Out of the goodness of our mammaries
April 21, 2016 10:12 PM   Subscribe

Breast Milk is Not Free, so Stop Saying It Is

By saying that breast milk is free, you are undervaluing a mother’s time, physical and mental costs, and actual financial costs to sustain breastfeeding.

posted by wonton endangerment (81 comments total) 31 users marked this as a favorite
Recently on Reply All.
posted by axiom at 10:40 PM on April 21, 2016 [5 favorites]

Ugh absolutely! I exclusively pump my breast milk for my baby (he is not a good latcher) and it is amazing how much that completely overtakes your life. While I have a little more freedom to run errands without Baby Kitty, I am stil up at 1 am pumping to make sure my supply keeps up, even though my baby sleeps through the night at this point. It's not something my husband can do for me.

Another cost she doesn't discuss is the HUGE amount of water you have to drink to keep your supply up. I ho to bed with 4 bottles of water next to me and kill them all by morning.

I prefer to give my baby breast milk over formula since I have a lot more control of what goes into it/manufacturing process - but it is hard to breast feed and exhausting. I feel like a cow - or the milked women in Fury Road - not exactly the miracle of life I was hoping for.

So thank you to the author for noting the additional costs that come with breastfeeding.
posted by Suffocating Kitty at 11:02 PM on April 21, 2016 [31 favorites]

I am extremely grateful to the women who sustain the human race by enduring the physical toll of pregnancy and its aftermath. I couldn't do it. Y'all are champs.
posted by schroedinger at 11:48 PM on April 21, 2016 [23 favorites]

My costliest one-off breastfeeding expense was the hefty washing machine repair fee from the time a breast pad got sucked into one of the pipes. This was not exactly something I'd factored in as part of the new-baby budgeting.

Pumping was not too costly for me in a financial sense, but I hated hated hated it, and then by the time I went back to work my baby wouldn't take bottles but I had to pump anyway to avoid painful physical consequences. (I ended up donating the milk to a hospital milk bank, so it didn't go to waste, but there was a lot of gritted-teeth reminding myself to think of the NICU babies at the time.) Hey, people who think mothers shouldn't breastfeed in public because we can 'just pump' instead? Screw you, and no.

At the same time, I feel like the flip-side of the costs of breastfeeding not getting appreciated is that there are costs to formula feeding which don't get appreciated either, especially the non-financial ones, because they're swept up in standard societal expectations of, well, you have a baby, that's just part of the deal. So I breastfed exclusively and people did sometimes comment on the perceived burden of this when out and about, either negatively ("that must be hard/scary/a hassle, why be such a martyr?") or positively ("that must be hard/scary/a hassle, good for you!"), but my friends who formula fed had to deal with a lot of stuff I didn't - they had to make sure to take milk and bottles with them, keep milk chilled, find ways to safely prepare it, or deal with the additional costs of ready-made cartons, always need to know in advance how long they'd be out for or how much milk they'd got with them if plans changed, etc. And nobody eye-rolled them for being martyrs for this, which is good, but at the same time this wasn't acknowledged as hard in any sense because, e.g., having to take a bag big enough to carry bottles and formula and thermos flasks of hot water about with you, well that's just what people with babies do so that's not worthy of any kind of appreciative comment. So it's lose-lose, either way. (And then people who really don't appreciate the work involved make comments about maternity leave being time paid to sit around and drink coffee, but this is another rant for another time.)
posted by Catseye at 12:28 AM on April 22, 2016 [30 favorites]

She's right to point to the successful monetisation of a range of peripherals, which levels things up somewhat. But you have to bear in mind that the profits from that business don't automatically flow to the formula manufacturers. For many people, it's still a little hard to get past the fact that these women are basically using product they haven't paid for. We need to put in place a more economically realistic arrangement.

Currently there is a curious gap in that there are no actual patents on breast milk or breast feeding themselves, and in the business it's widely agreed that the way forward is to assert the natural ownership rights of the manufacturers. Legally the only real obstacle is some residual disagreements between the main corporations involved over the details of the management and ownership structure.

In practical terms we're thinking of a range of legally required devices, probably wireless, that monitor the flow and the royalties accrued. This would also give us a gateway for some much-needed safety checks and some basic sterilisation of what is currently a raw, untreated animal product, exempt from reasonable food safety regulations (another market anomaly).

The truth is that when a practice like this has become so widespread we tend to tiptoe around it. Your daughter might have dabbled in it, even your wife. The truth is that in plain language, feeding your baby this way is theft.
posted by Segundus at 1:41 AM on April 22, 2016 [16 favorites]

On a related note, there is a decent case to be made for including breastmilk in GDP (currently I think Norway does this, but nowhere else). From this feminist economics book:

Others agree that GDP wrongly excludes breast milk. The 2009 French Presidential Commission on the Measurement of Economic Performance and Social Progress, led by two Nobel Laureates in economics, Joseph Stiglitz and Amartya Sen, cited the example of breastfeeding to illustrate how exclusion from GDP devalued important non-market work and biased policies against unpaid production:
There is a serious omission in the valuation of home-produced goods - the value of breast milk. This is clearly within the System of National Accounts production boundary, is quantitatively non-trivial and also has important implications for public policy and child and maternal health. (Stiglitz, Sen and Fitoussi, 39)
Including breast milk in GDP is important not only because it acknowledges women's lactation work. It also provides a focus for government actions to promote economic growth and development.

posted by Catseye at 2:00 AM on April 22, 2016 [15 favorites]

I read somewhere, and have said repeatedly to those who share their opinions on the topic, that breastfeeding is free if you assume a woman's time has no value.
posted by kat518 at 3:29 AM on April 22, 2016 [77 favorites]

I read somewhere, and have said repeatedly to those who share their opinions on the topic, that breastfeeding is free if you assume a woman's time has no value.

This is true, and applies also to the whole array of domestic tasks allocated in a "traditional" gender arrangement, including childcare, cleaning, and so on. They are given no economic value and little social value either, despite a lot of supposedly "pro-family" rhetoric to the contrary.
posted by Dip Flash at 3:35 AM on April 22, 2016 [17 favorites]

There is a lactation room on each floor where I work, and on one floor a mechanical problem has temporarily closed the room and a small conference room was set aside for that purpose, with two signs on the door stating that it is not to be used for any other purpose.

A guy recently went in there to make a conference call and refused to leave when asked by the next visitor. It is the ONLY time that HR has stepped in to resolve a conference room issue, and it was handled by kicking the fucker out with extreme prejudice.
posted by EmpressCallipygos at 4:10 AM on April 22, 2016 [70 favorites]

I really liked this part:

And pumping doesn’t just take time when you’re a working mother–it also taxes your brain. I would have to come to a stopping point on whatever work I was doing, leave my desk for 20-30 minutes, and then come back and take a minute to think about what I was doing.

It's the pernicious side of the "women are great at multitasking" stereotype -- what big fancy brain stuff could you possibly be doing that you can't be interrupted every 5 minutes with a beeping washer or screaming kid?
posted by Ralston McTodd at 4:12 AM on April 22, 2016 [21 favorites]

Kat518 - that was Hanna Rosin and I love that quote too.

I pumped out breast milk when my first was in NICU because there was a proven benefit to breast milk over formula for the intestines of preemies. Once he was out of the hospital I ended up having to supplement with formula.

With my second I exclusively breast fed and I'm in Canada so had a lengthy mat leave. I had no problems with it but found he needed to feed all the time. It made me resent him and for a healthy baby I think that in my case giving him a bottle a day would have done wonders for my sanity.
posted by biggreenplant at 4:24 AM on April 22, 2016 [3 favorites]

I read somewhere, and have said repeatedly to those who share their opinions on the topic, that breastfeeding is free if you assume a woman's time has no value.

I agree, but also think there's a broader picture behind this which doesn't always get acknowledged.

When I was pregnant we did spend a bit of time thinking about the way that breastfeeding would fall all on me in a way that formula feeding wouldn't, and did vaguely plan on ways that other people could feed the baby and give me a break even if breastfeeding did work out. Because, well, it's obvious that bottles are transferrable to someone else in a way that breasts aren't.

In practice though it ended up looking not like I had imagined, because of the breakdown of labour when on maternity leave. In practice, I was at home with my baby most of the day while my husband worked full-time, so I was going to be doing most of the feeding no matter what the method was. And so were all the other women I knew who had babies around the same time. Even the people I know who exclusively formula-fed from birth or close to, they did pretty much 100% of the night feeds themselves, because they were on mat leave and their partners were working. Their partners would maybe do one feed in the evening. Sometimes. And this was a fairly long-term thing too - I'm the only person among that group of us who went back to work before the baby was 6 months old, most people took closer to a year. (Not in the US, so different maternity leave arrangements.)

So I don't know, because on the one hand I think we absolutely do need to value women's time, and appreciate that even when breastfeeding is going easily and painlessly and enjoyably, it is still one hell of a time commitment by the one doing the lactating. On the other hand... while I think me and my husband did find ways to divide up the baby-care labour in a way that worked fairly, I wish I'd had a better idea of how that could work beforehand, because I was basically relying on "well if it gets tough I can just do less breastfeeding, problem solved!"
posted by Catseye at 4:30 AM on April 22, 2016 [5 favorites]

Does this seem silly to anyone else? Who actually says "free" in regards to breastmilk and means "literally rains from heaven directly into my infant's stomach"?

