The American Breastfeeding Crisis of 2027

Eyes close-up little boy

This post is speculative fiction.

A thesis submitted

in partial fulfillment of the requirements for the degree of

Master of Public Health

May 2052


From the vantage point of May 2052, the American Breastfeeding Crisis of 2027 seems impossible to fathom. As early as 2020, elementary school teachers had been pointing to the rising rate of learning and conduct issues — previously seen most commonly among poor children deprived of adequate early nutrition — in an otherwise privileged cohort of Western, white children of high socio-economic status. This was initially thought to be evidence of a harmful exposure to an environmental toxin and throughout the early 2020’s vigorous investigative efforts were made to identify the source.

It was gradually realized that although the crisis was indeed of our making, the environmental “toxin” was not a substance but rather the relentless effort to promote breastfeeding that had been underway for decades but reached a peak in the first quarter of the 21st Century. Simply put, an entire generation of children was demonstrating the insidious effects of early infant starvation and resulting brain injuries. American policy makers and health officials had inadvertently created an artificial “famine” among the very young by refusing to acknowledge the limitations of exclusive breastfeeding and making infant formula expensive and difficult to obtain.

Why did Americans unwittingly starve their youngest, most vulnerable citizens? The artificial breastfeeding famine resembles other much larger artificial famines — The Irish Potato Famine, the Stalinist Famine of 1932, and the Great Chinese Famine of 1959-1961 in that the causes were ideological, not natural.

When the potato blight destroyed the crop repeatedly in Ireland of the late 1840’s, the island was still producing substantial amounts of grain that could have fed the majority Catholic population living at a subsistence level. Instead the grain was shipped to England by Protestant land owners for outsize profits, a result of the British Corn Laws that kept the price of grain artificially high. British politicians justified the suffering that the famine produced with economic and moral arguments. They argued that the natural laws of economics meant that providing aid to the population would destroy the economy and they insisted that that Irish Catholics were in part responsible for the tragedy due to their lazy, shiftless ways.

The Great Stalinist and Chinese Famines also had their roots in government policy, in this case the collectivization of farming and the spread of agricultural pseudoscience like Lysenkoism. Millions died but they were seen as deserving of their misfortune because they opposed government efforts.

As this thesis will explain, the American Breastfeeding Crisis was the result of a tragic mix of ideology, pseudoscience and economics. The ideology was lactivism, the pseudoscience was the tremendous exaggeration of breastfeeding’s benefits while simultaneously hiding its risks, and the economics was the rise of a group of medical paraprofessionals — lactation consultants — whose income was entirely dependent on promoting breastfeeding regardless of the consequences.

During the 2010’s a growing body of research findings documented the pernicious effects of aggressive breastfeeding promotion:

The incidence of newborn hypernatremic dehydration rose dramatically
Over 90% of cases of jaundice induced brain damage (kernicterus) were the result of breastfeeding
Breastfeeding was found to double the risk of newborn hospital readmissions
Many cases sudden unexplained infant collapse was related to babies being smothered in their mothers’ beds
A rise in skull fractures and deaths of infants falling from maternal hospital beds.

In response, the breastfeeding industry blamed everything but breastfeeding. Just as British politicians insisted that the Irish Potato Famine was the result of the laziness and sloth of the Irish themselves, the lactation industry insisted that insufficient breastmilk was the result of the laziness and sloth of breastfeeding mothers themselves.

Just as British politicians introduced draconian policies meant to discourage access to soup kitchens, the breastfeeding industry introduced draconian policies meant to discourage access to formula: banning it in hospitals, requiring women sign shaming consent forms for access, refusing to allow formula to be advertised, etc.

Just as British politicians invoked the “natural” laws of economics, the breastfeeding industry invoked nature itself, conveniently ignoring the fact that all natural processes have failure rates. Indeed, there is nothing more natural than a dead baby.

What changed in 2027? White, well off Americans of the 2020’s were obsessed with the educational achievements of their children. Indeed, one of the favored exaggerations of the breastfeeding industry was that breastfeeding increased IQ. Research ultimately conclusively demonstrated not merely that breastfeeding does not increase IQ, but that insufficient breastmilk, particularly in the early days of infancy, decreases IQ and leads to disorders of executive functioning.

How could the breastfeeding industry itself as well as the public at large fail to see the damage that aggressive breastfeeding promotion was causing? How could they turn away from the suffering that resulted? Cultural beliefs provided complete justification. Lactivists and lactation consultants believed with every fiber of their being that breastfeeding was always good, never failed, and anyone who claimed otherwise was either lazy or under the sway of formula manufacturers. But then British politicians believed with every fiber of their being that the “natural” laws of economics were immutable, never failed and anyone who claimed otherwise was either lazy or under the sway of radicals.

And in both cases, children suffered terribly as a result.

This post is speculative fiction.