Claiming breastfeeding has major benefits is politically correct, but sadly not true

Caution - Politically Correct Area Ahead

In a world of vicious clashes over ideas and even over facts themselves, there is one thing on which everyone can agree. Thought leaders on the left and the right, among every possible ethnic and religious group, among scientists and lay people are united in their insistence that breastfeeding has major benefits for babies.

Too bad it’s not true.

Consider these papers detailing the dangers of aggressive breastfeeding promotion. Even they start with the premise that breastfeeding has major benefits.

Lactivists have constructed a narrative about breastfeeding that allows them to insist — against factual evidence to the contrary — that they are being discriminated against.

The revised United States Preventive Services Task Force (USPSTF) guidelines

There is convincing evidence that breastfeeding provides substantial health benefits for children …

The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature

There is no doubt regarding the multiple benefits of breastfeeding for infants and society in general…

Or this opinion piece:

Are Breastfeeding Messages Actually Hurting Mothers?

There is no dispute that breast milk and feeding has innumerable benefits and is the gold standard.

But the scientific evidence shows the opposite. The benefits of breastfeeding in industrialized countries are limited to a few less colds and episodes of diarrheal illness across the entire population of infants in their first year. While there are a variety of mathematical models that claim to show how much money and how many more lives could be saved if breastfeeding rates were higher, there’s no evidence that the tripling of breastfeeding rates in the past 40 years has saved any lives (except for premature infants) or any money.

The insistence that breastfeeding has major benefits is political correctness run amok.

According to Wikipedia:

The term political correctness is used to describe language, policies, or measures that are intended to avoid offense … to members of particular groups in society. Since the late 1980s, the term has come to refer to avoiding language or behavior that can be seen as excluding, marginalizing, or insulting groups of people considered disadvantaged or discriminated against …

No one dares offend lactivists and professional breastfeeding advocates, people whose self-esteem or income depend on their insistence that breast is best. Lactivists have constructed a narrative about themselves and breastfeeding that allows them to insist — against the massive amount of factual evidence to the contrary — that they are disadvantaged and being discriminated against.

For lactivists and lactation professionals, the history of formula begins in the 1970s when Nestle, in an immoral effort to increase market share convinced African mothers to forgo breastfeeding in favor of powdered formula. Thousands of babies died because the water used to prepare that formula was contaminated with pathogens, a fact of which Nestle was well aware. To hear lactivists tell it, formula use is rarely necessary and was foisted on mothers by an avaricious industry with the collusion of doctors who were both ignorant and greedy.

Though it was black African women whose babies died as the result of corporate malfeasance, lactation professionals — almost exclusively white and well off — expropriated the tragedy to insist that they were victims of the formula industry, discriminated against for their heroic efforts to feed babies the best way, the way nature intended.

The truth is that formula was invented 100 years before Nestle ventured to Africa and it was invented to save the lives of countless babies who were dying for lack of breastmilk because their own mothers had died or couldn’t produce enough. Those babies were being supplemented with raw cow’s milk that proved to be deadly for many.

Doctors, far from discriminating against breastfeeding, were the original lactivists. As Jacqueline Wolf explains in the chapter Saving Babies and Mothers: Pioneering Efforts to Decrease Infant and Maternal Mortality, in the book Silent Victories: The History and Practice of Public Health in Twentieth Century:

The custom of feeding cows’ milk via rags, bottles, cans and jars to babies rather than putting them to the breast became increasingly common in the last quarter of the nineteenth century progressed… In 1912, disconcerted physicians complained bitterly that the breastfeeding duration rate had declined steadily since the mid-nineteenth century “and now it is largely a question as to whether the mother will nurse her baby at all. A 1912 survey in Chicago … corroborated the allegation. Sixty-one percent of those women fed their infants at least some cows’ milk within weeks of giving birth…

The medical community deemed human milk so vital to infants’ health that doctors even feared that providing clean cows’ milk to babies might be counterproductive since it tended to exacerbate low breastfeeding rates…

Infant formula, far from being a corporate plot to harm infants and discriminate against breastfeeding, was designed to save babies from the reality that breast is often not best.

