Wednesday, April 14, 2010

A New "Trend" in Breastfeeding

In the breastfeeding community, a certain article from Time has been making the rounds (online) recently: Mothers Who Opt for Breast Milk, not Breast-Feeding. It discusses how there is a growing trend in mothers who choose not to feed their babies at the breast and to instead pump their milk full-time (often called "exclusively pumping") to be given to their babies using bottles.

I have known mothers who had to pump full-time - not chose to - because of medical problems with their babies. The babies physically could not latch on to the breast, so thank goodness that the option of pumping all their milk was available and that the mothers were able to maintain a full supply by pumping (some mothers have difficulty maintaining a full supply using a pump alone). These babies were still able to receive the nutritional and immunological benefits of breastmilk overall, and this is of special importance to children who have medical problems.

I have also counselled several women who, for whatever reason, have ended up pumping exclusively and want to get the baby back to exclusively nursing at the breast. Unfortunately, these mothers who wanted to nurse their babies faced obstacles in the early weeks, such as hospital staff who insisted that the babies had to have bottles due to illnesses or prematurity (babies can develop a preference for the faster flow from a bottle nipple and should be fed expressed milk in other ways if the mother desires nursing once the baby is able to do it). Some of them had problems getting the baby to latch on (for a variety of different reasons) and pumped in order to maintain a supply and feed the expressed milk to the baby. Some had severely cracked and bleeding nipples and turned to the pump or were encouraged to do so by family and friends who wanted to help - yes, a quick fix, but understandable that relatives and friends would want to try to remedy the issue and fast. Husbands particularly can have a great desire to solve the problem as quick as they can because they so hate to see their wives and babies struggling. Some moms just had an emotional time getting started, and they were convinced by well-meaning people that they should "just pump," because then they wouldn't be "tied down" to the baby and could "get back to normal" faster (uh, life never goes "back to normal" after having that first baby! ;). There are so many reasons why moms who intended to nurse end up pumping exclusively... and then, when they want to get the baby back to the breast, the baby has forgotten how to nurse and sometimes even cries and rejects the breast, which makes an already hormonal new mother doubt herself. It is such a shame! That sounds kind of cliche, but it really is tragic to see. It is really unfortunate to see that it could have been prevented, and how much work it can take to get the baby back to the breast and to wean from the pump and bottles. Some of these mothers I have worked with are devastated that their baby won't nurse at the breast, but they are also very strong and courageous, as many of them present a positive attitude and continue to try offering the breast in a relaxed, no-pressure kind of way, so as not to get stressed out over it, yet hoping and praying that one day, the baby will nurse at the breast. Some of these mothers, when initially contacting me for help, seem almost apologetic and say things such as, "This might sound weird, but I just have this overwhelming desire to nurse my baby!" It only "sounds weird" because of the cultural views on breastfeeding. But it is not weird at all - that's a mother's biology crying out!

There are also some mothers who decide from the beginning not to nurse, not just because "it's weird" or "it's not for me" or "I just don't want to be the sole baby-feeder," but because of past sexual abuse. Some mothers have a really hard time coping with the idea of something intimate like that occurring due to the terrible things that happened to them in the past. I can't fathom how awful that would be, to have such bad feelings due to somebody violating them in that way. And for the ones who can still manage to pump even though nursing at the breast is too emotionally unsettling to them, then hooray for them! I can only hope and pray that these mothers are able to resolve the pain from the past and heal through therapy and whatever else it might take, and maybe even one day be able to nurse a future baby one day.

So, this apparent "trend" in mothers choosing to pump from the get-go, or after trying nursing for a week and then deciding "it's not for me" leaves me with many concerns. On the one hand, I am very glad that breast pumps have become so much better than they were in years past. If a mother or baby cannot nurse, then thank heavens for the pump, which can be quicker and more comfortable for many women than manual hand-expression. For mothers who chose to go the exclusive pumping route, thank heavens that their babies can still receive breastmilk. In years past, if a mother didn't want to nurse, then her baby had to receive formula, and in the days before that, a wet-nurse, although I would guess that far fewer women decided to just not nurse then because access to a wet-nurse was limited to the wealthiest people. So, it was nurse the baby or he starves. So thank heavens we don't have starving babies, and of course the expressed breastmilk is far healthier for babies than infant formula. If mothers are going to not nurse their babies just because "it's not for them," then I am glad that some of them are still willing to provide the normal nutrition for their children. I do wonder though, if this were not such a readily accessible option, would less mothers choose it? Kind of a "which came first" question.

