Why do so many aspects of natural mothering — ostensibly designed to protect babies — end up harming them?

Natural childbirth, marketed as “safer” than modern obstetrics, was embraced wholeheartedly by midwives in the UK. The result has been the preventable deaths of dozens, possibly hundreds, of mothers and babies and massive maternity scandals like Morecambe Baby and Shrewsbury/Telford. According to the Independent, the government has thus far spent $65 million compensating and caring for the victims in JUST Shrewbury/Telford. And this is only the beginning.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Natural mothering promotes inequality, male dominance and women immured in the home as “natural.”[/perfectpullquote]

Breastfeeding is promoted as “best” for babies, but none of the purported benefits predicted for term babies in industrialized countries — reduced infant mortality, reduced severe morbidity, reduced healthcare costs — has come to pass. Worse, exclusive breastfeeding has become the LEADING cause of newborn re-hospitalization (tens of thousands of hospitalizations each year at a cost of hundred of millions of dollars). Shockingly, there has been an increase in babies dying by being smothered in or falling from their mothers’ hospital beds as a result of the closing of well baby nurseries.

Attachment parenting, which fetishizes constant, close contract between a baby’s body and that of his mother is promoted as improving child health, confidence, happiness and achievement. To my knowledge, there is no evidence that even a single parameter of child mental health has improved in the 25 years since its inception, and quite a few child mental health parameters have declined.

Why has a philosophy touted as benefiting babies ended up hurting so many of them?

Because natural mothering was never about babies; it’s always been about “naturalizing” the coercion of women. Given the rising rate of postpartum anxiety and depression, it has been quite successful in its real aims.

Psychologist Susan Franzblau has written about this issue. Although Franzblau refers to attachment theory in her writing, it seems to me that she is criticizing natural/attachment mothering.

First, attachment theory steers women into accepting motherhood as the dominant condition of their lives, by characterizing and then romanticizing women as mother. Second, attachment theory promotes women’s labor within the confines of maternity by narrowing, reducing, and mandating women’s primary role as that of heterosexual mother. Third, attachment theory acts as the overarching paradigm with which to scrutinize women to see if their behavior meets the definition of “good mother.” Finally, if a woman resists the work of motherhood, either in thought or deed, attachment theory pathologizes her resistance.

Natural mothering elides its coercive, misogynist origins by insisting that it has the imprimatur of science. Franzblau describes it as “ideology configured as science.” And it’s not particularly good science because it takes animals, particularly higher order mammals and primates, as a starting point for determining normative behavior for women. In doing so it assumes inequality, male dominance and female nurturance of infants. In other words, the only thing natural about natural mothering is the gender stereotyping.

The ideology of natural mothering conveniently intersects with societal and political efforts to marginalize women. This is not the first time that mothering has been romanticized. It also occurred in the Victorian era and the immediate aftermath of World War II. In both cases, structural issues (the Industrial Revolution, the return of men from the military) made it attractive to pressure women back into the home, reserving employment for men. This was justified by ignoring women’s needs in favor of restricting them to their biological functions.

It the 21st Century, these so called experts are midwives, doulas, lactation consultants and attachment parenting advocates. Women’s needs are ignored and women who don’t want to give birth without pain medication, don’t want to breastfeed, and dare to have careers outside the home are pathologized as weak, lazy and selfish.

The bottom line is that natural mothering has never been about what’s best for babies; it’s always been about manipulating women into pre-approved choices by claiming sexist ideology is science.

It’s very challenging to explain science to those with low scientific literacy.

Consider my oft repeated claim that the predicted benefits of breastfeeding (based on mathematical models) have never been shown in real populations. Lactation professionals do not deny this. Indeed, in a memorable exchange I had with Dr. Melissa Bartick, she actually confirmed it.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]The same way we know that routine episiotomy doesn’t have the benefits claimed for it.[/perfectpullquote]

In the comment section of a piece on the Academy of Breastfeeding Medicine blog, I asked Dr. Bartick directly:

Where is the evidence that term babies lives has been saved? Where is the evidence that the diseases you insist are decreased by breastfeeding are actually decreasing as a result of breastfeeding? Where are the billions of healthcare dollars you claimed would be saved as the breastfeeding rates rose?

Her response:

… To my knowledge, no one has actually dug it up yet.

Even Dr. Bartick acknowledges that the evidence simply doesn’t exist.

But low science literacy lactivists like Lisa Bridger of the FABIE Facebook group (Fed Ain’t Best, It’s Expected) are struggling mightily to understand.