But in 2018 very few dare to point that out because they will be subjected to a torrent of lactivist abuse.

And that brings us to the Baby Friendly Hospital Initiative. I’ve been told (and I can find no evidence to contradict this) that the BFHI is the only private organization allowed to operate within and determine policies for hospitals. Until the BFHI, private organizations were prevented from operating within hospitals because it was understood that their beliefs, no matter how well intentioned, might be in conflict with patient values, provider values or even safety.

And that’s exactly what has happened with the BFHI. The BFHI privileges a process, breastfeeding, over the outcome of healthy mothers and healthy babies. It privileges belief over scientific facts. The facts are that insufficient breastmilk is common (up to 15% of first time mothers), formula supplementation makes successful breastfeeding more likely, pacifiers prevent SIDS and extended skin to skin contact lead to babies falling from their mothers’ hospital beds or suffocating while in them. In addition, it is well known that the leading cause of jaundice induced brain damage (kernicterus) is breastfeeding.

I have no ax to grind. I breastfed four children successfully with minimal problems. My babies were fat and happy and I enjoyed breastfeeding. But as a physician I have become increasingly alarmed at the number of babies and mothers who are being harmed by aggressive breastfeeding promotion. These harms are often justified by the claim that breastfeeding has major benefits. There’s no doubt that it is politically correct to say so, but there’s also no doubt that it is absolutely untrue.

  • Puffin

    During our infant feeding small group session in medical school, I tried to impress upon my colleagues the fact that breastfeeding promotion is blown way out of proportion to the facts and the harassment to which newly delivered parents are subject is harmful. The group leader said I was “obviously anti-breastfeeding.”

    My first two werw breastfed for two and a half years each, my third for ten months, and I had been a peer helper for many others. I will breastfeed my fourth when he’s born later this year.

    It was frustrating to be labelled as “anti-breastfeeding” because I refuse to perpetuate popular myths, no matter how pervasive. I’m in favour of treating new parents like competent adults. I’m in favour of enthusiastically supporting safe feeding choices.

    But I don’t, and won’t, lie to my patients to guilt them into doing the popular thing.

  • mabelcruet

    OT. I really hope there was a good medical reason for not doing a section, rather than not doing a section because vaginal delivery was simply considered preferable.

    https://www.independent.co.uk/news/uk/home-news/decapitated-baby-doctor-mothers-womb-delivery-death-vaishnavy-laxman-tribunal-ninewells-hospital-a8344696.html

    • BeatriceC

      JFC. I don’t have words.

    • Daleth

      That doctor should be struck off and sued into oblivion.

    • Cartman36

      OMG! that is horrifying and tragic.

    • Eater of Worlds

      Especially since she was told at her regular visit that she’d have to have a c-section regardless.

      In the UK you don’t give birth with your personal OB, is that correct? Unless you have a scheduled section. So there’s no continuity of care if you go into labor, you’re stuck with the doc on call and you don’t get to call your own doctor like in the US? Because I wonder if there were more continuity of care would this situation happen. If her doc had treated her she would have gone straight to a c-section and avoided all this.

      I do think the woman should lose her license to practice. How could she even think that she could pull a baby’s head through a cervix dilated to 2 when the mother wasn’t even in labor.

      I wonder how much of the woo led to this happening. The belief that vaginal birth is better than c-section, that breech birth isn’t as dangerous as it’s said to be, the lack of pain medication and they were cutting her cervix with scissors because of the general anti-pain med stance during vaginal birth? And by lack of pain meds, I don’t consider getting a dose or two of tylenol with codeine (the cocodamol) before they started to be anything better than a sugar pill in a situation like this.

      • mabelcruet

        My thoughts exactly. If you come in as an emergency, the on call consultant is responsible for your immediate care, although care would devolve back to your named consultant of you were in when they came back on duty. . But in the NHS, women carry handheld notes-the maternity notes are kept by the women and updated everytime they are reviewed either by midwives or medics. They are told to bring these wherever they go so that there is immediate access to records so it would have been clear to anyone reading the notes what prior discussion had taken place.

