Monday, 30 March 2009

another 2 cents

This article on breastfeeding has been a topic of conversation in my environs a fair bit of late. I am not so much fired up about it, outraged by it, as interested in how the differing conversations have gone. There's the ones had with other mums, breast feeders and not, and ones had around the lunch room table at work with largely childless colleagues.

My overwhelming response to these conversations is that I think they are kind of pointless. Any debate which sets out to 'prove' that breastfeeding is either 'right' or 'wrong', 'best' or 'worse', fundamentally doesn't help. These debates don't help with best outcomes for kids or mothers or fathers, and they sure as heck can't get to any kind of essential truth.

Choices like whether to breastfeed or not or for how long and in what way are not binary choices between good and bad. They are choices made in complex multi variable situations in which factors for consideration come in an overwhelming array of possibilities. I'm not going to run through all those factors here, I can't because they are too many but also because they would most likely appear to be stacking the deck in an unhelpful way.

The article written by Rosin is lengthy and does better than many in not reducing the whole situation to so much faff, but it is still fundamentally flawed in the way it grapples with a black and white oppositional 'rational' perspective and a personal intuitive and angry feeling about the whole thing. Neither of these approaches are without merit, but as the discussions about this article I have witnessed make plain, few people are really interested in bridging the gap between the two.

So let's start on the whole rationalist thing. Rosin's research, historical and social analysis points to the way in which the benefits of breastfeeding have been both overstated and perhaps misunderstood. While I can't comment on the veracity of her position (not being overly well versed in medical studies on the topic myself), I can certainly see that there has been a certain kind of breastfeeding fundamentalism that is historically specific that makes her claim entirely plausible. Equally, the sheer number of regular healthy humans who have been raised without breast milk (myself included) is evidence enough for me to know that formula is not the insufficient nourishment it is often made out to be.

I also think, as Rosin points out (and as others before her have too) that the benefits often attributed to breastfeeding may not be just about milk. That well educated, 'advantaged' women (in America anyway - and let's not generalise this point too much because it does not follow in many other places in the world) are more likely to breastfeed may well indicate that breastfed babies get better everything else as well - time, nutrition, genes, care...the works. There is an enormous amount of room for reinterpreting what breastfeeding is really about, especially when it is wrapped so tightly in an ideology of trying to do the best thing for baby. When the milk flows so do lots of other things - and most if not all of those other things are also (in theory at least) available to babies who are not breast fed.

The reality of both scientific investigation and, you know, life, is that the difference between correlation and cause and effect is often imperceptible and yet critically important.

The next part of her argument, the one about female oppression/feminism/the conspiracy to tie women to the breastfeed is weak for me. I was struck by what was to me an obvious problem with her analysis. Her claim that the time taken to breastfeed is an argument against breast feeding overlooks the time taken for the alternative. Fundamentally bottle feeding takes more time than breastfeeding because in addition to the actual feeding time, you have to buy and make formula or pump milk (and don't go starting me on that time suck), wash and sterilise bottles and heat them up - even if babies drink from bottles faster than from the breast, there is still a lot of time overhead to be made up. And her article doesn't factor in the highly differential feeding rates of babies, both between individuals and between ages - 9 half hour feeds is not some standard rate and I don't really want to quibble about such a minor detail but let's just say this is not an evidence based estimate.

In her claim that breast feeding is not 'free' because women's time is worth something I wonder again about what alternatives she has in mind? Is her argument resting on the idea that if not breastfeeding, then the labour of child feeding can in fact be outsourced to someone lower paid than oneself? This is essentially an economic argument about opportunity costs and the relative efficiencies of feeding methods and as such really must factor in the other costs associated with alternative feeding such as bottles, formula or expressed milk paraphernalia and administration of formula or expressed milk overheads as well as a sound ledger about the value of most mothers' labour. In addition, several studies have demonstrated that outsourced parental/domestic roles do not replaced parental labour on a 1 to 1 ratio, so any analysis must also include the loss of labour value in the transfer of responsibility.

And plus, and this is really glaring for me, all these arguments are not about the cost of breastfeeding but about the cost of babies (since come on there is no way to feed babies for free). And by just looking at feeding the real crux of the labour cost is overlooked, which is all the other parts of the care package. Who looks after baby between feeds? Can one really go through this process of analysing the cost of a woman breast or bottle feeding without making the same analysis for wiping bums and bathing and washing and patting to sleep? Because let's be honest, there is no good economic argument for having children at all once you remove the social contract of elder care (and even then...). In a strictly economic sense (and I don't think economics is all so don't take me out of context here) women are not so much ripped off by breastfeeding, as ripped off by having babies.

