“Case Against Breastfeeding” Overlooks Big Dirty Secret
Posted March 17th, 2009 by Bettina ForbesHere’s what Hanna Rosin is missing in “The Case Against Breastfeeding”: Moms are being urged to breastfeed but set up to fail.
Ms. Rosin finds that breastfeeding no longer works in her life and doesn’t want to be made to feel guilty about not breastfeeding her third child. Unfortunately, instead of examining why it doesn’t work, and why something that can be so easy, pleasurable and beneficial is being made so difficult, Ms. Rosin conducts a selective, cursory review of the scientific literature, concluding that the evidence is “thin” in favor of breastfeeding, a point of view that was furthered on the Today Show.
We all agree that mothers should not be made to feel guilty, whether they choose to breastfeed or not. What would be far more helpful, though, is to ensure that expecting parents have the best, evidence-based information to make their decisions on how to feed their babies, and that they can actually carry out that decision without constant interference. For the 74% of mothers who want to breastfeed, that is simply not the case. Many women throw in the towel before they want to—according to CDC data, 60% do not meet their personal breastfeeding goals, and only 11% meet the minimum six months of exclusive breastfeeding recommended by the American Academy of Pediatrics (AAP). They unfairly blame themselves and lash out at other mothers, instead of at the “booby traps”—the cultural and institutional barriers that are tripping them up at every turn.
As soon as an expecting woman tells her doctor that she plans to breastfeed, she starts receiving formula samples and coupons in the mail—coupons and samples which her friends who checked off that they do not plan to breastfeed will not get. She will probably have taken a childbirth education class, while a breastfeeding class is optional at best. She’ll expect to receive breastfeeding support in the hospital; she won’t know that in fact, “most hospitals perform poorly on breastfeeding support”. She won’t know that only 3% of the 3,000 maternity centers in the U.S. are designated “baby friendly” and follow a protocol proven to result in breastfeeding success.
While in the hospital, 25% of babies will be supplemented with food other than breastmilk, whether or not there is medical indication and often irrespective of parental request. Mom and baby will leave the hospital before the mother’s milk has fully come in and before breastfeeding is established. 70% of mothers will receive a diaper bag filled with more formula samples and coupons—a practice known to be highly effective in undermining breastfeeding duration. At home, the new mother will be subject to disapproval from family, peers and a society that normalizes bottle-feeding.
Having received insufficient support in the hospital, the mother will probably need to find a lactation counselor to address unnecessary breastfeeding complications. Unfortunately, professional help is not only scarce in some areas, but often not covered by health insurance. While the American College of Obstetricians and Gynecologists and the AAP both recommend exclusive breastfeeding for a minimum of six months, it seems that neither organization requires that doctors be trained in even the basics of breastfeeding support (such as latching in the first hour, or referring patients to lactation counselors or support groups as needed). Finally, if moms manage to make it through the gauntlet of the first few weeks, they face discrimination in public, and from stores, restaurants, airports, and employers. The U.S. has the worst maternity leave policy of any industrialized nation, despite evidence that breastfeeding benefits employers.
No wonder women like Rosin and her friends are ticked off (although their anger is misplaced); breastfeeding has become a lot harder than it is supposed to be! Worse, too many have a miserable experience breastfeeding. The longer we let women suffer through unnecessarily difficult nursing experiences without removing these barriers or “booby traps,” the more disgruntled they will become, the more likely they will be turned off by the nursing experience altogether, judge each other, and miss what can be a wonderful part of motherhood.
As for the scientific debate, Tanya Lieberman, IBCLC does a great job listing the facts, and I’m sure the Academy of Breastfeeding Medicine has more to say.
I do find it hard to believe that the World Health Organization, Unicef, the AAP, hundreds of respected scientists and doctors as well as every other medical and scientific body would go so far to promote breastfeeding if the evidence were as marginal as Ms. Rosin asserts. Consider that there is no financial gain to be had for promoting breastfeeding, there are no kick backs to be had, funding for a hospital’s NICU, or charitable donations for “causes” that breastfeeding actually protects against. The converse can not be said to be true, the deep pockets and lobbying power of the formula industry and the pharmaceutical companies that own them are well-known.
