Everybody—friends, family, strangers, advertisers, public health officials—wants to tell new mothers what to do. Some of those people are qualified to make recommendations. But those recommendations, while created with the best intentions, don’t always take real-world experience into consideration.
Current recommendations from the National Institutes of Health (NIH) and the World Health Organization (WHO) are firm: women should exclusively breastfeed their babies for the first six months of their lives. There’s plenty of science to back this idea up; breast milk is a super-duper superfood, providing an infant with nutrients, helpful bacteria, and immune-boosting antibodies and proteins. Scores of studies have linked formula feeding with poor health, obesity, and disease risk. In an expert’s ideal world, every baby would be exclusively breastfed.
But we don’t live in an ideal world. We live in a world where breastfeeding is undesirable or downright impossible for many women. It’s a physically demanding and time-consuming endeavor that’s become more common among upper-class women who have the resources to spare. There’s a strong link between formula feeding and poverty, and it’s not because poorer women don’t also want the best for their babies.
Myriad studies have investigated the breastfeeding/formula divide, asking who’s doing it and why. But few have asked how women feel about the way they feed their babies or how it affects the way people treat them. So researchers at the UK's University of Liverpool conducted two surveys: one of 679 women who at least partially breastfed their babies, and another of 601 women who used infant formula. They asked the women about their current feeding practices and if those differed from the ideas about feeding they’d had while pregnant. They asked how they felt about the way they fed their babies and how they felt other people treated them because of it.
As expected, formula feeding came with some real emotional baggage. The authors note “a worryingly high percentage of mothers experienced negative emotions as a result of their decision to use formula.” Sixty-seven percent of respondent said they felt guilty; 68 percent felt stigmatized, and 76 percent felt the need to defend their choice to others.
But even women who breastfed were stressed by, and judged for, their choice. Fifteen percent of nursing mothers said they felt guilty; 38 percent of nursing mothers felt stigmatized, and 55 percent found themselves defending their decision. Some of their guilt came from introducing formula after breastfeeding. Others felt bad about returning to work while their baby was still nursing. They felt bad that they were neglecting other family members and stigmatized when breastfeeding in public. Women in both studies felt judged by doctors, family members, the media, and other parents. They simply could not catch a break.
Co-author Victoria Fallon notes that less than 1 percent of British women actually breastfeed their infants for a full six months. “We need social reform to fully support and protect those mothers who do breastfeed,” she said in a statement, “and a different approach to promotion to minimise negative emotions among the majority who don't."
She notes that well-intentioned public health recommendations can still contribute to stigma, shame, and guilt. "The 'breast is best' message has, in many cases, done more harm than good,” she said, “and we need to be very careful of the use of words in future breastfeeding promotion campaigns. It is crucial that future recommendations recognize the challenges that exclusive breast feeding to six months brings and provide a more balanced and realistic target for mothers."