The ads on the bus go bad, bad, bad – a response to the Calgary Breastfeeding Matters Group campaign

“Children of parents who have diabetes have higher risk of diabetes themselves. Reproduce responsibly. Learn more.”

“Hispanic and Black children have higher risk of diabetes. Race matters. Learn more.”

“Children who are poor have higher risk of diabetes. Money matters. Learn more.”

 

If any of the above statements were posted on the walls of a bus, there would be an intense backlash, and rightfully so. Not only do these messages contribute to the shaming of people with diabetes – a condition that, according the American Diabetes Association, is primarily due to genetic predisposition – they are also offensive, misleading, and would fit quite well into a sci-fi thriller about eugenics. True, these factors are associated with higher rates of diabetes, but the story is far more complex than these slogans suggest, and to imply otherwise is nothing short of irresponsible.

Yet, a similar advertisement will be posted on public buses in Canada, suggesting that mothers of children who develop diabetes may be to blame for their children’s condition, due to their infant feeding choices (or lack thereof).

Ad from the Calgary Breastfeeding Matters Group (CBMG.ca)

Ad from the Calgary Breastfeeding Matters Group (CBMG.ca)

The slogan Babies who aren’t breastfed have higher risk of diabetes, is problematic. The omission of the word “may” (“Babies who aren’t breastfed may have higher risk…) implies that ALL babies whose mothers do not (or cannot) provide mother’s milk are doomed to a higher risk of diabetes.

Yet, the recent meta synthesis study by the World Health Organization (1) which examined 314 studies from 43 countries, reported that while breastfeeding may have protective effect for type -2 diabetes among adolescents, “Generalization from these findings is restricted by the small number of studies and the presence of significant heterogeneity among them” (p. 12). Moreover, there is no evidence to support that breastfeeding is protective against Type 1 diabetes, which is more common in the pediatric population (2).

To understand how this ad is misleading, it’s important to understand that diabetes is not one disease, but actually a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Saying blanket statements about diabetes is like saying “Brittany S sucks”. Who? Brittany Spears? Brittany Snow? Brittany S. Pears from Glee? Brittany spaniels? Same name, but very different entities. The causes of the various types of diabetes also vary. Although there are 3 main types of diabetes (Type 1, Type 2, and Gestational), people can get diabetes as a result of other conditions, like cystic fibrosis, organ transplantation, or having HIV/AIDS.

Type 2 diabetes, formerly known as non-insulin dependent diabetes or adult onset diabetes, is the most common form of diabetes across the general population. It is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities, and can typically be managed via weight control, dietary changes, and exercise. It has come to be viewed in society as a disease of “fault”; another spoke in the wheel of the obesogenic machine that is currently speeding through our society like a shiny, red Corvette, crushing all nuance and holistic scope in its path.

Type 1 diabetes is an autoimmune disease, unrelated to weight or lifestyle factors. This is important to distinguish because children with Type 1 and their parents often get unjustly blamed for the condition (imagine how it must feel, on top of worrying about your chid’s blood sugar levels getting deathly high or low, to contend with people asking if you fed him or her nothing but junk food?) While there is some data suggesting the existence of environmental, viral, or physiological “triggers” for Type 1 diabetes, current research has not shown that it can be prevented (3) by any means, including maternal feeding.

Furthermore, to date, no studies have shown direct correlation between maternal feeding and the development of either form of diabetes, as this campaign would suggest. There is some evidence that children who were breastfed have a lower incidence of developing Type 1 diabetes [4] but the data are merely associative, as there are multiple confounding factors known to develop conditions for the disease. For example, the data coming from the burgeoning field of epigenetics have demonstrated a fairly robust association between allostatic load, or stress, in pregnancy, and higher risk for diabetes, coronary and ischemic disease. [5]

The Babies who aren’t breastfed have higher risk of diabetes advert, sponsored by the Calgary Breastfeeding Matters Group (CBMG), is the fifth in a series of pro-breastfeeding posters. The first four successfully inform and empower public awareness regarding breastfeeding; promoting the message that breastfeeding in public is normal with witty slogans and amusing imagery. This makes the current diabetes-themed poster all the more troubling–with its image of a bottle marked with the word “insulin” next to a foreboding hypodermic needle. To promote the scientifically inaccurate message with hyperbolic imagery misleads the general public, and burdens the parents and children affected by both Type 1 and Type 2 diabetes with unnecessary doubt and concern.