Now instead of saying our family breastfeeds infants whenever possible and convenient because it's free (in addition to purported health benefits for momma and baby), we'll make sure to spell out the entire shorthand of "free" in this conversations context and say it's because it doesn't require a physical outlay of actual cash of $20-$50 a month? I guess?
posted by resurrexit at 4:48 AM on April 22, 2016 [3 favorites]

Great article, people saying breastfeeding is "free" irked me so much when my son was an infant (sorry, resurrexit, but it did). Those little breast milk storage bags are expensive, the pump parts that needed to be replaced, nursing pads, lanolin, bottles. When I went back to work (at 10 weeks) I pumped once a day, for half of my half-hour lunch break in a windowless room, and it was soul crushing. I hated pumping so much, mostly I kept breastfeeding as long as I did because it was amazing for my metabolism and I could eat so much pizza and cupcakes. My son got a combo of breastmilk and formula for a year, and I kept nursing him daily until he was almost two. He's a great kid, healthy as a horse, but I remain unconvinced about the touted magical benefits of breastmilk. He also drank gallons of formula and it wasn't the toxic sludge some people on the internet make it out to be. We even used the cheapest Target / Costco brand formula we could get, because babies are expensive.
posted by banjo_and_the_pork at 5:11 AM on April 22, 2016 [8 favorites]

In the US, we DO acknowledge breastfeeding has a cost for poor women by including more food in the WIC benefit for women who are breastfeeding and need more calories to produce. But for women who are middle class, acknowledging the cost of breastfeeding would mean providing paid maternity leave with job protections. So instead we get this enthusiastic support for pumping as "the same thing." Which, it's great to have that available, but it's pretty obvious employers only support it because the alternative is paying for real maternity leave like a civilized country.

Breast-feeding or pumping is basically a full-time job, and it's an exhausting one, and it's depressingly physical (like, you have just submitted your body to another human for nine months; now do it for another year, but with way less sleep and way more surprise leaking. There's an emotional toll to losing that much autonomy for that long.).

Also, my babies never gazed lovingly at me while breastfeeding. They stared at a point in the middle distance and went hell for leather on the sucking. Dad and the rescue bottles got eye contact and grins. Mom was the utility provider. I still get kinda mad when I see advertising pictures of lovingly gazing babies breastfeeding.
posted by Eyebrows McGee at 5:24 AM on April 22, 2016 [40 favorites]

One thing I basically knew already, but has been confirmed by doing research during my wife's pregnancy is that there is basically no aspect of pregnancy, childbirth, or rearing that cannot be turned into a vector for vicious judgmental bullshit. It's a shame because there's all kind of information we need and sifting through the nonsense, the woo, and the blame to find the real kernels of truth has been like a second job before the baby even comes.
posted by Bulgaroktonos at 5:27 AM on April 22, 2016 [29 favorites]

You know what is free though? Lactation consultants. If you are in the US and have health insurance. Obamacare mandates that insurance companies reimburse lactactation consultant visits. This isn't well known but sure could help a lot of women.
posted by MisantropicPainforest at 6:08 AM on April 22, 2016 [3 favorites]

So instead we get this enthusiastic support for pumping as "the same thing."

[small voice] I...kind of liked the stimulation of being at work while still being able to produce milk. (And eating lunch at 11, and at 12:30, and maybe 2...that was fun too.)
posted by Ralston McTodd at 6:18 AM on April 22, 2016 [4 favorites]

No, it's legit great to have pumping available. Staying home with a baby can be soul-crushingly dull and women should have enough options to choose one that suits their temperament and parenting beliefs without sacrificing their career goals. But employers aren't all excited about pumping because they believe in pumping; they're excited about it because it means they don't have to offer real maternity leave.

I found lactation consultants the WORST part of breastfeeding, mine was super-shamey. I am angry I was forced to meet with her and angry she got paid for being a jerk face to me. I know there are good and helpful ones. Mine was awful.
posted by Eyebrows McGee at 6:35 AM on April 22, 2016 [27 favorites]

I'm so jaded about breastfeeding. I was SO enthusiastic about it when I was pregnant, I was going to exclusively breastfeed until my baby was two years old or so. Maybe a little formula when I went back to work, but mostly breastmilk. HA HA HA.

My milk never really came in. My baby lost almost a pound of his birth weight and all of our time for the first week of his life was spent trying to feed him, him screaming and flailing and hitting me in hunger-fueled rage, me sobbing. I remember weeping on the phone to a counselor from LLL (who was kind but ultimately unhelpful) that I was sure my baby hated me. And my poor husband, and mom just had to stand by helplessly while this little drama played out because they couldn't really help us. And it turned out, I haaated pumping. And got very little from it. I liked actually nursing my son when we could make it work, when my milk was actually flowing and he was in the mood to work to get it out.

What little milk I had dried up when I went back to work. Now when I look back and think about how I had to basically trick my son into nursing (wait until he was hungry and make him nurse before giving him a bottle of formula! Stick my boob in his mouth when he was half-asleep!) and getting up at 3am to pump, feeling like I had to explain myself to everyone (I have low-supply. Yes, I tried that. Yup, that too.), I feel all stressed and panicky. I find it almost painful to hear people talk about how well breastfeeding went for them and how great and easy and free and wonderful. It was not that way for us. It really spoiled my first week with my son. Breastfeeding had a cost, a steep one.

And I'm sure lactation consultants can be wonderful but an LC was the only person to shame me for feeding my son formula. That woman sucked but I still feel the sting of her judgment.
posted by Aquifer at 6:35 AM on April 22, 2016 [28 favorites]

Breastfeeding should be rated the same difficulty as, I don't know, walking part of the Appalachian Trail. You can maybe get through on your own without help, especially if you happen to be lucky/gifted, but things can also go horribly wrong and make you want to feel like dying, and the people who do best are the ones with lots of support, training, time and money. Lots of people drop out because the actual difficulty level was way higher than they were told/expected. And they often feel shame about it. And everybody and their dog has an opinion on how you should do it or what you did wrong.

My body just wasn't interested in making enough milk no matter what I did; I blame the trauma of my kid's birth (c/sec then complications) plus the flat-out abuse I received at the hospital, plus lack of support/time/money and of course my inexperience with a very difficult and daunting task. I no longer feel any shame for that "failure", but instead sadness and compassion for myself. And also white-hot rage at the brutality of how we treat birthing and lactating women in this country/society.
posted by emjaybee at 6:46 AM on April 22, 2016 [23 favorites]

8 years later, I am still bitter that I was not allowed to use my FSA money to purchase a breast pump when I went back to work because the government said "pumping is for the convenience of the mother." (That was the actual language in the rejection letter I got.) Talk about a kick in the gut when I already felt terrible about having to go back to work and leave my tiny baby.

I think breastfeeding ended up costing us nearly as much as generic formula did, when you add up the breast pump, milk bags, replacement pump parts, breast pads, and Fenugreek pills (which increased my milk supply but then proceeded to screw up my thyroid, resulting in more medical costs).
posted by belladonna at 6:56 AM on April 22, 2016 [6 favorites]

My favorite line from the article: "I tried all of the tricks to stimulate more milk production (yes, I tried all of the tricks, including the one you are thinking of suggesting to me right now)"

Because holy hell, *NOTHING* brings out assvice faster than creating and feeding a new human.

My thoughts on lactation consultants:
1) More people need to be aware that this is a thing and that it is covered by insurance. They need to fucking TELL YOU THAT at the hospital. And write it in the discharge paperwork. After my first child was born and my nipples fell off and I got thrush, I called the OB practice and they were like "... uh... we don't do boobs. I mean, I *guess* we could call something in for you, but we don't really want to look at them..." And I was LITERALLY going insane because the pediatrician only takes care of the baby, not the boobs. The OB would only take care of the crotch, not the boobs. I didn't have a GP. It was like, WHO THE FUCK TAKES CARE OF BOOBS????? NOBODYYYY. So yeah. Would have been nice to know that LC's were a thing.

2) My second baby, someone pointed out that I actually could see a LC and I even found one. And, while she did have some useful advice to offer (e.g. baby was jaundiced and instructed to nurse every two hours, but that was making her too tired to drink and me too tired to make milk, so LC advised breastfeeding every 3 hours followed by an extra ounce of expressed milk.) But other than that, the experience was.... horrible. My nipples were, once again, in bad shape, one worse than the other. So she was, like, let me see you latch on that side. And I said, look at this, this is horrible, the skin is barely attached, I don't know if I can do this. And she said, no, you have to do it, show me, latch her on. So I did and all the skin came off at once and my whole body clenched with the searing pain and I started sobbing and 2 minutes later LC took the baby off and weighed her and said, yeah, this baby isn't getting nearly enough milk you need to relax when you feed her.

Oh my fucking god, lady.

