I just recently completed a rotation in a very poor part of rural America. Nearly all the moms of babies I saw were on public assistance, many were underemployed, and only one of them (out of maybe 80-100) was breastfeeding.
I am honestly totally baffled by this. Breastfeeding is cheaper, arguably more convenient, and definitely healthier for babies. It’s possible that all these moms tried to breastfeed and were simply not able to, although I doubt that. Also I saw some new moms immediately state postpartum (and prepartum as well) that they were going to bottle feed.
My preceptor declared it was because formula was free with WIC and these people wanted to do as little work as possible, but I would like to hear some other opinions. Is bottle-feeding very common among the American poor? Or was my experience not representative? And if it is common, why?
Back in the day, formula companies pushed formula as being more scientific, more civilized than breastfeeding. Now, of course, they have to say that breast milk is best, but that their formula is a good substitute.
Also, if you’re the type who likes to smoke and drink and use recreational drugs, even the dimmest bulb knows that a lot of that shit is gonna end up in your breast milk.
Other than that, I got nothing. But I nursed my daughter until she was about 14 months old…and I would have nursed her longer, but I needed to go on antidepressants, which would have ended up in my milk. She was violently allergic to cow’s and goat’s milk, so after I weaned her, I gave her soy formula until she outgrew the allergy.
Breastfeeding is easier for a mother who is mostly stay-at-home. It’s NOT easier for a mom who works outside the home, or who wants to go out without her child for several hours at a time. And it’s not easier to pump and save the milk and have someone else bottle feed the baby.
Probably because for the last 40-60 years poor mothers received free formula, but not access to a lactation nurse once they leave the hospital (assuming they even get one then).
Here in Peru, you still see -although less through gigantic effort by the authorities including banning formula ads in public hospitals- dirt poor women using the little money they had to buy formula.
It was a case of imitating what upper class women were doing.
Thankfully this is going down to almost zero. Now all public hospital have breastfeeding being taught to mothers (especially very young ones) and active encouragement by all health services staff.
I think a large part of it is that our society to a large degree shuns breastfeeding. A woman feeding her baby in public is considered somehow “indecent”. We need to get over that, though I’m not sure how.
This. Breastfeeding is cheap – breast pumps are NOT cheap. You also need a consistent source of refridgeration to preserve breast milk so that others can feed the baby while you’re gone. If your power gets shut off you’re going to lose everything. This is why the formula in WIC is virtually always premix, not powder.
Just because a woman receives WIC doesn’t mean she is unemployed. The OP said that many of these women are underemployed. I’m pretty sure WalMart et al doesn’t let you bring your baby in a sling and breastfeed on demand while you’re working – or give paid leave to part time employees.
This has to be a large part of it. Women have been breastfeeding forever without the aid of breast pumps or refrigeration. It can’t be for lack of those things. It’s our society and the stigma (for lack of a better word) that breastfeeding has associated with it. And, of course, working women not being able to keep a feeding schedule going while at work.
Breastfeeding can be very hard in the beginning. It can also be quite time consuming later on. I nursed my first for two years without a problem.
The second has been a different story. She never latched despite three sessions with lactation consultants. She lost weight at her two week check up because I couldn’t get her to latch. I’ve been pumping ever since and supplementing with a few bottles of formula a week. To get enough milk I literally have to spend about four or five hours a day either hooked up to my $300 pump or pumping by hand. In the morning I tend to get about ten ounces of milk in less than half an hour. But the other fifteen to seventeen ounces she eats takes hours to get out.
My youngest daughter is five months old. Not a day goes by when I don’t think about saying to fuck with it on the pumping and just giving up. I’m so glad she’s starting to eat solids.
Nursing a baby is not always as easy as people like to think it is.
In Appalachia I’m surrounded by young mothers and bottle fed babies. Formula is the norm, and the breast is largely utilized by more educated, financially stable mothers. In Virginia WIC was originally intended to provide nutrition for nursing mothers instead of formula, but was quickly modified to include infant foods because all mothers cannot be expected to breastfeed. Fair enough: breast feeding is not always the best choice for reasons ranging from the physical, to the practical and economical.
