Hey, breast-feeding fanatics: Stop shaming moms who use formula!

As a doctor, I think breast-feeding infants is best. But it doesn't work for everyone, and that's OK

Published March 13, 2014 11:43AM (EDT)

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Like the overwhelming majority of pediatricians, I think breast-feeding infants is best for them. When new mothers come in with their babies and tell me they’re nursing, I do everything I can to encourage and support them. When breast-feeding goes well, it’s great.

Except sometimes it doesn’t go well.

I was interested to read about a new study in the journal Social Science & Medicine, which calls into question some of the purported benefits of breast-feeding commonly trumpeted by its most ardent proponents, including lowered risk of obesity and improved academic potential. I wonder what, if any, impact it will make in the incredibly fraught discussion of mothers’ decisions to breast-feed or not.

It’s important that we not dismiss the benefits of breast-feeding too broadly or too quickly. This is only one study, after all, and it doesn’t seem to have addressed some other benefits of breast-feeding, including those related to improved immunity from illness. Like I said, I genuinely do think breast-feeding is best.

However, there is a world of difference between “best” and “the only choice of right-thinking people.” And too many in the stridently pro-breast-feeding community don’t seem to recognize that. Formula may not provide all of the benefits of breast-feeding, but it’s not strychnine, either. For families who either cannot or choose not to nurse their babies, it is a totally reasonable way of nourishing their children.

And it is nonsense to imply otherwise.

Yet the implication is everywhere. It starts in some hospitals, where the clear message is that choosing to formula-feed one’s infant is baby “unfriendly.” It comes from lactation support professionals who are too assertive in stating their viewpoint when meeting new mothers on postpartum wards. And of course, it comes from other mothers.

The message communicated is that all women can and should breast-feed their babies, and that it is innately selfish and harmful to choose otherwise. This despite generations of babies who have been formula-fed without our nation sliding inexorably toward disease and destitution. Good mothers choose “the” normal and healthy way to feed their babies.

Of course, many mothers absorb this message and strive to abide by it. And sometimes it simply doesn’t work. I have had more new mothers than I can count come into my office with their babies, desperately trying to nurse and having no success. They have met with the lactation consultants and tried every trick recommended, and still things are going wrong. The baby is losing weight, and the mothers are frantic and distraught. (Lest these troubles be unfairly ascribed to ineptitude on the mothers’ parts, on numerous occasions these are women who successfully breast-fed an earlier child but for some reason couldn’t make it work with a later one. It happens.)

These women come to me in emotional extremis and feeling like failures. They have been told that any woman can do this and every mother should, and have internalized the shame placed on them.

It is my job to reassure these fragile new moms that they are no less caring and selfless for supplementing with or switching to formula. That what matters most is that they feed their babies. That being an exhausted, anxious wreck of a mother is doing them no favors during those precious first days when bonding is just beginning, and if breast-feeding is getting in the way of their enjoying their new relationships with their children then they should accept the alternative.

They are invariably relieved. And I’ve yet to encounter one who was not grateful to have heard that advice.

I have no patience for the notion that these women have failed, nor with a movement that would seek to shame them. Frankly, I have no patience for a movement that would presume to tell women that they are less worthy as mothers if they have chosen to formula-feed from the get-go. Nobody has perfect insight into the lives of other people or the functioning of their families, and thus nobody has proper authority to browbeat women into adherence to a certain wholesome but undeniably demanding nutritional ideal.

When asked, I always advise prospective mothers that breast-feeding is the best possible option for their babies. I endeavor to be as supportive of that decision as I can. But it’s not the right choice for everyone, and it’s time we stopped preaching otherwise.

By Russell Saunders M.D.

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