Let’s be honest: breastfeeding DOESN’T matter

Fact text

On the eve of World Breastfeeding Week 2018, I’m reminded of the tale of The Emperor’s New Clothes:

…about two weavers who promise an emperor a new suit of clothes that they say is invisible to those who are unfit for their positions, stupid, or incompetent – while in reality, they make no clothes at all, making everyone believe the clothes are invisible to them. When the emperor parades before his subjects in his new “clothes”, no one dares to say that they do not see any suit of clothes on him for fear that they will be seen as stupid. Finally, a child cries out, “But he isn’t wearing anything at all!”

Sadly, the story of lactivism is similar: professionals promise women that breastfeeding is a better way to feed their babies, provides massive benefits, and has no risks. They tell women that anyone who questions those benefits is stupid or incompetent, while in reality, the benefits of breastfeeding are trivial and the risks — of dehydration, hypoglycemia and jaundice — are significant. This has been going on for nearly three decades and there’s no evidence that increased breastfeeding rates have any impact on mortality, morbidity or healthcare savings for term infants. Breastmilk does reduce the risk of death from necrotizing enterocolitis in extremely premature infants, an exception that serves to prove the rule.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Everyone knows that breastfeeding has massive benefits, just as everyone knew that the sun revolved around the earth.[/pullquote]

It’s time to cry out the obvious: breastfeeding DOESN’T matter!

Why do we keep pretending it does? For the same reason that the emperor’s subjects were afraid to tell him he was naked: peer pressure. No one dares accept the evidence of their own eyes for fear of a powerful backlash.

In the case of the emperor, his subjects feared that he would punish them for insulting his dignity. In the case of breastfeeding, everyone is afraid they will be demonized by lactation consultants and their medical allies. Why? Because lactation professionals, whose dignity is apparently insulted by the truth that the promised benefits of breastfeeding have never appeared, react by vilifing, slandering and shunning.

Everyone “knows” that breastfeeding has massive benefits, just as everyone once “knew” that the sun revolved around the Earth. That wasn’t true, either, but there were religious leaders with a vested interest in promoting the biblical view of the solar system; because they had access to the levers of power, they were able to suppress the truth for generations. It was more important to religious leaders to maintain their belief system regardless of what the evidence showed. Anyone who opposed them faced draconian penalties.

The situation is not as bad for breastfeeding. A doctor like myself who dares point out the obvious does not face a trial and potential execution for heresy, just withering criticism. It is babies and mothers who suffer because those who hold the levers of power in the world of public health have a vested interest in suppressing the truth. It is more important to lactation professionals to maintain their belief system regardless of what the evidence shows and regardless of how many babies and mothers are hurt in the process.

It would be pathetically easy to prove me wrong if I were wrong:

Just show me how the infant mortality rate has dropped as breastfeeding rates have risen.

Just show me how the rate of serious medical illness has dropped as breastfeeding rates have rise.

Just show me how the rate of healthcare spending on infants has dropped as breastfeeding rates have risen.

Wait, what? No one can demonstrate even one of those things, let alone all three of them?

Of course not, because the emperor has no clothes.

No amount of pretending by his subjects could change the fact that the emperor was naked. Similarly no amount of pretending by lactation professionals changes the fact that breastfeeding doesn’t matter for term infants.

I will continue to point that out; vilification, slander and shunning won’t stop me. The only thing that will convince me otherwise is if someone demonstrates that breastfeeding has an impact on term infants in the real world, not just in the unvalidated theoretical models beloved of lactivists.

I’m not holding my breath.