Layne Sullivan, a member of Bridger’s group, asks:

How could it be studied without mathematically modeling?

And:

[H]ow could you possibly remove every confounder that predicts health? There are hundreds. It is not possible.

Bridger, demonstrating a different aspect of low scientific literacy, writes:

Sure more women in the US are initiating breastfeeding but less than 25% are actually meeting the world health organisation recommendations for exclusive breastfeeding for 6 months. So how can she demand results, when the foundation hasn’t been achieved??? Not a single country in the world is achieving the WHO recommendations, yet she sees her perceived lack of data as a slam potato dunk

How can I explain science to those whose understanding of science (and math and statistics) is so low that they make such nonsensical claims? I’m hoping I can explain it by analogizing to something they already believe:

How do we know that breastfeeding doesn’t have the benefits claimed for it? The same way we know that routine episiotomy doesn’t have the benefits claimed for it.

Serious vaginal tears had posed significant health hazards for women since time out of mind. They could lead to permanent urinary incontinence, permanent dribbling of stool from the vagina and permanent sexual dysfunction.

Tears occur when the diameter of the baby’s head exceeds the capacity of the vaginal opening to stretch to accommodate it. Doctors reasoned (wrongly as it turned out) that by cutting an episiotomy to accommodate the baby’s head they could avoid jagged tears and injury to the nearby bladder and rectum.

Why don’t doctors cut routine episiotomies any more? Canadian obstetrician, Michael Klein, decided to find out if the predicted benefits actually occurred in real populations. Despite the fact that everyone “knew” that episiotomies prevented severe vaginal tears, Dr. Klein showed that women who underwent episiotomies were MORE likely to experience a severe tear.

Dr. Klein did not “model” the impact of episiotomies, he looked at what actually happened when women were cut. He compared the predicted benefits of episiotomy to the actual benefits of episiotomy and found out that the predicted benefits did not exist.

Contrary to Bridger’s misunderstanding of research, Dr. Klein did not need to investigate what would happen if 100% of women had episiotomies. He didn’t have to reach any specific threshhold. He merely had to compare what the model predicted for ANY given episiotomy rate and the actual outcome at that episiotomy rate.

Layne Sullivan also misunderstands what it required for proof. Real world evidence is far more important than mathematical models.

Population based data shows that episiotomy not only doesn’t reduce the incidence of severe tears; it increases it. Real world breastfeeding data — as Dr. Bartick acknowledges — fails to show any reduction in term infant mortality, severe morbidity or healthcare costs. Dr. Bartick’s models are wrong.

How about confounding variables? They can never be eliminated entirely, but science does not require that they be entirely eliminated. Advanced statistical methods can correct for the most important confounding variables. If a benefit no longer exists after correcting for confounding variables, it wasn’t a real benefit in the first place.

The bottom line: we know that breastfeeding doesn’t have the benefits predicted for it the same way we know episiotomy doesn’t have the benefits predicted for it — by looking at population data and correcting for confounding variables.

The conventional wisdom among many laypeople is that natural is best.

Advertisers market it. Organic food purveyors rely on it. And it is obviously at the heart of natural childbirth advocacy and breastfeeding promotion. Women are supposedly designed to give birth vaginally and breastfeed. As a result, those who give birth vaginally and breastfeed are supposedly bestowing a gift of better health on their babies.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Survival of the fittest means a lot of babies naturally die.[/perfectpullquote]

But that, like nearly all of natural childbirth and breastfeeding advocacy, is nonsense that reflects a deep and abiding misunderstanding of evolution. In birth and breastfeeding the difference between natural and medical is NOT the difference between best and second best. It’s the difference between survival of the fittest and survival of the most.

Simply put, survival of the fittest means that by definition not everyone survives. Lots of people die. In the case of childbirth it means high levels of neonatal and maternal mortality. In the case of breastfeeding, it means high levels of insufficient breastmilk for mothers and dehydration, jaundice and failure to thrive by babies. And in contrast to the nattering of natural childbirth advocates and lactivists, high rates of offspring death are natural for the rest of the animal kingdom, too.

Modern medicine, in contrast, rests on the moral principle of survival of the most.

We don’t throw up our hands when a grown man breaks his leg; we don’t start planning the funeral for when he dies of starvation because he can’t hunt or is eaten by a predator because he can’t run away. Even in pre-history his group or tribe would have splinted the leg to promote proper healing and fed and protected him until he could once again hunt his food and protect himself. Moreover, we don’t pretend that a broken leg is a variation of normal that should be ignored or that, once healed, the man is somehow “lesser” than his peers.

