"If we could imagine a world where men had to breastfeed their babies... the formula shortage there would not be so dire." Photo / 123RF
OPINION:
My son began drinking formula in earnest when he was 7 weeks old, after I was taken to the emergency room in an ambulance because I had postpartum pre-eclampsia and a blind spot had erupted in my vision, a potential stroke symptom.
The whole experience was terrifying, but as I sat in the emergency room having not eaten in 12 hours, my breasts leaking all over the hospital dressing gown, my biggest concern was not that my brain might be malfunctioning, but that my baby might be going hungry because I wasn't at home to feed him. As the doctor informed me that I appeared to have a brain aneurysm, it barely registered; all I could think of was how I was going to get breast milk to my son if I had to stay in the hospital overnight. (Mercifully, the doctor was wrong about the brain aneurysm, but I learned that six weeks later.)
When I finally got home and found that my baby had been happily guzzling formula and was fine, instead of feeling relief, I cried. By feeding him formula, I felt, I had failed him on some level. That now seems ridiculous, but at every turn, formula had been framed to me as a distant second-best, a somewhat shameful option you turn to only as a last resort.
As news of the American baby formula shortage spread, I was once again reminded of the ways in which new motherhood, venerated in theory, is not fully supported in practice. Voices from across the ideological spectrum suggested that women should simply breastfeed their babies. As I watched the discussion unfold around this distressing situation — caused in large part by an oligopolistic system and government failures — I had the uneasy feeling that the demands that breastfeeding makes of women were precisely the point.
The suggestion that women who sustain their babies with formula should just breastfeed is, sadly, not coming from the fringe: It was articulated by both the editor in chief of a prominent Catholic publication and Bette Midler, among others. Eric Sammons, the editor of Crisis Magazine, put it this way: "I would also say that hopefully this is a wake-up call to become more self-sufficient — God literally designed mothers to feed their babies."
This is woefully ignorant. It is insulting to the many women who cannot breastfeed, or cannot produce enough milk to keep their babies fed, but it is also insulting to the women who choose formula because it is the most rational decision they can make — because their babies need it, because they can't or don't want to pump at work, because formula allows fathers to participate more.
It's also worth noting that formula, whatever you think of it, is better than the alternative, which in many cases is letting babies starve. Before the advent of modern formula, this is what often happened, especially if women did not have access to communities of other women who could feed their babies for them. But the judgment of mothers for feeding their babies formula is not really about self-sufficiency; it's about justifying the suffering of women as a motherly virtue.
Promoters of breastfeeding like to suggest that it lowers the child's obesity risk (which at least one randomised trial suggests isn't true) and that it can improve I.Q. (though some researchers say the results of a widely cited study that illustrated this were not convincing), and that it generally improves the child's health. But research increasingly shows that the benefits of breastfeeding outside of the potential bonding experience (and it must be said, it isn't always a bonding experience) are probably marginal, especially when you control for economic factors. In the United States, wealthy, well-educated women are more likely to breastfeed. If their children have better outcomes in terms of education and wealth later, is that a function of breastfeeding, or the fact their mothers started with those things and others did not?
As an adoptee, I was a formula-fed baby by necessity. But in 2015, when I gave birth to an 8-pound boy, I was strenuously encouraged by doctors, nurses and the books and articles I read to breastfeed. Sometimes that encouragement bordered on bullying.
The benefits of breastfeeding are discussed copiously, but rarely the costs. The reality is I tried very hard to make it work. But after four months of the baby not latching on, frantic pumping at home, going back to work and having nowhere to pump, and more than one overnight hospital stay for postpartum complications (including the brain aneurysm scare), I stopped.
When I mentioned switching to formula to medical professionals, I always encountered a volley of questions about why, usually followed by a question or two about whether I had tried various methods to extend breastfeeding, some of which involved expensive equipment and various schemes to trick the baby into feeding at the breast when he clearly preferred to just eat in the easiest possible way. Not a single person who asked me these questions seemed convinced that I was doing what was best for my family and child, not to mention myself.
