The Big Letdown

by Kimberly Seals Allers

  More strikingly, most of the messaging we receive from commercial marketing, both directly and indirectly, is decidedly antifeminist. Women should never be forced to make a choice between mother work and other work. Yet, across the board, individuals who assume the role of nurturer are punished and discouraged from performing the very tasks that everyone agrees are essential. We are told breastfeeding is too hard, as if we are weak. We are told breastfeeding hurts, while we queue for tattoos and bikini waxes. We are told that breastfeeding distances our men. In this vein, I recently decided that we should stop telling women to go to college. College is very hard. Not to mention trying to carve out a meaningful career as a woman in corporate America. Way too difficult. My mother and father did not go to college and they turned out just fine—they bought a house, always had two cars, and put me through university. College has never been proved to lead to true happiness, and many people who didn’t go to college are very successful. When I look at the high rate of divorce, and the number of corporate women who end up single, childless, or otherwise unfulfilled, I’m starting to question the benefit of college and career pursuits.

  Truth is, if I ever seriously uttered this idea, an army of feminists would drag me through the streets for treason. But insert the word “breastfeeding” everywhere I said “college,” and suddenly it becomes a very acceptable message. Every day women, who fought for independence and autonomy, are being told which pursuits are worth the sacrifice—which areas of our life are “worth” overcoming challenges for and which are not. There is a popular refrain that breastfeeding is hard and too difficult for the payoff. We are fed messages that toned bodies are worth hours of sweating in the gym and the cost of buying expensive products to achieve, but somehow contributing to the long-term health of our children is not worth any committed effort. We encourage each other to crash through glass ceilings, use off-ramps and on-ramps to maintain our career and to “lean in” for greater corporate success—but with breastfeeding we are told to give up and not feel bad. And any impassioned support to continue is misconstrued as pressure. That is deeply troubling, as a feminist.

  Women as Real People

  At the end of The Feminine Mystique, Betty Friedan writes, “If women were really people—no more, no less—then all of the things that kept them from being full people in our society would have to be changed.… It would be necessary to change the rules of the game to restructure professions, marriage, the family, the home.” Seven years later, as the women’s movement gained momentum, she said, “We have to break down the actual barriers that prevent women from being full people in society, and not only end explicit discrimination but build new institutions.” To do less, she concluded, would be to make women’s movement “all talk.”

  For women to be truly equal and realize the noble feminist goals, then all the things that still keep us from being equal in our society have to change. These issues transcend breastfeeding. We must redefine “working mom” to be more inclusive so that we stop devaluing the work of mothering. Instead of participating in the so-called mommy wars pitting “stay-at-home moms” against “working moms,” we must demand high-quality, affordable child care, flexible work, and paid maternity leave so that each woman can pursue both market work and caring work to the extent that each woman sees fit. We should work to end the structural inconsistencies that undermine mothering, such as the fact that a woman who devotes all of her time to caring for her family does not earn any Social Security benefits, whereas if she gets a paying job and sends her children to day care, she and her day care provider earn credits toward financial security in old age. When advocates for women’s rights and advocates for breastfeeding come together, these structural issues should be front and center.

  In the feminist effort to neutralize all that ridiculous individualist blaming of women for their choices, we often diminish telling the truth about the significance of their choices to them. We silence the conversation of informing and educating women about the true risks and benefits of their options, so that they have genuinely informed decision making. We quiet the conversation about the structural inequities that undermine us and keep us from having true “choice” anyway. When we say breastfeeding is not all that important, we silence the grief some women feel about not having been able to breastfeed and we take away the sense of achievement other women feel about breastfeeding in spite of multiple obstacles. But possibly worst of all, we undermine the broader message every woman needs to echo, which is that structural and institutional change needs to happen. It’s been so terribly easy for a patriarchal culture to put all the responsibility on mothers and not chase the real culprits behind the paltry breastfeeding rates in the United States—deep structural barriers like inflexible workplace policies, the absence of universal maternity leave policies, insufficient antidiscrimination legislation, and hostile societal attitudes toward women’s bodies.

