Breastfeeding is just one part of raising healthy, happy, successful kids. Women who can’t nurse — or choose not to — shouldn’t be pressured or judged.
o what’s up with that?” asked the midwife during our final prenatal appointment before she would deliver my second child, Orion. The “that” to which she was referring — and a little too casually, I thought — were my breasts, those uncooperative, malfunctioning appendages I’ve never much cared for, the ones that were supposed to nourish my children. So far, they had proven they weren’t up for the job.
I explained to the midwife that despite having devoted myself wholeheartedly to the task of breastfeeding (and it is a task) when my daughter was born four years earlier, I had never produced enough milk to feed her. By her first pediatric visit, Mariel was starving, I told the midwife, and the doctor would not let us leave his office until we had pumped her full of formula. What I didn’t tell her was how defeated I felt at the time, defeated because my body wasn’t conforming to what every medical professional and parenting handbook said was best for my baby, and defeated because I was letting my daughter starve. I had listened to the insistent voices of the midwife, the nurses, and a lactation specialist who told me she would be okay if I just gave my breasts enough time and relaxed about it all. The milk would come in soon, they assured me, and my daughter and I would be able to establish this most essential of bonds. Meanwhile, Mariel howled every night, a plaintive, primitive cry that signaled deep need. Exhausted and unsure what to do, I burrowed deeper into the bed while my husband picked up our daughter and held her in his arms, singing and soothing her all night long.
“Breastfeeding is natural!” I could read the bold text on the poster from the examining table as I narrated my medical history to a new doctor, the one who would deliver my third child, Olivia. The newborn on the poster nuzzled comfortably in its mother’s ample breasts. The mother looked calm and peaceful, blissed out by the connection with her baby and the rush of prolactin and oxytocin — the so-called “pleasure hormones” (the latter the same that contributes to orgasm) — coursing through her body. It was an image that appeared in various racial and cultural combinations throughout the office. While sitting in the waiting room, I’d flipped through a postpartum handbook featuring pages and pages of women of all colors and sizes, all breastfeeding happily and, apparently, easily and successfully, including the mother of twins, who managed quite handily to hold a babe at each breast.
“Natural, vaginal births at the birthing center,” I answered in response to the doctor’s query about the nature of my previous children’s labors and deliveries. “No problems at all. Fast labors. Mariel was born in under three hours; Orion in just 55 minutes,” I said, not without some pride. At least my body was good at giving birth. The doctor flipped through the pages in my chart, speed-reading my medical history. “Good blood pressure. No allergies. No medications. No history of medical problems. No tobacco use. Limited alcohol. Excellent diet. Healthy children. So no problems then,” he said, already summarizing our visit in his notes and signing his name and date on the entry.
“Well, there is one thing,” I began, reluctant to subject myself again to the same monologue about the importance and ease of breastfeeding. “What about pumping?” he asked, as if I’d never considered, much less attempted, every possibility for extracting milk from my breasts. I had pumped. I’d used hot compresses and massages. I’d bought and drank “Mother’s Milk” teas, waiting, hopefully, for my breasts to start leaking. I’d participated in consultations with a lactation specialist in an attempt to understand whether better latching would coax the milk out of my body. Time, energy, money, hope, and pride had all been invested in my efforts, but still, my stubborn breasts refused to do what everyone said was natural and easy.
The insinuation that I was somehow resistant to breastfeeding, that if I just worked through what was obviously my own mental block (not to mention the pain of breasts sucked raw by children who could latch perfectly and were doing their part to suck vigorously), was starting to piss me off. No one suggested that perhaps some underlying medical condition was hindering milk production, though I learned after my third pregnancy that endocrine and pituitary problems could do that, and maybe I should have both checked.
What bothered me more, though, was that no one seemed to notice or be interested in the fact that I was doing everything else right, that every decision my husband and I made, that the entire constellation of our lifestyle choices, were intended for the optimal physical, psychological, and mental development of our children. I’d given birth without an epidural, without Pitocin, without the aid of any drugs. My husband and I both worked from home and were full-time, baby wearing, co-sleeping parents who fed our kids homemade, organic purees, read to them and took them for walks daily, never yelled or used foul language with each other or with them, and gave them every opportunity we could afford, and even some we couldn’t. Our friends considered us model parents. Some joked that they wanted to be our children. One even sent a text message telling me she wished “every kid was lucky enough to have parents like you so they could journey through life with a sense of wonder and inquisitiveness. Thanks for raising an awesome member of society.” Somehow, all of this was canceled out by the fact that I wasn’t breastfeeding.
