Another problem with the new guidelines is that they don’t discuss maternal mental health, but instead state that “medical contraindications to breastfeeding are rare.” This, though one in seven women may develop postpartum depression and some mothers experience a phenomenon called D-MER – dysphoric milk ejection reflex – which is “characterized by dysphoria that begins shortly before ejection of milk and lasts for several minutes.”
“In my clinical practice, diet and sleep deprivation — which are, of course, linked — are two of the biggest triggers for maternal anxiety and mood disorders,” Dr. Pooja Lakshmin, a psychiatrist specializing in women’s mental health, emailed me. “I worry that the lack of centering on maternal mental health continues to reinforce the narrative that to be ‘good’ mothers, women must sacrifice their own emotional and mental well-being for the well-being of their families, when in fact, the data support the opposite, prioritizing maternal mental health has a positive impact on the entire family.”
But perhaps the most glaring problem with the new policy statement is the apparent disregard for the lived financial realities of so many families. In a technical report Published alongside the new guidelines, the organization suggests that pediatricians should not hand out free formula in their offices because it “provides mixed messages to families about the importance of exclusive breastfeeding.” This goes against a recommendation made during the formula deficit: that parents should call their parents pediatricians to help find the formula†
Mothers who are beneficiaries of the special supplemental feeding program for women, infants and children, popularly known as WIC, need government assistance to pay for the formula. WIC recipients often find that they still need extra supplies to feed their babies throughout the month and struggle to afford them, even when there may not be a shortage rely on a diaper bank that stocks formulas to fill the gap† Given the frayed state of the American social safety net, any guidance that could encourage shutting down a source of free formula seems painfully out of hand.
The tone of much of the breastfeeding literature implies that if mothers were given adequate education about breastfeeding and the advertised benefits of breastfeeding, more of them would abide by the recommendations and embrace exclusive breastfeeding rather than feeding their babies any formula. also. And I have no doubt that many American mothers need more comprehensive breastfeeding information and support – which they absolutely should have available for free.
But in a country where, until March last year, only 23 percent of civilian workers had access to paid family leavethree months of paid leave is considered generous and has on-site childcare described as ‘extremely rare’, even for Fortune 100 companies, I don’t think lack of training is the main barrier. It’s that for many mothers, exclusive, long-term breastfeeding is quite difficult to achieve.