  The collective failure to properly value and embrace mothering has been a critical failure of the feminist movement. But the breastfeeding movement has had its own blunders. Like the overriding feminist thinking, well-intentioned but misrepresented breastfeeding supporters have also undermined women in several ways.

  • 7 •

  The Problem of No Problem: The Breastfeeding Movement

  The surest way to inoculate a social movement is to keep it embroiled in the matter of choice.

  —GOPAL DAYANENI, MOVEMENTGENERATION.ORG

  Three simple words: “Breast Is Best.” It’s been the mantra of the pro-breastfeeding movement for decades. International public health organizations use it. Physicians and nurses use it. On the surface, it’s perfect messaging: simple, rhythmic, and to the point. But the phrase has become a loaded one in the breastfeeding movement and representative of its problems.

  The strategic focus on evidence-based research and on propping up the scientific benefits when the real struggle is social norms and unsupportive policies makes the movement, led by middle-aged, mostly white and female activists, appear grossly disconnected from the reality of modern-day women’s lives. Given changing gender roles, increased economic demands, and less social support, women aren’t being shown how to do what’s “best” in today’s environment, under today’s life circumstances, and in the modern context of motherhood, where conflicting ideas about maternal roles and career ambitions loom large. The message hinges on the benefits of breast milk instead of on how women’s lives are being materially changed by not having the basic infrastructure to successfully breastfeed for any meaningful duration. It ignores the denial of a basic reproductive right—the right to feed. At times, infant formula makers and physician organizations have colluded to keep this simplistic message intact, knowing its ineffectiveness, even when advocates pressed for something more provocative. Inside the industry, the confusing layers of certification of lactation professionals make it hard for mothers to understand who knows what and what type of credentials really matter for support. Either way, “Breast Is Complicated” may have been a more accurate slogan.

  Taking such a simplistic messaging approach to such a complex issue was bound to be risky. Although “Breast Is Best” is factually accurate, it speaks only to the act of breastfeeding and the benefits of human milk, completely ignoring the experience women have when breastfeeding, as if our breasts are disconnected items from our bodies and our bodies aren’t affected by the environment in which we exist. I see this problem all the time. When women say breastfeeding is hard, do they mean the act of breastfeeding—the literal process of placing a baby on your breast and your nipple into its mouth—or are they mostly referring to the experience of breastfeeding, that it feels impossible with so many structural and social barriers? Most times, it is the latter. Yes, breast milk may be best, but breastfeeding amid societal pressures and systemic letdowns is the absolute worst. Yet the movement has been, by and large, too focused on benefits messaging for too long, ignoring the emotional toll it takes to deliver such benefits. As a result,
the same three words are often used against the movement to question new scientific research and challenge how “best” is best, especially since best can be a culturally derived or personal notion. It also implies that breast milk is best but that infant formula is good enough. The phrase contributes to the dangerous thinking that breastfeeding is just a better parenting choice, like a cloth diaper instead of a disposable one or homemade baby food instead of store-bought, when it is actually a critical public health issue.

  The messaging, though well-intentioned, was doomed from the start. It was conceived with a focus on countering the infant formula rhetoric of being “just as good.” Instead of attempting to counter a false narrative, the movement, and the women they seek to help, would have been better served by a genuine issue-oriented message that could rally women together. Standing behind a message that is all fact and no emotional affinity creates a fertile ground for the media to corrupt or create their own narrative—and they have, with dangerous implications. Lastly, let’s face it. It sounds a little preachy. Women need a message and a movement that engages women as actors, with a role and a mission, not just as an audience.

