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‘Breast Is Best’ Nearly Cost My Baby Her Life

I followed the mantra against my better instincts. I wish I never had.

Elaine Kasket
Feb 11 · 13 min read
Photo: Jordan Whitt/Unsplash

Our daughter arrived with the snow. We decided to commemorate that on her birth announcement, a card with a snowflake-decorated border. Not for over 20 years had there been such a cold winter in normally temperate southeast England. We skidded to the hospital on ice-covered roads and watched the growing snowdrifts through the window of the maternity ward. When we took her out into the world for the first time, bad roads blocked our passage, forcing us to park some distance from our street. In her baby album is a photo of her homecoming: My husband’s figure recedes into the distance ahead of me as he trudges across a barren expanse of snow-encrusted playing fields under a slate-gray sky. Only in the center of the image is there a flash of color: the scarlet-red cushions of the car seat he is carrying, a bright protective shell encasing the pearl that lay within.

From that moment, we had one job in the depths of that dark, cold winter: to keep our baby alive. I reassured myself we wouldn’t really be alone in this unfamiliar endeavor. Friends could be phoned, and relatives would come to stay. My mother marveled that a weekly baby clinic was held just across the street and that we expected our first postnatal home health visit soon. She recalled the isolation she experienced as a new mother in 1970s America, her uncertainty, her loneliness. I was lucky.

Feeding was the most fundamental element of helping our daughter thrive, and, of course, we knew what to do. The antenatal class facilitator had emphasized it, the posters in the obstetrics department proclaimed it, the parenting books championed it: Breast is best. At the maternity ward orientation, they brandished disembodied demonstration boobs at us, crocheted or maybe knitted, areolae and protruding nipples rendered in contrasting orange-red wool.

When we are in uncertain and unfamiliar territory and someone in a position of power and authority tells us how to act, the majority of us obey.

At first, I was apprehensive — not about breastfeeding itself but about my ability to carry it off. The doctor who examined me before the birth had observed a physical anomaly I share with 10–20 percent of women. To my joy, though, my daughter suckled and seemed content. Just before discharge, a nurse had nodded with satisfaction as she observed us together, and she jotted down “feeding established” on my chart.

Our new daughter was what they call a “good baby.” She rarely cried and slept well. The first health visitor came, cooed over her, and pronounced a clean bill of health. What was it, then, that made me feel uneasy, that provoked me to send my husband out under cover of darkness to buy plastic bottles and powdered formula from the 24-hour grocery store? I don’t remember that now, but when he returned, we huddled with her by the fire in the warm front room and dropped bits of formula into her mouth with a tiny syringe. No one else was there to question or judge, but still, I felt it. The shame.

When the second health visitor came, she was as terrifying as the first had been benign. She saw the powdered-formula container and barked at me, told me that I was forcing my daughter into a dangerous state of nipple confusion. By allowing her to feed on this poisonous concoction of unnatural foreign chemicals, I was ensuring that she would never return to the breast, and then we could kiss a healthy immune system and at least 10 IQ points goodbye. I stood wordlessly by as she bundled up the formula, bottles, and sterilizing equipment into a bag. “Put this away where you can’t see it, so you won’t be tempted,” she ordered.

She then strode into the kitchen and seized a pair of scissors from a container of kitchen implements. She smacked them down on the countertop. “Cut two holes in a T-shirt,” she said. “Just let them hang out so you’re always ready. No formula, no bottles. Everything will be fine — as long as you persist.”

A blast of cold air and a scattering of snow gusted into the house, the door slammed, and she was gone. Clutching my silent daughter to me, I stood numbly in the hallway. My husband was at work, and my mother-in-law had not yet arrived. I was alone.

In the early 1960s, a Yale psychologist named Stanley Milgram carried out his now-famous studies of obedience. In a life-or-death situation, he wondered, would ordinary people abandon their moral compass and follow the orders of an authority figure? To find out, he designed a psychological experiment that participants were told was a study of learning. The participant would be the “teacher,” and the “learner” was the so-called “Mr. Wallace” (in actuality an accomplice who was, on some occasions, played by Milgram himself). The learner sat some distance away from the teacher, completely concealed behind a screen. Each time the learner answered a question incorrectly, the teacher was instructed to use their control panel to remotely administer an electric shock of increasing voltage.

As the punishments progressed from slight to severe, concerning sounds began to issue from behind the screen. Mr. Wallace complained of a heart problem and begged that the shocks be stopped. Eventually, an eerie silence descended. Again and again, the teachers looked to the experimenter for guidance, and his responses were scripted: “Please continue.” “The experiment requires you to continue.” “It is absolutely essential that you continue.” “You have no other choice but to continue.”

One hundred percent of the teachers proved willing to administer a potentially lethal shock of 300 volts to the hapless Mr. Wallace. Two-thirds of them went all the way to 450 volts, to the switch that was simply labeled “XXX.” Far from being sanguine about this process, the participants sweated their way through this moral maze, fought mightily against the experimenter, and went through so much agony that this psychological experiment would struggle to receive ethical approval today.

