Breastfeeding, cognitive dissonance and effort justification


Breast is NOT best.

Sure, all else being equal, fully fed with breastmilk by a well off, mentally healthy mother with access to high quality healthcare and high quality childcare who has freely chosen to breastfeed and has sufficient breastmilk has tiny benefits compared to formula feeding; but all else is rarely equal. Indeed, the scientific research shows that if the many factors in the previous statement are listed in order of importance to infant wellbeing from most important to least important, we get a list that looks like this:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Women who have expended great effort to breastfeed need to believe that the benefits are large and are hypersensitive to any suggestion that they are not.[/pullquote]

1. Fully fed
2. Access to high quality healthcare
3. Mentally healthy mother who has freely chosen to breastfeed
4. Breastmilk

So if we REALLY cared about infant health, instead of merely pretending that we do, we’d work to ensure that every baby is fully fed, that every baby has high quality healthcare, that we do everything in our power to prevent and treat postpartum depression and only then promote breastfeding. Instead we do the opposite.

Why do we ignore the scientific evidence that the benefits of breastfeeding are tiny? Why do we ignore the growing body of scientific evidence that aggressive promotion of breastfeeding is leading to tens of thousands of neonatal hospital readmissions each year at a cost of hundreds of millions of dollars? Why do we ignore the minor epidemics of infant dehydration, severe jaundice, babies falling from and smothering in their mothers’ hospital beds leading to permanent brain injuries and even deaths? Why do we ignore the harms of aggressive breastfeeding promotion to mothers’ mental health?

The reason: effort justification.

According to Wikipedia:

Effort justification is a person’s tendency to attribute a value to an outcome, which they had to put effort into achieving, greater than the objective value of the outcome.

It’s an attempt to reduce cognitive dissonance:

[T]here is a dissonance between the amount of effort exerted into achieving a goal or completing a task (high effort equalling high “cost”) and the subjective reward for that effort (lower than was expected for such an effort). By adjusting and increasing one’s attitude or subjective value of the goal, this dissonance is resolved.

Simply put, women who have expended great effort to breastfeed — who have endured the screams of a starving baby, cracked and bleeding nipples, multiple episodes of mastitis, sleep deprivation and (in some cases) serious depression — need to believe that the benefits are large and are hypersensitive to any suggestion that they are not. That’s why the Fed Is Best Foundation is excoriated in the loudest possible terms with an endless repetition of lies.

For lactivists, the Fed Is Best Foundation is cognitive dissonance writ large. It’s very name is anathema because it suggests that breast is NOT best for every baby and it only gets worse from there. In order to protect future babies from being harmed by aggressive breastfeeding efforts, the Fed Is Best Foundation reports on existing babies who have been harmed, injured and even died from complications of breastfeeding. How dare they?

In order to protect babies, the Fed Is Best Foundation exposes the lies propounded by lactivists. Such lies include:

  • The claim that insufficient breastmilk is rare (it’s common, affecting up to 15% of first time mothers)
  • The lie that formula supplementation is harmful to breastfeeding (it’s not; judicious formula supplementation in the first few days INCREASES the likelihood of extended breastfeeding)
  • The lie that pacifiers cause nipple confusion (they don’t; they prevent SIDS)
  • The lie that a newborn’s stomach is the size of a marble (it’s not; it’s 4X larger)

In order to support mothers, the Fed Is Best Foundation provides accurate assessments of the tiny benefits and significant risks of breastfeeding. They support breastfeeding in every way they know how, but they aren’t willing to lie to do so. How dare they?

But perhaps most egregious is the fact that the Fed Is Best Foundation supports women who can’t or choose not to breastfeed. That produces unbearable cognitive dissonance for lactivists. If it’s okay not to breastfeed (and it is okay), then the effort that they expended to breastfeed was not heroic; it wasn’t even necessary. When lactivists insist against all evidence that the Fed Is Best Foundation doesn’t support breastfeeding what they mean is that the FIBF doesn’t support their view of themselves as superior mothers. How dare they?

Sadly, cognitive dissonance and effort justification affect breastfeeding professionals nearly as much as lay people. Consider this obnoxious lie tweeted by lactivist Prof. Rafael Perez-Escamilla:


Thank you Baby-Friendly USA for exposing the FIB Foundation which is an organization based on the principles of “Astroturfing” defined [by Wikipedia]

What is Astroturfing?

Astroturfing is the practice of masking the sponsors of a message or organization (e.g., political, advertising, religious or public relations) to make it appear as though it originates from and is supported by grassroots participants… The implication behind the use of the term is that instead of a “true” or “natural” grassroots effort behind the activity in question, there is a “fake” or “artificial” appearance of support.

We have a word for that kind of tweet. The word is libel.

To date, the Fed Is Best Foundation has not chosen to pursue legal action against liars like Dr. Perez-Escamilla, but that doesn’t mean they couldn’t. Like all charitable foundations, FIBF has publicly accessible tax documents. But you don’t even have to look them up; the Foundation has published those documents on the Web. They show that there is NO secret funding source, NO corporate sponsors, nothing but real, grassroots support. Perez-Escamilla and other lactivists who lie have reason to know that they are lying, yet they do it anyway.

Why? Effort justification.

These people have devoted their entire careers to the belief that breast is best for every baby. They’ve raised and spent millions of dollars putting unethical, aggressive breastfeeding promotion efforts like the Baby Friendly Hospital Initiative into practice. Ironically — unlike FIBF founders whom they accuse of profiting from their advocacy — these liars actually DO profit from their advocacy. Their professional raison d’etre is breastfeeding and they need to believe that the effort they have expended, the money they have spent and the money they currently earn are justified by the overwhelming superiority of breastfeeding.

The cognitive dissonance that results from acknowledging that the benefits of breastfeeding are tiny and the risks significant is simply unbearable. The need for effort justification compels otherwise responsible professionals to blatantly lie in order to protect their self-image.

Prof. Perez-Escamilla and the other professional lactivists who have lied about the Fed Is Best Foundation owe them a public apology and an acknowledgement that there is no evidence of corporate sponsorship beyond lactivists’ desperate efforts to avoid confronting the facts.

Breast is NOT best for every baby and I’d be happy to debate Prof. Perez-Escamilla in print or in public on that issue. But I suspect that he, like most professional lactivists, wouldn’t dare.