Bottlefeeding Without Guilt
A Defense Manual for New Mothers
Who Choose Not to Breastfeed Their Babies
(Bottlefeeding Without Guilt was published by Prima Publishing, and is in print.)
by Peggy Robin
Author of How to Be a Successful Fertility Patient
Bottlefeeding Without Guilt
A Defense Manual
for New Mothers Who Choose Not to Breastfeed Their Babies
by Peggy Robin
Overview
Every year over four million American women have babies. Every one of these new mothers must make an important decision for herself and her baby: to breastfeed or to bottlefeed? One might assume intuitively that the matter is something calling for personal reflection, that it's an intimate decision, not open to public comment. But that's far from the case-ask any new mother! Breast-versus-bottle is not just the subject of discreet debate; these days it's become a topic arousing impassioned argument and ideological fervor. Nor is the controversy limited just to new mothers and fathers; everyone has an opinion: doctors, childcare experts, grandparents, employers, teachers, childless couples, and even complete strangers who just happen to be watching as the new mother begins to feed her baby in a public place. The simple act of taking out a formula bottle can make a parent the target of repeated unsolicited advice, and even public criticism.
That's a big change from about a decade or so ago. It used to be that when a woman started to breastfeed her baby in public, she had to be ready for stares and sometimes rude remarks from strangers. But fortunately for nursing women, advocates of breastfeeding have worked tirelessly and effectively to change public attitudes and promote acceptance of nursing as a normal and natural way to feed an infant at any time or place. Now many states have laws protecting the rights of nursing mothers. Now many employers have set aside rooms for new mothers to express milk for their babies. Now all formula manufacturers put an acknowledgment on the labels of all their products stating that breast milk is the best choice for infant nutrition. Now most obstetricians, unless told otherwise by their patients, simply assume that the new mother will breastfeed her baby.
The net effect of the many victories of breastfeeding advocates has been to turn the tables. Now it's the woman who chooses not to breastfeed who finds herself the object of social pressure. Now when a woman starts out with the bottle, she's in a minority- since up to 60% of all new mothers breastfeed, and among educated women, the figure is over 70% (according to USA Today, August 9, 1993). As is usually the case when a minority prefers to do things differently from the rest of society, intolerance crops up. These are just a few of the many instances I've observed:
Sally was waiting at the grocery check-out with her formula cans when the woman in line behind her told her, "You know, formula is just not as good for babies as breastmilk." Another incident: Margaret was bottlefeeding her son in the park when another mother sat down beside her and began to nurse her toddler. The nursing mother asked if Margaret had ever nursed her child. Yes, Margaret answered (though somewhat stunned to be asked by a stranger about her personal life), adding, "I switched to formula at six weeks when I had to go back to work.". The nursing mother immediately told Margaret that she could have expressed milk while at work and that it was too bad she had given up nursing so soon. And here's a third case: Anne set out to breastfeed but after two weeks contracted a severe breast infection called mastitis. Choosing not to continue nursing while in pain and on narcotics, she told her nurse at the hospital that she would now be bottlefeeding the baby. The nurse plainly showed disapproval, urging her to continue to breastfeed despite her pain. When Anne insisted on a switch to the bottle, the nurse from then on treated her as neglectful mother, one who cared little for the welfare of her baby.
Talk to any bottlefeeding woman these days and chances are good you'll hear at least one story along these lines. Non-breastfeeding mothers of infants are feeling increasingly on the defensive, increasingly under scrutiny. They could use some understanding and support. They could use a book that points out the often overlooked benefits of bottlefeeding for both mother and child. Bottlefeeding Without Guilt is that book. Here at last is the book that makes the case for all those millions of women who choose not to nurse.
