All too often, advocates cross the line from supporting a woman in her decision to breast-feed into compelling a woman to do so.
By COURTNEY JUNGOCT. 16, 2015
IT began just after I started to show. Friends, acquaintances and even strangers began to lecture me about breast-feeding. I was moved when mothers described the joy of bonding this way, but people talked a lot about antibodies, too. One night at a party, a woman I barely knew told me all about colostrum, racial disparities in breast-feeding rates and how I absolutely had to have a hands-free pump. By the time the teacher at our hospital birth class announced that she wouldn’t explain how to use formula because it was against hospital regulations, I was pretty fed up. I wasn’t sure if it was formula itself or talking about it that was against the rules, but either way I had had enough of the righteous zeal that surrounds breast-feeding. Surely a mother could bond with her baby if she was feeding her with a bottle?
It turns out that American mothers breast-feed just as much, and often for much longer, than women in many other Western countries. Seventy-nine percent of American mothers initiate breast-feeding, and 49 percent are still breast-feeding at six months. We come close to Canada, where just over half of women are still breast-feeding at six months, and we are way ahead of Britain, at 34 percent. Yes, Norway is higher, but France is much lower. In 2011 we met or exceeded most of the 2010 Healthy People Goals set by the Centers for Disease Control and Prevention. Yet the moral fervor surrounding breast-feeding continues unabated, with a steady stream of advocacy and education campaigns, hospital initiatives, social pressure and workplace and insurance regulations designed to push breast-feeding numbers still higher.
A lot of what passes for breast-feeding advocacy, though, actually promotes breast pumping, not breast-feeding. In 2010, the Affordable Care Act amended the Fair Labor Standards Act so that it now requires employers to provide “reasonable break time” and space for women to pump breast milk at work. Not that the law requires them to be paid for those breaks. Since 2013, the A. C. A. has also required insurance companies to reimburse mothers for breast pumps. Faced with the gap between the standard recommendation to breast-feed exclusively for six months and the absence of federally mandated paid maternity leave, women are expected to pump on the job so that someone else can feed their baby breast milk from a bottle. One large study of American women found that roughly 85 percent of those who breast-fed were also using a pump. Nowhere else in the world is pumping so widespread.
Oddly, the fervor of breast-feeding advocacy has ramped up even as medical research — published in The Journal of the American Medical Association, BMJ in Britain and The American Journal of Clinical Nutrition — has begun to report that the effects of breast-feeding are probably “modest.”
Some sobering results have come from Dr. Michael Kramer’s Probit trial, which has studied a wide range of outcomes among about 14,000 mother-infant pairs for 16 years. Dr. Kramer’s research does not compare breast-feeding with non-breast-feeding, but by measuring dose response effects in a large group of subjects his research challenges the findings of many observational studies. While Probit found that breast-feeding had some benefits, including for cognitive development, it did not reduce the risk of obesity, asthma, allergies, dental cavities or attention-deficit hyperactivity disorder.
The benefits associated with breast-feeding just don’t seem to warrant the scrutiny and interventions surrounding American infant feeding practices. Just last month, a British study found that breast-feeding has no effect on I.Q. from toddlerhood through adolescence. And a meta-analysis of the research on breast-feeding done by the United States Agency for Healthcare Research and Quality in 2007 concludes that much of that research is weak: Some studies are too small, or they fail to control for confounding variables. The findings themselves are often inconclusive. One study will find evidence of an effect and another won’t — so we just don’t know which results to trust.
I had my doubts from the start that breast-feeding would protect my children from everything from Crohn’s disease to cancer, but in the end I breast-fed for a long time. Years. The truth is that it was easy for me, it worked for my family, and I always felt like this time was precious, something I would never be able to do again. But even though I wasn’t breast-feeding primarily for the health benefits, wading into this research was pretty disappointing.
Doctors and researchers generally do agree that breast-feeding reduces the risk of infection, at least during the period a baby is actually breast-feeding. That is certainly not nothing, but here, too, we shouldn’t get carried away. As the director of the Agency for Healthcare Research and Quality explained in 2009, if six babies are breast-fed exclusively for six months, one of them will not get an ear infection she otherwise would have had. That’s about 5,400 hours of breast-feeding to prevent one ear infection. If 26 women breast-feed exclusively for six months, they can collectively prevent one hospitalization for a respiratory tract infection.
So where does all of this moral fervor about breast-feeding come from?
