In many ways, breastfeeding is a template for parenthood: by turns embarrassing, painful, blissful, and, inevitably, a unique ever-changing process. You will swing between having too much to give, and not enough, between taking pleasure in the giving, and feeling impatient, between yearning for this stage never to end and wishing it were over. –Carrie Snyder[1]
I had the opportunity to visit Los Angeles over the weekend and facilitate a panel discussion about breastfeeding. The audience consisted of mothers of infants and toddlers as well as expectant mothers, who came for a “Mom’s Night Out” to hear from a panel of experts that included Elaine Stuart (childbirth educator and doula), Dr. Tanya Altmann (LA pediatrician), Corky Harvey (long-time lactation consultant and co-founder of The Pump Station & Nurtury), and Jamie Lynne Grumet (the mom at the center of last year’s controversial TIME magazine story about extended breastfeeding). After hearing some of the audience questions I was reminded once again why these discussions are so important, why lactation consultation is on the rise, and why there is a constant demand for breastfeeding classes and breastfeeding support groups: because breastfeeding is not always the easy relationship that most of us expect it to be, and mothers need this information.
So, instead of an historical post this time, I’m offering three thoughts about breastfeeding, in the hope that each of us will keep them in mind as we walk with the new mothers in our lives:
1. Support is key – from partners and family in particular, but also from friends, and, if we’re being idealistic – or realistic, – from society at large. This point is echoed again and again by doctors, lactation consultants, and everyday mothers. Partners and families are the new mother’s emotional support system and their encouragement (or lack thereof) can make or break the nursing relationship. Communities large and small now offer lactation support services at hospitals and clinics, through non-profit groups like La Leche League, and through parent groups at churches, libraries, and local stores. Don’t be afraid to reach out and offer the support that someone might need.
2. Every mother has a unique breastfeeding experience, which can change with each child. As part of the “Mom’s Night Out,” a number of Los Angeles-area mothers shared openly and honestly about their struggles with nursing. One mother used a nipple shield for two years to nurse her child. Others recounted tales of low milk production, or at the other extreme, of significant over-production. Still others shared about painful but necessary decisions to stop breastfeeding. Remember that our bodies do not always work as we expect them to and that breastfeeding does not always go as planned. Blame and guilt help nothing.
3. Breastfeeding is a legal right. Many states have now passed laws to protect a mother’s right to nurse in public, yet we still hear stories about nursing mothers being asked to leave restaurants, health clubs, airplanes, and other public spaces. Occasionally, the mothers in question are able to rouse community support and create a backlash – see the media and Facebook outcry after California mother Katie Hamilton was shamed for breastfeeding last year at the Los Angeles County Museum of Art – but many times mothers slink away silently, embarrassed and ashamed at being told that feeding their baby is an obscene act. Breastfeedinglaw.com lists the limitations of the laws, state by state, many of which seem to get particularly bogged down in enforcement: “If a law has no enforcement provision, there is nothing you can do if the law is broken. The vast majority of public breastfeeding laws in the United States have no enforcement provision.” In other words, a law is on the books, but it may well be in name only. New mothers should not have to continually reinvent the wheel: we must continue to make sure that nursing mothers know their legal rights and that we as communities and organizations uphold these as well.
Come on, people. Help a mother out. We owe it to each other, to our children, and to our communities, to be part of the solution, not part of the problem.
[1] Carrie Snyder, “When A Body Feeds A Body,” in Have Milk, Will Travel: Adventures in Breastfeeding, ed. Rachel Epp Buller (Toronto: Demeter Press, 2013): 129.
** The featured image, Head of a Woman: Study for “The Happy Mother” (L’Heureuse mère) was provided free by Getty Images’ Open Content site – See more here.
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Looking at this from a comparative historical viewpoint, it has always seemed to me that the rhetorical justifications for maternal nursing are crucial, and the effective ones rarely have much to with medicine. Looking at how things used to be other than they are can help us to understand some of today’s issues, if we step back from the construction our own beliefs.
In 17th-century England, there was a decline in the use of wet nurses. This took place among Calvinist families, especially those whom we would call Puritans. The old medical arguments were still used, but it was a new religious argument that seems to have been crucial. Following St Paul and Calvin, orthodox Calvinists directed at affluent women the argument that God’s general providence had provided breasts for feeding, not for sexual attraction. Affluent families were not universally persuaded. This argument seems to have had little traction with Catholics and Quakers, in particular, whether because they had different theological frameworks, different books or different social interests.
In the late 17th century, there continued to be appeals to motherly love, but natural theologians moved away, in general, from moral arguments taken explicitly from Providence, which had proved so divisive in mid-17th-century England, and translated them into non-sectarian arguments from Nature. Archbishop Tillotson went so far as to say that, being commanded by Nature, maternal breastfeeding was even more universally obligatory than anything in the revealed Word of God.
Medical arguments, such as the transmission of character or disease through the milk, kept being offered in the 18th century, but these could as easily be used as guidance on how to choose a good midwife. Excellent character required, and no redheads! It was the argument from Nature that appealed to those who embraced Enlightenment principles. Not London Quakers, who had the much higher infant mortality rate one might expect. Rousseau was astonished to discover that even duchesses in England nursed their young. On the whole, the link with divine with divine providence did not need to be stressed, although some authors, such as the midwife Elizabeh Nihell, made it clear that the laws of God’s general Providence and the laws of Nature were identical.