I also want to say that exclusive pumping is a huge commitment - one that most mothers don't plan to make ahead of time because of the immense amount of work involved. Not only does one have to pump every 2-3 hours in the early months and thereafter every 2-5 hours for many mothers, depending on mother and baby, but she also must clean the pump parts after each nursing, she must maintain the pump and make sure it stays in good working order, she must pack it up and take it with her any time she stays away from home more than a few hours, she must clean bottles and nipples... oh, and she still has to feed the baby a bottle! Add to that the fact that she is unable to pacify the baby at the breast, and she may well spend the rest of her time trying to comfort her baby, as one cannot pacify a baby with a bottle for any longer than it takes him to drink the milk it contains! So, like I said, a huge commitment. All moms who have ever done it for any length of time should pat themselves on the back for not resorting to using formula instead. It is hard! Of course, lots of things in parenting can be hard, nursing at the breast included, although that usually improves after the first few months. Pumping doesn't really get better/different other than eventually being able to go longer stretches in between each pumping session.

So why would mothers choose, either before the baby is even born or after just a very brief time of nursing with only minor problems (or no problems at all), to pump exclusively? The reasons are ones I want to explore here. A few that come to mind are:
  • fear of nursing being "sexual"
  • fear of nursing in public (goes along with the first one in many ways!)
  • thinking nursing is "gross" (also related to the first one!)
  • pressure from other family members to be "equal" with the mom in baby care
  • fear of "being tied down" to the baby/wanting the baby to become "independent" (as the women in the article called it, "a lifestyle choice")
  • having pumped exclusively for the first baby and thinking "well, this is all I know" or wanting to be "fair" to both children
  • the concern that breastfeeding will be too much of a hassle or will be too difficult
I am sure there are more, but these are reasons I have observed and heard.

Before digging deeper into these reasons, I want to address the question: whose fault is this? Not because we need to place blame somewhere, but because it is not necessarily the mother's fault. I doubt there are many women out there who want to go through the trouble of pumping milk for their babies who also don't care about the well-being of their children. It wouldn't make sense! Clearly, most of them must have good intentions. So why do they choose this route? We have to look at their influences. I come back again to society/culture. Oh, how I love to blame everything on the media, pop culture, etc. ;) - because while they don't force people to make certain choices, they do shape and influence us in our decisions. So, things that may influence a mother to choose to pump exclusively from the get-go:
  • cultural/societal expectations about both women and babies
  • cultural/societal beliefs about breasts and sexuality
  • marketing
  • the "me" mentality of individuality so prevalent in our culture
  • the technology boom of the past two decades and the corresponding decrease in the virtue of patience
  • feelings of relatives and friends about nursing
  • advice from "experts" such as doctors
  • misinformation regarding nursing and/or pumping
So, let's break down these reasons and influences...

Mothers choosing to exclusively pump because of a concern of it being seen as sexual or as an inappropriate thing to do with breasts in front of other people:

Some people - many people, actually, in our culture - view breasts as sexual. They are to be covered up because they are a "private" part, and therefore feeding a baby with them is also something to be done only in private. The irony of this is that more cleavage is seen in skimpy tops worn by teenagers, on commercials, and in magazine ads. The message is being sent that it is okay to see parts of the breast as long as it is done in a "sexy" way, or a way that makes money. So how is it then something "private" when breasts are being used to fulfill their primary biological function? Shouldn't using breasts for sex be the thing that is done in private?

Cultural/societal expectations and beliefs: If our culture has an expectation for breasts to be sexual, then many people are going to see them this way regardless of how they are being used at the time. If our culture expects women to use their breasts for sexual purposes primarily, then people may get uncomfortable when seeing a baby attached to those breasts instead. When cultural views of babies are that they should be made to be independent, that they should have bottles, that they shouldn't have to be with their mothers (the cultural view that women should work outside the home to be of value and/or to be "fulfilled" comes into play here)... then these things influence people to see breastfeeding as unnecessary or even as a "bad habit" in need of breaking.