Similarly, we shouldn’t throw up our hands when a baby is one of the 4% in the breech presentation and declare that such a baby is less fit and therefore not worthy of our concern. Even in prehistory, “wise women” trained each new generation to master special techniques to save babies from deadly breech complications. They didn’t pretend that breech was a variation of normal that should be ignored or that a baby delivered from the breech position was somehow “lesser” than her peers. Today was can improve further on the survival of breech babies by offering C-sections. We are always striving to save more babies.

Eyes are designed to see, but that doesn’t change the fact that 30% of the population will develop nearsightedness. Today, when a child or adult becomes nearsighted, we don’t throw up our hands and lament the fact that they aren’t the fittest and are henceforth less likely to survive. We provide vision correction in the form of glasses or contacts; we even the odds of survival; and we don’t deride the products and achievements of those wearing glasses as inferior to the products and achievements of those with 20/20 vision. We act to ensure excellent vision for the most, not acquiesce to it being the province of only the fittest.

Breasts are designed to breastfeed but that doesn’t change the fact that up to 15% of first time mothers will not produce sufficient breastmilk to fully nourish a baby, especially in the days immediately following birth. Contemporary lactivists have chosen to thrown up their hands in the face of insufficient breastmilk and declare that it doesn’t exist (“cluster feeding is a variation of normal”) and to fetishize exclusivity. They’d literally prefer to stick an IV in a baby’s head vein, or feed him dextrose gel for no better reason than to pretend that the baby was “exclusively” breastfed. There’s a much easier way to ensure survival of the most babies; supplement with formula.

The dirty little secret about breastfeeding is that formula saves more lives than breastfeeding ever could. Breastfeeding has a high failure rate (up to 15%) while formula has an exceedingly low failure rate. Yet lactivists still cling to their cherished belief that breastfeeding must be better than formula because natural is always best. Yet nature allows for survival of only the fittest while technological formula allows for survival of the most.

Is vaginal birth “best”? Is breastfeeding “best”? How can they be when they only ensure survival of the fittest? The best outcome is survival of the most.

Anti-vaccine sentiment, in addition to being intellectually bankrupt, is remarkably immoral.

Anti-vaxxers have been known to declare:

I’m not going to set MY child on fire to keep YOUR child warm!

Consider what that statement means. The anti-vax parent who utters it does so on the assumption that vaccines work and that herd immunity is real. She recognizes that vaccines protect the most vulnerable among us, but refuses to contribute to that protection. She’s not willing to accept any risk to her children from vaccines in order to protect all children in the community.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Anti-vaxxers are free loaders.[/perfectpullquote]

But the statement isn’t just unethical; it’s completely backward. When an anti-vax parent refuses to vaccinate what she’s really saying is this:

I’m happy to keep MY child warm by setting YOUR child on fire.

She’s happy to accept the benefits of herd immunity for her children (the warmth), while letting the most vulnerable children get sick and die (the fire resulting from refusal to vaccinate). And if figuratively setting vulnerable children on fire isn’t enough to keep her child warm, she’ll get him or her vaccinated.

For example, earlier this year:

Demand for measles vaccines leapt 500 percent last month in Clark County, Washington—a hotbed for anti-vaccine sentiment that has now become the epicenter of a ferocious measles outbreak.

As of February 6, the county which sits just north of the border from Portland, Oregon—has tallied 50 confirmed cases and 11 suspected cases of measles since January 1. The case count is rising swiftly, with figures more than doubling in just the last two weeks. On January 18, the county declared a public health emergency due to the outbreak.

The ugly truth about anti-vaxxers is that they are free-loaders. They expose other people’s infants and immunocompromised children to injury and death. But when their own children face the very same risk of injury and death they were willing to countenance for other mothers’ children, they vaccinate.

It’s an example of the ethical conundrum known as the free rider problem.

The classic example is a conservation water ban. People in a town are told not to water their lawns in order to conserve water for drinking. Most people, understanding the importance of having enough water to drink, comply. However, there are always a few people who secretly violate the ban. They believe that they will be protected from a water shortage because everyone else is conserving, and — immoral as they are — they imagine they are entitled to keep their own lawns green.

Free riders are free loaders and they’re unethical.

