All day Tuesday I was cranky about the NYT breastfeeding article. I sat down to read it with my morning cup of coffee, and it left such a bad taste in my mouth that I had to add a spoonful of Nutella to my cup. (I made that in February for Carmen, who didn't know, apparently, that hazelnuts are full -- just full! -- of good fats.) In the afternoon I complained about it with my neighbor the La Leche League Leader, while our kids fought over who got to spray everyone else with the extra-large water gun (peaceful parenting in action, my friends). In the evening I read the annoying bits to my husband, who agreed with me that they were annoying. But then he read the rest of the article when I sat down to write my ickquay ostpay, and he came in here waving the newspaper.
"This is an amazingly pro-breastfeeding article," he said. "It doesn't get any more pro-breastfeeding than this. You have to be pretty extreme to think this is a negative article."
I looked guiltily at my bare feet, wondering if that shoe fit or not. But I think I have put my finger on the reason for our disagreement: the article is pro-breastmilk, yes, but pro-breastmilk and pro-breastfeeding are not the same thing.
This is an issue I have struggled with for as long as I have been writing about breastfeeding, beginning with this post from the first month of this blog's existence. I like Kathy Dettwyler's oil well analogy a lot (it's in the fourth paragraph of that earlier post). Oil is indisputably a valuable natural resource. But you can recognize the value of oil and oppose drilling in the Arctic National Wildlife Refuge. Human milk is the right choice for human babies (barring unusual circumstances like inborn errors of metabolism or maternal HIV or HTLV), but for some women the cost of getting the milk into the baby may just be too high. I'm pleased that the Times was clear about the importance of breastmilk. I wish the article had addressed the issue of making breastfeeding easier.
On reflection, I think I may have hurried through the paragraphs on the effects of breastmilk because it's such familiar stuff for me. It was an "In Other News, Sky Found To Be Blue" reaction. Realistically, as long as a sizable segment of the population is saying, "Well, I was formula-fed and I turned out just fine," we need more articles on the impact of infant feeding choices. I'm glad, sincerely glad, that formula works as well as it does for families that need it. But anecdotes cannot counter the irrefutable evidence: across populations, breastfed babies are a lot more likely to be just fine than their formula-fed counterparts. Families are entitled to accurate information about the consequences, short- and long-term, of their choices about infant feeding.
And yet committed families are only part of the battle. As long as 48% of breastfeeding newborns are supplemented with formula during their hospital stay, breastfeeding duration rates will remain low. As long as mothers like Emily get no help when their nipples turn green, breastfeeding duration rates will remain low. As long as pediatricians' first response to slow weight gain is, "You need to give formula now" (one of the frustrating parts of the Times article), mothers will continue to battle iatrogenic supply problems and breastfeeding duration rates will remain low.
(While I appreciate that breastfeeding problem-solving can be time-consuming, it takes no longer to hand a mother a copy of the LLL pamphlet on increasing her milk supply than it does to recommend formula. It takes no longer to suggest she call a lactation consultant (check out ILCA's directory) or a La Leche League Leader (start here) than to recommend bottles. And it takes no time at all to say, "There's a lot of good information at Kellymom if you need some ideas.")
If you google "tax breaks oil industry," you get pages of results detailing multi-billion-dollar deals in Congress. What if some of that money went to support clean-burning fuel -- i.e., breastfeeding -- instead? I'm not just talking about maternity leaves, even though so many women say, "If it takes six weeks to get comfortable breastfeeding, and I have to go back to work in six weeks anyway, what's the point in trying?" How about tax breaks for companies that establish lactation support programs for their employees? (Can anybody point me to a reference for the statement that CIGNA saved $300,000 in one year with its lactation support program? I would send you big smoochy cyber-kisses and maybe even a pot of oh-so-healthful Nutella.) How about subsidizing lactation consults, so that women aren't paying more than a thousand dollars out of pocket to try and make breastfeeding work?
My least favorite part of the Times article was its focus on the nursing mother of three daughters. I hope it's obvious to everyone here that I support her choices 100%. I think it's great that she wants to be with her kids full-time, great that she recognizes their need for her, great that she's committed to long-term nursing. But in featuring her, the author failed to make the point that breastfeeding is flexible. You can make it work in a huge variety of circumstances: whether or not you're employed, whether or not your baby takes to it easily, whether or not you want to do it for the long haul. I wish they had talked to my friend who went to the Caribbean for a week alone with her husband, and then came home and resumed nursing her 4yo. Or my friend who kept nursing for four months in spite of her punishing schedule as an OB resident. Or the woman I have been helping by email, whose baby has a bubble palate and a posterior tongue-tie -- it's really hard, she says, but she's going to do it anyway.
It's easy to say, about breastmilk, "There's gold in them thar hills." (Oil in them thar hills, I suppose I should say if I were aiming for a consistent use of metaphor, even though that's geologically implausible.) The evidence for human milk is overwhelming. What I'd like to see, if I were the Monarch of Media, is more emphasis on extracting it in ways that are manageable for all concerned.
You would not BELIEVE the chaos that erupted while I was typing that last paragraph. If I had more time I'd say more, but I do not so I won't. Tell me what you think, please, and I'll be back later when my children, who failed to read the books explaining that attachment parenting would turn them into peaceable caring denizens of peaceable caring communities, are calmer. Over and out.
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