When Choice Is Not Really a Choice
By Kaylee Costa, MBA, IBCLC, PMH-C, CHW | July 8, 2026
We talk about infant feeding like it is always a clear personal choice. Nursing, pumping, formula, combo feeding. Choose what works for your family.
And yes, choice matters. Parents deserve autonomy. They deserve respect. They deserve to make decisions without shame.
But I also think we need to be honest that choice does not happen in a vacuum.
Is it really a free choice if nursing is painful and nobody can see you for two weeks?
Is it really a free choice if you have to go back to work before feeding feels established?
Is it really a free choice if your pump does not fit, your insurance options are confusing, or you cannot afford private support?
Is it really a free choice if your mental health is unraveling and every feeding decision feels like proof that you are failing?
Feeding choices do not happen in a vacuum
Sometimes parents are not choosing from equal options. They are choosing from the options that are available, affordable, tolerable, and possible with the support they have.
That does not make their choice less valid. It means we should be more careful before we judge it.
A parent may want to nurse and still need formula. A parent may want to pump and still decide the schedule is too much.
A parent may want to stop and still grieve stopping. A parent may want to continue and still resent how hard it is. None of those experiences are contradictions. They are part of real postpartum life.
Good support does not force one definition of success.
It helps parents understand their options, their bodies, their babies, and their capacity.
It gives them information without using fear.
It respects their goals without ignoring their limits.
It helps them make a plan that is clinically sound and emotionally survivable.
When we talk about feeding choices, we need to include the conditions around those choices.
Paid leave. Insurance. Access to care. Partner support. Pain. Sleep. Anxiety. Culture. Family pressure. Work schedules. Money. Transportation.
All of it.
Because sometimes what looks like a simple choice from the outside was actually a survival decision made by a parent doing the best they could with what they had.
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About the Author
Kaylee Costa, MBA, IBCLC, PMH-C, CPST, CHW is a maternal wellness practitioner and founder of Costa Consultation, serving families throughout Greater Boston and the South Shore. Her work spans lactation and infant feeding, perinatal mental health, nutrition, movement, car seat safety, and complementary maternal wellness services. She holds degrees in psychology and sociology, an MBA, and is currently completing her Master of Public Health in Maternal and Child Health.
Through Costa Consultation, Kaylee provides prenatal and postpartum lactation care, pumping and bottle-feeding support, infant oral function assessment, starting solids guidance, perinatal Pilates, car seat education, Reiki, reflexology, and additional support throughout pregnancy and postpartum.
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