The CBMG may have expected backlash as its website offers a “Resource Sheet” to accompany the advertisement. They link to three different sources of data to back up their claim, with the introductory proclamation that “Recent 2013 research states that breastfeeding as a preventative measure against Type I and Type II diabetes is Level III Evidence”. The first link, to a Nordic systematic literature review, does confirm that the evidence supporting longer-term breastfeeding as a preventative measure (as opposed to “any” breastfeeding) is “Level III evidence”, indeed. What the CBMG fails to mention is that “Level III evidence” is defined as “limited-suggestive”. [6] (To be fair, the study does qualify the evidence for “any” breastfeeding being potentially protective as Level 2 – “probable” – based on studies of varying quality and methodologies.)The other two citations – another review and a seminar about epigenetics [7] [8] – both contain numerous caveats about their findings; neither offers anything close to conclusive evidence that breastfeeding is protective against diabetes – evidence that is hardly worth screaming from the rooftops. Or posting on the wall of a bus.

Without going into a lengthy discussion on the limitations of using two reviews and a lecture as the basis of an emotive advertising campaign, It should suffice to say that infant feeding has not been adopted as a significant reductive factor worthy of promoting to the general public by the American Diabetes Association, nor the Canadian Diabetes Association, expert authorities on this condition (although both of these sources do discuss the research into the breastfeeding-diabetes connection on their websites). In fact, diabetes expert Dr. David Lau  has already spoken against about the campaign, telling the Calgary Herald that the studies used to support the campaign “were essentially surveys…(and) he called any ad based on current, formal research to be an ‘extrapolation’.”

The CBMG “Resource Sheet” also contains a “Q and A”:

So, I breastfed my baby but she still got diabetes!  Is that my fault?

  • There are many risk factors which influence chronic diseases, not breastfeeding is only one of these risk factors.
  • When you have not realized your breastfeeding goals, you may inappropriately blame yourself, when it is the lack of information and support which is the real culprit
  • Let go of guilt. Use that energy to enjoy and celebrate your child and the accomplishments you have made.

This ad is cruel! It makes women who did not breastfeed feel guilty.

 

  • This argument by the public and health professionals takes the responsibility away from those supporting mothers who have not provided the information and support to help her reach her breastfeeding goals. 

  • Information about the health risks of formula do not come from formula companies, but it is very important for moms-to-be to realize there are risks. This needs to be delivered along with breastfeeding support resources.

(Source: CBMG.ca)

In other words, if your baby was breastfed and still got diabetes, there’s a potential that other factors may be at play- but more likely, you didn’t meet your breastfeeding goals. Don’t feel guilty, though – you were probably booby trapped! It’s not your fault you gave your baby diabetes. Although it kind of is.

This ad, well intention as it may be, will quite possibly inflict unnecessary shame and guilt on the parents of children with diabetes; perpetuate the confusion between Type 1 and Type 2 diabetes; and stigmatize women into breastfeeding rather than encouraging them to do so in a positive, constructive way. It would serve CBMG to remove this ad from their otherwise positive breastfeeding promotion campaign. Otherwise, they risk ruining an empowering, powerful campaign with the usual polarizing, negative, and historically ineffective tactics that have perpetuated the “bottle/breast” wars and kept parents from the important work of keeping themselves, and their babies, happy and healthy.

This post was a collaborative effort between Suzanne Barston (the FFF) and Walker Karraa, MFA, MA, with assistance from Polly Palumbo, PhD,  Sarah Lawrence, PharmD, MA,  Teri Noto, and Kristin Cornish, and several others who wish to remain anonymous for professional reasons. 

Citations

[1] Word Health Organization. 2013. Long-term effects of breastfeeding: A systematic review.

[2] University of Rochester Health Encyclopedia, date unknown. Type 1 Diabetes in Children.

[3] American Academy of Pediatrics, 2013.  Healthy Children.org – Diabetes Mellitus.

[4] American Diabetes Association, date unknown. Genetics of Diabetes.

