Los Angeles Times - Formula for Guilt

Promoting breast-feeding by trying to shame women into doing the right thing is bad public policy By Peggy Orenstein Peggy Orenstein is the author, most recently, of "Flux: Women on Sex, Work, Love, Kids and Life in a Half-Changed World."

January 11, 2004

BERKELEY — When the American Academy of Pediatrics recently complained about a TV campaign to promote breast-feeding, mother's milk advocates nursed suspicions about why: Formula manufacturers are, after all, among the academy's largest donors, with Ross Products, a division of Abbott Laboratories and the makers of Similac, giving some $500,000 a year. The spots, which were developed by the Ad Council and abruptly shelved last month, focused on "risks [to the baby] associated with not breast-feeding," such as diabetes and leukemia. One ad, titled "Roller Derby," showed pregnant women lumbering around a skating rink. "You'd never take risks while you're pregnant," intoned the voice-over. "Why start when the baby's born?"

As a journalist, my instinct too is to follow the money and suspect unsavory influence in the ad campaign's cancellation, but as a new mother who has struggled with breast-feeding, I find myself agreeing with the decision to pull the ads. Shaming women is simply bad health policy.

There's a lot of guilt that comes with motherhood these days. The pressure starts as soon as the pregnancy shows. There are the people who give you the evil eye when you order at Starbucks or the ones who inform you when (or if) they think you should return to work after the baby is born. And everyone has an opinion on the correct way to give birth. In Berkeley, where I live, the hospital-sponsored childbirth preparation class barely even mentioned C-sections, though up to a quarter of us — I among them — would end up having one. One natural-childbirth advocate even informed me that a baby's birth experience affects her psyche for the rest of her life. I thought I was immune to such "advice" with its ugly subtext of the "bad mother." I understood it was part of the never-ending attempt — by both conservatives and liberals — to control women's behavior. Breast-feeding, however, turned out to be my Achilles' heel.

Radiation treatment I'd had for breast cancer six years ago left me with only one lactating breast. I tried to tell myself I was lucky to be alive, lucky to have the baby and if I couldn't breast-feed, well, I would be grateful for what I had. Still, I knew the benefits of nursing, and all the parenting books filled me with terror about the dangers of passing it up. It was unbearable to think that my deficiency would increase my daughter's chances of becoming asthmatic, diabetic, obese, or contracting cancer. Like all mothers, I wanted desperately to give her the best possible start.

As it turned out, I could supply about three-quarters of my baby's needs, but the lactation consultants I sought out were rigid. One even urged me to underfeed my child rather than supplement with "junk food" (that's formula to you and me). The baby's meals quickly became a source of anxiety, a block to intimacy instead of a bridge. Discouraged, I considered stopping nursing entirely, as most American mothers do: Nearly 70% have given up by six months.

I don't question that breast-feeding is the best thing for babies or that promoting it is necessary. When done right, breast-feeding advocacy, as well as education in natural childbirth, returns women's health to women's hands: It's an important corrective to the medicalization of mothering.

What I wonder is why the first impulse is to bully moms into compliance, particularly given that public-service campaigns focusing on scare tactics (such as those discouraging drug use or unsafe sex) are notoriously unsuccessful. New mothers are an anxious group: stressed out, sleepless, overwhelmed and desperate to do the right thing. Why not simply emphasize the benefits of breast-feeding and trust that mothers will make good choices?

Apparently it's easier, or at least more comfortable, to blame women than to truly help them. A more supportive approach might condemn those who shove publicly nursing moms into the bathroom or perhaps encourage workplaces to become pump-friendly. Why not join forces with advocates of on-site day care in the workplace; that would certainly make longer-term nursing easier.

As for me, I stopped consulting anything but my own heart. I still nurse my 5 1/2-month-old baby, delighted to be able to give her what I can, but if she's still hungry afterward, I top her off with an ounce or two of formula. And when, on occasion, the busybodies give me disapproving looks, this "bad mother" smiles, snuggles her daughter and wonders what that smug intolerance means about how they raise their own children.

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