In certain overachieving circles, breast-feeding is no longer a choice—it’s a no-exceptions requirement, the ultimate badge of responsible parenting. Yet the actual health benefits of breast-feeding are surprisingly thin, far thinner than most popular literature indicates. Is breast-feeding right for every family? Or is it this generation’s vacuum cleaner—an instrument of misery that mostly just keeps women down?
Hanna Rosin, April 2009, The Case Against Breast-Feeding, The Atlantic Monthly
Oh Baby! There is a real war out there about Mother's Milk, and it's a pretty heated one.
And it's not as simple as, "Breast is best, do it for the health of your child." This is an emotional political, cultural, social, economic, psychological, physical and medical debate. I think I'm finally understanding its complexity--and bottom line: You've gotta do what you've gotta do. We all try to do the best we can for our children--but everyone's experiences are different.
Back in the late 70's & early 80's when I breastfed there weren't the piles of research out there to convince you of the benefits of breast milk. Any support I got in my effort to breast-feed came from books & phone calls to the mostly unknown Le Leche League. Back then, breast-feeding was more about bonding with your baby, the thought that maybe human milk was better for human babies, and the reality that it was so darn easy & convenient once you got the hang of it.
It was only years later that I read the research that confirmed what I suspected--there were benefits to breast-feeding, both to the baby & to the mother. But, medical research or not, it was a warm wonderful magical experience that by its very nature "forced me" me into hours of eye-gazing cuddling time with my babies every day. I didn't have to think about skin-on-skin cuddle time--it was a built-in part of the experience. The breast was instant comfort to crying upset babies--like magic--it was a powerful experience--and guess what--it had nothing to do with the milk.
And fortunately or not, breast pumps weren't viable options back then. For better or worse the breast pump is what's fueling a much of today's debate. Now it's all about the medicalization of the milk--not that much about the mother. With breast pumps, you can get right back to work, and still do right by your baby. That breast milk can be given in a bottle--by anyone. Not just mom. Huh? What about longer paid maternity leaves, not breast pumps? And since hardly anyone can afford to not work these days, and hardly any employers can afford to give away 6 months of paid maternity leave, this debate isn't going away anytime soon.
Here's the recap of the recent Breast-feeding Wars:
1997: The American Academy of Pediatrics advises women to exclusively breast feed for six months, followed by six more months of partial breast-feeding, supplemented with other foods.
August 2008: "Most Moms Give Up on Breast-Feeding", this NYT story reports on the research published in the August 2008 issue of the Journal of Lactation. According to the article, three out of four new moms try breast-feeding over the bottle, but most of them have quit by the time the baby reaches six months. The report from Brigham Young University shows only 36 percent of babies are breast-fed through six months.
Why are women giving up? According to Dr. Renata Forste, the lead study author from Brigham Young University:
Here's what I had to say on the subject:
Dr. Forste is absolutely correct--–breastfeeding isn’t easy in the beginning and we’re just not prepared for that.
It really hurts until you toughen up; your milk takes days to come in; you get nervous that your baby isn’t getting enough to eat; breast-fed babies need to nurse every 2 hours in the beginning; you can get breast infections and cracked nipples with all that nursing; and there are lots of people around to encourage you to quit.
But if you can hang in there for 6 weeks, nothing could be easier, healthier, or more rewarding.
My now all grown up kids slept in their own rooms, self-weaned at 2 1/2, and took occasional bottles when I worked (part-time) or went out for the evening.
Your body adapts to the missed nursings. The babies adapt. Pumping was impossible back in the late 70’s & early 80’s, with only cheezy manual Playtex breast pumps available.
My doctor told me at 4 weeks I should stop nursing when I had a breast infection. I called La Leche instead, and took their advice to dose every 2 hours with vitamin C. It did the trick.
The fact that the kids stayed healthy & never had ear infections was a welcome bonus. Once you get over the initial trials, absolutely nothing could be easier.
-- The Healthy Librarian --
January 2009: The New Yorker article by Jill Lepore, Baby Food. If breast is best, why are women bottling their milk? This is a fascinating social political history of breast-feeding and how it fell out of favor in the early 1900's when it was replaced by the modern convenience of the bottle.