Instead of ending the mommy wars, it seems that Ms. Rosin has only added fuel to the fire. We hope it’s an opportunity to put heat on the barriers that are undermining us all.
(Author’s note: Special thanks to Melissa Bartick, M.D., Marsha Walker, RN, IBCLC, and Cindy Turner-Maffei, MA, IBCLC.)
42 Comments
May 9, 2009 at 11:19 am by taraI didn’t even read this entire article, but wanted to bunk your notion that only women who plan to BF get formula samples. I’ve made NO bones about NOT wanting to BF. I have received no less that 5 cans of formula in the mail.
The truth of the matter is taht which ever side you are on, you can sway the evidence in your favor. Why don’t people get their noses out of everyone else’s business? It’s no one’s business but the parents’ if their baby is FF or BF. As long as a baby is being fed, people need to shuddit!
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Melissa Reply:
November 3rd, 2009 at 3:16 pm
@tara,
Maybe you missed the memo but you are a minority, honey. Nearly 80 percent of mothers WANT To breastfed. Yes you read that right! Now you do the math because only 11 percent are still breastfeeding at 6 months. The big point, which you obviously missed is that women who want to breastfeed (which includes the majority of mothers) do not have the support in order to breastfeed. You made “no bones about it” so you probably did not research breastfeeding any, if at all. This might be news to you but breastfeeding sure is natural but common sense, it is NOT. Mothers need help and it’s not there for them! It’s foolish that all you got out of this article was that perhaps mothers who checked off formula feeding get samples, too. I am 100 breastfeeding and every month I get formula samples and coupons and advertising that tries to lure me into going down the formula road.
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Kwistina Reply:
January 14th, 2011 at 6:57 am
@Melissa, you are so right! My son is seven months now, and I pumped for 4 months until he finally had enough wet diapers that i felt comfortable breastfeeding without the pump. My son was born early, and honestly, the only thing that kept me going was my sister in law constantly nagging me to use formula, lol!!
My son is thriving, healthy, and I can feel the change in our relationship. I no longer feel like the nanny, I sleep better, and my son seems to enjoy the interaction as much as I do.
. . . and we still get samples and coupons and emails to “switch to formula”. I find it funny that the new labels say “almost as good as breastmilk”, I’m breastfeeding, and people like to insist that I should stop BF. I’ve even been giving cans of formula from other people who don’t seem to understand what I mean when I tell them we are BF!
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Anita Reply:
January 14th, 2011 at 3:03 pm
@Kwistina- So happy for you that your son is thriving after being born prematurely and that you’ve been able to breastfeed successfully!
After reading Rosin’s article, I couldn’t help but say aloud, “Spoken like a mother who has never bottle fed her baby.” After my c-section with my first daughter, I tried and tried to breastfeed, but due to lots of bad circumstances, couldn’t. I was heartbroken, not because of societal pressure to breastfeed, but because I wanted it more than anything.
I find it utterly laughable that Rosin complains about how inconvenient breastfeeding is. Try running to the store spending vast amounts of money on formula, packing bottles and powder with you whever you go, trying to find warm water when you’re at the mall, sterilizing nipples all day and night, stumbling down the stairs at 3 in the morning to microwave water for a botlle….the joys go on and on.
Now that I’ve had my second daughter, I am successfully breastfeeding. The utter joy of feeding my child is that much more now that I’ve experienced life with formula. At 3 in the morning, I simply reach for my daughter and put her to my breast, which happens to have the perfect milk for her at the perfect temperature. I close my eyes, kiss her forehead, and sigh relief that her food doesn’t come in a can.
Anyone that suggests that bottle-feeding is easier, just try it! Breastfeeding is a wonderful experience on so many different levels, and I myself wouldn’t trade it for anything. I only hope that the ignorance of Rosin’s article doesn’t persuade mothers to forego this joy.
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Kwistina Reply:
January 14th, 2011 at 7:00 am
@tlawrie, would you mind elaborating? I can see how that would easily fit into both viewpoints.
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Pointing out that mammals have mammary glands for a reason is not an endorsement of intelligent design but of evolution.