Counterintuitively, for those of us who identify formula manufacturers with big business, the contemporary obsession with breast milk is also driven in part by big business — including the companies that manufacture breast pumps, the companies that make breast-milk-based nutritional supplements, and the companies that sell breast-feeding accessories.The A.C.A. regulation requiring insurance to cover the cost of breast pumps hands breast-pump manufacturers a substantial subsidy. Market analysts predicted that this regulation alone would expand the breast-pump market by more than 50 percent, to almost $1 billion a year in the United States alone, by 2020.
The breast-feeding accessory market, for things like clothes, pillows and nutritional supplements, will be roughly double that. Not surprisingly, some of the research that corroborates the benefits of human milk for infants is funded by companies like Medela, which makes breast pumps, and Prolacta Bioscience, a company that makes infant nutrition supplements from human breast milk. This does not mean that the research is false, but it does mean they have a vested interest in the outcome. It also supports a subtle shift from breast-feeding to the consumption of human milk — a commodity that now routinely trades on the open market.
Most of the intensity surrounding breast-feeding, however, has nothing to do with profits. Breast-feeding has become an important marker of who we are and what we believe in. For some it signals a commitment to attachment parenting, for others it is an environmental issue, and for still others it is a protest against the predatory marketing practices of the big formula companies. Some parents on the Christian right see breast-feeding as a sign of the rightness of heterosexual marriage, with different roles for men and women, and some feminists believe it is an emblem of female empowerment and the life-sustaining force of female bodies.
Recently, breast-feeding advocacy has begun to generate a backlash as some women, including some feminists, chafe against the message that women who don’t breast-feed are bad mothers. We all want to protect our children from every danger that we can, but some experts believe that up to 15 percent of women don’t produce enough milk to feed their babies. And it’s a lot easier to comply with the recommendation to breast-feed exclusively for six months if you are a stay-at-home mom with a breadwinning partner. In a country where the average working mother who goes on maternity leave returns to work 10 weeks after having a baby (and nearly 30 percent of new mothers take no maternity leave at all), breast-feeding for any length of time is very hard to do.
The effect of the moral fervor surrounding breast-feeding goes beyond mere shaming. It also reflects, and reinforces, the divisions of race and class that have long characterized American social life. Although 91 percent of women in the top income quintile breast-feed, 71 percent of those below the poverty line initiate breast-feeding. Whereas 81 percent of white women breast-feed, 62 percent of black women do. Breast-feeding is a lifestyle choice the majority now make, but it is more common among white middle- and upper-middle-class parents.
Demographic differences in breast-feeding rates also justify government interventions that punish poor women who do not breast-feed. This isn’t just the unobtrusive little “nudge” in the right direction, designed to compel people to make better decisions. It’s more like a shove, with a kick for good measure.
Middle-class women primarily experience breast-feeding advocacy in the form of education campaigns and limits on their access to formula in hospitals. Poor women are vulnerable to more explicit coercion. The Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, which serves more than 50 percent of infants born in the United States every year, offers different benefits to breast-feeding and non-breast-feeding mothers and babies.
WOMEN who breast-feed are eligible for WIC for twice as long as women who do not breast-feed, and they get an “enhanced food package,” which includes vouchers for a wider range of more nutritious food. Unlike formula-fed babies, who are eligible only for infant cereal and fruit and vegetable-based baby food, breast-feeding babies also receive meat-based baby food, which is richer in iron. The difference in benefits is intended to create incentives for poor mothers to breast-feed, but withholding food from mothers at nutritional risk, and from their babies, seems more like punishment to me.
And that is just the problem. All too often, breast-feeding advocacy crosses the line from supporting a woman in her decision to breast-feed into compelling a woman to breast-feed. If breast-feeding is the measure of our moral worth, it isn’t long before the idea of a mother not breast-feeding her child summons the familiar tropes of bad parenting and irresponsible citizenship that we have long deployed against poor women and minorities.
Does all this mean that women should stop breast-feeding? No. If you want to, if it’s easy for you, if you are healthy, if your baby is thriving on breast milk, if it’s important to you, then by all means do it. If I had to do it all over again, I probably would. But it would be different. Even though I might breast-feed as a way to nourish my baby, I could no longer use it as a talisman to ward off evil and disease. It’s a perfectly good choice, but it’s not the only choice, and it may not always be the better choice.
