Breastfeeding policy is tainted by bias


Hundreds of women are venting their fury on my Facebook page. Why? It isn’t merely because I have spent World Breastfeeding Week 2018 challenging their cherished belief in the perfection of breastfeeding. It’s because I’m raising doubt about their conviction in their own minds.

Nearly all of the touted benefits of breastfeeding are based on predictions made by extrapolating from small studies. The predictions often take the form of how many lives would be preserved, how many cases of serious illness would be averted and how many healthcare dollars would be saved if only the breastfeeding rate were higher. I’ve had the temerity to point out that breastfeeding rates in the US have risen dramatically since their nadir of 24% in 1973, yet NONE of the predicted benefits have occurred. Many have searched for data to rebut this claim but to their shock and horror have found that the predicted benefits of breastfeeding have indeed failed to appear.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Breastfeeding policy has been determined by biases that have nothing to do with actual science — bias toward the natural, anti-corporatist bias and anti-feminist bias. [/pullquote]

In their fury, they’ve accused me of being biased. I must be anti-breastfeeding, though I breastfed my four children. I must hate breastfeeding although it’s hardly hateful to point out that breastfeeding has failed to live up to the claims made on its behalf. Most egregiously, I must be in the pay of formula companies. No one has any evidence for that libel; I don’t receive any industry money from anyone.

In response they keep citing the same faulty studies whose predictions have failed to occur. Or they advance the logical fallacy of arguing from authority, insisting that if the WHO, UNICEF, the American Academy of Pediatrics, and various other health organizations claim that breastfeeding is superior, then it must be superior.

What they fail to realize is that contemporary breastfeeding policy is tainted by three specific kinds of bias: cognitive bias, anti-corporate bias and anti-feminist bias.

Cognitive bias

The belief in the innate superiority of breastfeeding has its intellectual root in the naturalistic fallacy, the belief that anything natural must be superior. This bias toward the natural is specific to Western cultures of the late 20th and early 21st Centuries. Prior to that, the same cultures exhibited a pronounced technological bias. That’s part of the reason why infant formula became so popular in the first place; in the early 20th Century all technology was viewed as inherently superior simply because it was an innovation. But neither is inherently superior. The relative value of the natural vs. the technological varies with the circumstances.

But cognitive bias toward breastfeeding is so strong that it led to publication bias. The aim of nearly all breastfeeding scientific literature is to validate the belief that breastfeeding must be better, not to test it. Most of the breastfeeding scientific literature is produced by partisans in journals that are edited by partisans. I am aware of researchers who cannot get their scientifically accurate papers published because calling the purported benefits of breastfeeding into question produces cognitive dissonance among those who have staked their scientific careers on the supposed superiority of breastfeeding.

Anti-corporatist bias

Breastfeeding policy is rooted in anti-corporatist bias toward Nestle and other formula companies. Don’t get me wrong, Nestle and other formula companies DID engage in unethical behavior in Africa by luring women away from breastfeeding even though they lacked access to clean water with which to prepare formula. The result was the death of tens of thousands of babies.

But what got lost in the righteous anger toward Nestle’s behavior is that there was NEVER anything wrong with formula itself; the problem was the water used to prepare it. All the African babies who died would have lived if Nestle had provided clean water along with powdered formula. No matter; formula itself was demonized and a series of draconian advertising restrictions instituted specifically to punish formula companies. Bias toward Nestle was transmuted to bias toward its completely safe, perfectly healthy product.

This anti-corporatist bias is a form of white hat bias:

‘White hat bias’ [is] bias leading to distortion of information in the service of what may be perceived to be righteous ends… WHB bias may be conjectured to be fuelled by feelings of righteous zeal, indignation toward certain aspects of industry, or other factors…

But bias in the service of righteous ends is still bias and bias has no place in scientific research or policy.

Anti-feminist bias

La Leche League and its daughter organizations have been the prime movers in ALL breastfeeding policy in the past 35 years. They lobbied the WHO/UNICEF to punish Nestle and other corporations and to demonize formula in the process. But LLL always had another agenda entirely. It was created by religious traditionalists to promote breastfeeding as a means of forcing working mothers back into the home.

In the book La Leche League: At the Crossroads of Medicine, Feminism, and Religion, Jule DeJager Ward explains that LLL was founded as a backlash to the emancipation of women:

[A] central characteristic of La Leche League’s ideology is that it was born of Catholic moral discourse on family life … The League has very strong convictions about the needs of families. These convictions are the normative heart of its narrative… The League’s presentations and literature carry a strong suggestion that breast feeding is obligatory. Their message is simple: Nature intended mothers to nurse their babies; therefore, mothers ought to nurse…

The original goal of LLL was to convince women that their primary purpose in life was to use their reproductive organs rather than their intellect or talents. It has succeeded beyond its wildest dreams. Now there are women who actually claim that the decision to breastfeed is feminist when it is nothing more than biological essentialism. And it has produced a cadre of lactivists — women who define both themselves and other women by how they use their breasts. Because breastfeeding has become part of lactivists’ self-image, any suggestion that it is less than immensely beneficial produces profoundly uncomfortable feelings of cognitive dissonance.

