Advice From A Lactation Consultant: When Breast Isn’t Always Best

Is breast best? Objectively yes. But our lactation educator dives deep into how feeding our little ones has much more to do with family dynamics and cultural support than we may think.

breastfeeding baby

I watched a Ted Talk recently that forever changed the way I think about new motherhood, postpartum life, and making choices that take care of our littles ones and of ourselves.

In her talk, reproductive psychiatrist Alexandra Sacks M.D. maintains that, like adolescence, new mothers undergo a similar period of identity transformation called “matrescence.” While we expect that teenagers will feel awkward, uncomfortable, and likely question their sense of self during adolescence, Dr. Sacks argues that we don’t grant new mothers the same opportunity.

Put simply, new mothers aren’t given room to feel all of the feelings. The new mother’s shift in identity and hormonal makeup is “often silenced by shame or misdiagnosed as postpartum depression,” Sacks states, rather than exposed as a normal, albeit uncomfortable, part of the postpartum period.

As a lactation educator, I see this shame come through when clients feel the need to justify how they feed their little ones: “I bottle-feed with formula only because I couldn’t make enough milk;” “I wanted to breastfeed exclusively but I couldn’t figure out the pumping thing when I went back to work. It was just too hard;” “We had to supplement at the hospital and it seemed too late to get the ball rolling with breastfeeding by the time we got home. But I wanted to breastfeed; I really did.”

Before watching this Ted Talk, I was convinced that our “Mommy War” culture was fueled by our own insecurities as new parents and, no doubt, by advertisers who want us to make choices that support the use of their products. We often judge others for making parenting choices that don’t align with our own; we pit ourselves against each other — “She does the cloth diaper thing, how granola is that?” — and ultimately end up feeling more isolated, more me vs. them. But Dr. Sacks’ work on “matrescence” contextualizes the “Mommy War” phenomenon in a new and profound way. As new mothers, we’re shamed into making choices that seemingly need justification. And the choice I encounter as a lactation professional is always about baby-feeding.


Is breast fundamentally, scientifically best? You bet.


Breast milk contains the perfect balance of fats, sugars, and protein for your growing baby. It has immunological properties that help prevent and fight disease; it contains anti-allergens and changes its properties based on baby’s needs at a given moment in time. The benefits to mom and baby are countless. The American Academy of Pediatrics advises exclusively breastfeeding for the first 6 months of life, then to continue breastfeeding for at least the first year of life with the introduction of complementary solid foods at around 6 months. The World Health Organization also recommends exclusively breastfeeding for the first 6 months of life, but advises breastfeeding for the first two years of life with the addition of complementary foods at around 6 months. And while we know that breastmilk’s essence is the perfect first food for our little ones, we must also remember that breast isn’t always best for mom or for family dynamics.

I’m a lactation educator, breastfeeding advocate, and breastfeeding defender, so this isn’t some ploy to get women to stop breastfeeding if this is the choice they’ve made. I work to ensure that women have the education, support, and emotional strength to make informed choices about how to use or not use their bodies to feed their children. But I’m not naive, and I know that our country does not have adequate systems in place to support a woman’s right to breastfeed at all— let alone to breastfeed for a minimum of 6 months. We have no national paid family leave policy, and laws about expressing breastmilk in the workplace have been generally nebulous. To categorically maintain that “breast is best” is to disrespectfully simplify a nuanced and complex issue. Instead of shaming ourselves or others for the choices we/they make around baby-feeding, why not reframe the way we think about the topic?

Dr. Sacks’ concept of “matrescence” makes room for a simple truth: it’s okay to supplement with formula if mom feels out of sorts and needs some feeding distance from her little one every now and again; it’s okay for mom to breastfeed in the privacy of her own home and to pump/bottle-feed when she’s in public if this feels right to her; it’s okay for mom to nurse before and after her workday but to send formula to daycare if pumping at work feels stressful or overwhelming.

It’s all okay, and it’s okay to have a lot of feelings about all of it. New motherhood is a trying time, complete with the highest of emotional highs and the lowest of emotional lows. Allowing all of this variation to be okay means that it’s also okay for us to make informed choices about how to feed our children that reflect our particular needs and our particular family dynamics.

If you want to breastfeed and need the support to make it happen, reach out to a local lactation consultant or contact me for additional resources.


Interviews, stories, and guides on contain information that is general in nature and should not replace professional medical advice, diagnosis or treatment. If you have a medical condition or concern or plan on trying a new diet, supplement or workout, it’s best to first consult with your physician or a qualified health professional.


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