[5] Barker DJ, Winter PD, Osmond C, Margetts B, Simmonds SJ (1989) Weight in infancy and death from ischaemic heart disease. Lancet 2:577-580.

Barker DJP, Bull AR, Osmond C, Simmonds SJ (1990) Fetal and placental size and risk of hypertension in adult life. BMJ 301:259-262

Barker DJP (1995) Fetal origins of coronary heart disease. BMJ 311:171-174.

Barker DJP, Osmond C, Forsén T, Kajantie E, Eriksson JG (2005) Trajectories of growth among children who later have coronary events. N Engl J Med 353:1802-1809.

[6] Hörnell A,et al. Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res. 2013; 57: 10.3402

[7] Nolan CJ, Damm P, Prenkiki M.Type 2 diabetes across generations:from pathophysiology to prevention and management. Lancet. 2011 Jul 9;378(9786):169-81.

[8] Patelarou E, et al. Current evidence on the associations of breastfeeding, infant formula, and cow’s milk introduction with type 1 diabetes mellitus: a systematic review. Nutr Rev. 2012 Sep;70(9):509-19]


 

 

 

FFF Friday: “My body made the right decision for me.”

Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts, and I hope we can all give them the space to do so.

I think my mouth is permanently stuck in an agape position after reading the following submission from Amber. With all the talk of physical impediments to breastfeeding, no one ever stops to consider that conditions that have nothing at all to do with your mammary glands can wreak havoc on a woman’s breastfeeding experience. 

While Amber’s story is especially dramatic, anyone who is dealing with a medical crisis while simultaneously learning how to parent and figuring out how to nourish a baby has the right to say enough is enough. Until someone walks in your shoes, they have no clue what the “right” choice is for you – or for your child. We commend breastmilk for being woman-made rather than created in a lab, and this is of course a true and typically wonderful thing – but our bodies sometimes screw up. That’s okay. We’d never tell a person with a disease that their condition should define them – and yet in the realm of childbirth and motherhood, we are constantly allowing ourselves to be defined by the physical.

That has to stop. Now.

Happy Friday, fearless ones,

The FFF

***

Amber’s Story

When I was pregnant I told myself what I thought was the truth: I would try breastfeeding, but if it did not work out I would accept that.  Because breastfeeding isn’t all unicorns and leprechauns like mommies-to-be are told it is.  Breastfeeding can be Hell, and it’s ugly little hand-basket too.

So let me tell you about my own personal hell.  First of all there are a few important health details that play into my “failure” at breastfeeding.  The first and most obvious is that I have Type 1 Diabetes.  You know, the one you get as a little kid, and not from over eating.  That being said I have particularly aggressive diabetes.  I take unusually large amounts of medications, and they still don’t keep my disease in check.  And for some reason, Diabetic mothers statistically have more trouble with milk production than otherwise perfectly healthy mommies.

Needless to say, I knew from the second that second blue line showed up that I was in for 9 months of unending terror, unimaginable pain, and quite possibly…death.  I had experienced 2 prior miscarriages, both of which nearly killed me, and had been told by many doctors that in my case I may never be able to birth a live child, and it could be life-threatening if I ever tried.  I took precautions to keep from getting pregnant, but after 4 years from the last time my birth control failed and I miscarried it happened again…I was pregnant.

I sat on the toilet, shaking all over, cold sweat covering me with my panties still around my ankles…staring at the “you’re knocked up” line that had popped out before the control one had even begun to show up.  The Fear hit me like an ocean tide and I screamed silently in terror for about a minute.  Instantly I loved this baby, instantly I would give my life for it…I was simultaneously trying to accept the fact that this baby would not live.  I could not let myself hope that it would survive my treacherous body, for fear that I would not survive the loss of another baby.

I told my then-fiancee, who knowing full well my medical history, was also hit with The Fear, but to a slightly lesser degree: my fear was mostly for the baby…his was mostly for me.  We…mostly I…decided to keep it.  I am stoically pro-choice, but the key word there is “choice” and it is not one I can bring myself to make.  When faced with keeping the baby I am like a two year old who has gone wild after realizing the word “mine” means it belongs solely to them.