The bottom line is that breastfeeding policy has been determined by biases that have nothing to do with actual science — bias toward the natural, anti-corporatist bias and anti-feminist bias.

Pointing out that breastfeeding has failed to deliver its predicted benefits isn’t hating breastfeeding; it’s simply loving truth more than comforting biases.

28 Responses to “Breastfeeding policy is tainted by bias”

  1. Lisa
    August 21, 2018 at 2:16 pm #

    Thank you for writing this! I’m so tired of the lack of robust evidence-based discussion about the actual benefits and risks of breastfeeding! I was fortunate enough to have a doctor who told me that, because I had a high risk of post-partum depression, breastfeeding was optional, but sleeping was not. I breastfed exclusively with my first and with my second, am doing a mix. A helpful lactation consultant told me that there is evidence that 8oz. of breastmilk per day is enough to confer the mother’s current antibodies, so I’ve been aiming for that amount and not making myself crazy waking up all night to pump and boost supply. The whole conversation around breastfeeding seems emotionally based, and rife with judgement, but light on well-designed, peer reviewed studies. Glad to see someone with a medical degree and an evidence-based approach!

  2. mabelcruet
    August 5, 2018 at 6:56 pm #

    Slightly OT-the parents of a baby who suffered severe brain damage after breast feeding in hospital have lost their case for compensation. They blamed the midwife for not warning them about keeping the baby’s airways uncovered, but the court didn’t agree.

  3. August 5, 2018 at 9:37 am #

    OT: Love Modern Alternative Mama’s piece on how unschoolers learn to read; note the lack of formal diagnosis and remedial therapy for the oldest, who probably has dyslexia based on “online” and “regional coordinator” assessments:

    • namaste
      August 5, 2018 at 10:22 am #

      Dear God, I knew she was a nutcase, but I didn’t know she is withholding education from her kids. It didn’t bother her at all that her 9 year old couldnt read?! She should have been in the 4th grade by then learning U.S. History and the function of bone marrow. There is no telling how far she has fallen behind academically.

      • August 5, 2018 at 7:01 pm #

        Well, I didn’t know about bone marrow until high school, but yes, your point is well taken. This is the despised c-section daughter, though, so I’m sadly unsurprised at her neglect.

        • namaste
          August 5, 2018 at 7:26 pm #

          I remember when I was in 4th grade 4th grade, the teacher brought in a cow’s femur sawed in half longitudinally and we actually saw the bone marrow. The smell wasn’t too awesome, I must admit.

    • maidmarian555
      August 5, 2018 at 5:20 pm #

      Jesus, they waited til she was 9 to go the local library and sign up for the summer reading program? We signed my son up at the local library when he was 6mnths old. We kept at him trying to read books with him until he was about 20mnths and from then we read to him every night (the book that tipped the scales was Chu’s Day by Neil Gaiman- yes, that Neil Gaiman, if anyone’s interested). He’s not even two and a half and we’re already learning letters with him.

      My father was sent to work at 13yrs old and couldn’t write much but could read and always prevailed upon me how important it was to be able to educate yourself and open your imagination to different worlds.

      I totally get that a child with additional needs might need more help and encouragement with learning to read and write but that doesn’t prevent you reading to your child. You suck them in with the pictures and the words and stories flow from there. How is she only bringing all her kids into her room for story time when they’re all so old? It’s insane, these people care *so* much about ‘health’ and how one drop of formula may decimate those precious infant tummies but something as advantageous as READING TO YOUR CHILD (which is also proven to be advantageous afaik) isn’t a big deal?! Jesus Christ.

      • August 5, 2018 at 7:00 pm #

        It’s mind-boggling, isn’t it? I guess she’s too busy with her wellness junk to ensure that her kids are learning basic skills.

      • Amazed
        August 5, 2018 at 8:02 pm #

        An old retired nurse, a relative of mine, says that when school-age children entered, she could never say which one was breastfed and which one was formula-fed.

        My primary school teacher grandmother? She could say which kid had not been read to right on the spot.

        They waited until the kid was 9? Like in nine?

        Amazing Niece is also two and a half and we have been learning letters with her since before she was two. A few days ago, we took her to the Book Alley and her eyes went as wide as saucers. She read the title of the first book we bought her on her own – Dear Kitten.

        They waited until nine?

