Formula Feeding as a 'Choice'

I would like to share with you, a rant I found on Mumsnet today. It was titled, "Women are Stupid":

"Elsewhere, there is a complaint about being unsupported when breastfeeding. This is a feminist issue - and the fault lies fairly and squarely at the feet of women. 

I am astounded that after the battles fought in the seventies and eighties, women have allowed such regression. 

Look how stupid women are today. They have their bodies surgically adapted to men's fantasies - breasts enlarged, labia trimmed - they bleach their hair, tattoo their eyeliner and lipstick and have themselves spray-painted. They remove their pubic hair so they look like children for their (multiple) partners. If you read about it in a book on social anthropology you'd be horrified at the 'oppression' of women. But women think they are choosing this! 

Then they say 'oh, its not fair, no-one supports me when i'm breastfeeding'. Too damn right they don't. Because you and your compatriots have allowed everyone to see you as barbie dolls to use and abuse. They don't want to see you being women, being grown up, feeding your babies, that spoils the fantasy. You created this; live with it.

When you've finished screaming at me about your 'rights' to have your mons pubis decorated with fake jewels and to have your isabella piercing, organise yourselves.

Wash your faces, let the fake tan fade, cut off your dyed hair and let it grow back naturally, so your babies can recognise the human being their genetic memory was expecting to find here. Stay free from chemicals that mask your natural odours, so your babies can recognise you by smell. If people are pressurising you to 'go back to work' say, 'certainly. When this baby chooses to stop breastfeeding'. That gives you four to five years at home, maybe longer, when you are doing something no-one else can - being your babies' mothers."

It may be abrupt and 'out there' but it got me thinking about how infant feeding is a feminist issue, and in particular, it got me thinking about the issue of 'choice'.

I believe a significant part of Patriarchal culture is the brainwashing of women into believing they are making 'free choice'. However in reality, all these supposedly free choices are merely parroted human responses to decades of social conditioning. Take applying makeup for example. The common mantra is that women apply makeup for themselves, yet 90 per cent of British women won't leave the house without applying it (Michaels 2012). What does 'doing it for ourselves' actually mean? One Mumsnetter put it wisely when she suggested, "to me it means we have so inculcated the norms of the male fantasy society that we no longer have our own notion of a desirable self."

Could the same theory be applied to 'choosing' formula? Common reasons women give for rejecting breastfeeding include:

• they don't want their breasts to sag.
• they see breasts as exclusively sexual.
• their husband is uncomfortable with breastfeeding.
• they are uncomfortable with breastfeeding.
• they don't want to breastfeed in public.
• they want to 'get their body back'.

Much of this discomfort springs from the fact that breasts, and in particular breastfeeding, disrupt the border between motherhood and sexuality. Many women cannot cope with the dual-functionality of their breasts. When a woman is desperate to "get her body back," to return to "sexy," to "be her husband’s again" she is consciously or subconsciously trying to appease the notion that her breasts are the property of the male gaze and have to be "good enough" for men again. She is buying into the idea that one cannot be maternal (madonna) and sexual (whore) at the same time.

Nurtured Child alluded to this in her blog when she wrote that, "In trying to conform and be accepted into a patriarchal society, women have learned to ignore their instincts for mothering.  Those who are still able to hear their instincts are not supported in trying to follow them.  Why are we as women so desperate to ignore our own biology in order to fit into an outdated model of what society should be?"

A choice laced with fear

She has a good point. The choice to formula feed is made in a climate in which women harbour mistrust, disdain, and even fear of their bodies. Like those who dare not leave the house without camouflaging their faces with makeup, when feeding their babies many women believe nature needs a constant helping hand. As women we seldom have confidence in our bare naked selves. Our natural state is to be is feared, seen as faulty and insufficient.

On the topic of rejecting nature, someone called 'Sam' left a fascinating comment on one of my previous articles (here). Her comment is worth reproducing in its entirety:

"Breastfeeding is not a "choice". You can "choose" NOT to breastfeed, but breastfeeding is just the normal thing to do next, once the baby is born. It's like saying you "choose" to placenta-feed. Nope, while the baby is in utero your body just gets on with it and the baby is nourished. There is no "decision" involved. Then the baby comes out and breastfeeding is a continuation of that. You can "choose" to disrupt that continuum. That is your right. Let's just be honest about it and call it what it is."

