Читать книгу Bottled Up - Suzanne Barston - Страница 9

Introduction

I’m watching an Internet series about pregnancy. While a new mom is being interviewed, her baby begins crying. She informs her husband (and the camera) that she’s going to “go make him a bottle.” A nervous glance passes over her face; it’s almost imperceptible, but I can see it. The guilt, the conflict, the defensiveness … it’s all there. And it hurts to watch.

Other women viewing this show will catch the moment as well, subtle as it may be. Some will grimace, familiar with the shame of being a bottle-feeding mom. Others will judge, wondering why someone held up as a shining example of motherhood isn’t breastfeeding.

Before I had my son, I probably would’ve wondered the same thing. I had always intended to nurse my child for at least a year; I didn’t allow the thought that I might fail to enter my mind. I didn’t want to breastfeed. I had to breastfeed. Which is what makes watching that episode with the bottle-feeding mom so hard.

Because that woman is me.

As the subject of a popular Internet reality series for Pampers.com, every ultrasound, contraction, and hormonal rant I experienced during my pregnancy and first few weeks as a mom was recorded and turned into a romantic, ethereal version of new parenthood. Through the gauzy lens of the camera, a journey filled with fear and anxiety looks easy, complete with a heartstring-tugging soundtrack and fancy cutaways to the most dramatic moments of an often arduous nine months. But one scene, that scene with the bottle, rings painfully true and blaringly corporeal. No amount of editing could have softened the conflict I was feeling in that moment.

Six weeks prior to filming that episode, the filmmakers had been there to record my session with a renowned lactation consultant. She wasn’t the first breastfeeding professional I had seen; no one could figure out what the problem was with my son’s “latch,” why the two of us couldn’t seem to figure out what was supposed to be a natural, instinctive process. The footage from that day was never used. I suspect it was too uncomfortable to watch: my eyes were rimmed red from exhaustion and tears, my voice shook due to a major bout of postpartum depression, and my child was starving and miserable (later we would discover that he had a severe intolerance to all milk, even mine, causing him to writhe in pain and discomfort every time he ate). I imagine what they managed to cut together was more like a horror movie than an inspirational Web series. So the producers casually glossed over how we were feeding our son for the postpartum episodes, and other than that brief moment with the bottle, you would never suspect the hell we went through.

Besides the fact that my breastfeeding “failure” was televised, my story isn’t unique. Whether a matter of necessity or preference, the way we feed our infants has become the defining moment of parenthood. Breast is not only best; it is the yardstick by which our parenting prowess is measured. Hospital maternity wards plaster posters with slogans suggesting that if you want to raise a happy, healthy child, nursing trumps both nature and nurture. Headlines announce new studies touting the superiority of children who are breastfed. The politics of pumping becomes a feminist issue, making any self-respecting NOW member want to burn her bra for entirely different reasons. Governments release public health campaigns imploring women to nurse for the good of the nation, and activists lobby to treat formula like a controlled substance. For many women of my generation, social class, and educational level, breastfeeding is seen not as a choice but as a given.

The day the cameras caught me “making a bottle,” I felt pretty sure that, given our circumstances, formula feeding was the best decision I could have made for my family. But my intellectual rationalizations couldn’t mitigate my worry. Was I condemning my child to a life of suboptimal IQ, reduced immunity, and psychological issues, as the “facts” suggested? Like many new mothers, I couldn’t shut out the ominous voices on television, in the news, in the parenting circles both in my own reality and online; I had nothing to back up my decision other than a gut feeling and a few kind words from my son’s pediatrician. Unlike many new mothers, I was a journalist specializing in consumer medical issues and the former editor of a Los Angeles area parenting magazine, but this only increased my anxiety: the sources I depended on in my professional life for factual information offered only vague, foreboding statistics on the detrimental effects of formula feeding. I desperately needed support from someone who had been through a similar experience, but I found none, save for some thinly veiled “I told you so’s” from relatives who seemed to think my fanatical attempts to nurse were an insult to the choices they had made in their primarily formula-feeding generations. Between my lack of sleep, my confusion (my son was healthy for the first time in his young life, thanks to formula—so why did I feel so disgusting every time I made him a bottle?), and my feelings of alienation from the other nursing moms around me, things were pretty bleak.

So I muddled through. I surreptitiously shook up bottles of formula in the bathroom at Mommy & Me class. The chip on my shoulder remained securely fastened in preparation for any attack I might endure at the grocery store while buying my teddy-bear-adorned cans of powdered poison. I made it a point to tell all my friends that I was envious of their ability to nurse, frantically defending my choice, or lack thereof. He couldn’t latch; he was allergic to my milk. Yes, that’s possible. Yes, it was devastating.

