The vast majority of new moms try breastfeeding—and if they work, breast pumping too. Professor and author Courtney Jung discusses with Working Mother's Jennifer Owens the difference between the two—and why it matters so much.
Okay, it’s a bad pun, but chances are you’re intimately familiar with the meaning behind it. Pumping can be painful, time-consuming and, let’s face it, a hassle. Even so, studies show that some 79 percent of new moms initiate breastfeeding—and in New York City, where Working Mother is based, it’s 90 percent. In an election season of intense conflict, it’s amazing to think that breastfeeding babies is an issue on which nearly all of us agree.
Yet we didn’t always believe “breast is best”—likely your mother didn’t. So what changed? That’s the question political scientist Courtney Jung sought to answer in her recent book, Lactivism. But it led to many more, revealing that the science behind breast-is-best is at the minimum suspect, while public policy built on the belief could be called questionable. We sat down with the University of Toronto professor to find out what she’s learned.
JENNIFER: What led you to write this book?
COURTNEY: Having my first baby, of course. I was surprised by how much moral fervor there was surrounding breastfeeding. I wasn’t opposed to it at all, but I had never thought about it.
It was 2005, and I thought I should really write about this because there was such a consensus building around breastfeeding among people who agreed about nothing else. But then I was busy. I had a second child in 2011, and things had only grown more extreme in the intervening years. I thought, I really need to write this book.
I was born in 1965. My mother did not breastfeed, nor did any of her friends. She still thinks breastfeeding is kind of gross. So I knew that in the space of 40 years, there had been a total sea change in our attitudes. How do we come to believe what we believe? I started the book with that question.
J: Let’s start with the terminology. We call it breastfeeding—and when I was doing it, I called it breastfeeding. But in actuality, a lot of what I was doing was breast pumping. You note that this distinction is an important one, but why?
C: It’s important for a number of reasons. One is that breast pumping is a particularly American thing. Women are breast pumping, and all of our public policies are about breast pumping—facilitating pumping, making pumping easier, making pumping cheaper. That’s an explicitly American response to the contradiction between six months of exclusive breastfeeding [recommended by the American Academy of Pediatrics] and the absence of a federally mandated paid maternity leave.
So there’s a particular reason that we in the United States are pumping instead of breastfeeding. That’s one reason it’s important to draw that distinction and realize what we’re actually doing here. Pumping is compatible with U.S. government policies because it’s business-friendly; it’s all about maintaining a competitive economy and labor force. It’s not primarily a benefit to mothers and children.
That’s the reason it’s important to point a finger at what we’re actually doing in the U.S. Maybe some women will want to continue doing it and some women won’t, but we should at least know what is actually going on here.
J: I think when I was choosing to breastfeed, I was in my own world, not looking any further than my own relationship to my baby and how to find time to pump at work.
C: I know! I don’t think we’ve all sat up and noticed that.
J: Even at Working Mother, we haven’t tied this conversation about breastfeeding versus breast pumping to the fight for paid leave. We also haven’t asked, “Why are we all breast pumping so much rather than breastfeeding?”
C: One reason it’s important to make that distinction is that there’s absolutely no research into whether or not they’re the same thing. If breast- feeding reduces the risk of infection, it’s not at all clear that going through the stages of pumping breast milk, then freezing or refrigerating it, then heating it will reduce the risk of infection, or reduce the risk of infection as much as breastfeeding. I’m not saying it will or it won’t. I’m saying nobody has any idea because nobody—nobody—has done that research. There is no research into whether breastfeeding is the same as feeding a baby human milk from a bottle.
J: Yet why did I want to do it so badly? I was fully committed to breastfeeding my babies and breast pumping because I knew “breast is best.” I wanted to make sure they had the best, especially as a working mom who was going to leave them with a caregiver. I saw it as something I could do to protect my babies when I couldn’t be with them.
C: Probably a lot of that is driven by guilt, as in, “I’ve got to leave my baby to be taken care of by someone else; the least I can do is feed her breast milk.”
J: I breastfed both my babies for a year, but for my daughter I supplemented my milk with formula. And 12 years later, I still hold a bit of guilt that I was able to do better by her younger brother.