Marketing: Well, breasts are certainly used sexually in marketing... beer commercials, right? The other day, I noticed an image printed on the truck of a rent-to-own store, and the woman pictured (who was presenting the two glamorous options of a big screen TV or whatever else it was they were trying to sell) was wearing a tight-fitting top with lots of cleavage visible. It is used in all kinds of advertising! Then there's the marketing of women's clothing itself, and how stores display their revealing clothes as being sexy and fashionable.

But then the marketing of breastfeeding itself... let's think about that a moment. Some of the very things that are marketed for breastfeeding mothers continues to perpetuate the idea that breasts are mostly for sexual purposes and are therefore best kept out of sight: the Hooter Hider, for instance. The product itself is not a bad thing, because some moms desire this level of modesty particularly when they are still learning in the first few months, but it is the name that is a problem. Although the cover is for nursing, it refers to the breasts as "hooters," which clearly has a sexual connotation. The inventor of the Hooter Hider probably just thought it was a cute, catchy name without considering the message it might send. I have also heard about one called the "Udder Cover." Not a good choice of words there, either!

Nursing covers in and of themselves can probably be traced back to the cultural issues we have about breasts, too. Mothers would not even feel like they had to go to that much modesty if nursing were seen as just a natural and essential part of life. I have said lots more on the issue of nursing in public, go here to read it.

The "me" mentality: As it relates to sexuality, some women have a desire to make themselves as attractive as possible, at all costs - and that would be "attractive" in the way that society defines it in women, which really just means "sexy." As one person wisely said, "It takes nine months to grow a baby, it's going to take nine months to get your body somewhat back to normal." And bodies never go back to exactly the way they were once a woman has been pregnant. A big myth about breastfeeding is that it will make your breasts sag. Actually, the changes that happen to the breasts during pregnancy contribute to that regardless of whether a mother nurses, pumps, or neither. Aging also contributes to sagging breasts. So if a mother (who may have pressure put on her by her husband, or it may just be her own perception) feels like her breasts must be a certain way so they'll remain "sexy," then she might choose not to breastfeed at all if she hears this piece of misinformation.

Mothers who feel like they have to maintain a perfect body image may plunge themselves into such a rigorous exercise routine that they don't feel like they have time to nurse the baby. Perhaps they have time to express milk with a pump every three or four hours, but to nurse on-demand would not allow them the same flexibility with regard to working out intensely. Now, I have never heard of a mother exclusively pumping for this reason - maybe pumping part-time - but there can be many smaller choices that lead up to making the bigger choice of exclusive pumping, and this could certainly contribute.

Feelings of relatives and friends about nursing: This is a big one when it comes to breastfeeding being seen as sexual and how that affects mothers' decisions on nursing at the breast. Studies have shown that the main factor in a woman's decision to breastfeed is the support of the baby's father. Supportive family and friends are highly important as well, particularly the ones with whom a mother spends the most time. When relatives or friends see nursing as very uncomfortable to be around because of their subconscious (or completely conscious!) feelings of the breasts being sexual and therefore they shouldn't see a woman who is nursing, then they can make comments that are less than supportive and even extremely critical. When nursing mothers are made to feel as if they are doing something dirty, private, or sexual, then they often begin to feel uncomfortable when nursing around those whose attitudes lead to these feelings. So, many mothers end up trying to avoid nursing in front of others. They will go to another room for every nursing, pump for when out in public (or nurse in places like the bathroom or their cars), and even try to schedule nursings and hold off a hungry baby so that they can wait to nurse at home. Some mothers decide that the hassle of trying to avoid nursing in front of others is not worth it, and they turn to exclusive pumping - particularly if their husbands are uncomfortable seeing their wives nurse but agree that human milk is healthiest for their babies. Women who feel like they have to hide away for every nursing often feel isolated and lonely, which can lead to their desire to wean completely and to either pump exclusively or to formula-feed. I have known mothers who would never nurse in public, and by the time the baby was right at a year old, they were so relieved to be "done." They hated that they had to hide away to nurse. They were only nursing out of obligation because of what doctors told them about breastmilk being important for a child's development for at least the first year. What most people ignore is the "at least" part and think that must mean that babies are supposed to be weaned completely by their first birthday.