Her placenta analogy highlights the undeniable fact that birth and breastfeeding are designed to exist on a continuum, and the body of the mother during pregnancy and breastfeeding is the natural 'habitat' of the baby. No amount of technology will improve on this biologically determined pattern. If we see formula feeding for what it really is - a deviation from the norm, rather than a 'choice' - then we can bust the myth that formula feeding is somehow feminist; that brandishing a bottle is liberating.

Rights Vs Choices

In reality, breastfeeding is a maternal and child health imperative and reproductive right. However, rather than being respected as a right, our culture frames breastfeeding as a consumerist and lifestyle choice. The Feminist Breeder has rightly noted that:

"When a biological function is viewed as a 'choice' being made by an individual, society easily decides that it has no vested interest in supporting that 'choice.' If society has no vested interest in supporting that choice, then it’s no wonder a Judge recently ruled that employers can fire breastfeeding mothers. The judge thinks it was the mother's “choice” and the company was not obligated to support it." 

Framing breastfeeding as a 'choice' weakens legal protection for breastfeeding families. A lot of women are economically forced into employment in order to feed their families yet are legitimately denied pumping breaks. In this set-up, breastfeeding becomes no more than a privilege disguised as a choice.

How informed is your 'choice'?

One of the most prolific and powerful architects of the pervasive shift from 'right' to 'choice' is - you guessed it - the formula industry. Formula companies use emotional rhetoric to focus on mothers' feelings and intuition rather than knowledge in making decisions. In their marketing propaganda, formula companies cloak and draw attention away from what is actually important in infant feeding. For example, in some of their articulations, love is more significant than breast milk or formula. Their argument is that it is love that counts in infant feeding and care, not what goes into the baby. We see how ludicrous this displacement strategy is when we consider how we would we feel if the tobacco industry used the same argument: "It doesn't matter if you smoke in front of your baby, as long as you love them".

Another, perhaps even more insidious, formula company strategy is to provide 'information' about breast and bottle feeding under the premise of 'helping' mothers to make an informed choice. This 'service' comes in the form of pamphlets, websites, advertorials in magazines, new baby packs, telephone carelines and even assimilated via the bating of health professionals. However when we examine more closely the content of this 'information' we notice how the material is tailored to exploit mothers' fears regarding their breast milk supply, or concerns regarding their partners' ability to bond with their baby (for examples, see my article, "15 Tricks of Formula Companies").

What about Feminism?

Formula companies even leach off feminist notions of liberty, appropriating the discourse of personal choice and female empowerment. A noteworthy example is Elisabeth Badinter who wrote a provocative book called 'The Conflict'. In her book, Badinter argued that if women were to stop breastfeeding and give their babies formula, their economic and social status would rise. However unbeknown to her readers, Badinter holds a controlling stake in and is the board chair of the p.r. and ad agency Publicis, which represents formula makers Nestle, Similac and Enfamil. 

The reality is that breastfeeding mothers are less dependant on medical professionals and commercial products, which refutes Badinter's assumption that formula is 'liberation in a can'. Her equation of formula with women's commercial freedom is a grossly false quasi-feminist gesture. It panders to a Patriarchal economic set up in which mothering is devalued and male ways of living are seen as the norm, femaleness as a deviation; A culture where bread-winning is revered, child-rearing belittled, where the functioning of women's bodies is shameful, where pills are dished out to dry up the milk supply of new mothers and where men are more than happy to hand out formula whilst simultaneously lining their pockets. This doesn't sound very feminist to me.

In fact, history has shown us that when women give up breastfeeding, this does not lead to an increase in their employment. In the 1950s, when mothers were encouraged by formula companies and pediatricians to bottle-feed their babies, there was no huge influx of female employees flooding the workforce. Even in contemporary times, "choice" in infant feeding has not created equality in the workplace nor has it liberated women from the burdens of maternity. As I said in a previous article (here), even in contemporary society, it is still mothers who have to take time off from employment to care for their sick formula-fed child.

