My Breast, My Choice

Source: Charlie Chipman, used with permission

I’m in that early-postpartum period when my newborn (just a couple of weeks old) is nursing seemingly nonstop. Days and nights are blending to the point that whether the sun or moon is out—let alone what day of the week it is—feels irrelevant. When the baby sleeps, I sleep. It’s a precious, if hazy, time.

The other day, after marveling at the silly, milk-drunk look on her face as she nursed, I picked up my phone with my one free hand and began scrolling through social media. And there it was: the new guidelines from the American Academy of Pediatrics (AAP) for breastfeeding. I clicked on the link. What could be more relevant at this moment?

The new AAP recommendations

The AAP now recommends breastfeeding continue for two years or longer if both parent and baby can manage it. The previous (2012) recommendation was one year, with the first six months being exclusively breastfeeding, followed by the introduction of solid foods.

I immediately saw that this news isn’t going over well with many parents, as Nicole Karlis has clearly summarized.

Coming on the heels of Roe being overturned, this is like another punch in the gut. In the words of one mom who texted me, “It’s like they are trolling us.” SCOTUS has just ruled that people with uteruses can’t make basic choices over their bodies, their futures, and their overall well-being. On top of that, parents have been through two-plus years of a pandemic with little government aid for their needs. And now we’re in the midst of a nationwide formula shortage. In this environment, it’s hard to believe the government is on your side when it comes to choices about a nursing parent’s body.

What the science means for us now

To be clear, I’m all in favor of following the science with respect to the nutritional benefits and attachment bonding that nursing can facilitate. This isn’t about “do your own research.” We already know that only gets us lower vaccination rates and higher COVID deaths compared with other countries. So I believe we should listen to the science now if it is saying children and mothers will be healthier if they maximize breast/chestfeeding.

However, science doesn’t exist in a social vacuum. As a nursing parent who is also a professional therapist, I can’t just snap my fingers and arrange two years of open-ended nursing cuddle time. I need to work to help support my family financially. The AAP acknowledged this issue by including a caveat that encourages the government to step up its support so parents can nurse for two years.

What would this entail? For starters: paid family leave, affordable childcare, nursing support, work regulations to support nursing people, and a shift away from the shaming of public nursing. That’s a tall order. I don’t think you can blame me for not being optimistic these changes will happen within the two years the AAP is recommending I continue to nurse my daughter.

Some years ago, when I was nursing my son, as we neared the one-year milestone (the recommendation at that time), both of us seemed over it. He preferred the quickness of the bottle, and I was tired of pumping on bathroom floors so I could be close to an electric outlet. Or in the car, while battling LA traffic. Still, I wanted to persevere because I had been informed it was “best” for my son.

Charlie, my husband, noticed I was struggling. So we talked. We discussed the decision to nurse in terms of “insiders” and “outsiders.” Insiders are the ones (i.e., Charlie and me) who make the final decisions for our family. Outsiders are those whose support we take and whose opinions we listen to before we make a decision. In this case, it became clear I was giving outsiders (e.g., the AAP, our pediatrician) a say that didn’t belong to them. As soon as we clarified that this needed to be an insider decision, it became easy. I was the ultimate insider, and it was my choice. My breast, my choice. And Charlie was there to fully support me in whatever I decided.

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So I borrowed a technique from Brené Brown—giving yourself a permission slip to take care of yourself—and penned a note that read “To Whom It May Concern, I give Kara Hoppe permission to quit breastfeeding and pumping and continue to be a great mom. Signed, Kara Hoppe.” I pinned it to the fridge and knew I was ready to enter a new phase of parenting, not being tethered 24/7 to a pump or my son.

Carefully weigh your options

You may or may not have the ability or privilege or desire to breast/chestfeed. But if you do and are thinking about whether or how long to nurse, here are some things to consider:

Clarify who your insiders are

• Who should have a say in any decisions related to your breast/chestfeeding? A partner? Close friend? Relative?
• Are you giving undue weight to the opinions of any outsiders?

Assess your mental and physical health

• Would your health benefit from continuing to nurse?
• Have you considered supplementing with formula? Can your family afford—and do you have access to—formula?
• Do you need support (e.g., lactation consultant or formula supplementation) for feeding your baby so you can thrive, not just survive?

Assess the needs and desires of your baby

• Would your baby’s health benefit from continuing to nurse?
• Does your baby prefer a bottle or breast/chestfeeding?

Assess your environment

• Could you benefit from the support of your partner, a work situation, or maybe a lactation consult?
• Does your commute to work allow you to continue breast/chestfeeding?
• Do you have access to a safe and private place to pump?

This country has a long way to go before it can be considered an inviting environment for nursing parents. In the meantime, I believe the choice to breast/chestfeed is ultimately up to nursing parents. It’s your breast (or chest), your choice. But it’s also helpful to weigh all your options from both a practical and an emotional perspective before you settle on a choice.

So sit down and compare the pros and cons. Identify your insiders and outsiders, and then have those clarifying conversations, even if they’re difficult. At the end of the day, how long and whether you nurse your baby at all doesn’t define your status as a great parent. You and your baby decide that.