Just for the record I was right… It. Was. Hell.  At 32.5 weeks pregnant I went pre-ecclampsic, like I knew I would eventually.  I “knew” this as in I am a great believer of statistics, which told me that diabetics have a 30% higher risk of this complication.  So I monitored my blood-pressure daily (if I’m being honest, it was actually a few times a day) at home, and at 33 weeks it was getting worse, and I was feeling worse…something just wasn’t right.

I was admitted to the hospital, and given the likelihood that my baby would be born early I was given steroid shots for the baby’s lung development.  Which meant that I had to have my blood sugars checked every hour for the next two days, and be kept in the hospital, as steroids can screw up your levels out of nowhere!  Which meant that I had not slept…not one single minute…for 3 days straight when our daughter was born.

My fiancee and I had planned to get married on Valentines Day 🙂 because I like to consolidate my holidays like that.  It would be a month before my “scheduled” c-section.  Because although I would not even be attempting a vaginal birth, there was nothing elective about it…with asthma, a hernia, diabetes, pre-e, and the fact that I am exactly 5 feet tall with a proportionate pelvis…all of these things gave me about 10% chance that I could go through labor…for like 5 minutes…if I insisted, and then be rewarded with a c-section anyway.  So I fully embraced the c-section inevitability, because I wanted to survive.  And in the end all I wanted was a healthy baby, no matter the pain, or the scar, or the public judging I could receive.

SO…here we were in the hospital, coincidentally ON Valentines Day, and there was bad news…I was dying.  I had such extreme edema that fluid had started to build up in my lungs, and I could barely breath even with the oxygen mask.  It was getting dangerous for me and our little girl.  If we did not take her out today we would both die.  But we waited a couple hours…we had already done all the planning, only the venue had changed.  We would be married less than 3 hours before my daughter’s birth.  In the hospital, with our parents and grandparents clustered around us while I lay gasping in a hospital gown, hooked up to about 5 different machines, and a dozen different chords.

It was beautiful :).  And I was pleased that out of the 17 people in the room most of them had no idea that I was dying.  I am awesome at downplaying my pain.  I couldn’t hide it completely though…my husband’s(!) grandmother had been a nurse for 50 years…and The Fear was barely contained in her face as she saw me, every part of my body was retaining water, and I had gained 4 pounds in the last day…all of it fluid (I know this because I couldn’t eat before surgery).  I was also pleased that I was wearing underwear.  It’s a small detail, but hey, I’m happy 🙂

So after we were wed and before the surgery I remind my husband: you must pick her.  If only one of us is to survive it MUST be her, no matter the odds.  He agrees, knowing that I would never speak to him again if he did not.  We have talked about this before, and he knows the choice I expect him to make, and I know the cost.  I am taken to the OR, alone, because my condition is so severe I must be put completely under so they can control my breathing (there is so much fluid in my lungs it is almost impossible for me to breath at all).  They put a tube in my artery to do this.  Since I was out for that part I didn’t figure this out till awhile after I woke up.  Not a fun wake-up surprise to find a tube in your neck.

I do not fully remember the day following.  I did not react well to the anesthesia, and was in no way lucid at all (the 3 days of exactly NO sleep may have played a part in this).  I was in ICU, my baby was in NICU…the two don’t connect.  So I didn’t really meet my Cupcake till a day and a half after she was born, but I really don’t mind much…I don’t remember most of it 🙂 But I can say I was in surprisingly little pain from the c-section…the edema was still excruciating, but the surgery went swimmingly.  In fact, my edema was SO extreme…I lost a toenail.  That’s right, my feet swelled to such epic proportions one of my TOENAILS came off!!!!!!!

We met, she was perfect, and tiny…little over 4 pounds.  Skinny, tiny, beautiful, my precious.  She recognized me!  She heard my voice and her eyes popped open and she craned her little neck around to find me!  The only time she had ever done that the nurses said.  I held her and I knew her…I recognized her too, this tiny girl I had never seen before.  She could breath on her own by this time, but spent all of her time not in my arms in an incubator.  I held her as long as I could take it…I was still in so much pain, and could barely sit because of the edema (my legs would swell more and more the longer I sat or stood).  And throughout my 8-day hospital stay I pumped with the hospital grade breast-pump dutifully as often as I could.

