The Globe and Mail

From the day he was born, Alison Evans breastfed her son Christopher with the understanding that breast milk is the most nourishing, natural and healthy thing a mother can feed her baby. So when, at four weeks old, he suddenly began rejecting her milk and stopped gaining weight, Ms. Evans was distraught and uncertain about turning to infant formula.

“I’d had this ... idea [breastfeeding]’s what I’m supposed to do,” the Pitt Meadows, B.C., resident says.

Christopher’s health immediately improved on a formula diet.

A greater struggle, however, was dealing with the reaction of strangers who would give her unwanted advice on how and why she should breastfeed instead. Nurses at her local health clinic also gave her disapproving looks when she reached for his bottle.

Among friends, however, Ms. Evans found she was not alone in having problems with breastfeeding.

“Once you start to talk about it, I find, the floodgates open and people are like, ‘Ohhh, I use formula too.’ It’s almost like a dirty secret.”

With research showing that “breast is best,” , mothers often feel tremendous pressure to breastfeed their babies. So when they turn to formula, whether by choice or necessity, many feel stigmatized as bad parents.

“When I went to buy the first case, I cried in the middle of Save-On because I thought ‘this is the worst thing ever,’ ” Ms. Evans says. “I felt like I was going to be judged – and I was.”

The bottle-feeding taboo is especially strong when it comes to women who choose not to breastfeed for non-medical reasons. Recently, an article by Kathryn Blundell, the deputy editor of Britain’s Mother & Baby Magazine, caused a stir because she said breastfeeding was “creepy,” she wanted her “body back,” and her “fun bags” were part of her sexuality. The piece sparked criticism from online commenters who called her “selfish,” “self-centred” and “vain.”

“Breastfeeding these days is associated with being a good mother,” says Tasnim Nathoo, co-author of The One Best Way? Breastfeeding History, Politics, and Policy in Canada. “We have all this scientific evidence of all the benefits of breastfeeding and, on the other side, all the risks of formula feeding. So when, I think, women choose not to breastfeed ... there’s a real sense of failure of not being able to live up to this ideal.”

Nevertheless, a majority of women use formula during the baby’s first six months, at least occasionally, for a number of reasons, says Ellie Lee, senior lecturer in social policy at the University of Kent in Britain, who studies mothers’ attitudes toward breastfeeding. While some women encounter complications, others use formula out of convenience, to accommodate their work schedules or because they simply don’t like breastfeeding, Dr. Lee says.

While research clearly shows the benefits of breastfeeding, the intense demands breastfeeding places on a mother are not captured by the medical studies. The messages mothers receive about breast milk versus formula are “phenomenally black and white and unequivocal,” she says.

Breastfeeding lobby groups have become increasingly influential on social policy, and they have put the onus on individuals to “choose health” or else risk becoming a social burden, Dr. Lee says.

“The moral dimension, I think, comes in with babies where people say, ‘Well, actually it isn’t just your choice, Mum. What’s at issue is another person – a particularly vulnerable person – so actually it’s not right to say, ‘Well I just don’t want to do this.’ ”

Through her research, Dr. Lee has encountered mothers who experienced “moral collapse” when they found themselves unable to breastfeed, and some isolated themselves, overwhelmed by shame.

Ms. Nathoo adds that, given the emphasis on breastfeeding education at hospitals and maternity classes, women receive comparatively little information about how to bottle-feed. “I think it’s harder to find that information, and so where do women turn?

“We felt kind of stranded, in the sense of … how far should I fill it up? How many ounces a day should [he] be eating? And that was a lot of confusion.”

Nancy Owens of Port Moody, B.C., also felt guilty at first about giving formula to her daughter Ruby, now 1. She had breastfed her two older children without any difficulty, but Ruby, who had early health issues, never latched on.

While she still advocates breastfeeding, Ms. Owens accepts that it doesn’t work for everyone. Moreover, she adds, it’s a personal matter.

“I think it’s shameful and very sad that [mothers] are being made to feel inadequate and guilty and not good enough,” she says.

Breastfeeding has always officially been promoted as the best option in Canada, says Tasnim Nathoo, co-author of The One Best Way? Breastfeeding History, Politics, and Policy in Canada. But it hasn’t always been practised.

A century of suckling

1900s: Breastfeeding is close to universal.

1920s: The federal government advises breastfeeding exclusively for nine months.

1950s: The government reduces recommendation to three months.

1960s: Women turn away from breastfeeding, associating science and infant formula with modernity and flexibility.

Late 1970s, early 1980s: A new wave of feminism has women reclaiming motherhood from experts and scientific authorities.

Present: The federal government advises mothers to breastfeed exclusively for six months.