May 18 in the USA has been declared a Day of Action to Protect Parents and Babies.

This Day of Action is supported by Best for Babes Foundation1,000 Days, ROSE, and Commercial Alert, in order to encourage grassroots action challenging unethical infant formula marketing, and fight for access to unbiased information about infant feeding. Participants are encouraged to use social media to share photos and ping WHO Code violators with messages demanding that the health and wellbeing of families take precedence over corporate greed:

Terrible, right? I mean how very dare they.

Naturally, the Day of Action’s Facebook page has been flooded with pictures of kittens snarky comments attacking the organisers and objectives for “shaming” formula feeding mothers.

My personal favourites are these two:

Lest you think this is an isolated incident, this is actually a thing now – the latest hammer in the anti-breastfeeding toolbox is to accuse breastfeeding advocacy of ‘ableism’ in an attempt to shut down the discussion. The idea is to make breastfeeding advocates look like bullies hell-bent on pushing a lactivist ideology which is ignorant of and discriminatory against women who are not able to produce breastmilk, thus ad hominem undermining the validity of their work.

Leaving aside the bizarre and completely unfounded claims (straight from the Fed Is Best playbook) that demanding that doctors and hospitals do not receive their breastfeeding training from formula manufacturers “results in potentially starved, brain injured or dead children”, let’s take a moment to enjoy the special turn of phrase that is “predatory lactivist ableist ideology”.

International Board Certified Lactation Consultants are health professionals with a minimum of 90 hours of lactation-specific education, who have successfully passed the IBLCE exam. Like other health professionals they may work in the public system or private system, where they are financially compensated for their work. Their customer base is women who want to breastfeed and are seeking help to succeed in their goals; their job is to try to get their client to a point where their services are no longer required as soon as possible. Peer breastfeeding supporters (e.g. breastfeeding counsellors) are volunteers who often work in their communities and pay for their own training.

In 2016, Similac Advance was the highest-selling brand of infant formula on the USA market, netting USD$65.8million, followed by Similac Sensitive with USD$40.4 million. Enfamil Enspire, which claims to be “our closest to breast milk”, is priced at USD$40 per can. Their customer base includes women who don’t want to breastfeed, but mainly consists of women who wanted to breastfeed but stopped before they were ready. It is in the explicit interests of formula manufacturers to create brand loyalty and encourage repeat business well into the toddler years.

All of which to say – if I was a breastfeeding mother trapped in a shark tank with a lactivist and a formula brand rep, I think I can guess who would eat me first.

It’s very difficult to pin down how many women are physiologically unable to produce breastmilk. Mainly because there’s typically very little money or interest in breastfeeding research, so nobody’s had the resources to do the numbers yet, but it’s also more complicated than a binary able/unable scenario. It is clear that there are medical conditions which cause delayed or failed lactogenesis, as well as insufficient milk supply. However it is also clear that environmental and social factors play a far more significant role in insufficient lactation. But as Dr Alison Steube of The Academy of Breastfeeding Medicine points out: “From a health and wellbeing perspective, however, I’m not sure that it matters whether we “count” both “biological” and “perceived” insufficient lactation together. The total burden of this problem is enormous, and mothers are suffering, whether they lack glandular tissue and or they lack self-efficacy and support.”

What do we make of this when considering the ‘ability’ of women to breastfeed? It’s tempting to begin arguing about whether or not a medical condition which results in impaired lactation qualifies as a ‘disability’, or if we would consider other public health campaigns (e.g. promoting exercise) as similarly ableist. However, to do this is to allow accusations of ableism to do exactly what they are intended to do: derail the discourse.

What we must not lose sight of is the fact that the vast majority of mothers both are physiologically able to breastfeed and want to breastfeed, yet encounter barriers which prevent them from doing so. And one of the biggest barriers to breastfeeding is a culture which insists on framing breastfeeding as a merely individualistic matter of whether women ‘can’ or ‘can’t’. This narrative completely ignores the hostile realities of class, race, gender, education, and economy for the purposes of making privileged women feel better about their infant feeding choices (or lack thereof). And infant formula manufacturers are laughing all the way to the bank.

Formula companies don’t give a toss if the women who buy their product suffered from insufficient glandular tissue or insufficient support, but they care very much about the threat to their bottom line when lactivists demand social corporate responsibility. Women deserve to be able to access information about how we feed our babies which is not provided by the very people who stand to gain the most when we fail to breastfeed and then hold ourselves personally accountable for that ‘failure’. Predatory Lactivist Ableist Ideology? Only if you consider formula manufacturers to be the prey.