Although breast-feeding was resurrected & recommended by the American Academy of Pediatrics in 1997, it's never quite "caught on" because most mothers have to return to work before six months. The 1993 Family Leave Act guarantees only 12 weeks of unpaid maternity--in stark contrast to other industrialized nations.
Jill Lepore's article details the crazy-mixed-up policies that have grown up around this whole U.S. schizophrenia surrounding breast-feeding. Women are supposed to do it, but since they can't afford to stay home with their babies, the brilliant solution is to encourage breast-milk pumping in the workplace. In a "poor excuse for support for breast-feeding" WIC (The Women, Infants, & Children Program) permits the use of food-stamp funds to buy or rent a breast pump. Lactation rooms are now part of the workplace. I used to think Lactation Rooms were for breast-feeding--little did I know that they were for breast-milk pumping.
Bottom Line: "Breast-feeding rates increase with maternal age, education and income."
Lepore finally asks the important question. Is it the mother's milk that's the important part of breast-feeding or the mother?
April 2009: The Atlantic Monthly article by Hanna Rosin, The Case Against Breast-Feeding.
Hanna has three children, she nursed them all, but now with her third she's busy, she's tired & even though she wants to stop, she's sick of having to feel guilty about quitting, and feeling the pressure-of-the-playground moms.
Here's a little of what Ms. Rosin has to say about the subject:
Here's the American Academy of Pediatrics' response to Hanna Rosin's "review of the breast-feeding literature"
Here's a list of conditions where studies have shown positive evidence-based effects for breast-feeding for infants:
Acute Otitis Media
Atopic Dermatis
Gastrointestinal Infections
Lower Respiratory Infections
Cognitive Development
Obesity
Type 1 & Type 2 Diabetes
Risks of Cardiovascular Diseases
Infant Mortality
Childhood Leukemia
Infant Mortality
SIDS
However, Hanna Rosin does a much better job of pleading her Case Against Breast-Feeding in person, than she does in print. I got her point. I actually liked her. She won me over, after I watched her argue her case, along with three of her friends.
After watching it, I was sympathetic to Hanna's situation & her argument, sympathetic to her pediatrician who couldn't breast-feed her fourth child after having a double mastectomy, sympathetic to the Baltimore friend who wasn't able to breast-feed & courageously gave up on pumping her milk, and sympathetic to the New York work-at-home mom who was a breast-feeding booster.
If you have some time to spare, check it out on this YouTube video. It's 4 parts--all worth it--but watch one if you lack the time.
Here's the link to Hanna's compelling argument about breast-feeding. Click here.
April 2, 2009: The New York Times Opinion piece by Judith Warner, Ban the Breast Pump.
Warner's piece is based on Hanna Rosin's Atlantic Monthly article. She's buying into Rosin's argument to "Ban the Breast Pump". She's no fan of the pump--it made her feel like a cow. But she knows how dangerous such a remark can be. Breast-feeding has become sacred among some.
Here's what Warner has to say about Hanna & her buddies' breast-feeding discussion video:
Here's one of my favorites:
Above all, don’t beat yourself up and do what works for you and your family. Women spend too much time doing this as it is, and it only gets worse when you have kids.
Do I think breastfeeding is best? Well, it’s certainly a important biological mechanism that has been honed over time, and therefore a very important practice that does not deserve to be forgotten.
Is it easy? No. Is it always supported the way it should be? No. Is it for everyone? No, but I wish that choice were easier.
I have no doubt that nutritionally and immunologically it is superior, despite body burden chemicals. We no longer raise our children communally or with wet nurses (well, rarely) in the developed world so there will always be a need for formula, particularly for adoptive parents.
So this is where we are. Not perfect, but moving forward. I guess I find breast-feeding to be a fulcrum for talking about the importance of families and raising children well in a very busy, sometimes indifferent world. How we as women, families, society do that is to me one of the most important conversations we can have. It is important work and as such deserves our best thinking.
--Ana Folpe--
Oh Baby! There is a real war out there about Mother's Milk, and it's a pretty heated one.
And it's not as simple as, "Breast is best, do it for the health of your child." This is an emotional political, cultural, social, economic, psychological, physical and medical debate. I think I'm finally understanding its complexity--and bottom line: You've gotta do what you've gotta do. We all try to do the best we can for our children--but everyone's experiences are different.