I bought nipple shields on the way home, and when I told her over the phone that I was using them, she told me to stop immediately. I clenched my teeth and remembered a good friend telling me, "Yeah, they told me not to use nipple shields because the baby would get dependent on them but I was like, which is better, a baby who needs a nipple shield to breastfeed or a baby who ISN'T BREASTFEEDING BECAUSE I COULDN'T FUCKING TAKE IT ANY MORE?"

Anyway, we got through the first few weeks and the nipple shields let me heal and then we weaned off of them and had the picture perfect as-advertised breastfeeding relationship from there on out (aside from all the goddamn pumping) and it was a lot of effort but otherwise pretty great.

posted by telepanda at 6:59 AM on April 22, 2016 [34 favorites]

It seemed weird to me that she left off the cost of more and nutritious enough food not to fuck up your own body while nursing, but I am guessing that's a function of either how cheap food is in the US and how willing people are to fuck up their own bodies in ways that aren't immediately noticeable (like losing bone mass)?
posted by ROU_Xenophobe at 6:59 AM on April 22, 2016 [5 favorites]

Does this seem silly to anyone else? Who actually says "free" in regards to breastmilk and means "literally rains from heaven directly into my infant's stomach"?

Number of people in this thread who have actually nursed human beings who don't seem to think it's silly: at least eight.

Number of people physically incapable of nursing and whose comments aren't inconsistent with thinking it's silly: two.
posted by ROU_Xenophobe at 7:06 AM on April 22, 2016 [30 favorites]

It seemed weird to me that she left off the cost of more and nutritious enough food not to fuck up your own body while nursing


I have to eat a TON of protein in order to keep my supply up, it's not like I can just have a salad for lunch because at some point later in the day my body's gonna be like "Okay, it's time to make up for the calories you missed earlier today. Bring on the smorgasbord."

(See also: not everyone loses weight when they breastfeed).
posted by vignettist at 7:59 AM on April 22, 2016 [5 favorites]

So I got triple the fun: breastfeeding, and pumping, AND formula feeding with the most expensive special formula on the market, sometimes all three in combination. I can say without a doubt that even paying what we did for formula, it was the least burdensome form of baby feeding by far. To leave the house, all you do is measure out the formula in one bottle, fill up another bottle with water, and you're good to go. By comparison, three years later, I still shudder with gut-level despair when I recall pumping at work on 3 hours of sleep and desperately trying to sort of, kind of, remain functional at work. And then return home to a baby who nursed 3x/night.

Breastfeeding itself was OK after the extreme marathon of the first few weeks, but still just meh overall. The best phase was probably during maternity leave, when I could just stick kid on boob and sit and watch TV for hours.

The worst part about breastfeeding, though, was that I almost starved my baby. He was not gaining the way he should, and yet the pediatricians never really said straight up "just give the kid some extra formula." Once I finally figured it out by necessity (when I went back to work and clearly couldn't pump enough) and supplemented, the baby rocketed from below the 5% to the 75%-90% percentile in weight. That was sobering. Even then, I went on to nurse him 2-3x/night until 10 months because I wanted to limit the amount I supplemented with formula.

Now that research has come out that casts serious doubt on whether breastfeeding has ANY benefits at all, I feel fairly duped by the whole experience.
posted by yarly at 8:04 AM on April 22, 2016 [10 favorites]

Now that research has come out that casts serious doubt on whether breastfeeding has ANY benefits at all, I feel fairly duped by the whole experience.

Ehhh... I appreciate this is a massively massively massively controversial and touchy subject, around here and in many other places too, but the state of research in public health at the moment is pretty soundly conclusive that there are positive health outcomes associated with breastfeeding. Not miraculous unicorn-tears medicine of cure-all wonder, but definitely positive health outcomes. So, yeah, don't feel duped on that bit at least?

(That's at a population level, not an individual one; it doesn't affect all areas of health at all; it doesn't mean breastmilk is magical and one drop will fix all illnesses; it doesn't mean that any given breastfed baby will be healthier than any given formula-fed baby; it doesn't mean that parents who formula feed are bad parents; and it definitely doesn't mean that the benefits of breastmilk for any given baby outweigh the downsides for that baby or its mother or their whole family by sticking to breastfeeding if it's not working, for whatever reason. But it probably does mean that even if the only thing we care about as a society is population health, even if we don't give a damn about women at all, we should put some effort and money and strategy into properly supporting mothers who want to breastfeed - not filling them full of "you MUST!" and then just shrugging at them when they hit problems, which I seriously think was the official strategy of some of the professionals I've met.)
posted by Catseye at 8:33 AM on April 22, 2016 [9 favorites]


My tiny infant failed to gain weight from breastfeeding alone, so I supplemented despite being a card-carrying LLL member.

Mom's who have breast and nipple pain shouldn't have to nurse. Parents whose toddlers kick shouldn't be guilted into co-sleeping. People who have pleasant experiences shouldn't deny or contradict the experiences of those who are not getting the pleasant experience. (Or when contradicting, please acknowledge that your lived experience is a data point, not a trend or a norm.)
posted by puddledork at 8:42 AM on April 22, 2016 [12 favorites]

Oh and speaking of the abuse at the hospital, in order to meet with the lactation consultant, I had to haul myself out of my hospital bed, gingerly trying not to disturb my c-section staples, and walk, hunched over and holding my 10-lb baby and the nursing pillow I was told to bring, down a long hallway to another room. Trying to keep my hospital gown on at the same time, looking like hell and having to dodge people. Nobody would help me, they were too busy. No she couldn't come to me.

By the time I got there I was woozy and weepy and nothing she told me helped anyway. PPD was setting in hard (closer to PTSD honestly) and I was shutting down mentally in self-defense.

That night I lay awake staring at the hospital room ceiling and sobbing, disturbing my roommmate (yeah, no private room) and wishing more than anything that I would just die. It seemed easier.
posted by emjaybee at 8:54 AM on April 22, 2016 [6 favorites]


I hated pumping so so so so much. The thing I remember most is sitting in my living room with a dear friend who is a female engineer and who grew up on a 60 head dairy farm. She was watching me get all the pumping stuff out and ready and noted how I had to sit slightly hunched over in order to get everything working properly, and said to me "they put much more time and effort into designing machinery to milk cows than to pump, don't they."

And they do.

Once the first three horrible days were over, I actually greatly enjoyed nursing my son, but he got much more formula than breast milk, and although I know it can't be true there is a small part of my brain that wonders that had I simply been able to nurse him more if he would be more neurotypical. I know he wouldn't really, but ......
posted by anastasiav at 9:16 AM on April 22, 2016 [3 favorites]

I thought breastfeeding was so much easier than pumping and personally didn't want to share the bonding time with my son, I didn't want to be forced to pump and give my child over to others so I can go to "work" to do "real" work when suddenly by virtue of me handing my child over to someone else, the work of caring for him suddenly become "real". When I do it it's not real, it's laziness, but when someone else does that work it's respectable and worthy of pay. Ok shitty pay, and not THAT respectable, let's be clear childcare work is treated as unworthy of payment that matches "REAL" career pay for women.

I like nursing but yes it was work and getting so immersed in it that is was comfortable and easy took me away from focusing or caring about the kind of business, detail, task oriented work that people wanted to push me and so many other new moms back into right away.

In short. we need a year of maternity leave. This encouragement to breastfeed while in the workplace is bullshit. We need affordable (ideally free) daycare available to women when needed and desired, pumps to be accessible when desired or needed, AND ALSO year long maternity leave provided by the government not based on an employer (since employers tend to find workarounds, what if the woman was working part time or unemployed etc).

We also need to value childrearing as a community service outside of institutionalizing childhood and support parents financially who would rather do it themselves but need financial supports to work part time, spend afternoons and/or summers with their children or have a stay at home parent in the home.
posted by xarnop at 9:25 AM on April 22, 2016 [12 favorites]

Actually, resurrexit, I am spending way more than $50/month to breastfeed, just on extra food for myself. It's not like my body turns oxygen and water into breastmilk. It requires a great deal of caloric intake to produce milk. Prior to pregnancy, I ate probably 2/3 as much as my husband (who outweighs me by 50+ lbs; neither of us is overweight). While nursing, I've eaten between 1.5 - 2 times as much as him, depending on whether my child is having a growth spurt and how much she is nursing. And I can't just eat toast or something - I need large amounts of protein, fat, and fruit/veggies to feel satisfied and not wake up too hungry to sleep in the middle of the night. So, yes, there is an actual cost outlay to my milk production. And given that I've nursed now for almost two years, it's quite a significant amount of money spent.
posted by john_snow at 9:29 AM on April 22, 2016 [18 favorites]

I had kind of a weird situation overall, in terms of breast-feeding: I wasn't able to actually nurse at all, my daughter didn't latch on because of physical issues, but I pumped daily and fed solely with breast milk for nine months. I think there's this perception that either you have your baby physically on your breast or you can't breast-feed, but that is not my experience at all. My daughter got all of the beneficial results of breast milk, and I didn't feel like my body wasn't my own. I pumped milk every four hours, except at night, and found myself producing so much that I had to start freezing it, as she couldn't drink that much. It was kind of nice for when I wanted to go out and get drunk or eat a billion onions, or something that wouldn't go well with breastmilk. By the end of the nine months, when I stopped, I had a three month supply of frozen breastmilk, that we supplemented with afterwards.