Bottlefeeding Without Guilt will cover:
Why a book like this? Because for many years women who have chosen to breastfeed have had good books supporting their decision, but there has been no comparable work in support of bottlefeeding. Most of the popular pro-breastfeeding books go farther than simple advocacy of nursing; they include long passages proselytizing against the bottle, portraying the non-breast option as not merely inferior but actively harmful to the baby and the mother. (See for example, representative books such as La Leche League's The Womanly Art of Breastfeeding, or The Nursing Mother's Companion from the International Lactation Consultants Association, or Bestfeeding by Renfrew, Fisher and Armes.) Implicit in such books is the idea that the bottlefeeding mother is an inferior parent. It's not hard to see how the nursing mothers who read these books can end up feeling smug-and how easily they might end up saying thing to make the bottlefeeding mother feel guilty. To get an idea of what bottlefeeding mothers are up against, let's just take a quick look at a few letters to the editors that have appeared in recent magazines and newspapers:
The World Health Organization and UNICEF rank acceptable infant feedings as follows: first, breastfeeding; second, the mother's own milk expressed for her child; third, milk from another human mother; and fourth, artificial baby milk. No baby deserves fourth best, whatever the circumstances.
-Diane Wiessinger
writing to Science News magazine, Aug.
14, 1993
It is well established, for example, that breastfed infants have lower hospital admission rates and suffer fewer ear infections, episodes of diarrhea and skin disorders, among other ailments, than do bottlefed infants. All this sounds bland enough, but for the infant whose sensitivity to pain is razor sharp but whose understanding of it is nonexistant, the difference is hardly trivial.
-Stewart Wills
writing to The New York Times, Oct 23,
1993
When there was a good [breast]feeding, I felt like the perfect parent. Similarly, when there was a difficult feeding, I would feel like a complete failure. At those discouraging moments it was tempting to reach for one of the sample bottles that formula companies had bombarded me with just before my son's birth. The formula companies make seductive claims at a very vulnerable time in a new mother's life, with their promises of ease of preparation....
-Cindy Bertaut
writing in Washington Parent magazine
July/August 1993
Bottlefeeding without Guilt is here to restore balance to the debate-and to debunk some of the wilder claims we hear about breastmilk. Do breastfed babies really have higher IQs? And are they protected against ear infections, asthma, eczema, obesity, allergies, and childhood leukemia? At last there will be a book to inject some much needed reasonableness into this overheated topic and put in a few good words, as well, for tolerance and and respect for an individual's choice.
Bottlefeeding Without Guilt will be the
book for the woman who takes her motherhood seriously but does
not make a cult of it, who understands that just because she can
make milk, that doesn't mean she must do so. In the stressful
first few months of new motherhood, a book that supports the
parents' nutritional choice for their baby will appear like a
reassuring friend. It's sure to be talked about and recommended
by mother to mother.
The Market
Who will buy this book? Some of the large potential markets are:
Pregnant women trying to make up their minds before the baby is born.
New mothers who have already chosen the bottle, who will be delighted to have a book they can quote as an authority to anyone who questions the infant-feeding decision they have made.
Mothers who started out nursing, but who must switch to bottlefeeding for any of dozens of reasons such as whose babies have just acquired teeth, need to take medication, need to travel away from baby, poor infant weight gain.)
New fathers, who, increasingly these days, are assuming a primary or co-equal role in childcare.
New grandparents, aunts, uncles, and other relatives who play a role in infant care and feeding. The older generation who bottlefed their 1950's era babies may feel under attack from their own children who refuse to consider anything but breastfeeding. There will at last be a book for older generation to cite that will validate what they did with their own babies.
Medical professionals. Even those who urge their patients to breastfeed would be happy to have a manual to recommend to patients who have announced their intention to bottlefeed from the outset. Doctors who take a more evenhanded approach might like to recommend this book along with some pro-breastfeeding books to the patient, and let her come to her own conclusions.
Employers and employees. Mothers who choose not to take any time off from work to express milk or to nurse a child in daycare sometimes resent being asked to take over tasks from nursing mothers who need frequent breaks. Employers often find themselves caught between demands of conflicting groups. Bottlefeeding Without Guilt will explore the workplace dilemma from the much-neglected point of view of the non-nursing parent.
Adoption advocates. Some 25,000 infants are adopted in this country every year. Pro-breastfeeding arguments often imply (or explicitly proclaim) a bias in favor of biological mothers over adoptive mothers, because adoptive mothers can't nurse. Defenders of adoption will welcome a book that doesn't stigmatize the feeding practices of adoptive parents as inferior to those of birth parents.