        It sounds like there is some discrepancy between versions of events, but given the outcome it’s clear that whatever happened went horribly wrong.

  • Melissa

    I struggled with breastfeeding from day one with my daughter. And I supplemented with formula on day 3 and never looked back nor did I ever feel guilty. Supplementing enabled me to make breastfeeding work for us and we made it seven months. At my post-partum visit, I told my OB that I was supplementing and mentioned that I had some family members who were pressuring me against formula. He told me that I could tell them, and anyone else who questioned my decision, that my OB says that they can f*^k off. The pediatrician said almost the same thing, minus the colorful language. There are supportive doctors out there and I’m thankful I found them. I’m currently pregnant with my second and while I’d love to have the supply that eluded me with my first, if I don’t, I’m not at all hesitant or ashamed to turn to formula. It is possible to support breastfeeding without shaming other options, something “lactivists” seem to not understand.

  • Jessica

    Off topic but would appreciate prayers and good thoughts for my friend A, who just had her baby girl at 26 weeks due to HELPP. Little girl is doing OK so far (2 days in) but is very tiny, only 1 lb 6 oz at birth and down a bit from that now. She’s in a Level IV NICU and is getting the best care possible but obviously it’s a very tough situation.

    • moto_librarian

      Hoping for the very best for your friend and her baby. I have a friend who had to deliver her daughter at 27 weeks due to severe pre-e. That little girl just turned six months old, at home with her parents, and I see her gorgeous smiles every day in my FB feed. Hoping for the same outcome in your situation.

    • Allie

      Random stranger love is winging its way toward A and her baby girl now. I am not being facetious… I believe in the power of love in all its miraculous forms : )

  • Russell Jones

    “It privileges belief over scientific facts.”

    The sheer number of words with which you can replace “It” and still have that sentence convey a true proposition is downright disheartening.

    But hey, what do I know? Not much is what. When my old pacemaker’s battery went to be with Jesus last month, I sought out an actual cardiologist for replacement; I didn’t even try raw water or homeopathic pacing. Guess I’m just another duped, dumbass sheeple. 🙁

  • Cartman36

    I had my 35 week appointment yesterday which included the GBS test. I got NO handout or any information about GBS but I got a lovely colorful printout about breastfeeding. My favorite line is “Go everywhere! Plan to take your newborn everywhere with you for the first several weeks”. Ummm no, Mama just spent 9 months teatotalling so I’m going out for oysters and wine as soon as my MIL comes to visit. Being able to go out without baby is one of the main reasons I supplement from birth.

    • Charybdis

      Doesn’t that contradict the advice a lot of lactivists like to spout? The “Just lay in bed/on the couch skin to skin with Baby and nurse, nurse, nurse!! Let the housework go! Let the grocery shopping go! Just NURSE ALL THE DAMN TIME!!!” mantra they spew. How can you properly establish the mother/baby breastfeeding bond if you have to be up, out and around the first few weeks? You certainly cannot go out and about topless with a newborn hanging off your nipple like a boob ornament.

      It would be nice if they could get their stories straight. I’m not holding my breath though.

      • Empress of the Iguana People

        Why not? People shouldn’t be ashamed to show their naked boobs in public. After all, they’re there just for the baby’s nourishment and aren’t sexual at all. There’s no reason why midwinter should matter either.
        /sarcasm.

        • Lisa Hansen

          Breastfeeding is natural and winter is natural, so breastfeeding will protect your naked boobs from frostbite. Trust nature! /s

          • Eater of Worlds

            Besides, a fresh winter breeze against spit moistened nipples is invigorating, not frost bite inducing and must be celebrated just like the word moist should be used much more often.

          • Roadstergal

            “Spit-moistened.” This might be the most skin-crawling compound word ever.

