Guilt, Breastfeeding, and Moving Beyond it All

This past Saturday I attended a breastfeeding education day, featuring Dr. Katherine Dettwyler. She’s an anthropology professor, lecturer, author and breastfeeding advocate. She discussed a variety of fascinating topics, including breastfeeding and the media, her research on what the natural age of weaning would be in modern humans if we set aside our cultural beliefs, and caring for children and why babies cry. The topic that really caught my eye, however, was addressing guilt around breastfeeding (or, more specifically, not breastfeeding).

Dr. Dettwyler shared a quote from Harriet Lerner, which I immediately fell in love with:

Try to remember that our society encourages mothers to cultivate guilt like a little flower garden, because nothing blocks the awareness and expression of legitimate anger as effectively as this all-consuming emotion.

I found the quote online in the book The Mother Dance, and Dr. Lerner goes on to say:

Guilt keeps mothers narrowly focused on the question “What’s wrong with me?” and prevents us from becoming effective agents of personal and social change.

guilt breastfeeding parenting social change

These ideas resonated with me. When we’re preoccupied with our shortcomings, whether real or imagined, we’re using up all our energy feeling bad when we could be actually doing things to change the situation. This made me think about this quote from Brene Brown’s book, The Gifts of Imperfection:

The majority of shame researchers and clinicians agree that the difference between shame and guilt is best understood as the differences between “I am bad” and “I did something bad.”

Guilt = I did something bad.
Shame = I am bad.

When you do something bad, there’s room for you to choose to do something different next time. When you are bad, there’s not much room for improvement. When Dr. Lerner is talking about focusing on the question “What’s wrong with me?” I read that as a discussion of shame. It’s about believing that you are fundamentally deficient in some way.

During her conversation at the breastfeeding education day, Dr. Dettwyler explained this as the difference between guilt and regret. Guilt can be a positive emotion, because it can encourage us towards continuous improvement. Shame or regret, on the other hand, are paralyzing emotions that result in inaction. Regardless of the phraseology we choose, however, what Dr. Dettwyler suggested is that rather than feeling guilty, we should feel angry.

If you did not receive adequate support; if you were given misinformation; if someone put pressure on you not to breastfeed, or not to breastfeed in a certain way, in a certain place or at a certain time; if unnecessary barriers were placed in your path that interfered with the successful establishment of breastfeeding, then she suggests that the appropriate response is not guilt, but anger.

Day 1 - Mom is doing better

I breastfed my daughter Hannah for nearly three years, however, the truth is that I’m still angry about some of the obstacles that were placed in my path. Even though she was very healthy for a baby born at 34 weeks, weighing over five pounds and with Apgar scores of eight and eight, she was removed from the delivery room within minutes of her birth, before we were able to initiate breastfeeding. Once in the NICU, she was given formula in a bottle before I had a chance to try breastfeeding her, and without consulting me. She was given a pacifier, and when I expressed concerns about her refusal to latch, I was told that there was ‘no such thing as nipple confusion’.

While I managed to overcome our initial difficulties, it wasn’t easy. There were moments that were touch and go, when I almost threw on the towel. Had it not been for a supportive spouse and a midwife who came to my house and worked with me while I cried, I may not have made it. On the one hand, there’s no telling how Hannah would have done as a preemie even if I had been allowed to breastfeed her shortly after birth, and we hadn’t been separated. I understand that. On the other hand, we’ll never know. And so, yes, I am angry. In retrospect, I feel that it would have been better for both of us if we had been able to spend the crucial first hour after birth together, as she was as healthy as a baby of her gestational age could possibly be.

If I hadn’t managed to pull through and breastfeed, I do wonder how I would feel. Would I feel angry, or would I feel guilt and shame? Would I be beating myself up, or would I be pointing the finger at a system that conspired against us? To be honest, I suspect that I would probably be focused on my own shortcomings. I feel anger, in large part, because I know that I did all that I could to make it work. If it hadn’t worked, I think I may always wonder what I could have done differently – what I should have done differently. I’m not saying that I should feel that way, but knowing myself as I do I’m saying it’s likely this is what would happen.