Surprisingly, the question of choice, which is central to so many women’s issues, is almost totally absent from discussions about infant feeding. Some breast-feeding advocates actually identify “choice” as the language of the enemy. Breast-feeding, they insist, is a maternal obligation.
But it is not choice that is the enemy. There is a difference between supporting a woman’s decision to breast-feed through policy changes like improved maternity leave, flexible work schedules and on-site day care facilities, and compelling women to breast-feed by demonizing formula. A woman should breast-feed because she wants to, not because someone tells her she has to.
WOMEN who breast-feed are eligible for WIC for twice as long as women who do not breast-feed, and they get an “enhanced food package,” which includes vouchers for a wider range of more nutritious food. Unlike formula-fed babies, who are eligible only for infant cereal and fruit and vegetable-based baby food, breast-feeding babies also receive meat-based baby food, which is richer in iron. The difference in benefits is intended to create incentives for poor mothers to breast-feed, but withholding food from mothers at nutritional risk, and from their babies, seems more like punishment to me.
I'm really surprised that no one has argued against this practice before or that it continues to go on. It really does seem like a kick and a shove rather than a gentle nudge.
Great article, thanks for posting. Very timely, as I was at a gtg with a group of women last night. One of whom is a breast-feeding advocate & brought information re: buying breast milk, as I'd previously expressed how I wasn't planning to breastfeed, given my necessary narcotic intake. So this woman (also my cousin- ack!) brought me info on buying breastmilk. And started her rant about breastmilk's importance until I shut her down. And promptly tossed her "helpful guide" in the trash.
I don't have kids; I'm not pregnant; we're thinking maybe TTC in 1-3 years. PLUS we were surrounded by 6 other girlfriends, 5 of whom have kids, 2 of whom didn't/ couldn't breastfeed. Sit the Muther Down!
Couldn't agree more with the author in how BF'ing seems to have become a measure of a woman's/ mother's worth. It also makes me plug my ears when people start talking about it, because I don't wanna hear what a bad mother I already am (BEFORE I'VE EVEN TTC!!) because I'm not going to BF. I'm afraid of what will happen once I do get knocked up...
Eta: That part was also shocking to me CheeringCharm. Sickening that is a current practice in this county that has been overlooked, seemingly publicity-free. Ick
WOMEN who breast-feed are eligible for WIC for twice as long as women who do not breast-feed, and they get an “enhanced food package,” which includes vouchers for a wider range of more nutritious food. Unlike formula-fed babies, who are eligible only for infant cereal and fruit and vegetable-based baby food, breast-feeding babies also receive meat-based baby food, which is richer in iron. The difference in benefits is intended to create incentives for poor mothers to breast-feed, but withholding food from mothers at nutritional risk, and from their babies, seems more like punishment to me.
I'm really surprised that no one has argued against this practice before or that it continues to go on. It really does seem like a kick and a shove rather than a gentle nudge.
I think the withholding from moms is horrible. I see the baby food as different thought. BF babies are at risk of iron deficiency, formula has iron in it. For whatever reason WIC can't provide iron supplements so it provides food. I mean it is still odd, but there is at least science behind it.
Post by jeaniebueller on Oct 18, 2015 9:00:25 GMT -5
Never nursed at all, never wanted to, still have two happy, healthy kids. I really find the big business aspect of the pro-BFing movement to be fascinating because it's so counter intuitive.
The whole time I was reading this I was like "thank god I didn't breastfeed."
It was something I was so in favor of while pregnant but then I was unable to due to having no milk. I fear I would have been a real asshole had it worked out.
I also wish I could go back and post this article on every dumb parenting board BF FF post with a big fuck you to all the militant BF shamers.
I live in the land of crazy parenting, and I cannot once recall anybody asking me if I planned to nurse when pregnant. Maybe once someone asked once I had lilshirley, but that's it.
I sincerely can't give less of a rats ass how women feed their babies, as long as they are fed enough.
I'm here. I don't remember this being even remotely an issue with either one of my pregnancies. I breastfed because I wanted to and I could. I got praised by a nurse when I was BFing SST while waiting for H in the ER, and I got some dirty looks from people in various places when I BF'd in public, but that was pretty much the extent of other people opining or commenting on my method of feeding my kids.
My mom and grandma talked to me about it, but not in any sort of pressuring way - just sharing their own experiences. My mom wished she had been able to BF me and my brother but couldn't, my grandma did BF back in the 50s when it was unfashionable to do.
