Breast of Burden

The pump. The poop. The panic. A dispatch from the nursing wars.

Early in my career I accepted an assignment from one of the advocacy groups working on this issue to visit hospitals around South America to report on how formula was being marketed. The job took me to neonatal intensive-care units in several nations, each of which was packed with starving babies the size of my hand. Nearly 15 years later, when the nurse told me to start giving Baby supplemental formula, I had to be convinced that this wasn't tantamount to poisoning him. (The boycotts of the Seventies and early Eighties helped draw awareness to the problem, and some formula makers pledged to change their marketing tactics. But the hospital in your neighborhood and its counterpart in Peru still hand out the same free samples.)

By the 1980s the "natural mother" had been eclipsed by Supermom, who caused enough "fright, fatigue, grief, or passion" to soon be replaced by the "Good-Enough Mother." Most recently those icons have made way for my generation's archetype: The Pumping Mother. She is inundated with propaganda about the "secure attachment" created by baby's time at the breast but, lacking adequate subsidized maternity leave, carries her Pump in Style--and a truckload of guilt--to work.

It seems all too predictable that as breastfeeding in absentia has become more widely accepted, there's been a backlash of voices arguing that breast milk alone isn't enough--that mom needs to be physically present in order for baby to reap maximum benefit. Thinking back on my department-store expedition, I almost pity poor Ms. Medela. No sooner had she lined up all the right accessories when someone found a whole new way to make her feel guilty.

 

Any woman who's contemplated nursing for any length of time has probably run into the most visible movements advocating breastfeeding. There are the devotees of "attachment parenting," a philosophy organized around five core values, dubbed the "baby B's": birth bonding, breastfeeding, bed-sharing, baby-wearing (remember those slings that keep baby at the breast?), and "belief in the signal value of an infant's cry."

And there's La Leche League, a volunteer-run breastfeeding support group that has been the leading source of advice and motivation for nursing mothers for nearly 50 years. League literature describes breastfeeding as "the key to good mothering," noting that "A nursing mother is physically different than a non-nursing mother. She is in a different hormonal state. Because she is breastfeeding, she has a high level of prolactin--the 'mothering' hormone."

Although she documents many positive experiences the group has provided for women, Blum also notes that until quite recently, working mothers weren't allowed to become leaders. League officials, she found, "had been instructed to discourage women from returning to work. Leaders were also to steer the conversation, if mothers mentioned economic need, to suggestions for supplementing family income from home."

One Texas mother posting to Hipmama.com, a parenting Web site I visit regularly, recently wrote that she'd called her local Leche League chapter to ask whether they might have leads toward finding a baby sitter for her toddler so she and her husband could enjoy their first evening out alone since the baby's birth. The group leader--a perfect stranger, she reported--told her to abandon the idea. Her baby needed her too much.

What cold comfort that kind of advice must be to single or low-income mothers who have to work, or whose partners are too harried bringing home paychecks to pick up the slack while mom nurses. After interviewing mothers of different economic and racial backgrounds, Blum concluded that a woman's socioeconomic status pretty much predicts what kind of nursing advice she'll get. The medical establishment, she posits, doesn't work as hard to encourage certain women to breastfeed, often out of fear that they won't be able to resist polluting their younger or darker-skinned bodies and, by extension, their babies.

"The low-income clinic that I did field work in asked mothers to keep food diaries of everything they ate and drank," Blum recalls. "It tends to get so exaggerated that you can think that one cigarette or one beer can do irreparable harm. I think we've gotten to a real height of expecting purity from mothers."

One mother I know, Kathi, gave birth just a month after her 20th birthday and quit breastfeeding two weeks later. "When I told them I had stopped, I felt ashamed," she says, adding that to her surprise, her doctors seemed a tad relieved when she informed them that she was feeding the baby Similac (as opposed to what? Mountain Dew?).

Although Kathi checked herself out of the hospital just 12 hours after giving birth, she says she was there long enough to realize that she wasn't going to get consistent advice. "There were so many different nurses who would come in and put their two cents' worth in," she recalls. "They were all telling me different things, and their way was the right way and I was doing it wrong. They talked at me, not to me. That was really all it was."

All of the breastfeeding advice heaped on new parents is doubtless well-intentioned. The problem is the implication that if you truly love your infant, nothing--giving up income and a career, sleeping with Baby on his schedule, learning to nurse him hands-free in a sling in the grocery checkout--should be too much. And if you're affluent, white, and married, perhaps it's not.

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