5 minute read
ESSAY
Pressing the Flesh
How medicine’s aggressive push toward breastfeeding is harming families
BY STEVE FRIESS
AT FIRST, IT STRUCK ME AS FUNNY. Our doctor’s office always provides some age-appropriate parenting health information along with the after-visit report for our kids’ appointments, and my daughter’s 2-month-old checkup was no exception. This time, though, mingled among the most rudimentary, uncontroversial advice — Talk to your baby! Use a car seat! Don’t smoke! — was a section about the paramount importance of breastfeeding. As with most heteronormative things that come my way as a gay dad, I smirked and tried to shrug it off.
Except I couldn’t. The more I thought about it, the more I realized how inappropriate it is for my provider, Michigan Medicine, to be including this admonition as a general rule for everyone — and that it is a symptom of a trend in neonatal pediatrics that has gone way too far.
Here’s a shocker: Breastfeeding isn’t for everyone. It is not a universal truth that breastfeeding is always the best option or an irrefutably correct opinion — like, say, that you shouldn’t let a baby’s room get too warm — that it is better. And yet, since the advent of baby formula, there has never been a time when the pressure to breastfeed was more intense.
It starts within the hour of a birth and doesn’t let up for months thereafter. A nurse at Rush University Medical Center in Chicago encouraged my daughter’s birth mother to nurse the newborn because — move over blueberries, goji berries, and chia seeds — the first squirts of breast milk, known as colostrum, are the super-est of superfoods. If you buy the hype, and enough people do that there’s actually a market for goat milk colostrum, this stuff has Lewis Carroll-level magical qualities. Never mind that everyone at Rush maternity knew this child was being adopted; the idea of encouraging a woman who is placing her baby with another family to begin and then have to cease lactation is ridiculous — and cruel.
This push causes real damage to mothers and to families. My niece, Arielle Zellis-Paley, had a baby boy in 2019, two weeks after the birth of my son. About a year later, she opened up in great detail for The Layers Project Magazine, an online journal for Jewish women, about how her struggle to nurse exacerbated postpartum depression the rest of the family didn’t even know she was dealing with.
Arielle wrote, “I had a low supply of breast milk, and I was trying around the clock to nurse, pump, nurse, and pump. The pressure was on. YOU NEED TO GIVE YOUR BABY YOUR LIQUID GOLD. The nurses had yelled at me day one postpartum, and they grabbed my breast and shoved it into Nafshi’s mouth. I was sobbing. It really hurt and I felt like a failure already.”
Yes, researchers have identified some health benefits of breast milk for babies — lower incidence of allergies and asthma, antibodies that can fight viruses and bacteria, less constipation — and those upsides deserve to be considered. But the data on this lacks context; the vast
majority of people actually don’t have asthma or allergies, for example, and that means most kids do fine with or without breast milk.
But the emotional damage to mothers who cannot nurse — including nonbiological moms via adoption, surrogacy, or same-sex co-parenting, as well as women who have undergone mastectomies and women, like my niece, whose bodies don’t cooperate — is rarely weighed in the too-cutesy axiom that actually is the World Health Organization’s motto on breastfeeding, “Breast is best.” There’s also a World Breastfeeding Week (first week of August, for no apparent reason) and a recommendation from the American Academy of Pediatrics to exclusively breastfeed for a baby’s first six months.
This is not to say pediatricians and health care providers should stop encouraging women to nurse if they can and if they want to do so — although it might help women relax and learn how from lactation experts if they’re not also being told that they’re bad mothers if they end up unable to. As an economic matter alone, I know from ongoing experience how great it would be to have a “free” food supply for our children; for families who cannot afford formula, then, nursing provides relief from financial stress that can also be emotionally taxing.
There are, however, better ways to strike these balances. Grabbing a breast and shoving it into an infant’s mouth while a mom screams in pain is not one of those. Blanketing all parents, regardless of circumstance, with edicts that suggest
nursing is as fundamental to child-rearing as holding your baby is offensive and unproductive.
As it happens, Michigan Medicine says the fact that only breastfeeding information was included in the 2-month after-visit handout was a mistake. The handouts given at less-than-1-month and 4-month visits “balance content for both breastfeeding and formula feeding,” writes Dr. Jill Noble, lead of the division of general pediatrics at C.S. Mott Children’s Hospital in Ann Arbor, via email.
And Dr. Rosalyn Elizabeth MabenFeaster, a Michigan Medicine OB-GYN whom the press office made available to me for an interview, went to great lengths to agree with pretty much everything I said about the matter. “I have many patients who have had struggles with breastfeeding — I 100-percent have seen what your niece mentioned in terms of that exacerbating both their anxiety and their depression, and I myself had issues with breastfeeding my first baby,” Maben-Feaster says. After then reciting the science about the benefits of nursing, she went back to empathizing. “I do agree that we have a ways to go to think about how we can be more inclusive about the materials that we provide to patients and our sensitivity.”
Good. Still, I question the inclusion of this sensitive information at all in such a general manner. Presumably, the parents and child had just had an in-person visit with their doctor. That doctor would seem to be the one to scope out what the feeding and family-structure situation is and express concerns or offer advice. If a baby is thriving and hitting all the milestones, there should be no need to lecture anyone about nourishment, right? And if there’s a handout to be provided, the doctor can make that decision on an individual basis.
Obviously, it’s a bit silly to present this material to gay dads with no lactating breasts to offer. And most gay men understand that this kind of material exists to accommodate the most common circumstances. That’s fine. But it’s cruel to foist such information on all women with babies. There is no one-size-fits-all, except for this: Parents who cannot or choose not to nurse deserve the exact same level of respect as those who can and do.