  Ironically, there was a time when the movement attempted to dramatically shift its messaging, but infant formula makers and physicians worked together to stop it. In June 2002, the New York nonprofit Ad Council—renowned for its ability to alter human behavior and attitudes through memorable public service campaigns such as “You Can Learn a Lot from a Dummy” and “Friends Don’t Let Friends Drive Drunk”—announced that its next task would be to formulate a campaign to convince Americans of the importance of breastfeeding. Breastfeeding advocates were elated at the prospect that such a highly visible campaign might influence breastfeeding rates as profoundly as the Ad Council has affected other healthy behaviors. The plan was a campaign to show the risks of not breastfeeding. Previous breastfeeding campaigns had always focused on the pros, but after conducting a series of focus groups, the Ad Council and the Department of Health and Human Services decided the ads would be more effective if they warned women, rather than encouraged them, just as ads have strongly warned women of the dangers of smoking or drinking alcohol during pregnancy. One of the more striking ads showed a pregnant woman riding a mechanical bull with a voice-over saying, “If you wouldn’t take risks before your baby was born, why start now?” Accompanying the ad was the tag line on the screen: “Babies are born to be breastfed.” It was a dramatic change in messaging.

  But before the campaign even hit the airwaves, it was mired in controversy over politics and money, as formula companies and the heads of the American Academy of Pediatrics protested the strong language of the campaign. The infant formula makers and AAP leaders took issue with the Ad Council’s plans to include statistics published in the past decade showing that formula-fed babies had a higher risk of developing diabetes, leukemia, and other illnesses. They argued that there was not enough hard data to show a direct link to leukemia or diabetes and recommended those two conditions be dropped from the ads. Formula companies focused their opposition on the campaign’s cautionary tone. “It could frighten parents,” said Mardi Mountford, the executive director for the International Formula Council, an Atlanta-based trade association representing formula interests, in a newspaper article published at the time. The comments suggested parents should be shielded from important information.

  The most surprising opposition to the campaign came from the AAP itself. Dr. Joe Sanders, the AAP’s executive director at the time, and Dr. Carden Johnston, then its president, sent a letter to Tommy Thompson, then secretary of Health and Human Services, expressing concern about the campaign’s strategy and the validity of the science behind the claims. “We don’t want to go out there and lose credibility by putting out false data where people will accuse the groups of using a scare tactic,” Sanders told one news organization. That letter did not sit well with the academy’s own breastfeeding experts, who had been working with the government on the campaign and supported the aggressive approach.

  Dr. Lawrence Gartner, the head of the academy’s breastfeeding committee, sent his own letter to the Department of Health and Human Services expressing support for the campaign. “To not breastfeed is a risk, that’s what the research data show,” he says. At a critical juncture for shifting how we talk about breastfeeding, there was infighting at the leading pediatric association—the one publicly supporting breastfeeding as optimal nutrition. It was hard not to question whether AAP leaders had been influenced by their financial entanglements with the formula industry, which has provided significant revenue to the organization over the years. In fact, the year before the ad campaign, Ross Products, the division of Abbott which makes the formula Similac, purchased three hundred thousand copies of the academy’s book on breastfeeding, for about $500,000. Soon after the campaign was shelved, the company bought another three hundred thousand copies.

  The comments by the AAP insulted women, questioning their strength and intellect. “If a woman can’t breastfeed or chooses not to and then her baby develops one of these conditions, what kind of guilt feelings is that going to put on this young mother?” Dr. Sanders continued. These comments are a classic example of the ruse of anti-breastfeeding messaging: comments made ostensibly to protect and support women when, in fact, they are extremely patronizing, implying that women are feeble, weak, and need to be protected from the truth. Those who are ambivalent about breastfeeding often use this bogus claim to justify withholding information instead of viewing women as strong individuals who deserve to be fully informed of the outcomes of their decisions. This dangerous manipulation has been used to undermine women for centuries, even though blatant factual information has been successfully used in other areas of health promotion. Much of the credit for reducing smoking rates, particularly among teens, has been attributed to the highly effective “Truth” ads—the largest national youth-focused antitobacco education campaign ever. It candidly exposed big tobacco’s marketing and manufacturing practices, as well as vividly highlighting the real toll of tobacco. If teens can be given accurate information, regardless of how potentially frightening it may be, why not give it to grown men and women? The subtext was beyond reprehensible.

