Breastfeeding Limitations: Are some women incapable of breastfeeding? Are formula mothers neglectful?

Breastfeeding Limitations: Are some women incapable of breastfeeding? Are formula mothers neglectful?

Breastfeeding is interpreted as a natural process of which mothers are biologically prepared. Therefore, how is it possible that some mothers find it very difficult to breastfeed, are repulsed by it, or are actually unable to breastfeed? The debate surrounding breastfeeding versus infant formula is currently highly discussed. Health professionals are in agreement that breastfeeding is healthier for both the baby and the mother, but does this mean that infant formula is dangerous? Mothers who do not breastfeed either because they cannot, their baby cannot, or they choose not to are under scrutiny for not doing the best for their children. This apparent medical and biological debate is becoming socially problematic. Studies have shown that the choice to breastfeed is contingent upon age, education, race, and income. Women are often reprimanded in different circles for both breastfeeding and choosing not to breastfeed. Why do some women choose not to breastfeed, why are some unable to breastfeed, and what role does social structure play in the debate?

Much research has been done on breastfeeding, and many have found that breastfeeding is incredibly beneficial for both the mother and the child. Breastfed children are less vulnerable to acute infectious diseases including respiratory and gastrointestinal infections. They are also at a decreased risk for sudden infant death syndrome and possibly diseases later in life such as asthma, diabetes, and leukemia. (4) Compared to formula fed children, breastfed children are less fussy eaters. A particularly media-favored issue is that breastfeeding makes babies smarter, which is partially true as it has been shown that children who are breastfed score higher on I.Q. tests. For the mother, extended breast feeding can help reduce the risk of breast and ovarian cancer. (4) Women who breast feed lose weight faster and enjoy sharing the intimate moments with their child while feeding. (3) Given all of this information and that the medical community strongly encourages breastfeeding, it seems ludicrous that any mother would not breastfeed her child. However, there are some credible reasons why some women do not breastfeed.

To further explain the natural process of breastfeeding before explaining why some women do not, it helps to understand some of the biological processes of breastfeeding and the role of hormones. Breastfeeding is primarily controlled by the hormones prolactin and oxytocin. Prolactin stimulates milk production and oxytocin controls the milk ejection reflex, also referred to as the let down from the mammary glands. (6) Breastfeeding immediately after birth causes oxytocin to stimulate the uterus which then contracts in order to return to its smaller, pre-pregnant state, and reduces blood loss. This process can be extremely important and seems to further emphasize how breastfeeding is a necessary practice for mothers. The hormone prolactin increases during pregnancy but before childbirth it is prevented from producing milk due to high levels of the hormones estrogen and progesterone. After birth, the levels of estrogen and progesterone drop and the prolactin is allowed to become effective and begin producing milk. Along with estrogen and progesterone, prolactin also decreases after childbirth but every time the baby nurses a signal travels from the nipples to the brain. In the brain, the hypothalamus triggers the pituitary gland to release more prolactin as the mother continues feeding. Therefore, if a mother ceases to feed for more than a few days, her prolactin will drop so low that she is unable to produce milk. (6) The baby has a biological impulse to feed at the breast as well. The baby is born with a sucking reflex and the ability to smell its mother. The baby is drawn to the mother and her nipples by its olfactory (or smell), and in fact the baby is able to decipher his or her mother from other mothers. (9) Often learning about hormones and parts of the brain and the signals they send to each other causes people to believe that that particular process is natural and perhaps imperative. However, some mothers are indeed unable to breastfeed and experience guilt or shame feeling that they are biologically inept. Is this the case, or is breastfeeding not an entirely natural process?