I wanted the midwives and doctors and nurses to know this; I wanted this information to absolve me of their judgment about not breastfeeding and to relieve me of the failure I felt as a mother. Swedish researchers Lina Palmér, Gunilla Carlsson, Margareta Mollberg, and Maria Nystrom have named that sense of failure: existential lostness, which they define as “a mother forcing oneself into a constant fight” due to severe breastfeeding difficulties. Existential lostness, they explained in a 2012 article, is characterized by “shattered expectations, a lost time for closeness, being of no use to the infant, being forced to expose oneself, and gaining strength through sharing.”
I also wanted our medical providers to acknowledge our efforts as parents beyond breastfeeding because I hoped it would compel them to stop pushing breastfeeding on women who, like me, couldn’t produce milk, and even women who simply didn’t want to breastfeed. As natural as it is — and as convenient and affordable, too — breastfeeding isn’t for every woman or every baby. It’s a fact that medical providers don’t want to admit because doing so might seem like an endorsement of something dangerous. After all, the research literature is filled with study after study trumpeting the benefits of breastfeeding for dozens of developmental indicators. Breastfeeding reduces the incidence of asthma, ear and respiratory infections, and sudden infant death syndrome. It wards off infant diarrhea, childhood obesity, diabetes, and poor dentition. It’s even a predictor for long-term academic and professional success. And if a mom isn’t convinced that she should breastfeed for the good of her baby, maybe she’ll be swayed by the benefits for herself, including protection against certain reproductive cancers and accelerating postpartum weight loss.
As 12-hour-old Olivia slept on my chest, I heard the mother in the bed next to me struggling through the first few hours of her own newborn’s life. A nurse named Toy tried to coach the woman through her novice nursing efforts, which were, as far as I could tell, not going very well. As the lesson proceeded, the mother’s unease built, and it was hardly alleviated when Nurse Toy said, “But breastfeeding is eaaaasy!”
There is only so much time a nurse can devote to a single patient, and Toy continued on her rounds. She turned the lights off in our room and as I settled into light sleep, I heard my roommate despair each time her daughter mewed. “Why are you crying, dammit?” she asked, her frustration about her inability to soothe the baby alternating with expressions of tenderness. “Now I have someone to love,” she whispered to the baby. “I will take care of you.” Sometime deep in the night, she poked her head around the curtain that pretended to separate us and asked me why I was so calm. “This isn’t your first, is it?” she said. “No, it’s my third.” Suddenly a torrent of questions flooded out of her. We sat in our open-backed hospital gowns and talked for a bit. There are so many things no new parent knows, but my roommate had a whole deck of cards stacked against her. She had fled her abusive partner, the father of her baby, and she was living in a shelter. She had no job, very little money, and no family or friends to support her. Breastfeeding? That was the least of her problems.
I wanted the midwives, doctors, and nurses to acknowledge that breastfeeding, while important, isn’t the only variable of parental care that is predictive of short- and long-term attachment, health, and success. I wanted them to look at my children and see how they were thriving: how observant they were, how articulate Mariel was at the age of 4, how funny and tender and emotive 1-year-old Orion was. I wanted them to look at their medical records and see that my kids were healthy and robust, in the 99th percentile of every developmental marker that pediatricians measure. I wanted them to observe their interactions with us and see that healthy, loving attachment isn’t the result of just nursing at a breast. I wanted them to understand that though encouraging women to breastfeed is good, it’s also important to talk about and prepare a mother and her partner for the entire cluster of behaviors and practices that set a child up for a good life, aspects of care that extend far beyond the period of breastfeeding and which aren’t necessarily natural or easy, either.
I thought about all of this as I drifted in and out of sleep the night before Olivia and I were discharged from the hospital. In the quiet of our room, I tried nursing again and allowed Olivia to suckle for as long as she wanted. Small drops of milk, not even a trickle, were her meager reward, and I decided then and there that I’d had enough of feeling ashamed about not breastfeeding. Mariel and Orion were proof enough for me that formula feeding, if not ideal, would not necessarily produce children who would end up at a developmental disadvantage compared to their breastfed peers. Unable to correct or compensate for my body’s mammary deficits, I could only focus on doing what I did well: being a good mother. When the discharge nurse asked if she could provide me with any supplies beyond the standard issue bag of nursing pads, abdominal binder, peri bottle, and two sample size bottles of Johnson & Johnson baby shampoo, I told her she could add a six pack of Similac. I winked at my roommate, wished her luck and strength, and walked out the door without looking back.