Breastfeeding has been so much harder and more painful than I ever imagined. If I had gone back to work I definitely would have stopped. Really, if they recommend exclusively breastfeeding for 6 months, you should be able to take 6 months off work and it should be paid.
I am surprised though at my feelings about it. I'm thinking about stopping due to the pain (I have chronic plugged ducts). But I really don't want to. I feel disappointed in myself and my body. I never really put pressure on myself. from the beginning I said I'd try but not be opposed to formula if it was too hard. I think because I've made it so long, I thought if I made it this far I'd make it a year. I honestly think it would have been easier to quit in the first few weeks.
Anyway, this article makes me feel a little better if I do decide to quit. I'm really disappointed and sad though that I feel like i didn't get the sweet, bonding experience of breastfeeding. The constant struggle and pain has made it a very frustrating experience for me and makes me wonder what I did wrong that it hasn't worked out the way everyone seems to say it should be.
Post by omgzombies on Oct 18, 2015 10:55:35 GMT -5
My mother headed up a La Leche League, and my dad is was an OB, so there was definitely some pressure on behalf of my parents to breastfeed, but if I hadn't done it, I doubt there would have been more than a couple comments, and "helpful" tips from that, mostly from my mother. Apart from that, my experience was very similar to ttt 's all I got was a few "good for you"s from nurses and my pedi and a few looks from people when I nursed in public.
I've never really understood the debate to be honest about it. There are some benefits absolutely, but like most parenting choices, you do not need to do every little thing to benefit your baby, and the edge is usually so slight so as to be completely unnoticeable to anyone but a statistician looking at data from the results. Some people do organic home made baby food, some people do no screen time, some people breast feed, some people worry about sleep schedules.
My only problem with the whole breast feeding/formula debate is that I don't think it is very well communicated how hard it is to primarily pump or occasionally supplement with formula. If you do those things, there is a real chance that you will end up using formula full time. Which again is perfectly fine, but I know a lot of women who thought those were easier options, and then were crestfallen when they ended up using formula full time. Primarily pumping and/or supplementing are difficult to do without hurting supply. Obviously there are women out there who manage without a problem, but it ends up working against a lot of women too.
BF-ing just didn't work for me. I had two little ones that got to a point in the hospital where the only thing keeping them from going home was their ability to eat. After 6 weeks in the hospital, I wanted to get them home! They responded to a bottle so much faster, and that's what we decided to stick with. I pumped, but just could not keep up with the demands of two growing babies. Plus we were fortifying with Neosure anyway. I wasn't sleeping, and I was just a royal mess with a supply that was quickly declining.
Finally after 10 weeks I said hell with it and we went to solely formula. Anyone who wants to judge me for that can go fuck themselves.
And like Lucy mentioned above, I only got pressure from other moms. The pedi and nurses didn't care as long as they were fed and growing.
Also, pumping sucks. I don't know anyone who didn't hate pumping.
Pumping is the worst. I was never able to pump successfully, and I tried everything under the sun. My kids could both get plenty when they were eating off the tap, but the moment I had to sit down with pump, I would get maybe an ounce. Eventually I was getting so upset trying to pump that I think the stress contributed to a lack of ability to produce even an ounce when pumping. Finally I just gave up pumping altogether, it sucked because I was permanently attached to the kids for feeding, but it was better than trying to sit for an hour only to get an ounce. And when I had a bag of milk leak in the freezer, and I ended up sobbing hysterically because all my hard work was now for nothing, I knew it was time to give up on the stupid milk machine.
WOMEN who breast-feed are eligible for WIC for twice as long as women who do not breast-feed, and they get an “enhanced food package,” which includes vouchers for a wider range of more nutritious food. Unlike formula-fed babies, who are eligible only for infant cereal and fruit and vegetable-based baby food, breast-feeding babies also receive meat-based baby food, which is richer in iron. The difference in benefits is intended to create incentives for poor mothers to breast-feed, but withholding food from mothers at nutritional risk, and from their babies, seems more like punishment to me.
I'm really surprised that no one has argued against this practice before or that it continues to go on. It really does seem like a kick and a shove rather than a gentle nudge.
I think the withholding from moms is horrible. I see the baby food as different thought. BF babies are at risk of iron deficiency, formula has iron in it. For whatever reason WIC can't provide iron supplements so it provides food. I mean it is still odd, but there is at least science behind it.