But it was painful…god it was hell.  And none of the nurses, doctors, or lactation consultants could figure out why it was hurting so bad.  It shouldn’t, they told me…but after a few days it was almost unbearable…even with the vicodin I was on my entire chest hurt more than my c-section.

I persevered.  I was told the rampant lie that it would stop hurting…as if by some magical day my tits would just get used to it.  Because my Cupcake was premature she could not directly breastfeed, and was fed through a tube through her nose.  The entire time she was in the hospital (2.5 months) I only tried breastfeeding her 4 times, during the 1st month.

She was terrible at it, if I’m going to be honest about it.  One thing no one ever seems to mention to new moms is that breastfeeding is actually done…like, 95% by the baby…the actual WORK is done by them.  Cupcake did not work.  She latched just fine!  But then she sat there…staring at me with confusion…as if *I* should be the one squirting what miniscule amounts of liquid I was able to make into her mouth.  She did not suck the first 2 tries.  Hours of sitting in a chair with a baby hanging off my teat was not exactly satisfying when I knew she wasn’t receiving a drop of sustenance and all I recieved was pain.  I never felt like we were “bonding” …I just felt used, and very uncomfortable with everyone’s invasive interest in my private parts.  I bonded with her before she was born, I loved her the second I knew she was there.  And we formed a “relationship” while I cuddled her all day in the NICU, and took on as many of the Nurse duties as I could.  I fed her through her tube, I changed her diapers, I took her vitals, I bathed and changed her…we were bonded just fine.  But I tried some more ’cause hey…I’m no quitter, and I was assured by the entire medical staff that she would eventually just “get it.”

And then it seemed she did! Hooray! Success! ….it was not…we did a weigh-feed-weigh…there was no difference in her weight at all…not even a tenth of an ounce.  And I was honestly not surprised: I had never been engorged, never felt a “let-down” of milk…I kind of just slowly leaked 1/2 to 1 ounce of milk at each pumping session…it never really flowed.  The most I EVER made in a day was almost 6 ounces.  And it was the most painful time of my life…and 6 months later I STILL have some chest pain.

So I tried one more time before quitting.  Still no success, and all the while she was being supplemented with donor milk, because I would NOT stand for my daughter starving! Because she was in NICU she qualified as “at risk” and so we got free donor milk through our insurance until she was considered full term.  And I kept pumping, developing BLISTERS on my nipples, and an unhealthy fantasy about smashing the hospital’s booby-torture device into a million little pieces.  I could not sleep well from being in so much pain.  I was mad, and uncomfortable, and righteously pissed off at everyone else’s belief that I should keep doing this.  I am still sure to this day that many of the LC’s thought I was exaggerating how much it hurt.  I was not…I was understating it…there are not words to describe how painful it was…I fainted more than once while hooked up to the pump, and I have an unusually high pain tolerance.  I hated my boobs with an intense fiery passion.  Hated the way they felt, they way they were hurting me.  The way everyone told me I was doing what was best for my baby, and to keep it up!

Eventually I began to doubt the whole “breast is best” mantra I was hearing.  I knew that in my particular case it was not.  Not only for me, but for HER.  My body is a notorious traitor…it tries to fail on me constantly, and I have consistently low blood levels of many vitamins, protein levels, and other necessary things.  I doubted that any breast milk coming from MY body was truly liquid gold.

Another complication I faced was that less than a week post partum I was diagnosed with gallbladder disease, I had “too many gallstones to count” the ultrasound technician told me.  Besides the awful pain this caused it had the side effect of making me extremely nauseous, and killing my appetite.  I felt no hunger at all, and when I could manage to force-feed myself it made me sick.  I could not get the surgery scheduled for two and a half months, so I just had to grin and bear this.

I was only ably to eat perhaps 1,000 calories a day without throwing it up.  Not exactly great for milk supply.  I was weak, exhausted, and in agony 24/7, even on my high-grade prescription painkillers. I had lost over 60 pounds in the last month and a half. More than one doctor changed their tune from “breast is best” to “you need to stop this before you kill yourself.”

I didn’t.

