I am a planner, so when I was pregnant, I tried to plan for all aspects of becoming a mom. I was the woman who read ahead. I took the hypnobirthing classes and practiced every night. I prepared a detailed maternity leave plan, talked with my husband about the kind of parents we wanted to be, ate only whole organic foods, and even preemptively childproofed our home. I prepared my body, my life, every part of myself.
The one thing I did not adequately prepare for was breastfeeding. The message I’d received during pregnancy was that breastfeeding was something my body would just know how to do. I didn’t need to overthink it or stress. When the time came, I’d be Mother Earth—or so I’d been told.
But breastfeeding didn’t come easily for me and my daughter, and I was overwhelmed by the pressure to try to make it work. I felt so much guilt about not being able to get it right, that I was failing at what was I was told was the biggest part of new motherhood. It affected my relationship; it affected my ability to bond with my baby; and it affected my ability to heal. It was the first place in my life (though not the last) where I felt mom guilt. My struggle with breastfeeding stole much joy from the first months of motherhood.
After spending hundreds of dollars on lactation consultants and trips to the ENT to explore my daughter’s possible tongue tie, I eventually turned to formula. In desperation, I chose the brand my pediatrician recommended without question.
Months later, when the fog of new motherhood finally started to lift, I learned that it—and so many other infant formulas on the market—was loaded with corn syrup solids. What?!?!? How is this possible? I remember asking myself.
My experience made me wonder: Why are women, including my generation of the most educated women ever, being guilted (without support) to breastfeed for a year? And when we can’t, or choose not to breastfeed, why are there so few healthy alternatives for our babies?
While mothers are under an incredible amount of pressure to breastfeed, we lack the access to information, cultural support, and healthy options that we need to successfully feed our babies.
Less judgmental, didactic education about feeding infants
When I started to dig into why I felt so misled about the realities of breastfeeding I learned that the World Health Organization, the organization that established recommendations around breastfeeding, as well as guidelines for marketing breast milk alternatives (all of which trickle down to lactation consultants), has an enormous influence on hospitals.
To earn a Baby-Friendly designation from UNICEF and the World Health Organization, hospitals must adopt clinical practices intended to promote successful breastfeeding. One of these practices is, “Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.” In practice, this essentially means hospitals are encouraging moms to do whatever it takes to make breastfeeding happen.
And, the influence of the WHO’s International Code of Marketing of Breast Milk Substitutes extends well beyond hospitals. This code, though not legally enforced in the U.S., discourages the marketing of not just formula, but also bottles and nipples. Ironically, this ignores the fact that many moms rely on nipples and bottles to feed their babies breast milk.
It also encourages health professionals who support breastfeeding, such as lactation consultants, to take a firm stand against collaborating with companies who violate the Code. That means that if a media company takes advertising money from a bottle company, they jeopardize their ability to draw upon a lactation consultant’s expertise in the future, thus potentially limiting moms’ access to information.
This isn’t to make the WHO out to be the bad guy. There are plenty of benefits to breastfeeding for both mom and baby — especially in countries where clean water is scarce and formula feeding poses serious health risks. The Code, too was developed with the best intentions: to prevent misleading marketing claims and reduce corporate influence on feeding practices. And for many moms, certified lactation consultants are a force for good and a source of support.
But forcing a binary choice between breast and bottle-feeding — without giving moms all of the information they need — doesn’t support mothers. Instead, moms deserve access to information about all their options, including formula supplementation.
Better leave and pumping policies
Even if breastfeeding does come easily, our culture is not set up to support women exclusively breastfeeding for the WHO-recommended length of time.
While we’re told that we should exclusively breastfeed for six months and continue to breastfeed for at least a year, the median length of (paid or unpaid) maternity leave in the U.S. is 11 weeks, and only 14% of American workers have access to paid leave.
This is especially frustrating when research indicates that leave is a key part of the breastfeeding puzzle. Returning to work before three months may reduce a mother’s ability to meet her breastfeeding goals. Studies show that working women who receive 12 or more weeks of paid maternity leave are more likely to start breastfeeding and continue breastfeeding for six months than women without paid leave. In another study, researchers found that a one-month increase in maternity leave led to a 2.2 month increase in breastfeeding duration. If we want moms to breastfeed — and to sustain breastfeeding — we need to provide better paid parental leave.
And once women do return to work, we need to provide them the time and space to pump. Despite the Break Time for Nursing Mothers Law, women still face barriers at work that prevent them from expressing milk. Research suggests that 60% of women do not have the time and space they need to pump at work, but women who did have the time and accommodations were 2.3 times more likely to be breastfeeding exclusively at six months.
An alternative to sugar-laden formulas
Unfortunately there are barriers for formula-feeding mothers too. In the United States, we’re lacking in not just education about formula, but also healthy options that we feel good about feeding to our children.
While formula is highly regulated, there aren’t yet restrictions on the sugar content in baby formula. Formula needs to contain a certain number of carbohydrates in order to meet a baby’s nutritional needs. In breast milk, the primary carbohydrate is lactose. But in formula, that carb is often corn syrup or sugar. In some formulas, babies are getting up to 10 grams of corn syrup per 5-ounce serving. That means over the course of a day, they’re guzzling more sugar than you’ll find in a bottle of Coke!
Recently, many parents have begun to seek out better options by purchasing formulas from the European Union. The E.U. has stricter rules about pesticides and limits the amount of corn syrup in formula (there, corn syrup can only make up 50% or less of carbohydrates, while in the U.S. all carbs can come from corn syrup). Unfortunately, European formulas pose risks too.
The bottom line: To be successful, moms and families need support without judgement. We need education that acknowledges the real challenges of breastfeeding at the same time it teaches the benefits. We need information about all of our options. We also need policies that help working moms meet their breastfeeding goals. And for the mamas who rely on alternatives to breastfeeding, we need formulas with ingredients lists we can understand and feel good about using to nourish the next generation.
This story originally appeared on Apparently.