How to spot a breastsuffering apologist

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I’d like to propose a new term: breastsuffering.

Breastsuffering refers to the large and growing toll of aggressive breastfeeding promotion. Breastsuffering encompasses breastfeeding starvation, breastfeeding suffocation and breastfeeding skull fractures for babies and breastfeeding guilt, anxiety and depression for mothers.

Sadly, lactation professionals and lactivists have become apologists for breastsuffering.

More than three decades ago lactation professionals decided, absent any evidence, that breastfeeding is best for babies. In their defense, they were responding to the egregious, deadly corporate practices of large multi-nationals like Nestle; they had sought to replace breastfeeding in Africa with formula made using contaminated water. Although it was the water that harmed and killed the babies, breastfeeding advocates sought to elide that point in order to promote breastfeeding.

Moreover, at the time there was very little scientific evidence about the harms of breastfeeding.

Now we know that each year tens of thousands of breastfed babies starve to the extent that they need to be readmitted to the hospital at a cost of hundreds of millions of dollars. Why? Because lactation professionals — with no scientific evidence of any kind — have claimed that formula supplements interfere with breastfeeding.

Each year hundreds of babies suffocate to the point of brain injury or death in their mothers hospital beds in an effort to promote breastfeeding. Why? Because lactation professionals — with no evidence of any kind — insist that prolonged periods of skin to skin contact are required for breastfeeding.

Each year an unknown number of babies are injured or die after falling from their mothers hospital beds. Why? Because lactation professionals — with no evidence of any kind — have claimed that mandated rooming in of babies and mothers increases breastfeeding rates.

Each year tens of thousands of women suffer soul searing guilt, disabling anxiety and life threatening postpartum depression. Why? Because lactation professionals — with no evidence of any kind — have claimed that women who don’t breastfeed don’t care about their babies.

You might think that lactation professionals and lactivists would be horrified by what they have wrought. You would be wrong. Instead they have become breastsuffering apologists.

How does it work?

Breastsuffering apologists invoke the naturalistic fallacy.

Starvation apologists insist that starvation while breastfeeding is impossible because it would have ended our species. That’s nonsense. Approximately 20% of established pregnancies end in miscarriage and it has not prevented growth of our species. Even 15% of babies starved to death, it would not hardly have wiped out the species.

Suffocation apologists — like Prof. James McKenna who coined the term breastsleeping and Melissa Bartick, MD — insist that because babies in nature sleep on the hard, flat ground with their mothers, contemporary babies ought to sleep on soft, suffocating beds with their mothers. Skull fracture apologists invoke similar “reasoning.”

Breastsuffering apologists insist that the benefits of breastfeeding outweigh the permanent brain injuries and deaths.

There’s a major problem with that argument. Though I can show you tens of thousands of babies readmitted to hospitals, hundreds of babies brain injured and even babies who have died as a result of breastfeeding, they can’t show that any term babies’ lives have been saved, incidence of any serious disease being reduced, or that even a nickel has been saved by promoting breastfeeding in term babies.

Breastsuffering apologists insist it is “lack of support” that is leading to the hospitalizations, brain injuries and deaths.

It is not a coincidence that many of the very people who profit by providing support insist that more support — and therefore more money for themselves — is needed. They evince a startling lack of awareness that it is precisely their support for any amount of breastsuffering in the pursuit of higher breastfeeding rates that has led to the hospitalizations, brain injuries, maternal depression and death.

Breastsuffering apologists accuse anyone who tries to increase awareness of breastsuffering of hating breastfeeding.

That’s just a way of diverting attention from the real problem. Many of those who oppose breastsuffering — like me — breastfed their own children. The difference between us and lactation professionals is that we would never have let our own babies suffer just so we could say we breastfed; we despise the fact that many lactation professionals are willing to let their own and other people’s babies suffer for bragging rights.

Breastsuffering apologists attempt to assuage their cognitive dissonance by tormenting women who chose or were forced to choose bottlefeeding.

The mantra of breastsuffering apologists is “fed is minimal” (or for the grammar challenged “fed ain’t best”). But the truth is that fully fed with formula is far better than underfed with breastmilk. This also speaks to the high premium lactation professionals and lactivists place on their own hunger for achievement and recognition. For breastsuffering apologists, the need to feel superior to other mothers outweighs any other considerations, including the suffering of their own children.

Breastsuffering apologists are everywhere. They run webpages and blogs that grossly exaggerate the benefits of breastfeeding and ignore the risks. They create Facebook groups to bully formula feeders and to wallow in their unmerited sense of superiority. They engage in testimonial silencing on the their social media feeds, trying to banish the evidence of breastsuffering. And should anyone draw their attention to breastsuffering, they act as apologists for it.

Breastsuffering is real, significant and growing. Breastsuffering apologists are legion. It’s time to recognize the harm and put an end to it.

  • mabelcruet

    I agree, they are everywhere, and a lot of it is pointless value signaling. I was recently sent an email about a neonatal ethics conference due to be held towards the end of the year-its a multidisciplinary thing aimed mostly at paediatricians, neonatal nurses, and bereavement staff with some of the workshops also very relevant for parents. The topics are looking at issues like palliation in neonates and extreme prematurity, organ donation using organs from deceased neonates, neonatal pain relief, and bereavement. The last one was held in 2014. On the facebook page, there is a comment from a person claiming the conference is invalid because they accepted sponsorship from a formula company, and she claimed this was in violation of the WHO guidelines on infant feeding. Formula feeding is unethical, according to this woman, so how could an ethics conference be sponsored by profits from such a company? Personally, I’d have thought starving a baby was more unethical, but the organisers have reassured her that the company sponsored the last conference in 2014, but not the upcoming one.