        A hook line for the Alternative Mamas of the world: when Amazing Niece was even younger, she did not say, “I want to write.” She used to say, “I want to write Mama”. Weep over this, Katie! What a chance to feed your narcisism you have missed!

        I can’t fathom how people who claim to be so knowledgeable and nurturing neglect the basic soul nurture for their children. Reading to a kid leads to better imagination, better vocabulary, better… everything but a mom’s patience since it isn’t always easy. It can be time consuming and AM might have been forced to give up on her natural cult thing to some extent – and THIS is unthinkable.

        • maidmarian555
          August 6, 2018 at 4:32 am #

          From what I can gather from these ‘unschoolers’ like MAM and that batshit Naugler family who’ve got like a million kids living in a shed in Kentucky, the appeal of unschooling seems to be that you can just let your kids look after each other while you get on with important business of blathering on Facebook all day.

          If you’ve got a local library, reading is an activity that will only cost you your time. Books can be bought for super-cheap second-hand too and they last (more or less- we’ve had to chuck quite a few out as both my children started off by trying to eat them). What’s even more galling is that MAM’s entire business exists because she can read and write. So she of all people should understand the importance of being literate.

          I mean, all she has to do is sweep up all the kids for 30 minutes a day and sit and read them a story. That’s it. It blows my mind this isn’t something that somebody who isn’t sending their kids to school, where somebody else might do that for them, would do.

          Actually teaching them to read is obviously going to take a lot more effort than that. I guess she figured if she just ignored it then the kids would figure it out themselves but that’s not how it works! That’s why we have proper schools because knowing how to teach is in and of itself not easy and not something anyone can just do. I don’t think I’d even know where to start with something as complicated as reading, over and above the basics. Which is why both my children will be going to school so an expert can take them further with it than I am capable of myself.

          • Amazed
            August 6, 2018 at 7:51 am #

            But it isn’t as easy as to sweep up all the kids and sit and read them a story. Some of the kids are going to whine. Others are going to do the reading themselves. Others yet are going to incessantly ask, “Why?” and “What?” (Just yesterday, Amazing Niece interrupted me five times in a single page to insist that Mama Bear in the picture was no Mama Bear but Bunny’s Daddy.) It can be noisy and inconvenient, and too much of an effort for such an unnatural result! Why put a natural mama like her through THIS?

            Bad thing is, children mimic each other’s behavior. The Intruder would sit for five minutes with every book he could snatch at age two because *I* was reading. He could read fluently at four and felt that he was ready to start primary school – again, because *I* went to school. Unschooling many children together is much worse than one kid at a time.

          • August 6, 2018 at 9:45 am #

            Thing is, I think a lot of kids will teach themselves to read, eventually; but parents must promote literacy by reading to them, and they must be on the lookout for any developmental problems that may impede learning. This is true for parents who send their kids to school, but triply so for parents who homeschool. If your kid is having problems, it is educational neglect not to address the problem properly.

          • maidmarian555
            August 6, 2018 at 2:24 pm #

            Children are a lot like dandelions. Even if they’re neglected and never cared for or watered, they will often find a way to sprout through the cracks.

            What I find fairly astonishing is how she’s managing to frame what is both medical (with the whole homebirth/not vaccinating/letting her kid crawl about with a broken arm for a week) and educational neglect as some sort of lifestyle choice to aspire to. Although she talks about reading with her kids further down the article, it’s so telling that in order for her daughter (who is basically being blamed for not pushing her own education forwards by only remembering to ask for help at 10pm at night) to practice reading with the family, they have to schedule a special event instead of just getting her to be the one to read the story to the littles at story time. It’s really clear reading is not a regular part of their everyday life, which with five children who don’t attend school is horrifying!

    • Heidi
      August 5, 2018 at 9:34 pm #

      I’m surprised she admits her daughter even has dyslexia. These types seem to think learning disabilities and intellectual disabilities are the fault of the parents — vaccines or GMOs or formula.

      • Chi
        August 5, 2018 at 10:29 pm #

        It’s just another piece of ‘damage’ for her to flaunt in order to ‘prove’ that vaccines/GMO’s/formula/c-sections etc are BAD.

        Cos this IS the one who was ‘damaged’ by a c-section, so what’s one more bit of damage?

        I feel so sorry for that poor little girl.

        • Who?
          August 5, 2018 at 10:50 pm #

          It’s such a strange way to think-surely if you believe a child had a difficult start, you’d want to build them up a little, lend a hand, put something extra their way, in case they need the help.

          • August 5, 2018 at 11:16 pm #

            That’s because you either like children or have an innate sense of fairness, kindness or justice. MAM…not so much.

