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Breast Is Best?: A Critical Analysis of A Personal Experience

Breast is Best? A Critical Analysis of A Personal Experience

“If you can’t think critically you have no chance of recognizing, let alone pushing back on, those times you are being manipulated.” [1]

Many people (me included at one time) believe that critical thinking only takes place in formal settings like academia – but they would be wrong. In fact, critical thinking is an essential life skill.

Brookfield identified five phases of critical thinking: trigger event, appraisal, exploration, developing alternative perspectives, and integration. [2] Mezirow similarly developed ten phases of transformative learning. [3]

Though I didn’t realize it at the time, I had painfully progressed through each of these phases in the following situation, as I’m sure others before and after me have done and likely will do.

Trigger Event

For years women have been told that breastfeeding is not only good for the short- and long-term health of baby and mom, but that it can be economically and environmentally advantageous too. So it may not come as a big surprise that when I had my daughter, I was dead set on breastfeeding for at least 6 months to a year or longer (as recommended by the American Academy of Pediatrics). [4]

From the beginning, my pregnancy was difficult and high-risk. Then, late in my second trimester, I started to develop signs of preeclampsia. I was in the Middle of Airmen Leadership School* at the time – something that I had already waited months for (and needed to complete to be promoted) that I just wanted to get done before joining motherhood – so I did everything I could to stay out of the hospital until graduation.

Shortly afterwards I became an inpatient at Walter Reed National Military Medical Center and ended up delivering my daughter at 34 weeks pregnant… a whole six weeks prematurely.

As may be expected, I was bedridden, and my daughter was immediately wheeled away to the NICU. Because of this, my breastfeeding journey actually began with learning how to pump until I was eventually able to hold and feed my daughter.

Unfortunately, after a couple of months, a number of issues, and several attempted solutions I knew that I would not be able to exclusively breastfeed my daughter.

I’m not sure whether the entire experience was my “trigger event” (or “disorienting dilemma,” as Mezirow puts it), or if it was that moment at 2 in the morning, ashamed, exhausted, heartbroken, and holding a screaming hungry child that finally did me in.

* For those who are not members of the military or are not familiar with the Air Force, Airmen Leadership School (ALS) is a required training program (usually) one must complete upon being selected for promotion to Staff Sergeant (SSgt) before they can officially “pin on” the rank.

Appraisal

Following the realization and distressing acceptance of the fact that I could not produce much breast milk, if any at all, I had to take stock of the situation. I needed to uncover what my underlying assumptions about breastfeeding were and to judge their accuracy.

To be able to think critically on a topic, one must understand that assumptions are “guides to truth embedded in our mental outlooks. They are the…rules that frame how we make decisions and take actions.” [5]

What “truth” did I maintain in my mind about breastfeeding? Why was I so against feeding my daughter in any other way?

Credit: UV Group/Shutterstock

Like probably every mother who has ever breastfed or plans to breastfeed, I held the espoused theory that “Breast Is Best” – because it was natural, helped you bond with your baby, and reduced the risk of morbidity and mortality and sudden infant death syndrome (SIDS), among other benefits. I also incorrectly assumed that it was easy, and that mothers who chose not to did so for selfish reasons. Oh, how wrong I was!

Critical reflection helped me recognize how my thinking “may be restrictive and thus limit[ed] [my] options.” [6] Yes, I did – and still do – believe wholeheartedly that breastfeeding is beneficial, but I discovered that my theory-in-use did not quite align with my espoused theory:

When someone is asked how [s]he would behave under certain circumstances, the answer [s]he usually gives is [her] espoused theory of action for that situation. This is the theory of action to which [s]he gives allegiance, and which, upon request, [s]he communicates to others. However, the theory that actually governs [her] actions is this theory-in-use. [7]

In practice, another reason I wanted to (and tried extremely hard to) breastfeed was because the ideology has been around for as long as mankind; for the most part likely simply because formula wasn’t invented until ‘recently’ in 1865. [8]

Additionally, the “Breast Is Best” campaign is strongly supported by governments around the world and entities like the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF), who launched the Baby-friendly Hospital Initiative to encourage breastfeeding. [9]

Even more, immense societal pressures can make mothers (like me) believe that there is no other choice, lest you be deemed uncaring or a ‘failure.’

Exploration and Developing Alternative Perspectives

Once I judged my assumptions about breastfeeding to not be entirely accurate, I had to search for ways of dealing with the problem. In my particular situation, I had already tried any and every method I could find to increase my supply, as well as supplementing with formula.

