Why do lactivists value ideological purity above the wellbeing of babies?


My latest piece on Time.com, The Breastfeeding Police Are Wrong About Formula, addresses new research that shows that early supplementation with formula actually improves rates of extended breastfeeding. Contrary to the dire predictions of lactivists, giving hungry babies formula until their mothers’ milk comes in does not sabotage breastfeeding.

It’s not surprising when you consider anthropological research that shows that early supplementation is common in a wide variety of cultures from the Indian subcontinent, to Southeast Asia to Africa. Mothers around the world, who fully intend to breastfeed for years, and do breastfeed for years, see nothing wrong with giving a baby supplements in the first few days after birth. So why have lactivists insisted that supplements sabotage breastfeeding and advocate letting babies scream for hours in hunger until a woman’s milk comes in?

It’s very simple; they value ideological purity over the wellbeing of babies.

Consider the Baby-Friendly Hospital Initiative, bizarrely named since it is not friendly to babies or to mothers. It is being implemented in hospitals around the country despite the fact that there is no evidence that it works and quite a bit of evidence that it does not. Indeed a paper published in the April 2013 issue of the journal Pediatrics found the opposite. According to the authors of Baby-Friendly Hospital Accreditation, In-Hospital Care Practices, and Breastfeeding:

…After adjustment for significant maternal, infant, clinical, and hospital variables, women who birthed in BFHI-accredited hospitals had significantly lower odds of breastfeeding at 1 month (adjusted odds ratio 0.72, 95% confidence interval 0.58–0.90) than those who birthed in non–BFHI-accredited hospitals. BFHI accreditation did not affect the odds of breastfeeding at 4 months or exclusive breastfeeding at 1 or 4 months…

When you consider the 10 steps of the Baby-Friendly Hospital Initiative, it’s hardly surprising that they don’t increase breastfeeding rates. Instead of addressing the problems that mothers identify — pain, difficulty, low milk supply, inconvenience — the 10 steps identify the problem that lactivists insist, without evidence, is responsible for low breastfeeding rates — cultural pressure.

Having misidentified the problem as a lack of ideological commitment, lactivists have misidentified the solution as greater enforcement of ideological purity.

Why is there such a massive disconnect between what works to improve breastfeeding rates and what lactivists recommend? Because lactivists aren’t really interested in the wellbeing of babies. They’re invested in boosting their own self-esteem by having their personal choices mirrored back to them … and punishing those who refuse to copy them by making them feel like bad mothers.

CDC statistics show that rates of combo-feeding (breastfeeding plus supplementation) exceeds rates of exclusive breastfeeding by 30 percentage points, demonstrating that large numbers of women are already successfully combining breastfeeding and supplementation. Anthropological studies show that women from many different cultures do the same. It’s time to re-orient our breastfeeding recommendations toward what actually works for babies and mothers, and away from the ideological purity demanded by lactivists.

It’s time for breastfeeding without guilt.