“Just breastfeed…”
When uttered in response to the American formula milk shortage, this statement is often met with intense exasperation and antipathy. Now, in the midst of a crisis, we have a chance to understand why this is such a difficult issue for women and work towards a less divisive narrative.
According to Dr. Natasha Sriraman with the Division of General Academic Pediatrics at the Children’s Hospital of The King’s Daughters, human milk is the epitome of individualized medicine—each mother makes milk that is specific to her baby’s needs at any time. In my research work as a breastfeeding advocate, we are taught that breastfeeding plays a big role in sustainable and safe feeding and is the physiologic norm for infant nutrition. Not breastfeeding means children may consume ultra-processed food and miss optimal immune system priming and gene programming. We are also taught that it is ok if all mothers are not able to breastfeed, but that the key is we must do what we can to set them up for success and accept that they are not built like every other mother.
Mothers acknowledge the loss of not breastfeeding. Why does lactation failure bring about so much grief and trauma? It hurts because it is THAT important to many mothers. To add to this, there is constant control from companies and the patriarchy who make assumptions about how a woman should feed her baby. What results is anger, but the anger becomes faultily placed against the promotion of breastfeeding when we must be angry at the systems that fail to protect women and children.
It is disheartening to hear that breastfeeding is not a very welcome option for American women because of many barriers to breastfeeding. For example, women with lower income bear the burden of suboptimal nutrition from food insecurity. This disproportionately affects single parents and Black and Hispanic households who often do not have the option to spend the time and care required to breastfeed.
s breastfeeding advocates, we learn that without the proper nutrition, children may be more at risk for frequent illnesses such as respiratory issues, gastrointestinal illnesses, and terrible allergies. Establishing and maintaining breastfeeding becomes more difficult from the lack of information, skilled support, and enabling environments. It doesn’t help that in America, women need to be back at work by two weeks working double shifts just to make ends meet, and when they feed in public, they feel embarrassed from sexualization of breasts.
All babies need to be fed, and all mothers need support, no matter what feeding choice. In the current crisis, as ever, we should explore all options to support mothers. Enabling mothers to breastfeed is one of them. Breastfeeding has become an unnecessarily divisive issue. While mothers are being pitted against each other and others are being ostracized for their preference of feeding methods, we are ignoring the largest issues. Mothers and allies must rally together and ask for accountability to the system that allowed this crisis to be left unchecked. We should be asking why the government allows corporate interest from the billion-dollar formula industry to prey upon its citizens. It is not just a manufacturing and supply chain issue, but a deeper broken system that sets mothers up to fail.
Capitalists have created a model in which creating formula has become a profit-seeking industry rather than a holistic focus on a mother’s need. The 55-billion-dollar milk industry spends millions more to influence consumer behaviors and undermine policy to keep status quo—suboptimal food is still the main source of nutrition for a high-income country that can afford better. For decades, the public health system and policymakers favor and support expensive feeding with huge financial benefit to industry and less focus on care and sustainable environments for mothers and babies. Though the Breastfeeding Peer Counselling Program in the USDA’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has shown effectiveness, WIC allocates only 0.6% of its budget toward breastfeeding initiatives and formula expenses accounted for 11.6%.
As a breastfeeding teacher and advocate, I have seen mothers who are not able to breastfeed. And I want to stress that in this divisive issue, breastfeeding is not the problem. It is the formula industry’s aggressive marketing and corporate greed and a lack of government policy to support women that is the problem. Are policymakers and investors willing to pour the same amount of funding into creating enabling environments and policies for women who want to breastfeed but do not have the resources?
If breastfeeding and mothers were given more importance and investment, we would be able to provide economic support for adequate parental leave, pay for skilled lactation support, establish milk banks, protect those who breastfeed from public harassment, create mother-baby friendly workplaces, subsidize childcare, provide maternal mental health support, and much more. Why put our trust into an industry that uses interference tactics to shape global and national governance to suit their interests to keep on producing and supplying at a steady revenue?
The nuances of policy and health systems should be left to those in charge of defending and protecting the interests of the people in the systems. Systems are not changed overnight, but this doesn’t mean we can’t keep working towards a better future. The conversations need to start now. Formula milk is still unavailable, and breastfeeding is left unsupported. What else can we do in this crisis?
We should give more credit to women who are responding to the crisis to support each other. Women’s movements mobilize milk donations, offer wet nursing, and post information online about where to get breastmilk or formula milk. In the early days of the crisis before any supplies were airlifted, it was mothers, peers, lactation consultants, and concerned citizens that were mobilizing to support one another.
Do not underestimate breastfeeding because it is an extremely important and legitimate part of the solution. Lactation can be established with early stimulation and constant milk removal. 35% of breastfeeding failure is not from the inability to lactate but from the perception of low milk supply and the lack of support when needed the most. What kind of help are we doing to correct those perceptions?
According to Christy Hendricks of Lactation University “Let’s not just try to solve the problem one way, let’s solve it as many ways as possible and support everyone in their feeding decisions.”
Consider breastmilk sharing or relactation. Do not discourage mothers and decide it is too difficult and causes stress before even trying. In the Philippines, we can relactate mothers and grandmothers with constant suckling and the simple system of drip-dropping milk while the baby nurses using a clean cup and teaspoon. No need for medications or specialized pump protocols. Mothers should not be hindered to initiate breastfeeding because of fear and skepticism.
Activists should investigate the history of aggressive formula milk marketing in minority populations like Black and Brown communities through the WIC program, corporate greed, and lobbying to hamper political will. Breastfeeding supporters know better not to shame or discredit the challenges of women who cannot breastfeed. According to Professor Amy Brown’s Compassion Code, despite limited resources and influence, lactation care providers show passion, grit, and dedication to protect and support women in an environment that doesn’t value breastfeeding.
“Just breastfeed” is not enough. Mothers do not need to work harder than they already do. Governments and society need to act now to protect women and children. Period.