Those who’ve followed my work over the last couple years know that I’ve been on about “self-honesty” (or “cognitive integrity,” as I’ve termed it in scholarly contexts). Self-deception has received theoretical and empirical attention in the psychology literature; but the field does not have so much as a term to describe the opposite practice: the act of being deliberately, consciously honest with oneself. And yet, as I’ve argued, doing so is among both the most difficult and most necessary character virtues for a human being to cultivate if she is to live her own best life.

No doubt I’ll be returning to this theme in many posts to come, and I welcome you to explore some of my other writing on the topic in the meantime (e.g., here, here, and here). For now, in keeping with the subject of Alice—since she happens to be my main preoccupation at the moment—I’d like to reflect on some of the ways that self-honesty becomes especially difficult and salient in the context of caring for a newborn.

One reason to regard self-honesty as such a crucial virtue is that it sensitizes us to the difference between actually knowing and merely wishing or pretending to know. To the extent that we’ve internalized this virtue as part of our identity and character, we’ll be less tempted to bullshit ourselves about what we know, and thus also less tempted to act on such BS.

This is particularly relevant when making decisions in a realm like infant health and development, because the invitation to accept and act upon BS abounds. On the one hand, actual knowledge is often scant and hard to come by, given that much of the relevant science is still in its infancy (pun intended). On the other hand, the stakes feel extremely high, as does the pressure to prove ourselves as competent parents. And then there are the midwives and nurses and Facebook ads and family members who relentlessly bombard us with scientific-sounding dictates that they expect us to take as knowledge—“breast is best,” “screen time stunts development,” etc. etc.—and pass harsh judgement on us if we don’t obey. So of course we’re tempted to accept these dictates as a shortcut route to feeling as if we know what we’re doing. But at what cost?

Taking the “breast is best” dictate as just one example: throughout our postpartum hospital stay with Alice, we were inundated with advice from various medical staff who presented the alleged superiority of breastfeeding over formula feeding as an established, scientifically settled fact. This dogma runs deep, and the corresponding stigma against choosing not to breastfeed makes this an extremely difficult decision for many women to think honestly and objectively about. The quick-and-dirty shortcut route (epistemically speaking; nothing quick about the actual process of breastfeeding!) is to accept this assertion as “knowledge” and get on with figuring out how to breastfeed, come hell or high water.

This is the approach I know many new moms have been pressured to take, sometimes with tragic consequences for their mental health, physical recovery, and emotional connection to their baby. I witnessed some of these costs directly while working at a partial hospitalization program for women with peripartum mood disorders, so I fortunately knew better than to accept this particular dogma without question. And I owe a great debt of gratitude to Emily Oster’s books, Expecting Better and Cribsheet, for cutting through much of the BS about the pregnancy and postpartum periods (including the vastly overstated benefits of breastfeeding) and arming me with the information I needed to make my own decisions. As an aside, I highly recommend these books, not only to new and expecting moms, but to anyone interested in an exemplary demonstration of a self-honest approach to understanding quantitative research findings and making informed, responsible choices in light of them.

Whether or not we have Oster’s books to help scaffold the process for us, though, the process of achieving actual knowledge is one we must ultimately undertake for ourselves. This may involve an evaluation of the expert advice in relation to what we’re trying to achieve, which often means rolling up one’s sleeves and learning enough of the science to be able to make independent evaluations. (Much more on that in a later post.) Of course, we may honestly decide that doing our own research is too time-consuming or unlikely to yield enough insight to be worth it. In that case, the self-honest approach is to acknowledge what we don’t know, and to accept the potential consequences of taking our best guess.

Another aspect of self-honesty is being as clear-eyed as possible about the entirety of our own personal context. How much do these purported benefits matter to us, in proportion to the costs? In the case of breastfeeding, this means needing to think about all the relevant costs and benefits as they apply to our particular life with our particular infant. How will breastfeeding vs formula work with both parents’ schedules, and how will it affect the relative roles that each parent can play in the infant’s care? If breastfeeding is extremely painful for mom, how will it affect her mood and her interactions with the baby? Or if it is extremely time-consuming due to low milk supply or latching difficulties, what other bonding and growth-promoting activities will it lead mom and baby to miss out on?

Crucially, it’s unlikely that we’d know the answers to all these questions without gathering some of our own data first. This means we need to be willing to try a given method without yet knowing for certain whether it will be the best one. Again, the key difference here is whether we pretend to know, or whether we are honest with ourselves about the nature and extent of our ignorance. The former approach may do more in the moment to give us a comforting illusion of certainty; but only the latter approach positions us to weigh the risks and benefits realistically based on what limited knowledge we do have, and, crucially, to course-correct as needed once new data comes in.

In my case, largely for personal reasons that have only a little to do with the research literature, I decided that I would try breastfeeding and see how it goes. From the outset I had to make an explicit commitment, both to myself and to Matt, that I’d be willing to switch to formula as and when breastfeeding did not fully meet our or Alice’s needs. Already we’ve made various adjustments to the original plan, including some supplementation with formula when my milk supply was not yet adequate to satisfy Alice’s voracious appetite. And even this small adjustment, I admit, took some deliberate reassertion of self-honesty on my part: when Matt first suggested we supplement, I found myself balking at the idea, and even went in search of research on the alleged harms of supplementation (which, in fact, I do not find at all convincing). With a bit of reflection I realized it was “pretend knowledge” I was chasing, in hopes that I might avoid grappling with the unpleasant possibility that my supply was indeed inadequate. In other words, I had prioritized a comforting illusion over my daughter’s actual nutritional needs. Once I realized this and what it meant to me, it was suddenly not so hard to feed Alice the formula.

There is a great deal more I’m tempted to say here about the need for self-honesty, especially as I read the news and see the ever steeper price we’re paying for our culture-wide failure to practice and promote it. (The Trump administration’s approach to managing, or rather pretending to manage, the coronavirus outbreak is but the latest representative example.) But then that’s the beauty of blogging regularly, isn’t it? Stay tuned for more, and please leave comments or questions you’d like to see addressed in future posts!