It's not withholding food from mothers--women who breastfeed have greater nutritional needs and therefore get a higher caloric/nutritional allowance. Babies get meat because BM is lower in iron than formula. I can find a lot of reasons to critique WIC practices, but I don't think this is one of them.
I think the withholding from moms is horrible. I see the baby food as different thought. BF babies are at risk of iron deficiency, formula has iron in it. For whatever reason WIC can't provide iron supplements so it provides food. I mean it is still odd, but there is at least science behind it.
It's not withholding food from mothers--women who breastfeed have greater nutritional needs and therefore get a higher caloric/nutritional allowance. Babies get meat because BM is lower in iron than formula. I can find a lot of reasons to critique WIC practices, but I don't think this is one of them.
Well, I mean I get the need for it. I just think both moms should get more food. That is all. And I mentioned the meat/iron thing above . . .
I know some people here are from the Carolinas--has anyone heard about Chapel Hill and Carborro becoming breastfeeding friendly cities? I think the program is terribly formula shame-y.
It sounds like a good program until you realize that it discourages any advertisements/sales of formula, wants formula placed on non-preferential shelves, and provide literature where formula is sold showing the benefits of breastfeeding. It also says that pregnant women need to be warned about the risks of unnecessary formula feeding. It's so offensive, IMO: www.townofchapelhill.org/Home/ShowDocument?id=28918
Also, pumping sucks. I don't know anyone who didn't hate pumping.
Womp womp womp womp womp womp.
I will never not be able to remember that sound.
As I get older, I crave the camaraderie of women more and care more about the potential for dividing women (thereby disempowering them) than I do about the actual debate at issue. I think that as long as we are focused on whether women should or should not breastfeed (intentional use of "should" there because for many working women it's a questions of "can"), we will lose sight of bigger issues, which for me these days is government paid maternity leave for all working mothers. Breast feed or don't. Circumcise or don't. Co-sleep or don't. But goddamn if we should be fighting about that when women are returning to the factory floor when they're stilling wearing the mesh underwear.
I realize this is an about face from previous stances I have taken. A lot can change in 10 years. Yes, we've been together for that long.
I know some people here are from the Carolinas--has anyone heard about Chapel Hill and Carborro becoming breastfeeding friendly cities? I think the program is terribly formula shame-y.
It sounds like a good program until you realize that it discourages any advertisements/sales of formula, wants formula placed on non-preferential shelves, and provide literature where formula is sold showing the benefits of breastfeeding. It also says that pregnant women need to be warned about the risks of unnecessary formula feeding. It's so offensive, IMO: www.townofchapelhill.org/Home/ShowDocument?id=28918
I'm not a fan of the Baby Friendly Hospital initiative either. I had my third baby at one and it seemed like a lot of their policies just make things harder for moms who are recovering from childbirth.
Thank you for sharing this. I recently went to my group OB appointment where we had the lactation consultant come in as a speaker. I was astounded at how much BF was being pushed, it felt like she was using scare tactics and made me extremely uncomfortable.
The hospital said they give new mom bags but would no longer provide formula in these packages. While I decided a while ago to BF, this would have turned me away from BF. Who are they to tell me what to do with my body? And how to raise my child? If I want to use formula, that is my choice.
I also receive WIC and was astounded that mothers who BF receive double the amount of baby food (the lady told be I would receive 136 jars a month just for not using formula) than those who don't. When I questioned the lady, she said women are allotted a certain amount of benefits per child and if you choose formula, you will receive less to balance out the cost.
i am also so so so thankful to be past this stage in life.
if I were to do it again I would only BF for like 6 weeks. I do believe in the power of BM in those first couple weeks. I very much regret pumping at work. I wish I hadn't done it both times. It made me so angry at the world. Thankfully I clued in and weaned around 4/5 months both times.
I know some people here are from the Carolinas--has anyone heard about Chapel Hill and Carborro becoming breastfeeding friendly cities? I think the program is terribly formula shame-y.
It sounds like a good program until you realize that it discourages any advertisements/sales of formula, wants formula placed on non-preferential shelves, and provide literature where formula is sold showing the benefits of breastfeeding. It also says that pregnant women need to be warned about the risks of unnecessary formula feeding. It's so offensive, IMO: www.townofchapelhill.org/Home/ShowDocument?id=28918
I'm not a fan of the Baby Friendly Hospital initiative either. I had my third baby at one and it seemed like a lot of their policies just make things harder for moms who are recovering from childbirth.