Despite being fundamentally flawed in these ways, the dialogue of empowerment has been transmitted, like a virus, from formula company to formula feeder. Mothers who chose not to breastfeed assimilated this brand of "choice feminism", soaking it up like a sponge. The rhetoric of 'choice' enables these mothers to rest more easily with their guilt by hiding behind a cloak of 'liberation'. It enables them to argue that even anti-feminist behaviours such as formula feeding are feminist because "feminism is about choice." This approach has slowly caused the phrase "It’s my choice" to become synonymous with "It’s a feminist thing to do" - or, perhaps more precisely, "It is anti-feminist to criticize my decision."

Yes, feminism is about choice but one needs to be honest about the fact that feminism, and indeed parenting, is also about making certain types of choices, whether or not we like to admit it. Individual freedom is to be encouraged - but with one very important caveat - so long as it does not bring harm to others. This is reflected in law. We have the right to free speech, but not hate speech. We have the right to smoke, but not to force others to smoke passively. However during infancy the issue is less defined; a woman’s rights become tied to that of her child. The dialogue of "choice" fails to take in to account those who actually have the most at stake: the child, who may feel the effect of the mother's decision for the rest of their lives.

Feminism is not about reassuring individual women that they haven’t chosen badly. If you choose to hand over your control to medical professionals, to line the pockets of men, to surrender your baby's health to the will of corporations who have no vested interest in your baby's well-being, to contribute to the restriction of women's breasts to the sexual domain, to increase your own, and your baby's risk of cancer and obesity - according to your logic that means that the formula companies, the poorly informed health professionals and the sabotaging family members aren't misogynistic, because anything you as a woman choose to do is feminist. In fact, apparently the real misogynist is the feminist who’s trying to tell you that formula feeding isn't optimum.

A further irony is that, rather than being empowering and 'feminist', the discourse of "choice" operates to stratify mothers into categories of good and bad choosers (i.e. good and bad mothers). The pressures felt by defensive formula feeders – who feel that others look at them as if they have made a "bad choice" – are a legacy of the way choice rhetorically operates in relation to motherhood, functioning to distinguish mothers who choose well from those who do not. Formula company marketing material responds to this perceived stigma by suggesting that women choose well when they use their emotions. All choices, when made from the "heart," are good choices, especially when women make choices perceived to be detrimental from a medical point of view.

Making the Personal Political

Those who champion 'choice' in infant feeding (the "It's my choice and no one's business" brigade) are often motivated by a fear of politics. They hold a worldview that does not challenge the status quo. Instead, any and all choices women make are seen as equally valid, cherished, and beyond judgement. This rhetoric of 'choice' in infant feeding is troublingly tied to and reflective of trends toward hyper-individualism and hyper-consumerism (unsurprising considering its appeal in American and British society); the choice rhetoric tends to neglect the *contexts* (political, institutional, economical) of actual choices; it relieves women of the responsibility of considering the broader implications of their choices (by pretending that individual choices have no social consequences). It’s about making every woman feel good about whatever she does, and treating women like delicate wallflowers who can’t be criticized. In short, the 'choice' rhetoric enables mothers to sidestep the difficulties of making the personal political: i.e. making judgements and demanding change of health professionals, formula corporations, the media, employers, friends and family. Yet, as I explained in my article, "Why the Way You Feed Your Baby is MY Business", infant feeding is inevitably, inherently and unavoidably political.

Politics takes courage - courage to be unpopular, to say what one thinks, to be criticized. We should encourage judgements about the value of different choices, encourage being publicly accountable for our choices, and encourage discussion about which choices should be valued and which are illusions. 'Choice' is an important part of having sovereignty over ones own body and ones parenting, however it is only a part of it and can be completely irrelevant if the context in which choices are being made is not also assessed. Our 'choices' do not happen in a vacuum.

Whatever aspects of being a formula feeder work for you, enjoy them. But don’t fool yourself that you’re doing so of your own unconstrained free will. Your choices are being made in the context of a bottle-feeding culture. You may be doing what you love, but you’re also doing what you’re told. Lactivists who want to fight for your ability to reject patriarchal standards of what is 'decent' breast exposure or who want to ban the ability of formula companies to corrupt health professionals - are trying to give you more genuine, valid, supported options.