That a breast fed baby interferes with a return to paid work more than a bottle fed baby is, I think, obvious. But again the situation is complex. How quickly a mother returns to work and what kind of a workplace she re-enters will have a definite impact on just how much interference there is. And equally it should be said that a mother's level of commitment to breastfeeding may shape those choices and perceptions about the value of working through that interference. But this should not be confused with any kind of evidence about whether breastfeeding is good - merely an observation about the factors which may constrain or otherwise shape choices around breastfeeding (and returning to work in general after kids come on the scene).

I say all these points without making judgements about some of the underlying assumptions that I hear many people make. About whether it is 'right' to make choices about baby feeding using an economic model, about whether babies 'need' their mothers and whether mothers 'should' return to paid work during infancy, whether 'valuing' infant care means not getting it done by someone you wouldn't pay as highly as yourself (and for whom you would not be paying superannuation or workers compensation insurance and so on). I say it not because I don't have views, but because I recognise that different views on these questions may be entirely valid, and that my views are shaped by factors which do not come into play for others.

And I guess this brings us to the real meat. Rosin's article is really an article about an individual trying to find evidence to support her position and make sense of her feelings.

She feels oppressed by the pro breastfeeding 'fascists', and I know many many women have felt similarly pressured. But since by her own admission only 17% or mothers continue to exclusively breast feed for the recommended 6 months then clearly that pressure is not lethal for anywhere close to a majority. Women may feel pressured but they aren't necessarily changing their behaviour as a result. I think perhaps she's saying I don't like being told to do stuff I don't want, and hey, we can all identify with that. But let's not universalise this experience, one person's oppressive coercion is another person's helpful advice. Perhaps we should be teaching mothers to be more assertive and care less about what people say than trying to get either pro or anti breast feeders to shut up.

One reason Rosin doesn't like the pressure is because she sees it as both a source of mothering guilt and mothering anger about the imbalance of domestic responsibility. She seethes about the way she feels forced to be a good mother and breastfeed and yet her husband gets off scot free. And I can but agree! And yet I suspect bottle feeding mums may well stand up in equal measure to complain about who washes the bottles and does the laundry and so on and so forth. The statistical support for unequal contribution to domestic and child rearing labour is overwhelming and far exceeds the breastfeeding population.

And this isn't just an issue for domestic labour, but family inclusion and a raft of other stuff that may support either breast or bottle. Breast feeding can exclude dads and create a lack of harmony or equality of incentives in families, but bottle feeding can create other pressures if expectations for equality of parenting fail to mesh with other responsibilities. Again this is a factor, not an outcome that's the same for everyone.

Rosin in fact concludes her case against breastfeeding by saying she is still continuing to feed her youngest child not because she necessarily thinks it is the right thing to do based on the evidence but because somehow, it feels like the right thing to do for her in the situation she is in. Even in the context of a rational argument Rosin acknowledges that what drives her is stuff she can't quite explain and understand, and this point is significant not just in relation to understanding how the choice to breast feed is made, but also what we might imagine babies do or do not gain from breastfeeding. Quite aside from all the studies there may be more, there is almost certainly more, that takes place for a baby as a consequence of breast and bottle feeding. Now I am not saying I am assuming all that is good for the breast - this is not an argument for breastfeeding - it is simply saying that we must at some point acknowledge that those feelings we have are also mirrored in feelings babies have and these too can only be guessed and hinted at. As inconvenient as it is, we are all subject to emotions and instincts which are not part of the rational mind.

And there's the rub. The choice to have children at all, like the choice to breastfeed or not or return to work or any other of the millions of choices faced can be influenced by evidence and argument and experience, but few can really separate this from what they feel. The drive to procreate is an evolutionary hangover would argue my rationalist, childless friend and he is absolutely right. We no longer live in a world in which we need our own young for survival, and we don't need to care for our infants ourselves or breastfeed them or carry them on our backs working fields and so on. We can be free as individuals and keep and spend the money we earn and develop ourselves in whatever way we wish.

The gap between what we must do and what we can do is so wide that it is not surprising so many mothers feel themselves adrift on a far shore. But I absolutely disagree that our response to that should be to champion our own turf, to search out the one true promised land. We should not be making cases for or against any single position in relation to babies unless the evidence is utterly unequivocal (which is very rare indeed and covers such bleedingly obvious things as murder, substantial physical harm, serious neglect and the like) and utterly feasible for the vast vast majority, or already enshrined in law.

