Is 'Breast is Best' Always the Best?

Last week’s high-octane ping pong match between conservatives and Democrats erupted over the topic of breastfeeding. It followed an earlier IRS announcement that breast pump supplies would qualify for reimbursement as a medical expense under federal tax law.

Pro-breastfeeding pundit Michelle Obama took center stage, with Republican critics like Rep. Michelle Bachmann (R-Minn.) questioning whether the first lady's high-profile advocacy of breastfeeding might have been somehow coordinated with the IRS decision.

Bachmann accused Obama of pushing a “hard left” agenda designed to make "government the answer to everything" and uttered the now infamous statement, “To think that government has to go out and buy my breast pump ... You want to talk about nanny state, I think we just got a new definition."

Sarah Palin, who recently touted her own mothering skills as qualification for the office of the presidency, took no pause in adding her two cents, remarking, “No wonder Michelle Obama is telling everybody, 'You better breast-feed your baby.’ Yeah, you'd better, because the price of milk is so high right now."

All of the partisan jabs aside, the debate left me pondering the actual issues at play around a hot-button topic like breastfeeding. Does government support of a “breast is best” paradigm create unfair pressure on new mothers?

Any mother can tell you that there already is tremendous pressure related to breastfeeding; however, it is multifaceted, originating from sources more intricate than our federal government.

While 75 percent of U.S. babies start out breastfeeding, according to the Centers for Disease Control and Prevention, only 13 percent are exclusively breastfed at the end of six months. Barring the cases of women who physically cannot breastfeed for medical reasons (that number is estimated around 2-3 percent) for many, many women, the reasons not to breastfeed are more personal than political.

For starters, culturally there is a sense of disembodiment when it comes to breasts whose value, until motherhood, is relegated to the double-D cup-size of a Victoria’s Secret model. 

From childhood on, images of hyper-sexualized breasts are shoved in our faces. The fact that “boobs” also happen to produce milk is perhaps the least important message girls are taught, so little wonder that some women have a hard time making the mental leap to lactation.

If women are successful in shifting from the sexy supermodel mentality to a mama moo-cow mindset, they slam into much more impenetrable issues.

Tax deductions are great, but there is a big difference between making breastfeeding products affordable and creating a supportive environment for new mothers to breastfeed, many who find themselves back at work after six short weeks postpartum.

I speak from experience on this one. It’s challenging to return to a job after maternity leave. There is already this unnerving sense that someone’s doing you a favor by letting you keep your job, and now you have to ask your boss for a 15-minute break every two or three hours to express milk.

Nonetheless, lacking an office with a door that closes (and locks), like many women, I pumped in bathrooms, closets, my car, conference rooms, anywhere I could. Pumping on a toilet is not conducive to six months to one year of breastfed babies. In fact it’s just about the quickest way to ensure that formula is in an infant’s immediate future.

Yet from a medical perspective, the data is pretty compelling that we should be bending over backward to accommodate breastfeeding mamas.

Last month the surgeon general issued a "Call to Action to Support Breast-feeding," stating that breastfeeding can protect babies from many serious infections and illnesses, as well as drastically reduce asthma and obesity. That followed a 2010 report in Pediatrics, which estimates that the U.S. could save $13 billion per year in health care costs if 90 percent of U.S. babies were breastfed for six months.

Lily Beggs, director of lactation for Sutter Santa Cruz, agrees that a systemic re-education must happen for Americans to reap the benefits of breastfeeding as the norm.

“There is a trickle down effect that I hope will continue over the next few years,” she explained. “For decades formula was considered a scientific breakthrough; however, it was based on very little actual scientific data. As hospital administrators, we first had to re-educate ourselves about the benefits of breastfeeding. We are now increasingly successful in helping mothers begin breastfeeding in the hospital environment; however, the real challenges start when new moms go back to work.”

One obvious fix would be for the U.S. to take a long, hard look at its policies on maternity coverage. The U.S. is one of only four countries in the entire world with no guaranteed paid leave for mothers. Until recently, new mothers had no guarantee that they would have a job to come back to if they left to have a baby.

 In 1993, the Family and Medical Leave Act (FMLA) was passed, which now mandates the ability for some (not all) women to take 12 weeks of unpaid time off. Under FMLA, roughly 50 percent of women lack any pay and still risk losing their jobs entirely, while the rest must cobble together time using sick days, vacation days, disability leave and official maternity leave.

In comparison, our neighbor to the north, Canada, offers a total of 50 weeks of leave at approximately 55 percent of the average gross salary. Sweden offers an entire year of full pay. The U.S. lags behind more than 160 other nations, with only Papua New Guinea, Swaziland, and Lesotho ranking worse.

Getting back to my original question, I have to concede that a government push toward breastfeeding does create extra pressure on women, albeit with the best intent.

Of course, breastfeeding is natural, and logic dictates that “breast is best.” Without education, legislation and a massive shift in workplace policies, many women are locked in a painful and seemingly impossible position.

Kirsten Livingston, a Santa Cruz mother of three, weighed in on the controversy, saying, “For me breastfeeding was a huge gift, a privilege, but I was lucky enough to be a stay-at-home mom for each of my kids’ first years. I think we should definitely continue to encourage mothers to breastfeed, but not judge their decision.”

I couldn’t agree more. After all, Michelle Obama’s initiatives and the IRS announcement are just baby steps—and we’ve got a long road ahead of us before breastfeeding once again becomes the norm.