Hardly a month goes by without one or more individuals sharing their views on breastfeeding.

“I’m well into my 6th week of exclusive breastfeeding and I like it more than I thought I would,” writes Claire Bidwell Smith in a recent Huffington Post article. I like the bond it creates between me and my daughter, and I like the idea that I am able to provide nourishment from my own body. What I don’t like is how constant it is, how time-consuming it is, and I don’t like the divide it has created between me and my husband when it comes to our care-giving responsibilities.”

What makes Smith’s statement appealing is its frankness. Any woman who has breastfed knows that breastfeeding has it all—the good, the bad, and even the ugly. What frustrates expectant and new mothers is the extent to which breastfeeding advocates (health professionals and parents alike) emphasize the good, downplay the bad, and ignore the ugly. Throw in conflicting messages predicated on ignorance (breastfeeding is notably absent in educational curricula from kindergarten through medical school), and it’s easy to see why breastfeeding is such an emotional issue. The credo that “breastfeeding is best” has only amplified the emotional divide, suggesting that mothers who bottle-feed (whether by choice or out of necessity) are not good mothers.

Clearly, mixed messages are a source of frustration for parents. On one hand we have nurses and lactation consultants telling mothers that breastfeeding shouldn’t hurt if “you’re doing everything right”; on the other hand we have 75 percent of mothers reporting that breastfeeding is painful.

The mother of four, grandmother of six hears the “breast is best” message and feels defensive about her decision to bottle-feed her children, so she tells her pregnant daughter, “Formula was good enough for you.”

The lactation consultant believes she is being helpful when she tells a new mom struggling with latch, “Anyone can breastfeed if they really want to.” And when that mother is unable to breastfeed despite every effort the lactation consultant is quickly labeled a “breastfeeding Nazi.”

Doctors and nurses describe breastfeeding as “completely natural” but mothers report that it’s “the hardest thing I ever tried to do”?  Hospital staff tell new mothers that “every mother can breastfeed” then give out bottles of formula “just in case.”

Society plays a role in the deception as well, describing breastfed babies as portable and breastfeeding as something you can do “anywhere, anytime, anyplace”. Yet mothers bold enough to breastfeed in public often incur dirty looks—or fear being harassed by a security guard.

The shame of not breastfeeding
When you aren’t breastfeeding, “You think people are judging you,” says Joanna Soto Carabello, a freelance book editor and mother of two in Athens, Ga. “I remember intentionally hiding the cans of formula in my Target cart. I thought people would look at me and go, ‘You should know better.’”

Joanna knew the benefits of breast milk, but despite her best efforts she was unable to breastfeed. Her failure only made the pro-breastfeeding messages seem heavy-handed at best, painful at worst.

Before Joanna started hiding formula in her shopping cart, she knew that there was a chance she might not be able to breastfeed due to an earlier breast reduction surgery. She took breastfeeding classes anyway, and planned to do her best.

No lactation consultant visited Joanna in the hospital when Adam, now 6, was born. She tried nursing anyway, but at Adam’s first pediatrician appointment, the doctor recommended formula or hospitalization. Adam was severely dehydrated.

“When I gave him his first bottle, and it was heartbreaking to do it, he sucked it down like there was no tomorrow,” Joanna says. “He was so happy and contented. I was so happy that he didn’t have to go to the hospital, but I was devastated. I cried and cried. I wanted it (breastfeeding) so bad… the fact that my body wouldn’t do it felt like a betrayal.”

Joanna felt robbed, like she had no distinct parenting role to play, even though she was the mother. Anyone could feed her son formula, she thought.

When she became pregnant with Vivian, now 2, Joanna was determined to make breastfeeding work. She researched strategies for breastfeeding after reduction strategy. After Vivian was born, Joanna read more books, joined chat rooms and took herbs (the fenugreek made her smell like a waffle). She attended a breastfeeding support group at the hospital, used a supplementing system while breastfeeding, and pumped constantly.

“I was a lactating cyborg,” she says.

For two weeks, she had something constantly connected to her breasts. Her lactation consultant told her that maybe it wasn’t meant to be. That turned out to be a freeing moment. Once she stopped trying to breastfeed, she could simply enjoy being with her baby.

