Mother blame 2019: microbiome edition

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It’s always the mother’s fault.

There is a long and storied history of mother blame extending back millennia. Women who couldn’t conceive were labeled “barren” even though infertility is caused by male factors 20% of the time. Women who had only daughters and no sons were blamed for the sex of their children, even though it is sperm that determine gender, not ova. For hundreds of years of recent history, women were told that their dreams could affect the outcome of pregnancy; dream of something frightening and the baby might be deformed. Within the past century, “refrigerator mothers” were blamed for autism even though there was never any evidence to support such a link.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]We must “discover” ever more arcane “benefits” so we can continue to shame, blame and humiliate women who can’t or don’t breastfeed.[/pullquote]

The latest recruit to the deeply satisfying pastime of mother blame is the microbiome. For the past few years it has been used to chastise women who can’t or don’t breastfeed. Recently, it has offered an a new opportunity to chastise women who pump breastmilk because — duh! — women who give up career and livelihood to breastfeed supposedly represent the apogee of contemporary motherhood.

On the face of it, there’s no reason why breastfeeding, which in industrialized countries has only trivial benefits, has become a public health cause celebre.

There are so many, many issues that have a much greater impact on child health that are being ignored, while breastfeeding advocacy benefits from millions of dollars of public and private funds, extensive public health campaigns, and redesign of hospital policies. We have public health campaigns against smoking because that costs millions of lives; we have public health campaigns to promote vaccination because vaccines save millions of lives; we have public health campaigns to promote breastfeeding … which has never been shown to save even a single term baby.

If you want to see how trivial the impact of breastfeeding is on public health you need only look at the impact of breastfeeding on infant mortality in the US during the 20th Century when breastfeeding rates fluctuated dramatically from a high of over 75% to a low of 25% and back up to 75%. Breastfeeding rates had ZERO impact on infant mortality.

While breastfeeding advocates breathlessly promote studies that show trivial benefits within tiny groups of carefully selected individuals, we’ve already done the largest public health experiment possible and it shows that breastfeeding is NOT a public health issue since it has no impact on public health.

Why then do we continue to justify a multimillion dollar effort to promote breastfeeding rates in the absence of public health benefits?

Frist, breastfeeding advocacy is a huge business. While individual professional breastfeeding advocates don’t make large sums of money, 100% of the income of lactation consultant derives from breastfeeding promotion, and 100% of the income of lactivist organizations like the Orwellian-named Baby Friendly Hospital Initiative comes from the more than $11,000 they charge each hospital for the privilege of being designated lactivist baby friendly.

Second, breastfeeding promotion, which has its modern incarnation in La Leche League as an effort to keep women in the home and out of the workforce, is a response to the profound social disclocation of women’s emancipation. The political right has retreated into religious fundamentalism and the political left has retreated into mindless worship of “nature.” Simply put, aggressive promotion of breastfeeding is deeply retrograde and anti-feminist.

So we must “discover” ever more arcane “benefits” so we can continue to shame, blame and humiliate women who can’t or don’t breastfeed or — don’t breastfeed the “right” way by staying home with their infants 24/7/365.

It’s part of the effort to maintain a traditionally misogynistic “blame the mother” culture.

As Phyllis Rippeyoung explained in her paper, Governing Motherhood: Who Pays and Who Profits? published by the Canadian Centre for Policy Alternatives:

This individualizing of responsibility for child welfare has also been seen among breastfeeding proponents, as most explicitly illustrated in an editorial by Dr. Ruth Lawrence, a founder of the Academy of Breastfeeding Medicine. In her essay, “The Elimination of Poverty One Child at a Time,” she argues that breastfeeding is the panacea for health and cognitive inequalities between poor and non-poor children. She ends the piece by writing that breastfeeding may be the only gift that poor mothers have to offer their children.

… I have been unable to find any research assessing whether breastfeeding … will actually reduce either poverty or the consequences of growing up poor, one child at a time or otherwise. In research I have recently completed, I assessed the relative impact of breastfeeding versus the family educational environment on reducing gaps in child verbal IQ between the poor, the near poor, and the non-poor … This research indicates that individual solutions to low test scores will not solve the problems of inequalities in school readiness.

It is hardly a coincidence that the women who are targets for shaming by breastfeeding advocates are more likely to be poor, non-white and under-educated. It’s so much easier and cheaper (not to mention politically gratifying) to chastise these mothers for not breastfeeding than to address the terrible environments in which many are forced to raise their children.

The ugly truth is that money spent on breastfeeding advocacy benefits only the advocates — the very people who write and promote research that continually “discovers” new “benefits” — not mothers or children.

We should stop spending money on public health campaigns to promote breastfeeding and divert that wasted money to initiatives that we know will help ALL mothers and ALL children, not just those who breastfeed or are breastfed.

But is so much more satisfying to shame mothers for not breastfeeding — and blame them for everything!