    Are people not allowed to think for themselves? Are we so weak willed and brainless that the presence of a formula company handing out free pens and post-it notes is going to automatically turn all of us into evil baby poisoners? No, we are sensible, enquiring, evidence based professionals. We can assess the evidence, we can decide for ourselves. Banning formula companies getting involved in this sort of conference is nanny-state policing at its worst.

    • PeggySue

      How infuriating. When I still worked as a chaplain, I had to complete a mandatory online training module about the health care system’s BFHI status, and “Baby Friendly Ethics” was defined to include the removal of all materials referencing formula or supplied by formula companies. One of the things that finally pushed me out the door.

    • Anna

      That sort of thing is so frustrating. Formula companies are evil because all they care about is money – but if they offer money for a really worthy cause – in exchange for a bit of exposure – they get rejected. So who else is standing up offering to pay for these sorts of conferences? Big Lactation? No, of course not. I’ve even heard of conferences being attacked because Medela sponsored them – even our ole mate Maureen railed against that – though I suspect for different reasons. And yes, I agree, health professionals are not so stupid that they will sell themselves out for a free pen. Whenever I’ve ever heard anyone ask a health professional which is the best formula they always say “just get whatevers cheapest”. Funny though, I see a lot of “natural” childbirth and lactation consultants advertising or doing promotion of expensive brand name supplements, baby products (slings, nappies) and other woo-quackery – dodgy practitioners/useless modalities and theres a lot of “you advertise me, I’ll advertise you” going on between doulas, LCs, chiros, life coaches, flower essence sellers etc etc.

  • rational thinker

    I have a feeling this wont stop until the government steps in and does something about it. It’s really just a question of how high the death toll has to get before they can’t ignore it anymore and do something. I’m guessing after a few children or grandchildren of congressmen and women die of starvation.

    • BeatriceC

      Just one. Just like prematurity, it will take the death of a single high ranking politician’s baby before anything is done. Preemies were mostly left to die, with doctors and nurses just flying by the seat of their pants with no research money to help them find better treatments, until JFK’s baby was born at 32 weeks and died while he was president. It was only then that significant dollars were funneled into research for treating premature infants.

      • It would be nice, but don’t hold your breath. The government won’t even regulate midwifery standards of practice and licensure.

        • BeatriceC

          The point is that it doesn’t matter how many babies die. It will take the death of a single infant who’s the child of somebody politically powerful before anything is done. There could be thousands of dead infants before that, but they don’t matter. Only one will matter.

          • rational thinker

            And they will name the bill after the one deceased child not the thousand that came before. Truly sickening.

    • mabelcruet

      I’ve heard the same thing said about miscarriage and stillbirth-you wouldn’t wish that on any parent, but if a high profile woman had a late miscarriage or a term stillbirth and was willing to talk about it in detail, we’d get more funding. There are occasional stories but no sustained publicity, so it means that many women still think ‘it must have been something I’ve done wrong’ when it happens because there’s no openness about it all.

      In 1991, a prominent newscaster in the UK, Anne Diamond, had a baby who died of cot death. This was just at the same time that Peter Fleming, a paediatrician in the UK who specialises in cot death research, was looking at sleep positioning. There was data coming out of New Zealand and Australia showing very convincingly that placing the baby on its back to sleep was protective.

      So Anne Diamond did a documentary-she took herself off to New Zealand (within months of her baby’s death) to speak to researchers, and when she came back, she joined with the Lullaby Trust and they pushed relentlessly for the department of health to start a ‘back to sleep’ campaign. Her baby died in July 1991-the back to sleep campaign started in earnest in December 1991. 5 months for a huge, nationwide campaign, TV adverts, documentaries, public awareness, health visitors and community support workers all trained up-in a time without internet and social media it was an absolutely phenomenal achievement.

      In the 28 years since, that simple change from prone sleeping to back sleeping has saved countless lives. Anne Diamond was absolutely instrumental in getting that out there-she took her own loss and made it count for something. And I really hate the thought that she had to lose her baby to be the public face of cot death, but I think it needs a figurehead like that for the wider public to pay much attention-people aren’t good at thinking abstractly about issues, mostly having a face associated with it helps to get the message out there.

    • Mel

      Nothing says groundbreaking research like making the connection between recent stressful life events and the inability to add one more stressful life event.

      The best bit, though, is the idea that some additional training for lactation consultants and doctors is all that is really needed to help a woman who had been homeless during her pregnancy or lost a close family member in the last year breastfeed for six months.

      *rolls eyes*

      • rational thinker

        Pretty much every breastfeeding article on that site concludes that we need more support and more lactation consultants, it’s really just fucking sickening.

      • Juana

        I like the take that soon-to-be-breastfeeding-mothers are suggested to need protection from those stressful events precisely because that would drive up their exclusive-breastfeeding rates. Not because it’s an ethical thing to do, not kicking a pregnant woman out of her home, or try to save her dying family member – but for the exclusive breastfeeding rates, totally!
        Putting the cart before the horse, maybe?
        And how, pray tell, is throwing out more money for lactation professionals is going to achieve that?

  • Cartman36

    “The difference between us and lactation professionals is that we would
    never have let our own babies suffer just so we could say we breastfed;
    we despise the fact that many lactation professionals are willing to let
    their own and other people’s babies suffer for bragging rights.”

    YES! I have no problem with breastfeeding, I breastfed 3 kids. I have a problem with the way it is being promoted and that health care professionals, public health authorities, mommy bloggers, parenting magazines (etc) are lying to women about the supposed benefits and because FTM aren’t getting accurate information they are allowing their babies to go hungry in the pursuit of EBF.

    Thank you Dr. Amy! Keep up the good work