So my body made the right decision for me.  Always I have been a survivor, and this one time my body did not fail me, to make the decision I would not make for my own good.  I developed a fever for about a week and a half, got out of bed only to drink water and pee it back out.  Two days in my milk dried up completely.  I couldn’t see my daughter until my fever was completely gone, as she was in NICU there was too much risk to her and other babies of infection.  I didn’t even try…if I got her sick, or one of those other tiny babies with their frightened parents at their sides…I could never forgive myself.  So I stayed away…the first time I had not spent the entire day with her since we first met.  I recovered, and scooped her up like the holy grail.  She was so happy to see me! I had been gone so long and she still remembered me 🙂 She was being exclusively formula fed for a week by now, and she looked just as happy and healthy as she always had.  And she was bigger!

Finally I could accept it.  Cupcake would be formula fed.  I looked forward to my breasts healing from the relentless abuse I had put them through.  I had almost killed myself over breastfeeding because of the pressure to do what is “best.” Looking back on it I feel so foolish.  I had been so unhappy hurting myself like that…I had never willingly put myself through pain before and it had felt like outright self-mutilation.  It made me feel horrible.  My husband was so happy to see me happy when it finally stopped.

Cupcake is thriving on formula, and to all the strangers who look at me with their snarky opinionated eyes…I would gladly sit down with you and tell you all of this.  How breastfeeding almost killed me.  How hard I tried.  How badly I really wanted to do this for my daughter.  The literal scars on my nipples.  The pain I am still in today.

But I don’t think they are interested.  They only want to judge me for not being “crunchy” or “mom enough” to handle it.  I don’t care.  My daughter is happy.  My husband is happy.  I am happy.  And I would never judge them about their infant feeding choices.  I feel sad for them that they feel the need to judge me in order to make themselves feel better about their own choices.  I hope they are happy with themselves one day, like I am with myself today.

 ***

Share your story with the FFF community: email me at formulafeeders@gmail.com.

Beautiful study, ugly reporting

A new study from The American Journal of Medicine strengthens the link between breastfeeding and diabetes prevention. In looking at 2,233 Californian women, ages 40-78, from a single health plan (Kaiser), the researchers discovered a signficantly higher rate in the women who had children but never breastfed (405 of the women), compared to those who either hadn’t given birth (703 of the women) or who had nursed or pumped exclusively for at least a month (1,125 of the women).

The breakdown of those who developed Type 2 diabetes later in life was as follows (copied from WebMD):

  • 17.5% of the women who hadn’t given birth.
  • 17% of the women who breastfed all their children for a month or longer.
  • 20.3% of those who breastfed, but not all children for a month or longer.
  • 26.7% of moms who didn’t breastfeed.

Of those, 405 were not mothers, 1,125 were mothers who breastfed for at least a month, and 703 were mothers who had never breastfed.

You might expect that I’m going to pick apart this study, explaining that it was impossible to control for all confounding factors, lamenting the fact that the results relied on the (personal, and therefore likely flawed) recollections of women who’d been in their childbearing stages up to 50 years prior…. but I’m not. It’s a beautiful study, mostly because the authors are judicious in their analysis, and don’t hide behind “breast is best” rhetoric to disguise shaky results. I can’t copy and paste from the PDF of the entire paper here, but I did link to it, and I’d highly suggest reading the “Discussion” section, which outlines the advantages and flaws of a study such as this. The authors are also responsible enough to point out that the mechanisms behind their findings are completely unknown – in other words, while breastfeeding for even a short duration seems to have some protective effect against later development of Type 2 diabetes, they aren’t sure how this protective effect is conferred. Some have hypothesized that the type of fat lost more easily by lactating women may be the reason, or the apparent ability of lactation to alter insulin resistance. But the really important thing to acknowledge here is that once again, this could be a simple case of chicken and egg. Some of the same factors that may increase the risk of diabetes later in life – insulin resistance and obesity – are also significantly linked to shorter breastfeeding duration and lactation complications. So the same women who developed diabetes in this study could have refrained from breastfeeding for the same reasons that contributed to their later development of the disease… make sense?

Regardless, it’s an interesting finding, and I have no problem with it. I’m happy to see a study that examines the benefit of breastfeeding to mothers, rather than just focusing on what it can do for babies. It takes two to tango, after all. Plus, a month of breastfeeding, for those who physically/emotionally can handle it, doesn’t sound so daunting. Considering most U.S. maternity leaves are approximately 6 weeks, this could indeed be possible for women without having to deal with pumping, engorgement, etc, at work.

