The "Breast is Best" debate

Is breastfeeding best? Or is it normal?

Given the dismal rates of continued breastfeeding in the US and other western cultures, it doesn't actually look like we think breastfeeding is best OR normal.

I've been thinking about the slogan "breast is best" a lot since seeing conversation in blogs and articles about changing our language a few months ago. My reaction was initially "well, breast IS best so what's the problem?" But as someone commented on this topic on our FaceBook Page, "'Best' makes it seem a bit unobtainable to many." Almost like saying "organic is best" when it comes to fruit and veggies, though this is a flawed metaphor. Organic may be "best" but not everyone can afford it and they still need to eat their veggies anyway. It is pretty accepted that not everyone can have "the best" in life. However, it is expected that everyone can have what is considered "normal." If there are obstacles preventing someone to have the "normal," the healthy standard of living, then there are ways, interventions, to help them get as close as possible. That's what we need, this "normal" is how we need to view breastfeeding, in my opinion. Breastfeeding needs to replace the position baby bottles and formula hold as part of the normal way to feed a baby, it needs to rise again as the new normal instead of the elite position of being "best." Besides, "Breast is best" came from formula makers. And there's a good reason for that too.

The language of "breast is best" is a double edged sword. The broad side of that sword just seems to be stating the obvious: Boobie milk is the best milk for human babies. But I think it has more cutting implications in reality. "Breast is Best" divides those who breastfeed and those who formula feed as those who do what's "best" and those that don't. Great mom vs. OK mom. I really don't think that's healthy. Divisive language also inhibits dialogue. People become defensive and all-too-enthusiastic to stand on some soap box. The truth is, divisive language does not change minds or educate. It puts down and builds barriers. Not too long ago I read a formula-feeding mother's comment when she felt attacked about not breastfeeding in an online community: "Yeah, I know 'breast is best' and all that but it isn't an option for me and I don't have to explain myself to you. I guess that makes me a bad mom and my kid is f*cked, right?" If, instead of dividing into groups and categories, we're uniting and supporting everyone's desire to do what is best for their family and embracing breastfeeding as normal we can move beyond debate and onto supporting mothers and babies. Guilt isn't a quality motivator nor something we should encourage or breed in people. And please, please don't say they should feel guilty. Lactivist Leanings has an excellent post on how those words are not only counter-productive but also down-right dangerous.

"Breast is Best!" Once upon a time that would have been as obvious a statement as "the sky is blue!" or maybe even more fitting "water is the best beverage for living creatures!" Within the verbage thrown around when talking of breastfeeding we hid the obvious: breastfeeding is normal. The other side of the double-edged "breast is best" sword is that best doesn't usually mean normal. When something is normal, or should be, a culture naturally gathers around to support and protect it. Best is equated with advantage or privilege, reserved for only a portion of society and often a bit elite. The need to protect that falls only to those that benefit from it. When something is normal (i.e. eating) society understands that everyone should have that normal opportunity and accepts that without question providing education and resources to that end. PhD in Parenting has a post I greatly appreciate about how this is an issue of breaking down societal barriers rather than picking on moms. Something that is often lost when the conversation hits a personal nerve. Check out the CDC's breastfeeding report card for an idea of how your area is doing to protect and normalize breastfeeding.

And what about when a woman can't breastfeed? Though rare, actually, not all women have enough milk or even make any milk at all. No matter how badly she wants to breastfeed. Or perhaps there are other circumstances complicating a woman's attempts to breastfeed. The "Breast is Best" slogan can sting of failure that she didn't, couldn't do "the best" for her child. But if breastfeeding is normal and something she can't do it isn't an issue of her being a good mother or bad mother, rather one of complications, whatever they are. I have horrible pregnancies. Craptastic-organ failure-constant IV's-boat loads of medication-pregnancies. It's not what I want, it just is what is. I can't help it, can't change it and most importantly, can't ignore it or pretend it away. Is it BEST to not to take drugs during pregnancy? Absolutely, everyone knows that. Some people are afraid of taking Tylenol, they are so vigilant. Is it NORMAL to vomit non-stop and drop 12 pounds in a week and keep that pattern up for 18 weeks of pregnancy and then a milder version until the very end? No, it's not. Taking drugs in pregnancy because I need to isn't normal but, after weighing the risks of taking the medications vs. not taking them, it is the right option for me, for my babies. It is the difference between normal and surviving. Not the difference between best and normal. Or good and bad. Does it sting to not be normal? You betcha. It sucks. But it happens, our world isn't perfect and sometimes things that should work, should be normal, aren't. When breastfeeding is the normal that goes awry, those moms dealing with that have other options: donated human milk and formula. Those moms need support, it can't always be breast even though breast is the normal way to feed a human baby. Just as with any decision regarding what we put into our bodies, it needs to be an informed choice with the risks associated with formula-feeding carefully spelled out and understood. Something I believe would happen more easily when breastfeeding is normal and the polarizing language of "best" is dropped.

This isn't a new conversation. Diane Wiessinger addressed this issue in her essay "Watch Your Language" in 1996, I first read about it here. And it continues today on blogs, forums, on Facebook, in chat rooms, at breastfeeding support meetings and more. Just today I posted on this topic shared on Facebook: "I'm a huge breastfeeding advocate but I prefer to leave pointing out that formula is "substandard" to those with credentials and the recognized voice to do so. On my end I just try to provide information and encouragement. And sometimes the decision to formula feed is born out of non-physical yet very real complications related to breastfeeding. Implying that a woman didn't try hard enough to get through those issues is invalidating her struggle."

The day we move from asking if a woman is going to breastfeed to automatically assuming she will unless there are complications (physical or not- that's for another post) is the day that we will have moved beyond the "breast is best" campaign to "breastfeeding is the universally accepted norm."