Although most women produce efficient levels of milk to feed their child, some women are unable to generate enough milk and can actually begin to inadvertently starve their baby. In this case, infant formula or a wet nurse can actually save a child. Other obstacles to breastfeeding are if the mother is on some types of medication, has a breast infection or abscess, breast cancer or other cancer, previous surgery or radiation treatment. Furthermore, “Breastfeeding is a natural function but is not necessarily a natural instinct for mothers. Most mothers need education during pregnancy to make informed choices about how and what to feed their babies. Mothers also need support, encouragement, and assistance after birth to establish, maintain, and enjoy feeding and caring for their babies.” (1) Mothers often experience sore nipples, engorged breasts, leaking breasts, and difficulty knowing how much milk the baby is drinking. She may also be confused by lack of experience, afraid or ashamed to ask for help with such a “natural” activity, overwhelmed by the time commitment, socially isolated from other activities, and experience conflicting emotions of enjoyment and resentment. (1) Sometimes the baby is unable to breastfeed because they are premature, too small, have a weak physical condition, difficulty sucking, birth defects of the mouth, or digestive problems. Beyond seemingly physical obstacles to breastfeeding is the fact that it is difficult to breastfeed in a society where most women work. In the United States women are given twelve weeks maternity leave and only a third of companies provide a secure and private area for breastfeeding. (4) The process of breastfeeding is therefore not as simple as it seems, and is continually confounded by social pressure and the workplace.

Although there are often some strong restrictions for mothers wanting to breastfeed, such as those listed above, other times mothers choose not to breastfeed. The reason behind this choice varies but what is interesting is that studies have shown that women who are more educated, have higher incomes, and are older are more likely to breastfeed. It has also been found that in America, black women are least likely to breastfeed. (4) The levels of black mothers that breast feed are startlingly low at 51% at birth, and 9% at six months. This trend is not completely understood but is worth trying to explain. According to Mommy Too! magazine, black mothers and especially young black mothers associate breasts with sexuality, and particularly as sexual objects. In this view, it is culture that influences the choice to breastfeed, and in the American (and particularly black American) patriarchy, feeding a child with a sexual object is considered gross. (2) The same article from the Mommy Too! states that “…black women consider the sexual satisfaction of their mate a higher priority than the healthy nourishment of their baby.” (2) Furthermore, the article claims that if you are a mother who cannot breastfeed, the first thing to do is assess your own attitudes and see a specialist that can help you express breast milk. Although this view, in my mind, is both dismissive and racist, the article accurately stresses the ways in which social pressures are strong enough to prevent women from breastfeeding. This prevention is caused both by women choosing not to breastfeed and feeling unable to do so because they feel embarrassed by the process due to lack of support. There are both social pressures like this that tell women that breastfeeding is “nasty,” and then others that argue the use of formula is so dangerous that the use of it is neglectful parenting. According to statistics, black women are the most likely group of women to have babies young, be less educated, and have a low income. (4) Therefore, it seems that the low levels of breastfeeding with the African American community are perhaps less influenced by their “mates” viewing their breasts as sex toys, and more impacted by the social structure that prevents black women from breastfeeding on multiple levels.

Breastfeeding is a natural process which involves emotion, hormones, and brain structures. However, breastfeeding is also a process that needs learning, support, and encouragement. There are many benefits to breastfeeding and therefore health professionals prefer and encourage breast milk for infants. But infant formula was developed for a reason, for women who are unable to breastfeed and may also be unable to hire a wet nurse. Other women choose not to breastfeed, which may be due to social structure, social pressures, workplace inconvenience, or a personal decision that does not include any of these issues. There is currently a very strong debate waging where even the World Health Organization has referred to breastfeeding as the “biological norm.” (4) Those who reprimand women who do not breastfeed should not attack the women and their inability or choice not to breastfeed. It is a problem with deeper causes and therefore the entire structure must be amended in order to greatly influence the levels of breastfed babies. From the example of black American women and their low levels of breastfeeding it is clear that many mothers who are not breastfeeding are part of a social structure that prevents them from expressing milk. In other words, the natural, biological, and extremely beneficial process of breastfeeding is influenced by the structure and culture of society. If those campaigning for breastfeeding want more women to breastfeed, particularly black women, then there must be a broader attempt to raise the education, age, and income of American mothers.

1. http://www.shands.org/health/pregnancy/firstweeks/articles/breastbottle.html

2. http://www.mommytoo.com/babyandpregnancy/cannot_breastfeed.htm

3. http://www.breastfeeding.com/

4. http://www.nytimes.com/2006/06/13/health/13brea.html

5. http://pediatrics.aappublications.org/cgi/content/abstract/47/4/736

6. http://www.menstruation.com.au/breastfeeding/breastfeedingphysiology.html

7. /biology/b103/f01/web2/shelton.html

8. /biology/b103/f05/web1/lvries.html

9. /exchange/node/518

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