        • Liz Leyden

          Any woman who does not want to expose her breasts in public has been brainwashed by the patriarchy! Nursing covers are tools of oppression!

      • Cartman36

        LOL! Yes, I have seen people recommend camping out on the couch and focusing on nothing but nursing for the first few weeks. Ummm, when I finally stop laughing, we can discuss the absurdity of doing this 1. when you have other kids and 2. because mama needs a life outside nursing.

    • Cat

      The way we do things is fucked up. My brother is currently in the shit with his boss because he refused to come into work two days after his wife had an emergency c-section, when he was meant to be on paternity leave. Mothers, on the other hand, get told that they can’t leave their babies at all for the first year, even to take a shower alone (wouldn’t want all those stress hormones to damage your baby for life, would you?).

      • Mel

        Your brother has my sympathy. My father-in-law worked on his farm the same day each of his kids were born so harangued my brother-in-law and my husband to go back to work on the farm while their wives and children were still in the hospital.

        My brother-in-law complied. Thankfully, I was at loose ends after recovering from a car accident and was able to take care of my sister-in-law and my nephew for the first few weeks. My brother-in-law damaged his marriage, missed most of his son’s newborn period and my father-in-law treats him like shit.

        A few months later when I gave birth to a micro-preemie and was hospitalized for a week afterwards because my blood pressure remained dangerously high, he pulled the same stunt. My husband refused to come back to work for two weeks. He worked full-time while my son was in the NICU followed by half-time for two months when my son came home and needed specialized medical care. Our marriage is stronger than its ever been, my husband has precious memories of caring for his son, and my father-in-law treats him like shit.

        It’s probably not a likely outcome for your brother, but my FIL’s (and MIL’s) insane behavior for my son’s first 8 months of life caused my husband (who was a partner) to decide to leave the family farm business. This week, my husband started training with a man he knew through his dairy contacts to work on repairing and installing refrigeration systems for agricultural, industrial and commercial settings. My husband is happier than he’s been in years – and is learning that getting paid time-and-a-half for workweeks over 40 hours does amazing things for our income.

        Unless my father-in-law makes some serious changes that he doesn’t want to make, there’s a ~75% chance he will lose the family farm in the next 2-5 years. The farm is the only thing he cares about in life so I have some sympathy for him if he loses it – but then I remember my in-laws’ continual unspoken message that my husband and I were massive disappointments and losers for allowing the premature birth and medical complications of our son to inconvenience my inlaws….and I don’t feel bad about having a major consequence for major bad behavior.

        • Eater of Worlds

          You should read https://www.reddit.com/r/JUSTNOMIL you might find it cathartic to read about MIL problems (and some are real doozies) and sometimes they managed to stop the problems, generally by going no contact.

      • Bugsy

        That sounds like my husband’s boss. The day after our first son was born, he was expected not only to return to work, but to work OT. Needless to say he found a better work environment 5 months later.

        For our second son (in Canada, not in the US anymore), he took off a week and then worked part-time for a month. It was great for all four of us.

      • guest

        It really is messed up. When mine were born, my husband was going to be the stay-at-home-parent and I obviously had maternity leave to recover. The newborn period was awesome for all of us. Everyone bonds, gets to sleep, and generally hang out and get used to the new people in our life stress free. I recommend to anyone who can do it to have the father take as long off from work as he can. People make due with whatever circumstances they are living with, but it is nice if parents can take a breather when a baby comes and settle in to their new normal. And also seems like the compassionate way to treat a family. I hate the US attitude of making life as difficult as possible.

      • StephanieA

        Its so awful. This is the norm where I live, its a blue collar part of the midwest and a lot of people are employed by the RV industry. So when moms have their babies, dads are allowed to be off the day of birth but that’s it. Legally they should be eligible for FMLA, but their shamed to oblivion if they try to use it.

    • StephanieA

      Yep! I formula feed for a lot of reasons, but this is definitely one of them! I love my freedom, and I can’t imagine having to carry a pump and/or my baby everywhere if I have a reliable adult around who can take the baby so I can have a little bit of alone time.