Next time you find yourself muttering the hyper-clichéd words, "I support a woman's choice to feed her baby however she likes", stop and think. Your choice rhetoric:

• obscures the fact that formula feeding is a deviation from the norm.
• contributes to the illusion that breast milk and formula are on an even keel.
• weakens legal protection for breastfeeding ('choices' are weaker than 'rights').
• fuels Mother Vs Mother dialogue ('The Mommy Wars').
• relieves formula companies, health professionals and poor support systems of their responsibility (instead all responsibility is placed on the choice-maker).
• discourages individual social responsibility.
• sees women as weak and unable to field criticism.
• shuts down debate, discussion, activism and progress.

Breast and Formula Feeding Over Time

What no one tells you about child spacing

You may have in mind the perfect age gap for your brood. However did you know that certain age gaps carry with them, emotional, financial, intellectual and even health consequences?

At present, we parents do not have the option of determining whether a next-born child will be active or quiet, able-bodied or disabled. But we at least have some control over the child’s age relative to that of his older sibling. Here I am going to explore the serious (and not so serious) consequences of each birth spacing.

1 Year Age Gap

Pros:

• It consolidates the exhausting years that you are in "baby mode". Especially handy for older mothers.
• If you work you will be on maternity leave while your eldest is still very much a baby, so you'll be around for important milestones such as first steps and words.
• Your children will go through the same stages in fairly close succession, which makes it easier to hand down clothing, toys and equipment rather than arranging storage for years.
• This age gap is thought to be best at unifying the family. "The early hardship of caring for two young children can help draw fathers into the action.  The tasks are so demanding that even the most alienated and reluctant father would have to step in" (Hart).
• Your children may have the same friends, watch the same TV, and play the same games, all of which often means less work for you. 
• You can organise family outings without having to wait years until the youngest child is ready to participate.
• They'll play well together. “Siblings who know they need each other to continue their games are motivated to sort out their disagreements” (Baby Centre). In other words, as the importance of companionship goes up, the importance of rivalry goes down.

• Your existing child is less likely to reject the new baby as they won’t fully understand issues such as displacement, territory or personal possessions. Having not experienced an extended period of exclusive parental attention, they develop lesser expectations of receiving preferential treatment from parents. These benefits have been shown to extend into adolescence (Kidwell).
• Studies have shown that girls benefit intellectually from closer-spaced sibling age gaps. However the reverse is true for boys (Rosenberg and Sutton-Smith).
• The closer the age gap, the more creative your children are likely to be, regardless of gender (Baer et al).
• The ever-increasing age of first-time mothers can make it feel like that their so-called biological clock is ticking faster and faster. Having your children in quick succession can pacify fertility fears.
• This age gap can also help career and childcare choices. If you’re working it can be easier to organise childcare for children of a similar age, rather than having years of juggling different childcare arrangements. You may save money because you can get a nanny for both children - this can work out cheaper than two daycare places.

Cons:

• Looking after a baby while you're pregnant can be very tiring. Your body won’t have fully recovered from the last pregnancy. You may be excessively tired and easily run down. Iron and calcium stores will not have had time to replenish (Winkvist et al; King).
• Anything less than an 18 month gap has been shown to reduce a woman's life expectancy (Centre for Population Studies; The Independent).
• Giving birth within 12 months of a prior birth is associated with complications such as placental abruption, which happens then the placenta separates from the uterine wall, and placenta previa, which occurs when a portion of the placenta covers the cervix (MayoClinic).
• Having a gap of less than 17 months is associated with a significantly increased risk of having a baby of prematurely and underweight. The risks are highest for babies conceived less than six months after the birth of a previous child (World Health Organisation; Conde-Agudelo et al).
• You may feel that you haven't had enough time alone with your first-born before the next arrives.
• Tandem breastfeeding is not appealing to everyone. Even if you like the idea, some babies self-wean during pregnancy (due to taste changes and possible drop in supply) so your breastfeeding relationship with your firstborn could be prematurely cut short.
• The early years may pass in a blur. It will be an all-consuming experience of sleepless nights, nappies, breastfeeding, pureed food and laundry.
• Being so close in age may mean that you are less able to enjoy your babies as individuals.
• Your toddler may not be sleeping through regularly when your baby arrives.
• In the early years, outings will be limited as you struggle to attend swim lessons, the park, and Mother & Toddler groups with both children.