However, there are millions who can breastfeed, and choose not to for personal reasons. Ultimately none of our business, but I agree, Gestalt: huge waste of money and waste of nutritious food for baby. Breastfeeding carries a huge stigma among the low income largely Christian population in the south. Perhaps it is because unchurched natives of third world countries breastfeed and it seems unsophisticated. Perhaps the idea doesn’t live up to little girls’ dreams of cradling and bottle feeding baby. But based on personal anecdotes related from acquaintances and co-workers, it seems that breasts are seen as naughty, dirty, or intended for sexual purposes only and many women choose the bottle because the alternative squicks them out.
Someone will drive by to chew me out for disrespecting the personal choice of bottle Moms, but if the choice to eschew the breast is because of peer pressure or social/sexual hang-ups… both Mom and baby are being deprived of a nutritious, economical, and physician recommended opportunity to grow and bond.
ETA: maybe someone who was disgusted by the idea of breastfeeding will chime in. Genuinely curious as to how that disconnect (between utility and sexuality) occurs
Bottle-feeding is very common, full stop. Only about 10% of American women exclusively breastfeed for 6 months or more. Maybe your expectations are not representative.
Nursing a baby especially is not easy if you are on your own without experienced nursing moms around you. I sometimes think it is easier if a new mom can try it with an experienced baby, and vice versa. If you and your baby are both fumbling, and the little one cries with hunger, it takes determination, knowledge and self assurance to keep on fumbling untill you both get it.
Thank you for clarifying, but how is that stat relevant to the discussion? Introducing new foods in addition to breastmilk is not comparable to feeding formula *instead *of breastmilk. For that matter, breast milk can be pumped and fed via bottle instead of directly from the breast if that is more convenient for mother and baby. It isn’t the mechanism of delivery or the introduction of new foods that is the issue; it is breastmilk vs. formula.
The poor don’t sew their own clothing, bake their own bread, etc. even though you would think it made sense for un/under-employed people to substitute the time they have for the money they don’t. It’s astonishing how many people, even poor people, even forego cooking when they can get by on takeout, ready-to-eat, and prepackaged food. For some reason most people would rather earn money at a job and then spend the money on not having to do any other work. Formula rather than breastfeeding fits this pattern.
The numbers do reflect the use of formula, but I suppose I could have cited the those who are breastfeeding who supplement with formula and added that number to those who aren’t breastfed at all. Postpartum (less than 2 days) 25% of those who are breastfed are also supplemented with formula and by 6 months it’s almost half (source). Add in the babies who are not breastfed at all and no matter how you slice the numbers, the majority of babies are being fed formula.
Totally anecdotal, but I teach at a public university in a low-income part of the country, and I’ve had students who wrote in papers that they were shocked when a friend or relative decided to breastfeed because nobody they knew had ever made that choice before.
I think it’s very much a cultural thing; in general, people will do whatever they see people around them doing. (If I had to speculate about why the cultural norms are different at different income levels, my guess would be that bottle-feeding initially started to carry a certain cachet for poor people because it demonstrated they weren’t destitute, whereas breast-feeding subsequently began to carry the same cachet for middle-class people because it was different from what poor people did. But this is only a guess.)
In a previous thread we discussed the rise of labor-saving devices and the decline of the classic house servant in upper and middle class households, and I mentioned a phenonemon called Baumol’s Cost Disease, which affects the relative cost of labor in an economy. Could it be that even the poor don’t consider being “self-employed” in household labor worth the effort anymore?
I agree with those above who think it’s cultural. I am also in the South, so the religion thing probably is part of it (although somehow your religious beliefs didn’t stop you from having 3 kids out of wedlock with two different men . . . ). Anyways, this is an interesting topic for me. I wish there was a way to change the perceptions of breastfeeding.
Oh, and regarding the time issue . . . pretty much every middle-class and upper-middle-class woman I know is both working part-time or full-time and managing to breastfeed. Or at least they tried very hard to breastfeed. I totally absolutely understand that not every woman can breastfeed, nor should they be expected to. And of course it is every parent’s personal decision to do what’s they think is best for their child. But it seems to me like large swathes of the population are selling their children short for no particularly good reason, other than what they have seen others around them do.