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March 18, 2009 at 8:49 pm by BettinaYou are right that employment issues are a huge barrier. And I’ve heard many women say that they didn’t bother trying to breastfeed because they knew they would have to go back to work too soon. However, other studies have found that just taking a prenatal breastfeeding class improves duration, regardless of employment plans. Also, the point of this post is that too many women are not making it through the first few DAYS after giving birth, forget weeks! I didn’t have room to go into more detail, but you wouldn’t believe what a huge difference latching on in the first hour makes to breastfeeding continuation, and how very few hospitals ensure that this happens when possible. It would be great if Ob-Gyns would at least make sure after delivery that the baby latches on or that a lactation counselor on site is there to help. In Baby-Friendly hospitals, 76% of babies are still exclusively breastfeeding at discharge, compared with a national average of 48%, and once again this is irrespective of employment plans. Hopefully, the more women are aware of the barriers the more they will put pressure on employers and other barriers.
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March 17, 2009 at 6:04 pm by CoachBRAVO. Let’s face it – babies are not convenient, and especially inconvenient in the USA with its lousy maternity leave, discriminatory practices, and competition for “stomach shares” by the formula companies. If we can’t even support mothers and babies who are doing the biologically normal and natural thing, who DO we support? Maybe the AIG execs could trade in some of their bonuses for paid maternity leave.
Rock on.
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March 17, 2009 at 6:08 pm by AnonymousWow one of the best articles I have read in regards to breastfeeding and why mothers do not succeed. Bravo, bravo.
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March 19, 2009 at 9:29 am by AnonymousTo me, the point of feminism is to ensure that women have the power to make their own choices.
1. I did not *want* to stay home and breast feed. I love my job and wanted to go back to work. There is always the implication–and I see it here in this blog post & comments, again–that a woman should of course *want* to stay home for a longer maternity leave. This would not have been the best thing for me psychologically, and therefore not the best thing for my baby or my family.
2. I did not want to be the primary parent. My husband and I wanted to equally co-parent. This started early, with me breast feeding half the time, and him feeding our baby the other half the time with pumped milk and formula. The incredible bonding between them has been a wonderful force in our family as our baby has become a child.
Yes, the formula industry is awful, and its marketing practices are unethical. And yes, I did receive inferior breastfeeding support at the hospital. But my baby got some breast milk for 6 months and has a (knock wood) better immune system than many of his exclusively-breastfed peers. I don’t take that as scientific data, but rather to illustrate that the relationship between babies’ health, bonding and breast feeding is not as simplistic as some would have us believe.
I don’t feel convinced that exclusive breast feeding for 6 months or more is always best for babies and women. I think every woman and every family has to make their own decisions, and that is what feminism must aim to allow us to do–not to attempt to manipulate us into accept dogma about the “power of breast feeding” and then talking about how something went “wrong” if we “didn’t get the message.”
In addition, I am tired of the notion that men cannot be nurturing primary or fully supportive co-parents. We continue to foster a culture that perpetuates this idea. I think women are afraid to give up some control in the child-rearing sphere. I get that, but think it’s time to get over it.
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March 19, 2009 at 9:30 pm by deborahPerhaps it’s just me but I find Hanna Rosin’s article “The Case Against Breastfeeding” ridiculous and confusing. It is a puzzlement to me how someone who is breastfeeding her third child could write such an article which is, on the whole, quite damning of breastfeeding. Rosin states that she does not believe the evidence claiming that breastmilk is superior to formula; well she does concede some minimal benefits. She compares breastfeeding her child to the onerous task of vacuuming – i.e.vacuuming and other household chores kept women down in the last century but now it is breastfeeding that is taking on that role.
Rosin whines about having to answer the phone while breastfeeding her child and “barking” at her two other kids to get their own juice. If she were bottlefeeding, would this scene be so different? I guess she could have one of those babybottle propping things – but this doesn’t match up with the ideas put forth on the companion video available on The Atlantic website in which Rosin and a few friends put down La Leche League and how their focus is now on “the milk” and not about the bonding with the baby (as someone who has had a great deal of experience with LLL and other breastfeeding advocates in the past several decade I can state this is patently untrue: although there has been a rise on what is sometimes called “breastmilk feeding.” this is not something advocated by LLL, but rather something individual mothers choose to do when they want to provide their babies with their breastmilk but for various reasons cannot or choose not to deliver it in the traditional way) : so Rosin seems to value bonding with her baby so wouldn’t bottlefeeding a baby make it even harder to answer the phone as she would have only one hand free as opposed to possibly two?