• Your children will be at an increased risk of attachment problems. The theory is that neither child gets enough attention from the mother to create the close mother-child bond that children need to flourish (Kauai Longitudinal Study).
• At school, your younger child may feel like they are in the older child’s shadow academically. Being closer in age encourages competitiveness.
• A recent study suggests that children who are born only a year after an older sibling are three times more likely to be diagnosed with autism (Pediatrics). This is because women are more likely to have depleted levels of nutrients such as folate and iron, as well as higher stress levels, after a recent pregnancy (affecting fetal brain development). 
• In the future, when your children want to start college, it’s going to cost a lot of money in a short space of time (Powell).
• You are likely to need extra equipment, like a second cot (if you haven’t transitioned number-one by number-two’s arrival, or if your cot was intended to convert to a bed), a second car seat and a double stroller.

2 Year Age Gap

Pros:

• Having a 2 year gap may capitalise on changes to your body as a result of the previous pregnancy and birth that benefit carrying another baby (Zhu et al). For example, it may be that increased blood flow to the uterus from the last pregnancy benefits the next baby, but that there is a limited time window of about two years before blood flow returns to pre-pregnancy levels. 
• You’ll remember how to care for a newborn whilst also having the confidence that comes with being a more experienced mum.

• Your children will play reasonably well together.
• Firstborns often take to their newly acquired status as the older child by showing new self-reliance in matters such as dressing, toilet use and feeding, even volunteering to give up their “babyish” bottles and by contentedly entertaining themselves.
• This age gap has been shown to enhance the older child’s ability in maths and in reading (Notre Dame University).

Cons:

• If you suffer from morning sickness or other pregnancy issues, your toddler is old enough to observe it yet still too young to understand, and thus may become distressed.
• There is likely to be times during pregnancy when you will need to lift your toddler which can put undue stress on your abdomen.
• You'll be slammed with first-trimester exhaustion at a time when your wobbly toddler is learning to run and climb, and needs constant supervision.

• Sibling jealousy will be at its worse than it would be with a smaller or larger age gap (Cave and Fertleman 2012). At the age of two children are at their most egocentric and become frustrated easily when they cannot control their environment, which leaves them prone to jealousy (Bounty).
• You have the double pressure of an irritable newborn and toddler tantrums. It may seem at times that you have a very disharmonious household.
• When you go out you’ll have worry about packing enough nappies for the newborn as well as packing extra clothes and making sure you know where the nearest bathroom is for your toilet-training toddler.
• The younger sibling is twice as likely to be diagnosed with autism than a child with a larger age gap (Pediatrics).
• Children are more likely to have a negative view of themselves and their parents when their closest siblings are around two years apart (Kidwell). It is believed that children of this age are simply not ready yet to share their parents and thus experience intense resentment towards new siblings and lowered self-esteem because they’ve been “jilted". (If the space between siblings is under one year or over four years, the negativity disappears).
• If your newborn is a constant crier this could distress your toddler. Two year olds are beginning to develop empathy and concern, yet are still too young to understand that crying babies are displaying normal, healthy behaviour.

3 Year Age Gap

Pros:

• Your elder child should cope well with your pregnancy, understanding on a basic level, morning sickness and your need for rest.
• She will have her own established life and friends which will continue once the baby is born. This adds a helpful layer of consistency and familiarity to her life when she needs it most.

• This age gap is best for the health of the new baby, with a decreased risk of being born prematurely or underweight (Conde-Agudelo et al). In fact, a 3 year gap is nature’s preferred pattern. This is because until babies began using bottles, and a surplus of food for their mothers became available, women’s bodies were unlikely to conceive again until at least 3 years after birth.
• This age gap between children is so common that your firstborn will have friends with similarly spaced siblings, which is very convenient for double playdates.
• By the time your second baby arrives you should have caught up on sleep.
• You’ll have time with just your baby while your older child is at pre-school.
• Some of the most intense parts of parenting become easier with a calmer, and more independent 3 year old.

Cons:

• Sibling jealousy is still intense. Your older child will understand exactly what the new arrival means, and may compete furiously for her share of you. She is old enough to make comparisons, but not mature enough to understand that babies need more of your care. 

