Confident Beginnings: March 2009

The furor continues after The Atlantic published Hanna Rosin's op. ed. The Case Against Breast-feeding this month.

Some of the latest news:

MSNBC picked up the article to spread it further into the mainstream consciousness. At the end of article there's an option to discuss it on Newsvine. Have a look at the comments. Many thank yous from women who themselves couldn't or didn't want to breastfeed. All these women who did not or could not breastfeed applaud The Case Against Breastfeeding because it makes breastfeeding the villain and assuages their own guilty consciences.

Brings me to the point Dr. Newman makes about guilt and breastfeeding. He says "In order to prevent women feeling guilty about not breastfeeding what is required is not avoiding promotion of breastfeeding, but promotion of breastfeeding coupled with good, knowledgeable and skillful support."

Once again, we have to remember that difficulties breastfeeding are not because breastfeeding is the problem; it is usually because mothers are not getting the support they need from spouse or family, the work place, the community, health care practitioners, the government...the list goes on.

Of course, The Academy of Breastfeeding Medicine issued a statement this week in rebuttal. You can read it here.

Here also is the response from the American Academy of Pediatrics:

In the article, "The Case Against Breast-Feeding" by Hanna Rosin, the author skims the literature and has omitted many recent statements including the 2005 statement of the American Academy of Pediatrics which supports the value of breastfeeding for most infants.

This policy references every statement with scientific evidence from over 200 articles which meet scientific standards for accuracy and rigor. The statement was meticulously reviewed by the Section on Breastfeeding, the Committee on Nutrition and numerous other committees and approved by the Board of Directors of the Academy. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, a study released by the Agency for Healthcare Research and Quality (the AHRQ Report) strongly supports the evidence of benefits demonstrated in the breastfeeding research.

The evidence for the value of breastfeeding is scientific, it is strong, and it is continually being reaffirmed by new research work.

The American Academy of Pediatrics encourages women to make an informed decision about feeding their infants based on scientifically established information from credible resources.

David T. Tayloe, Jr., MD, FAAP
President, American Academy of Pediatrics

Thank you to Tanya Lieberman at Motherwear's Breastfeeding Blog for posting that. Her response is also well worth a read as she tackles some of the scientific claims.

And here is a joint letter to the editor of The Atlantic from the United States Breastfeeding Commitee.

I'm interested to see a round up of the blog posts and articles that address Rosin's science. I think there should be something forthcoming from Phd In Parenting who also put together a collection of the voices who responded to the feminist issues in the original article. Thank you to Annie for including us in such great company.

And just for fun, Hathor the Cow Goddess's take on it all.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

I don’t consider myself a lactavist. I didn’t call the CBC when I was asked to move into a change room at Superstore while nursing my daughter. I have not been to a nurse-in. I have never smuggled breastmilk onto a plane.

I do think that breastfeeding is a normal natural beautiful act. I breastfeed my daughter anywhere I choose. I don’t let people’s opinions or rude looks stop me. I will breastfeed in a restaurant. At my table. Without a cover. I exclusively breastfed both of my children to 6 months. I continued with my son until he was 2.5 years old and probably will with my daughter as well. I fervently believe that it is the best and in most cases should be the ONLY choice for feeding our children.

Why?

Because I distrust processed food. Because just like I prefer to make my own food from scratch as much as I can, I also prefer to give my babies the food that is specially made for them. I believe that if my body is making it for my baby, it’s obviously the best thing to give her. I trust this million year old evolutionary biological process way more than I trust Nestlé. Because I am amazed that the composition of breastmilk changes depending on the time of day and depending on if my baby is a preemie or a toddler. Because I’ve seen the list of ingredients of breastmilk and I’ve heard that they don’t even know what it’s all for or how to replicate it in formula. Because I believe that there is a purpose for all of those ingredients even if science and medicine hasn’t been able to figure it out yet. Because I don’t doubt that they would find a link between every single one of the components of breastmilk and better human functioning in some area (physical, cognitive, emotional) if it were ethically and humanly possible to do so. Because I believe that the act of breastfeeding is about so much more than food.

So it was with utter dismay that I read Hanna Rosin’s recent article for The Atlantic, The Case Against Breast-feeding. The article is so ridiculous and odious that my husband even suggested that it may be a farce, another attempt by the author to have a little game with us, just like she did on the playground. Farce or not, I couldn’t remain quiet.

