Full response to “An Effort to Increase Breastfeeding” in the Philadelphia Inquirer, June 2016

An abridged version of this letter appeared in on Philly.com on June 19, mind 2016. 

Breastfeeding has been a journalistic topic du jour for years now. As an author of a book about breastfeeding promotion, viagra the founder of a website supporting all methods of infant feeding, and a trained breastfeeding counselor, I read every piece on this topic with interest; after all, public perception is affected by what we see in the media, especially in today’s shareable, digital environment. It was for this reason that I was dismayed to see the interview with Arnetta Stewart and Katja Pigur of The Maternity Care Coalition (“An effort to increase breastfeeding in Philly”, 6/5/16). Not only was the piece rife with incorrect, misleading rhetoric, but it was also sadly indicative of how our society is going terribly wrong in efforts to enhance maternal/child health.

The interview begins with a discussion of breastfeeding initiation rates. While the figures used are spot-on (78% of mothers initiating breastfeeding), the hand-wringing about their inadequacy is not. These statistics do not take into account the deeply personal reasons the remaining 22% do not breastfeed from birth – women who have undergone mastectomies, women on certain contraindicated or borderline medications, and women who have histories of sexual trauma, to name a few. Also, of the many women included in this figure, how many might be second or third time mother who have learned from prior breastfeeding attempts that the practice is not possible or preferable for them? Or women who simply do not want to breasfeed, and make a fully informed choice to use formula? Seen in proper context, 78% nationwide is pretty darn impressive.

Moving on, Ms. Stewart claims that “Babies that are breast-fed are healthier babies. They have fewer infections and colds because it boosts their immunity. Breast-fed babies are less likely to be obese. The reason is if you give a baby a bottle and turn it upside down, the milk just flows out. Breast-fed babies do not overeat. Babies that drink from a bottle are overfed, and their bodies begin to recognize being overfed as the norm.”

Notice that the language used here is absolute. Not “babies may be healthier,” but rather that they most certainly will. This is patently false; the vast majority of infant feeding research is associative, bogged down by shoddy research methodology and confounding factors. We do have enough evidence to suggest a health benefit from breastfeeding, but this does not mean that every formula fed baby will be sicker than his breastfed peer. Likewise, there are numerous ways to mitigate overfeeding in a bottle-fed baby; her description brings to mind a defenseless child choking on a rapid flow of formula, which with today’s advanced bottles is virtually unheard of. And breastfeeding has not been conclusively proven protective against obesity; this is one of the most contested and questioned benefits, with several studies suggesting otherwise.

Next, Ms. Stewart makes the mind-boggling statement that “Breast-fed babies usually speak earlier because the jaw muscles are strengthened by breast-feeding.” If there is any evidence out there to support this assertion, I haven’t come across it in 7 years in this field.
She claims that breast-feeding promotes bonding between mom and baby; perhaps in most cases, but certainly not for the women who I’ve counseled, women who despised breastfeeding or for whom the act of nursing triggered memories of sexual assault, severe physical pain, or feelings of failure. Bonding happens between two calm, connected individuals, and sometimes a bottle serves this better than the breast.

But of all the misleading claims in this piece, one stands out as particularly alarming. Says Ms. Stewart, “breast-feeding puts their children physically, mentally, and emotionally on the same playing field as moms of a higher income.” No, the way we feed our babies in the first year does not level the playing field. Better healthcare, secure and safe housing, and equal education for all begins to level it. Breastfeeding, not so much.

Breastfeeding is a human right, a healthy and empowering choice, and one that deserves support and promotion. That does not – cannot – mean over-selling its benefits or presenting it as a panacea to the real problems families face. It does not mean causing unnecessary panic for women who are unable to breastfeed with overstated blanket proclamations that mean very little on an individual basis.
The time has come for an evidence-based, culturally and emotionally sensitive discussion of infant feeding. Instead of absolutism and zealotry, we need neutral, evidence-based advocacy that put the needs and rights of both women and babies ahead of breastfeeding statistics.

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