Breastopia vs. the real world

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It’s the ur-myth of lactivism, the belief that we came from Breastopia and we should return to Breastopia.

There’s just one problem: Breastopia never existed and frantic efforts to “reclaim” it are harming babies and mothers.

To understand why it helps to compare Breastopia to the natural world. That’s why I created the handy chart below.


In Breastopia every baby is breastfed, but in the real world many mothers died in childbirth and therefore couldn’t breastfeed. Many of these babies died.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Breastopia never existed and frantic efforts to “reclaim” it are harming babies and mothers.[/pullquote]

In Breastopia colostrum is enough to support a baby through the first days after birth. In the real world many babies suffer dehydration, hypoglycemia and severe jaundice as a result of insufficient breastmilk. That’s probably the reason why indigenous cultures around the world offer pre-lacteal feeds. Many of these babies died.

In Breastopia a mother’s breastmilk production completely matches her baby’s needs. In the real world up to 15% of first time mothers don’t produce enough breastmilk to fully nourish an infant. Many of these babies died.

In Breastopia all babies can easily latch and can effectively suck. In the real world some babies can’t latch properly or have a weak, uncoordinated suck. Many of these babies died.

In Breastopia every baby “breastsleeps” with its mother, nursing freely throughout the night. In the real world many babies are smothered their mothers beds.

In Breastopia nearly all babies survive until weaning. In the real world anywhere from 20-40% babies or more do not survive their first year.

The clever among you are probably sensing a theme: breastfeeding, like any natural process, is far from perfect. As a result there are high rates of infant wastage. In other words, many babies naturally die in infancy.

Despite the fact that Breastopia literally never existed, many lactation professionals insists that we can and should return to it.

Consider the latest data dump on breastfeeding released by UNICEF.

According to a CNN article entitled The countries where 1 in 5 children are never breastfed:

A new UNICEF report released Wednesday that ranks countries by breastfeeding rates shows that in high-income countries, more than one in five babies is never breastfed, whereas in low- and middle-income countries, one in 25 babies is never breastfed…

“The data and the analyses are a confirmation of a trend that we have seen for a number of years now,” said Victor Aguayo, UNICEF’s chief of nutrition, who was involved in the report’s policy analysis.

Aguayo bemoans the fact that many children are never breastfed and insists that we must make breastfeeding the norm.

“In higher-income countries, we see that the proportion of children who have never been breastfed is significantly higher than the number of children in low- and middle-income countries. That is a fact,” he said. “We need to create environments — including in the US — that make breastfeeding the norm.”

It’s almost as if he thinks breastfeeding makes infants healthier and saves lives. But that’s NOT what the data shows.


You can examine the full chart of international breastfeeding rates embedded in the article.

Let’s look at a few representative countries.

Afghanistan has a breastfeeding rate of 97.8%. It also has an astronomical infant mortality rate of 102.9/1000.

Burundi has an even higher breastfeeding rate of 98.8%. It’s infant mortality rate is also appalling at 81.1/1000.

How about the countries that UNICEF chastises for low breastfeeding rates like the US and France?

The US has a breastfeeding rate of 74.4% and an infant mortality rate of 5.87/1000.

France has an even lower breastfeeding rate of 63% and an even lower infant mortality rate of 3.2/1000.

Are you noticing a trend? That’s right, breastfeeding rate has NOTHING to do with infant mortality.

Moreover, as far as I know, there is no evidence that increasing the breastfeeding rate in a country leads to any measurable benefit in reduced infant mortality. The only exception to this is the case of very premature babies who have a reduced incidence of necrotizing enterocolitis when fed breastmilk.

None of this should be remotely surprising. Breastfeeding was far from perfect in nature and it is far from perfect now. Indeed, as I’ve written many times in past, the benefits of breastfeeding in countries with clean water are trivial, and not particularly compelling elsewhere, either.

So what’s driving the relentless pressure to increase breastfeeding rates? It obviously isn’t scientific evidence since no one can demonstrate any real world benefit to increased breastfeeding rates for term babies.

What’s driving it is the lactivist belief in Breastopia — the belief that Breastopia existed in the past and we could return to Breastopia in the future if we just offered greater support pressure to breastfeed. Lactivists are longing for a past that literally never existed. By relentlessly seeking to recapture it they are coming up against the real world limitations of breastfeeding … and seriously harming babies and mothers as a result.

31 Responses to “Breastopia vs. the real world”

  1. myndchanger fumblesmcstupid
    June 17, 2018 at 8:09 pm #

    It has become difficult to ignore the fact that breasfeeding may be responsible for the rise of allergies. They both rose together.

    • Roadstergal
      June 17, 2018 at 10:15 pm #

      There is a fair amount of evidence from interventional trials showing that exposure to food allergens at 4-6 months of age decreases the risk of food allergy. Therefore, it’s reasonable to hypothesize that the current messaging of “EBF for 6 months at the minimum” would indeed increase the risk of food allergy…

      • Daleth
        June 18, 2018 at 10:33 am #

        Yes, we saw a study about peanut allergies being significantly higher the longer that kids were prevented from eating peanut butter. So ours were like 10 months old when I purposely fed them peanut butter for the first time. They loved it and have been snarfing it regularly ever since.

    • BeatriceC
      June 17, 2018 at 10:58 pm #

      I agree with Roadstergal. I think it’s an attribution error to blame breastfeeding itself. But delaying foods until six months, or even a year, has substantial evidence showing an increase in allergies.