How do we know? If everyone ignored the water ban the town would run out of water for people to drink and everyone would be harmed. So no matter how much you might want to water your lawn during a water ban, it is unethical to do so. It doesn’t matter that the harm is not immediate, or that no one can draw a direct line between your violation of ban and the lack of water. People who continue to water the lawn during a water ban are stealing an unfair share of a communal good and put the entire community at risk. You have to be remarkably entitled to imagine that you have a right to do that.

Similarly most people, understanding the importance herd immunity, vaccinate their children. In contrast anti-vaxxers assume that they will be protected from diseases like measles because everyone else is vaccinating, and — unethical as they are — they imagine they are entitled to keep their own children unvaccinated. But anti-vaxxers have been stealing an unfair share of a communal good (the high level of vaccine induced immunity) and, because of their immoral actions, the entire community is now facing a terrible risk.

In contrast to their delusions, no one is asking anti-vaxxers to set their own children on fire to keep other people’s children warm. We’re merely insisting that they stop lighting other people’s children on fire to keep their own children warm.

Intensive mothering (often called natural mothering) is the dominant mothering ideology of industrialized countries in the early 21st Century.

Hallstein et al. explore intensive mothering through the lens of celebrity moms in a chapter from the new book The Routledge Companion to Motherhood. They describe it as “the new momism.”

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Intensive mothering replaces women’s traditional subservience to their husbands with subservience to their children.[/perfectpullquote]

The new momism is the form of intensive mothering that emerged in the 1980s and continues to be in full force today, albeit in new and more intensive ways… Douglas and Michaels argued that this “good mothering” ideology rests on three core beliefs and values:

“the insistence that no woman is truly complete or fulfilled unless she has kids, that women remain the best primary caretakers of children, and that to be a remotely decent mother, a woman has to devote her entire physical, psychological, emotional, and intellectual being, 24/7, to her children”.

… In addition to creating impossible ideals of mothering, the new momism also defined women first and foremost in relation to their children and encouraged women to believe that mothering was the most important job for women, regardless of any success a woman might have had prior to motherhood.

Simply put, intensive mothering is a way to constrain women by replacing their traditional subservience to their husbands with subservience to their children.

What is the role of celebrity mothers?

… Douglas and Michaels argued that celebrity mom profiles primarily worked to encourage guilt and failure in mothers because the profiles always showed celebrity moms juggling it all – work, family, and mothering – with ease and without difficulty… The hallmark of these profiles was to show celebrity moms glowing, happy, content, and with their children, often one-to-two years postpartum, while the moms extolled the virtues of motherhood.

The entire chapter is fascinating but one issue in particular caught my eye because it confirms something I have been observing for at least a decade: intensive mothering is becoming more intensive!

While there is no doubt that the new momism has always been a demanding approach to mothering, by the late-2000s, scholars and writers … began to argue that intensive mothering was intensifying and contemporary mothers were doing even more motheringrather than less, even though more and more American women were working…

This intensification does not mean, however, that the three core principles of the new momism have changed. Rather, the core principles have only become more demanding and exacting for mothers and require mothers to devote even more time and energy to their mothering and children in order to be “good” mothers.

What has changed, then, is that contemporary motherhood requires mothers to have and utilize yet more energy to meet the even-more demanding requirements of “good” mothering today.

You can see this in the realms of natural childbirth, breastfeeding and attachment parenting.

The father of natural childbirth, Grantly Dick-Read, thought that natural childbirth meant “awake” childbirth unlike the majority of women who had general anesthesia for birth. Over the years, particularly after the advent of the epidural, which allowed women to be both awake and pain free, the goal posts were repeatedly moved. Natural childbirth came to mean avoiding any pain medication, any interventions of any kind, using a midwife and doula, and preferably giving birth at home far from medical aid.

Breastfeeding promotion used to mean breastfeeding and nothing more. Now it is hedged around with ever more onerous restrictions including the fetishizing of exclusivity (“just one bottle can be harmful”), the closing of well baby nurseries, and the entirely new phenomenon — found in no other historical or contemporary culture — of expecting women to fully care for their babies from the moment the placenta detaches.

Attachment parenting fetishizes proximity. Mothers are supposed to “wear” their babies and never be parted from them even to sleep at night.

The ultimate irony is that the intensification of intensive mothering has made it dangerous for babies. Homebirth and the arbitrary refusal of obstetric interventions increase the risk of death for babies; exclusive breastfeeding now results in the re-hospitalization of tens of thousands of babies each year; bed-sharing is literally deadly for babies. No matter. Intensive mothering has NEVER been about what’s good for children; it’s always been a way to control women, keeping them out of the workforce and protecting men from the economic competition that they represent.