Formula feeding is a guilty secret for women like me, women who read the news, worry about health, and overeducate ourselves to our own detriment. The more you know, the more bottle feeding becomes a scarlet letter of sorts, the mark of bad motherhood. We’ve all been told that breastfeeding is the nutritionally superior choice; due to its lack of accoutrements, it is also environmentally superior. Is it any surprise, then, that it has also become the morally superior choice?

Breastfeeding is usually a beautiful, mutually beneficial act between mother and child. But breastfeeding isn’t necessarily the right choice for every mother and every child, whether it is for medical reasons, psychological reasons, professional reasons, or a myriad of other reasons that are, frankly, nobody’s business. Under certain circumstances, breastfeeding becomes a painful, emotionally fraught, conflicted act. And if you find yourself in these “certain circumstances,” there is little support. You’re left hanging in the shifting winds of public opinion, during those first fragile days of new parenthood when you need reassurance most of all.

During my own days as a lactation-challenged Hester Prynne, everything I read portrayed formula as a last resort, sufficient but pretty darn bad, the Big Mac to a breastfeeder’s organic salad. Even the can of formula itself pronounced that “breastmilk is best.” I wanted reassurance that went beyond the sweet but ultimately insufficient message that we “shouldn’t feel guilty” about formula feeding. That was all well and good, but I wanted facts. I wanted science.

When my son was eight months old, I began writing a blog about formula feeding, called FearlessFormulaFeeder.com. I wanted to provide a community for concerned, questioning, loving bottle feeders and to encourage the public to frame breastfeeding as an empowering personal choice rather than a government-mandated, fear-induced act. It turned out I’d stumbled on an unfulfilled niche—there were thousands of women like me in the world, desperate for the same sort of community, discussion, and information. I soon found myself completely immersed in the online parenting world, becoming the unofficial spokeswoman for formula feeding. I was far from fearless, but I put on a brave face for the women who followed my blog. They deserved it. Every Friday I’d invite readers to share their stories on the blog; these stories made my own struggle to breastfeed seem like a walk in the park. I learned about rare health conditions that made it difficult to produce milk or nurse without experiencing severe pain; anxiety disorders that were triggered by not knowing how much a baby was drinking at a given time; workplace complications that made pumping an impossibility, despite laws that supposedly mandated otherwise; breastfeeding that brought up painful memories of abuse; micropreemies who couldn’t manage the simple mechanism of “suck, swallow, breathe” without turning blue. The more I learned from these women, the more a slew of questions kept me up at night (okay, to be fair, my infant son was keeping me up at night, but the questions didn’t help). Is breastfeeding exclusively for six months a realistic goal when most women reenter the workforce (sometimes by necessity, sometimes by choice) after a few short months of maternity leave? What about women who need medications for depression or serious health conditions that are contraindicated for nursing moms—should they sacrifice their own health in order to give their children “liquid gold”? Should women with histories of sexual trauma or eating disorders, for whom breastfeeding might feel particularly oppressive or uncomfortable, be forced to bite their lips through six months (or more) of suffering? Is the antiformula culture insensitive to the realities of some parents, including teenage mothers, gay dads, adoptive mothers, or those in any number of other situations that stray from the middle-class norm? Why are we focusing so much energy on convincing women they have to breastfeed rather than offering better help to those who want to, and working to make formula the safest and healthiest alternative that it possibly can be? All of these questions danced seductively in my head, coming together for a big Chorus Line finish, the one singular sensation question that no one seemed willing to answer: Is breastfeeding really so superior that it justifies the guilt trip we heap on all of these women, essentially scaring them into nursing?

It took me two years’ worth of interviews with pediatricians, researchers, academics, sociologists, feminists, statisticians, and fellow moms and countless hours of reading through medical journals, websites, breastfeeding literature, parenting books, and chat room discussions to answer these quandaries. I couldn’t help wondering how much better my postpartum experience would have been had there been a book synthesizing all this information, one that lived alongside The Nursing Mother’s Companion and The Womanly Art of Breastfeeding, which would have offered a dose of rational perspective and given me some context in which to make a truly informed decision on how best to feed my child. I couldn’t find that book, so I decided to write it myself.