The ultimate conclusion? When we are in uncertain and unfamiliar territory and someone in a position of power and authority tells us how to act, the majority of us obey.

Audio recordings from the archive show that the experimenter actually failed to adhere exclusively to the pre-scripted prompts. Instead, he resorted to more flexible and creative ways of inducing the reluctant teachers to carry on in the face of their better judgment, as psychologist Stephen Gibson and filmmaker Kathryn Millard have pointed out. He may have gone somewhat off course, but there is at least one form of inducement that the experimenter did not use. In those transcripts, it appears that Milgram’s authority figure never cloaked his persuasions in a moral mantle and never engaged in character assassination. He did not say, “If you do not continue, you are a bad person” or “If you do not continue, you are a selfish human being.”

Though the women I was listening to as a new mother weren’t administering electric shocks, they were exerting a powerful and punishing sort of authority nonetheless. These women differed from the authority figure in Milgram’s experiments in one critical way. Overwhelmingly, they let me know — explicitly and implicitly — that choosing to bottle-feed would reveal me as a selfish and bad mother.

The experimenter in the Milgram studies did, however, repeatedly tell the participants that what they were doing was not really dangerous to Mr. Wallace. They were told that they should defy all their instincts, doubt their perceptions, ignore even the most worrying signs of distress, and push on. These instructions worked — just like the persistent, unwavering directives to exclusively breastfeed worked on me.

It was London in 2010. I was a highly educated woman, an academic with a doctorate. But I was also a first-time parent: ignorant, struggling, and housebound in midwinter. So I obeyed the second health visitor, desperate as I was to do right by this quiet little creature, my tiny mystery of a daughter, her dark eyes studying me as I held her to my breast. As little maternal instinct as I might have possessed at that point, I vaguely knew that something was not right. But I had no choice but to continue, they’d said. What could I do but trust in their greater wisdom? Just as the health visitor had ordered, I kept the triggers to powdered-formula temptation packed away in their bag, shoved into the furthest recesses of the under-stair cupboard.

I have a photograph of my daughter from just before the third health visitor arrived at our door. I hate to look at that image now. She is about seven days old, I think, and stares flatly over my mother-in-law’s shoulder and straight at the camera with disinterested eyes and a jaundiced face. I told the health visitor how quiet she was, how uncomplaining.

She regarded my daughter’s complexion with concern, and when she compared her birth weight with that day’s number on her portable scales, she flinched.

“You need to take your baby to the hospital immediately,” she said. “Take her now. Your daughter is starving to death.”

What I had interpreted as a lovely, docile nature was my only child slipping away because of a health system’s slavish devotion to three words: Breast is best.

Abject horror hit me like a fist to the gut, winding me with the realization that I could have very easily followed the supposed experts all the way to the end of the line, the terminal station. I remember shaking too hard to dial the number of the cab company and asking someone for help. I remember frantically pulling at the canvas bag of formula wedged under the stairs. I remember fearing that my baby would die en route to the hospital. I remember her tininess in the hospital bed, how I was alone with her in the night because only one parent could stay. I remember ripping a “breast is best” poster from the wall of the ward and throwing it on the floor. I remember a senior doctor examining my breasts again and telling me that my daughter would never have had a chance of getting enough milk from me to survive. I remember wondering whether this doctor also felt angry at the system of which she was a part.

But one thing stands out in my memory the most. I received a phone call from another health visitor soon after our second discharge from the hospital, asking when she could call on us. I told her that if she or any of her colleagues came within a meter of our doorstep, I would have at them with a cricket bat. I didn’t even own a cricket bat, but the imaginary one was effective enough. Nobody ever came again.

For a long time, I pushed this episode into the recesses of my memory. But the other week, I turned on Radio 4’s Woman’s Hour in the midst of a story on breastfeeding. In a recent nationwide poll, they reported, more than a third of respondents had reported feeling ashamed that they had given their child formula. The radio piece — and the associated BBC article I later read — featured one new mom who had been “110 percent determined” to breastfeed but had faced an uphill battle. Her resolve snapped when a health worker said to her, “That’s the sound of your baby starving. What are you going to do?”

“The sound of your baby starving” — the phrase hit me like a punch to the stomach, an echo of what I’d experienced so many years ago. My happy, healthy, clever daughter had at that point recently celebrated her ninth birthday, but nevertheless, I broke down in floods of tears, my hand flailing blindly to turn off the radio. The mother hadn’t said what the “sound of starving” was, but in our case, it was silence. What I had interpreted as a lovely, docile nature was my only child slipping away because of a health system’s slavish devotion to three words: Breast is best.

Before I switched it off, the program mentioned that the Royal College of Midwives issued a new position statement on infant feeding in June 2018. Not a moment too soon, if you ask me. Of course, it held to the advice that breast is best, which I do not dispute, but crucially, it also said the following:

If, after being given appropriate information, advice, and support on breastfeeding, a woman chooses not to do so, or to give formula as well as breastfeeding, her choice must be respected.

Presumably, this means that any maternity support worker who fails to weigh a newborn baby, seizes formula away from a new mother, and suggests she simply cut breast holes in her T-shirts would be brought up sharply by her employer. That would be a good thing.