There’s nothing wrong with intensive mothering if that’s the choice that a woman thinks is best for her children and herself. But there’s something very wrong with constructing intensive mothering as an ideal and pretending it is the sum total of good mothering.

Natural childbirth, breastfeeding and attachment parenting have little to nothing to do with the way that children turn out. I’m not aware of a single physical or mental health parameter that has improved for children because of intensive mothering.

Mothering is far more complex than fetishizing breastfeeding exclusivity or fetishizing maternal proximity. But that doesn’t matter when the real goal is to keep women subservient.

Breastfeeding is a good thing. Lactivism? Not so much.

Breastfeeding is the act of feeding a baby at a mother’s breast. Lactivism, while claiming that feeding a baby at a mother’s breast is critical to the health and wellbeing of the baby, is really about the mother’s ego. Hence the slogan “breast is best” a slogan that lactivists are willing to defend to the death … of underfed babies.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]If breastfeeding isn’t best, then lactivists aren’t best.[/perfectpullquote]

Don’t believe me? Exclusive breastfeeding is now the leading cause of newborn re-hospitalization. Approximately 40,000 babies are readmitted to the hospital each year at a cost of hundreds of millions of dollars. I have yet to find a lactation organization — not La Leche League, not the Baby Friendly Hospital Initiative, not Baby Friendly USA — that dares deny these facts.

Why the willingness to sacrifice the health and well being of babies and mothers to promote breastfeeding? There are two reasons:

1. Breastfeeding is a multi-billion dollar business that represents 100% of the income of breastfeeding professionals. The moralization of breastfeeding has closely paralleled the monetization of breastfeeding.

Is the breastfeeding industry as large as the formula industry with which it competes? No, but formula manufacturers have multiple products while the breastfeeding industry has only one. The income of breastfeeding professionals is arguably far more important to them than the income of formula is to multi-national conglomerates.

You don’t have to be an economist to understand that if women realized just how trivial the benefits of breastfeeding are in industrialized countries, they’d be spending far less money on lactation consultants.

2. The second reason for the willingness to sacrifice the physical health of babies and the mental health of mothers on the altar of breastfeeding promotion is even more powerful. Lactivism is ego driven. Breastfeeding has been weaponized in the mommy wars. If breastfeeding isn’t best, then lactivists aren’t best.

This was the original goal (and some might argue the continuing goal) of La Leche League. It was formed in the late 1950’s by women who were religious traditionalists and sought to keep mothers of young children from working. They reasoned that if women could be convinced that breastfeeding was important, fewer women would go to work.

The founders of LLL did not invoke medical benefits of breastfeeding since no one was aware of any medical benefits of breastfeeding. They simply decreed that women who stayed home with their young children were better mothers than those who did not stay home. As late as the 1970’s LLL’s national leadership argued about whether a working mother — even one who fed her child only breastmilk — could be a good mother.

The medical benefits of breastfeeding were not “discovered” until the advent of lactation consultants. Nearly all of these benefits were asserted in the absence of any scientific evidence. It was almost a decade before the first research studies were produced that seemed to support these “benefits” and another decade before nearly all them were debunked by studies that finally corrected for confounding variables like maternal education and socio-economic status. That second wave of studies demonstrated that most of the benefits ascribed to breastfeeding were benefits of relative wealth. Indeed, recent studies have shown that “intention to breastfeed” provides the SAME benefits as breastfeeding itself.

But over the years, many women imbibed the subliminal message conveyed by “breast is best”: that breastfeeding mothers are better mothers than women who formula feed. And they are not about to give up the ego gratification that veneration of breastfeeding provides. That’s why there has been such a visceral reaction among lactivists to the soaring popularity of the “fed is best” movement. If breast isn’t best for every baby (and it isn’t), then they are not the best among mothers.

Watching them fight back is alternately painful and hilarious. It’s painful since their sense of self-worth is so closely tied to their ability to lactate. As we approach 2020, it is disappointing to realize that so many women still believe that their only value lies in the function of their reproductive organs.

It is hilarious because …. well, I’ll let you judge for yourself. Head over the the FABIE Facebook group. The name is an acronym for “Fed Ain’t Best, It’s Expected.” It is run in large part by Lisa Bridger an Australian lactivist who achieved her 15 minutes of fame by declaring that she breastfed her school age sons.