Back in the late 70's & early 80's when I breastfed there weren't the piles of research out there to convince you of the benefits of breast milk. Any support I got in my effort to breast-feed came from books & phone calls to the mostly unknown Le Leche League. Back then, breast-feeding was more about bonding with your baby, the thought that maybe human milk was better for human babies, and the reality that it was so darn easy & convenient once you got the hang of it.
It was only years later that I read the research that confirmed what I suspected--there were benefits to breast-feeding, both to the baby & to the mother. But, medical research or not, it was a warm wonderful magical experience that by its very nature "forced me" me into hours of eye-gazing cuddling time with my babies every day. I didn't have to think about skin-on-skin cuddle time--it was a built-in part of the experience. The breast was instant comfort to crying upset babies--like magic--it was a powerful experience--and guess what--it had nothing to do with the milk.
And fortunately or not, breast pumps weren't viable options back then. For better or worse the breast pump is what's fueling a much of today's debate. Now it's all about the medicalization of the milk--not that much about the mother. With breast pumps, you can get right back to work, and still do right by your baby. That breast milk can be given in a bottle--by anyone. Not just mom. Huh? What about longer paid maternity leaves, not breast pumps? And since hardly anyone can afford to not work these days, and hardly any employers can afford to give away 6 months of paid maternity leave, this debate isn't going away anytime soon.
Here's the recap of the recent Breast-feeding Wars:
1997: The American Academy of Pediatrics advises women to exclusively breast feed for six months, followed by six more months of partial breast-feeding, supplemented with other foods.
August 2008: "Most Moms Give Up on Breast-Feeding", this NYT story reports on the research published in the August 2008 issue of the Journal of Lactation. According to the article, three out of four new moms try breast-feeding over the bottle, but most of them have quit by the time the baby reaches six months. The report from Brigham Young University shows only 36 percent of babies are breast-fed through six months.
Why are women giving up? According to Dr. Renata Forste, the lead study author from Brigham Young University:
"A lot of women don't understand the discomfort. They aren't
necessarily prepared for that. There is a sort of an expectation that
it's a very natural process--bring the baby to your breast and it's
very simple. But it's not. I think it's much more complicated than
that. It requires a lot more support."
"We're also a culture that is focused much more on bottle-feeding in terms of support networks. A lot of women have to return to work. They don't have the support in the work environment so they can continue to breast-feed. If you don't have support network around you, if you don't have a partner who is supportive, it's much more difficult to continue."
Over 500 very angry people wrote into the New York Times in response to this article--some who felt breast-feeding was just a luxury for the rich who could afford to take time off of work--some angry that they're made to feel guilty because they weren't able to breast-feed--and on and on. I told you this was a heated debate."We're also a culture that is focused much more on bottle-feeding in terms of support networks. A lot of women have to return to work. They don't have the support in the work environment so they can continue to breast-feed. If you don't have support network around you, if you don't have a partner who is supportive, it's much more difficult to continue."
Here's what I had to say on the subject:
Dr. Forste is absolutely correct--–breastfeeding isn’t easy in the beginning and we’re just not prepared for that.
It really hurts until you toughen up; your milk takes days to come in; you get nervous that your baby isn’t getting enough to eat; breast-fed babies need to nurse every 2 hours in the beginning; you can get breast infections and cracked nipples with all that nursing; and there are lots of people around to encourage you to quit.
But if you can hang in there for 6 weeks, nothing could be easier, healthier, or more rewarding.
My now all grown up kids slept in their own rooms, self-weaned at 2 1/2, and took occasional bottles when I worked (part-time) or went out for the evening.
Your body adapts to the missed nursings. The babies adapt. Pumping was impossible back in the late 70’s & early 80’s, with only cheezy manual Playtex breast pumps available.
My doctor told me at 4 weeks I should stop nursing when I had a breast infection. I called La Leche instead, and took their advice to dose every 2 hours with vitamin C. It did the trick.
The fact that the kids stayed healthy & never had ear infections was a welcome bonus. Once you get over the initial trials, absolutely nothing could be easier.
