The cruelest lactivist lie has been exploded: breastfeeding does NOT promote bonding

7DBFA365-D8E9-40DA-9AC0-FC4CAC2D1D0E

Most lies are cruel, depriving people of information they need. Lies about breastfeeding are particularly cruel because they are used to shame women and often harm babies. But the cruelest lactivist lie has just been debunked: breastfeeding does NOT promote bonding!

That’s not what the authors of Mother-infant bonding is not associated with feeding type: a community study sample expected to find.

The believed they would find the exact opposite:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]”Contrary to our hypothesis, and to commonly held beliefs, breastfeeding was not associated with the quality of mother-infant bonding.”[/pullquote]

The first hypothesis was that there will be a negative correlation between breastfeeding and bonding difficulties … Second, that this relationship would be age-dependent such that breastfeeding would have a greater impact on bonding during the first weeks of life … Finally … we further hypothesized that breastfeeding would be protective against the ill-effects of mood and sleep disturbances on mother-infant bonding.

Instead, they found that breastfeeding had NO positive effective on bonding and some negative effect:

Contrary to our hypothesis, and to commonly held beliefs, breastfeeding was not associated with the quality of mother-infant bonding. Moreover, and in contrast with previous reports, breastfeeding did not attenuate the association between depression symptoms or sleep-related daytime symptoms with bonding. In fact, a positive association between mood symptoms and bonding difficulties was observed among mothers who were actively breastfeeding, but not among those who never breastfed or stopped breastfeeding.

How could that be? The idea that breastfeeding facilitates bonding was fabricated by lactation professionals in the ABSENCE of evidence, as the authors acknowledge prior to detailing their investigation:

However, only a handful of studies have directly tested the existence of a positive association between breastfeeding and bonding in humans with inconsistent results… Thus, it remains unclear if breastfeeding considerably contributes to bonding among healthy mothers.

Sadly, this is a common tactic employed by the lactation industry. For example, at the inception of the Baby Friendly Hospital Initiative, there was literally no evidence for most of the recommended Ten Step and it was a full decade before anyone tried to find any (and often couldn’t).

The authors acknowledge this, too:

Arguably, the notion that a link exists between maternal bonding and breastfeeding originates in cultural norms. Although human mother’s milk has been the primary form of infant nutrition for thousands of years, in the absence of appropriate alternatives, wet nursing (AKA, adoptive breastfeeding), whether paid or via communal sharing of maternal responsibilities, was very common well into the eighteenth century … Only in the later decades of the twentieth century, with the surgence of breastfeeding advocacy, which recommends exclusive breastfeeding for the first 6 months of life and beyond (e.g., ‘Breast is Best’) has breastfeeding also been linked with maternal affiliative bond to her child.

This is part of a larger trend of trying to force women back into the home by problematizing infant attachment. As I noted recently, before the past century in highly industrialized societies, the bond between mother and child was understood as spontaneous and not contingent on any specific practices. Natural mothering advocates, in contrast, imagine mother-infant attachment to be a fraught process constantly shadowed by the looming risk that mother and child will fail to bond. Therefore, they have medicalized it, prescribing specific behaviors like breastfeeding.

This paper is so important not merely because it explodes the lie that breastfeeding facilitates bonding but because it analyzes the history and purpose of the claim:

In the past several decades public health policies have actively promoted breastfeeding adducing three apparent evidence-based benefits to the health and development of the infant the health of the mother the quality of the relationship between mother and infant… [D]irect evidence in support of a positive effect on maternal bonding is scant, at best. It has been argued that implicit in the assumption that breastfeeding has positive effects on maternal bonding is the notion that lactation activates endocrine cues that reinforce engagement with the infant.

Indeed, an elaborate hormonal theory was advanced without any evidence at all and some evidence of the opposite:

Oxytocin release, specifically, has received the most attention, being a key pro-social biological cue that enhances parental care in both human and non-human animals. However, recent evidence suggests that oxytocin is released by parents in response to many innate infant behaviors, such as clinging, facial expressions and vocal calls. Feldman, Gordon, Influs, Gutbir & Ebstein also showed stable oxytocin levels across a three-year period, concluding that: “long-term stability of peripheral oxytocin suggests the notion that oxytocin represents a ‘trait-like’ dimension”. Thus, breastfeeding-related oxytocin release may not have additive effects to oxytocin release associated with other infant-parent interactions.

The authors recognize the pernicious effect of this cruel claim:

Despite inconclusive empirical support, the bonding function of breastfeeding has permeated social meanings of motherhood and is often cited as a major motivation for wanting to breastfeed, as demonstrated in a recent meta-analysis of 17 ethnographic studies … The study found that the majority of women identified breastfeeding as “important for bonding”, that the belief that breastfeeding is consonant with being a “good mother” was highly prevalent, and that women who ceased to breastfeed experienced guilt and failure. Thus, in Westernized cultures breastfeeding has become a “moral” choice, and a test of motherhood, while the psychological, social and economic costs to women have largely been ignored.

The take home messages from this study are deeply important:

1. Breastfeeding does NOT facilitate bonding.

2. The claim was made DESPITE the fact that there was little to no evidence to support it.

3. The claim originated in CULTURAL norms about the role of women, not biological facts.

4. The false claim was highly effective in attaining the goal of its fabricators: shaming women who can’t or won’t breastfeed.

As the authors conclude:

…[M]others may be reassured that we don’t currently have evidence that their bond with their child will be negatively impacted if they do not breastfeed.