Every post is about boosting their egos as the “best” mothers and denigrating anyone and anything that interferes with their ego gratification. Most posts are taken directly from the Fed Is Best facebook pages and the Skeptical OB facebook page. (Ironically, they drive a significant proportion of my Facebook traffic.) Anyone who doesn’t agree that they are the best mothers is vilified and labeled a “potato.” The internalized misogyny is on full display with frequent comments about the appearance of those with whom they disagree.

Their viciousness is on full display when they attempt to debunk or simply refuse to believe stories of babies and mothers harmed by aggressive breastfeeding promotion. They are so psychologically needy that they have no compassion left over for babies and women who have suffered as a result of lactivism.

Fortunately, the tide is turning.

Lactation consultants may be clinging desperately to the purported “benefits” of breastfeeding even though they can’t seem to show that they occur anywhere but in mathematical models. And lactivists are still desperately clinging to their cherished belief that the use of their breasts — not their actual parenting — marks them as superior mothers. But a large and fast growing number of mothers and health professionals are realizing that “fed is best.”

Lisa Bridger and the FABIEs will just have to find another source of ego gratification.

I tried Facebook Live for the first time today! I did a 30 minute question and answer session.

Lactation professional Amy Brown has written a new book about breastfeeding grief and trauma. She has also inadvertently demonstrated a variant of it. Brown is not grieving the ability to breastfeed; she’s grieving the loss of status of the breastfeeding profession. Brown and her colleagues are steadily (and thankfully) losing ground to the Fed Is Best movement.

Her response is a combination of denial and anger. Not coincidentally, these are the first two stages of Elisabeth Kubler-Ross’ five stages of grief.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]How does “fed is best” hurt women who want to breast any more than “breast is best” hurts them and everyone else?[/perfectpullquote]

Her new piece is a perfect illustration. Titled Don’t Tell me Fed is Best. My Body SHOULD be Able to Breastfeed!, it’s basically an extended temper tantrum. And it’s a temper tantrum that can only be thrown by the massively privileged. It’s like claiming you are entitled to have a child of a chosen gender. Sure it could happen and if you have enough children it is likely to happen. But you’re not entitled to it.

Brown starts with a bizarre claim:

Telling a woman that ‘the main thing is that your baby is fed’ can seem like their feelings and experiences, particularly their right for their body to work as expected, are being dismissed.

Actually, for loving mothers, the main thing IS that their baby is fed. Most loving mothers put their babies’ well being ahead of their feelings. After all, for years that’s what they have been counseled to do by lactation professionals. When Brown and colleagues declare “breast is best,” they assume that every mother wants to give her baby what is best. When they encourage (and often pressure) women to ignore their own pain, exhaustion and depression, they imply that the purported benefits to the baby eclipse any suffering for the mother. How ironic that lactation professionals can’t accept when women discover that fed is best for THEIR babies.

Brown continues:

What about the women who really wanted to breastfeed?

But challenging the use of the ‘fed is best’ message is not about implying that every woman can or should want to breastfeed. It’s about fighting for justice for those women who really wanted to breastfeed, but encountered difficulties, only to find that the thing they were told was so important during pregnancy, suddenly didn’t seem to be anymore. For them the message can hurt – and it’s important we listen to what they are saying.

Justice? Seriously? Are women who wanted to breastfeed but can’t more entitled to justice than women who didn’t want to breastfeed but feel pressured to do so?

“Fed is best” hurts women who wanted to breastfeed? How? Or — more to the point — how does “fed is best” hurt them any more than “breast is best” hurts them and everyone? Judging by the soaring popularity of the fed is best movement, “breast is best” is hurting hundreds of thousands of women and their babies. Where is the concern for their feelings and their physical and mental health?

Brown has closed her eyes and ears to the desperate entreaties of the women that the fed is best movement supports.

As usual, Brown plays fast and loose with the truth:

A further kick for these women, is that breastfeeding doesn’t have to be like this. If you look at breastfeeding rates in other countries they are much higher. Take Norway for example – whilst over three quarters of women there are breastfeeding at six months, just a third are in the UK.

But only 2.1% of Norwegian mothers are breastfeeding exclusively at 6 months. Only 2.1% in the country that Brown lauds for their breastfeeding support.

Perhaps the reason more women in the UK aren’t doing so is that British (and American) lactation professionals fetishize exclusivity and imply that supplementation of any kind “invalidates” breastfeeding. When you demonize supplementation, you imply (or even state) that “just one bottle” of formula means that there is no point in breastfeeding any longer.