I have to warn you that I won’t even have a chance to tackle Rosin’s research and studies because I have so much to say about her attitude. And to be honest, I don’t give a damn about the studies she quoted. Personally, I think that science has a long way to go in explaining most human functions from breastmilk to the brain. Inconclusive studies about the power of breastmilk are not going to convince me that evolution was flawed when it came up with mammals.

The tone of The Case Against Breast-feeding is sarcastic, resentful and bitter and I can’t help but wonder why Rosin is so unhappy. She writes about how it is “hard not to seethe” as she breastfeeds her new baby while her husband sleeps, about being “unreasonably furious” at her husband as he leaves her “stuck at home breast-feeding.” She writes about what the What to Expect authors can expect her to do “with this damned fork” (Ok, fair enough, I can’t stand the What to Expect books either) and about wanting to “hit {people} with a two-by-four.” Wow. Really? Why are you so angry Hanna?

When I start to dissect her article, it really doesn’t seem that breastfeeding is the issue. To me her article reads like the whiney self-pitying diatribe of a woman who is unhappy in her marriage, has few real friends, is not supported to breastfeed by her mother, dislikes all the women on the playground and resents her children for interrupting her career and her life. Okay, so now I have to take back the whiney and self-pitying part because wow, that really does sound sad and my heart goes out to such a woman. To be fair to Rosin I have experienced episodes of the rage, loneliness, “crying jags” and cursing at husbands that she writes about but I realise that those times don’t sum up my breastfeeding experience. I really don’t understand how breastfeeding became the scapegoat in this story and I struggle to forgive someone who can damage years and years of work in public health trying to raise breastfeeding rates just because she is unhappy with her life.

Acceptance
The whole article begins with the way Rosin felt at the playground. She witnessed firsthand how judgmental her so-called friends and fellow moms on the playground could be. Of course, she is busy judging right back. She tries to be funny as she describes the “urban moms in their tight jeans and oversize sunglasses” and ridicules their “signifiers” (“organic content of snacks, sleekness of stroller and ratio of wooden toys to plastic”) but she comes off just as awful as she tries to portray them. She talks about her “mother friends” in a way that doesn’t sound like they are her friends at all.

Mothering criticism is definitely running rampant these days; Rosin is right to bring it up. Lord knows I’ve felt it. And stooped to it. We all need to work a little harder to accept each other. That’s a post on its own right there. Yes, moms need to cut each other some slack but that doesn’t amount to a case against breastfeeding (even if it is the major point we judge each other on—“the real ticket into the club” as Rosin puts it).

Breastfeeding Rates
Rosin goes on to wonder why every woman she knows “has become a breast-feeding fascist.” Apparently Rosin only associates with a very slim percentage of the population if every woman she knows is a breastfeeding fascist. In the US, only 17 percent of babies are still breastfed at 6 months. Rosin quotes the breastfeeding rates in the States triumphantly: “breast-feeding is on the rise—69 percent of mothers initiate the practice at the hospital, and 17 percent nurse exclusively for at least 6 months”—as if to say “How much higher can they really go?” I personally find these numbers shockingly low, especially when you consider that those women who initiate the practice in the hospital may not even stick it out past a week or two.

Meanwhile, 83 percent of mothers are NOT breastfeeding for 6 months. These are the women that the Department of Health and Human Services are trying to target with the ad campaigns that Rosin hates so much that she would wean her child out of spite. The tv ads may be tacky and the print ads may be extreme but they are up against big bucks formula companies (with marketing dollars and Washington lobbyists). Ms.Rosin, they are also up against people like you who do so much damage by suggesting that breastfeeding is holding women back from all the things they want to be doing. The ads are a desperate bid to squeak that 17 percent just a little higher.

Rosin herself explains that “the numbers are much higher among women who are white, older, and educated.” Exactly. Like the women Rosin describes in her “playground set” with their “Baby Einstein videos, piano lessons and the rest.” I would wager that the other 83 percent of the population who give up on breastfeeding after initiating it includes all the women who are working because they have to, not because they have a feminist axe to grind.

Class Struggles
Rosin explains that formula was demonized in the 70’s because South American and African studies showed that formula fed babies were more likely to die. “The mothers, it turned out, were using contaminated water or rationing formula because it was so expensive. Still, in the US, the whole episode turned breast-feeding advocates and formula makers into Crips and Bloods,” she says. Oh, I see. It wasn’t really the formula’s fault. It was the mothers. For being poor. For using dirty water. And besides, it isn’t relevant because it wasn’t in the US. As long as you can afford it and have access to clean water, formula isn’t a bad thing—is that what Rosin is saying? That sounds a little elitist coming from the same woman who (rightfully) derides breastfeeding campaigns that encourage working mothers to pump at work for being unrealistic for the lower classes (waitresses and bus drivers).