So in the end I have just wasted a whole morning (oh the opportunity cost there!) contributing to a debate I think is not just pointless but possibly damaging too. I'm anticipating a range of people being offended by what I have said, taking a part of what I have said out of context, feeling judged by me when I so really don't feel judgemental and pointing out all the ways I am wrong. I may get an angry comment or two, a couple of yeah, you are rights and a few more stony silences.

And I am wondering why oh why I am writing all this out...when really all I am thinking is I wish people (myself included) were better able do what they feel is right but not universalise their own experience. And ask better questions which don't have right or wrong answers but which aim to result in people making better choices and feeling better about the choices they make. And mostly that they could feel that they can be confident of their own choices regardless of whether everyone agrees with them and not feel the need to trash people who are different. That's what I'm thinking.

And for full disclosure I will say I breastfed my first child on demand and she self weaned gradually and stopped completely at 18 months. I am still breastfeeding my two year old son twice a day, though he also had some formula from a very young age so his dad could be more involved in the whole feeding thing and I could get more sleep, and he skips lots of feeds when I'm not around and doesn't seem to mind but very much loves the feeds he gets and would be happy for more.

While I am happy with the feeding choices I have made (though I do occasionally wonder how the whole weaning thing will happen with the younger), I can well imagine things having taken a different path, and feeling equally happy about that. In particular if I had my kids the other way around, I may well not have persisted in trying to breast feed since Wil was hopeless at it and the first month or two involved lots of pain and frustration. But I did persist because my experience with Amy had been as easy as breastfeeding can ever be and I felt I could get back to that place. If she had been bottle fed I do think that my life probably would have been easier in some ways, but I will never know that for sure.


MildlyCrafty said...

I agree, people should just do what they feel is right for them and not bang on about it like it's the only "right" choice.

(And I'm so jealous of your writing skills!)

Naomi said...

I'm so glad you give your time to writting this stuff. It makes the thoughts of my muddled brain crystallize. So thank you - for putting yourself on the line and talking about untouchable subjects.

Ren said...

What you said... "I wish people would just do what they feel is right but not universalise their own experience" is, I think, spot on.


JustJess said...

In total agreement with Ren here. I had two polar opposite experiences with each of my kids. Neither option was right or wrong, just the choice I made. Judgements don't help. This is a brilliant post - I'm off to read it again. Thanks Sooz.

travellersyarn said...

This post has started me thinking my own muddled thoughts about breast feeding. I came under pressure to supplement older daughter with formula because she was gaining weight slowly. Older daughter was a paid up member of the militant wing of the la leche league, and would have nothing to do with it. Then I really felt stuck!

Younger daughter had a life threatning reaction to her first bottle of formula; and I was stuck again.

At the time, the stuckness felt like a permanent state; but they are not babies forever (and I was pretty keen to direct weaning after younger daughter's first birthday).

sueeeus said...

You certainly are a thinker, and you articulate so well!

I desperately want(ed) to breastfeed, but couldn't make it work, even though I tried valiantly. In retrospect, it was more about me than about the babies. It was a mothering experience that I wanted for myself. Instead, I pump, and I suppose in some ways it's still more for (or about) me than the baby. I can see how people want to universalize their own experience --just looking for validation that they've made a good choice. Which is an excellent point you make about the choice, whatever it is, not being a binary matter at all.

Lisa said...

Well put Sooz. It's such an emotional subject isn't it. My own experience with breast feeding was a complete failure for many and varied reasons, which made me feel a complete failure. Even though she's a teenager now, and in my head I know she was fine and I was fine, but I have to say it's still a soft spot. What you've written made me feel quite alot better about the whole thing, even after all these years.

scientician said...

That was so well expressed. So much so I had to write a comment to that effect. See, right above this. Anyway, just wanted to say that I was very impressed with the clear way in which you expressed your thoughts. I wish I had the same skills when it came to my thesis.

Wendy said...

I completely agree with everything you have written in this post. And I also think you wrote it very good.

Di said...

Well said, well said.
A little bit of tolerance could go a long way in this world.
As could freely available support and encouragement for each and every person facing the steep and treacherous learning curve that is early parenthood.

tiawebb said...

So refreshing to read a well articulated and non judgemantal perspective on this issue.

