New York City Mayor Michael Bloomberg has again been the focus of criticism for promoting a “nanny state,” this time for his initiative to promote breastfeeding by preventing hospitals from displaying and promoting breast milk substitutes. The many voices in the outpouring of criticism that followed the unveiling of Bloomberg’s new plan are right about one thing: most women’s decision to breastfeed is not determined by where and whether hospitals display breast milk substitutes on their shelves. But most criticism has focused on a somewhat illusionary notion: choice.

And by this I don’t mean that women in the United States have no choice in the matter: obviously, we do.

What I mean is that choices, everywhere, are determined by our circumstances. When a substantially larger percentage of women in Western European countries, as compared to the United States, consistently choose to breastfeed and to continue to breastfeed past 3 months, logic has it that circumstances in those countries facilitate the healthier choice (which, undisputedly, in most cases is continued and exclusive breastfeeding for at least 6 months).

And what are those circumstances?

Here’s a hint: it’s not that European countries hide breast milk substitutes on the back shelves far away from maternity wards. Sure, many hospitals in Europe aggressively discourage bottle-feeding, but breast milk substitutes are freely available and the shaming of non-breastfeeding mothers—which many critics of Bloomberg’s initiative rightly point to as counterproductive—is no more or less strong than in the United States.

The fact that more women breastfeed in Europe is also not an indication of European women lagging behind their American sisters in terms of emancipation and modern living. If true, this might make European women more likely to live traditional homemaker lives with time to breastfeed. Women in Europe face different, not more, obstacles to equality than women in the United States. The pay gap between men and women has long been less pronounced in Europe than in the United States, whereas legal protections against sexual harassment are stronger in the United States than in most European countries.

Many of those who criticize Bloomberg’s initiative refer to the fact that some women just can’t breastfeed, and they shouldn’t be made to think they are lesser or worse mothers because of it. And, yes, that is obviously an issue. Some women just do not produce milk, regardless of how long and how well they teach their newborns to suckle. But it would be facile (and, frankly, naïve) to conclude from the difference in breastfeeding statistics that substantially fewer women living in the United States are physically able to breastfeed. There is, after all, nothing in the water (one would hope) that so systematically impairs our bodily functions.

There is, however, something in our laws. The key difference between Europe and the United States when it comes to breastfeeding are legal protections of paid parental leave, paid sick leave, and, in some cases allowances for longer lunch hours to breastfeed.

Consider this: in Denmark, where I gave birth and started breastfeeding my daughter, women have a right to at least 46 weeks paid leave after birth (unless your union got you a better deal). After living seven months in Peru (where women are entitled by law to 90 days paid leave to be taken before or after birth, and an additional one-hour break for breastfeeding while at work until the new baby is six months old), I moved to the United States for a full-time job. My daughter was then eight months old and had until then been exclusively breastfed.

My conditions were comparatively good. I had an office with a lock on the door, and I could organize my meetings and other work around the regular pumping I needed to do to maintain the flow of milk. Crucially, there was a fridge where I could store the pumped milk to later bring home to my daughter. Even so, my milk production, which
had until then been copious, all but seized in a few months, largely due to the difficulties in keeping a rigorously regular pumping (and water intake) schedule and—who am I kidding—the physical discomfort the pumping caused. And I am not alone. Many women find it hard to keep up a steady breast milk supply when returning to work after time at home.

So imagine what might happen to a new mother without such discretionary protection, and with only the narrow extended (and unpaid) sick leave afforded by the law. She’d be back to work after 12 weeks (or less) of unpaid leave, often have no place to pump, no allowance for time to pump, and no place to store the milk.

Crucially, the oddly myopic view of what’s at stake in the breastfeeding debate that was displayed in last week’s criticism of Bloomberg’s initiative suggests that new mothers enjoy little understanding from co-workers, employers, or even those claiming to represent women’s best interests.

At best, we are encouraged to feel empowered in rejecting breastfeeding and Mayor Bloomberg’s blame politics. At worst, we are told bottle-feeding is the price we pay for equality. The former is a limited read of reality, while the latter is just plain wrong. There are more effective ways than blame and coercion to encourage healthy breastfeeding for women who want to lactate and are physically able to do so, starting with paid parental leave.