And her point about wanting to hit people who say that breastfeeding is free with a two-by-four because that means a woman’s time is worth nothing? Well, for the working poor, a woman’s time is only worth $6.55 an hour (US federal minimum wage – 28 states have minimum wage that are either the same or less than the federal rate). If she buys the cheapest formula at Walgreen’s, it is $9.99 for 105 fl. oz. and her three month old baby will go through it in 4-6 days. So on top of the time it takes to feed her baby she is spending almost 2 hours every week working just to buy the formula. And that doesn’t even get into the number of hours she has to work to pay for her childcare.

Of course, Rosin who talks about launching Web sites, answering cell phones, the luxury of working part time from home, and even having a husband to curse at over division of labour is coming at the whole article from the perspective of the privileged. As she herself says, she is “too privileged for pity” so how does she know the real cost of formula?

Working Moms
Rosin doesn’t even question whether or not the same mother who can’t pump at her waitressing job can even afford to buy formula. Rosin focuses all her anger on breastfeeding and the people that she feels are pushing it down our throats. She brings up the American Academy of Pediatrics’ 1997 policy recommending that babies be breastfed to 1 year (still only half of what is recommended by the WHO) and explains that the National Organization for Women “complained that this would tax working mothers, but to no avail.” The real question is not what a woman’s time is worth (and whether she should spend it nursing her baby) but rather, why are so many new mothers working?

Rosin implies that public health officials should have tempered their child health policies to make it easier on working mothers. I would like to suggest that the problem in the United States is actually that the lack of solid maternity leave is taxing breastfeeding mothers. It certainly is difficult to breastfeed your baby to 6 months or a year when your country’s maternity leave would have you back at work when your baby is 12 weeks old (if you can even afford to take those 12 weeks off unpaid).

Support
Of course, a good maternity leave is only one aspect of the broader issue which is the need for support. Rosin herself appears to feel alienated and unsupported in her attempt to breastfeed. “Being stuck at home breast-feeding as he walked out the door for work just made me unreasonably furious, at him and everyone else,” she says. “So I was left feeling trapped,” she says. She likens her life to a prison. Her mother pesters her about whether her breastfed children are getting enough to eat. She is obviously uncomfortable with breastfeeding in public: “There I was, sitting half-naked in public for the tenth time that day, the hundredth time that month, the millionth time in my life.”

Doesn’t she realize that all the books, lactation consultants, support groups, public health campaigns, and legislation that she is tearing down with her sarcastic and mean words all exist to try to help the women who feel alienated and unsupported? All these people are working so hard to try to make the general public understand that breastfeeding moms have a huge job that is hard and often lonely, that breastfeeding in public is acceptable, that no one should have to stay home and breastfeed all the time, that mothers need help with the hours of breastfeeding they put in. They are trying to make these women feel supported. And they don’t expect you to stay away from your mother. They just want her to realise that her comments don’t help.

Feminism
But for Rosin anyway it sounds like the problem isn’t one of lack of support, but rather of feminist discontent. Her angry ranting unfortunately discloses way too much about her own feelings about children and her husband for my comfort level and tells me in no uncertain terms that she resents breastfeeding (and by extension, her children) for the inequalities in her marriage and for her inability to focus on her career.

“But fear not, You,” she says, “The root of the problem is not the sudden realization that your ideal of an equal marriage, with two parents happily taking turns working and raising children, now seem like a farce.” Who is this You she is talking to? It feels like maybe this is her own issue, especially when you see how often it comes up. I already mentioned how she seethed at her husband in the night, how furious she was that he got to go to work. She goes on to say that she “was raised to expect that co-parenting was an attainable goal. But who were we kidding?” Okay, so she resents the fact that her feminist ideals of marriage are perhaps unrealistic? Fair enough.

But listen to the way she talks about raising children:

“after three children and 28 months of breast-feeding (and counting), the insistent cheerleading has begun to grate.”

“This time around, nirvana did not describe my state of mind: I was launching a new Web site and I had two other children to care for, and a husband I would occasionally like to talk to.”