            MAM dislikes her oldest daughter intensely and blames her feelings on the fact her daughter was born by C-section. Personally, I blame her for not woman-ing up and seeing a therapist….or doing a healing rain-dance…or taking up marathoning….or whatever she needed to be an adult and deal.

            She’s the one who wrote the extremely poorly thought out “If I had to make a “Sophie’s Choice” decision, I’d sacrifice my daughter ’cause I really like my son” article and was amazed by the blowback. Because – you know – she’d be really sad if she had to sacrifice her daughter in a Sophie’s Choice-like situation, she said she’d be really sad, and we don’t talk enough about the hard times of parenting – so don’t blame her for writing a brutal essay that we’re all praying that her daughter never reads.

            ‘Cause lots of adults would prefer to just sacrifice themselves to save two kids. We had a gallows humor joke among the Small Baby Unit Parents that life would be a lot easier if we could just lop off limbs to protect the babies. Sure, the adults would all be quadruple amputees – but the babies would be safe and healthy so where’s a bone saw and a fifth of high-proof liquor?

          • Who?
            August 6, 2018 at 1:39 am #

            Lovely woman that she is-that poor little girl.

    • August 5, 2018 at 11:04 pm #

      I’m not a reading or language arts teacher, but I picked up a lot about helping students who had reading difficulties when I was teaching.

      I guess I’m glad that she’s kind of figured out how kids learn to read in the total absence of a parent who keeps literacy on the forefront of her mind – but even her ideas on how kids learn to read is shoddy with a lot of missing steps. Like how and when her kids learn letters and the sounds they make and that there are some tricks to figure out when a vowel will be short or long. You know, those rules that are really helpful for people with dyslexia.

      My mind is more than a little blown from the fact that she’s learned that kids remember “important words” – which most people would classify as nouns, active verbs (I’m assuming) adjectives while often forgetting “less important words” – also known as articles and helping verbs. Hmm…wonder why children learn and remember nouns and active verbs better than articles and helping verbs? Could it be that concrete items are easier to remember than abstract items? Especially during simple plots?

      Also, the fact that she thinks that early elementary educators focus on the 100 most common words in the English language because those words are the ones that “adults think they are easy” is going on my list of “signs you personally shouldn’t be home-schooling.” Most of the words aren’t easy; they are non-phonetic nightmares like “the” or “for”.

    • J.B.
      August 6, 2018 at 12:51 pm #

      Homeschooling/unschooling ugh! If my kids were around me all day the’d do nothing but fight. The older one is gifted and would learn nothing because she “already knows everything”. Instead she goes to a school that balances making her learn skills with new challenges. Bless her teachers!

    • Madtowngirl
      August 6, 2018 at 2:18 pm #

      All I can think about when I read this piece of trash is how this morning my daughter was confirmed to have a significant astigmatism, and at 3 she already needs glasses. We caught this early – and thank goodness, because impaired vision would almost certainly have affected her academic abilities later on. I just can’t fathom why she wouldn’t go get help for that poor child.

  4. Anna
    August 4, 2018 at 10:15 pm #

    So its Sunday, does that mean Breastfeeding Week is over….The seagulls on FB are so boring, especially the AVers.

  5. Russell Jones
    August 3, 2018 at 6:52 pm #

    “I must hate breastfeeding although it’s hardly hateful to point out that
    breastfeeding has failed to live up to the claims made on its behalf.”

    That’s reminiscent of members of the invisible magic sky daddy crowd who believe that atheists are atheists because they “hate God.” They, like a significant chunk of lactivists, just can’t wrap their minds around the idea that there are legitimate grounds for not embracing their belief systems.

  6. MaineJen
    August 3, 2018 at 2:14 pm #

    Typo under “Anti-Corporatist Bias:” should be ‘…Nestle and other formula companies DID *engage* in unethical behavior…’

  7. The Kids Aren't AltRight
    August 3, 2018 at 1:15 pm #

    One of the most baffling parts of the societal pressures surrounding pregnancy (I still have a month to go, so naturalistic fallacy peddling has mostly limited to birth) is how misogynistic the so-called feminists are. Suddenly it’s the feminists saying you don’t need to worry your pretty little head about statistics, you have no right to control your body, any identity outside of motherhood makes you some sort of unwoman monster, etc. It has been very depressing and disorienting.

    • AnotherOor
      August 3, 2018 at 7:52 pm #

      I hear you. I’ve been disappointed by what I now think of as “mainstream feminism”.

      • The Kids Aren't AltRight
        August 3, 2018 at 8:22 pm #

        My sister and I call it “moontime feminism”

    • Madtowngirl
      August 6, 2018 at 2:14 pm #

      It’s so true. Once you make the choice to carry a pregnancy to term, you no longer have any bodily autonomy or identity outside of “mama.” It’s gross.

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