Lactation professionals and the medicalization of infant feeding

Pump breastmilk by Autimatic machine

You might think — I always have — that childbirth is about the birth of a healthy baby to a healthy mother. But according to many midwives, that isn’t enough. A mother’s birth experience is deemed critical and the experience is apparently ruined by technological interventions. Hence the dangerous campaigns for “normal birth,” defined as birth without any interventions, any machines or any surgery.

Indeed, midwives wax lyrical on the subject of the medicalization of childbirth, forcefully arguing that most babies would be fine without intervention of any kind, insisting that doctors have medicalized childbirth for their own benefit, and claiming that doctors cause emergencies so they can heroically step in and “save” their patients.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Lactation professionals have created breastfeeding “emergencies” from which they heroically “save” babies. But most of these emergencies have been caused by lactation professionals themselves.[/pullquote]

Clearly, medicalization is a very, very bad thing … until it comes to infant feeding. With infant feeding medicalization isn’t just awesome, it is absolutely necessary.

You might think — I always have — that infant feeding is about providing a developmentally and nutritionally appropriate food resulting in a healthy baby and a healthy mother. But according to lactation professionals, that isn’t enough. Trivial benefits and fabricated benefits are deemed critical to infants who are apparently ruined by formula. And any intervention, no matter how artificial, burdensome or technological — including surgery on babies — is not merely justified, but necessary. The mother’s breastfeeding experience? That’s irrelevant!

But I’m here to tell you that the medicalization of infant feeding is harming babies and mothers. We KNOW, though generations of experience involving millions of babies, that term infants will be healthy on formula. And I have come to believe that lactation professionals have medicalized infant feeding for their own benefit, creating feeding “emergencies” so that they can heroically step in and “save” patients breastfeeding.

Wait, don’t lactation professionals say that breastfeeding must be best because it is natural? Don’t they demonize formula because it is technological?

Yes, they say that, but their behavior belies their rhetoric.

First, breastfeeding is apparently a bodily function that is outside the natural realm of other bodily functions, all of which have failure rates. Most women won’t conceive the first month they try to become pregnant; up to 20% of established pregnancies end in miscarriage. Breastfeeding, too, has a natural failure rate: up to 15% of first time mothers will not be able to produce enough milk to fully nourish an infant, especially in the first few days after birth. Some babies are incapable of fully draining the breast. Furthermore, just as some pregnancies aren’t wanted and will be terminated, some women have no desire to breastfeed.

But not according to lactation professionals. To hear them tell it, breastfeeding is perfectly designed for every mother and every baby and failures rates are exceeding low. Moreover, all good mothers want to breastfeed; only inferior, lazy women who are dupes of the formula industry and lack lactation support would ever consider formula.

Second, the process of infant feeding itself has been medicalized. For most of human history, infant feeding involved giving infants food so they could grow. In our contemporary culture — with its twin emphases on intensive mothering and reducing risks — breastfeeding has recently acquired all sorts of medical benefits ranging from the trivial (8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of infants in their first year), to major “benefits” (supposedly increased IQ, decreased risk of allergic disease, improved long term health), all of which disappear when socio-economic status is taken into account. Therefore, ever more arcane, highly technological benefits are dreamed up like a “better” microbiome or “better” epigenetics for which there is only speculation and no actual evidence at all.

Third, any and all technology, no matter how invasive, is embraced if it results in more women breastfeeding for longer.

Don’t produce enough breastmilk to fully nourish your baby? Pump after every feeding with an electric pump whose plastic parts are strapped to your body! Take drugs like domperidone!

Baby having trouble extracting milk from the breast? Tape a plastic Supplemental Nutrition System (SNS) to your nipple in order to feed the milk that you pumped! Or perform surgery on the baby’s tongue!

And above all, pay money to a lactation professional who will press all sorts of unnatural interventions on you so you can “naturally” breastfeed.

I’m reminded of the paper by anthropologist Margaret MacDonald in the Lancet entitled The cultural evolution of natural birth:

Natural birth has long held iconic status within midwifery and alternative birth movements around the world that have sought to challenge the dominance of biomedicine and the medicalisation of childbirth…

But there’s is nothing natural about waterbirth, listening the fetal heart with a Pinard stethoscope or recommending chiropractic. Yet midwives do it anyway. Why?

[If an intervention] can bring back the clinical normalcy of the labour pattern and keep it WITHIN THE MIDWIFERY SCOPE OF PRACTICE, it is generally regarded as a good thing by midwives and clients alike … (my emphasis)

The same thing is true about lactation professionals. ANYTHING is acceptable as long as it can keep the women breastfeeding and within lactation consultants’ scope of practice. Lactation professionals have created breastfeeding “emergencies” from which they heroically “save” babies. But most of these emergencies have been caused by lactation professionals themselves with their relentless pressure to breastfeed. They could easily be solved, or avoided altogether, by feeding babies formula.

In truth, the scientific evidence tells us that breastfeeding is a lifestyle choice, NOT a health choice. We know that because breastfeeding rates have no impact on infant mortality and major causes of infant morbidity. We know that because nearly two entire generations of Americans were raised on formula and every possible parameter of infant health improved during that time.

But in their relentless effort to claw market share from formula companies, lactation professionals have medicalized infant feeding by claiming a perfection of breastfeeding that doesn’t exist, medical benefits for breastfeeding that don’t exist, and by creating medical emergencies that they caused.

That’s why we should stop medicalizing infant feeding and return it to its unhindered state. Above all, we must end intrusive breastfeeding promotion in hospitals. It is harming infants’ physical health (exclusive breastfeeding is now the leading cause of newborn hospital readmission) and mothers’ mental health.

Let MOTHERS decide what’s best for babies, their families and themselves, NOT lactation professionals.