In the following pages, I’ll present evidence that suggests that the benefits of breastfeeding don’t always outweigh the risks to a woman’s physical, emotional, or financial health, and I’ll advocate a new outlook on infant feeding: one that refuses to embrace a one-size-fits-all strategy. I’ll tell the story of a cultural phenomenon that has touched many arenas—politics, feminism, healthcare, science, and our personal lives; a story about how we view motherhood, how women view each other, how science gets bastardized by bias, and how our choices are not always simple. Each chapter interweaves my own personal journey with informative research, interviews with experts and other mothers, and contextual perspective, in the hope that my travels through the infant-feeding wilderness can personalize an issue that too often degenerates into assumptions and generalizations; that my own struggles and realizations can prevent other women from feeling inadequate based solely on their lack of desire or inability to breastfeed. I’ve chosen to tell this story in a manner that will, I hope, be useful to policymakers, care providers, and researchers but also accessible to the parents who are going to “go make a bottle” and feel terrible because of it.

Most parents are unaware that there is an “other side” to this debate, because the conversation has mostly been relegated to academia, most notably in the fields of sociology and feminism. Joan Wolf eloquently picks apart the breastfeeding science in her 2010 book Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood, arguing that the body of evidence is inherently flawed and used coercively to support the stifling goal of “complete motherhood”; that breastfeeding “sits at the intersection of public discourse on science, health and personal responsibility.” A decade earlier, the book At the Breast detailed the impressive fieldwork of Linda E. Blum. Through interviews with women of different ethnicities and social standings, Blum highlighted the social inequities that put breastfeeding squarely in the purview of feminism. A myriad of academic articles have taken the current state of breastfeeding promotion to task, provoked in part by a 2003 U.S. Department of Health and Human Services/Ad Council campaign that compared not breastfeeding to debauched mechanical bull–riding while pregnant. At the forefront of the infant-feeding debate is the Center for Parenting Culture Studies at the University of Kent, spearheaded by Frank Furedi and Ellie Lee; this notable group has begun challenging how the “moralisation of infant feeding” has contributed to the “belief that ‘parenting’ is a problematic sphere of social life.”¹

Yet, most scholars of the infant-feeding debate take a subjective approach, save for a few like the Australian women’s studies scholar Alison Bartlett, whose intimate and fascinating book Breastwork focuses on the sexualization of breasts and the dichotomy this creates for modern mothers. I am eternally grateful for the skilled research and analysis that these pioneers have provided, but I hope to take what they have started one step further: by taking readers through the journey of breastfeeding failure, one step at a time, I hope to show the very human side of this debate. Breast versus bottle is not just a matter of public health discourse or a feminist issue, but a battle that affects women in the most intimate of ways—we cannot possibly understand the toll breastfeeding pressure is taking on women without hearing from the women who have suffered through it. If we leave the women most affected by this battle out of the discussion, by limiting it to the pages of academic journals most of them will never see and discussing it in a theoretical sense rather than a practical one, we may never come to a cease-fire. I hope this hybrid of memoir and reporting will speak for the scores of other women who wanted very badly to do the best for their children and found themselves in conflict about what “the best” truly was.

I begin, in chapter 1 (“Preconceived Notions”), by arguing that the current state of breastfeeding promotion sets women up for failure, framing the “choice” as one that is no choice at all and ignoring the (very real) underlying reasons that make formula feeding the better, or in some cases only, option for some women. I demonstrate how the “good mother/bad mother” dichotomy is manipulated as a way to encourage breastfeeding, by considering the emotionally vulnerable position most women are in when they start thinking about how to feed their babies, and by examining how a now infamous government-sponsored breastfeeding campaign brilliantly capitalized on this vulnerability. Other mothers weigh in on subtle—and not so subtle—forms of pressure and guilt surrounding infant feeding that plagued them during pregnancy.

Prenatal desires notwithstanding, once in the maternity ward, many mothers will find themselves smack in the middle of an inherent conflict between the “natural” discourse surrounding breastfeeding and the medical model that supports the actual practice of nursing our children. In chapter 2, “Lactation Failures,” I show how infant feeding became the purview of the pediatric community, how this shady history resulted in an unstable marriage between breastfeeding advocates and the medical community, with modern mothers caught in the middle. Detailing my own inability to breastfeed successfully in the hospital, I also ponder if, from an evolutionary perspective, we may be evolving—slowly—into a state where breastfeeding is simply not as “natural” as it used to be; hence the need for lactation consultants, breast pumps, supply-boosting drugs, and so forth. We are often told that women in Western culture fail to breastfeed because of societal barriers, but further examination suggests that this interpretation may be limiting our understanding of real, lived experiences.