It was pretty free for me, though I had military health insurance. My Medela pump was included in that, as well as some nursing pads and initial supplies. Lanolin was prescribed to me by doctors and so I didn't have to pay for that. I only brought the manual pump with me if I was going out in public and might need to give her a bottle. Manual pumps, I could get about one bottles worth in about 15 minutes. With mechanical pump, about three bottles in 20. At first I did use those expensive nursing bag, but then after the first week I just use Ziploc's. It worked fine And was a lot cheaper. There's this perception that if you don't get the fancy baby stuff, they are somehow being a bad mom. But I think we really need to rethink that. You don't need a special nursing bag to tell you precisely how much milk is in each bag. You just need something that won't spill.

But it's also worth noting that when I was nursing, I was working at the NSA at the time, which has marvelous accommodations for nursing women. There is a locked room on multiple floors, with a passcode, that is only given to nursing women. The room is about the size of maybe two bedrooms together, and has seating at outlets for your plugs. There's magazines and things to read as well. So no one ever tried to interfere or intrude there, and you could be 100% certain the only people in there seeing your breasts were the other nursing ladies. So you didn't really have to worry about if your breast was exposed or trying to make sure that no nipple was seen.

I think the actual answer is that for some women, nursing is pretty easy. But for others it's really hard. I feel like sometimes we swing from one to the other, either saying that nursing is easy for all women and all women should do it, or that nursing is really hard for all women and all women should get plaudits for suffering. I personally had a wonderful time nursing, I liked the peace and quiet every few hours, I liked knowing that I always had milk with me just in case, I liked not having to buy formula, I liked the health benefits of my daughter not getting sick. But for some people, especially for low producers, it may not be worth it. And I think we need to be OK with that and not shame ladies for not being Good Enough mothers or whatever.
posted by corb at 9:34 AM on April 22, 2016 [2 favorites]

Oh, I suppose it's also worth noting that I'm a fat lady. So I didn't really have to eat extra food, my body was just burning stored fat and all that stuff.
posted by corb at 9:36 AM on April 22, 2016

Ugh. It sounds like a lot of the unhappy BFing stories are about the lack of support given to the moms. That really fucking sucks. I dropped my OBGYN in favor of a independent midwife specifically because I felt like too much of a number in the health system, and because she (the OBGYN) was, as alluded above, "crotch-only" focused. (I cried during our first hearing of the heartbeat and when I asked to hold my husband's hand, she asked, "Why? Are you scared?" WTF, lady? You're a seasoned professional and haven't ever seen people be emotional about having their first kid before?!?) But, the IBCLC that my midwife brought to our appointments wasn't very helpful with my latch the few times she was there. It was the longtime LLL leader who helped fix our latch issue.

The first 6 weeks were the hardest, bloodiest, most painful for me. Somewhere between 6 weeks and 10 weeks, it got easier (thanks to that LLL leader). We have two LLL meetings a month around here, and they were my sanity savers. I still go to the evening one every month, now, and the kiddo is almost 3 years old. I was lucky that I have a 1 hour lunch break at work and the daycare was close by, so I'd take my lunch break to nurse my baby. That was wonderful. Pumping was easy for me, thankfully, and our office admin lady got us tall fancy blinds to put on the interior conference room window, so I could pump in peace, with a view of the river. I was able to pump some extra and donate to HMBANA. Our state only protects a mother's pumping time up to 12 months, so when I asked my boss if I could keep pumping past that, due to still figuring out my kid's food sensitivity, he said, "Do whatever you need to do for you and your family. That is the most personal thing in the world. It isn't a hassle for us at all. I get more interruptions from [coworker]'s long run schedules than from your pumping schedule." So I was able to keep pumping through 17 months, then getting my pump refurb'd so I could give it to a coworker's young friend who couldn't afford a good pump. And kept on nursing at lunch time til 22 months when I was ready to have my lunch breaks back for just me.

It wasn't easy to get here, at almost 3 years of breastfeeding. One time I had to print out my state's statutes regarding being able to breastfeed wherever the fuck I was "otherwise authorized to be" to my daycare provider because she wanted to be "proactive" and not have to field questions from the preschoolers (or their parents) if they happened to be in the toddler room when I nursed my toddler at pick-up time. I had to tell her "IT IS MY LEGAL RIGHT". You have to tell these small children about other body functions like pee and poop, you can do the same as with breastmilk. "But what if they ask what's going on?" "You say, [child] is getting milk from his mama, then redirect to a different thing as usual." If I wasn't as stubborn and opinionated, she most definitely could have compromised our breastfeeding relationship.

Food sensitivities were the bane of my kid's second 6 months. I mean, by that time, the need to breastfeed wasn't just my kid - it was me and my body, too! So casual suggestions of "just give him formula" or "just pump instead" or "maybe he's allergic to your milk" were so insensitive, and from some of my closest family members so it hurt me even more. Then health care professionals only caring for the 10 minutes they are in the room with you when there is a hurting! baby! is so frustrating and helpless and just made me feel alone in the world as the only caregiver for this little child. Literally, the only one who could give a care for that little hurting child.

Support of motherhood and parenthood is so fucked up in this country.
posted by jillithd at 9:39 AM on April 22, 2016 [4 favorites]

"just on extra food for myself. It's not like my body turns oxygen and water into breastmilk. It requires a great deal of caloric intake to produce milk."

For real. I ate like Michael fuckin' Phelps, 6 meals a day, with meat at every single one (I'm otherwise not a big meat eater), as calorie-dense as I could make them, and I was still freaking STARVING all the time. It was a significant uptick in our grocery bill.
posted by Eyebrows McGee at 9:49 AM on April 22, 2016 [2 favorites]

Oh you know on second thought it might have not just been fat-lady stuff - I was also exercising every day because Army so I /already/ ate like a ravenous wolf. It's possible that once you're already eating like your starving the difference at that level is minimal.
posted by corb at 9:52 AM on April 22, 2016 [1 favorite]

My aunt is a social worker who works with eldercare services and wants to change the face of that, in her work she has found it actually costs a lot less to pay family members a wage for caregiving in the home or for hiring in home care rather than institutionalizing the elderly which costs a lot more money overall.

I wonder if we were actually going to pay for full daycare and afterschool care and summer for any child that needed, if it wouldn't actually be cost effective to give parents who want to opt out of the additional care options a fraction of what would be spent on the institutionalized care.
posted by xarnop at 9:59 AM on April 22, 2016 [3 favorites]

Ugh. It sounds like a lot of the unhappy BFing stories are about the lack of support given to the moms.

Nope. I just found breastfeeding, and especially pumping, not all that great, especially in light of the minimal (if any) benefits of breastfeeding. If by "support" you mean "one year paid maternity leave" ... that would be great, but mainly in order to take care of my baby, not to breastfeed. My doctors in fact supported breastfeeding so much that the basically let me starve my baby. And this started in the hospital where I gave birth, too!
posted by yarly at 10:02 AM on April 22, 2016 [4 favorites]

Ehhh... I appreciate this is a massively massively massively controversial and touchy subject, around here and in many other places too, but the state of research in public health at the moment is pretty soundly conclusive that there are positive health outcomes associated with breastfeeding. Not miraculous unicorn-tears medicine of cure-all wonder, but definitely positive health outcomes. So, yeah, don't feel duped on that bit at least?

Nope. First of all, even the population-based benefits are minimal. Second of all, this is sort of the whole point: breastfeeding is so costly to women in many ways that it is frankly sexist to just blithely say "oh but the population benefits are so great!" without actually taking the costs into account. It's like recommending that poor people should earn more money so they stop being poor. Well, ok ... Third, I am very persuaded by the "discordant siblings study" that compared pairs of siblings where one breastfed and the other did not. This approach allowed for far better controls of other factors since the children were being raised in the same family. It found barely any difference between breast and formula fed children. Ironically asthma (which my son has!) was actually higher in the breastfed group ...
posted by yarly at 10:08 AM on April 22, 2016 [17 favorites]

Yeah I think a major problem with "Support" for moms with breastfeeding is that is too often essentially LECTURING rather than actual support that involves paid maternity leave during the breastfeeding year/s, free breast pumps and total understanding that breastfeeding does NOT work for everyone for a myriad of reasons (including just emotionally not being able to deal with it). Instead lecturing, judgment, shaming, and controlling (like so much of social work and "helping" professions can happen particularly when it comes to mothers) stand in for actual support.
posted by xarnop at 10:14 AM on April 22, 2016 [10 favorites]

I hated breastfeeding so much the first time around (I ended up pumping exclusively because her latch sucked, her appetite sucked, and I just mentally couldn't handle beeing physically attached to a baby all the time) that I decided to formula feed my second right off the bat. Please, let me tell you about the epic amount of SHIT I got from the lactation consultants and the nurses at the hospital. The most benign example being a mournful "oh, you're going to have to learn to live with this decision" as if I'd somehow decided to throw my baby out with the recycling.