So, before I ramble too much, back to the mothers who are made to feel as if they must be confined to their homes in an isolated bedroom so as not to nurse in front of anyone... a mother's comment on the Motherwear Breastfeeding Blog spoke volumes on this:
"One thing that worries me about this trend [choosing to pump exclusively] is that it might become expected that all breastfeeding moms pump and bottlefeed for public situations. I've already been chastized by my family for not formula feeding in public-seems that people like my relatives would see pumping as a "good" solution..."
The woman in the Time article who chose to pump exclusively for her second and third children even before they were born said this:
"I just did not like it. I felt locked away. I was young and self-conscious, and everyone would leave the room when I breast-fed. I was lonely."

What a shame that the attitude of family and friends can cause people to feel so isolated when they are just trying to do what is normal for their children! People callously say, "Oh, just go somewhere private to nurse!" But if a mother feels that she must do that at least every two or three hours for a year, then how upsetting! Humans are social creatures - we thrive on contact with each other, as a general rule. Some mothers do not mind being isolated when nursing because they enjoy the private time with their babies, but they have chosen to go somewhere private in that case - it is a very different thing when they are made to feel like they must go into seclusion every time they nurse when other people are around.

Mothers choosing to exclusively pump because of pressure from other family members to be "equal" with the mom in baby care:

Cultural/societal expectations of both mothers and babies: Mothers are seen as replaceable in our culture. Anybody can care for a baby, we are told. Women are "equal" with men, which really is construed as meaning that women are the same as men, and if that is true, then shouldn't men have an equal chance to feed the baby? This mentality, that women and men are the same, ignores basic biology. It claims that women who nurse directly at the breast for all feedings are being selfish when all they are actually doing is following their biology, the way God made their bodies!

Many people in our culture also expect for all babies to take a bottle at some point. This is an especially popular view with older generations, who often ask, "Well, when is he going to get a bottle?" Almost as if it is a developmental milestone which must be achieved and recorded in the baby book.! People sometimes think it is practically their right to be able to feed your baby a bottle.

Marketing: Bottles are everywhere. This leads to others within the family seeing them and potentially thinking, "Well, why can't I feed our baby a bottle?" When something is available so readily in all stores, and well over 99% of babies seen on TV shows or in commercials are bottle-feeding rather than nursing at the breast, then it slowly becomes ingrained in people's minds that this is what is done, and feeding the baby can be "fair" among everyone. Biology isn't always fair - males and females are designed differently! Unfortunately, people want to try to convince us otherwise nowadays in many cultural trends.

Breast pumps are also marketed as being practically essential for all nursing mothers. Family and friends may well want to buy pumps and bottles as baby shower gifts, thinking they are needed because "Dad has to feed the baby, too."

The "me" mentality of individuality so prevalent in our culture: It is supposed to be about what is best for the baby, not what other people want to make themselves feel good. Yes, it feels nice to feed another person's baby a bottle, because it is a loving act (I know - I have given bottles to babies while working in day care centers and while babysitting as a teenager). But making Grandma feel good is not a good reason to have her give the baby a bottle. She can do so many other things that are good for the baby: change him, hold him, play with him when he is older, help out around the house so that mom and baby can rest in those early months...

Misinformation regarding nursing: Some parenting books perpetuate the idea that dads can't bond with the baby unless they are able to feed bottles to their babies. While this may well help their bond, at what expense? Babies were designed biologically to form a primary attachment, and biology dictates that that be with the mother. Thankfully, babies are also designed to be able to adapt to other situations in case of maternal death, but in the ideal situation, the baby will bond first with his mother, the one inside of whom he has been growing and developing for many months. He can then form more meaningful bonds with others as he grows. Mother-baby separation stresses young babies, and it has a biological effect on mothers as well. So, many people will criticize that a nursing baby is "too attached" to his mother and won't accept comfort as readily from any other family members or friends. What is not recognized is that this is biologically normal.