Having a snack at the midwives picnic

Knowing that I have my own confused dance of guilt vs. shame vs. anger, I try very hard to be sensitive of the way that other mothers feel. Because I know that all too often mothers are told what they should do, while receiving very little actual support towards achieving those goals. We’re told to breastfeed at all costs, and then sent home with a tiny baby and a bag of formula samples. Is it any wonder that we struggle?

Breastfeeding is just one instance of how a mother can fall short of the societal ideal. There are no shortage of examples of how the wider culture likes to weigh in on our parenting – no shortage of ways we can “fail” as mothers. If we’re too permissive or too strict, we fail. If our babies are too big or too small, we fail. If our children don’t sleep the right amount of time or refuse to sleep in a crib, we fail. If our children sleep better in a crib than in the family bed, we fail. If we don’t get every vaccination on time, we fail. If we vaccinate at all, we fail.

I’m drawn back to the Harriet Lerner quotes. Maybe what we really need to do is stop focusing on the ways that things haven’t gone well, worrying over our own failings. Maybe they’re not really our failings at all. Maybe the real problem is a culture that holds mothers to high standards, but fails to provide adequate support. Because if we can move beyond the shame and regret to become effective agents of personal and social change, we can make a difference.

This doesn’t mean that we shouldn’t strive to be better parents. Of course, there’s always room for improvement, which is where Brene Brown’s distinction between guilt and shame comes in. If we learn better, we can do better. But the truth is most of the mothers I know are already doing the best they can with what they have, every single day. So let’s cut ourselves some slack, and work for better social supports, so that no one else has to feel the same shame, guilt or regret that we have. Because, truthfully, much of it wasn’t ours to begin with.

Repost: Podcast on Facebook and Breastfeeding

I’m re-sharing this episode of the Strocel.com Podcast. My friend Gina Crosley-Corcoran (a.k.a. The Feminist Breeder) recently had her breastfeeding photos removed and her account suspended by Facebook, and I’d like to shine a light on this issue again.

Over the years there have been countless stories about mothers having their breastfeeding images removed from Facebook. In some cases, mothers even had their accounts deleted. Over three years ago, in December, 2008, I myself participated in a virtual “nurse-in”. I updated my own profile photo to an image of myself breastfeeding my daughter Hannah and changed my status to say, “Hey, Facebook, breastfeeding is not obscene!” And yet, in spite of the outcry, new stories continue to crop up all the time.

Facebook Breastfeeding Emma KwasnicaEmma Kwasnica lives here in Vancouver, and she herself has had a number of photos removed from the social networking site. She’s also had her account de-activated. Finally, it reached the point where she had enough, and she went public with her story. Media coverage followed, and as it did, Facebook took notice. They held a conference call with Emma, and issued statements underscoring the fact that they welcome breastfeeding photos on Facebook. In part, their policy regarding images depicting breastfeeding reads:

We agree that breastfeeding is natural and beautiful…Photos that show a fully exposed breast where the child is not actively engaged in nursing do violate Facebook’s Statement of Rights and Responsibilities.

The problem, according to Emma (and other mothers whose images have been removed), is that Facebook sometimes removes photos that do not show an exposed nipple that is not engaged in breastfeeding, and which therefore comply with the site’s policy. It has also locked mothers out of their own accounts without warning or recourse. Emma is trying to stop that from happening. She wants Facebook to follow its own rules and regulations. Breastfeeding is not an obscene act, and the Facebook policy agrees. It should be applied properly, and it should be applied in the same way for all users. The question of whether or not an image is obscene should not depend on whether someone else decides to flag your photo or not, and it also should not depend on who happens to be evaluating a complaint on any given day. To reinforce this message, a Facebook page called FB! Stop harassing Emma Kwasnica over her breastfeeding pics was started.

