Breastfeeding may be “free,” but it’s still a luxury

If you’ve had a difficult time breastfeeding or supported a partner through the experience, this might sound painfully familiar. Two days into my son’s life, he wouldn’t latch properly.

Whenever I successfully encouraged him to nurse, he would fall asleep, exhausted from the previous hour’s efforts at struggling to eat—time he had inadvertently spent crunching through my nipples instead. My midwife suggested shields, but nursing reference books railed against them. I tried pumping and bottle-feeding, but the lactation consultant informed me that the brand of bottle I was using encouraged the baby to bite, so we kept searching for one that wouldn’t. My hospital’s 24-hour breastfeeding hotline suggested an elaborate scheme that involved administering tiny amounts of formula through a tiny medicine dropper, a few millilitres at a time. For several days, I fed him this way, like a sick bird, so he wouldn’t starve.

More than once, my husband rushed out to a 24-hour pharmacy in the middle of the night to find a brand of formula that wouldn’t stretch our son’s little belly with gas. More than once, I didn’t feed him; I just stared at him and cried.

Three months and 500 nursing sessions later, my son and I eventually got the hang of it. But looking back on this anxious time, I couldn’t help but feel that the most surprising lesson was how lucky I was to go through it in the first place. Many parents might not use the word “lucky” to describe sleepless anxiety, cracked nipples or the desperate sound of a baby sucking his fingers in hunger. The work of feeding a newborn can be a second labour of birth unto itself, imbued with the politics of feminism, biology and public health, and mainstream culture is only just beginning to catch on. But amid all the Instagram #brelfies and ads for fashionable nursing gear, the fact that the ability to nurse exclusively can be as reliant on privilege as it is on perseverance can easily get lost.

Consider some of the details I’ve just told you: Despite the excruciating first few weeks, I was able to consult a midwife and lactation consultant for advice, the latter on home visits not covered by insurance. I was also able to try pumping as a supplemental option with expensive equipment that many employer health plans don’t cover. And with a year-long maternity leave, I also had time—something that, though federally offered to every parent in the country, isn’t always feasible, whether due to a parent’s type of employment or simply because spending 12 months earning 55 percent of, say, minimum wage won’t cover basic living expenses.

In Canada, parents who breastfeed exclusively for the recommended six months are statistically more likely to be 30 years or older and married, with post-secondary or higher levels of education. Studies in the United States tell a similar story, with employment and income levels also playing a role. And sometimes public health programs only complicate the divide. The federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the United States, for example, provides food supplements and nutrition education to low-income families, regardless of how they feed their infants. But with the decision to nurse or not comes one caveat: Those who breastfeed are eligible for WIC funding for twice as long and with more food voucher options, even though the program offers free formula as well. In effect, this inadvertently punishes parents who are statistically more likely to bottle-feed in the first place.

There is also the issue of racial disparity—and all the baggage that comes with it. Studies show that women of colour, particularly black mothers, have lower rates of initiating breastfeeding or continuing it into mid-infancy. As journalist and author Kimberley Seals Allers points out, for black women, this is also influenced by generational trauma, where a history of enslaved labour—including wet-nurse breastfeeding—has shaped ideas about what black motherhood looks like.

Chances are, in those foggy, sleepless first months of parenthood, the facts and stats of breastfeeding inequity won’t readily come to mind. And certainly each and every choice to nurse or formula-feed isn’t solely a question of privilege but what’s in the best interest of a mom’s own well-being and, therefore, her child’s well-being.

More often than not, though, this highly personal decision is also informed by systemic factors that aren’t necessarily of any individual’s choosing. If we really want to support mothers and infants, we need to acknowledge this when nursing in public, shopping for pumps or formula and discussing this with other parents. It would probably go a long way toward boosting advocacy for public policy that supports breastfeeding and fostering a much-needed cultural shift in developing understanding and respect for the families who have found a set-up that works for them.

Just before my son was born, my mother brought over a gift that, at the time, I treated like a Trojan horse: a box of ready-to-feed formula samples from different brands, just in case my intention to breastfeed didn’t go the way I’d planned. Horrified and more than a little insensitive to the fact that she had formula-fed me and my brother, I made her donate it all to a local food bank. I was determined to make a physically and emotionally demanding act part of my parenthood. Didn’t she want to support that?

The thing is, that’s precisely what she was doing. “I just don’t want you to be harder on yourself than you have to be,” she said at the time. Nursing wasn’t easy, she went on (big understatement!), and my experience of learning to do it mattered just as much as the outcome.

I still think about this every time I hook myself up to a pump to prepare a nightly feeding. While breastfeeding may be “free” in the sense that you don’t have to pay your body to do it, the conditions that support it as an exclusive feeding option are anything but.

This article was originally published online in May 2017.