March 10 2014

Why So Touchy About Breastfeeding?

Carrie L. Lukas

Last week, I noted that a new study calls into question previous studies about the many benefits of breastfeeding.

In that post, I mentioned that I am personally a huge believer in breastfeeding for many reasons and have put this belief into practice with my own kids. The point of my piece was to highlight that what all new moms hear about the superiority of breast milk for babies appears overstated. That's important information for women to have since some women simply can't breastfeed for physical reasons or have to make huge sacrifices to do so, and end up feeling guilty for not breastfeeding for as long as experts recommend. These women deserve a break: Let's stop the endless haranguing about the superiority of breastfeeding, especially when it may not necessarily be true.

Note that I got one important fact wrong in my post. I had suggested that the study found that breastfeeding seems correlated with less asthma, when in fact, it was the opposite: According to the new study, breastfed kids seemed to have higher incidence of asthma than their formula-fed siblings.

This post generated scores of comments on Facebook, most from those who are pro-breastfeeding and viewed my piece as an attack on those who breastfeed. Unsurprisingly, since I was suggested that previous breast-is-best studies were flawed, they claimed the sibling study I cited was flawed.

If that's true, I want to hear more. But so far, no one appeared to offer any actually critique of the study other that to allude to the idea that we needed to check on who was funding and writing it (because it just must be a formula company, right? Or some other evil right-wing group that wants (for unknown reasons) women to stop breastfeeding).

In fact, the sibling-study was conducted by the Ohio State University and hardly seems the product of a research team with an ax to grind against breast feeding. Here is a write up of the study:

“Many previous studies suffer from selection bias. They either do not or cannot statistically control for factors such as race, age, family income, mother’s employment – things we know that can affect both breast-feeding and health outcomes,” said Cynthia Colen, assistant professor of sociology at The Ohio State University and lead author of the study. “Moms with more resources, with higher levels of education and higher levels of income, and more flexibility in their daily schedules are more likely to breast-feed their children and do so for longer periods of time.”

Previous research has identified clear patterns of racial and socioeconomic disparities between women who breast-feed and those who don’t, complicating an already demanding choice for women who work outside the home at jobs with little flexibility and limited maternity leave.

Colen’s study is also rare for its look at health and education benefits of infant feeding practices for children age 4 to 14 years, beyond the more typical investigation of breast-feeding’s effects on infants and toddlers.

Federal health officials have declared breast-feeding for at least six months a national priority, which could end up stigmatizing women who can’t opt to nurse their babies, Colen said.

“I’m not saying breast-feeding is not beneficial, especially for boosting nutrition and immunity in newborns,” Colen said. “But if we really want to improve maternal and child health in this country, let’s also focus on things that can really do that in the long term – like subsidized day care, better maternity leave policies and more employment opportunities for low-income mothers that pay a living wage, for example.”

So much for the research being a tool of the formula industry or evil right-winger: She argues that instead of pretending that getting low-income moms to breastfeed will boost children's prospects, we need to focus on other things. I disagree with the other things she wants (the so-called living wage and subsidized daycare) for a variety of other reasons, but agree that the government should ease up on lecturing to low-income moms.

The superiority of using siblings to control for other environmental factors makes sense to me. Do any commentators have an actual reason to suggest that this concept or her execution was flawed?

Again, this study doesn't deny that there aren't some benefits to breastfeeding. This study focused on claims about long-term benefits, and allows that there are likely short term benefits in terms of reducing infant illnesses. That (and saving oodles of money on formula) is reason enough to breastfeed if you can, in my mind. Yet why is the pro-breastfeeding community so threatened by any suggestion that some benefits are overstated? Why do they seem to want to make moms who can't or don't want to breastfeed feel bad about it?

Activist groups have every right to push their agenda, regardless of what the stats say. The government is another story. Hard-earned tax dollars shouldn't be pushed into pro-breastfeeding propaganda. (Perhaps this is the reason that the pro-breastfeeding groups are so touchy about any study calling their cause into question? Should we really be looking into if they dependent on government funding for their own outreach work so they are the ones in a financial interest in pushing this misinformation?)

The bottom line is that women deserve to hear the facts—and the real facts, as best we know them to date—and then should be free to make decisions for themselves without any more cajoling from Uncle Sam.   

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