Wednesday, November 28, 2012

Breast Is Best: Are Moms Just Breast-Milk Delivery Devices?

Is a new mom just a set of breast milk-delivery devices? Excuse me for getting the wrong impression. It's easy to forget a mom comes with a head and other features that sometime complicate the equation of what's best for baby to say nothing of mom. It's easy to forget a mom comes with a rather complicated emotional and cognitive life. 

Speaking of the psychological demands of motherhood, I've been wondering where my psychologist friends have been through out the current parental paradigm of Breast Is Best or Milk Culture as Alissa Quart just called it. So I took to social media to ask if they have anything to add about the cognitive and emotional components of breastfeeding and the current breast-milk craze.   

Here's my open letter published in a somewhat revised format from my perch at Psychology Today.  


My Dear Psychologists,

I come to you about a pressing public health matter affecting a number of families across the country—breastfeeding. As professionals who are concerned with the well-being of parents and children you must be aware of the importance of breastfeeding. You know the reduced risks of ear infections, colds, gastrointestinal distress and the other often cited but less rigorously documented benefits. You know the American Academy of Pediatrics strongly recommends mothers breastfeed for at least twelve months, the first six months exclusive of other types of nourishment (i.e. infant formula).

You might remember several other memorable breastfeeding moments:

Health officials and elected officials like NYC Mayor Michael Bloomberg, celebrities and breastfeeding researchers joining together to ban formula samples in Baby Friendly hospitals and in some instances lock them up alongside the narcotics.

Public service advertisements comparing not breastfeeding to the dangers of smoking, log-rolling or riding a mechanical bull during pregnancy (note the ads are no longer available for linking purposes).

Harvard researchers claiming over 900 child deaths from diseases like leukemia and asthma could be prevented every year if only 90 percent of mothers would breastfeed exclusively for six months. As if breast milk could have saved them.

In sum, you know breast is best.


Except of course when it isn’t.


As psychologists, we know about some conditions that can make mommy putting baby to her breast every few hours for months at a time a bit difficult: postpartum depressionstress, anxiety, guilt, a history of depression, a history of eating disorders or distorted body image, unrealistic goals, fear-inducing health messages, the demands of new parenthood including negotiating a new identity, balancing work and family, ministering to the needs of the neglected spouse or older child, coping with sleep deprivation, financial changes and the realization you might never squeeze into your favorite jeans again.

It doesn’t take a Ph.D. to recognize breastfeeding is not always best.

It doesn’t take an expert to recognize the breast does not come without costs and complications.

There is no free lunch here. Anyone who has ever lactated or watched someone lactate knows this. We all know this and yet our community has remained relatively silent.  It sometimes seems we’ve come to believe psychology has nothing to offer parents until kids start disrupting preschool. We've ceded infancy to the real docs. 

Where have we been all these years of breast-is-best?

Where we been when the media touts the latest evidence of the benefits of breastfeeding without mention of the limitations including relatively moderate effects?

Where we been when authorities conclude what’s best without 
a shred of consideration for a mother’s well-being, emotional or otherwise?

Where we been when new mothers are lectured, humiliated, disrespected even bullied for not doling out enough breast milk?

Where are the studies that include not just the benefits but the costs of breastfeeding or the costs of the breast-is-best atmosphere?

Better yet, why haven’t we been telling parents what or how they feed their children in the first few months if not year of life is not all that important to their child’s long-term health, success or happiness?

New moms need a reminder there are many, many other things they can do for their children that far outweigh how much breast milk they sucked down as infants.

I hate to be a boob but speak up. Parents deserve better.

Yours,

A mom who breastfed all her kids.

Thoughts? 

I heard from several people via email. I'm not sure why they didn't post their comments. Was it because they didn't want any potential criticism of breastfeeding displayed in a public though potentially anonymous manner?

As for published comments, the sole one posted is titled "What a Terrible Message."
  
As if it's a waste of time to ask for an accurate and nuanced discussion that doesn't reduce a woman to a set of milk sacs. 

9 comments:

Awesome Mom said...

The link is not working so I can't go over there and support you. I agree with you, we need to demand better research on the topic. Maybe we can figure out why so many women are unable to produce enough so that if they choose to they are able to breastfeed. How about coming up with better PPD treatments so that you don't have to worry about medication in your milk. How about researching how to make those first super painful weeks less painful. How about researching the best possible formula so that those that choose not to or can't get the most optimal nutrition for their baby.

Polly Palumbo, Ph.D. said...

Hey Awesome, yeah how about those other important issues though I suspect the formula companies are working overtime. Of course only a double-blind randomized study get test formula v. breast milk, but I get your point. And even then it wouldn't be enough (good or bad for the breast) bc this discussion has left the realm of empirical evidence long ago!!

Having much trouble with Blogger on my new Mac. Sorry, will fix the link. Haven't been able to solve several other formatting oddities...please bear with me.

Anonymous said...

I have to second the thoughts in the article (from my personal experience). I was one of the mums who couldn't breastfeed no matter how much we tried (and how many midwives, doctors, advisers and nurses we saw in two countries Japan and UK)... I was so overwhelmed with guilt for failing to be the best mother that I cried 3 months nonstop at night while pumping. My girl could never transfer the milk, so I pumped round the clock for 6 months feeling like I as failing her of not giving the breast directly. The environment in the west is just poisonous and I felt like a felon for pulling out the bottle (even if it was with my own milk for most of the time)... Anyway, breast might be great for those slight effects mentioned in research, but what about the psychological support for those that fail?

Polly Palumbo, Ph.D. said...

Hi Anony,

So sorry to hear you struggled to breastfeed. How disrespectful to you and your child, the exaggerated recomendations coupled with all the current Milk Culture(Alyssa Qart in NYMAG).

As you point out there are indeed costs, including psychological ones. I've not heard or read of a single researcher looking into the psychological aspects of breastfeeding or not breastfeeding. As for support for those who fail, are you familiar with Susie Barston, the Fearless Formula Feeder?

Polly Palumbo, Ph.D. said...

Hi Anony,

So sorry to hear you struggled to breastfeed. How disrespectful to you and your child, the exaggerated recomendations coupled with all the current Milk Culture(Alissa Quart in NY Magazine).

As you point out there are indeed costs, including psychological ones. I've not heard or read of a single researcher looking into the psychological aspects of breastfeeding or not breastfeeding. As for support for those who fail, are you familiar with Susie Barston, the Fearless Formula Feeder?

(Here's my original comment I accidentally deleted.)

andrea said...

I find it very disappointing that psychologists have been so silent, especially after you specifically asked them to comment. Why no opinion? And what did those who emailed you have to say?

Polly Palumbo, Ph.D. said...

Andrea, I wish I had answers why psychologists have kept rather mum. Most of those who emailed pretty much agreed that breastfeeding poses challenges even if they disagreed about other points. Some agreed the pressure to breastfed was too great. None identified themselves as trained psychologists or working in the field.

Polly Palumbo, Ph.D. said...

Andrea, I wonder if more would have responded if I'd titled the piece: The Top Ten Reasons Psychologists Keep Quiet about Breastfeeding. Or What Parenting Experts are Getting Wrong. Or What Parenting Experts Won't Tell You about Your Newborn. Maybe I should do an informal pilot study...what do you think?

andrea said...

You may be right about that. Try it!