Keep your agenda off my breasts, please!

A reader writes:

I’m due with my second child soon. I breastfed my first for only four months – I don’t beat myself up too much about it, but I do regret it because of the reasons I quit. We had no physical problems whatsoever, and she wasn’t an all-day comfort nurser. What sent me into a breastfeeding-related depression spiral was all the breastfeeding advice I was reading.
Even though we didn’t have problems, lots of times I’d want to know if something was normal, etc., so I’d look at kellymom or the LLL site or something. And as you know, those sites DON’T just give breastfeeding advice – it comes with a healthy side of Agenda. So by the time my daughter was a few months old, I was convinced that the only way to successfully breastfeed was if you also coslept, never left the baby’s side for a moment, fed at every single peep, were willing to forgo sleep for years on end, blah blah blah. And I just wasn’t willing to do all that stuff, so I stopped.

I’ve since talked to a lot of other women about this and realized that it IS possible to breastfeed for a year or more without following the AP party line. Maybe you have to pump, maybe you have to give a formula bottle here and there, maybe you sleep train – but you can still breastfeed. At least that’s what they say. I’d like to believe that’s true, because I’d like to be able to go longer with my second child. Does “breastfeeding for the real world” sound like something you’d be interested in weighing in on?

Yes, I would. I think many breastfeeding resources, in print and online, “mix issues” far more often than they may realize, or at least are willing to admit. While a site like Kellymom is at least up front about being about “breastfeeding and parenting”, the La Leche League, which is supposed to be for the support of breastfeeding only and despite its protests to the contrary, recommends books and takes positions on diverse issues such as promoting “natural” birth, bedsharing and leaving work to SAH full-time, as ideals we women should strive for. While it could be argued that these practices promote breastfeeding, so do a lot of other things – like farming out your older kids for the first 6 weeks or having an LC live with you 24/7. But I can’t see The Womanly Art of Breastfeeding pushing that as ideal. The fact still remains that women overwhelmingly choose analgesia during birth, choose not to cosleep, return to work either out of desire or necessity, at some point expect their babies to sleep through the night…and they still should receive BF support without the dollop of judgement so favored by certain popular books and organizations. For many women, not working or having a “natural” birth is as practical as farming out your eldest in favor of the nursling.

Mind you, in the circles I work with (ultra-Orthodox Jews), women who’ve given birth to their 3rd, 4th or even 15th child often go with their babies to a few days at a “convalescent home” after they are discharged from hospital, to get some much-needed rest before they return to the demands of a large household. These women often refuse to “room in” at the hospital, and these facilities often have baby nurseries if Mom needs a break. Somehow, despite all the ‘detachment’, these women have the highest breastfeeding rates in Israel (which overall has higher BF rates that the US or the UK). These women could probably teach LLL a thing or two about breastfeeding…even without the AP trappings.

I’d like to suggest an alternative breastfeeding guide (no, I’m not getting paid for this and I don’t know the author from Adam, in case you were wondering) which doesn’t toe the AP party line, but still manages to be fairly comprehensive : Dr. Mom’s Guide to Breastfeeding By Dr. Marianne Neifert. While Dr. Neifert (a pediatrician and a lactation expert, who had a hand in composing the 1997 AAP policy statement on breastfeeding), is very pro-BF – and it shows – she also was in the proverbial BF trenches while a college student, intern and resident, and she can well appreciate the very real difficulties women run into while breastfeeding, as she herself needed to supplement with formula with 4 out of her 5 babies. The book covers insufficient milk supply in the most in-depth manner I’ve ever seen in a breastfeeding manual (ex. – did you know certain breast shapes can help predict if you might run into supply problems?), and how, and with what, to supplement if appropriate. Most importantly, the book is the least preachy of all the books of this kind: It discusses the different (as in equally valid) sleep arrangements of the family bed and sleep “training”, never once suggests that if you go back to work, your commitment to your baby is lacking, and gives various solutions to working and breastfeeding (some of which, believe it or not, may include mixed feeding with no guilt trip attached), and the section on weaning doesn’t make you feel like an evil selfish bitch for even considering it.

I would have liked to see an appendix about medicines and breastfeeding (instead of the few examples in a few paragraphs given), but this information can be found elsewhere and is subject to change as medical knowledge updates itself.

Neifert was a member of the Health Advisory Council of LLL, and is a lot more enthusiastic about them than I am. However, some of her advice, and her general approach to the subject, goes against what the “official” LLL is saying in the most unapologetic manner. While the book was published in 1998, I think she’d still be uncomfortable with LLL’s wimpy and confusing 2005 statement regarding HIV(+) women breastfeeding.

Anyway, the ideal is to breastfeed. AP Purism isn’t, and shouldn’t be, the goal.

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2 Responses

  1. I didn’t think their was a choice of HIV + moms BFing. It does put the baby at risk to aquire HIV? Have I missed something big? I mean if the baby can get AIDs from BFing, isn’t that a big bad thing?

  2. In the developing world, the dangers of not breastfeeding in the early months are significant. It’s also been shown that exclusive breastfeeding (no solid food or anything else) may be as good as formula in preventing HIV transmission along with preventing infant mortality from other causes, therefore the current recommendation is – where formula isn’t easily fed safely, to exclusively BF for 4-6 months and then put the baby on formula + solid food. However, where formula can be safely made, the recommendation is the formula feed from day 1. Apparently the idea of not BF at all or only a few months rubs the LLL the wrong way.

    The current WHO guidelines about HIV and breastfeeding.

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