Agreed. IMO, the baby friendly designation is not caught up to the current science regarding what makes BFing successful, particularly around pacifier use (the hospitals aren't supposed to supply them after babies are born). I brought one in with me when my second kid was born because it was a lifesaver the first time without a single ill effect.
There have been a lot of debates about breastfeeding on these boards over the years. Frankly, I found most of the pressure I felt came from peers, not hospitals or doctors. Other mothers were the worst for me. Open judgment about "women who don't even try" were the worst.
I was told, on the old politics board, that not even trying meant I wasn't worthy of being a mom. It was awesome.
I find this utterly unsurprising. The whole notion that women produce liquid gold capable of warding off a whole host of issues, some for years after breastfeeding ceases, always sounded rather overblown to me.
I had almost NO issues breastfeeding either of my kids and I still relied on the boards for advice because the sheer responsibility of being solely responsible for a baby's nutrition while also sleeping in 1-2 hour stretches and bleeding and jiggling and sweating through my clothes at night was ending me. Sometimes only the thought of not adding cleaning bottles to the load of chores kept me going.
Shaming mothers for breastfeeding or for formula feeding is abhorrent to me. I'm still ashamed that once when talking to my friends about that stupid 16 and pregnant show (AFTER I had a kid) I was all "I can't believe how few of them try because of the cost savings." Like, lol that whipping out your breast on your parents' couch to feed your newborn at age 17 in between doing U.S. history homework isn't borderline traumatic. I blame postpartum insanity. I seriously think about how I said that nearly 6 years ago and want to slap myself. For my incredulity about PEOPLE ON A MTV REALITY SHOW.
I know some people here are from the Carolinas--has anyone heard about Chapel Hill and Carborro becoming breastfeeding friendly cities? I think the program is terribly formula shame-y.
It sounds like a good program until you realize that it discourages any advertisements/sales of formula, wants formula placed on non-preferential shelves, and provide literature where formula is sold showing the benefits of breastfeeding. It also says that pregnant women need to be warned about the risks of unnecessary formula feeding. It's so offensive, IMO: www.townofchapelhill.org/Home/ShowDocument?id=28918
I'm not a fan of the Baby Friendly Hospital initiative either. I had my third baby at one and it seemed like a lot of their policies just make things harder for moms who are recovering from childbirth.
I delivered at a Baby Friendly Hospital both times. I fucking hate that name with the fire of a thousand suns.
I did notice however that they were far less aggressive about trying to make breastfeeding happen with DD2 compared to DD1, perhaps because I could articulate my previous difficulties.
I have spent over 7 years of my adult life BFing and will soon be doing it again. I do it because it's easier for me and I am super lazy - no warming bottles in the midfle of the night, makes washing diapers easier and is free. But I recognize that my experience is different than othet women. First, I actually enjoy doing it. Plus I have an overabundant supply, don't have to work outside the home, and have had very eager nursers. If I were a working mom who had to mostly pump, or had to get a baby used to a bottle, or couldn't cosleep snd wake on demand all night due to my job, I'm not sure I would enjoy it as much or even want to do it at all.
With that said, I understand why WIC is the way it is. If every mom is alloted the same amount, and one chooses to BF for free, she should be able to use her allotted money on other necessities.
I will say, due to shit I saw going down on the boards all sharks v. jets style about bfing and comments about how doctors handled it I asked the potential pediatrician very pointed questions about her views. When she said she thought it was best, but a woman should only do it if she wants to and not her doctor, friends, or family, I knew I loved her.
I still love her. One of my greatest regrets is that it's super creepy and line crossing to ask your kids' pediatrician out on a friend date. I WANT TO BE HER FRIEND.
My only problem with the whole breast feeding/formula debate is that I don't think it is very well communicated how hard it is to primarily pump or occasionally supplement with formula. If you do those things, there is a real chance that you will end up using formula full time. Which again is perfectly fine, but I know a lot of women who thought those were easier options, and then were crestfallen when they ended up using formula full time. Primarily pumping and/or supplementing are difficult to do without hurting supply. Obviously there are women out there who manage without a problem, but it ends up working against a lot of women too.
Really? That was certainly the opinion of my least favorite lactation consultant, but I guess I haven't met many moms for whom occasional supplementation brought about a result of full time formula use.