Breasts and body fluids are two topics of conversation that are generally taboo in decent society. Passing off as “mommy club” conversation, however, women ask new moms about breastfeeding.  In my experience, such questions come without invitation and the answers are less clear-cut than might be expected.

The American Academy of Pediatrics recommends exclusively breastfeeding babies for the first six months and encourage breastfeeding, along with solids, for as long as “mutually desired” by mom and baby.  Studies abound regarding the desirability of breast milk – reported results include higher IQs and less illness.  It benefits mothers, too.  Women doggedly advocate for breastfeeding by citing such studies and telling new mothers breastfeeding is what they “should” do.  Many express disgust when a mother says she did not breastfeed, especially if by choice.

The pressure on women to breastfeed is enough to make an otherwise strong woman break. Pressures are many on a new mother and changing hormones make emotions unusually rollercoaster-like. Self-doubt about the new role in life easily settles in and the gaping mouths and “tsks” that follow the admission of formula in a baby’s life serve only to add fuel to that hormonal fire.  Conversely, women who proudly proclaim their choice to breastfeed are met with approving nods and atta-girl pats on the back without regard for a woman’s unseen behaviors while breastfeeding – smoking, drinking alcohol, or taking prescription and over-the-counter medications.  Some medicines are categorized as “moderately safe.”  Is that better than formula?  Sure there have been mishaps, but breast milk can have “trace amounts of pesticides, dioxin and a jet fuel ingredient — as well as high to average levels of flame retardants.

Some women cannot breastfeed due to illness or breasts that never got the order to support another life.  Even the mother’s blandest diet can result in gastrointestinal distress for the infant.  Prescription drugs for galactagogue effects include metoclompramide, an anti-nausea/heartburn medication that has a side effect of major depression – nobody needs that.  Many mom-baby pairs have latching issues, some due to inverted nipples or a tongue-tie.  Rather than telling a visibly stressed mother that it is okay if breastfeeding does not work, women implore others to seek lactation support and to avoid introduction of a bottle, no matter the level of frustration.  When a mother is tired or has back pain, common advice is to feed the baby while lying down, contrary to the advice that parents should not share a bed with their infant.  Better advice might be to bottle-feed and give the mother a break, while simultaneously giving the father a chance to bond with the baby over a meal.

The study linked above shows breastfed babies have an IQ advantage of less than four points compared to formula-fed counterparts.  The margin of error in IQ tests is about five points.  Other research has shown that “smart mothers have smart babies” and just 15 points equals a mother being twice as likely to breastfeed her baby.  Further, most studies that show better outcomes for breast-fed babies compared to their formula-fed counterparts do not have adequate control groups.

Physical barriers to breastfeeding create logistical issues with pumping milk at work. Post-partum depression sufferers need to be freed from stress and guilt. Many just do not wish to breastfeed.  These women are not less of a woman or of a mother, but are are doing the best they can.  Perfect is the true enemy of good enough.  Breast milk might be “perfect,” but formula is good enough.

As I finished writing this, I was off to pump some milk for my still-breastfed six-month old and to write an encouraging email to a mom friend who was struggling with supply.  I did not tell her it is hard, but she should keep trying, essentially demonizing her if she chooses to stop breastfeeding, or encourage her to continue to starve her child with an insufficient milk supply just to assuage her guilt about choosing formula.  I told her that a good mom is a happy mom, that her baby can sense her stress, and that she needs to do what works for her family.  I told her lactation consultants (now no cost to consumers through insurance) are a great resource if she wants to keep trying.  I closed by telling her that her baby will thrive based on love and devotion, regardless of what type of milk fills her stomach in the early months.  As for the “mommy club,” there is more to the conversation than breastfeeding.