The socioeconomics of breastfeeding

The poor do things that are easier for the short-term–because their worldview doesn’t really allow them to plan for the long-term. It’s a luxury.

If you grew up on formula and so did everyone you know and you think you’re all doing alright, some statistics about how much healthier a breast-fed kid is compared to a formula-fed one isn’t going to necessarily resonate. Even if you believe the stats, you have to do a cost-benefit analysis if the costs seem tremendous. Factor in the time/money/energy in training (some people may make it sound “instinctual”, but hospitals and the experiences of new mothers certainly don’t make it sound that way) and the chance that the baby won’t latch even when you do all it takes. All the pumping and the inconvenience. I don’t understand why a poor working woman WOULDN’T see the benefits of formula over breast-feeding. I think it would require more than abstract statistics for someone just struggling to survive to modify their behavior in such an enormous way.

I agree what’s been said earlier. A lot of middle-class women are turning to breast-feeding not just because of the presumed benefits, but because of cultural pressure. When it comes to bringing up baby, there is a stigma to doing stuff that “conventional” wisdom says is wrong–and the middle-class has always been about marching to conventional wisdom. I was relaying to a coworker that I don’t like soy milk because it’s smell reminds me Similac (the form found in my niece’s diapers :)), since my sister didn’t breast-feed at the time, and my coworker’s response was “HOW LAZY!” Turns out this coworker, like me, was raised on formula. She’d never dare call her mother out for being “lazy”, so why would she think it was appropriate to do that for my sister? Because conventional wisdom says the wisest choice is to breast-feed your babies. And if you don’t follow conventional wisdom? Well, you be lazy or something.

To be perfectly honest, I breastfed all of my kids out of sheer laziness! Okay, okay: maybe I started with the first based on earnest research about the benefits for both of us, but after it turned out to be so cheap and easy, the subsequent four were nursed for at least a year because (for me) it was so much easier than formula. No mixing, sterilizing, warming, or carting around bottles. No ear infections, very few illnesses of any sort, and (bonus!) less-stinky poop. I have a hard time thinking of formula as the lazy choice, but I personally never had to pump. I had the luxury of working from home with the oldest, and an awesome boss who let me bring the littlest with me when I went back to work.

In Spain, most women go back to work a month after the baby is born. That immense majority who can’t bring the baby to work usually mix breastmilk and formula. It isn’t a XOR proposition, people!

:confused: that’s crazy
How does that even make sense, I hope the big smilee still provides fridges.

jaw/drop.

Doubtful. I just stuck her name up on the board last week for making the Honor Roll.

It’s more than just “conventional wisdom” . . . the superiority of breast-feeding is scientifically supported and well-established.

It’s interesting to me that most people here are being much more charitable to poor mothers who bottle-feed than the doctors I work with. Even the doctor at the academic institution, where they tend to be much more sympathetic towards the issues that poor people face with regards to medical care, seemed very frustrated at the lack of breast-feeding among his patients.

I wonder if there are two classes of American poor. The group that you all are talking about, who are working and also aware of the benefits of breast-feeding and in an ideal world would like to breast feed but have decided through a cost-benefit analysis that the difficulties it would pose outweigh the benefits and a second group who seem generally sort of ignorant of much of the new information regarding child-rearing. Because honestly the group of people I worked with seemed to fall into the latter category. Just total ignorance about contraception and proper nutrition and milestones, etc.

That’s a great question. I wonder how many changes we could make in the world if we took all the energy spent judging the choices of other mothers and put it to better use.

It’s certainly possible.

I’d guess the poor women who are intelligent and sensible and can make highly rational decisions probably don’t spend as much time in doctors’ offices as the ignorant, irrational, and stupid. Doctors and nurses, like cops, see more people at their worst than the average person does. Maybe this could bias them slightly? Maybe?

The subject actually has been studied.

Race does matter. (These are cultural issues among low SES groups.)

Overall the decision to bottle feed is made well before a child is born and the reasons center around

Personally I think we market breastfeeding all wrong. We focus on the health benefits for the baby, and sure they are real, but we do not adequately advertise the other, selfish, reasons to choose breastfeeding (as Lacunae Matata realized):
[ul]
[li]Once established breastfeeding is lots easier. No bottles to mix, no formula to lug from the store, always ready and on tap.[/li][li]Helps Moms lose weight while eating more. Better figure faster.[/li][li]A best buy.[/ul][/li]And Dad’s need to have their concerns addressed as well, obviously.

Formula is not poison and individuals will make their own choices and should, but as a society it is in our interest to get more mothers deciding to breastfeed for at least some period of time for some percent of the time.

There are a lot of things that are scientifically supported and well-established that middle-class and wealthy people don’t do. Like exercising and avoiding fatty foods. Or wearing sensible shoes and not reusing water bottles. Or not douching or always having protected sex. When everyone starts making scientifically sensical decisions, then you can start bashing poor women for choosing perceived convenience over what some faceless scientists say–who (and I say this as a scientist) seem to come up with contradicting findings every day, if you watch enough TV.

Perhaps because having an “M.D” after your name doesn’t make a person any more understanding or empathetic about people than someone else? In fact, I could see it making one less understanding. “How dare these people not listen to me!? I’m the authority! I’m the doctor! They know nothing and I know what is best! Don’t they know that?!”

It’s not surprising to me. I had a doctor with a minstrel black-face picture on his office wall. And he saw African American patients. I’m betting he probably didn’t understand them either. (I know that’s why I stopped seeing him).