Rosin claims to have accessed many, many studies that do not match up with what breastfeeding advocates claim when they cite studies. I remember one study more than a decade ago from a hospital in western Canada that tracked more than a 100 admissions of babies and close to 100% of them formula fed. This seems fairly conclusive to me. But if Rosin does not want to believe in dramatic health benefits of breastfeeding nor in any risks inherent in the chemical soup we call formula, what about this: in the last 9 years there have been 9 major recalls of infant formula. For example, in 2002 a premature infant died from meningitis caused by a formula contaminated with enterbactr sakazakii and in 2001 magnesium content was excessive in a batch of formula which put babies at risk for low blood pressure and irregular heartbeat. That doesn’t happen with breastmilk. Of course every now and then there are articles about contaminants in breastmilk, which is more a sad statement on what we have done to our planet than an indictment of breastmilk, but the cow’s milk and other products used to make formula do not come from some pure planet somewhere off in space.
Rosin seems to make light of the formula industry’s efforts in the third world to push their product, resulting in the deaths of millions of babies. She refers to it as a “take no prisoners” turf war. She neglects to mention the unethical practices they used to infiltrate the market in these countries, practices that still continue today as formula companies try to widen their markets with decreasing profits in the U.S.
And even if Rosin does not believe in the health benefits, or care about risks does she really think that ash, emulsifiers, flavor enhancers, PH-adjusting agents and other not-yummy sounding ingredients sound like good things to put into a new baby’s body? When she refers to barking at her other kids while she is breastfeeding the baby she is telling them to get their “100% organic juice”: I guess the older kids warrant the good stuff.
Rosin does, begrudgingly, acknowledge that breastfeeding is probably best. But she clearly doesn’t think it is that important. She recalls a relative who refused to breastfeed her child in the name of keeping a relationship of equality between her and her husband. She thought it was crazy at the time but now thinks she had the right idea. Well jeez why did she even get pregnant? Perhaps they could have had someone else carry the baby to term?
Rosin ends the article all warm and fuzzy, claming she will miss breastfeeding when it ends. So she does have some good feelings about it after all. Too bad her article does such a damn fine job of hiding it and possibly turning other women off from even trying.
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March 19, 2009 at 7:18 pm by AnonymousMen can support breastfeeding and my husband did. I ended up being unable to breast feed full time b/c of under supply (after illegal lactation drugs, herbs, wonderful lactation consultants, rented hospital pumps, etc.). I am grateful that formula was an option for us, and that we could both feed our baby and it ended up being great bonding time for baby & dad–a benefit of a not-so-ideal situation.
You can go all “Natural Woman” on me all day. “We have mammary glands for a reason.” I don’t believe in intelligent design. Is it “castration of my normal female functions” to take birth control? Does that interfere with the “reason” for our ovaries? You go ahead and stay home and breed. I’m going to work.
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March 19, 2009 at 2:22 pm by AnonymousI am a nursing mom and plan to contiure nursing for at least a year. I had good support in the hospital, from my doula, and my family, especially my husband. My son also recieves formula supplement, because I was not able to keep up with him by pumping. I believe that if I were able to stay at home with him, I could have nursed him exclusively for the first year, but that is another discussion. The choice to start supplementing him was a very difficult decision. I felt as though some how I was failing him. Then I realized that what is equally as important it that nursing should be source of comfort and joy to us BOTH, not a source of stress and anxiety. Once I made the choice to supplement and started fenugreek to help improve my pumping, things got a lot better. Now that he is starting solids, we have been able to reduce the amount of formula he consumes and will hopefully eliminate it altogether soon. Parents are some of the most competative people, myself included sadly. The simple fact of the matter is that you know what is best for your child yourself and your family, though everyone else may think they do. While we do need better support for breastfeeding mothers, we have no right to judge the choice that other parents make. We are not their positions and do not have all the information that lead them to that point. The most important thing is that we all raise happy healthy children. Perhaps we shoudl devote our energy to that and not to judgement.
P.S. I was breastfed and my husband was formula fed and we both ended up as healthy, intelligent, well adjusted individuals.
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