-- The Healthy Librarian --
January 2009: The New Yorker article by Jill Lepore, Baby Food. If breast is best, why are women bottling their milk? This is a fascinating social political history of breast-feeding and how it fell out of favor in the early 1900's when it was replaced by the modern convenience of the bottle.
Although breast-feeding was resurrected & recommended by the American Academy of Pediatrics in 1997, it's never quite "caught on" because most mothers have to return to work before six months. The 1993 Family Leave Act guarantees only 12 weeks of unpaid maternity--in stark contrast to other industrialized nations.
Jill Lepore's article details the crazy-mixed-up policies that have grown up around this whole U.S. schizophrenia surrounding breast-feeding. Women are supposed to do it, but since they can't afford to stay home with their babies, the brilliant solution is to encourage breast-milk pumping in the workplace. In a "poor excuse for support for breast-feeding" WIC (The Women, Infants, & Children Program) permits the use of food-stamp funds to buy or rent a breast pump. Lactation rooms are now part of the workplace. I used to think Lactation Rooms were for breast-feeding--little did I know that they were for breast-milk pumping.
Bottom Line: "Breast-feeding rates increase with maternal age, education and income."
Lepore finally asks the important question. Is it the mother's milk that's the important part of breast-feeding or the mother?
"Pumps can be handy; they’re also a handy way to avoid privately agonizing and publicly unpalatable questions: is it the mother, or her milk, that matters more to the baby? Gadgets are one of the few ways to “promote breast-feeding” while avoiding harder—and divisive and more stubborn—social and economic issues. Is milk medicine? Is suckling love?"
April 2009: The Atlantic Monthly article by Hanna Rosin, The Case Against Breast-Feeding.
Hanna has three children, she nursed them all, but now with her third she's busy, she's tired & even though she wants to stop, she's sick of having to feel guilty about quitting, and feeling the pressure-of-the-playground moms.
Here's a little of what Ms. Rosin has to say about the subject:
"The medical literature [on breast-feeding] shows that breast-feeding is
probably, maybe, a little better; but it is far from the stampede of
evidence that Sears describes. More like tiny, unsure baby steps: two
forward, two back, with much meandering and bumping into walls. A
couple of studies will show fewer allergies, and then the next one will
turn up no difference. Same with mother-infant bonding, IQ, leukemia,
cholesterol, diabetes. Even where consensus is mounting, the meta
studies--reviews of existing studies--consistently complain about
biases, missing evidence, and other major flaws in study design. "The
studies do not demonstrate a universal phenomenon, in which one method
is superior to another in all instances," concluded one of the first,
and still one of the broadest, meta studies, in a 1984 issue of
Pediatrics, "and they do not support making a mother feel that she is
doing psychological harm to her child if she is unable or unwilling to
breastfeed." Twenty-five years later, the picture hasn't changed all
that much. So how is it that every mother I know has become a
breast-feeding fascist?"
"Breast-feeding is a serious time commitment that pretty much guarantees
that you will not work in any meaningful way. Let's say a baby feeds
seven times a day and then a couple more times at night. That's nine
times for about a half hour each, which adds up to more than half of a
working day, every day, for at least six months. This is why, when
people say that breast-feeding is "free," I want to hit them with a
two-by-four. It's only free if a woman's time is worth nothing."
Gotta tell you--Ms. Rosin's attitude really got to me. For one thing--she's wrong about the scant medical evidence for the benefits of breast-feeding. Just take a look at the exhaustive Evidence Report/Technology Assessment Breastfeeding & Maternal & Infant Health Outcomes in Developed Countries, published in 2007 by the U.S. Agency for Healthcare Research & Quality.Here's the American Academy of Pediatrics' response to Hanna Rosin's "review of the breast-feeding literature"
Here's a list of conditions where studies have shown positive evidence-based effects for breast-feeding for infants:
Acute Otitis Media
Atopic Dermatis
Gastrointestinal Infections
Lower Respiratory Infections
Cognitive Development
Obesity
Type 1 & Type 2 Diabetes
Risks of Cardiovascular Diseases
Infant Mortality
Childhood Leukemia
Infant Mortality
SIDS
However, Hanna Rosin does a much better job of pleading her Case Against Breast-Feeding in person, than she does in print. I got her point. I actually liked her. She won me over, after I watched her argue her case, along with three of her friends.