But the bottom line for lactation professionals is always money for themselves and their services. Amy Brown is no exception:

…[I]f we are led to believe that breastfeeding doesn’t matter and we shouldn’t mind how our baby is fed, then this reduces pressure on governments and health services to make the investments needed to better support women.

That’s right! In industrialized countries breastfeeding DOESN’T matter for term babies and governments and health services have received NO return on the multi-million dollar investment in breastfeeding they’ve made so far. Brown is in the UK, where breastfeeding rates are literally the lowest in the world and the result has been … one of the best infant mortality rates in the world!

Unfortunately, breastfeeding support has become a gravy train for lactation professionals and they can never get enough money or employment opportunities. “Breast is best” is their marketing slogan and they are angry and in denial about the fact that their preeminence is coming to an end.

Follow the money! Fed is best might hurt lactation professionals, but its soaring popularity is testament to the fact that it helps mothers and babies. Isn’t that what justice requires?

What would it look like if midwives and lactation consultants cared about human rights in breastfeeding as much as they care about human rights in childbirth?

I consulted the paper Human rights in childbirth, narratives and restorative justice: a review to find out.

The authors identify five critical rights encapsulated in the FREDA principle:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]The over-medicalization of breastfeeding is ‘lactation violence.’[/perfectpullquote]

… The FREDA principle, is a useful human rights summary of the core issues at stake – fairness, respect, equality, dignity and autonomy.

Those goals — fairness, respect, equality, dignity and autonomy — apply equally to breastfeeding.

Fairness requires bringing back well baby nurseries and ending mandated rooming in.

Respect applies to women’s decisions regarding formula supplements, pacifiers and decisions NOT to breastfeed.

Equality means ending the privileging of lactation professionals’ views over patient views.

Dignity means requesting permission to provide lactation care, awaiting permission to touch women’s breasts and making sure that women get enough rest to recover from childbirth.

Autonomy means it’s her baby, her body, her breasts, HER choice.

There are other factors in common, as well.

Factory line conditions in healthcare facilities

Women who receive care from factory line conditions within health facilities are experiencing disrespect and abuse worldwide. Factory line conditions includes care … where women are made to adhere to routine protocols without consent i.e., to lie on delivery tales for hours without freedom of movement, forced to give birth while lying flat on their backs or in stirrups, routinely administering intravenous lines without medical need and episiotomies as of routine.

Similarly, women subject to factory line conditions in breastfeeding care are experiencing disrespect and abuse. Such conditions include women being made to adhere to routine protocols without consent, i.e. forced to be seen by lactation consultants, forced to room in with the baby 24/7, and deprived of well baby nurseries. Their rights are denied in relation to decisions over their body, self-determination and freedom from guilt and shame.

Over-medicalization

The WHO has recognised that childbirth has become over-medicalised particularly in the case of low risk pregnancy and that the caesarean section rate worldwide is much higher than it needs to be. The over-medicalisation of childbirth without informed consent has been also termed from a human rights perspective as ‘Obstetric Violence’.

Breastfeeding has also become over-medicalized, particularly in the case of term babies where the benefits of breastfeeding in industrialized countries are trivial. Over-medicalization includes forced instruction in breastfeeding, mandated periods of skin-to-skin care, brutal pumping regimens to boost supply and artificial supplemental feeding systems. Furthermore the rate of surgical frenotomy to correct purported tongue and lip ties has exploded and is much higher than it needs to be.

The over-medicalization of breastfeeding could be termed: ‘Lactation Violence.’

How have we gotten to the point where lactation violence has become a significant problem?

A technocratic model of breastfeeding

Contemporary healthcare is now being driven by a technocratic model … guided by risk, cost and fear, at the expense of personalised care. Accordingly, patients can feel “tyrannised when their clinical management is inappropriately driven by algorithmic protocols, top-down directives and population targets.” Consequently, in some cases, evidence based medicine can be a shackle to a woman’s autonomy.

Contemporary lactation care is driven by a technocratic model guided by claims of risks of formula, costs of not breastfeeding and fear of being a “bad mother.” Women are tyrannized when their clinical management is inappropriately driven by “Baby Friendly” algorithmic protocols, top-down directives and population breastfeeding targets. Consequently, “evidence based medicine” about breastfeeding shackles women’s autonomy.

Insensitivity of healthcare providers

Sometimes health providers simply do not realise that they have lost their compassion through insensitivity caused by working in some healthcare systems. This can also true for the nursing and midwifery profession and therefore it is important to avoid unintentional blindness of any health provider to dehumanised aspects of industrialised healthcare.

