The health benefits of breastfeeding are already well established and continuing research finds new benefits every year. Breastfed infants have fewer infections, fewer illnesses, fewer allergies, better cognitive development and improved long-term health well into childhood and maybe even adulthood. If breast milk could always be administered with the same ease that formula is administered, it would be absurd to give babies anything else. However, for many reasons, breast milk is not always as easy to give as formula.
In the U.S., women are damned if they do and damned if they don't when it comes to breastfeeding. We, Americans, are acutely uncomfortable with breasts, irrationally incapable of divorcing our concept of our bodies from sexuality, even in the most clearly nonsexual contexts. The Victorian mindset of the U.S. is a real inconvenience for women who are trying to breastfeed their infants. Women bold enough to feed their infants in public are subject to constant stares and occasional glares. Most women retreat to bathrooms to feed their infants or pump milk. On the other hand, women who simply choose to forgo the hassle of breastfeeding, opting to feed their infants with formula, are subject to scorn from those who view such a choice as willful child neglect.
Despite all of its benefits for babies, there are many reasons women might choose, or be forced, not to breastfeed. Aside from the embarrassment of public breastfeeding, there are also myriad medical complications that may occur with breastfeeding. Most are "minor" and can be overcome with a little extra counseling or effort. But at the same time, the assumption that all breastfeeding complications can be overcome may be an unreasonable expectation for moms. I've followed the struggles of a few friends who set out with the wonderful goal of exclusively breastfeeding their infants. But, in each case, a combination of latching problems, breast infections, and/or intensely painful nipple conditions caused each of them inordinate stress and, worst of all, guilt and feelings of inadequacy as they faced the impossibility of achieving their goal. The postnatal period can be an acutely stressful period for women. For many women, the expected blissful glow of motherhood is obscured by the stress of having their lives turned upside, being deprived of sleep, money and relationship woes and even postpartum depression. Most women return to work not long after giving birth, and breastfeeding becomes further complicated by the challenge of finding time and a place to pump milk. At some point, we must allow for the negative effects of the additional stress of breastfeeding to be sufficient justification for formula feeding.
Ultimately, I think the best thing we can do for moms and their babies is to make sure that women are able to breastfeed, or not, for the right reasons. One way we can help is to get over our discomfort with public breastfeeding. Easier said than done. But women who are proud and bold can help by continuing to do what they probably do anyway--breastfeed in public. The more we are exposed to public breastfeeding, the less caught off guard we'll be the next time we see it. Employers can help by working with their employees to provide time, and reasonable accommodations, for pumping breast milk. What doesn't help? Bullying women into breastfeeding by comparing formula feeding to child neglect. Formula fed babies may not have some of the advantages of breastfed babies but they do, overwhelmingly, do just fine. What I would recommend to new moms is to breastfeed if you can, for as long as you can, even if it's only for the first couple of weeks. Those first couple of weeks of breastfeeding can provide valuable immunity to your baby in a period when it's not yet safe to immunize. Take advantage of lactation consultants and support groups if breastfeeding proves challenging, but don't let anyone bully you into feeling guilty if it doesn't work out.