Feeding Without Shame: The Need for an Evidence-Based, Compassionate Culture Around Infant Feeding Choices

By: Ly Ngo MSN, RN, IBCLC
   
    The early postpartum period is a vulnerable time, and how a mother chooses or is able to feed her baby often becomes a focal point of her identity as a parent. While breastfeeding is widely supported by public health guidelines—including the WHO and AAP—for its numerous benefits, the current cultural climate can unintentionally create shame around any choice that deviates from exclusive breastfeeding.

 

The Problem: Shame in Every Direction

Studies show that women who exclusively breastfeed often feel pressure to maintain perfection, even at the cost of their mental health. On the other hand, mothers who formula feed—whether by choice or necessity—often report feelings of guilt, failure, or judgment from peers and healthcare professionals alike. This double bind fosters what researchers call a “culture of feeding shame” (Lee, 2008).

Mothers frequently internalize societal messages that equate “good parenting” with exclusive breastfeeding, despite varying access, health, and emotional realities. Yet a 2022 study published in Maternal & Child Nutrition revealed that shame—regardless of feeding method—is associated with postpartum depression, reduced bonding, and lower self-efficacy in new mothers.

The Solution: Evidence + Empathy

Evidence supports breastfeeding as a powerful public health tool—but it also supports informed choice, mental health, and individualized care as equally vital components of maternal well-being. The best outcomes occur when mothers are educated on feeding options without coercion, supported regardless of their method, and provided with culturally sensitive, trauma-informed guidance.

The American Academy of Pediatrics recognizes that while breastfeeding should be supported, it should not be enforced at the expense of a mother’s emotional health. Respecting a mother’s context—return to work, medical conditions, previous trauma, or low milk supply—should be central to feeding conversations.

Moving Forward

An evidence-based culture doesn’t mean pushing one method. It means honoring what’s best for each family with the best available information and a foundation of compassion. That’s how we feed babies, and mothers, without shame.

 

References:

1. Lee, E. (2008). Living with risk in the age of ‘intensive motherhood’: Maternal identity and infant feeding. Health, Risk & Society, 10(5), 467–477. https://doi.org/10.1080/13698570802383432

• This study explores how mothers navigate risk and societal expectations around infant feeding, contributing to feelings of shame and failure.

2. Fallon, V., Harrold, J. A., & Chisholm, A. (2022). The impact of infant feeding attitudes on breastfeeding duration: A systematic review and meta-analysis. Maternal & Child Nutrition, 18(3), e13274. https://doi.org/10.1111/mcn.13274

• This review examines how attitudes toward feeding influence emotional well-being and breastfeeding outcomes, including shame and depression.

3. American Academy of Pediatrics (2022). Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics, 150(1), e2022057988. https://doi.org/10.1542/peds.2022-057988

• This statement acknowledges the importance of supporting breastfeeding while also considering the emotional and physical well-being of the mother.

4. Tomori, C., Palmquist, A. E. L., & Quinn, E. A. (2018). Breastfeeding: New Anthropological Approaches. Routledge.

• This book provides anthropological insight into the cultural narratives and pressures surrounding infant feeding.