moms. Really, we just need to feed our babies and take care of them and ourselves. It’s that simple.

Steve: Men can lactate – http://www.unassistedchildbirth.com/miscarticles/milkmen.html so why did you leave all the breastfeeding upto only your wife? If a man really cared about his baby and his wife he would breastfeed. There is no excuse, if you think you can’t do it then you are just not trying hard enough, lazy, misinformed or fallen for the booby traps of the Formula companies who have made you believe that men can’t breastfeed so that they can sell formula. All men can breastfeed, breastfeeding creates a special bond. How dare you deny bonding with your child because you couldn’t be bothered to breastfeed…. I feel so sorry for you not have a bond with your children

Thank you for this wonderful post! Wondefully written and put a smile on my face… which is a difficult task these days considering the amount of stress and bullying I’ve endured recently after making it clear that I will be formula feeding my baby who is due to arrive in a few weeks. I have never wanted to breastfeed; it’s just not for me. I have tried and tried to picture myself nursing my child and I just can’t. I love this baby that I am carrying more than life itself but I honestly can’t justify breastfeeding just because society tells me to. I just can’t. And the benefits of breastfeeding are to unclear for me to jump on the bandwagon. I was not breastfed and my mother was not breastfed. We are both healthy women with white collar careers. We are not obese. We are not “stupid”. We don’t have health issues.
I’ve been reading a lot about breastfeeding over the past few months as we prepare for our baby girl and the comments by women who breastfeed towards those who do not are absolutely disgusting. I wish they knew the amount of tears that I have shed, the sleep I have lost, and the amount of stress that they have caused by their hurtful comments. They have told me that I am a bad mother, that I should not be allowed to have a child, that I am selfish… I take great offense to that as I am not a bad mother – in fact I would do anything for my child. I love her more than anything but loving her also means doing what I think is best and if I think formula feeding is best, that is what I will do. My husband and I feel that formula feeding works best with our lifestyle and he is over-the-moon with excitment that he has the opportunity to help with our baby in a way that most new dads are unable to.
I recently received a packet of paperwork from the hospital that I will be delivering at. It contained standard paperwork on privacy acts, various waivers, etc… it also included a paper on the “Facts of Formula Feeding” complete with about 20 risks that you are placing on your child if you choose to formula feed; increased risk of childhood cancers, increased risk of mortality, etc. The fact that this paper was conveniently snuck into my packet has me furious. How dare they not only promote breastfeeding as the only feeding option to new mothers but to scare new mothers to death in the process. It’s disgusting. They should not be able to be one-sided on the feeding debate; especially when most of the research is “inconsistent” at best. Happy and healthy mothers and babies are what a hospital should strive for; and a mother should not be forced or scared into doing something that they do not want to do.
Thank you again for this wonderful article. I only wish more people knew the harm they were doing by promoting breastfeeding in a way that bullies those who choose not to. Maybe one day…?

Jessica, thankyou for being the voice of reason against the irrational formula-hate campaign.

Most articles I’ve across have been written by people with some strange manic obsessive need to convince other people to make the same choice that they did.