“So I was left feeling trapped, like many women before me, in the middle-class mother’s prison of vague discontent: surly but too privileged for pity, breast-feeding with one hand while answering the cell phone with the other, and barking at my older kids to get their own organic, 100 percent juice”

“With her first child, for instance, a mother may be extra cautious, keeping the neighbor’s germy brats away and slapping the nurse who gives out the free formula sample. By her third child, she may no longer breast-feed…Maybe she is now using day care, exposing the baby to more illnesses. Surely she is not noticing that kid No.2 has the baby’s pacifier in his mouth, or that the cat is sleeping in the crib (trust me on this one). She is also not staring lovingly into the baby’s eyes all day, singing songs, reading book after infant book, because she has to make sure that the other two kids are not drowning each other in the tub.”

She uses words like grate, prison, trapped, germy brats, slapping and barking to describe raising children. She talks about 28 months and counting of breastfeeding. Maybe she should stop counting and try to enjoy it. She says that by her third child, she is not staring lovingly into the baby’s eyes. Maybe she should have stopped at two children then.

Rosin closes her article with a most jarring tribute to breastfeeding after more than 5000 words in her case against it. She says “breast-feeding does not belong in the realm of facts and hard numbers; it is much too intimate and elemental. It contains all of my awe about motherhood” and yet that is the only indication in the whole article of any kind of enjoyment, let alone awe of motherhood. The only positive thing she says about breastfeeding or her children is the last sentence: “But I also know that this is probably my last chance to feel warm baby skin up against mine, and one day I will miss it.”

She spends the rest of her article comparing breastfeeding to the vacuum in keeping women downtrodden, lamenting that there aren’t more women in “positions of serious power,” complaining about pumping at work as a newspaper reporter, and as mentioned above breastfeeding while answering the cell phone and launching a new Web site while caring for two children and a nursing baby. Hmmm. Maybe the problem isn’t breastfeeding but thinking we can have it all? Maybe it’s this unrealistic feminist ideal that is the problem. Maybe Rosin is upset because she is realizing that we can’t have it all, that we do have to make choices and sacrifices.

Rosin’s feminist rhetoric fumes about a woman’s time being worth nothing and yet it is the feminists themselves who decided that the work of mothers was not valuable, the ones who said that we should all want to get out and work with the men.

Personally I think it’s time for a new brand of feminism, a feminism that says that the most amazing work a woman can possibly do is to bear, nurse and raise her babies, a brand of feminism that says that if you want to work outside the home you can but you might have to make some tough choices, a brand of feminism that says a woman’s time IS worth something and a mother’s time is invaluable. I think feminism has done us a major disservice by saying that we should be able to work AND raise kids AND have time for ourselves. The simple biological truth is that child bearing and nursing must fall to women so now with our quest for workplace power we have the pressure to do everything. No wonder we are tired and stressed out and alienated. No wonder Rosin resents breastfeeding. Because the reality is that breastfeeding and motherhood (at least while our children are young) are pretty much a full-time job. It’s hard bloody work and yes, it’s really frustrating to do all that while holding down an outside job too.

Let me be clear here. I am NOT saying that mothers shouldn't work. I am saying that the demands on today's mothers are unfair; the bar has been set too high. My own feeling is that breastfeeding shouldn't really be a choice. That is, as much as possible, with a huge margin for medical difficulties and other issues like lack of support, breastfeeding should be one of those things that is a given for parents - just like providing shelter, food, love and schooling as our children grow. Because pregnancy, birth and breastfeeding fall to the females, there will undoubtedly be times in a woman's life where she has to choose between working and mothering. The first year after the birth of a baby is one of those times. If maternity leaves allowed mothers to stay home and focus on their babies while they need to be breastfed, women might find it easier to balance work life and family life. The problem is not breastfeeding. The problem is the lack of programs and support for women who want to prioritize breastfeeding. The problem is the expectation that no one should have to make those choices, that women should do everything.

Rosin needs to look in the mirror and consider if it really is breastfeeding that she is so disenchanted with. The illusion of co-parenting is not shattered by breastfeeding. The illusion crumbles because the expectations on women are unrealistic and unfair. As Rosin’s life became more complex breastfeeding seemed to her an unbearable burden but she never stops to ask why she took on so much. In The Case Against Breast-feeding, breastfeeding became the unfortunate scapegoat in our society’s quest to have it all.

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Saturday, March 21, 2009

Creating Community at Home and in School

Breastfeeding Furor Post Script

Tuesday, March 17, 2009

The Case Against Doing It All

Thursday, March 5, 2009

Technicolor Birth Memories

Confident Beginnings

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