But I wouldn’t be the FFF if I didn’t find something to get all hot and bothered about with this news byte, would I? This time, it’s the media that I want to skewer. Because let’s face it – most folks are not going to read the entire study, cover to cover, and draw their own conclusions; they’re not going to see the sensitive discussion and thorough analysis the researchers did. They will probably just read about it in, oh, say, the Los Angeles Times, where reporter Shari Roan treats us to this little nugget of wisdom:

Breastfeeding a newborn for even one month will lower a woman’s lifetime risk of developing Type 2 diabetes, according to a study published Friday. Other research has also linked breastfeeding to a reduced risk of diabetes among women, but the new study establishes the strength of the association to a much greater degree…The question now is, why wouldn’t every new mother breastfeed for at least one month? 

Oh, Shari. Shari, Shari, Shari. If you’ve got 10 minutes, I’d be more than happy to answer that burning question for you. And while we’re at it, a little basic math might be useful, considering you write:

Researchers found that 27% of the mothers who did not breastfeed developed Type 2 diabetes. These women were almost twice as likely to develop the disease compared with women who had breastfed or who had never given birth. Among the women who breastfed for one to six months, 19% developed Type 2 diabetes compared with 16% among women who breastfed for six months or more.

Um, where did you get these numbers? I’m craptastic at math, so if any FFFs feel like picking through the actual study and figuring out why her numbers are off from the ones cited by Web MD, I’d be grateful. Either way though, unless I am even worse at number crunching than I thought (not bloody likely, as I believe I’m borderline LD on math stuff), last I checked 19% (the percentage of diabetes cases in those who had ever breastfed, which I’m assuming this writer is referring to by “compared to women who had breastfed”)x2= 38%. That’s significantly more than 27%, isn’t it? Not exactly “doubling”. Even if we use WebMD’s numbers (and I honestly can’t tell you who is right, although I’m assuming WebMD has a review board which is more familiar with accurate assessment of studies, so I’m leaning towards them), 17%x2= 34%, and again, the statistic for parous (meaning “having given birth”) women who never breastfed was 26.7%. Closer, but still no cigar.

Another strange piece of journalism comes out of the UK’s Daily Mail, which either misquotes lead study author Eleanor Bimla Schwarz, or Dr. Schwarz has changed her tune since writing the original paper:

“We have seen dramatic increases in the prevalence of type 2 diabetes over the last century,” said Eleanor Bimla Schwarz, M.D., M.S., assistant professor of medicine, epidemiology, and obstetrics, gynecology and reproductive sciences at the University of Pittsburgh. “Diet and exercise are widely known to impact the risk of type 2 diabetes, but few people realize that breastfeeding also reduces mothers’ risk of developing the disease later in life by decreasing maternal belly fat.”

Huh. That’s interesting, considering in the actual study, the authors discuss the possibility that belly fat might be the reason for this breastfeeding advantage, but are also quick to add that “further studies are needed to identify the pathways and mechanisms through which lactation reduces subsequent risk of diabetes.” Again, not a huge deal, but these little soundbytes have a way of spreading like swine flu through society – and even more dangerously, through science and medicine – and before you know it, you’ll be seeing every breastfeeding study citing this study as definitive proof that breastfeeding lowers diabetes risk by reducing belly fat. This is sadly how these things work (For a great breakdown on this phenomenon, I highly recommend reading Jules Law’s definitive paper, The Politics of Breastfeeding.)

Anyway, this quote is also used in CBS’s report on the study, which, like the LA Times, has to throw in its own clever digs to bottle feeders. First, the headline:

Breast-Feeding Protects Moms from Diabetes, Study Shows: Why Use a Bottle?

And then, the classic snappy ending:


“Our study provides another good reason to encourage women to breastfeed their infants, at least for the infant’s first month of life,” said Dr. Schwarz.
As if moms needed another reason.

Thanks, David W. Freedman. There’s a free seat in my lecture about why moms might choose a bottle, right next to your colleague from the LA Times. I’ll even throw in some free coffee and donuts.

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