The difference between "I can't" and "I won't" - and why it matters to all of us.

This should sound familiar.

A woman posts on a public online parenting forum, expressing feelings of discouragement about how her breastfeeding is going. She doesn't think she has enough milk, and has been supplementing with formula in a bottle, including one overnight feeding, as her mother-in-law wants to help her get more sleep (and has insisted that she move the baby from the bassinet in the master bedroom to the crib in the nursery). She has tried pumping but says she's not getting more than an ounce at a time, further cementing her belief that her breasts are just not working correctly. She confesses she's about to throw in the towel.

In just about every forum that exists, the response is usually immediate: breastfeeding advocates of all stripes begin offering advice for all kinds of different strategies she could use to get her nursing back on track. (If you're reading this, you probably thought of a few things right off the top of your head already, didn't you? I know I would have, if I hadn't written it myself.) Some of the comments are phrased more supportively and sensitively than others, but the objective is to arm the mother with information and cheer her on. Then, when the mother quits breastfeeding, if she feels guilty about it, the source of that guilt, in her mind, becomes the breastfeeding advocates who she now perceives as pushing and judging her.

And the lactivists feel frustrated that their advice and efforts seemed to go unused, or fell on deaf ears altogether. But why be frustrated? This was just one woman, and it's ultimately her choice, her prerogative as a parent to weigh the risks and benefits of her feeding choices and how they will impact her child. It doesn't affect the lactivists personally. It's really none of their business.

Why DO breastfeeding advocates, or lactivists, if you will, often get very worked up about, and seemingly invested in, other women's breastfeeding stories, particularly if their attempts to breastfeed were unsuccessful? Why do we seem to insist on making the personal into the political? Where does individual choice come into the discussion? Sensitive questions with complicated answers. Part of the answer includes the public health aspect, the impact on both infant mortality, and even the economy - all of which are extremely well-covered by other bloggers and a huge variety of articles.

One aspect of the answer I'd like to zero in on: I think one major reason many lactivists work so hard at helping women to succeed does go beyond helping that individual woman. This individual help is the most important thing, of course, and while one could argue that breastfeeding might not be the right choice for every mom, as some have observed, it is right for every baby*. Yet here's where it goes deeper: every time a woman publicly struggles with some aspect of breastfeeding - say, on a message board, or a blog, or on Twitter, and then succeeds due to being given good resources, support and information, other women see this example and learn from it. And every time a women publicly struggles and does NOT get the same quality of response, other women see this example and learn from it as well - and may not have any idea that the right resources, support and information could have made any difference. [Disclaimer: there are situations where breastfeeding is truly not possible, as in the infant conditions in the footnote, and the exceptional instances where low milk supply is a reality. They are incredibly rare, but also very real and certainly deserve respect (and frankly, more research).]

But even beyond that, there's another part of the picture that circles back to the matter of mother's individual choice. I saw this comment by Mary Woodring on the Facebook page for Peaceful Parenting the other day, and hereby hit "Like" a thousand times over. THIS is the rub, and the inspiration for this post:

"When a woman is unwilling to breastfeed, but tells people she was unable, it inflates statistics and seeds fear in other women that breastfeeding is an unreachable ideal for most women."

Yes.

Thank you.

There IS a flip side to that - and I can already feel the murmurs. In order for women to feel safe about publicly admitting that they were simply not willing to breastfeed, and that it was a choice, not some failure of their anatomy or - another frequent claim - "refusal" by their child*, we, as a breastfeeding advocacy community, need to be able to accept those choices and not condemn or harass these mothers who have made different choices.

Now, two immediate points: First, I definitely feel that the lactivists who TRULY do bully and judge mothers are in the minority. Far too often, advice is solicited, and then when things aren't working or the mother makes a different choice, the advocate becomes a scapegoat and a target of their own guilt, as in the example above. We've all seen it happen. But we also all know there are times when lines are crossed and unfair judgments are made . . . even insults. This needs to stop, and we need to make an active effort, even in the cases where guilt over the choice to formula-feed is directed at us inappropriately, I feel that it IS worth it to make doubly sure that we are kind and nonjudgmental. Annie of PhD in Parenting recently wrote a masterpiece on this matter, a post which I have made my personal mission to work on embodying. It's not easy. It does involve biting my proverbial tongue and sitting on my literal hands at times. But in order to move forward and start being able to make a clearer distinction between the "I couldn't" moms and "I wouldn't" moms, I think it's very much necessary.

Secondly, and I can't emphasize this part enough: being willing to accept mothers who have made the choice to formula feed and treat them respectfully does not, not, NOT mean cutting back on promoting information about the benefits of breastfeeding/risks of artificially feeding. Nor do we reduce efforts to provide moms with solid support and resources and information, and especially easing the access to all of the above. On the contrary, I feel it's all the MORE reason to redouble such efforts.

There are many, many moms out there who had no desire to breastfeed for any number of reasons, many of them cultural but some of them personal - and yet, after learning more, and more, and more about how dramatically it would benefit not only their babies but themselves, they slowly changed their minds. I know one such mother who started out being totally turned off by breastfeeding with zero plans to do so herself - who is now becoming a lactation consultant as a result of her experience. You probably know one too. They're out there, and they matter, and they can become some of the best counselors of all, since they've been there themselves.

If information and resources are copious and available, some of those moms who were initially unwilling might make the transition all on their own, and then, in the absence of judgment, the remaining mothers would be able to be honest and forthright about their choice WITHOUT perpetuating myths about their "inability" to breastfeed.

Let's all assume that mothers, with very few exceptions, actually do do the very best they can with the information they have at the time. Look how this gives moms the benefit of the doubt, assuming the best intentions, AND underscores the need for copious, accurate, easily accessible information. I am CERTAINLY not saying we throw in the towel, far from it. I'm saying we need to work harder and work smarter. Getting the information out there as positively and honestly as we can without diluting the message (that might seem cryptic, but it's best saved for another post) is mission critical. And I feel that reducing the number of mothers who state publicly that they could not breastfeed when it isn't actually true could have a major impact.

You may say I'm a dreamer, but I'm not the only one (I hope).

*Remember, only one in every 30,000 to 60,000 of all babies actually has galactosemia, and congenital lactose intolerance/lactase deficiency are likewise extremely rare - the conditions unrelated to mom's own diet that would cause a baby to have difficulty with the milk that was biologically designed for them, and are true contraindications.

[And no, the picture doesn't have much to do with this post unless you really stretch it into the abstract. But I thought it was fun nonetheless, no?]