Mothers who choose to pump due to fear of "being tied down" to the baby/wanting the baby to become "independent":

Cultural/societal expectations about both women and babies: Women may distance themselves emotionally from their babies, either willingly or subconsciously, in large part because of our culture's expectations about them and their babies. We are taught from an early age in the US that independence is one of the most desirable traits. We are told through parenting books, magazines, friends, family, and doctors that children should be taught to be independent as soon as possible, and that we must train them to become this way. Nursing a baby at the breast is not seen as aiding to this push for early independence. Many people seem to think that nursing a baby on-demand or nursing for comfort, particularly once the baby is past a few months of age, is "spoiling" the child and making him a "Mama's boy" who will never grow up, never be independent, and will have to have his mommy go off with him to college. Studies on attachment of children to their caregivers don't back up these myths - in fact, the evidence suggests that children who develop a close, trusting attachment in the early years will become more independent - in their own time.

So, mothers who are persuaded to ignore their instincts of nurturing their babies and instead to distance themselves from their babies - not picking them up when they cry, for instance - may very well see nursing as too close of a relationship and that if the baby gets pumped breastmilk, then he can still get those benefits while not becoming "too attached" to the mother and thus "spoiled."

Our culture also views mothers in a certain way - that is, expecting them to return to work soon after the baby's birth, as being strong and independent rather than admitting that biologically, they also need their babies! Mothers who nurse their babies for comfort or on-demand after a certain age are often seen as "hovering" or "smothering" to their children. While it is true that a mother can be smothering of her children as they are growing in independence, this does not happen in the first few years! This happens in situations where the child is really becoming independent after he is past the baby and younger toddler stage, but babies do actually need their mothers! Very young children still need their mothers, and breastfeeding is a natural way to meet their needs. Very rarely does a mother nurse her toddler or older child to meet her own needs of feeling important... as many will say, you cannot force a child to nurse!

So, if mothers are viewed as dispensable and needing to get back to their "real lives" after childbirth, and children are viewed as needing to be taught to soothe themselves and become independent as babies, then is it any wonder that some women may see the pump as a perfect tool for encouraging independence and fulfilling these beliefs about mothers and children that are held by our society?

The "me" mentality of individuality so prevalent in our culture: As mentioned before, we are taught along with independence being so important that having our own personal lives separate from our babies is of utmost importance. This is a bit different from having some time to yourself sometimes to take a relaxing bath or something, but it is more of an attitude that everyone has to have their personal "me time." We hear it in advertising a lot - pamper yourself. Treat yourself to some "me time," because you deserve it! Of course, mothers need to take care of themselves, and sometimes a walk alone or an hour to work on a project without children around can be very refreshing. But when we take it to the extreme - that we are deserving of our private time and how dare these little children's needs interfere, then something has gone wrong. As adults, we are supposed to be self-sacrificial because we can understand delaying our own desires in order to meet the needs of very young children. This is not spoiling them... buying them a toy every time they cry in a store is spoiling them! But making an effort to give closeness to your young child meets their need for security, whereas choosing to pump so you don't have to feel so "touched out" by your baby is purposefully distancing yourself from the baby who biologically expects to be up close to his mother much of the time.

Why do people in our culture feel this almost need for alone time, for not being touched much, for feeling like we'll go nuts if our baby is "too clingy?" It is apparently in our culture and the way we are brought up... other cultures are far more touchy than we are here. Americans seem to shy away from touch, and that is a shame since touch is so important to us thriving emotionally, particularly in the early years: touch helps to actually form connections in the brains of babies!

The technology boom of the past two decades and the corresponding decrease in the virtue of patience: This goes right along with mothers (consciously or subconsciously) not wanting to feel "tied down" to their babies. The technology of having a powerful breast pump allows them the "freedom" to be away from the baby longer.

Has anyone else noticed how the Internet, cell phones, etc. have led to decreased patience in younger people lately? We are becoming a society that expects to have things instantly at our fingertips. Having what we want when we want it can contribute to that "me" mentality, and it can also contribute to a lack of patience towards our children. Babies are so helpless and require lots of time, and that can be hard for us to accept when we are used to not having to be patient. Pumps are relatively quick, and they are often over-suggested by medical professionals as a "quick fix" to breastfeeding problems in the early days, or for moms who feel "burned out," because they are readily available and are mechanical - and we are used to dealing with mechanical things in our culture, while emotional and personal relationships (such as nursing) are much more complex to deal with. So pumps are prescribed as an easy solution and as a way for mothers to "get a break." But if mothers get to where they are intentionally pumping more and more in order to get away from the baby, it can easily lead to exclusive pumping - or to a decrease in milk supply and then weaning.

