This post follows on from Parts I, A Recent Saudi Thesis and Book, and II, "Breastfeeding vs Bottle vs Formula", with the goal of suggesting how women can decided for themselves, in collaboration with their physicians, nurses, lactation consultants, and significant others if they so desire, whether to breastfeed or formula feed exclusively, or to do some combination, including breast and bottle for breast milk feedings. As was mentioned in the very introduction to Part I, these are highly personal decisions; yet as emphasized in Part II they can, at the same time, involve a crowd of "advisers" and considerable social, and even religious pressure (given the perceived Islamic recommendation to breast feed for up to 2 years).
Formula Feeding Without Guilt or Shame
Deciding about breastfeeding with or without bottle feeding, and formula feeding can be psychologically and socially problematic for any individual in any culture, but may vary depending on the emphasis on guilt or shame by individual and the culture. Anthropologists often create paradigms regarding guilt (the feeling one has transgressed a rule) and shame (the feeling one has failed collective norms): guilt vs shame; western vs eastern; guilt-based vs shame-based cultures; laws/individual rights based vs honour/ collective responsibility based. All individuals and cultures are on a spectrum; and ambient context will make a difference to the individual, and to a lesser extent to the immediate culture. In a mixed family one set of inlaws may be firmly in the guilt camp, the other in the shame camp which determines how they handle "advice" and "persuasion". Guilters might throw statistics and the latest facts, and offer articles and books. Shamers might throw comparisons with cultural norms, and others' actions in the group, and may do so more publicly. Of course, rivalry and a desire to be helpful/ in control, are common to both groups.
Because formula feeding is now the modality under attack, I will address that choice primarily, though the decision-making implies all three types of feeding options. Wet nursing and breast milk banks are uncommon enough that they have been largely omitted, though they have their place.
How to decide for yourself
Learn as much as you can from websites, magazines, books, family, and friends. You may have to do a bit more searching because of the preponderance of breastfeeding information. Give due consideration to your own health, your family composition, how much help you will have with baby, your own needs for rest. Be honest with your self about your own conception of your body, and your body image. Think about your own lifestyle considerations and where breast feeding, supplementing, and weaning fit in to that. Leave yourself the option of trying it if you aren't sure, but also of stopping if you change your mind. If you do breast feed leave yourself the option of having someone else bottle feed your pumped milk.
Discuss this with the father of the baby, usually your husband, or at least an involved father, and take his preferences into consideration. However, the one doing the breast feeding should make the final decision for herself, and hopefully have her husband's/the father's support in it. Be wary of the politicized (including nursing staff and prenatal teachers), the family experts (mother, MIL, sisters, SILs, cousins, aunts, etc) who may be long on advice and short on consideration for your personal choices, and of the friends, some of whom may be more rivalrous or conflicted than you imagine. Decide, and decide to opt for flexibility, unless you are really not willing to consider anything else (and then choose to be flexible if circumstances push you in the opposite direction). Have an informal support network of family, friends, mommy neighbours. Consult formalized groups if necessary or desired.
What to say to yourself
It is important to have a ready-made, positive, self-talk speech for times when you are in doubt, and especially when other women are having a bragfest about how many babies they nursed for how long, or tell horror stories about bottle feeding or formula feeding, cite statistics which buttress pseudo-science or ideology, and toss around the term "nipple confusion". Frankly I cringe inwardly every time someone uses the term "nipple confusion".
Remind yourself of your own well thought out reasons for your choice(s) and the realities of the research on breast-feeding and formula feeding. Remind yourself that you are the one to be doing it or not, that your immediate family is the one most concerned, and most likely these women aren't volunteering to breast feed your baby.
What to say to others
It is also important to have some ready - made responses, which suit your reasoning and your style of communication. Deflection through wit, or changing the topic, can be helpful, as can a pat answer, that shuts down the conversation, like "My husband and I have decided formula is best for our family." "My doctor said it is contra-indicated and my husband is supportive of that", "I am firm in my decision, it is best we change topics". Some other formulations may be more culturally or situationally appropriate. Beware of the obtuse, persistent, and crusaders. Have an escape route--ie excuse yourself and end the phone call, chat, skype session, conversation, or leave the premises.
If you are good at turning tables, interrogating with useless questions, or other less pleasant techniques go ahead. Just try to preserve the relationship, if it is important to you, for after the insanity of infancy, or of infantile adult behaviours, has passed.
Please share your comments, thoughts, impressions, and experiences.
Men and women, mothers and non, are all welcome to share their opinions.
Please be sensitive to the choices of others, as I know regular commentators are, and expect all readers/commentators will be.