The cost of formula? Pales in comparison to the emotional cost of breastfeeding, for me. I was a shell of a woman for months, the thought of doing it again brought me to tears throughout my second pregnancy until I almost had a panic attack trying to get my screaming son to latch in the delivery room. Fuck you, mom guilt, bring on the bottles!
posted by lydhre at 10:28 AM on April 22, 2016 [15 favorites]

Nope. First of all, even the population-based benefits are minimal. Second of all, this is sort of the whole point: breastfeeding is so costly to women in many ways that it is frankly sexist to just blithely say "oh but the population benefits are so great!" without actually taking the costs into account.

Yes, honestly. I mean, you're free to disagree or whatever, I'm just saying what the current overall state of the research is in the public health field. But that isn't really the point of the thread, so there's no point hashing it out in detail anyway!

I really don't think it's fair to accuse me of being blithe and sexist and not taking costs into account in this discussion, though. That's quite a big jump from me saying that we should provide better support for breastfeeding mothers, and an even bigger jump from me discussing my own experiences and the unacknowledged costs of breastfeeding for me personally and for women on a wider level upthread.
posted by Catseye at 10:50 AM on April 22, 2016 [3 favorites]

Well, now, even the purported population-based benefits are not necessarily all that, with reexamination of data. See a recent blog post at science-based medicine which discusses it.
posted by gaspode at 10:56 AM on April 22, 2016 [9 favorites]

(Side note: I absolutely hate breastfeeding stock photos that show a bad latch. /peeve)
posted by Eyebrows McGee at 10:59 AM on April 22, 2016 [3 favorites]

If it helps to clarify: I absolutely know that if my baby had refused to latch, I would not have exclusively pumped, I'd have just switched to formula. Ditto if breastfeeding had been painful, or any other big issue with it. People who carry on despite those obstacles, good for them, but for me personally the costs would have outweighed the benefits at that point and I would have moved to formula. And for me and my family that would have been the right thing to do.

I'm absolutely not saying that people should breastfeed at any cost. Really. No, they shouldn't.

(Re population benefits - look, I linked to the recent Lancet series upthread, I put in a lot of caveats about how this does not outweigh somebody's individual situation and doesn't mean breastmilk is some magical unicorn-tears medicine, and like I said this is really not the point of the post, so I'm really not going to get into it other than that.)
posted by Catseye at 11:05 AM on April 22, 2016 [4 favorites]

After the kiddo was born, I was on a breastfeeding support board, where the participants where telling the most ridiculous (in their opinion) reasons for not breastfeeding they'd heard. One wrote that a friend had said the pain was worse than labor, and wasn't that dumb, because labor is soooo painful. And I thought, labor is more intense, but it doesn't last for weeks, you don't spend every hour dreading it, they have great drugs for most women, and yes, in my experience, drug-free labor was preferable to that first three weeks of trying to nurse. Shortly after that, the board's web server failed, and all the accounts were wiped, and I didn't go back.

I hate, loathe and despise the conflation of bottle feeding with child abuse that certain extreme proponents make. It is counter productive, and makes parents, especially moms feel like failures when they are most emotionally vulnerable.

I don't know why parents are so invested in making everyone else raise their kids exactly the same way. Is it that someone doing it the "easier" way makes us feel stupid that we did it the "harder" way, so we need to predict doom and gloom when anyone chooses not to martyr themselves? We don't know what works, won't admit it, and panic at the reality of how little control we have over our offspring?
posted by JawnBigboote at 11:28 AM on April 22, 2016 [12 favorites]

Could we perhaps agree that new moms need support with regards to feeding a baby, and Feeding Consultants should help moms make informed decisions to breastfeed, supplement, or not breastfeed, where all options are on the table?

In my imagination, they would LISTEN to the moms and then say things like:

* It sounds like you had a really bad experience breastfeeding last time. You're certain you don't want to try again? OK, here is information specific to feeding babies formula.

* It seems like you're having a lot of nipple pain and it's driving you to the breaking point. A lot of moms experience this at the beginning. For most people it clears up in about 3 weeks and doesn't come back. But that isn't true for everyone.
- OK, so you think you can power through for a few more days? Here are some things you can do that will help (olive oil ointments, air, giving a whole feeding on one side and alternating, etc).
- You're really on the edge but want to make a last ditch effort? Here are some things you can consider (nipple shields, pumping alternate feedings, supplementing a little with formula)
- You've had it and that's enough? OK, here's some information about feeding your baby formula.

* It seems like your baby might not be getting enough to eat.
- Here are some first line things you can try. Let's check back soon.
- You want to do everything you can to avoid/minimize formula? Here are some things that require extra effort but will maximize breastfeeding opportunities.
- You don't mind some formula but you don't want to stop breastfeeding either? Here is some information about supplementing with formula. It might slow breastfeeding down a bit, but it doesn't mean you have to stop completely if you don't want to.
- This is too frustrating and you're Done? Here is some information about feeding your baby formula.

Basically, a whole lot less ZOMG YOU'RE DOING IT WRONG and a whole lot more sharing of aggregated knowledge like, X is rough but usually short-term and a lot of people get through it. When Y happens, it's not too likely to improve. How do you feel about Z? OK, I have some ideas that might help you.

The key is ideas that might help YOU, the actual person with the actual problems. I think this mythical unicorn person would probably have been super helpful to the happy breastfeeders, the unhappy breastfeeders, AND the formula feeders in the thread. Sadly, of course, you can't really legislate unicorns into existence.
posted by telepanda at 12:07 PM on April 22, 2016 [19 favorites]

The key is ideas that might help YOU, the actual person with the actual problems.

The problem with this approach is that it is set out to favor breastfeeding, when the benefits of breastfeeding are wildly overstated. I think unless you start out dispelling that belief then you can't really have an honest conversation about it.

Women don't make the decision to embark on incredibly painful and exhausting regimens like pumping, nursing, and bottle feeding around the clock (like some LCs in my town recommend to a lot of new moms with supply problems) and/or severely restricted diets unless they believe that breastfeeding is incredibly important. It's important to make sure that before they take such costly efforts that you make sure they are informed about the degree of benefits breastfeeding actually offers.
posted by yarly at 12:12 PM on April 22, 2016 [6 favorites]

emjaybee, I'm so sorry to hear you had such horrible mistreatment in the hospital.
This thread is actually bringing tears to my eyes, because I'm not sure I've ever heard such honest accounts of breastfeeding and pumping before. I consider breast feeding my 2 kids to be two of the greatest accomplishments of my life. It was work and it was hard. And I did my best and was lucky to be able to do so, but I still supplemented with pumping and formula. And I didn't nurse for as long as I was "supposed to" because of supply issues but also because I was DONE. The LC consultants at the hospital where I had my daughter were some of the meanest people I've ever encountered anywhere. I still get so angry when I think of myself, alone with my first baby in a crappy, shared hospital room and those judgemental women yelling at me that I wasn't feeding my baby. I did learn to nurse, but it was despite their "help." The LC consultant with my 2nd was much better (well the first 2 weren't, but the woman who stopped by last was great). She saw the terrible bruising and scarring I already had, that I was clenching my whole body and crying, and she gave me a nipple shield! I know, I can't believe it either! I used that shield for weeks afterward, but didn't tell most of my friends because I was ashamed. Which sounds ridiculous, but that's how much shame and judgement moms face. And yes, pumping stations are necessary, but they're a very small step in the process of actually supporting moms and babies.
posted by areaperson at 12:29 PM on April 22, 2016 [4 favorites]

"* It seems like your baby might not be getting enough to eat.
- Here are some first line things you can try. Let's check back soon."

One thing that would help a LOT with this would be providing loaner baby scales and teaching parents how to weigh and track at home ... a lot of times when mom suspects baby isn't getting enough from the breast, the presented solution is daily treks to the lactation center for weigh-ins, or purchasing an expensive scale that you will use for two weeks, or just waiting a week (which is an eternity for baby to be hungry and underfed) between weigh-ins. Then you could check in by phone and have a much faster, better idea of when intervention is necessary.

(Of course there'd be some judgment calls about whether parents were competent to manage this on their own and you wouldn't want to over-intervene and so forth, but anything has to be better than the mother of a two-week-old making daily 40-minute round trips for weigh ins, or just not getting weigh-ins at all for a week.)


I had a pretty easy go of breastfeeding (cluster feeding is balls, but other than that -- good latchers, no production problems, no significant pain beyond getting started, compliant boobs that didn't get too complainy if I missed a feeding), and I STILL have pretty mixed feelings about the entire process -- from the judgmental, rather than supportive, attitudes you encounter everywhere (even from the people claiming to be the support); to the way it's presented as a life-or-death decision that will ruin your child if you choose wrong; to just the physical and mental exhaustion of being physically attached to another human for so many hours for SO MANY MONTHS. My younger son I fed more than 3,000 times in 12 months. (He really didn't slow down on the "every three hours" thing until 10 months.) THAT'S JUST A BIG NUMBER. I didn't want to be touched by anyone, ever, when I was breastfeeding because I got SO TIRED of being touched all the time. Not my husband, not my other children, not even my cats. The physical and emotional drain of breastfeeding definitely contributed to my post-partum depression (and everyone kinda acted like "stopping breastfeeding" was not even a discussable option for treating PPD, while in the end it was the only thing that helped for me). Both times I didn't realize how miserably physically exhausted I was until I stopped and a few days later was like "OH HELLO ENERGY, I FORGOT WHAT YOU FELT LIKE!"