Consequently, I focused on two alternatives: using breast milk donations, exclusively feeding my daughter formula, or a combination of the two.

Naturally, another woman’s breast milk carries virtually the same benefits as anyone else’s (even though it is ‘tailored’ to their child – the body is a wonderful thing!), making it especially useful for premature babies such as my daughter.

Unfortunately, the process for receiving donor milk can often take some time, or cost too much, for those who need it immediately or may not be able to afford it. [10]

On the other hand, formula is readily accessible, easier, and can provide much of the necessary sustenance growing children need. This can be a fine alternative for avoiding common breast tissue infections, or for women who have certain medical conditions or are on medications that could be harmful if passed on to a baby, or for those who just cannot produce the breast milk needed to nourish their child, for example. [11]

Because our daughter was premature, struggling with medical problems, and losing weight every day, we had to quickly plan a course of action and decided that the best option for all of us at the time was to feed her formula.**

** Every baby is different, but we found Enfamil Gentlease and Avent bottles to work best for our daughter (believe me, we. tried. them. all.).

Integration

While I hated that my body seemingly couldn’t perform a function that it was made to do, I saw first-hand that though breast is generally best, ‘fed’ could be best too. The idea behind the ‘Fed Is Best’ movement is “that the most important thing is not whether you breastfeed or formula feed your baby, but that your baby is well-fed and happy…and that you are too.” [12]

Nothing is black and white – though presuming that had been a fallacy of mine. At first I struggled with my initial assumptions, considering myself inadequate or a ‘bad mom;’ but upon taking a critical look at the entire situation, I ultimately knew that the choice my husband and I made was for the best. My daughter could be properly fed; my husband could bond with her and be more involved with the feedings; I could get some much-needed sleep; and it diffused some of the stress, anxiety, and depression I was feeling.

By building my competence and comprehension, and integrating these new views and information into my life, I had completed Mezirow’s final phases, undergoing a perspective transformation that allowed me to see that there was more than one ‘right’ way of feeding a child.

Moms – what do you think?
How do you feel about the whole thing?

Anna

References:

[1] Stephen D. Brookfield, Teaching for Critical Thinking: Tools and Techniques to Help Students Question their Assumptions (San Francisco: Jossey-Bass, 2011), 1.

[2] Stephen D. Brookfield, Developing Critical Thinkers (San Francisco: Jossey-Bass, 1987).

[3] Jack Mezirow, “Perspective Transformation,” Adult Education 28, (1987): 100-110, doi: 10.1177/074171367802800202.

[4] Centers for Disease Control and Prevention, “Breastfeeding: Frequently Asked Questions (FAQs),” last modified May 28, 2020, https://www.cdc.gov/breastfeeding/faq/index.htm.

[5] Stephen D. Brookfield, Teaching for Critical Thinking: Tools and Techniques to Help Students Question their Assumptions (San Francisco: Jossey-Bass, 2011), 1.

[6] Riki Savaya & Fiona Gardner, “Critical Reflection to Identify Gaps between Espoused Theory and Theory-in-Use,” Social Work 57, no. 2 (2012): 146, https://www.jstor.org/stable/23718919.

[7] Chris Argyris & Donald Schön, Theory in Practice: Increasing Professional Effectiveness (San Francisco: Jossey-Bass, 1974), 6-7.

[8] Samuel X. Radbill, “Infant Feeding through the Ages,” Clinical Pediatrics 20, no. 10, (1981): 613-621, doi: 10.1177/000992288102001001.

[9] World Health Organization, “Ten Steps to Successful Breastfeeding,” accessed February 4, 2021, https://www.who.int/activities/promoting-baby-friendly-hospitals/ten-steps-to-successful-breastfeeding.

[10] Heidi Murkoff, “Sharing Breast Milk: Donating and Co-Nursing,” What to Expect, October 11, 2018, https://www.whattoexpect.com/first-year/breast-milk-donation#:~:text=Donated%20breast%20milk%20from%20a,Milk%20Bank)%20in%20the%20U.S..

[11] Elitsa, “20 Reasons Why Some Moms Choose Formula,” Babygaga, November 23, 2018, https://www.babygaga.com/20-reasons-why-some-moms-choose-formula/.

[12] Wendy Wisner, “‘Fed Is Best’ Is Fine, But We Can’t Gloss Over The Benefits of Breastmilk,” Scary Mommy, June 3, 2020, https://www.scarymommy.com/problem-fed-is-best-breastfeeding-facts/.

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