Jana Kramer gave birth to her son Jace in late November, and she recently spoke publicly about her decision not to breastfeed him. Unfortunately, the feedback hasn’t all been positive, she said during a new episode of her Whine Down With Jana Kramer podcast.
Kramer said that people have flat-out asked her if she’s nursing or not, and that she’s gotten unwelcome feedback on the benefits of breastfeeding when they learn she’s not. “I totally get that. It’s just frustrating when women [are told], 'Breast milk is the best and all the nutrients!'” she said. Kramer said she even feels “like I have to hide the bottle when I’m in public because people are judging me. I feel judged,” she said.
She didn’t give a specific reason for not breastfeeding, but that was part of her point: "Do I have to explain to everyone why we're not breastfeeding? I feel like I have to. I have no problem talking about it, but why can't it just be OK that we're not? Why do we have to always explain our decisions?"
Kramer followed that up with a post on Instagram that showed her feeding her son with a bottle. “FED IS BEST!” she wrote in the caption. “You have all asked or commented, wondering if I was breast feeding or formula. I have wanted to explain myself because I felt like I had to, especially in a world of shaming. But here’s my decision…I don’t have to explain shit. I’m doing what’s best for me and my baby!”
There are a few reasons why someone might not want to breastfeed or be able to nurse.
The CDC lists a number of health conditions that could affect breastfeeding, including some that might force you to temporarily avoid breastfeeding or prevent you from breastfeeding entirely.
For instance, you shouldn’t breastfeed if your baby is diagnosed with classic galactosemia (a rare genetic metabolic disorder) or if you have HIV, human T-cell lymphotropic virus type I or type II, or Ebola, the CDC says.
And you should temporarily refrain from breastfeeding if you're dealing with issues such as an untreated brucellosis infection (a very rare infection that’s spread from animals to people, usually by unpasteurized dairy products) or an active herpes simplex virus (HSV) infection with lesions on your breast. And if you're taking certain medications (the CDC has a list) or undergoing diagnostic imaging with radiopharmaceuticals, those are also reasons to take a break.
There are also physical reasons why it might be difficult or impossible to nurse, like having undergone a double mastectomy, Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF.
But, overall, "there are few absolute reasons that women can’t breastfeed. Most health conditions are compatible with breastfeeding," lactation consultant Joan Younger Meek, M.D., chairwoman of the American Academy of Pediatrics Section on Breastfeeding and professor at the Florida State University College of Medicine, tells SELF.
Of course, as Kramer pointed out, you don’t owe anyone an explanation (health-related or not) for not breastfeeding.
“Everyone’s reason is different and that’s OK,” Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells SELF. Some people have to get back to work quickly and know that they won’t have time at work to pump, she says. “Others just don’t feel comfortable with it, are anxious about it, or are very concerned that they’re going to do it improperly,” she says. Some may have had a bad experience in the past with nursing—like getting a nipple injury or frequent mastitis—and don’t want to run the risk of going through that again, Dr. Greves says.
You might also choose not to breastfeed after having a difficult delivery or complications that occurred around the time of delivery, Dr. Meek says. There may also be a mental health reason behind it. "Occasionally, women who have been victims of domestic violence, rape, or other trauma, describe that the experience of having the baby in such close contact during direct breastfeeding may trigger additional trauma," Dr. Meek says.
There can also be a reason related to the baby for not nursing, like the child having tongue tie (technical term: "ankyloglossia"), a condition where a band of tissue called the frenulum tethers the tongue, restricting the range of motion, the Mayo Clinic says.
So, you don’t even need to tell anyone whether you’re nursing or not—that’s your prerogative. Ultimately, the choice is yours and other people should respect that, Dr. Minkin says.
Just be aware that, if you're not breastfeeding, your doctor will probably ask why.
“If a woman says she’s not going to breastfeed, I do say, ‘No judgment, but what’s your reason?’” Dr. Greves says. “We just want to make sure she has the right information, but the choice is ultimately hers.” Dr. Minkin says she encourages new moms to try to breastfeed—even for just a few months—if they can. “But if you can’t, you can’t—that’s all there is to it,” she says. Your doctor may offer to help ease any anxieties or set you up with a lactation counselor who can help you troubleshoot some common issues. But, after that, your doctor should drop the topic (and if they don’t, it may be time to find a new one).
"Our goal should be to provide information, education, and assistance, but ultimately we should support the mother in the choice that she makes in regards to infant feeding," Dr. Meek says. "She can be a good mother, a good caretaker, and a good nurturer, and choose to feed formula."
As Dr. Minkin says, “Whatever works for people is great. As long as the baby thrives and is growing, that’s all that matters.”