And even just the little things. Sure, it's convenient not to have to wash bottles all the time or pack up formula to leave the house (although, really, packing up formula not that big a hassle!). But the trade-off is that a quick trip to Target had to be timed around my best guess of when the baby would be hungry again, since my husband couldn't feed him. Every activity I wanted to do had to fit in the two to three hour gap between feedings, and not everything does. And you can't breastfeed on the road, and while I actually COULD do it while walking around and basically had no shame about doing it in public, there are better and worse locations. I felt like the INconvenience of MY BODY always having to be ready to feed outweighed a lot of the convenience of not having to carry around bottles.

Anyway, sometimes people say, "Aren't you glad you did it for a year?" And I'm like, I guess? I mean, I'm glad I fed my baby as it is a key part of having them NOT DIE. I'm not sure I particularly care about the chosen method. I'd probably be just as glad I fed them formula? They'd be just as alive.

(I will say if I'd had to pump to provide breastmilk for whatever reason (work, latch issues, whatever), I wouldn't have done it -- I found pumping an utter misery and there is no way I could have kept it up. I did it every now and then if I was going to miss a feeding, but really just for my own comfort and just enough to stop the pain of missing a feeding ... I found it so uncomfortable that walking around feeling like my boobs were going to explode was preferable. It's so idiosyncratic, I had friends who pumped like champs for 18 months and were totally unbothered by it, but I could barely stand it.)
posted by Eyebrows McGee at 12:34 PM on April 22, 2016 [15 favorites]

One thing that would help a LOT with this would be providing loaner baby scales and teaching parents how to weigh and track at home ... a lot of times when mom suspects baby isn't getting enough from the breast, the presented solution is daily treks to the lactation center for weigh-ins, or purchasing an expensive scale that you will use for two weeks, or just waiting a week (which is an eternity for baby to be hungry and underfed) between weigh-ins. Then you could check in by phone and have a much faster, better idea of when intervention is necessary.

When my wife was in the hospital with our first baby, I signed up for a home nurse visit that was offered for free as part of a local program. I did it kind of as an afterthought, but after a difficult start to breastfeeding and a lot of angst and stress, having a very nice nurse come to our house, weigh the baby, and tell us she was doing fine was SOOOOO GREAT. I really hope other people have access to programs like that one.

And man, after hearing some of the stories about OBs here I want to stop by our midwives' practice after work and just give each and every one of them a hug. I'm sorry you all had to go through such intense bullshit.
posted by selfnoise at 1:00 PM on April 22, 2016 [1 favorite]

You know what I just realized would be great? Wetnurses or the ability to sell breastmilk in this country. I'm just hearing women who wanted to breastfeed for the benefits, but hated breastfeeding, and thinking of when I had so much milk in the freezer I couldn't have ice cream, and I'm sure I wasn't the only one who was just like "my breasts flow forever" and could have used some extra money. Why is this not a thing?
posted by corb at 1:45 PM on April 22, 2016 [1 favorite]

A combination of difficulty ensuring safety/purity of human breastmilk for sale, and the usual concerns about exploitation that come up whenever we discuss the sale of human bodily products.

Also it turns out to be so expensive that only rich women can afford it, so it turns into "rich women can buy poor women's intimate bodily labor" pretty quickly. Private sales of breast milk also drive up the cost and drives down the supply for NICUs who try to get donor milk and drives donors out of the donation economy into the pay economy ("The nonprofit Human Milk Banking Association of North America estimates that there are 4,000 moms using its banks across the country and that it would take 60,000 to meet the demand for milk in hospitals nationwide.").

The profits in the for-profit market mostly go to the milk bank, which pays the women providing the milk around $1/oz and collects around $4/oz from buyers. If you opt to find a buyer directly, that market it is fairly heavily infested with creepy dudes with boob fetishes, who can afford to buy breastmilk more easily than mothers of newborns can and have many fewer concerns about purity and health.

Then there's a lot of problems with ensuring the safety of the supply, both that the women providing it aren't taking problematic drugs or whatever and that they don't have any disqualifying milk-communicable diseases; ensuring that it's safely stored from one end of the production chain to the other (do you trust random people's freezer settings?); ensuring that it isn't contaminated with bacteria ... and then there's actually very little data on whether frozen-and-thawed human breast milk retains the nutritional content and other virtues of fresh breast milk.
posted by Eyebrows McGee at 2:00 PM on April 22, 2016 [6 favorites]

If you opt to find a buyer directly, that market it is fairly heavily infested with creepy dudes with boob fetishes, who can afford to buy breastmilk more easily than mothers of newborns can and have many fewer concerns about purity and health.

Every time I think I find something it is impossible for creepy men to ruin I am sadly disappointed. RUINERS.

(I appreciate all the other very solid and horribly fascinating stuff! My ideas on this may be like 5 years and many countries out of date.)
posted by corb at 2:07 PM on April 22, 2016 [1 favorite]

Yeah, I donated to the HMBANA and just got receipts for tax purposes, having to value it myself. I had an oversupply for a few months, so donating it was what I did. Before baby, I was a regular blood donor. I figured that breastfeeding was a unique time in my life that I could donate breastmilk, so I did that. One day, when my little milk monster is a little more monster than milk, I hope to go back to regularly donating blood. Just not yet.
posted by jillithd at 2:13 PM on April 22, 2016 [2 favorites]

And also white-hot rage at the brutality of how we treat birthing and lactating women in this country/society.

posted by sutureselves at 2:16 PM on April 22, 2016

Corb I recommend the podcast linked to in the first comment, it goes into detail on the situation with selling breast milk and nursing as a service in the U.S.. It's quite good!
posted by selfnoise at 2:27 PM on April 22, 2016

The LC consultants at the hospital where I had my daughter were some of the meanest people I've ever encountered anywhere.

I'm thinking it must be a job requirement.
posted by sobell at 2:39 PM on April 22, 2016 [4 favorites]

Talking about costs, though, HMBANA gave me a suggested valuation of my breast milk at about $4 an ounce, if I remember correctly. And if the average baby takes in 1-1.25 ounces per hour on average, the first six months is

1.25 ounces / hour * 730 hours / month * 6 months * $4 / ounce = $21,900.

posted by jillithd at 4:02 PM on April 22, 2016 [9 favorites]

The LC consultants at the hospital where I had my daughter were some of the meanest people I've ever encountered anywhere.

This was my experience as well, except I gave birth with a midwife at a very reputable freestanding birth center (ie: almost a home birth, but not at home). While trying to teach me how to get him to latch a few hours after birth, she would just keep explaining the same thing, using the exact same words, BUT LOUDER each time, and got exasperated when I didn't/couldn't get it.

We were saved by a friend who is an OB nurse, who came to my house and really helped me sort out both latch and also nursing while lying down, but without her, I would have given up within a few days.
posted by anastasiav at 4:59 PM on April 22, 2016 [4 favorites]

I was lucky to have had a good experience with my home-visit midwives and lactation consultants. My daughter was born with a complete tongue-tie, but while in the hospital as far as they could tell she was latching okay (because you can totally tell on day 2), so they sent us home rather than fixing it in hospital. I spent the first night home "sleeping" sitting up on the sofa - which caused my episiotomy stitches to come out leading to an infection shortly thereafter which took over 8 weeks to fully heal - holding my daughter and just swapping sides every 45 minutes when she started screaming for food. Both sides were extremely painful, but my left side was so bad I'd start crying in panic before putting her on. But "it's always a little sore at the beginning," they said. A friend of mine put it this way to explain it to her husband - imagine your child's health and well-being depending on you attaching a snapping turtle to your testicles for 20+ minutes every 2 hours. How would you deal with that?

A midwife took pity on me during a home visit the following day, realizing that my daughter was simply unable to efficiently get enough milk, and let me borrow a hospital grade pump until the one I had ordered would arrive, and told me to supplement with formula. I had a complete emotional breakdown - three days in and I was already using artificial nipples and formula, I was a failure, blah blah. I got an appointment with a hospital lactation consultant a few days later, who ended the session by handing me nipple shields, which made an immediate difference; within 48 hours I had her off formula completely and I could stop pumping. The nipple shields got us through the next few weeks until we could get an appointment with someone to fix the tongue tie. After that, she was back on the boob normally within a couple of days, and happily breastfed till about 9 months; she was an early teether and by that point she had so many teeth and such an interest in the outside world to distract her that I was being bitten regularly during feedings, and fuck that shit.

My best friend's son is about five weeks younger than my kid, and she's still nursing him now at about 16 months, but it took about six months of using nipple shields and dealing with monthly bouts of mastitis (involving courses of antibiotics and missing work) to get her there.