C: Oh, no, don’t think that!
J: But where does that guilt come from? I had read that breast milk would protect babies from infection, stave off obesity, develop their brains. It was a magic halo that only I could provide them—which, by the way, fed nicely into my internal dialogue of Mommy is going to keep you safe. But you argue that the research isn’t really there to support that magic halo.
C: It’s pretty alarming. It shocked me. Even as I was figuring out what the book would look like, I did not think there would be a chapter on medical research. I just assumed the medical research was what it was and that I would focus on the question about the moral fervor. It did not occur to me that the medical research was pretty far removed from what I believed. Maybe I’m an idiot, but I really did believe that breast milk and breastfeeding would protect my kid from pretty much everything.
J: All of which connects back to the way many of us have viewed women who choose not to breastfeed.
C: That’s part of the reason it’s so important to get information about the research out there. Because if you really do believe that breastfeeding is going to protect children from pretty much anything that could ever happen to them, it’s almost impossible not to slip from “Breastfeeding is my choice; it’s what I’m going to do” to “Breastfeeding is an obligation; it’s what everybody should do.”
But if you believe that breastfeeding has a modest impact on the risk of infection, then you can step back and say, “OK, it’s totally reasonable for a family to weigh the modest reduction in the risk of infection against all the other things that are going on in their lives and make their own decision.”
J: It’s so complicated. Because you’re not saying, “Don’t breastfeed”; you’re saying, “Know the whole issue.”
C: I wanted to put it out there with all of its complexity. It’s almost as if I’m writing two books. On the one hand, I’m saying back off with all this breastfeeding pressure. The benefits of breastfeeding aren’t all that great, so women need to be able to make their own choices. This should be a space of choice. On the other hand, I’m saying a lot of women love breastfeeding, but let’s think more about all this breast pumping we’re doing.
J: So let’s talk about pumping. The Affordable Care Act was touted as supporting breastfeeding because it requires many employers to provide time and space for women to pump.
C: The Affordable Care Act was heralded as good for women; and later, when Sen. Barbara Mikulski (D-MD) pushed through an amendment to provide free breast pumps to women, these were widely heralded as really important women’s health milestones. But again, it’s complicated.
J: Those are certainly positives for working moms, but while employers must give you the breaks, they don’t have to pay you for them— and there’s very little enforcement available if they refuse. We as a society are putting pressure on moms to breastfeed but then giving them very little support to do it.
C: A strong position has to be: “If you want me to breastfeed exclusively for six months, you need to give me six months of maternity leave.” Period. The End. What concerns me about pumping at work is that we’ve bought into it hook, line and sinker—so much so that it doesn’t seem as if it’s a contradiction anymore.
Pump if you want to. I’m not against pumping, per se. I’m against feeling an obligation to pump because you’re not getting maternity leave. I’m against the government, public health officials and businesses being able to hook on to this solution that places quite an extensive burden on mothers. It’s only mothers who are expected to bridge the gap between working and breastfeeding by pumping at work.
J: Meanwhile, too many mothers still face lack of support—or even hostility—at work when they do try to pump. Much like with paid leave, it all depends on how supportive your employer is, as well as your manager and co-workers.
C: A lot of what happens to new moms pumping at work ought to be classified as workplace harassment. It’s horrible what a lot of women go through. It opens up a whole new space of vulnerability for women at work—in a place where women can’t afford to be vulnerable.
J: You end Lactivism on a thought I’ve had: that if I had the money and were younger, I’d do it all over again—breastfeeding and pumping included. There’s a closeness that comes with breastfeeding that’s only for women, that men will never have.
C: (Laughs) What I really mean is I wish I could have more children. But yes, if I had more children, I would breastfeed them. I was lucky. It was easy for me, and it was easy for my kids. It all clicked, but it doesn’t for everyone.
Courtney Jung’s book Lactivism: How Feminists and Fundamentalists, Hippies and Yuppies, and Physicians and Politicians Made Breastfeeding Big Business and Bad Policy is published by Basic Books, a member of the Perseus Books Group.