Like Emma Kwasnica, I’m one of the one billion Facebook users worldwide. The odds are pretty good that you are, too. Facebook depends on us for its livelihood. It might be free to sign up, but our presence allows them to sell ads, which make them a lot of money. We have power in this relationship to make our voices heard. To get started, listen to my conversation with Emma, find out how she’s working to ensure Facebook plays by its out rules, and learn how you can take action:

I’m working on an interview for next week at the moment. No matter what happens, I promise I’ll be sharing something worth listening to, so please tune in. Or subscribe to the Strocel.com podcast in iTunes, and you won’t miss a minute! Also, if you have a podcast idea, please share it with me. I’d love to hear your suggestions!

Today I am Disappointed in LLL

As I write, I have just finished reading about Trevor MacDonald, a transgender breastfeeding father. He corresponded with La Leche League (LLL) here in Canada about becoming a leader. I read an article on the CBC website. From there, I visited Trevor’s blog, Milk Junkies, and found a copy of his letter to LLL and their response. I also read a comment from Fiona Audy, chair of the La Leche League Canada Board and a past guest on my podcast. I have to say, I am very disappointed in LLL at this moment.

My summary of the situation is this: Trevor, who was born a biological woman, now identifies as a man. However, he still has a female reproductive system, and he became pregnant. He first attended a LLL meeting when he was expecting. Having had most of his breast tissue removed, he was concerned about breastfeeding. He credits the information and support he received through LLL with helping him to breastfeed his child, who is now a toddler. Like many other parents who have found help through LLL, he wants to pay that forward by becoming a volunteer leader. However, the organization has said that’s not possible. Here is an excerpt from their letter, as posted on Trevor’s website:

Our policies do preclude men from becoming Leaders. LLLC Policy states:

4.14 MEN AS LEADERS

Since an LLLC Leader is a mother who has breastfed a baby, a man cannot become an LLLC Leader. (March 1994)

Like Trevor, I love La Leche League, and the work they do. When I stumbled into my first meeting when my daughter Hannah was just a couple of months old, it felt as if I had come home. I credit the information and support I received there with being able to establish a successful breastfeeding relationship. But more than that, I found many friends at LLL. For more than seven years, I attended meetings at least once a month. The group has played a significant role in my personal parenting journey.

breastfeeding

I credit LLL with helping me reach this point in breastfeeding Hannah

As I understand it, LLL’s objections stem from the fact that the organization’s philosophies are based around mothering through breastfeeding. Leaders are expected to live in a way that represents those philosophies. As well, leaders must have breastfed their babies themselves. However, it seems clear to me that these philosophies and policies were written at a time when no one would have believed that a man could become pregnant or breastfeed. Transgender issues simply weren’t on anyone’s radar. Modifying the language to be gender inclusive, while retaining the requirement that a leader be a parent who has breastfed a baby, would be in the spirit of the policies in my mind.

One of the issues that LLL raised in their response letter, as posted on Trevor’s website, is that some women may be uncomfortable receiving breastfeeding support from a man. They say that a leader must be able to help all women with breastfeeding. This seems patently unfair to me, because it places the onus on a potential leader to be non-offensive. Would we respond in the same way if, for instance, a woman of one race was uncomfortable receiving help from a woman of another race? What about if a potential leader had a lot of tattoos? Those make some people uncomfortable. What if she had a disability? While a mother certainly has the right to seek support from someone she can communicate effectively with, it’s discriminatory to exclude someone from a volunteer role simply because someone else may be uncomfortable.

This is the crux of things for me. I understand that Trevor’s application is pushing the boundaries, so to speak. I understand that some people hold strongly-held beliefs around gender and sexual orientation, and may struggle to receive support from Trevor. If that’s the case, I would hope that they would contact another leader. But this doesn’t change the fact that a secular group that seeks to be welcoming to all breastfeeding parents must be prepared to adapt. If you believe breastfeeding is important, then it’s important for all babies, not just for babies with parents you approve of. You simply cannot say that you’re supporting LGBT parents, while excluding them from certain roles. That’s not a supportive action.