I breastfed both my children because I wanted to and not for any other reason.Friends haven't bothered and I think no less of them!!

Well done you for being able to stand on your soap box and say the arguement is futile!! Much admiration.


Anonymous said...

This is my first online comment to a post EVER.

Thank you for such a well-thought through and articulate piece that calmly and sensibly addresses a topic that often features, subtly or not, one particular view. Your piece provides those who may be feeling pressured, guilty or unsure about their choices an intelligent base with which to view the prevalence of opinions.

Caring for babies and young children is challenging enough without having to deal with feeling undermined, pressured or obliged to justify oneself or feel outraged every time a differing view is expressed.

I will be directly any mother who is having the normal concerns - either way and for whatever reason - to your well-written and empathetic post. Our society needs more people like you who genuinely seek to support. Thank you.

badmomgoodmom said...

Thanks for such a coherent post about such a hot button issue. I agree wholeheartedly with you about motherhood not paying off financially. Here is one rant.

"Years ago, I read about a discussion in Japan's parliament about their demographic time bomb. One legislator railed against women who didn't breed and wanted to make women's pensions dependent upon how many children they raised. I thought this was horribly unfair. Why pick on women and not the entire society that makes raising children such a chump job? What about infertility?

On second thought, why did I take on a whole 'nother job that comes with no pay, compresses my salary and costs tons of money. (Have you priced quality childcare lately? Bring smelling salts.) When I get my Social Security Benefits statements each year, I see red. For doing two demanding jobs, I will not be rewarded in retirement. In fact, I will lose benefits relative to the CFBC because I have been given much lower raises ever since I dared to breed. My husband, another breeder, has enjoyed increased raises. For many of those years, our raises were determined by the same man. It just makes my blood boil.

Breeders shoulder responsibility for a sustainable society. It is not unreasonable to expect nonbreeders to understand that we are also performing a service FOR THEM."

I tagged all my posts on the subject Birthrates:

froginthepond said...

Onya, sooz. Well thought out and written.

Was going to say more, then realised there was no need!

sooz said...

OK, I am totally bowled over by all these supportive comments - thank you all! I thank you not just because you are flattering (which of course is very nice) but because you make it really clear that you *can* have a constructive dialogue about complex and sensitive issues and that really makes me feel like there's a point to wasting my mornings writing about such things.

And in particular a couple of comments - Di yes yes yes! There needs to be more support that comes 'without strings attached'. Because as anonymous said - it's hard blood work.

And Lisa - you have absolutely made my day/week/perhaps year. To feel I may in some way have eased anyone's sense of confusion or hurt is the greatest compliment in the world. Really. And you to anonymous.

And to badmomgoodmom I encourage you to have a look in my archives - between 2004 and 2006 I wrote my masters thesis on work and family and I was in part focused on an analysis of the 'impact' of babies on women's (and fathers to some degree) lives in terms of work and finances. The evidence is clear but what it means is much harder to pin down. :-)

Joely Whiting said...

well said Sooz, it's up to the individual and what feels right for them.
women put far too much pressure on each other to be "perfect" or do the right thing, when there is no such thing.
it's different for everyone and we should be supportive of each other.
life is hard enough without all this pointless to-ing and fro-ing on a rather touchy subject for a lot of people.
who really cares as long as the baby is happy and healthy!

jean said...

Mothering choices often seem to touch a raw nerve.

Thank you for adding a voice of reason that sees the grey... that recognizes the beauty of our individuality... that says I will not take your choice to do "x" as a criticism of my choice to do "y" ... or as proof of my own superiority.

You are dead on in exposing our tendency to universalize our personal experiences and choices as a flawed defensiveness, and also in saying that taking a hard line position about the vast majority of mothering choices is damaging and pointless. Not that it is wrong to feel strongly about the choices we make and to be secure in knowing when they are right for us, but that we are brave enough and wise enough to see that our right is not the only right.

Not at all a waist of an afternoon. This turns the debate away from polarization and towards understanding and acceptance. Well done! We need more of this.

Melanie said...

You put your finger on it, lots of times, there. Whilst I don't like breastfeeding 'fundamentalism' I can see that it has come as a reaction to years of being out of favour and out of fashion. Like the organic and green movements, there is a whole spectrum of belief even amongst those who are 'pro', also mitigated by circumstances. I read every book in the library on breastfeeding for my first child and was amazed at the different fundamental beliefs that people had about it. The important thing is to keep all this information in perspective and work out what suits us and our babies best.