All these potential markets are expanding, because more and more women are finding breastfeeding not as rosy, wonderful and hassle-free as its organized advocates portray it. Over past decade more and more women have gone back to bottle, giving up breast (USA Today, Aug. 9, 1993).
In this current baby boomlet a high proportion of second children are being born, ever-increasing numbers are being born to older mothers, and a majority of babies are born to mothers who plan to go back to work within the first six months of the baby's life. Mothers in all these categories are more likely to have reasons to switch to bottlefeeding at an earlier age, or to rely on the bottle from the beginning. Nevertheless, these women often feel terribly guilty for taking the child off the breast, or for bottlefeeding a second or third child, when the first child was breastfed. Bottlefeeding Without Guilt is exactly the book these mothers need.
They'll eagerly read it and pass the word along to their bottlefeeding friends. Word of mouth is, of course, a great seller of books.
The subject of the book is one that will be
with us as long as there are babies and parents who feed them.
Because the book will never become obsolete, it should enjoy a
very long life in print.
Back to main page
The Competition
There is no book specifically for bottlefeeding parents. General infant care books will offer information about bottlefeeding, but nearly always following a lengthy section on breastfeeding and including an obligatory statement that breastmilk is best.
Dr. Benjamin Spock's 1985 edition of Baby and Child Care begins its infant nutrition chapters with a two-page account of the benefits of breastfeeding to both mother and child. His section on formula feeding contains several pages of information on proper sterilization of bottles and nipples (something, nowadays, that is recommended only in those parts of the country with unsafe drinking water). This out-of-date approach gives a false impression that formula preparation is time-consuming and potentially dangerous. Dr. Spock further devotes several pages to the preparation of home-made formula using evaporated milk and corn solids-something that practically no one needs to do in this age of well-stocked supermarkets in every city and town.
In Penelope Leach's guide Your Baby and Child from Birth to Age Five, she begins with the premise that "breast milk is physically better for babies because it is the milk that nature intended for them," but she goes on to devotes eight pages to bottlefeeding-three of them to sterilization procedures for bottles, nipples, rings, bottletops, mixing spoons, funnels, and anything else that might come into contact with the infant formula. She even has a section on storage of formula for families without refrigeration-hardly a concern for mainstream families of American babies today.
Although What to Expect the First Year (Eisenberg, Murkoff, and Hathaway) does contain some useful tips in its six page section on bottlefeeding, it too assumes that sterilization will be necessary in many cases; furthermore, in its advice about ways to maximize skin contact with the baby during bottlefeedings the book implies that the non-nursing mother won't be giving her baby enough cuddling during feedings.
In contrast to the limited space devoted to bottlefeeding, the literature on breastfeeding is enormous. A search of Books in Print found thirty-seven books devoted exclusively to the subject of breastfeeding. There are how-to guides, advocacy manuals, picture books, books for doctors and other professionals, books for nursing mothers of twins, mothers of premature babies, and many other categories of reader.
If breastfeeding needs so many books to cover the subject fully, perhaps the reason is that there are a great many problems associated with breastfeeding, and the nursing mother should expect to need much expert advice. Instead of working her way through a pile of books trying to find the right one to help with her specific breastfeeding problem, a new mother would welcome a book that offers a simpler alternative, Bottlefeeding Without Guilt.
No other book on the market today contains the kind of practical, up-to-the-minute advice about feeding a baby through commercially available products as Bottlefeeding Without Guilt. The book will discuss the pros and cons of all the different brands of formula on today's grocery shelves. It will also review the different forms available (powdered, liquid concentrate, ready-to-pour, and ready-in-bottles) and the different types (regular milk-based, lactose-free milk-based, and soy-based) that consumers can choose, while discussing pluses and minuses of each. Valuable tips about storing, transporting, heating, and cooling the formula, and what types of bottles and nipples to use will be included as well.