This can also be true for lactation consultants.

How can we address the harms that lactation violence causes?

Restorative justice

The key objectives of the process would be to repair the harm suffered by the victim; person at fault becomes aware of that his actions are unacceptable and the effect his actions are having on the victims and community; acknowledging responsibility for actions; participate in reparation decision making moving forward …

The key objectives for lactation consultants would be to repair the harm suffered by women, gain awareness of the impact their actions are having on babies and mothers (exclusive breastfeeding has become the leading risk factor for newborn re-hospitalization, breastfeeding guilt and exhaustion are factors in postpartum anxiety and depression), take responsibility for their actions and commit to doing better in the future. Most importantly, WOMEN would participate in decision making around breastfeeding care.

The author concludes:

Human rights in childbirth has served as a forum for highlighting many untapped or repressed areas of rage, anger and conflict within maternity care. Will this contemporary form of feminist rebellion against dehumanised healthcare lead to transformation of institutional attitudes? …

I heartily agree.

Human rights in breastfeeding serves to highlight feelings of anger, powerlessness and conflict with lactation care. A feminist rebellion against over-medicalized breastfeeding promotion could transform institutional attitudes. The way forward must be a joint effort between lactation consultants and the women they serve.

Anything else is lactation violence.

It is a truly horrific tragedy.

Brisbane baby girl dies days after twin sister died at Sunnybank Hills home:

A second baby girl who was found unresponsive in a Brisbane home has died in hospital overnight.

Police were called to the Sunnybank Hills home on Wednesday morning.

One of the six-week-old twins was declared dead at the scene.

The second girl was taken to hospital in a critical condition on Wednesday morning.

Police said preliminary investigations suggested the newborns had been sleeping together throughout the night.

Bed-sharing is a known risk factor for suffocation and sudden infant death syndrome. Every major pediatric health organization warns against it … except many breastfeeding organizations. Why? Apparently it’s more important to make breastfeeding easy than to ensure infants are safe.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Every major pediatric health organization warns against it … except many breastfeeding organizations.[/perfectpullquote]

Consider Dr. Melissa Bartick’s irresponsible and hypocritical opinion piece in Maternal Child Nutrition, Babies in boxes and the missing links on safe sleep: Human evolution and cultural revolution. Bartick promotes the deadly practice of co-sleeping in order to support breastfeeding. Apparently she is blind to the absurdity of letting babies die in order to breastfeed them.

Recommendations enforcing separate sleep are based on 20th century Euro‐American social norms for solitary infant sleep and scheduled feedings via bottles of cow’s milk‐based formula, in contrast to breastsleeping, an evolutionary adaptation facilitating the survival of mammalian infants for millennia. Interventions that aim to prevent bedsharing, such as the cardboard baby box, fail to consider the implications of evolutionary biology or of ethnocentrism in sleep guidance…

Seriously? How natural is the soft surface of a manufactured mattress? When in nature did bedding that can cover babies‘ heads evolve? If even the Bible mentions a bed-sharing death from a mother rolling onto an infant how is that fear based on 20th Century Euro-American norms?

La Leche League promotes a deadly policy of flat out denial:

It can be hard to continue your breastfeeding relationship if you are told you are not safe for your baby for a full third of the day! LLL believes there are many safe sleep options available to parents with infants. Education and accurate information are the keys to unlocking Sweet Sleep solutions!

Really, La Leche League? How sweet is a dead baby? Are two dead babies even sweeter?

The parents of the twins are “in a dark place.” It’s difficult to comprehend the grief, anguish and self-blame the parents will carry for the rest of their lives.

In an interview with the Courier Mail, their father revealed that the couple is in a “dark place” and their 2-year-old son has been distraught, searching the house for his baby sisters.

“We’re in a very dark place. But we have to try to keep going for our other children,” the father said.

“Our daughter is almost five, we told her the truth. We didn’t say they had fallen asleep … we told her they had died.”

However, he added that his daughter still hasn’t fully comprehended what has happened yet.

The twins’ father, who is a chemical technician, revealed he and his wife understood the dangers of co-sleeping, but they were struggling with the sleep deprivation after the birth of their twins.

He added that they are “educated people” and that it was only the second time her wife had co-slept with their children.

My heart goes out to these parents. They never, ever thought their babies would die … but neither does anyone else who practices bed-sharing.

Thinking about bed-sharing with your precious baby? Think again!