My health and well-being did not matter in these conversations in any significant way because society cannot conceive of motherhood without viewing women primarily as caregivers whose needs are secondary. If a woman is 90 per cent miserable, and her baby benefits 1 per cent from whatever is causing her suffering, that is deemed an acceptable trade-off.
That perverse calculus comes from the enduring belief, which often comes wrapped in the religious justifications on the right, that women exist primarily to be wives and mothers. It is of a piece with efforts to strip women of autonomy generally (via reduced access to abortion and contraception); opposition to public assistance for women and babies; inadequate paid family leave policies.
The version of this mentality that I most frequently encountered in Brooklyn, where I live, holds that women must deplete themselves physically, emotionally and economically to be good mothers. On community message boards, many insisted that breastfeeding efforts should be pursued up until a mother's nipples were practically falling off (there were many gory descriptions of bleeding and damaged areolas).
These evangelists for breastfeeding were very often women who had flexible schedules, long maternity leaves or did not have to work — the same mothers who shared recipes for organic baby purées and railed against the dangers of cheap supermarket food. Many of them would identify as liberals and seemed very aware of their privilege in other respects, but appeared to have no sympathy for women who fed their children differently, whether by choice or necessity.
This is misogyny, no matter where it comes from. No one demands that fathers damage their own bodies to demonstrate decent parenting.
If we could imagine a world where men had to breastfeed their babies themselves — learning how to do it, enduring the frustration of the baby not latching on and the pain of chapped and inflamed breasts, and figuring out how to continue to do it despite long hours at work, little support, nowhere to pump and not enough sleep — the formula shortage might not be so dire. In that alternative reality, it's hard to imagine that the industry in the United States would be dominated by just a few companies. Instead, I expect that we'd see a multitude of formula start-ups blossoming in Silicon Valley. Formula would not be stigmatised because it's a choice men would want to have available to them.
This is not to say that formula is better than breastfeeding, or that breastfeeding is not the best option for some people. Of course it is. Many mothers have no problem getting babies to latch on, and depending on how the rest of their lives are constructed, breastfeeding may also be the most convenient option. In countries where clean water is difficult to find, breastfeeding may be the safest option.
Many people also find breastfeeding to be a beautiful experience, and it can have postpartum health benefits for mothers as well as infants. Even then, it is not, as breastfeeding advocates like to suggest, free or cheaper then formula — unless you believe that a woman's time and autonomy are worth nothing.
The advent of modern formula is really as revolutionary as the advent of birth control, because it allowed many women to retain a degree of autonomy over their time and health while providing their babies with nutrition. For women who are dealing with postpartum depression and anxiety, on top of sleep deprivation, formula can be a godsend, something that allows them to restore some aspects of a normal life. This should be regarded as important by itself — and not only when it's coupled with a qualifier that a healthy mother is also good for the baby. Women should be happy and healthy, full stop.
That awful day in the emergency room, as I panicked over the thought that my son wouldn't eat, even though I knew we had formula at home, I asked through tears if anyone could find me a breast pump, but no one seemed to know where to get one — in the same hospital where on a different floor, new mothers were being lectured about the importance of breastfeeding.
In retrospect, this was sheer insanity. I was sleep-deprived and anxious, and my desire to be a good mother led me — a formula-fed adoptee — to see feeding my son formula as a grave personal failure.
Now, as the mother to a healthy almost-7-year-old, I regret not using formula sooner. I think the first few months of my newborn's life would have been much less torturous for both of us, and we both would have been happier and healthier.
Right now, families that rely on formula are still likely weeks away from relief. Their situation should be met with sympathy and a sense of urgency, not judgment about their choices. We should support breastfeeding when women can and want to do it, but that does not require us to stigmatise formula, or the mothers who opt for it.
This article originally appeared in The New York Times.
Written by: Elizabeth Spiers
© 2022 THE NEW YORK TIMES
