The US Infant Feeding Culture

When I started my lactation course, I tracked down some of the breastfeeding groups to follow on Facebook, figuring it might help me stay on top of new relevant studies and issues.   Earlier in the week I read these two blog post, are the Benefits of Breastfeeding Overstated and Shame, guilt and the search for common ground.  Both of these posts are powerful commentaries on infant feeding choices in the U.S., and were prompted by a recent breastfeeding study publication.  My goal in this post is not to discuss the study, but both of these posts spoke to something I’ve been grappling with for a while.  

How do we fully support women in breastfeeding without judging women who either do not want to, or cannot, breastfeed? 

The U.S. is in a cultural transition, an ambiguous phase where we are no longer a true formula feeding culture but neither are we a breastfeeding culture.  Breastfeeding has become powerful in public health rhetoric and policy, but our societal structure lags far behind in true breastfeeding support.  In fact, our society fails to support new families period, regardless of infant feeding method.  We are simply not a culture that values structural support for families; we are just a culture that likes to talk about it.

Breastfeeding is the biological norm, and in my opinion, a healthy society should hold it as the norm for infant feeding.  But this should not mean that formula is poison, or that feeding your baby formula makes you a bad mother.  Feeding decisions are not made in a vacuum.  There are many competing elements that influence what is the best choice for any given family.  Breastfeeding is one way to give your baby a healthy start, but it is not the only way.

Our culture is in transition, however, and our formula feeding biases are still strong and pervasive, as are breastfeeding rules dating back to a time when we knew far less about breastfeeding mother baby dyads.  Many people aren’t even aware of their infant feeding biases.  Uncovering bias and changing cultural norms are both uncomfortable processes.  Pushing public health policy without real societal change is a challenge, but how else to you start?  

Women are caught in the middle, being told to breastfeed but with little support or accurate information. Often time’s parents have no idea that the advice they are given, even from healthcare providers, is unintentionally undermining their breastfeeding goals.  No one wants to find out that the reason they could not breastfeed had nothing to do with their own biology and everything to do with a system that failed them.  

That system needs to change.  Biases and norms need to change.  Maybe we can’t fix all the factors that create barriers to breastfeeding or supporting families, but educating people, especially the healthcare system, is a big part of that process.  But change is uncomfortable and people get defensive.  That is true no matter the topic.  So, is it any wonder that infant feeding choices have become contentious?  

There are still too many breastfeeding barriers that are completely preventable.  These challenges can cause anyone to perceive problems, or in fact have problems, that would not have occurred with accurate information and appropriate support.  Although women of all socio-economic and education levels struggle with many of the same breastfeeding barriers, there is also a large breastfeeding disparity in the U.S.  Until preventable problems are tackled and there is breastfeeding equity, there is a need for advocacy surrounding breastfeeding.  

But what about women who can’t, or don’t want to, breastfeed.  Why does pushing society to make room for breastfeeding mean stigmatizing formula?  I don’t believe it has to do so. 

But for that to happen, we need to try and respect all feeding decisions.  We need to find ways to correct inaccurate information, without projecting judgment.  Parents need to be supported and informed so that whatever their feeding choice is, they can be confident in their decision.

Maybe I’m showing my bias by saying that I would love to see a culture where breastfeeding is assumed and supported, and if you are not breastfeeding, it is assumed that you had a very good reason not to do so. 

If you'd like to share your infant feeding experiences, or thoughts on our feeding culture please comment below!