I was pointed to an article in the April 2009 issue of The Atlantic, The Case Against Breastfeeding. Hannah Rosin is a mother of 3 (and, to read the article, an ex-compatriot of mine) who dutifully nursed her first two children until they were a year old, as per the AAP’s recommendation. However, when her third child arrived, she found herself thinking heretical thoughts:
I dutifully breast-fed each of my first two children for the full year that the American Academy of Pediatrics recommends. I have experienced what the Babytalk story calls breast-feeding-induced “maternal nirvana.” This time around, nirvana did not describe my state of mind; I was launching a new Web site and I had two other children to care for, and a husband I would occasionally like to talk to. Being stuck at home breast-feeding as he walked out the door for work just made me unreasonably furious, at him and everyone else.
In Betty Friedan’s day, feminists felt shackled to domesticity by the unreasonably high bar for housework, the endless dusting and shopping and pushing the Hoover around—a vacuum cleaner being the obligatory prop for the “happy housewife heroine,” as Friedan sardonically called her. When I looked at the picture on the cover of Sears’s Breastfeeding Book—a lady lying down, gently smiling at her baby and still in her robe, although the sun is well up—the scales fell from my eyes: it was not the vacuum that was keeping me and my 21st-century sisters down, but another sucking sound.
Rosin had stumbled upon the major disadvantage of exclusive breastfeeding: only you, Mom, can do it, and it tends to tie you down (and no, not everyone can breastfeed while running about with babe in a sling). As a result, she started looking into the benefits of breastfeeding – the actual scientific studies, not the hype put out by Dr. Sears and co. While I tend to be a bit more optimistic than she is about the benefits of breastmilk (even in the whitebread upper-middle-class world she lives in), I do agree with the conclusion:
So overall, yes, breast is probably best. But not so much better that formula deserves the label of “public health menace,” alongside smoking. Given what we know so far, it seems reasonable to put breast-feeding’s health benefits on the plus side of the ledger and other things—modesty, independence, career, sanity—on the minus side, and then tally them up and make a decision. But in this risk-averse age of parenting, that’s not how it’s done.
Which is very much what I’ve been saying for years, including in this post: breastfeeding is a moderately successful health measure, but it doesn’t have to be an all-or-nothing proposition and despite its proven benefits (the ones best grounded in research are related to prevention of infectious disease), the desicion to breastfeed should not override every other consideration.
Rosin mentions another dirty little secret about breastfeeding: because only Mom can do it, it can (and quite often does) cause a shift in the balance of power between partners. I’m happy to say from experience that it doesn’t have to be this way, if you and your partner acknowledge this and either take steps to correct this imbalance (e.g., Mommy feeds, Daddy changes the poopy diapers) or take care the balance is restored once the baby is weaned or takes bottles of breastmilk.
Speaking of the use of expressed breastmilk, I had a woman in last week with her 2.5 week-old newborn. Despite having nursed her previous four children and enlisting the help of the LC in the convalescent home she stayed in after the birth, this baby was having severe difficulty latching on due to tongue-tie, which the ENT will hopefully fix soon. However, she decided that even after his tongue is fixed, she’ll continue to exclusively pump. Her reasoning? She has four other children to run after, she finds pumping goes faster and easier for her, and her older children and husband can help feed the baby if she’s busy.
Rosin, however, ultimately opted for another compromise: she breastfeeds around her working hours, but her baby gets formula when she’s not there. I wish all women felt as free to make these decision without fear of facing public censure.
The 4-part podcast that accompanies the article is interesting as well. Hannah Rosin discusses the issues in the article with three of her friends. I was especially taken with the perspective of Dr. Meri Kolbrener, a fellow family physician. Her personal story is especially interesting – having four total years of nursing under her belt and enjoying it thoroughly, she underwent a double mastectomy for breast cancer when her youngest was a mere 8 weeks old. She, wisely I think, declines to speak about the purported reduction in premenopausal breast cancer that breastfeeding is supposed to confer (understandably; my own take on this is that the research has not finished hashing this out yet. Also, though giving birth to more children at younger ages is also considered protective against breast cancer, we don’t go around telling women they should start popping out babies – as many as possible, as soon as possible – for their own good, either.). But she does make mention of the AAP being subject to politics like any other organization – which could explain its inclusion of Kathy Dettwyler’s garbage in its breastfeeding policy statement, and last month’s embarrasment (I find it amazing their conclusions and analysis passed peer review, and discuss the study here).
While I don’t agree with everything said, I am happy to see women talking back and challenging the Breastfeeding Police, and demonstrating that breastfeeding doesn’t have to be all-or-nothing.
UPDATE: Interview of Rosin vs. Dr. Nancy Snyderman at NBC (well, technically. They don’t seem to disagree on all that much).