• Feeling that her security is being threatened can cause your older child to lash out at their younger sibling. Physical aggression peaks at age 3 (Tremblay).
• Your older child’s tiny-part toys are all over the house, which could pose a danger to your baby.
• Those baby activities you enjoyed with your firstborn are impossible with a lively preschooler in tow.
• Your older child can bring home illnesses from preschool (chicken pox, viral diseases, colds) which could prove harmful to your baby with their immature immune system.
• Be prepared for for an influx of questions re: the birds and the bees, genitals, boobs, and other topics some parents find embarrassing.

Four Years+ Age Gap

Pros:

• This gap is good for your eldest child's self esteem - they are more secure and more independent as they have had your attention for years. The rationale here is that the longer a parent-child relationship remains exclusive, or at least has the appearance of exclusiveness, the greater the chance it will gather sufficient strength to withstand a second child’s intrusion.  
• Many feel that older children, because of their greater intellectual maturity, are in a better position to understand and therefore be spared, jealousy. Your children won't feel that they are competing for the same kind of attention from you. The older child "does not see a baby as competition, but as an adorable being to enjoy and nurture. She sees a baby as an addition to her life rather than a threat to her primary relationship with mom or dad...She is not with the baby sharing mom, but with the mom sharing the baby" (Aldort).
• Your older child may be mature enough to attend the delivery, which can aid bonding.
• If the birth involves a hospital stay, your older child is likely to cope better with being separated from you.

• She is likely to be more gentle with the new arrival. Physical aggression in children is at its most frequent from ages two to four and gradually declines thereafter (Tremblay).
• Studies have shown that boys in particular benefit intellectually from a large sibling age gap, particularly if they are the eldest child (Rosenberg and Sutton-Smith).
• You’ll have plenty of time with your baby whilst your older child is at school.
• At about the age of five, children develop a distinct self-sufficiency that makes it easier for you to balance the needs of more than one child. Most can get themselves a snack, entertain themselves in their room, or have a friend over while you're busy with baby.
• When you are in the middle of nursing, the older sibling can answer phone calls, get you a drink of water, fetch a baby wipe, etc.
• You’ll have the confidence that comes with having been a parent for years. It's likely that you'll be more relaxed this time and less likely to worry about the little things.
• Some parents report “enjoying their children more” because they are able to concentrate on each child without feeling constantly under pressure.  
• Your older child will be more skilled at patience, sharing, compassion, and cooperation.
• You and your partner will have had time to build a strong, stable relationship.
• You extend your parenting years, delaying the quiet of the empty nest.

Cons:

• Waiting for years before having another child may not be an option for a mother who is reaching the end of her child-bearing years.
• Having a gap of more than five years is associated with a significantly increased risk of having a baby who is premature or underweight, suffers from dystocia and other problematic labour or delivery as well as increasing the chance of the mother suffering from preeclampsia and excessive amounts of protein in urine (Conde-Agudelo et al; MayoClinic).
• You’ll be stretching out the exhausting early years – particularly if you plan a third child.
• You may feel a bit rusty and out of practice those first few nappying and feeding sessions. It can be hard to get back into baby mode after enjoying the freedom of a more self-sufficient child.
• Baby-care advice is always changing, for example weaning recommendations and vaccination schedules change every few years.
• It may be tough to deal with sleep deprivation and hard to keep up with an energetic toddler when you’re a few years older.
• If your eldest child is four, they will be starting school (reception class in the UK) which is a stressful event in itself. Adding a new sibling to the mix will exacerbate the stress.
• Breastfeeding in front of an older child (who is perhaps a teenager) can feel uncomfortable, but rest assured it's helpful for him to understand that nursing is a normal, healthy process.

• Your children are less likely to play well together - one is creating a Lego castle while the other is trying to eat it.
• When your sociable older child goes to parties and concerts, you’ll struggle with a toddler in tow.
• On family outings, their needs will be different. There is often no way to satisfy both children, all at the same time. You and your partner may find yourselves driven in opposite directions, each with only one child. 
• Your children's bond may be weaker. “Having one child followed by a long gap before another child can be like having two singletons. They may grow up having little in common” (Baby Centre). For instance, preteens do not consider themselves in the same league as children, and teenagers feel well above preteens. In most places, children born four years apart will not be together during preschool, junior school, high school, or even college.