As I said, I love LLL. I value the work that the organization does to provide free, research-based breastfeeding support and information. But I know that one negative experience with an organization can taint someone’s opinion forever. When I’ve written about LLL in the past, I’ve heard many stories about leaders who said or did the wrong thing at a time when a mother was feeling particularly vulnerable. I’ve heard about leaders who weren’t welcoming, or who didn’t provide the information a parent was looking for. It’s terribly unfortunate when that happens, and I fear this decision may have the same effect. Many people may read it and wrongly believe that if they call their local leader they will be met with closed-mindedness or judgment. And so, today I am disappointed with the stance that LLL has taken. I dearly hope that they will reconsider it.

UPDATED: Both La Leche League Canada and La Leche League International are now reviewing their policies with an eye to Trevor’s situation. While this is hardly a solution, I’m choosing to view this as a positive step, and I’m hoping that something good comes out of it. You can read the official statements online.

Repost: Breastfeeding Acrobatics

I’m still on vacation in New York. While I explore the Big Apple, I’m taking a walk down memory lane, with this post from January 2010.

Jacob is currently 17 1/2 months old. His main interests seem to be climbing things he shouldn’t, pressing buttons and playing outside. Oh, and breastfeeding. While my toddler eats a wide variety of food now, he still relies on nursing to soothe him when he’s hurt, to lull himself to sleep or just for a quick snack on the go. Having breastfed his sister until she was almost three years old, I am in no rush to end Jacob’s time at the breast.

While our nursing relationship is still working well for the most part, it’s not all sunshine and roses. Toddlers, as it turns out, are not that considerate of others. They are hooligans, if you will. It’s not malevolent, really, they just don’t understand that you have feelings and can be hurt, and so it doesn’t occur to them that pulling your hair just to see what you’ll do is unkind. And so, it also doesn’t occur to them that performing daring feats of acrobatic skill while breastfeeding is kind of, well, rude.

Jacob, all dolled up
The little monkey, dressed the part

If you have ever breastfed a toddler, some of Jacob’s latest tricks while nursing might sound familiar to you.

  • Kicking me in the face.
  • Playing with my moles or my bellybutton.
  • Craning his head to look around without letting go.
  • Pulling off and squirting himself in the face and laughing.
  • Asking to switch sides every 3 seconds.
  • Undressing me in public so that he can nurse.

We are slowly working on some nursing etiquette. My current boundaries are that I won’t nurse him at the table or in the bathroom. He seems to be getting the message on those fronts, so we will gradually expand from there. I expect that he will also naturally develop more consideration as he gets older, children always do. But for right now, I will admit that occasionally when he makes the sign for nurse I offer him a cracker instead. Because as committed as I am to breastfeeding, sometimes I need a 5 minute reprieve.

So, tell me? Have you breastfed a toddler who could put Cirque du Soleil to shame with their handstand-back flip-double pike while nursing move? I would love to hear that I’m not alone.

Podcast: All About Human Milk Banking

Breastmilk is sometimes referred to as “liquid gold”. Its benefits are well-known. But as important as it is for healthy, full-term infants, it’s even more important premature babies, sick babies, and babies with some specific conditions. For example, human milk can significantly reduce the rate of necrotizing enterocolitis in preemies. The Human Milk Banking Association of North America (HMBANA) operates milk banks in the United States and Canada that provide human milk to the most vulnerable babies – but they always need more.

I recently had the chance to speak with HMBANA past presidents Frances Jones from the BC Women’s Milk Bank here in Vancouver and Pauline Sakamoto from the Mothers’ Milk Bank in San Jose, California. They explained how HMBANA milk banks differ from other milk banks. They also outlined why the need for donor milk is so great, and explained the donation process.