Feelings of relatives and friends about nursing: I have heard accounts on more than a few occasions where family or friends pressure a new mom to get back to the things they used to do without the baby, whether that be going out with them for adult-only time, or staying out late partying, or being able to just go anywhere at the drop of a hat (which we know is harder with children!). One mom told me that her relatives were repeatedly disappointed when she would turn them down on invitations and how they thought she was "no fun" anymore. If this happens, then a mother may feel pressured to bottle-feed so she can free herself up to make time for these other people. While it is important to spend time with people who mean a lot to us, friends and relatives shouldn't pressure new mothers to put their needs ahead of the baby's needs. This seems to happen particularly with friends who have not yet had children or whose children were young a long time ago and they have forgotten what it was like.

Mothers who choose to exclusively pump because of having pumped exclusively for the first baby:

This doesn't seem to be influenced by anything specifically, but I have heard it said before. And I have heard a lot of moms who ended up exclusively pumping the first time and saying, "Are you nuts?? That was hard work, and I'm going to do all I can to avoid getting onto that path again!" Many mothers who have pumped exclusively for one baby find that nursing future babies is easier and rewarding, and that that doesn't have to negate the experience they had with pumping for the first child. They are confident that they did the best they could at the time given their circumstances and what struggles they may have encountered that led to pumping exclusively, but they can do it differently for subsequent children now that they have more information or a different set of circumstances or more support. It is not in any way an insult to the first baby to nurse the next one at the breast, no more than it would be an insult to the first child if he was circumcised to then circumcise his brothers just so they'd all be the same and it would be "fair." If your first baby was hospitalized with pneumonia at a few days old, you wouldn't insist on leaving future babies in the NICU for a few days to be fair - that would be ridiculous, right? Life isn't always exactly the same for each child, and when we know differently, we do differently, and when we have different circumstances, we make different decisions.

All that being said, there are many reasons a mother may choose to go with the "status quo" for subsequent babies, and her decision may be based on a combination of many of the other factors already discussed, or simply on fear of the unknown and therefore just doing what she already knows how to do.

Mothers choosing to exclusively pump out of concern that breastfeeding will be too much of a hassle or will be too difficult:

Cultural/societal expectations about both women and babies: While our culture often thinks of breastfeeding as something to be done behind closed doors, it also views breastfeeding as "natural" and thus as coming naturally and being easy to do. Many mothers are surprised that breastfeeding doesn't just happen naturally for them in our society, and it is because of this paradox that we have this issue. If mothers are to be hidden away when nursing, then how will any of us learn how to do it without being exposed to it as being a natural, normal part of life on a frequent basis? Then new mothers hear the horror stories from friends and in magazines, and they become fearful of nursing - what if it doesn't come naturally for me? Should I even bother? Or if it starts out being difficult, the fear can set in and women may turn to the pump because it is easier and less of a hassle - at least it may appear that way at first when compared to overcoming initial difficulties with nursing.

Marketing: Expectant mothers are often influenced by marketing, which leads them to believe that breast pumps, bottles, and milk storage bags are essentials when it comes to breastfeeding. There is an excellent piece on the Blacktating blog that discusses this and is well worth the read. Please do read it; I promise it is shorter than my blog posts! ;) She asks,
"But are moms also being influenced by this message, that pumping provides the benefits of breastfeeding without having to deal with any of the stuff that might be uncomfortable or weird at first?"
Excellent point... and the comments there are also thought-provoking.

The technology boom of the past two decades and the corresponding decrease in the virtue of patience: When people become less patient, then hassles are to be avoided entirely rather than worked through until they are solved. If mothers begin to view breastfeeding as a hassle, then they may choose the pump because it is mechanical and therefore, there are less variables to contend with in making it work correctly. We are quick to rely on machines lately - how many people are lost without their computers? I sometimes am! ;) But this is a reliance on a machine that is replacing a natural act, and, like nearly all technology, it is designed to make people's lives easier - less hassle. But is it really less of a hassle in the long run to pump full-time, and even if that answer is yes, then is it worth it? Is it worth willingly sacrificing the natural act of nursing at the breast, which imparts so many benefits on mothers and babies?