My complaints about the entire thing:
- I know this ties in with dismissing womens' pain, but to just tell everyone in the hospital that "yeah, it's supposed to hurt" is extraordinarily harmful. It's not supposed to hurt *that much*. "Sore" and "excruciating pain that makes you cry and want to give up and you would if you weren't being guilted by everyone into accepting the pain" are two really, really different things.
- The dismissal of the fact that while dealing with the "really painful" part of breastfeeding, our bodies are also recovering from incredibly physically and sometimes mentally traumatic work, and come on, EVERYTHING hurts
- Pumping when you're exhausted and inexperienced with your first also means you do stupid things like forget to attach the bottle to the pump, or don't screw the lid onto the bottle tightly enough, resulting in the loss of the few mL of milk you managed to pump after 10 minutes, which is a whole other thing to have a breakdown about (and of course results in a screaming hungry baby)
- Pumping sucks. At least breastfeeding you can do in front of other people. For pumping I had to go confine myself to my bedroom while my parents fed my daughter bottles (since you of course have to pump every time the kid eats at that stage, and if you wait till after the kid eats it might mean you don't get a nap in between feeding sessions every two hours, which means no sleep at all). In those early weeks, going out was really hard when I knew I had to pump so frequently to keep my supply going in a vague hope we'd get back to normal breastfeeding. Potential power loss during cyclone season here was a serious concern - 48 hours or more without power (typical here) would mean a loss of all the milk I had stored, not to mention an inability to pump (since my manual pump and I didn't really get along).
- It is a lot of time. It's all on you. You can't share the load. It does feel like a loss of body autonomy. You can't just have a drink or go out for an evening or do something like that without having to plan and accommodate. Nursing bras are not sexy and don't make you look nearly as good as a regular bra. Nursing-friendly clothing, which you have a very limited amount of because why spend lots of money on things you'll only wear for a short time? is sort of "you get what you get" and gets really old when you're rotating the same three shirts every few days. I was proud I was able to do it for as long as I did, proud we overcame all the challenges at first, and yes, if we have another I'll definitely try to breastfeed again, but it was not easy, it was not no big deal, and it certainly did not feel "free."
posted by olinerd at 5:18 PM on April 22, 2016 [12 favorites]

I was able to nurse both kids just fine I had no pain, no real production issues.
I got hold of a book called 'Nature'sChildren' lots of good advice.
I prepared my breasts ahead of time. That is key! Whether breast - feeding goes easily, or iit's a terrible experience, it's a full time job.
Caring for children is a full time, undervalued job whether you feed them formula or you breast - feed. It's the absolute end of how life was before children.
Jobs, marriage, the other children if you have them, friendship, all are affected. We don't think about it in our culture. We just think of getting on with all those other parts of our life.
Of course that's not how it really works. Those children, breast or bottle fed come first now.
posted by Katjusa Roquette at 5:21 PM on April 22, 2016 [1 favorite]

I would totally wetnurse, 100%. Send me your babies.

That is, at least now that I know what I'm doing. The beginning was tough, and there are so many things I'd do differently next time, if there is one. I'd push for a tongue tie diagnosis sooner, I would never ever touch a pump (hand expression is more effective and efficient anyway!), and I'd work on feeling less ashamed at the fact that my child and I were a dyad. I mean, we still are, even well after 2. Breastfeeding means we have this whole emotional biological feedback thing happening still and I still have to deal-maybe more than ever before-with pressure to server that, and I just... Don't wanna.

It's not for everyone but it's been a life experience that has been really important to me.
posted by PhoBWanKenobi at 8:53 PM on April 22, 2016 [5 favorites]

I just want to say, I am literally breastfeeding an infant as I type this on my phone: I love this thread so much. I have had relatively good experiences breastfeeding - not perfect, definitely earned the "lactation consultant made me cry" badge while recovering from my daughter's birth - but it is so nice to see other women laying down Real Talk in public about what a fucking grind breastfeeding is. It takes a hell of a toll, across so many different aspects of a woman's life. The time, the physical pain, the career consequences, the disruption of adult relationships, the paraphernalia, you name it. It is brutal.

And here I am doing it again.
posted by town of cats at 9:29 PM on April 22, 2016 [4 favorites]

Oooh, I have thought of more unacknowledged costs!

(And this is in the context of finding breastfeeding a really good and positive experience overall - one that was fairly straightforward from the start, definitely easier than formula would have been after the first couple of months, and probably helped me avoid falling fully into perinatal depression after spending most of a horrible pregnancy getting closer and closer to the edge of the pit. For me for me for me, I am not saying that my experiences count more than anyone else's.)

So, things that were a cost, financially and otherwise:

- breast pads. I know these are mentioned in the linked article, but I am mentioning them again just because they were the biggest ongoing cost I had, even not counting the Washing Machine Incident. I thought I would need them for the first few weeks, maybe - I ended up needing them for eighteen months. And the washable ones never worked as well as I'd wanted, and the disposable ones felt like such a waste.

- biting, which fortunately only lasted for a couple of weeks, but dear Lord ouch. This was at 4-ish months before she had teeth (you might think a bite without teeth wouldn't hurt but you would be oh so wrong), and most of the advice I could find for discouraging biting was aimed at older babies who could understand things like cause - effect a bit better, so that didn't work.

- stress about my baby bonding with her father. In retrospect this was totally unfounded - she'd have happily climbed over my head to get to her dad from pretty much the day she was born. But at the time, when I was totally new to all of this, I knew so many people who talked about the importance for them of Dad being able to share the feedings "so he can bond too", and stress stress stress does that mean my baby won't? (Not even trying to claim this was rational - I was in that weird postpartum haze at the time - but it was genuinely stressful.)

- having to awkwardly discuss my breasts with people, in the context of having to make particular arrangements to feed my baby. So for one example, I had an assessment/interview day at central government offices on Whitehall, which I was already really nervous about, and I had to call ahead and say "so, um, this is a ten-hour day, I'm breastfeeding, and if I don't have time to express milk or leave to feed my child during the day, I'll end up with some painful health issues as a result, so... um... any chance of scheduling that in?" This ended up not being a problem (they actually arranged things so my husband could bring her in at lunch for me to feed her there -she was on the security list and everything), but just asking felt so weird and awkward at a time I was already stressed enough about the day.

- stress of worrying about my milk, due in large part to various very well-meaning friends and family suggesting problems with said milk as an explanation for anything my baby ever did. Baby acne? "Maybe it's something you're eating - have you tried cutting out citrus?" Evening fussiness? "Do you think it's something in your milk upsetting her?" Not sleeping through the night at 6 weeks old? "Maybe your milk isn't filling her up." In reality we were fine - she was gaining weight really well and just generally being a baby. But the stress of second-guessing myself constantly about this was horrible.

- in the first year after giving birth I had a few different health problems, and came into contact with a variety of different medical professionals (not specifically baby-related). Quite often the fact that I was breastfeeding would be relevant (e.g. for whether particular medications were safe to take), but the medical professionals wouldn't necessarily know a lot about breastfeeding. And the result of this was, repeatedly, ending up in situations where they were telling me to do/not do a thing, and I was disagreeing with them. And I just... really do not like having conversations that sound like "I see your medical degree and I raise you this article I found on Google!" anyway, and it was this extra burden to deal with at times when I was already feeling quite ill and just wanted things to be straightforward and not be That Awkward Patient.

- I am currently breastfeeding a 2-year-old. This is not always a widely accepted choice, shall we just say.
posted by Catseye at 2:25 AM on April 23, 2016 [9 favorites]

Yes, catseye, those are "costs" I experienced as well. I had a few medical issues that were all delayed due to nursing. The doctors I visited would say, "Well we're not sure... let's wait."
posted by areaperson at 5:11 AM on April 23, 2016

I can't help but wonder how much of the burden would be lighter if people weren't /assholes/. Now that I am thinking back, I think I came to my own pump-only stance in part because the lactation consultant was so useless.
posted by corb at 5:34 AM on April 23, 2016 [2 favorites]

I'm thinking a lot about catseye's costs and it's so hard for me to untangle the costs of the actual act of breastfeeding (which at this point is pretty much wine and roses unless I forget to cut my kid's nails and she twiddles me when I'm PMSing jesus chrrrriiiiiist kid staaaaaaahp) from the ones which are caused by our societal attitudes toward breastfeeding. It's so weird because we promote breastfeeding as this public health benefit admirable THING but the actual life and needs of a breastfeeding mother aren't supported at all. The fact that a breastfeeding child might be more bonded to a breastfeeding parent (and mine is, but that doesn't mean she doesn't love and like her dad) is threatening, the fact that most breastfeeding moms will sometimes fall asleep with her kid is treated as criminal, and I swear to god from the time my daughter was three weeks old I was being told to just give her a bottle so the in-laws could babysit even though my boobs hurt when I was away from her and I turned into a miserable lump of unhappiness. And any weird poops your kid has or disgestive issues or the fact that your kid doesn't sleep through the night or is frequently hungry are all blamed on something wrong with your milk and have you tried cutting gluten/milk/eggs/soy no big deal it's not like you have the appetite of a 14 year old boy right now or anything. If you're in pain or your kid has a crappy latch you're given this pump and told to pump all the time, maybe in addition to breastfeeding or topping up with formula also no big deal even though that turns feeding your infant--already something you might be spending 12 hours a day on--into like a 24/7 task with only fifteen minutes of intermittent occasional downtime.

