Cancer Survivor Still Hassled About Not Breastfeeding

Guys guys guys. I think it’s safe to say we’ve reached a critical mass of ludicrousness when a woman who cannot breastfeed DUE TO A DOUBLE MASTECTOMY still can’t dodge the heat of the breastfeeding brigade, intent to force breastmilk on her child or lecture her about how wrong she is.

Such was the case for the awesomely named Emily Wax-Thibodeaux, a writer at the Washington Post who recently wrote an essay and follow-up companion piece about her reasons for not breastfeeding, and the subsequent navigating of the landmines of shame involved in having to justify herself to every Tom Dick and Harry who felt entitled to know why, or emboldened to drop some knowledge on her about what a disservice she was doing to her baby.

In her first piece, “Why I Don’t Breastfeed, If You Must Know,” she recounts the relentless chorus of judgment she got for feeding her baby formula, from the insistence from another mother at yoga that “breastfeeding is optimal,” to a male friend of her husband’s remarking, ” So you’re not breast-feeding? It’s better you know?”

Oh, she knew. Suffice to say we all know. But the more important issue is what everyone else doesn’t know, apparently — that the decision to breastfeed or not is a deeply personal one. It’s one thing to encourage breastfeeding for its benefits, cost-effectiveness, and bonding and make sure all expecting or new mothers have access to information about the benefits and sacrifices therein and every resource they could need. It’s quite another to anoint everyone on earth as a personal ambassador for breastfeeding, especially those without any idea about the particulars of the person they are proselytizing to. Women got reasons, dig?

Wax-Thibodeaux had a reason. Not that she needed one! “Not for me” would suffice. But she had one. She’d been diagnosed with breast cancer at 32 and had a double mastectomy. After five years on anti-cancer drugs, and two rounds of IVF, she got pregnant. She would feed her son formula, a decision she was more than at peace with — until the lactation consultants made the rounds, advised her that she “really should” nurse her baby, and wouldn’t leave it alone when she said she was going to go the formula route.

“I can’t. I had breast cancer,” I said, looking down at Lincoln and stating proudly: “But I’m just so happy to be alive and be a mother after cancer.”

Silence.

“Just try,” they advised. “Let’s hope you get some milk.”

“It may come out anyway, or through your armpits,” another advised later when I was doing the usual post-labor, slow-recovery walk through the hospital halls.

Successfully scolded, Wax-Thibodeaux turned to her breast surgeon, Shawna Willey, who explained to her that the whole goal of the surgery she’d had was to remove all the breast tissue possible, which meant no milk production:

Willey added, “I think that women who have made the difficult decision to have bilateral mastectomies have already grieved the loss of not being able to breast-feed. No group should make a woman feel guilty about the decisions she made . . . or make her feel inadequate about not being able to lactate.”

But guilt and inadequacy plague many women who learn they can’t breastfeed for one reason or another, or who successfully nurse for a few days, weeks, or months, only to find the milk has dried up. In a private Facebook group for moms in Los Angeles I frequent, I see numerous posts a month about women who are loathe to resign themselves to formula, as if it is the equivalent of giving their infant soda. They consistently report extreme guilt, sadness and heartbreak.

A recent such post read:

Hi mommies. I need some support/suggestions. I have to stop breastfeeding for medical reasons and my LO is only 7 months old. I am feeling super sad and guilty. Anyone have any advice on how to help with drying up my milk supply?

A commenter replied:

I had to stop breastfeeding at 5 months for medical reasons, and it broke my heart – so I feel you, mama! But the good news is that my LO is thriving on formula, and I love feeding him his bottles too.

Another:

PLEASE NO JUDGEMENT on this post. I am in tears as I type this and am at a loss. Over the past 72 hrs my breast milk has dried up, and I have no idea why. I have frantically tried to keep it going (pumping around the clock, supplements, etc) have talked to Pump Station and have them totally stumped, and other lactation consultants as well. I’m devastated and totally confused. It completely breaks my heart to ask….but I need to know what the BEST CLEANEST organic formulas are?? I have already ordered Hipp but that won’t get here until Nov. What else can I feed my poor hungry LO?? Thanks so much in advance – a totally defeated and upset new mom

One commenter nailed it:

Wow are people out there so judgemental about formula that it makes people feel this way to ask this question? I mean there is absolutely nothing wrong with formula so please don’t feel bad about anything. Your child will do amazing drinking formula, there is very little if any difference between the two. You are doing great! Enjoy !