  When physicians and infant formula makers aren’t intervening, the media has stepped in. Their need for provocative headlines coupled with the breastfeeding movement’s weak message and lack of media savvy created fertile ground for the media to dominate and often override the movement’s message. The movement became a victim of what is known as the extremist effect. The extremist effect is a strategy to take something virtuous and turn it into a vice by using clever language such as calling it “extremist” or “radical.” Researchers wanted to understand how to diminish people who support universally held values (such as wanting a clean environment) without being seen as directly attacking the value itself. The study, published by the International Society of Political Philosophy, showed a common political practice to “vilify opponents as extremists in order to discredit their appeal to common values.” Even if the group represents a consensus value like equal opportunity, the extremist label suggests the group’s agenda embodies an excessive and uncompromising imposition of this value. Through a series of experiments, the researchers discovered that simply labeling those on the other side as feminists or environmentalists created a significant backlash against them. When the descriptor “radical” was added, the negative reaction was even stronger. The researchers concluded that this “extremist effect” results in negative associations for the audience and is most effective in an environment where the public is unsure about what its priorities should be. The chronic mislabeling of breastfeeding activists as extremists is a clever communication strategy often deployed in the political arena and is designed to undermine their work. And it makes for great headlines.

  Enter Courtney Jung, author of Lactivism: How Feminists and Fundamentalists, Hippies and Yuppies, and Physicians and Politicians Made Breastfeeding Bi
g Business and Bad Policy. The political science professor at the University of Toronto hit the media mother lode with a book review in The New York Times calling her book a “riveting exposé of breastfeeding zealotry.” Jung provides no specific examples of how exactly advocates are compelling women to breastfeed. The review on Slate.com had a less subtle headline: “Breastfeeding Extremists Are Even Worse Than You Thought.” The tagline said: “Courtney Jung’s Lactivism shows just how dangerous their cause can be.” The emotive nature of the headline mirrored Jung’s highly charged tome, which made me question if this was intended to be an academic work or just a political screed by someone with an ax to grind. What’s really unfortunate is exploiting an attack on passionate and dedicated advocates for media points or research dollars. In all of Jung’s bashing of breastfeeding advocates (even though she breastfed her own children) and belittling of the benefits of breastfeeding, she failed to mention her university’s past and present financial connection to breast-milk substitutes. According to the University of Toronto’s Web site, in 1930, Frederick Tisdall, Theodore Drake, and Alan Brown of the University of Toronto Faculty of Medicine invented Pablum, the processed food for infants and one of the earliest breast-milk substitutes, used throughout the 1930s. The site continues that Tisdall used his “business savvy” to strike a deal with Mead Johnson Company in Chicago (now maker of Enfamil) to mass produce the first precooked and thoroughly dried baby food. It was a financial success. Tisdall and Drake later worked with the National Dairy Council to enrich milk with vitamin D in the mid-1930s. Today, like many universities, the University of Toronto receives funding from various corporations. Among the companies in the 2014 listing of the $100,000 to $999,999 category are Abbott Labs, Mead Johnson, the Dairy Farmers of Canada, and Nestlé. As a member of the faculty at a school whose founding members were creators of processed infant food and that presently receives donations from a variety of infant formula interests, I can’t help but raise the issue of Jung’s possible bias, or at least an arguable conflict of interest that should have been disclosed—especially by a member of the Academy. It is unfortunate that the media narrative being shaped about the movement is one of pressure and coercion. In that space, any support is perceived as pressure because that is what you were told to expect. Women are being primed with a false narrative and so any action by well-meaning lactation consultants—most of whom are no more zealous than a doctor repeatedly encouraging you to stop smoking because it is bad for your health or the constant reminders we get about wearing seat belts—will fit into this story.