The Elephant in the Formula Can: Medicine’s Overlooked Influence on Breastfeeding Failure


Millard County, UT. The formula shortage is easing, but it’s not over. Stores across the country are still rationing their supplies, some eight months after Abbott had to issue a recall for contaminated formula. There’s been plenty of outrage over the sad situation of parents scrambling to find formula for their hungry babies, plenty of finger-pointing and calls for reform, but we’ve largely overlooked a critical aspect of the crisis: the role medical professionals play in creating dependency on formula in the first place.

Medical interventions during labor are directly or indirectly implicated in breastfeeding complications: IV hydration can lead to breast engorgement as excess fluids build up in a mother’s body; forceps, vacuum extraction, c-sections, suctioning, and resuscitation can injure the nerves, muscles, and ligaments in baby’s mouth, throat, and head, making it difficult to latch properly or even latch at all. Pain-killing drugs, too, can delay when a mother’s milk comes in. The physiological process by which a mother gives birth to a child and both learn to breastfeed is incredibly complex and only partially understood, but medicine routinely and cavalierly interferes with labor, thereby derailing, delaying, or disabling critical physiological functions necessary for successful breastfeeding.

Most women today at least try nursing their babies. But by six months of age, the vast majority of babies have stopped nursing. There are many reasons for this, including a culture that only grudgingly accommodates mothers and babies, but the role that medicalized birth plays in breastfeeding failure must not be ignored. To be clear, medical interventions in true emergencies have their most welcome place, but it has been well documented that many doctors and nurses aggressively push procedures on women in labor that they don’t need or don’t want. Then, when breastfeeding fails and the mother is dependent on formula to keep her baby alive, it’s not the doctors and the nurses who pay the consequences; it’s the family. They’re now at the mercy of far-flung supply chains—an economist’s fantasy but a hungry baby’s nightmare. In this current shortage, bare store shelves have resulted in the hospitalization of some of the most vulnerable babies and untold stress for millions of parents already stretched thin by the reality of caring for a young child in a society bereft of community.

For whatever reason, it’s not commonly known that medicalized birth can have such a detrimental influence on breastfeeding, even though there’s a solid body of research documenting the physiological effects of birthing practices on the breastfeeding relationship. When breastfeeding fails, blame falls on the mother or the baby. It’s commonplace to hear women say, “I didn’t have enough milk,” or “My baby couldn’t latch,” as though it were some kind of personal failing or the mysterious hand that Fate had dealt them. No connection is made between birth and breastfeeding.

There certainly are conditions that make breastfeeding inherently challenging, but even aside from those specific conditions, breastfeeding difficulties have become widespread and commonplace, and they’re becoming normalized. “Breastfeeding is hard. That’s just how it is,” many women tell themselves and each other. The result is that the medical system, which plays a pivotal role in so many breastfeeding challenges, escapes blame. That’s a heavy—and unfair—burden for mothers to bear, and it reinforces the idea that women’s bodies are deficient by default and in need of intervention, in turn training us all to accept the transhumanist premise that humans can only be made whole through technological saviors.

Portrait of a Mother and Child from the American Colony in Jerusalem, 1905-1913.

Earlier generations of women were encouraged to abandon breastfeeding for supposedly superior formula. Although breastfeeding has since been vindicated and countless people have worked to revive it, breastfeeding has re-entered a world that grew up on formula. The medical practices that became standard protocols for labor were developed for a formula world, where it didn’t matter what impact medical intervention had on breastfeeding. The protocols remain basically the same, but women’s goals have changed: they want to breastfeed their babies. Unbeknownst to them, standard medical practice makes achieving that goal much more difficult.

A quick internet search reveals that although major health organizations explicitly promote breastfeeding (for example, the US Preventative Services Task Force, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics), they neglect to mention birthing interventions as a potential stumbling block to successful breastfeeding, even as their stated goal is to improve breastfeeding rates. There are certainly breastfeeding advocates who recognize the impact of birthing practices, but their voices don’t seem to carry far enough. As a result, women are making choices about how to give birth without understanding what’s at stake. No wonder so many are failing.