But sometimes there are more subtle assaults on our freedom of choice, more insidious undermining messages. Perhaps they won’t lead to the death of children, but they can leave a mother with a lingering sense of guilt and shame for years to come. These are the unnecessary, unthinking, self-righteous slings and arrows that women inflict on other women. No position statement in the world can prevent them all. But I wish that people would think harder about what words can do.

Some months after my daughter was born, I gathered with my tribe of antenatal class veterans in a Quaker meeting hall tucked into the trees at the edge of an urban woodland. Not far from us lay a stunning example of one of the many delicate, quiet pleasures of an English spring: a bluebell wood, the fragile stalks of blossom acquiring power in their numbers and carpeting the forest floor in an overwhelming wave of blue-purple — a gorgeous blow to the senses. Some little stragglers were visible outside the windows of the meeting house, nodding to neighboring daffodils in the breeze with the brasher, bolder yellow blooms nodding back.

We mothers arranged ourselves facing one another, placing the conveyances for our children in a perimeter around the outside, circling the wagons. The six of us had drawn wisdom and succor from one another for many months, but we were still new mothers, shaky pioneers in an unfamiliar land, and so it was that we’d regrouped for a return engagement with our original leader. She worked for a national childbirth charity, and it was she who had prepared us for imminent labor when motherhood was just a nascent, expanding horizon of possibility, our children still silent mysteries lying in our swollen bellies.

I was an exposed nerve, exquisitely sensitive to every unthinking comment, every sideways glance at my daughter’s bottle from any judgmental person.

We had always felt cozy and safe together, but over the last few sessions of the new mother group, the comfort of our mutual companionship and commiseration had been corrupted, at least for me, by moments of pure, wild rage. As far as I was concerned, we were all the same. Our children were always in our thoughts. We were educated, privileged, and had comfortable homes and doting partners. We strove to keep our babies safe, celebrated their milestones in the company of family and friends, and dreamed and feared for their happy and healthy futures.

But half of us were different: We had, each for reasons of her own, bottle-fed our children from very nearly the start of life. I cannot speak for the others, but after my own experience, I was an exposed nerve, exquisitely sensitive to every unthinking comment, every sideways glance at my daughter’s bottle. Unfortunately, some of those looks had come from the leader of this group. I had begun to have violent nighttime visions of backhanding her across the face. On that day, I arrived filled with apprehension but fueled by purpose. Like the academic that I was, I had done my research.

I had with me an article by Joan B. Wolf, who the following year would publish a book, Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood. I cannot now locate my printout, marked up with its furious annotations and highlights and dotted with circular stains from cups of tea and my own tears. I can only find a review of the subsequent book that Wolf wrote. It contains the following passage, which I remember:

How did we arrive at a place where formula, which nourishes millions of healthy babies every year, can be likened to nicotine?… Where, without evidence, a doctor feels professionally and morally justified telling bottle-feeding mothers that not breastfeeding essentially causes babies’ illnesses or that breastfed babies do not get sick?

This article laid in my bag like a concealed weapon. As was our practice, each woman in the room began to speak about sleeping and routines, baby yoga and sensory groups. And then, as it always did, the conversation moved to feeding. My stomach, still soft and flaccid post-pregnancy, tightened into what felt like a rock-hard six-pack. I awaited my moment, some kind of ill-defined starting gun after which I would explode out of the gate with my intensively researched material, my well-justified ire, my manifesto.

My friend began describing her recent severe bout with mastitis, an inflammation of the breast tissue that can be extremely painful. She had endured great discomfort and not only of the physical variety; she had also suffered the terror and guilt of being potentially unable to breastfeed. She had taken rounds of antibiotics, employed the folk remedy of laying cabbage leaves upon her breasts, and battled to keep the faith. Eventually, supported by her worried husband, she had stopped sacrificing her health on the altar of “breast is best.” She had decided to be “selfish,” she said. Merely for the sake of her own relief, she had let her daughter down. Her announcement took on the tone of a confessional, an apology to her baby and to us all. Tears cascaded down her face. Mea maxima culpa. This my shame, this my fault.

I was certain the support group leader would encourage her to try again after the inflammation calmed. But the woman seemed to be looking upon my friend with kind eyes. She leaned forward and smiled beatifically; her manner seemed reassuring and accepting. Perhaps, seeing the world through the lens of my own horrific experience, I had viewed this woman too harshly.

“But just think,” the group leader said. “Your daughter had three whole months of breast milk before you stopped. What a lucky baby.”

The article was within my reach, somewhere among the washable nappies and cartons of contraband formula in my changing bag. But the rabble-rousing speech I had been so keen to deliver lodged in my throat, and I could only stare mutely across the space held by the middle of the circle. My gaze met that of two other wonderful women, my sisters in new motherhood. Each of us with dry breasts and overflowing hearts and each of us cradling, in her loving arms, an unlucky baby.

Elaine Kasket

Written by

Psychologist, writer, thanatechnology maven. Author of All the Ghosts in the Machine (2019). https://tinyurl.com/yxgxqfuz

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