Cook Infant Foods
Photo credit: Tzuhsun Hsu on Flickr

In an ideal world, every mother would be able to provide her own milk to her baby, if that’s her choice. However, even those of us who consider ourselves breastfeeding advocates know that for any number of reasons, this isn’t always possible. In my own case, with a premature baby in the NICU, I wasn’t able to pump as much milk as they said she needed to consume every day. In my hospital, and with a relatively healthy preemie, donor milk wasn’t an option, so my daughter was supplemented with formula until she got her latch down. While she’s healthy as a horse, I would have preferred to have donor milk as an option. Many other mothers with far greater need would also like access to donor milk, and they aren’t able to get it. This is why Frances and Pauline are always looking for more donors.

If you’re curious about human milk banks, how they operate, or how you can donate, listen to the podcast:

Next week on the Strocel.com podcast I’ll be sharing an interview with Samantha Reynolds of bentlily. She started writing a poem a day to chronicle the first year of her son’s life, and it turned into a movement. She inspired me to write my own poem, and I’m not the only one. If you’re looking for some inspiration or a greater sense of mindfulness, you’ll want to tune into this one. Subscribe to the Strocel.com podcast in iTunes, and you won’t miss a minute!

Formula in my Cupboard

I’ve been thinking about something recently. When my daughter Hannah was born at 34 weeks, she was given a bottle of formula in the NICU before I had a chance to try breastfeeding her. When I did try to breastfeed her, she refused to latch. I started pumping, but I was never able to get as much as the doctors and nurses said she needed, so about half of her milk intake was formula. When she left the hospital at one week old she still hadn’t successfully latched, and the nurses tucked a few jars of pre-prepared formula into my diaper bag. That formula only lasted a day or so, so my husband had to go buy a can within 24 hours of Hannah’s arrival home.

Now, I should make something clear: I had really not planned to give my baby formula. I was intent on breastfeeding for at least 12-18 months before my first child was even born. But when you have a premature baby, and many people in white coats are saying that baby needs a certain amount of food, you give that amount. When that baby refuses to latch, and you’re having limited success with pumping, you supplement. Looking back I think that a whole lot of things could have been handled better in general – like, say, not separating me from my perfectly healthy baby within minutes of her birth – but this was one of those times in life when I found myself doing the best I could with the situation I found myself in.

The good news in this story is that the morning after my husband’s trip to buy that big can of formula, Hannah finally latched using a nipple shield. Within 48 hours I had stopped pumping and she wasn’t receiving any more formula supplements. I think we ended up mixing a total of two bottles out of the big can of formula. I kept it for a few weeks just to be sure that everything would go okay, and then I threw it out with glee.

In the years since my first baby was born, I’ve spoken with many other mothers who found themselves giving their babies formula when they hadn’t planned to. Many of these mothers do everything they can to limit the amount of formula their babies receive. I also know moms who go to great lengths to ensure their little ones never receive any formula at all, spending their lives attached to breast pumps and forgoing sleep and showers and regular meals in order to get breastfeeding going.

I think that every mother needs to make her own decisions about just how far she’s willing to go to avoid infant formula. Some moms may not even try to avoid it at all. That’s not really my point here. I’m not writing this to moralize on why breastfeeding is so important. I think we’ve all read the public health messages, and we all know the drill. What’s interesting to me, however, is how different parents will respond to having infant formula available. Will you still avoid it all costs – or will having it in your cupboard lead you to offer that first bottle just that much sooner?

The evidence suggests that mothers who receive formula samples from the hospital are less likely to breastfeed. This is true whether we’re talking about commercial sample packs from a formula company, or nurses tucking a few jars into a diaper bag, which is what I got. To a certain degree, this just makes sense. Regardless of where you stand on formula companies, I think we can all agree that they’re big businesses, and they’re unlikely to engage in a widespread marketing practice if it doesn’t work. Formula marketing – such as handing out samples – is meant to sell formula, and at least some of the time it does that at the expense of breastfeeding.

I understand the evidence, but it doesn’t answer my initial question. Why do some mothers view that formula can on their shelves with extreme suspicion, while others view it as a welcome back-up plan or occasional alternative?