Advice from "experts" such as doctors: I touched on this before... doctors typically don't know how to solve breastfeeding concerns, because most were not given much training at all on breastfeeding. So, it would be more of a hassle for them to try to help mothers remedy the actual problems if they can just say, "Switch to pumping." When things get tough, doctors should be encouraging while giving actual evidence-based help to mothers who are nursing, and if they cannot help, they should refer them to licensed lactation consultants or to La Leche League or both!

Misinformation regarding nursing and/or pumping: Again, the advice given to mothers that pumping is "easier" if they are having a difficult time... it may prove to be true in the beginning, but when a mother is still taking a half hour every time she pumps, feeds, and cleans the pump parts when the baby is nine months old, then it is not easier.


Certainly pumping full-time is a necessity for some mothers and babies. The trend of choosing it willingly certainly says something about our society. The problems with hospital interventions and such in the early weeks that lead to moms ending up pumping exclusively when they were hoping to nurse are unfortunate and yet preventable in many instances. Hospitals need to stop giving formula as a band-aid fix for babies who aren't gaining enough , aren't nursing well, or are jaundiced. They need to be using science and common sense to back up what they do for nursing mothers and babies: not separating them except for grave reasons (as long as a baby is stable, separation is not generally necessary), encouraging skin-to-skin contact, avoiding artificial nipples rather than insisting that sick and premature babies must drink from a bottle before nursing at the breast, using alternative supplemental devices instead of bottles with the mother's own milk as the first choice for a supplement, making sure nursing is well-established before sending mothers home from the hospital, and having lactation consultants available. Society as a whole could be more supportive of mothers when they are having trouble instead of thrusting a pump and bottles upon them, or bottles and formula.

For moms who really are unable to nurse at the breast yet they can produce milk - the baby has a physical problem and cannot latch, or the baby will not latch because of a difficult start - how disheartening to see people choosing not to do something that is available to them, something that these mothers would give anything to be able to do! It probably adds insult to injury when they hear of people choosing to pump full-time even though they don't have to. How discouraging! How they must question, "Why? Why were they given the chance and I was not, when they don't even want to use their opportunity to nurse?"

Finally, how did we get this way? How can we get back to the basics, to mothers trusting their own biology rather than trying to escape from it? How can we turn back to a time when society accepted nursing, when it was commonly seen and thus handed down from one generation to another, where interventions didn't set mothers up for failure, where mothers don't feel ashamed to nurse their babies around other people? Gosh, I don't know the answers here. I do know that the more women who nurse in public, the more "normalized" nursing will become, which can help to slowly shift the attitude away from nursing being something to be kept behind closed doors. The attitude about babies and their utter dependence need to change as well. I don't know how to get a culture who is intent on believing that babies are spoiled when they get physical closeness to change their misconception, especially with organizations out there who teach that it is Biblical to force a child into independence as an infant. [Of course that is not Biblical, and it is not how children in the Bible were raised!] And lastly, women need to be shown that this is normal, it is just what mothers do, and that there are people who will help them do it!

I don't think this trend is the fault of the individual women... not at all. It is a much larger issue within the culture. When a mother wants to nurse her baby and nobody in her family has nursed before, none of her friends have done it, her birth experience is difficult, she gets poor advice from hospital staff, she is confronted with the marketing of feeding gadgets and formula in her very own mailbox (thanks, Motherhood Maternity for selling our info to the formula companies!!!), when she either must go back to work financially or feels pressured to do so... she really has the cards stacked against her. Mothers want to give their babies the very best, and they know that breastmilk is the best source of nutrition, far above infant formulas. And so when they can't make it work, or don't want to make it work because of cultural norms that interfere with their biological maternal instincts, they turn to pumping exclusively. What can we do, other than help with accurate info and support, and to encourage them because we have known the bliss of a happy nursing relationship and want that for all mothers? I think it is going to take a lot of years to change ways of thinking. We can't just throw out the pumps - they are valuable tools when used for certain situations. We need to change ways of thinking at the societal level. We need to stop blaming mothers when they don't want to nurse and address the deeper issues of what it is that causes them to feel this way.

I am sure I have not covered all the reasons why a mother may choose to exclusively pump, but that is not to say that there are not more. I don't claim to know what everyone's reasons are for their decisions, but I have tried to summarize some that I have encountered in the reading and work I do as a breastfeeding counselor.

