Stigma Around Formula Use and Breastfeeding Causes Stress During Formula Shortage

Note: We use the term "breastfeeding" throughout this article, but it should be noted that the terms "chestfeeding" and "human milk feeding" are also applicable, and often preferred by trans and non-binary parents.

The United States Department of Agriculture (USDA) continues to work to address the infant formula shortage that has impacted the country since February, but that may provide little relief for parents with babies to feed.

Amidst the conversations regarding the shortage, many uneducated people are wondering why more people don't just breastfeed (also known as chestfeeding)—why is so much formula necessary in the first place?

While this might seem like a fair question at first glance, it ignores the complexity inherent in feeding an infant, and the history of breastfeeding stigma that has placed shame on parents for hundreds of years.

Mothers who want to breastfeed and parents who want to chest feed are generally expected to do so in secrecy—as breasts are still sexualized and culturally taboo—and parents who opt to use formula for a variety of reasons are then criticized for not taking the "natural" route.

It can feel like an impossible battle, and the current formula shortage is highlighting the struggle all the more.

If you are not personally navigating the current baby formula shortage to feed your infant, it may help to consider the mental health of such parents in how you engage interpersonally regarding this issue.

Mental Health May Be Impacted

Licensed psychologist who specializes in perinatal, pediatrics, and infertility support, Danielle D. Jenkins, PsyD, says, "The formula shortage is contributing to worsening parental mental health in several ways."

Jenkins explains, "It is natural and normal for parents to be vigilant about making sure their babies are fed. So when something happens to impact one’s ability to feed their child, the anxiety ramps up."

Jenkins highlights, "It may reignite or worsen feelings of guilt and uncertainty about all that went into their family using formula in the first place. Even in cases where they began using formula after an arduous decision-making process or a grueling fight to nurse, guilt is present."

It can take time to work through those feelings, so Jenkins notes how the shortage may bring those doubts back. "For those who have come to using formula through an emotional battle and a lot of guilt and frustration, the judgmental comments are like a punch to the gut," she says.

Jenkins explains, "These judgmental comments that come from unhelpful strangers, family, friends, and even celebrities make parents feel like no matter what they choose, no matter what they do, it can be wrong."

Unfortunately, this can make parents feel powerless in caring for their kids, as Jenkins notes this can contribute to depression and anxiety. She underscores how problematic it is to respond to the formula shortage with assumptions that breastfeeding is free.

Jenkins highlights, "These comments are hurtful to all new parents because it dismisses the physical, mental, and financial sacrifices that go into [this]. It also dismisses the difficult circumstances that can surround formula feeding for some families such as medical issues, two dad families, adoption, fostering, low milk production, [etc.]"

Furthermore, such comments show a lack of trust that parents, particularly parents of marginalized genders, can make the best choices for themselves and their babies, according to Jenkins. 

Having completed her doctoral dissertation on predicting and preventing postpartum depression, Jenkins has been thinking critically about these issues that impact mental health following birth for decades.

In terms of the research, Jenkins explains, "There are two factors that rise above the others when it comes to perinatal mood and anxiety disorders—preexisting anxiety and perceived lack of support."

When anxiety goes unchecked and new parents feel unsupported, Jenkins notes that mental health is affected. "The negative comments about those who feed their babies formula is contributing to a culture lacking in support for parents, especially mothers," she says.

Jenkins explains, "This creates an environment where anxiety, depression, and stress breed and parents feel strain, isolation, and overwhelm. Parents are often reluctant to ask anyone for help, especially around hot button issues. It’s ok to ask for help."

Jenkins continues, "Call your local WIC office even if you don’t qualify. Call your pediatrician and ask if they have samples. Join parent groups on social media. Ask your friends and neighbors. Please consult with a pediatrician if you are going to try alternative means of feeding."

Given the formula shortage, some parents are watering down formula in desperation, according to Jenkins. "This is dangerous, and even life-threatening, especially for babies under six months of age," she says.

Jenkins notes that the current culture is not supportive of breastfeeding as parental leaves are insufficient to meet the needs of families, yet parents are often shamed for their decisions, despite structural issues that limit their control.

The reality is that "fed is best," according to Jenkins. "We should empower families for making the choice that works best for them. We should trust them to make the best choice for their situation and support them in whatever choice they make (or have to make)," she says. 

Handling Negative Feedback from Others

Licensed clinical psychologist who specializes in new parent challenges, perinatal mood & anxiety disorders, and infertility struggles, Emily Guarnotta, PsyD, says, "Most [new parents] are not prepared for the challenges that can arise, like difficulty latching and poor supply."

Guarnotta explains, "Coming to terms with these challenges and either incorporating formula or doing a combination can be difficult. The current formula shortage can add stress to an already stressful experience."

Parents may face anxiety about meeting their baby's needs, according to Guarnotta. "New parents can support their mental health by recognizing that this is a very stressful situation and is a national crisis," she says.

Guarnotta highlights, "Remember that you are not alone. Leaning on others for support can be helpful. Family and friends can support one another by keeping an eye out for formula while shopping and helping to reduce the burden on new parents."

It is important to remember that another person's judgmental comments may reflect their own lack of knowledge, according to Guarnotta. "You are not doing anything wrong, even if other people make comments intended to make you feel this way," she says.

Guarnotta explains, "Being prepared with a simple statement when faced with negative comments can be helpful. If you are unsure what to say, ask other parents how they have responded to similar feedback."

At the very least, Guarnotta recommends a simple statement like "You're entitled to your opinion, but I've chosen to do things differently" to stop an unproductive conversation. "I wish people understood that this national crisis puts parents in an impossible situation," she says.

Guarnotta highlights, "Parents are already stretched thin with trying to care for their children and meet their needs, and not having access to nutrition for their children is extremely stressful. We should all be asking parents how we can support them during this very difficult time." 

Each parent is trying to do the best that they can, according to Guarnotta. "Whether a family chooses to breastfeed or formula feed, more than likely a lot of thought has gone into the decision and we should respect each family's choices," she says.