The Breast Pump Battle: A Losing One for Women

Years of militant pro breastfeeding campaigns combined with an American economy that requires two incomes and doesn’t tolerate maternity leave have fueled sales of breast pumps and a culture of mothers expressing milk.

In case you have been living under a rock for the past 15 years, this is from the American Academy of Pediatrics policy statement (published in 1997, updated most recently in 2005. Full text here.)

Although economic, cultural, and political pressures often confound decisions about infant feeding, the AAP firmly adheres to the position that breastfeeding ensures the best possible health as well as the best developmental and psychosocial outcomes for the infant.

“Our message is that breast milk is the gold standard, and anything less than that is inferior.”

This message has been picked up by everyone from NOW to politicians (Iowa Senator Tom Harkin advocated warning labels on formula like we put on cigarettes). We have the “Liquid Gold Awards“, and ads produced by the AdCouncil in 2004 (never aired, by the way) that compared feeding formula to bullriding when pregnant.

Now, all of a sudden, the pendulum has reversed direction.

First it was Jill Lepore in January in the New Yorker:

Pumps can be handy; they’re also a handy way to avoid privately agonizing and publicly unpalatable questions: is it the mother, or her milk, that matters more to the baby? Gadgets are one of the few ways to “promote breast-feeding” while avoiding harder—and divisive and more stubborn—social and economic issues. Is milk medicine? Is suckling love? Taxonomical questions are tricky. Meanwhile, mamma ex machina. Medela’s newest models offer breakthrough “2-Phase Expression” technology: phase one “simulates the baby’s initial rapid suckling to initiate faster milk flow”; phase two “simulates the baby’s slower, deeper suckling for maximum milk flow in less time.” These newest machines, the company promises, “work less like a pump and more like a baby.” More like a baby? Holy cow. We are become our own wet nurses.

Then it was the Atlantic’s “Case Against Breastfeeding

After a couple of hours, the basic pattern became obvious: the medical literature looks nothing like the popular literature. It shows that breast-feeding is probably, maybe, a little better; but it is far from the stampede of evidence that Sears describes. …  So how is it that every mother I know has become a breast-feeding fascist?

And then Judith Warner of the New York Times weighed in. And it was the Warner that pissed me off enough to write this post.

Warner’s editorial questions the notion that formula is poison and mothers who use it are child abusers. That’s all to the good. Like Lepore and Rosin, Warner also points to the ways in which the focus on pumping has distracted us from looking for ways to support women who want to stay at home and breastfeed. Yes, she’s right.

But in doing so, she refers to pumping as “a grotesque ritual”, and suggests that pumping leaves women who do it without a “semblance of physical dignity”.

She concludes:

I hope that some day, not too long in the future, books on women’s history will feature photos of breast pumps to illustrate what it was like back in the day when mothers were consistently given the shaft. Future generations of female college students will gaze upon the pumps, aghast.

I became pregnant with my first child almost 10 years ago, and, being very unhappy with my job, I went on the market at the same time. When I was in labor, my family fielded phone calls from interested potential employers, and I conducted phone interviews from bed (I had a c-section). I pumped and pumped to be able to leave enough milk, and when my eldest was 6 weeks old, I got on a plane with my Medela Pump In Style and flew 1500 miles away to interview for a new job, where my potential employers scheduled breaks every two hours to allow me to pump some more.

I never took more than 6 weeks maternity leave, so I have done a lot of pumping in my time.  I never felt “undignified” or “grotesque” while doing it. I felt it was a way to provide a nutritionally superior form of nourishment, a way to keep my milk supply up for the breastfeeding I wanted to do when I wasn’t working, and, sometimes, a way to feel more connected during the day to my babies.

I had a very hard time breastfeeding, especially at first. It hurt, for one thing, which meant, according to the dogma, that I was doing it wrong.  Not only was it not supposed to hurt, but I was supposed to have orgasms when my milk let down! I remember reading one book, the Girlfriends’ Guide to Pregnancy and Childbirth, in which the author mentions that she took one of her post c-section prescribed Vicodin before breastfeeding to cope with the pain.  That admission was a wonder to me, and I clung to it.

Maybe things have changed, but at the time, there were two kinds of women who did not breastfeed:

1. The head-in-the-sanders, like the family of physicians into which I married, who wouldn’t breastfeed if you paid them. They didn’t deny the potential benefits. Rather, they refused to get into it. They just didn’t want to do it, and they didn’t.

2. Those who tried breastfeeding but, for “medical reasons” couldn’t do it.

For my part, I found breastfeeding, which I did for at least six months exclusively with each child, at times, wonderful, but also a major source of stress and a major cause of a gendered division of parenting labor that I had wanted to avoid.  I look back now at the amount of stress brestfeeding created, and I wonder if formula feeding (or mixed feeding) might not have been the right choice. I wondered why women who chose not to nurse had to either (1) appear selfish, or (2) come up with a medical “excuse” (and yes, lots of women have real medical reasons — mastectomy, chronic illness, etc., but my point is that many feel forced to come up with “medical excuses” to avoid the censure of the breastfeeding brigade). I longed for a space in breastfeeding discourse to talk about the family as a whole, about legitimate needs and goals of nursing mothers, about the role of fathers in all of this, and about the structure of the American workplace which, at the time, was not conducive at all to nursing (that has changed quite a bit in a decade, as Lepore outlines).

So, I am glad this conversation is happening. But I resent the implication by Lepore and Warner that pumping is a terrible thing, and that the correct stance is that all mothers stay home full time with their infants. This admission may shock you, dear reader, but my preference would not have been to stay at home full time for 6 months or a year, even if that option had been available (which it wasn’t). Why are these columists assuming it would (or should) have been? My preference was to work part time, which, being an academic, I more or less got to do, albeit covertly. But what about families where dads stay at home full time by choice or necessity? Why not advocate as well for flexible work schedules, for quality affordable day care, or — gasp!! — for more fathers to get involved in caring for newborns?

How did a reasonable corrective to hysterical breastfeeding discourse become an attack on the breast pump and those who use it, and a mandate that in a just society all women would become stay at home mothers?

When the pendulum swings on these issues, why does it always have to swing so far?

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