Formula Is a Lifeline

Photo: PeopleImages/Getty Images

In recent weeks, a nationwide baby-formula shortage has left parents scrambling to find enough food to feed their children. More than 40 percent of the usual formula supply is out of stock following supply-chain issues and a recent recall of certain batches of Similac, Alimentum, and EleCare, leading major retailers to ration the amount caregivers can buy. Online, parents who share their woes about the difficulty of finding formula have been met with snide comments about how they should “try breastfeeding,” which a surprising number of people seem to be under the impression is free. There’s a lot of ignorance about how breastfeeding actually works, but the response also reveals how stigmatized formula feeding remains.

The American Academy of Pediatrics recommends that infants be exclusively breastfed for the first six months of life. Like many AAP recommendations, that doesn’t quite line up with reality: The latest numbers from the Centers for Disease Control and Prevention indicate that only around a quarter of babies in the U.S. get all their nutrition from breast milk. The rest drink at least some formula. Many breastfeeding advocates say that’s a travesty, pointing to a lack of education and support services, including paid leave and workplaces that accommodate pumping — all of which are real problems. It’s also true that many women are unable to breastfeed or choose to stop for reasons including medical issues, low milk supply, personal preference, or practicality.

I cried when our pediatrician told me I would have to stop breastfeeding my one-month-old daughter. Life as a new mother had been full of twists, including postpartum psychosis, a rare but serious mental illness that meant I was in and out of the hospital for the early weeks of my daughter’s life. A psychiatrist recommended I try lithium, and while generally considered the most effective drug for treating bipolar disorder, it can be toxic in the wrong dose and is expressed through breast milk. Having a mentally ill mother posed a greater risk to my daughter’s health than switching to formula: The doctor reassured me that despite the overwhelming amount of breastfeeding propaganda out there, the evidence supporting any substantial medical benefits is actually pretty flimsy.

Truthfully, I didn’t even like breastfeeding. I was told my nipples were too flat, which made it harder for the baby to latch. Sometimes the discomfort was mild; at other points, it felt like someone was gnawing on a raw blister. The days I’d spent in the hospital apart from my daughter had diminished my supply. To get back on track, our pediatrician had told me to start pumping after feeding — a common recommendation to increase supply, and one that adds substantially to the hefty time commitment of nursing, which usually takes around 30 minutes eight to 12 times a day.

But it wasn’t until I was told that I had to stop that I realized just how deep my association between “breastfeeding” and “good mother” went. Feeding my daughter was the most essential thing I did to care for her, and it was hard to escape the feeling that not nursing was a failure. I was ashamed to tell my own mother, who had breastfed me and all of my siblings. The final time I fed my daughter at my breast, she looked so small and peaceful. It felt deeply unfair that we were being robbed of this primal intimacy.

Many mothers enjoy breastfeeding more than I did, and it is unacceptable that our society doesn’t do more to enable anyone who wants to nurse to do so. Once I stopped, however, I felt like I had been let in on a dirty secret: Switching to formula made my life as a mother much easier. It allowed me and my husband to share the responsibility of feeding our daughter equally, including overnight, which was crucial for me. Breastfeeding dogma often fails to take seriously the risks of sleep deprivation, which can be a trigger for many mental-health issues. Around male friends and relatives, it was a relief to pull out a bottle when our daughter was hungry, rather than have to flash a boob or try to find a private place. Even though I was working from home, I was grateful not to have to mess with a breast pump and freezer bags. Dropping my daughter off at daycare with a carton of formula was far simpler.

The online conversation around breastfeeding, which has spiraled out of control in recent days, reveals that many people are threatened by the idea of a mother who is able to separate from her baby for the workday with relative ease. Even if they don’t say it outright, the assumption that breastfeeding is the superior way to feed a baby is difficult to untangle from the belief that a woman should be home taking care of that child. At the same time, a lack of structural support that acknowledges the true demands of caregiving forces many mothers to rely on formula in order to return to the workplace, given that many jobs — particularly those with lower pay — still do not provide adequate accommodations for pumping. It’s not a coincidence that poor women of color, who are disproportionately represented in that workforce, have some of the highest rates of formula usage. And it doesn’t come cheap: As Jessica Grose points out in the New York Times, formula supplies for a baby’s first year of life cost an estimated $1,500 to $1,900. CNN reports that half of infant formula in the U.S. is purchased by families using WIC benefits.

These days, a common retort to “breast is best” is “fed is best.” But I’ve been surprised by how overwhelming the pressure to breastfeed remains, even from people who should know better. The hospital room where I gave birth had a poster on the wall with a picture of a wide-eyed baby, seemingly pleading. “Both breast and bottle? No. Mom, you have everything I need,” it read. “If you give me formula, you won’t produce enough milk for me.” Never mind that, according to the CDC, nearly 20 percent of breastfeed babies are given formula supplementation in the first two days of life. Even among the well-intentioned, formula is still often regarded as a last resort. It’s what you use if everything else fails. But as Carla Cevasco, a professor at Rutgers and historian of infant feeding, pointed out on Twitter, “in the absence of modern formula, a lot of babies died of illness or starvation due to lack of safe or adequate food.” The shortage has been even harder on caregivers of babies who need specialty formula due to allergies or medical complications. Most babies don’t start eating solid foods until they are around six months, so if your infant is exclusively formula fed, there’s no other food for them to eat.

The White House recently announced plans to encourage manufacturers to expedite production, import more formula from abroad, and crack down on price gouging. But the parents I know have been talking about formula rations at the store for weeks, and the news is now full of stories of desperate parents driving for hours in search of formula, only to find empty shelves. Many have observed the irony that a country poised to force women to carry unwanted pregnancies to term would display so little urgency in the face of a catastrophic infant-food shortage. Yet it’s hardly a surprise that the same leaders who have failed for years to take meaningful steps toward universal paid family leave or affordable child care are indifferent to what babies and their caregivers need to thrive — or even just survive.

Formula Is a Lifeline