All of these things make breastfeeding worse than it could be. Even now, at 27 months, breastfeeding would be fine and dandy except if my kid really wants it while we're out I'm looking around me like a shoplifter because what if someone says something and if they're old enough to ask for it. Breastfeeding is great except for the mother-in-law who tells me to "save my breasts and have another baby already!" Breastfeeding is great except for other people. Other people can go screw.
posted by PhoBWanKenobi at 6:27 AM on April 23, 2016 [16 favorites]

I have been reading this thread on and off while breastfeeding my one month old last night and this morning. I don't really have anything to add right now, but wanted to say thank you for posting this article and thank you all for sharing your stories.
posted by insectosaurus at 11:00 AM on April 23, 2016 [2 favorites]

have you tried cutting gluten/milk/eggs/soy no big deal it's not like you have the appetite of a 14 year old boy right now or anything

This crap is especially charming if you're coming off a stint with gestational diabetes...as a vegetarian. I lost weight in my third trimester with my daughter and you're seriously telling me to cut out, like, 90% of what normal humans eat, "just in case"?

I contemplated it for like 12 hours and decided lactation consultants were bullshit and didn't know what the hell they were talking about. Her poop went back to normal a few days later.
posted by town of cats at 12:39 PM on April 23, 2016 [3 favorites]

My lactation consultant told me I had a "bad attitude" about breastfeeding and was therefore going to fail at it, which is definitely the sort of encouraging thing the breastfeeding support people should be telling you!

(My "bad attitude" was that on my maternal side there's a history of an anatomical breast tissue problem that makes lactation difficult or impossible, so I went into breastfeeding thinking, "I will give it a try, but if it's not possible for me, I won't get upset about it," which the ob and the pede agreed was the right attitude because if you are anatomically lacking the necessary tissue, thinking happy thoughts is just going to starve your child, not make you lactate more. The lactation consultant was ADAMANT that with this attitude of "I'll give it a try," I would not lactate, and that if I committed to it for a full year no matter what happened, it would definitely work out for me, and that anything less than a full year commitment was an admission of failure before I began. She kept insisting that EVERY woman could breastfeed if she just TRIED hard enough. She also looked over my meds list after my C-section, saw the painkillers, and said, "Well we'll have to cut those off right away." I was like, "Uh, you're not a doctor." Anyway I had her barred from my hospital room after that first visit and the maternity nurse taught me how to get the baby to latch. Like I seriously do not understand how these people are hospital employees.)

The lactation consultant with my second was fine, but she came in and wanted to ask me four pages of questions when I'd been in recovery after surgery for like ten minutes and I was incredibly out of it from anesthetics. I have a very vague, foggy recollection of struggling to answer her questions and feeling very distressed that I couldn't really understand them. Again, how are these people hospital employees? Anyway she gave me a couple of boob cream samples, and checked in on the third day to see if my milk had come in, and that was that, and that was fine (except for the anesthestic interrogation).

I was glad I had my kids in my 30s and not my 20s because in my 30s, even in my over-emotional crazy-hormone post-partum state I was able to see that the first lady was a COMPLETE LUNATIC, but in my 20s I think she would have cowed me and I might not have had the sense to throw her out and forbid her from coming back, I would have just cried about being a bad mom and let her order me around with her terrible nonsense orders. And I guess it's just as well I didn't really have any problems getting going, because I kind-of can't imagine how either of them would have helped.
posted by Eyebrows McGee at 1:35 PM on April 23, 2016 [1 favorite]

I'm having a difficult time connecting that two things you said:

I would totally wetnurse, 100%. Send me your babies.


and I'd work on feeling less ashamed at the fact that my child and I were a dyad. I mean, we still are, even well after 2. Breastfeeding means we have this whole emotional biological feedback thing happening still and I still have to deal-maybe more than ever before-with pressure to server that, and I just... Don't wanna.

I think this is confusing. The message that at the same time everyone should do what's best for herself at the same time the message that breastfeeding creates a unique and special bond and intimacy between you and your child. How is that compatible with wetnursing? Can you really imagine doing that for/with another family's child, on a paid or volunteer basis?
posted by Salamandrous at 1:51 PM on April 23, 2016 [1 favorite]

I'm pretty sure the acknowledgement of a unique relationship between a child and their wetnurse, and indeed between otherwise unrelated children who nursed from the same mother, used to be A Thing in many cultures. Our failure to acknowledge or recognize it is a bug, not a feature. If I couldn't breastfeed but for whatever reason felt very strongly that I wanted my child to have breastmilk, I'd perhaps be a bit sad that I wasn't able to form that relationship, but would not resent the relationship that child formed with their wetnurse - I think the more "family" you have, however you come by it, the better. Equally, I'd be happy for someone else to have more of that happy-hormone-breastfeeding-bonding experience if it was something they experienced and enjoyed. When it is all working properly, it is pretty great.

Breastfeeding does indeed create a unique bond between the nurser and nursee. It's not the only bond, the only intimate bond, or exclusively definitive of the mother-child relationship.
posted by olinerd at 2:01 PM on April 23, 2016 [5 favorites]

I speak only for myself, but the wetnurse and dyad descriptions are not opposing forces! I personally have a hard time being around crying infants because I just want to pull them to my breast. And I'm pretty sure most people would not like that, at least in the USA. But that is my first instinct - stick a boob in 'em. So when my coworker's wife brings in their infant foster baby and the baby starts rooting, I gotta leave the situation. I am just viscerally unable to be around that child if I can't help them. That'll fade one day, right?
posted by jillithd at 6:45 PM on April 23, 2016 [3 favorites]

I've been reading this and feeling so bad.

My mom tried to nurse me in the 1950s and every piece of advice she got was garbage, so it didn't work. I had terrible colic and suspect it was intolerance to formula, but what did we know back then?

I nursed my daughter, it went fine, and when I left the house either I took a bottle with some powdered formula in it and added water or else I left her at the house and my husband gave her a bottle of formula. We basically made the decision to be poor as hell when she was born, and I stayed home for eighteen months. I made up for dropping out of the job market eventually, and the last twenty years made more money than my husband. The kid has allergies, mental health issues, and a badly deviated septum, but she's taller than either of us. I suspect all of that would have happened whether I breast fed or not.
posted by Peach at 4:23 AM on April 24, 2016 [1 favorite]

The message that at the same time everyone should do what's best for herself at the same time the message that breastfeeding creates a unique and special bond and intimacy between you and your child. How is that compatible with wetnursing? Can you really imagine doing that for/with another family's child, on a paid or volunteer basis?

It creates a unique and special bond for you and whatever child you're nursing, yes. Part of this is a hormonal, oxytocin thing. Part of it is just--if I don't feed this child regularly, my boobs are going to be hot, hard, and possibly letdown in the middle of the supermarket while she is hungry elsewhere. I would prefer to have that child with me to feed and hold and enjoy rather than going other places and dealing with pumping, which doesn't even work well for me.*

I mean, my kiddo is the best, and is a unique and special snowflake, but while our relationship might feel magical, we're not soulmates or anything. Our society is very anti-cross nursing, but that's highly cultural. As olinerd says, that wasn't always the case and cross nursing is bog standard in some societies, still.

Like jillithd, I have a lot of trouble being around hungry babies. At the supermarket, at music class. Once, some woman left her baby to cry and cry and stuff his poor little hands in his mouth and when she finally came over, she stuck a pacifier in and I had to kick my lizard brain into submission to not pick him up. My boobs, for some reason, having successfully lactated, really want to feed babies.

*I had an oversupply for the first eight months or so. I could pump, then--like 10 oz in 10 minutes, actually--but my daughter used to choke on my letdown, projectile vomit, and it made her latch shallow. My otherwise wonderful midwife first tried to get me to switch to exclusively pumping so I could donate. I asked her if I'd ever be able to breastfeed if I did that, and could tell by her look that it was unlikely. I think this happens with a lot of high supply mothers, that they end up pumping, but it makes actual breastfeeding difficult to impossible. My daughter definitely couldn't deal with that volume of milk. Anyway, I ate sage and blockfed and my supply went down to a reasonable amount, my daughter's vomiting went away, and we were able to achieve a deeper latch. My supply was still healthy. The last time I went away for a few days, I tried to pump and got barely an ounce but my boobs were hard and painful. Hand expressed, got 24 oz. Training our bodies to respond to physical touch vs. a pump are really different things.
posted by PhoBWanKenobi at 6:02 AM on April 24, 2016 [2 favorites]

PhoB, if you ever reconsider your stance on pumping with subsequent kids, check out the Spectra pump brand if you haven't. I just got one and it is uncanny how much more "real" it feels than Medela pumps, up to and including the Symphony.

I mean, it's still clearly not a baby, but when I started it up my reaction was "whoa, how did they do that?!" It's pretty weird.
posted by town of cats at 6:52 AM on April 24, 2016

Nah, I have a pretty great pump (a hygeia enjoye) and gave it a good go with two manual pumps.

Feeling myself up is the only way that works for me anymore which is fine. It's a little messier but works damned well.
posted by PhoBWanKenobi at 8:38 PM on April 24, 2016 [1 favorite]

Since we've started a little side discussion of pumps here, the Haakaa silicone manual pump is getting rave reviews from those in my nursing networks.
posted by vignettist at 8:30 AM on May 4, 2016 [1 favorite]

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