  2. Lisa Hayes
    May 25, 2018 at 1:35 pm #

    While it certainly can be dangerous if Moms who use formula in the poorest countries don’t have access to clean water and aren’t taught to fully boil the water. [Also American Moms who use the hot water tap]. That said, it can be just as dangerous to breast feed with HIV meds! I really do not understand this hysteria to strap a Mom to her baby 24/7/365 so it can nurse! Feed the kid. If he doesn’t nurse well–so what? Give him a bottle. A HEALTHY child is the goal, right?

  3. myndchanger fumblesmcstupid
    May 25, 2018 at 12:09 am #

    Explain to me why the rise of breast feeding matches the rise if life threatening allergies like peanuts, wheat, cow milk, etc There was a study in Australia about 7 years ago that got shut down. I come from 3 generations of bottle fed and we are so healthy that it was opiads that killed my eldest brother.

    • May 25, 2018 at 8:10 am #

      It’s the vaccinations, of course!

      (This is sarcasm. I have no idea why allergies are on the rise, but clearly bf isn’t terribly protective.)

      On a more serious note, what do you mean by “flowers” and people not doing their homework? Allergies aren’t really something to blame parents for.

      • myndchanger fumblesmcstupid
        June 17, 2018 at 7:43 pm # .

        • June 18, 2018 at 8:03 am #

          But you can do everything “right” and still have a kid with allergies, or “wrong” and have a kid without allergies. There’s a difference between saying “this may reduce your risk” and speaking with contempt of children who have allergies, and to me “flowers” connotes contempt.

          • myndchanger fumblesmcstupid
            July 5, 2018 at 1:29 am #

            Bull. It was not contempt, and you know it. My point was that the rise of breast feeding matches the rise of life threatening allergies. I don’t know why but I am very interested to know why there are no studies.

          • July 5, 2018 at 3:47 pm #

            I’d like to see the point studied, too, but your posts came across as contemptuous toward kids with allergies.

          • myndchanger fumblesmcstupid
            July 7, 2018 at 11:15 pm #


  4. Namaste
    May 10, 2018 at 6:27 pm #

    Guys, this is totally, 100% o/t, but I can’t seem to find squat on the Lisa Barrett case. Has anyone heard anything recently?

    • Anna
      May 10, 2018 at 7:39 pm #

      Caroline Lovell Homebirth Reform shared the latest article on FB. Trial still a while away.

    • Sue
      May 11, 2018 at 1:06 am #

      FORMER midwife and controversial homebirthing advocate Lisa Jane Barrett has eight days to decide whether she will challenge the manslaughter case filed against her.”

  5. Megan
    May 10, 2018 at 3:48 pm #

    Funny to read this today. I just had our third baby via RCS today and as soon as we were in recovery I got my formula feeding “education” that formula powder is not sterile and shouldn’t be fed to babies under 2 months old and that if using powder we have to use hot water to sterilize the powder. I was very tempted to ask how many cases of cornybacterial illness she’s seen in term babies but I resisted. Ugh. I’m tired from surgery. Can’t I just be left alone?? I know how to formula feed.

    • Megan
      May 10, 2018 at 3:52 pm #

      Oops, I meant cronobacter. In case you can’t tell, I’ve had no rest since my section.

      • The Vitaphone Queen
        May 10, 2018 at 8:30 pm #

        Congrats! Boy or girl? Unless you would rather not share.

        • Megan
          May 10, 2018 at 10:06 pm #

          A boy! It was a surprise for us. My two daughters at home will be so excited!

          Unfortunately, he developed tachypnea a few hours after birth and is in the nursery being worked up. I’m thinking and hoping transient tachypnea of the newborn but we’ll see. Tonight I just couldn’t keep it together. I miss my daughters at home and now I can’t even hold my son and I feel so helpless watching him struggle to breathe.

          • May 10, 2018 at 10:31 pm #

            *big hug*

            Not being able to hold your baby sucks. Hopefully, he’ll bounce back tonight and you can give him extra snuggles tomorrow.

          • Megan
            May 11, 2018 at 8:28 am #

            I hope so. He’s on O2 now, Does indeed have TTN, which should resolve in a few days. I hope he improves quickly and he can be with us again.

          • Jessica
            May 11, 2018 at 1:43 pm #

            Hoping for the best and a quick return to you!

          • Sue
            May 11, 2018 at 1:12 am #

            Hoping it all goes well very soon, and that he’s back to you in no time.

    • Empress of the Iguana People
      May 10, 2018 at 4:24 pm #

      *hugs* congrats! and you totally have a good reason to be tired today!

    • momofone
      May 10, 2018 at 5:53 pm #


    • Gene
      May 11, 2018 at 6:30 am #

      Did you mention that breasts aren’t sterile either and no one recommends pouring boiling water on a nursing mother’s areolas prior to latching?

      • Megan
        May 11, 2018 at 8:26 am #

        Oh believe me, there was lots I wanted to say but bit my tongue so she’d leave. Here’s the irony: they tell me that I shouldn’t be using powdered formula because it’s not sterile and to use it we need hot water so to heat up our water, she gets some random coffee cup to pour the sterile, now not sterile water into. *head desk

        • Gene
          May 11, 2018 at 1:32 pm #

          You are a much more diplomatic woman than I.

  6. Empress of the Iguana People
    May 10, 2018 at 2:15 pm #

    Nostalgia is a dangerous thing, especially when golden ages never were so shiny when you were living in them.

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