As bottlefeeding parents are advised to feed the baby formula for at least its first full year, this book will be one parents will turn to month after month for help. As breastfeeding mothers may at any time during the baby's first year decide to switch to formula, the audience for the book will expand beyond its original target of non-nursing mothers of newborns.
Because of its controversial thesis, that bottlefeeding is just as good in many ways as breastfeeding, the book will certainly attract the attention (and arouse the ire) of organized breastfeeding advocates. It's to be expected that Bottlefeeding Without Guilt will be sharply attacked in certain quarters, thus generating much publicity for the book. The author is willing to go head to head with any breastfeeding leaders in the media in defense of the choice of the bottle over the breast.
Breastfeeding has become something of a sacred
cow (bad pun intended)-and anytime a sacred cow is gored, people
take notice. The subject is one that the talk shows might very
much like to milk (another bad pun intended).
About the Author
Peggy Robin is the author of three books: How to Be a Successful Fertility Patient (William Morrow & Company, 1993); Outwitting Toddlers (co-author, Bill Adler, Jr., published by Lowell House, 1993); and Saving the Neighborhood: You Can Fight Developers and Win! (Woodbine House, 1990). Her articles have appeared in the Washington Post and elsewhere.
She is also the mother of two daughters, one born in 1990 and the other in 1993. She breastfed her older daughter exclusively for seven months, but after health problems prevented nursing of her new baby, she began to bottlefeed, and was amazed to discover how much easier it was than nursing. The idea for Bottlefeeding Without Guilt was thus born out of her personal experience, but the book will be based on substantial research, including personal interviews with both bottlefeeding and breastfeeding mothers.
Robin's previous book, How to Be a Successful Fertility Patient, was similarly born out of her own experience but also backed by hundreds of interviews and medical documentation. Her successful appearances on The Today Show and the Maury Povich Show brought letters and calls from infertile viewers eager to buy her book.
To quote two of the medical professionals who read the book:
"Excellent - it's chock full of information that I haven't seen anywhere else....I will certainly recommend it to my patients."
-Susan Cooper, Ph.D.
"Very interesting and helpful for infertile couples. I will enjoy utilizing it in the future."
-G. David Adamson, M.D.
Annotated Table of Contents
Introduction - Why This Book Is Needed
A short history of bottlefeeding, covering the
rise of the bottle in the late 1940s through the 1960s, the
rediscovery of nursing in the 1970s, and the growth of the
practice until, by the 1980s the use of the bottle had become a
minority choice. How organized breastfeeding advocates worked to
politicize the decision. Why bottlefeeding parents must refocus
the discussion on personal comfort and individual choice.
Chapter One - Why the Bottle?
A consideration of the several dozen reasons
why parents choose to bottlefeed their infants, including
discussion of: common difficulties in getting nursing
established; need for fathers, other relatives or caregivers to
feed the baby; demands of mother's employment leaving no time for
expressing of milk; speed of bottlefeeding compared to
breastfeeding; unwanted contraceptive side-effects of nursing;
painful vaginal dryness caused by nursing; nipple pain and
mastitis from nursing; desire to avoid difficult weaning period
during toddlerhood; faster infant weight gain possible with
formula; maternal medical reasons (e.g., breast cancer, or
fibrocystic breast disease) to avoid nursing; adoption;
sensitivity of baby to elements of nursing mother's diet;
mother's need to take medications that interfere with lactation;
mother's need to travel without baby; and many others.
Chapter Two - The Overselling of the Breast
Organized advocates of breastfeeding are
generally not content merely to point out certain advantages of
breastmilk over formula. They frequently attribute so many
wonderful qualities to breastmilk that it appears to be a miracle
potion. This chapter will examine some of the more extreme
claims, such as the protection breast milk has been said to
provide against ear infections, allergies, eczema, obesity in
later life, childhood leukemia, and others. Conversely, a few
breastfeeding zealots have attempted to demonize formula as a
near-poisonous substance, and the companies that manufacture it
as participants in a vast conspiracy to starve and exploit the
poor and ignorant all over the world. This section will tell the
story of the ongoing high pressure campaign against formula that
has forced its manufacturers to withdraw advertising, end charity
programs, curtail giving of free samples to consumers, and
otherwise restrain free trade.
