Tuesday, June 4, 2013

More on the feeding of babies

I wrote about this once, about my ambivalence about nursing this baby and my experience nursing the kid.

So now that she's been here almost 4 months (whoa time flies), here are some further thoughts. It's spurred by a lovely discussion over at PAIL about the realities of breastfeeding and how graphically real we should or shouldn't be when talking about it. Great discussion, go read it.

I still don't really like this "nursing" thing. I mean, I do it. I like it better than pumping by far, and it's less fuss than formula (and let's not talk about the cost of formula... ugh...). I will never be one of those folks who is all rah-rah nursing is the GREATEST.

I still have oversupply and it's not the greatest but it's much less terrible than before. There's 2.3 gallons of frozen milk in my freezer and I'm pumping at least 7 ounces extra a day, but that's cool. It's helpful to have a vast freezer stock so I can do this whole week-long field trip in October. Maybe I can even quit pumping early if there's enough frozen milk around to get us to my goal of a year! Oooh that's an inspiring thought.

Do I wish I could do formula? Only a few times a day. Mostly I like that I get extra snuggle time and extra smiles from Little Monster while she snacks. I will say that I'm glad I bumbled into a blog post about Raynault's phenomenon (that's where blood randomly stops flowing to some extremity, usually triggered by cold) and that it happens in nipples sometimes too. I then investigated and determined that it's very likely happening to me, and that's what causes the pretty consistent nipple discomfort. It doesn't fix the discomfort to know the cause, but it makes me less grouchy about it. Unless someone bumps my chest... ahem. Personally I would rather switch to formula sooner than later but if it's possible, we'll nurse to at least 12 months and then consider what's next and there will be pumping to go with it. Blerg.

I feel like the "breast is best!" versus "formula isn't poison!" discussion gets cut into this dichotomy of formula-feeders who feel guilty about not being able to breastfeed and women who didn't realize that breastfeeding was an option. That really isn't the adequately nuanced view of the issue. I think it's two ends of the spectrum, and clearly there are probably other folk out there who are ambivalent in the choice they made. And the reality of breastfeeding is that it might just be all right and not amazing.

So there's bigger things at work, of course, than a choice. We don't make choices in isolation. When I choose what to buy, it's based on what I see in the store or the catalog or wherever. If what I see isn't what I'd really like I can keep looking, hire someone to make it for me, make it myself, or just settle. That's because there's a system in place that limits my choices.

The same is true, of course, for women choosing how to feed babies. The choice happens for a whole pile of reasons that are personal (such as I don't feel like it, I want someone else to feed the baby so I can sleep, this is what's best for the baby so I will suffer to provide the best, I enjoy controlling all aspects of my baby's life and measuring food exactly helps me do that, etc) but lots of reasons are a part of the system that structures our lives.

Since I live in the US, there's the matter of maternity leave to consider. Nobody is guaranteed a paid maternity leave. At most, there's a guarantee for a few folks of 12 weeks of unpaid leave. The first time around with this nursing business, it took us 4 months to get it together to work really well. That's 16-18 weeks where we spent most of our time lounging around and practicing nursing (and me getting mastitis twice and being miserable and arg). Nursing to 13 months wouldn't have been possible without that extended time to get it all together.

I also had a lot of support. That isn't a whole lot of people's experiences. I'm gonna go out on a limb and say that oversupply is a benefit to a degree (aside from the screaming, choking, gagging baby who struggles to swallow fast enough, that is) and it helped my mom and her mom succeed at nursing. See, back when my mom was a baby, babies stayed in the hospital while moms went home, so you had to have a really big supply to be able to still have some milk when that baby came home. This good fortune meant that my mom was supported, and my mom was around to be helpful and support me. I also had a spouse to be my cheerleader, and a group of friends in college who cheered me on during all the miserable months pumping between classes. That support system helped me manage to stick with nursing even though it wasn't all roses and snuggles and rainbows with unicorns dancing on them.