A recent study — this time looking at the differences in siblings who were fed differently within families rather than across different families — shows this commenter’s assertion that her child will do amazing on formula is likely right. There may be less difference in breastfed versus formula-fed babies than previously thought. From a piece in Time analyzing the study:

When they looked at data across all families, breast-feeding had better outcomes than bottle-feeding in factors like BMI, hyperactivity, math skills, reading recognition, vocabulary word identification, digit recollection, scholastic competence and obesity. However, when the researchers looked just at the siblings who were fed differently, the benefits were not statistically significant. The exception was that breast-fed children were at higher risk for asthma, though it was unclear if those reports were self-generated or actual diagnoses.

This means that women who are more likely to breastfeed as it is — women with more income, more flexibility, more education, more everything — are already batting a thousand, making it harder to distinguish whether it’s really the breastfeeding making all the difference, or the fact that babies born to such families are already ahead of the game.

And it’s critical to remember that “can’t” breastfeed means a lot of different things. It could be a physical limitation or barrier, like problems with latch, or milk supply. But troubleshooting these problems is time-consuming, and often requires working with lactation consultants, taking time off, and a lot of trial and error. Support in your household is also essential. Not having any of this stuff or wanting to deal with it is not a moral failing.

None of this is to suggest that hospitals, pediatricians and the CDC shouldn’t promote breastfeeding if and when possible and desirable.

In a news release about that sibling study published in Social Science and Medicine, study author Cynthia Colen acknowledged that the national insistence on nursing for the first six months could end up stigmatizing the women who can’t do so. Colen said:

“I’m not saying breast-feeding is not beneficial, especially for boosting nutrition and immunity in newborns,” Colen said. “But if we really want to improve maternal and child health in this country, let’s also focus on things that can really do that in the long term – like subsidized day care, better maternity leave policies and more employment opportunities for low-income mothers that pay a living wage, for example.”

And let’s also remind regular folks, well-intentioned or not, that they should not take the breast is best campaign as a cue to become a one-woman or one-man advocacy group on a mission to shame every new mother into a latched-on life.

Come to think of it, let’s tell lactation consultants, too. In a follow-up piece to Wax-Thibodeaux’s first essay, she wrote that thousands of readers responded, mostly about how rigid and aggressive lactation consultants were. She wrote:

Many breast cancer survivors wrote in saying they had experienced this first hand, but plenty of other women said the message resonated with them simply because they found it hard to breast-feed, and said they felt they were constantly being judged by what my husband calls the “breast-feeding bullies.”

Breast is best is a snappy campaign, and according to CDC data, it’s working. The Times‘ Nicholas Bakalar recently reported that something like 75% of American mothers now breastfeed (only 2/3 did in 2000), and half are still doing it at six months, compared to only a third before. But there’s a disparity here that the sibling study also revealed, Bakalar notes:

A C.D.C. survey in 2008 found that 75 percent of white infants and 59 percent of black infants were ever breast-fed, and in 2013, the agency reported that 47 percent of white babies but only 30 percent of black babies were still being breast-fed at 6 months. Compared with bottle-fed infants, breast-fed babies are more likely to be born into families with higher incomes, have parents with higher educational attainments, and live in safer neighborhoods with easier access to health care services.

Maybe breast is best should renamed. Something a little wordier but closer to the truth. How about:

If your body is making milk and you are able to breastfeed, and want to, and it works for you, or it doesn’t at first but for whatever reason you want to put in the time and effort to make it work and have the resources and flexibility to do so, and then you still want to do it and are able to, then GREAT, feel free to do so for as long as you feel you can and want to and it works for your life and particulars. Otherwise, formula is great, too.