But she still feels pangs here and there. “You do feel left out of a club,” she says. “And unfortunately, science keeps telling you, ‘Ooh, you really should have been a part of that club.’”A former journalist, Joanna keeps up with breastfeeding research, and she says that each new article detailing newfound benefits of breastfeeding is important. “The news stories are valuable,” she says. “But there needs to be more of a general discussion of, if you can do it, you should; if you can’t, don’t beat yourself up about it.”

Joanna understands that many women have breastfeeding struggles but will succeed, and they need that push to keep going. But at a certain point, the women who have physical limitations will suffer from that message.

“It becomes a battle where you feel like you’re surrendering and giving up,” she says. “It sets up a level of personal and societal expectations that can make you feel crazy.”

Joanna now knows that parenting doesn’t begin and end with breastfeeding.

“It seems like these are the huge parenting decisions you have to make, but later you realize you’re doing more than keeping them alive, you’re shaping them into responsible, thoughtful people,” she says. “There’s more to being a parent than what you feed your kid.”

You can be a good mother and not breastfeed
Amanda Rinehart’s first child had a bottle of formula before she had a chance to properly hold him.

Rinehart, a retention specialist at Crowder College in Neosho, MO, gave birth to Zane, now 3, via Caesarian. Her nurses gave him the formula “supposedly because his blood sugar was low, but according to the pediatrician his sugar was fine; they just jumped the gun,” she says. “So my breastfeeding attempts started out with a baby who was not really interested in eating.”

The hospital’s lactation consultant was more interested in getting Amanda’s husband involved than inspecting Zane’s troublesome latch. She also told the new mother that he had to nurse correctly before the family was allowed to leave the hospital. “I was ready to cry when we finally got her out of the room,” says Amanda.

A more pleasant nurse helped Zane latch on later that night; Amanda was so grateful that she sent her a thank-you card.

But at home, things did not go well. Amanda never felt her milk come in. At Zane’s second-week appointment, the pediatrician suggested supplementing without offering to help with breastfeeding. Amanda says she wishes she had asked for help, but was “already feeling like a failure.”

Prescription drugs and a hospital-grade breast pump did nothing to increase her milk production. After a month of trying, Amanda’s nipples were bloody and scabbed.

“I can remember sitting in my bed, nursing Zane with tears pouring down my face at two in the morning because my breasts hurt so bad,” she says. “I was very attached to the idea of breastfeeding. I wanted Zane to be healthy, and I couldn’t understand why I couldn’t produce enough to feed him. I really think I entered a depression. Those first few months of Zane’s life should have been a very happy time for me, but instead I felt like I was moving through a blue fog.”

She stopped trying to breastfeed when he was two and a half months old. She felt like she was cheating her son. She felt defensive about her decision, and answered innocent questions with long-winded explanations on why she wasn’t breastfeeding. She got upset with articles that said breastfeeding was natural and anyone who really wanted to breastfeed could.

When Cole, now 8 months old, was born, “the guilt was back twofold,” says Amanda.

She felt like she owed it to Cole to try, but she didn’t want to go back to that blue fog.

“So I chose bottle-feeding for Cole,” she says. “I still felt like I was cheating him somehow, but I left the hospital feeling rested, and capable of handling a toddler and a newborn.”

Amanda is moving forward with formula feeding and enjoying spending time with her children, including watching Zane lovingly bottle-feed his brother.

“I think it is important that people be informed about the health benefits of breastfeeding, but that somehow needs to be balanced by the idea that what works for you and your baby is the right thing to do,” says Amanda. “You can be a good mother and not breastfeed.”

Good intentions don’t excuse bad advice
When Rachel Bainum was pregnant with her first child, she took a breastfeeding class held at the Athens, GA, hospital where he’d be born. “It was mostly a joke,” she says.

“There were a lot of chortles when we were watching the breastfeeding video and a breast would pop up on screen,” says the stay-at-home mom. “It made for an uncomfortable environment to ask questions.”

After Donovan was born, nurses kept suggesting nipple shields, glucose water, or trips to the nursery to give her a break as she recovered from a cesarean section. But Rachel knew from the lactation consultant that skin-to-skin contact and nursing on-demand would help with Donovan’s jaundice.

Rachel knew that some family members thought breastfeeding was gross and weird. Some people think it’s odd that she’s still nursing Donovan, now 20 months old, and plans to continue breastfeeding throughout her pregnancy with her second child, due in May 2010.