I’m sure a lot, maybe a majority, of poor people are uneducated about those things. And maybe they have overestimated the amount of work involved with breastfeeding. I don’t know.

But I really don’t see how people here have not answered your question correctly. Are there hurdles to breast-feeding that the well-to-do take for granted? Yes. Are there cultural issues with breast-feeding that poorer women have to contend with that other socioeconomic strata don’t? Yes. Are middle-class/wealthy women subjected to different cultural pressures (conformity to parenting trends and current issues in conventional wisdom, whether based on science or not) that poorer women are not subjected to as strongly? Yes.

I don’t see why all poor people have to be either lazy/stupid or hard-working/rationalists. This is a complicated issue requiring a complicated answer. If you expected different, sorry.

It really isn’t THAT superior. I have one breastfed and one who was adopted. And I spent a lot of time looking at this data.

You do get antibodies early which are important. But those antibodies will also build up over time if you don’t breastfeed and the protection can be imitated by reducing the babies exposure. Babies who are bottlefed tend to get more colds, but that isn’t the end of the world (unless the cold is serious like RSV).

There is a slight decrease in some diseases - the diseases I’ve seen are rare to start with.

A very small difference in IQ, but the co-variants in that study were not (IMHO) well teased out and the difference was something like 2 IQ points. Choice in feeding as an infant is not going to be the thing that condemns one child to remedial ed while the other goes to med school.

There is a reduction in obesity - again, I’m not sure if the co variants were well accounted for.

There is a HUGE impact in breast over bottle where the quality of water used for mixing formula is questionable. But that isn’t a problem for most people in the United States, even the poor here have pretty good access to clean water. Do NOT bottlefeed - especially powdered formula - if you do not have access to clean water.

Quite frankly, I don’t consider the supposed benefits of breast feeding to outweigh how much it disrupts a woman’s earning potential, reinforces the biological over the cerebral, and reduces a woman’s role in the family to that of animal. An illiterate drug-addict can breastfeed, but does it make her a better mother, certainly not (well at least in my opinion). Besides there is plenty of pro-breast feeding propaganda out there. It’s practically impossible for most mothers to escape it and many are guilted into trying to breastfeed when formula would be the best choice.

Making the Honor Roll doesn’t necessarily mean you like staying in class. I was fifth in my graduating group and skipped every chance I could.

These could all be reasons why it’s more common among middle and upper-middle class women. In my job, even before I was pregnant I knew where the lactation room was, because there are signs posted everywhere. My work is such that it will be easy for me to take pumping breaks without disrupting things, and it’s common in the culture of my workplace (it does not hurt that I work in a research institution associated with a children’s hospital). In addition, because my husband knows it’s my choice and something I don’t have to do, I’m calling the shots and my role in the family won’t be in any way altered. In families where women are already struggling with gender roles and whether they are equal partners, I’m sure it’s a bigger issue.
I’m not going to address the biological versus cerebral argument, because I don’t think it’s a remotely valid one, as there are plenty of “cerebral” reasons to choose breastfeeding.

Upper middle-class white women breastfeed partly because it’s better for the baby, but they breastfeed mostly because it’s their cultural norm. It’s expected of them, and people look askance at them if they don’t.

Poor people bottlefeed because that’s their cultural norm.

You’re assigning both credit and blame wildly disproportionately to individuals of either group.

I understand how frustrating and exasperating a newborn can be (my son’s about 3 days shy of 2 months old), but possessed, demonic, evil or cursed?

People seriously believe this stuff? In the twenty-first century? Wow. Fighting ignorance indeed.

I think it’s the time aspect myself; my wife’s staying at home, and even when I’m home, she pumps roughly every 2-3 hours, and it takes her about 20-30 minutes each time, which works out at between 160 and 240 minutes each day, or a little more than 2.5 hours to 4 hours spent solely pumping.

That’s not including the time spent feeding the kid, which is another 15-20 minutes or so, or changing diapers, or cleaning pump parts, etc…

It’s expensive and tough, even for people relatively well off. I can see how the convenience of formula (mix scoop into water, shake up well, feed baby) could be a BIG attraction, especially at 2 am.

It’s the norm because it’s considered better nutrition for the baby. If formula was openly considered better for the baby, breastfeeders would be criticized for going the “cheap” route, instead of buying the superior product.

There are many valid reasons for going formula, cultural norm is a lousy one. It’s like buying your kids unhealthy food because everyone else is. You can buck the trend for your kid’s well being.

All of that is true. The point is that no matter how it became the norm, it being the norm is why most people do it.

Let’s not pretend that the breastfeeders have a disproportionate percentage of deep thinkers.

It’s a lousy reason to nurse, too, but I assure you that it’s the reason a lot of people do it. I have a friend who suffered ridiculously to keep nursing, and while I have no doubt she was genuinely concerned for her baby’s health, in her most frustrated moments she was all “What will people SAY if I stop?!?!?”

You certainly can. Most people don’t, though.

Remember, guys, that ZPFZealot stands for “zero population growth.”

I am often surprised that many people (not necessarily any of you, but most of that “upper-middle class” social group) speak about research showing the benefits of breastfeeding as if it’s science direct from Einstein, but pooh-pooh studies showing the benefits of circumcision and call parents who circumcize monsters.

So, the science only counts when it’s in your corner, eh?