The rise of artificial feeding in the 19th century gradually led to the rise of that other 18th-century invention, Progress, coming to the fore. “Swiss milk” formula was recommended by doctors as more “scientific.” Retrospectively, it is possible to map, street by street, the fatal effects on children of cans of formula milk standing open to visits from flies that had been at the midden. This was not seen at the time.
Although there were already advocates of breastfeeding, what shifted opinion surely was the advent of the La Leche League in the US(1956; senior adviser — Herbert Ratner of Chicago Catholic Physicians’ Guild), appealing to the example of the Virgin Mary and “Mother Nature”, and the Natural (later “National”) Childbirth Trust in the UK (1955; president — Grantly Dick-Read) appealing to Nature alone. These rhetorics convinced those whose existing beliefs prepared them to receive the message, just as had been the case with the rhetorics of Providence, Nature, and Science in previous periods.
The above is only a thumbnail sketch, of course, yet it seems suggestive. Looking at the aceptance of new maternal nursing practices in terms of rhetorical frameworks helps us to understand aspects of today’s issues, at least at a basic level. Why do working-class Britons breastfeed reluctantly? Not persuaded by Nature. Why do Frenchwomen breastfeed so little? Science has a high value there. Why do the upper middle-classes of India not breastfeed? They are proud of their Progress beyond village level. There are clearly other social, cultural and economic factors involved, which should be addressed, but they will not be overcome by inaccurately targeted rhetoric.
David, you sound like you should be writing for Nursing Clio! Thanks for taking the time to share such detailed thoughts. What I’m reflecting on, though, is not why American women don’t nurse, because they are initiating lactation at higher rates (77% or more) than seen in decades. The steep decline in the percentage of mothers nursing after the first few months cannot be attributed to an interest in science or progress, but rather has much more to do with the lack of structural support, both personal and cultural. What struck me in conversations with dozens of mothers this weekend, women from a variety of social, ethnic, and cultural backgrounds, was 1) their repeated experiences of hostility to breastfeeding and pumping (from strangers, employers, public institutions, even family members) and 2) the lack of support needed to persevere through nursing difficulties. That’s why the percentages drop so sharply.
When I was pregnant with my first baby in 1980, the GP advised me to expose my nipples to sunlight for a few minutes each day to toughen them up for breastfeeding. I was scandalised by the idea! Needless to say, once I started breastfeeding, I had terribly painful cracked nipples, but managed to persevere and breastfed my son until he was 13 months old. Particularly once he got mobile, it was really the only cuddle time we had. With my second baby I followed the GP’s advice and had no problems – it was bliss!
I have spent the years since strongly encouraging every expectant mother I know (including my own daughter) to follow this simple advice – yes folks, I’m one of those annoying people continually offering gratuitous advice to pregnant women. No-one takes the advice; they all get cracked nipples; some persevere but some give up breastfeeding, which makes me incredibly sad, because for me it was the most wonderful experience. Such a simple thing, but no-one seems to take it seriously.
I succumbed to breast-feeding rhetoric and nursed my son for 10 months (at which point he could walk and was far more interested in the world than in my lap). I loathed breast-feeding, but I did it because dogma made me feel guilty. I found it imprisoning, and had no desire to go out in public and be congratulated for it by busy-bodies who thought that my presence in public was their ticket to any drive-by parenting they wanted to indulge. I hated how everyone wanted a ‘peek’ and castigated me for wanting to be left alone, thanks much. If I *had* to do it, I wasn’t interested in being on display like some kind of blend of Mutual of Omaha’s Animal Kingdom meets “the scared maternal”. I hated having to sit for that long, was stunned by the ‘every 2 hours, for one hour’ on demand timeline of nursing, hated the feeling, hated the leaking, the pumps, *everything*. I adored my son, and he is the love of my life, but If I could go back in time, I’d probably just pump and let anyone who cared to help me hold the infant also participate in feeding the infant. I would never nurse again, and that feeling factored into my decision not to have another child. I really, really regret it. I felt less than human for most of a year…. and that’s just not an experience I ever wanted to live through again. Especially as it *wasn’t* cheap (I had to feed myself all those extra calories, after all), and wasn’t convenient when I’d leak through bra pads while giving graduate seminars, or when all I desperately wanted was sleep and there was no other human being on the planet who could get up with him for the 5th time that night to feed him…. Ugh. And this is blasphemy because I was a prolific producer who had it easy and whose baby gained weight ferociously, so I should have nothing to complain about, but I *hated it* and that’s my right as an adult. Women are not subordinate to infants, and we are allowed to refuse to breast feed without being accused of succumbing to anti-breast-feeding dogma. I had all the support one could ask for, and no complications, and I *hated it*. I am *pro-choice* and that extends to a woman’s right to choose how to feed her infant. If she loves breast-feeding, that’s awesome, but, if, like me, she hates it I will NOT be lining up to castigate her for choosing to stop, and I wish someone had told me it would be OK to stop.