But most unhelpful was the advice she received in the early months of breastfeeding, when she had trouble with her son’s latch, a strong let-down reflex, and an oversupply of milk. People told her to try formula or simply to stop as soon after 6 months.

“I know they meant well, but that was not the kind of thing I needed to hear,” she says. “Hearing that made me frustrated because I knew that some women hearing that could be discouraged and give up when maybe all they needed was some friendly, non-judgmental advice or even just some encouragement.”

Inconsistent messages can be hurtful
Lisa Netterville breastfed her daughter, Lexi, for a year, supported by her partner, pediatrician, and family. But if she had listened to the inconsistent advice from the hospital staff when Lexi was born 6 years ago, it might have been a different story.

“The staff knew that she was to be a breastfed baby,” Lisa says. “And I’d have the lactation consultant telling me that I should under no circumstances supplement, and then the nurses tell me that if I wanted her to not starve, that I should supplement. I did not like that at all.”

Lexi had colic, and Lisa ignored advice to stop breastfeeding to cure it. As a new, stressed-out mother trying to do her best, she felt personally hurt by such comments.

In fact, that’s what stands out. Even though she fulfilled the American Academy of Pediatrics guidelines for breastfeeding and was encouraged by those who knew her best, all the discouragement “was more impacting…than the encouragement.”

Affirmations make a difference
For every distressing story of bad advice or hurtful words, there are others who receive the kinds of messages we wish all women who want to breastfeed would receive—mothers like Abigail Holbrook and Clare Norcio.

Holbrook, a licensed clinical social worker in a cancer treatment center in Athens, recently nursed her 4-month-old son, Ephraim, in the outside eating area of a grocery store.

One woman eating near her told her she used to nurse her own daughter. “A little while later at the next table two other women smiled at me,” Abigail says. “And one said, ‘I am so glad to see you nursing him out in public.’ The other woman said, ‘It’s wonderful that you are doing that. I nursed my children.’ It was so great to get two affirming messages back to back.”

Abigail knew she wanted to breastfeed when she was pregnant with her first child, Susannah, now 4. Abigail’s mother—who breastfed all of her children and has pictures in the family photo album to prove it—was very supportive.

She also felt encouraged by her friends, who made breastfeeding feel normal by nursing their children at group gatherings.”

I made a point of surrounding myself with messages that supported breastfeeding,” says Abigail, who nursed Susannah until she was nearly 3 and nurses on-demand with Ephraim.

Clare Norcio, a graduate student at the University of Georgia, also nursed her children to toddlerhood. Lucas, 5, weaned himself at 13 months; Zeke, 2, did so at 19 months. Clare never felt self-conscious nursing at family functions or in public.

“I nursed my boys everywhere—on airplanes, in moving traffic while they were strapped in to their car seats and I sat in the back, in the first pew during mass, at the mall, at playgrounds, at restaurants, you name it, I’ve probably nursed a baby there—without using a cover of any sort,” she says. There’s been little accompanying reaction.

The Norcios have moved enough that their children have had 5 pediatricians, all of whom have been “reasonably supportive,” she says. When her boys were born in Massachusetts and Michigan, respectively, the hospital nurses pushed free formula. When Zeke was born, one pediatrician at the hospital routinely recommended supplementing right away so the baby wouldn’t “lose too much weight before the milk came in.” Other nurses were surprised that Clare refused to give her child formula.

Clare has mixed feelings about free formula samples. She knows that some mothers truly appreciate them, and formula is expensive.

“But I also think it’s a very insidious and almost paternalistic way of undermining a woman’s confidence,” she says.

Another insidious message, Clare notes, is that women are encouraged to breastfeed, but not in public, creating the message that “breastfeeding is good, as long as I don’t have to see it.”

Hiding breastfeeding “marginalizes women in so many ways,” she says.  “It reinforces the oversexualization of women’s bodies.  It contributes to the isolation of new motherhood if women are told that they should breastfeed, but should not do so in public where others might be offended.  It causes stress in general during a time that is inherently very stressful.  And I think it also perpetuates the myth that women’s choices about health and child rearing are open to, or best served by, public debate.”

Every parenting decision is personal, but few attract the scrutiny that breastfeeding or bottle-feeding provoke. At a time when women young and old are trying to do what is “best” for themselves and their babies, perhaps the focus needs to be on what is “right”, believing that in the end the right choice will be the best choice.