I want to end this with a quote I came across from Marian Tompson, one of the founders of La Leche League. I think it hits the nail on the head: "The world is better off when mothers are allowed to take care of their own children." She referred to pumps as a transitional tool until we as a culture come to our senses." from:


Carrie said...

Wow! You have a ton of great info! How I wish I had known more when I first had Katie!
I was a first time mom who didn't "love" breastfeeding until I had DONE it! Neither grandmothers had nursed and I had no friends who were having babies at all, so no one to turn to! It was so hard. Katie was born in October, and so I spent Thanksgiving and Christmas holed up in a room by myself..struggling and crying often.
But, we stuck it out. Katie never had a bottle.
Noah was a different story. I had just graduated from college and I got my first job to start when he was FIVE weeks old! I brought him with me the first week of planning time to get him used to a bottle of breastmilk because he'd never had one before!
I pumped...and THANK YOU GOD IN HEAVEN for great breastpumps! We wouldn't have survived that first year without one as I was on a DAY TO DAY supply and it completely stressed me out. First year teacher, pumping in the middle of the day then rushing home to feed him right after school. Whew! I pushed myself though because I already had guilt because Katie never even had a bottle at all.
So..yeah... if I had it to do again...which I may one day who knows... I will be doing it WAY different...none of that hiding out stuff!
I feel so sorry for many moms because, like you, I feel like they often fight such a battle to do anything BUT breastfeed. I get so angry at people who are completely ignorant about it, but then again..I was ignorant too... which is what it is..complete innocent IGNORANCE (said in the nicest way possible!)

Kris said...

I just had to add my two cents - in the form of a couple of stories about people I know. My sister was unable to nurse because my niece would never latch on. She worked with multiple lactation consultants, nurses, LaLeche, etc., in a desperate attempt to make it work, but in the words of one lactation consultant "she had never seen anything like this baby!". My sister ended up having to pump and did it for almost a year, in order for her daughter to have breast milk. My cousin nursed her daughter until she was almost two, and then had to go back to work. Her daughter had severe food allergies (and still does at age 14), so my cousin "weaned" her from the breast, but continued pumping milk for her to drink until she was over 3 years old. I share both of these because it baffles me that people would "choose" to pump instead of actually nursing, when they are capable of nursing. In both these situations I mention, these women pumped because they HAD to, in order to benefit their children. After my first was born, I had to go back to work for about 6 months, until we could resolve from financial issues to allow me to stay home. I also pumped at work so that my baby could be fed exclusively by breast milk. The thing I found so interesting about it is that as soon as I stopped working (when he was 10 months old), he began almost immediately refusing the bottle when it was offered if I was not around, even though he nursed many more months after that. It was like he knew he "had" to take the bottle during that time, but after that, there was no need. I just find it baffling that anyone would "choose" to pump when there is not a necessity. It's extremely difficult and a big commitment, as I saw with my sister and my cousin. It takes dedication to keep it up long term.

Carrie said...

YES! You got that right. It is a HUGE commitment to pump full time, because just doing it once or twice per 24 hours about drove me crazy! All the cleaning of the pieces and storing it, etc. Whew! It's way harder to pump full time than nurse if you can!

Kate said...

sad story, i know someone who was actually told at the hospital to start off pumping while she got adjusted to the newborn and then she could start nursing when things settled down... after a few weeks. you can guess how well that ended... don't think her milk ever really came in. and she was a mother who really wanted to nurse, but was very naive and trusted her doctors. i cannot believe the information some hospitals have to offer about breastfeeding!

Maureen said...

Erin, your blog posts on breast feeding have 100% changed my view on it...but it is because I didn't really know better. Before reading your blog I thought a baby needed breast milk for 3-5 months or so...I most definitely did not understand the full benefits to both baby and mother. Plus, breast feeding is free...major bonus! I really look forward to this mother-baby bond in the future!! One thing I really appreciate in your educational-type posts is your factual support/backing that you share. THANKS!!!!

Anonymous said...

Reporting a bad link:

" Blacktating blog "

links to which is no longer a relevant site, in fact they even promote adult content...

Erin said...

Thank you, I have fixed the link, and apologies to anyone who ended up at the other place!!