This post is going to be very long and cross into some seriously personal territory and if you are not into reading about breastfeeding, I suggest you skip it.
Let me get the personal background out of the way first. I have a two year old daughter and am expecting a second child (a boy) in January. I had an incredibly difficult time breastfeeding my daughter due to low supply due to what the lactation consultant supposed was “insufficient glandular tissue.” That is, my breasts apparently never developed enough of the glandular tissue required to produce an adequate supply of breastmilk to feed an infant. I had never heard of this condition and still don’t even know how this is possible as I’ve never had issues with any of my reproductive health and development. I just have small boobs that are kind of spaced far apart. I never knew that was abnormal. And with what little I read about breastfeeding before having a child, I thought that just about everyone could breastfeed, if they actually tried hard enough. To find out that this was not actually true for me meant facing all kinds of disappointment and anger and guilt.
I’d had some issue towards the end of my pregnancy with my daughter with intrauterine growth restriction– meaning she wasn’t getting enough nutrition to grow on the inside. I had mostly come to peace with that, I carried her to term, and I was somehow much more prepared for things to not go perfectly during pregnancy/childbirth than I was with things going wrong in breastfeeding. It was pretty devastating to learn I could not feed my child the way I had planned to, the way I’d been told by well-meaning advocates was natural and healthy and BEST for my child. It was pretty devastating to take my 5 day old to the ER because she was so dehydrated and jaundiced, I couldn’t wake her up. It was pretty devastating to try everything that the lactation consultant told me to try (pumping after every feed, supplements, etc.) and everything other well-meaning advice-givers gave me (drink more water, eat more calories, pump, pump, pump) to have it make absolutely no difference in the amount of milk I was producing. I cried a lot about it, felt so embarrassed taking bottles out in public, tried to avoid (still try to avoid) moms who talk about things like “freezer stashes” and the glories of breastfeeding because it was just too painful to admit and explain that I was a failure at those things that other women worked for, sure, but actually had the capacity to do that I didn’t.
Anyways. All that to say, having another baby has brought so many of these feelings back to the surface. I can definitely not go through the newborn phase in the emotional stage that I was with my daughter again. I cannot sit attached to a pump while my baby is in the swing or held by his dad, all to get another third ounce of “liquid gold” to mix into the formula. And I certainly do not want to go through having another newborn hospitalized. I have to, for my own sanity, do something differently this time, which means I’ve been thinking very strongly about formula feeding from the start. And this makes me feel all kinds of guilty. How can I not even try, especially when I nursed my daughter using a Supplemental Nursing System (SNS) for an entire year? What if they were wrong last time and my issues were due to something other than my own anatomy that is now fixed? What kind of mother would I be if I didn’t even try to nurse? What kind of flack will I get from the breastfeeding advocates in my life (in particular, my own mother)?
In the midst of all this angst over things I cannot change or cannot predict, I decided to read Suzanne Barston’s book, after reading an article about her choice to bottle feed her second child from the start. She wrote this book with women like me in mind. Women who believe in the benefits of breastfeeding, but, due to whatever personal factors/choices, formula feed their babies.
Bottled Up is a very accessible, very readable book about how harmful the moralism surrounding breastfeeding promotion can be. I am not sure it is as thorough or conclusive or even as hard-lined as I wanted it to be, but this was exactly the book I needed to read with all these latent feelings swirling around in my head. This book somehow made it feel ok to have tried and fail and reminded me that formula was really not a devil. Without it, my child would have died of dehydration or jaundice or starvation or something.
As for the book itself, the first 4 chapters had me glued to the page and nodding continuously. Sometimes breastfeeding is more dangerous to the mother/child than formula and it is ridiculous and uncompassionate to suggest that every individual mother can/wants/should breastfeed. She mostly focuses on factors like post-partum depression, past rape or sexual trauma, or even a child’s allergy to its mother’s milk (one issue that Barston encountered personally), but does bring up low supply issues and provides a firm reminder that the low estimate of women who are unable to breastfeed is 5%. That’s 1 in 20 people, which if you extrapolate to the number of the women in the US is in the hundreds of thousands. That’s a lot of people being done a disservice by the dialog that “breast is best” and the really lackluster support systems in existence for women with breastfeeding issues. Barston also points out how our society isn’t really the same as it was when breastfeeding was last in vogue. Many more mothers work outside the home and pumping is difficult even in the best of situations (I had a very supportive work environment, but pumping was the worst, it was so isolating and provided a constant visual reminder of how little I was pumping, especially when my bottles sat in the fridge next to those of other users of the lactation room).
The last two chapters were a little more scattered. Barston claims that of course breastfeeding is better, but her chapter on statistics doesn’t do much to show this. I remember coming across an article (I cannot find a link to the exact article that I remember reading, unfortunately) that analyzed breastfeeding studies in much more depth with a much sharper conclusion: breastfeeding can only conclusively be linked to prevention of a couple instances of diarrhea in infants. I expected a similar summary here, but got a much more lukewarm one. As in, Barston points out that most of these studies are impossible to really take seriously because of all the complicating factors at stake (i.e. you can’t control for who breastfeeds vs. who doesn’t and some of these differences may come down to class differences or parental involvement, etc.), but doesn’t bother to draw a larger conclusion that we don’t have many reliable studies, free of bias, to base claims of “breast is best” on. She just kinda goes with “breast is best” as the inevitable conclusion, making the same mistake most of the researchers she faults do.
In the last chapter, Barston casts her net wider to encompass breastfeeding as an unrealistic choice not for medical, psychological, or health reasons, but for socioeconomic ones. This is a particularly important point, yes, but felt like too much for this little book. That, and Barston’s winding discussion about breastfeeding in the developing world, really draw her away from what made the first chapters so striking– her personal experiences and feelings and the white middle class angst about formula. I know she was trying to bring this around to a discussion of choice rather than a discussion of well, if you tried and failed, then it’s ok to use formula, but I left this book with a little less satisfaction than I felt after the first four chapters.
If you also had trouble breastfeeding (or couldn’t/didn’t want to for any number of reasons) and felt terribly judged and terribly guilty about having to/choosing to use formula, this book is definitely for you. There is something about realizing I am not alone in this experience, something about realizing that the hyped up talk about breastfeeding is, in fact, mostly talk, and something about remembering that feeding an infant is a deeply personal choice and experience that has helped me let go of some of my guilt. I am no further in knowing how I want to proceed with my next child, but I have some more food for thought. I have some validation for putting my mental health at the forefront in making that decision. And maybe, just maybe, I can make that tough decision with far less guilt and tears than I did the last time around.