Our supposedly advanced society has managed to destroy what should be a universal human experience of inestimable value for both spirit and body. To downplay this massive tragedy by pointing to other breastfeeding failures in other cultures throughout time, as formula apologists have done during the shortage, is to sidestep a crucial opportunity for introspection and, thereby, repentance. Medical interference with physiological birth is the elephant in the room—or in this case, in the formula can. It’s painful to admit that the miracle of modern medicine, which proclaims its preeminence in saving women from the “curse” of birth, has robbed many families of that first, most precious nursing relationship. It’s disturbing to realize that iatrogenesis starts from the very beginning of life. To acknowledge the harm that has been inflicted on uncountable human lives is to invite doubt about the underpinnings of our technologically sophisticated world. That is an uncomfortable and lonely place to be. Yet it’s necessary if humans have any hope of reclaiming their birthright at mama’s breast.

The formula shortage has dragged on much longer than predicted. The suffering and stress it has caused millions of American families shines a flood light on the weaknesses of our infant-feeding system. Fixing supply-chain issues and cutting bureaucratic red tape can certainly help families who need to find formula at the moment, but without training a critical eye on the primary causes of formula dependency, especially the role the medical system plays, we leave families vulnerable to future catastrophe and all of us more susceptible to the siren song of transhumanism.

Image Credit: Amelia Bauerle (1873 – 1916), “Woman Holding Child in Arms.”


  1. Absolutely loved this, thank you. We had complications with our second child that caused breastfeeding to be difficult in the beginning, but the Lord heard our prayers, and after a few months, the dam was broken, so to speak.

  2. The number of things we need to admit about modern medicine seems to rise daily. And it is definitely painful to admit; too much depends on the assumptions involved.

    I think medicine is now the deepest political fault line we have, much deeper than “right” v. “left,” and for good reason. It’s where the modern idea that we can and should control everything really shows up in our daily lives; it’s where it becomes not an abstract idea but a literally visceral experience.

    Thanks for this piece.

  3. This is very well written, but also depressing, in that I was hoping we had, as a society, progressed past all of this. My oldest child is 43 years old, my youngest, almost 35. My oldest was born in, what was considered at that time, a “hip” birthing center, and that was because I was reading about all these medical interventions 43-44 years ago! All my other children were born at home because even the “hip” birthing center too much for me. Of course breast feeding was never an issue because it seems to come naturally when there is a natural birth. And all my grandchildren have been breastfed because my children were raised around my friends who were breastfeeding their babies. And no, I’m not trying to brag, I’m only distressed because somehow I thought these battles had been fought decades ago. How wrong I was. But, as the article states, as a society and a culture we do absolutely nothing to support babies, older children, and families. I think it’s dreadful that so many women are forced to go back to work so quickly after giving birth, of course that’s a huge reason so many babies aren’t breastfed.

  4. Very good article, supported by facts that enable pointed criticism with emotional restraint, a rare combination nowadays.

    The transhumanist angle is recent, though, unless you want to go back to Karel Capek (R.U.R. 1920) and EM Forster (The Machine Stops 1909) as early warners.

    It started as pure profit motive. Some 30 years ago, Indonesian maternity hospitals posted signs forbidding the introduction of “free” formula to women who had just given birth — it was a sales practice (with commissions for nurses). Promotions in the US are less blatant, but probably exist as you imply.

    Babies find breastfeeding less appealing if their first liquid is overly sweet formula (which always plays catch-up as someone in the upper echelons of the manufacturing company discovers that DHA, etc. is present in mother’s milk and should be added to the new, improved formula).

    Consumers Association of Penang ( noted even earlier that poor women (mostly in the Third World) would mix formula with unboiled water, leading to diarrhea. C.A.P. even called cans of sweetened condensed milk “the other baby killer” because unclean water was used for diluting that, too.

    But it’s not only hospital staff who bear the blame. Healthy babies can go a day or so without consuming anything (just water if they look dehydrated). So, a kind of panic that “the milk isn’t flowing right away” takes hold, with no support from family or friends or doctor, who might encourage a little patience.

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