I also had/have the advantage of being in school rather than having a job. No boss to negotiate with for time off to pump or a change to the timing of breaks, let alone space to do it. So when most new moms in the US come back to work after far too little time off that probably was unpaid, they have to think clearly enough to lobby for legally protected but still awkward to ask about pumping accommodations. Unfun.

Another factor is doctors. Some docs are really supportive and don't get fussed about babies who are growing but not enough. Many are not so helpful and get all fussed about "not gaining enough weight" or not gaining enough in a short span of time or what have you. Mine have been knowledgeable and helpful and supportive of nursing, but without that cog in the support system, it is hard to stick with it.

There is, of course, peer pressure to think about too. What are your mom friends doing? What are the other moms you see around the community doing? I mostly see moms and dads giving babies bottles or nursing behind those giant nursing tents (or leaving the room to feed the baby). Here there is no peer pressure to breastfeed, but I'd say there isn't much peer pressure to feed formula in my specific microcommunity either. At least what I've seen, the immigrant moms who aren't working tend to be nursing and those who are working or are maybe second/third generation Americans tend to be using formula (and I hardly see any white moms around when I'm out and about, so I don't really know what they're up to). I totally hear those ladies who live in what I'd call a breastfeeding bubble though. The pressure to "do the best thing for babies" is heavy and the guilt if you need formula is immense (as is the misery moms put themselves through to try to increase milk enough to breastfeed). I feel like it's another part of the anti-abortion movement's "babies first" rhetoric that induces that guilt by demanding we put babies before mothers absolutely. It's terribly unpleasant thinking and it makes me mad that more women don't recognize it (imagine Admiral Akbar saying "It's a trap!" here). I'd do just about anything for my girls, but at the same time, I try really hard to remember that I can't do anything for them if I don't take care of me. I have to take care of myself and if that means at some point the baby gets formula, so be it.

So when you say "Success! Exclusive breastfed baby to more than 12 months!" about me feeding the kid, it comes with that system. If we expect other folks to choose breastfeeding, we as a world need to build a system to support that choice.

When the awesome support system is in place, when there are no barriers, then you can truly call it a choice. When nobody has to ask for accommodations to pump because they are offered before a baby is born, then there's a real choice. When there's 12 months of parental leave that's paid at more than 50% of income that the parents can split up any way they like, then there's a real choice. When affordable childcare is available close to the workplace of nearly all moms so less pumping misery is needed to keep those lactations going, then there's a choice.

I feel like so much of the time, we are having the wrong discussion. It isn't a real choice for most women to nurse or give her baby formula. It's a false choice when the system is so busy preventing conditions that could support a choice. There is no choice. If women manage to defeat the systemic barriers to nursing, they totally rock. If they can also defeat any personal physical barriers between mom and baby and be successful, awesome. I just feel like we need to be having the conversations around the system rather than berating individuals for their "choice" one way or the other.


  1. I'm still not completely over the guilt and self-hatred that came with my low supply, subsequent supplementation, nipple confusion, and eventually stopping pumping. In fact, thinking about it still makes me tear up.

    I had second thoughts about my pediatrician when she was nearly rude about supplementing because of weight loss in the first few weeks. She only became minorly more supportive when I burst into uncontrollable sobs. Even though it's a non-issue, now, I hope that our new GP after we move is much more empathetic.

    It IS really sad how sub-par our maternity leave system is, compared to other parts of the world. There just isn't enough time!

    1. Don't be hard on yourself! Being the best mom you can is important, not so much how babies get fed. Pumping is the most miserable thing I've ever done and I have had several highly unpleasant jobs.

      And also boo on rude pediatricians. Low supply happens and there's not much to do if it does beyond life-saving formula.

  2. Great post and points.

    Totally agree that for so many women, there just isn't the choice to continue breastfeeding when they have to go back to work. My sister had to wean around 3 months when she went back to work, worked retail, and had no way to secure a good pumping place or schedule. It just sucks. with so little time off and little support in place at most workplaces, it's so hard to continue to fight to pump when you're already exhausted and stressed. Something has to give.