Chapter Three - More Than a Simple Feeding Choice
Many of the most outspoken advocates of breastfeeding and critics of formula feeding have more on their minds than what's best for the baby. An examination of writings by some of these advocates reveal some strong links between pro-breastfeeding groups and so-called "pro-life" groups. A certain segment of the pro-breast movement is also firmly pro-stay-at-home mother and hostile towards working mothers. Other themes frequently sounded by anti-bottlefeeding writers include antipathy toward adoption; motherhood as the ultimate woman's achievement; self-sacrifice as basic to the nature of femininity; and a deep-seated discomfort with women's sexuality. There is also a prominent anti-capitalist spirit that became evident when the pro-breastfeeding side successfully organized an international boycott against formula companies that marketed their products in the Third World. This chapter will expose some of the hidden agendas of the anti-bottle camp, and detail for the first time the occasionally cult-like behavior of some leaders and members of breastfeeding support groups
.
Chapter Four - Bottlefeeding, Simple & Easy
Everything you need to know to get started.
Help in choosing the right formula for your baby. Comparisons of
different types of formula: concentrate, powder, ready-to-feed in
cans, and ready-to-feed in bottles. Soy versus milk. Milk,
lactose-free or not? Are all brands the same? Nipple shapes and
sizes: orthodontic, straight, rubber, silicone? Wide-top or
standard? Bottles: Bag insert style (the Playtex system) or
standard? Bottle gimmicks (the Anso "Easy Grip"
bottles; bottles that convert to cups, bottles that can be
attached to strollers) - are any of these useful?
Chapter Five - Working Mother & Hungry Baby.
An in-depth look at employoment issues. Should
breastfeeding mothers get time set aside to nurse or express
milk? Should equal time be given to the bottlefeeding parent? Can
a career-oriented mother who leaves her new baby with a sitter
and a bottle still be as loving and maternal as a stay-at-home
nursing mom? Will the bottlefeeding working mother successfully
"bond" with her baby?
Chapter Six - When the Feeder is Not the Mother
Dads as primary caretakers and bottlefeeders.
Stay-at-home fathers talk about experiences such as unsolicited
advice from women who assume that a man cannot competently feed
an infant, or rejection from "mothers' groups" that
deal with childcare issues. Discussion of bottlefeeding by
grandparents, aunts, uncles, and other relatives. Consideration
of the role of the sitter, nanny, or daycare provider in the
baby's feeding routine.
Chapter Seven - The Older Bottlefed Baby
Introducing solid foods into the older
bottlefed baby's diet. When and how to wean the baby from bottle
to cup. When and how to switch from formula to regular milk, and
what kind of milk to choose (lowfat or not?). What to do if baby
balks at any of these changes.
Chapter Eight - Having the Best of Both Worlds
Despite claims by breastfeeding zealots to the
contrary, women can successfully combine bottlefeeding with
breastfeeding. How and when to introduce the bottle. Different
ways to use the bottle: Just at certain times of the day; only by
sitter; only while traveling; other schedules.
Chapter Nine - Your Feeding Choice & Your Future
How your choice affects child spacing,
fertility problems, behavior of older siblings, weaning, your
sense of privacy, modesty, your long term health (including new
evidence on nursing's effect on bone marrow loss) your sex life,
diet & weight loss, your baby's weight gain, illness &
hospitalization in the family, longterm effects on child's
personality and behavior, and ways your relatives, child's
teachers and others will react to you and your child throughout
your lives (an example of the latter: Sisters-in-law who are very
competitive with one another may sometimes fall into a
"Who's-the-better-mother" contest. The nursing mother
may subtly or overtly try to make the bottlefeeding mother feel
inferior. The chapter offers ways to avoid this syndrome and
equalize the relationship with the relative).
Chapter Ten - It's Your Choice
Making your decision. How to know what's right
for you and your baby. Quiz to help expectant parents analyze
their own feelings and circumstances. Conclusions about society's
interest in an individual's health decisions.
Index
Manuscript details: 350 manuscript pages
Time to completion: 12 months