One of those real, lived experiences is that of postpartum depression (PPD). Recent studies estimate that as many as 20 percent of new mothers experience some form of postpartum mood disorder.² Chapter 3, “Of Human Bonding,” focuses on women who have struggled with PPD and other psychological disorders (eating disorders, body image issues, and posttraumatic stress from sexual abuse) exacerbated by breastfeeding problems—myself included. I relate stories of women for whom nursing was somehow inexplicably linked to psychological stress, for whom formula feeding was a lifeline, a way back into the light—and I speak with a postpartum mood specialist who weighs in about the detrimental impact of our society’s romantic notion of breastfeeding women, and the number this fantasy can do on the already fragile psyche of a new mom dealing with PPD. I also discuss how medications are determined “safe” for breastfeeding and how the complicated risk-benefit analysis necessary to treat nursing women with clinical depression is muddled by overblown beliefs about the dangers of infant formula.

Chapter 4, “The Dairy Queens,” tackles the convoluted relationships among feminism, women’s rights, and breastfeeding advocacy. Considering that the average American woman has three months maternity leave at the max, most moms have to pump their milk several times a day in order to comply with the American Academy of Pediatrics’ six-month exclusive-breastfeeding mandate. We’ve turned into a nation of dairy queens, with political support for breastfeeding focusing primarily on achieving pumping rights for working women rather than on fighting for better family leave policies that would allow all parents—both male and female—to spend more time with their infants. I speak with a sociologist whose landmark study on white-collar breastfeeding mothers shows how lactation-friendly workplace policies can be a “double-edged sword,” creating a goal-oriented view of parenthood that measures mother love in ounces of breastmilk produced. Through interviews with working women, I argue that even the most progressive lactation policies don’t acknowledge the realities of pumping in the workplace and that a reluctance to supplement with formula is adding a third shift to the already stressful second shift Arlie Hochschild described in her landmark book back in 1989.

This chapter also questions why feminists have either unequivocally embraced or completely ignored the pro-breastfeeding movement. By brushing off the concept of “choice” as a mere construct of the formula companies (as many feminist breastfeeding advocates have argued), we have muffled the voices of women who may not want to nurse and have insisted that their feelings are invalid, merely the result of formula marketing rather than legitimate concerns about body and autonomy.

The title of chapter 5—“Damn Lies and Statistics”—alludes to the specific, biased, and often sensationalized information the public receives about breastfeeding. I question why certain studies have been so markedly overstated and others attacked or ignored, and I explain how breastfeeding research is rooted in circular logic and confounded observation rather than controlled studies or facts. A poor understanding of relative risk has caused us to view infant feeding as a key way to protect our children from harm and “maximize” their potential; it is no longer a question of whether breast is better, but whether formula will do irreparable damage. This overwhelmingly antiformula mind-set has ruled out the possibility of creating better options for the children of those who cannot (or choose not to) breastfeed—ironic, considering that we claim to be promoting breastfeeding as a means of improving child health.

Finally, in the sixth chapter, “Soothing the Savage Breast,” I suggest how those involved in breastfeeding advocacy should reassess their goals and approach. The way breastfeeding is currently promoted and instructed ignores fundamental inequities in the daily lives of women in many parts of the world, and even within our own country. Breastfeeding needs to be promoted and protected, but so does the choice to feed our babies in the way that works for us on an individual level. Infant feeding’s dark past cannot justify creating a similarly dark future, where women are forced, whether through emotional coercion, peer pressure, or political means, to breastfeed to the detriment of their own physical or emotional health.

To be clear: this is not an anti-breastfeeding book. I think breastfeeding is an amazing thing, and I’ve seen it work very well for many of my friends. But this book is not for people who are trying to breastfeed—there’s already a plethora of great books on that subject, and more to come, I’m sure. This book is for the parents who wanted to breastfeed and couldn’t; women who are conflicted about nursing and want to make a truly informed decision about what to do with their bodies; breast-feeding advocates and care providers who are willing to listen to the myriad reasons that women may choose not to nurse; and for people who are curious about the other side of this worldwide baby-feeding frenzy.

Mostly, though, this book is for the woman who is in tears, with cracked nipples and a screaming baby whom she can’t mother because she is constantly hooked up to a pump, who wants so badly to quit breastfeeding and finds nothing but fear-and-guilt-inducing literature everywhere she turns. I hope that this book will help her understand not only the science informing the prescriptive advice in the infant-feeding wars but, more important, the context in which the research is undertaken, so that she can make a truly informed decision. I hope she will be able to find this book, buried somewhere among the seven thousand books about breastfeeding on the parenting shelves, so that this woman will have a legitimate choice. I hope that it will speak for her and others like her, a group that has been all but ignored in the ongoing, often one-sided conversation about infant feeding. I hope this book will help her sit beside her breastfeeding friends, free from insecurity and judgment. I hope that it can inform a discussion which ultimately allows all women to feed their babies with pride, whether they are nourishing their babies from their breasts or from a bottle held in their hands, and that, ultimately, all women will have the freedom to find their own formula for good mothering.