Squeezing a hand pump in a car while driving around Kauai wasn’t what I expected for my first postpartum vacation. My husband was enjoying our baby-free day, but as a breast-feeding mom, even a day without the baby isn’t truly baby-free. Instead of relaxing into our vacation, I spent the day uncomfortable and stressed.

The hand pump didn’t express as much milk as my electric one I’d left at home. Would I make enough milk for our baby-free dinner outing later that week? Would today’s poor pumping affect my supply? Would my breasts explode milk all over the side of the street? I was certain that last concern was the most likely, even if it was the most irrational.

Many women struggle with breast-feeding, whether because they’re unable to get a good latch, don’t produce enough milk, or have an unsupportive workplace or home. But there are other struggles you don’t hear about very often. Breast-feeding is a full-time commitment, and trying to find the balance between breast-feeding and all of the other demands of life can be a challenge for even the most organized mom.

I was lucky. My baby latched instantly, and for the first several months of his life I even overproduced. My employer is very supportive of pumping at work. I live in a city that is pro-breast-feeding, so feeding in public is never an issue. Lately, though, I’ve been thinking about ditching the pump and introducing formula. Am I a bad parent if, even with all of this support, I actively choose to give my baby formula? How can I reconcile the “breast is best” message with my need to find more balance in my life, and reduce the time I spend breast-feeding and pumping?

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Milk is constantly on my mind. As a full-time working and breast-feeding mom, I spend a lot of time with my breast pump, and I’m hyperaware of how much milk I need to produce per pumping session, right down to half an ounce.

My baby arrived three weeks early, weighing 5 pounds, 14 ounces. During my four-day hospital stay, a lactation consultant visited me three times. She had me pump after each nursing session, and then feed the extra colostrum and, when it came in, milk to my baby with a syringe. When I was discharged, I was encouraged to feed frequently and on-demand to help my baby put on weight.

We fell into a routine where I fed him about once every 45 minutes. This lasted almost three months until I finally couldn’t take it and stopped on-demand feedings following the advice of a lactation consultant. The frequent feedings were great for my milk supply, which is still meeting his breast milk demands nine months postpartum, five-and-a-half of which I’ve spent pumping and four of which he’s also eaten solids. That period wasn’t so great for my mental health, however. I felt like I never got a break. And with all of that nursing, I didn’t have time to pump until I returned to work. That meant I couldn’t leave my baby alone. Feeding responsibilities fell solely on me.

Now I pump three times during the workday and a fourth time in the evenings after my baby has gone to bed. That’s roughly 80 minutes of pumping each weekday. With additional evening sessions over the weekend, I’ve spent over 160 hours pumping, and expressed over 1,800 ounces of milk since returning to work. All of that is in addition to caring for my very active baby, working a full-time job, and managing my day-to-day life. To say I’m exhausted would be an understatement.

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As my husband watches me struggle to produce enough milk, get enough sleep, and manage my professional responsibilities, he often asks why I’m continuing to breast-feed. Wouldn’t it be easier to just use formula?

He’s right, it would be easier and then he could also help with the bottle feedings the way he helps with the solids, but the message of “breast is best” is so ingrained in my head that thinking about switching to, or supplementing with, formula fills me with guilt.

The American Academy of Pediatrics (AAP) recommends breast-feeding for at least the first year of a baby’s life. The World Health Organization (WHO) recommends continuing for at least the first two years of a child’s life. Both organizations encourage mothers to continue breast-feeding beyond those recommended time periods for as long as it works for the mother and her family.

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Breast-feeding provides many benefits to a child. It’s been linked to increased intelligence, and WHO claims it can lead to an increased earning potential later in life.

Strong research also suggests that breast-fed babies are at a decreased risk for:

  • sudden infant death syndrome (SIDS)
  • diabetes
  • obesity
  • gastrointestinal problems
  • earaches and other infections
  • leukemia
  • additional health issues

Additionally, breast-feeding may also benefit the mother by reducing her risk for certain types of breast cancer, ovarian cancer, and type 2 diabetes. It may also help mothers lose the weight they gained during pregnancy, though more research is needed to determine if there is actually a correlation between breast-feeding and weight loss.

Promoting breast-feeding is a good thing. I live in a bubble where breast-feeding has been destigmatized, but many women aren’t this fortunate and don’t feel supported in their decisions to breast-feed. Hopefully by continuing to educate people about the benefits of breast-feeding, women will face less opposition and socially constructed obstacles.

But what about the women who are unable to breast-feed or who actively choose not to breast-feed? Is the language used to promote breast-feeding leaving these women feeling like they are somehow doing less for their children?

When I read studies about the benefits of breast milk or hear phrases like “breast is best,” or breast milk is “liquid gold,” I feel like if I choose to stop breast-feeding, I will be failing my child.

My son’s pediatrician regularly congratulates me for continuing to breast-feed. I know she doesn’t mean it this way, but behind her words I hear that feeding formula would be something that doesn’t deserve congratulations. I read studies about the benefits of breast-feeding, and I take away from them that choosing for my own convenience to feed or supplement with formula would be robbing my child of a better life.

Learn more: 5 reasons to try supplementing with formula »

I know I’m overreacting, but there must be a way to promote the benefits of breast-feeding while also making women feel secure in whatever decisions they make, so long as their child is fed and properly cared for.

I’ve seen the phrase “fed is best” used more frequently, but is promoting that message enough to help women feel less guilty if they choose formula over breast milk?

Studies of the benefits of breast milk have been largely observational because of the ethics involved in studies on children. It’s difficult to determine how big a role home environment and parenting style also play in the beneficial outcomes that have been observed.

In a study on breast-feeding and child behavior in Africa, emotional development was determined to be affected more by the stress levels and emotional health of the caregiver than the method of feeding. Cognitive abilities were also seen to be linked more to genetics than nutrition.

Before becoming a parent, I regularly urged my parent friends to take care of themselves. “How can you be the best parent for your child if you’re struggling,” I’d ask. Now that I’m a parent, I find myself regularly sacrificing my own comfort and convenience so that I can see to the needs of my baby.

I endure chronic migraines because the alternative is to wait 24 hours after taking my medication to feed my baby, and I don’t have the freezer stash to support this. I do all of the middle-of-the-night feedings because I don’t have enough spare bottles for my husband to use. I’m anxious at the thought of leaving my baby with a sitter for more than three hours because I don’t know how I’ll find the time to pump to replace the bottles he’d drink while I’m away.

I spend so much time worrying about how to feed my child that I have to wonder if I’m negating the benefits of breast milk with all of my stress.

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I don’t know what the answer is. I’m not sure how we can continue to promote breast-feeding while also making women feel confident in whatever feeding decisions they choose.

I likely won’t get over my guilt issues today or tomorrow. In the meantime, I’ll continue drinking cup after cup of Mother’s Milk tea and eating bowls of oatmeal in an attempt to keep up my supply while I eagerly count down the days until my son’s first birthday when I can wean him guilt-free.