There are a whole lot of factors that influence breastfeeding rates, as it turns out. Here are a few, based on the research:

Looking at that list I see that there are a whole lot of factors that influence a mother’s breastfeeding experience. There’s no single thing that’s going to determine if a mother breastfeeds, how long she breastfeeds for, or whether she breastfeeds exclusively or supplements with formula. What’s more, any individual mother may have very different experiences from one baby to the next. It’s simply not true that any mom who has a can of formula in her cupboard is going to use it. However, that doesn’t mean we should all buy it, or that formula companies or hospitals should go ahead and hand out free samples “just in case”.

What I think it does mean is that, first and foremost, we need to make sure that mothers have good information and support. When you look at that list, most of the success factors centre around a mother who has access to the resources she needs, when she needs them. Whether it’s health care providers in the hospital, your mother helping you out at home, or a website you search out when you’re looking for information, if you can find the answers you’re looking for, you’re more likely to be successful.

Should we curtail formula marketing? I think we should. But I also think that we need to keep our focus where it belongs, and that’s on parents. The ideal outcome in my book is that parents are satisfied with their own experiences, whether we’re talking about breastfeeding or anything else associated with that transition to early parenthood. Because a can of formula in your pantry isn’t going to really be there for you, whether you ever give it to your baby or not.

What are your experiences with formula samples? Did you receive any? Did you use them? Where do you think we should focus our efforts at helping mothers succeed at breastfeeding? I’d love to hear your thoughts!

Podcast: Emma Kwasnica on Facebook and Breastfeeding

Over the years there have been countless stories about mothers having their breastfeeding images removed from Facebook. In some cases, mothers even had their accounts deleted. Over three years ago, in December, 2008, I myself participated in a virtual “nurse-in”. I updated my own profile photo to an image of myself breastfeeding my daughter Hannah and changed my status to say, “Hey, Facebook, breastfeeding is not obscene!” And yet, in spite of the outcry, new stories continue to crop up all the time.

Facebook Breastfeeding Emma KwasnicaEmma Kwasnica lives here in Vancouver, and she herself has had a number of photos removed from the social networking site. She’s also had her account de-activated. Finally, it reached the point where she had enough, and she went public with her story. Media coverage followed, and as it did, Facebook took notice. They held a conference call with Emma, and issued statements underscoring the fact that they welcome breastfeeding photos on Facebook. In part, their policy regarding images depicting breastfeeding reads:

We agree that breastfeeding is natural and beautiful…Photos that show a fully exposed breast where the child is not actively engaged in nursing do violate Facebook’s Statement of Rights and Responsibilities.

The problem, according to Emma (and other mothers whose images have been removed), is that Facebook sometimes removes photos that do not show an exposed nipple that is not engaged in breastfeeding, and which therefore comply with the site’s policy. It has also locked mothers out of their own accounts without warning or recourse. Emma is trying to stop that from happening. She wants Facebook to follow its own rules and regulations. Breastfeeding is not an obscene act, and the Facebook policy agrees. It should be applied properly, and it should be applied in the same way for all users. The question of whether or not an image is obscene should not depend on whether someone else decides to flag your photo or not, and it also should not depend on who happens to be evaluating a complaint on any given day. To reinforce this message, a Facebook page called FB! Stop harassing Emma Kwasnica over her breastfeeding pics was started.

Like Emma Kwasnica, I’m one of 850 million Facebook users worldwide. The odds are pretty good that you are, too. Facebook depends on us for its livelihood. It might be free to sign up, but our presence allows them to sell ads, which make them a lot of money. We have power in this relationship to make our voices heard. To get started, listen to my conversation with Emma, find out how she’s working to ensure Facebook plays by its out rules, and learn how you can take action:

Next week on the podcast I’ll be sharing an interview with Stephanie Bonn, a chiropractor with Coco Chiropractic Wellness in Vancouver. She focuses on treating families, and especially expectant moms and babies. If you’re curious about chiropractic care, what it entails, and what it can do, you’ll definitely want to hear what Stephanie has to say. Subscribe to the Strocel.com podcast in iTunes, and you won’t miss a minute!

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