After watching it, I was sympathetic to Hanna's situation & her argument, sympathetic to her pediatrician who couldn't breast-feed her fourth child after having a double mastectomy, sympathetic to the Baltimore friend who wasn't able to breast-feed & courageously gave up on pumping her milk, and sympathetic to the New York work-at-home mom who was a breast-feeding booster.
If you have some time to spare, check it out on this YouTube video. It's 4 parts--all worth it--but watch one if you lack the time.
Here's the link to Hanna's compelling argument about breast-feeding. Click here.
April 2, 2009: The New York Times Opinion piece by Judith Warner, Ban the Breast Pump.
Warner's piece is based on Hanna Rosin's Atlantic Monthly article. She's buying into Rosin's argument to "Ban the Breast Pump". She's no fan of the pump--it made her feel like a cow. But she knows how dangerous such a remark can be. Breast-feeding has become sacred among some.
Here's what Warner has to say about Hanna & her buddies' breast-feeding discussion video:
In coming weeks, as the news of their heresy spreads, they will undoubtedly roast in the hellfire of mommy-blog vituperation. *vituperation: abusive language
“(pumping my breasts) That was my least favorite thing I ever did in my whole life,” Washington writer Hanna Rosin says in a podcast conversation with three pals that accompanies her sure-to-be-controversial new feature, “The Case Against Breast Feeding,” on The Atlantic’s Web site.
Comments to Ms. Warner's piece had to be stopped at around 500. People certainly have very strong opinions when it comes to breast-feeding. Poor Ms. Warner is called lots of nasty names. I hope she has a strong constitution. There is a lot of vitriol and anger on both sides of the breast-feeding conundrum, and thankfully there are many reasonable understanding writers that make it clear, "Whether you choose to breast-feed or not, it's your choice. Your child will undoubtedly turn out well no matter what you choose."Here's one of my favorites:
Above all, don’t beat yourself up and do what works for you and your family. Women spend too much time doing this as it is, and it only gets worse when you have kids.
Do I think breastfeeding is best? Well, it’s certainly a important biological mechanism that has been honed over time, and therefore a very important practice that does not deserve to be forgotten.
Is it easy? No. Is it always supported the way it should be? No. Is it for everyone? No, but I wish that choice were easier.
I have no doubt that nutritionally and immunologically it is superior, despite body burden chemicals. We no longer raise our children communally or with wet nurses (well, rarely) in the developed world so there will always be a need for formula, particularly for adoptive parents.
So this is where we are. Not perfect, but moving forward. I guess I find breast-feeding to be a fulcrum for talking about the importance of families and raising children well in a very busy, sometimes indifferent world. How we as women, families, society do that is to me one of the most important conversations we can have. It is important work and as such deserves our best thinking.
--Ana Folpe--
In light of the information below, any argument/statement against breast-feeding seems awfully hallow.
"Here's a list of conditions where studies have shown positive evidence-based effects for breast-feeding for infants:
Acute Otitis Media
Atopic Dermatis
Gastrointestinal Infections
Lower Respiratory Infections
Cognitive Development
Obesity
Type 1 & Type 2 Diabetes
Risks of Cardiovascular Diseases
Infant Mortality
Childhood Leukemia
Infant Mortality
SIDS"
Posted by: Chris G. | April 13, 2009 at 01:16 PM
Chris, I strongly agree with you! It's just too bad that not everyone has the ability to stay home for the ideal 6 month-1 year with their baby. It makes nursing so much easier.
Your comment reminded me that I forgot to post a link sent to me by a reader. Very enlightening!
It's a 20-20 segment from a few years back about how the American Academy of Pediatrics efforts to place TV ads about the benefits of breastfeeding were thwarted by business interests that lobbied the gov't.
Here's the link
http://www.drjaygordon.com/development/media/2020.htm
Posted by: The Healthy Librarian | April 13, 2009 at 02:15 PM
It is a good site explaining about the health benefits of breast feeding and it will be very helpful for the first time mothers. Thanks!!
Posted by: Joe Lloyd | April 14, 2009 at 11:14 PM