Everyone knew it was the gold standard for both health and sophistication.
Doctors recommended it and were sure to do it themselves. This despite the fact that for hundreds of years there had been obvious casualties.
It’s wasn’t until the Surgeon General’s Report of 1964, that the truth was finally presented for all to see. Tobacco wasn’t safe and had never been safe. It caused cancer, heart disease and lung disease. Thousands of people had been dying each year for decades, so why hadn’t anyone noticed?
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Formula, not breastmilk, is the gold standard in infant nutrition.[/pullquote]
Marketing!
Breastfeeding is currently the gold standard for health and nutrition of infants.
Doctors recommend it and are sure to do it themselves. This despite the fact that for thousands of years there had been obvious casualties.
Aggressive breastfeeding promotion leads to tens of thousands of neonatal hospital readmissions each year in the US alone at a cost of hundreds of millions of dollars each year. Aggressive breastfeeding promotion causes neonatal brain injuries and deaths from dehydration, severe jaundice, low blood sugar and infants falling from or smothering in their mothers’ hospital beds. A single case of infant brain injury can cost millions in liability payments, not to mention the destruction of potential and the anguish of families.
So why hasn’t anyone noticed? Marketing!
As I explained yesterday, La Leche League, originally created by a group of traditionalist Catholic women in order to convince mothers of small children not to work, exploited the Nestle African tragedy to partner with the World Health Organization in promoting breastfeeding. Never mind that it was not infant formula that harmed babies, but the contaminated water used to make it. Never mind that children continued to die in their hundreds of thousands because they bathed in and ultimately drank that same contaminated water. This was the perfect opportunity to market breastfeeding and they took it.
They took it because it dovetailed neatly with their financial plans to profit from breastfeeding. At the same time that they partnered with the WHO to promote breastfeeding, they began to monetize it by creating the lactation consultant credential and lobbying heavily to install lactation consultants (themselves) in hospitals and doctors’ offices.
The heart of the marketing campaign was to convince everyone that “breast is best” and that breastmilk is “the perfect food.” Neither of those things were ever true (just as tobacco was never healthy) but after 30 years of marketing the average person “knows” that breastfeeding is the gold standard just like the average person in 1959 “knew” that smoking was healthy, or at a minimum, safe.
Don’t get me wrong: breastfeeding is not dangerous in the way that tobacco is dangerous. There is no safe way to use tobacco while millions of babies can be fully nourished with breastfeeding. But breastmilk is hardly the gold standard.
What would it take for something to be the perfect infant nutrition?
- It should contain all the nutrients and other factors that an infant needs.
- It must be available in sufficient quantity to promote vigorous growth of the infant.
- The infant must be able to access it easily.
Breastfeeding fails on all three counts. Breastmilk lacks sufficient iron and vitamin D; exclusively breastfed infants need vitamin supplements. As many as 15% of first time mothers cannot produce enough breastmilk to fully nourish an infant especially in the early days after birth. Moreover, a significant minority of infants cannot access milk from the breast. It has become fashionable to diagnose those babies as “broken” due to tongue tie and subject them to painful surgery though the scientific evidence provides no support for that treatment in the vast majority of cases.
You know what DOES meet the definition of the perfect infant nutrition? Formula!
It contains more nutrients than breastmilk. It is available in endless quantities. All infants can easily access it through bottles or feeding tubes.
In addition, it dramatically reduces the risk of neonatal hospital readmission, reduces the risk of dehydration, severe jaundice and low blood sugar, saving hundreds of millions of healthcare dollars and liability payments.
But, but, but breastfeeding is natural and formula is not. So what? Contaminated ground water is natural and filtered tap water is not. Living in caves is natural and central heating is not. Unvaccinated is natural and vaccines are not. In all three cases it is the “unnatural” that is far safer.
Wait, what? Formula doesn’t have maternal antibodies? That’s true, but the vast majority of antibodies a baby receives from its mother are transmitted across the placenta. Most antibodies in breastmilk can’t be absorbed through the infant gut; only the smallest antibodies, IgA, are biologically active within the infant. That accounts for the slight reduction in colds and diarrheal illnesses across the entire population of infants in the first year.
What about all those other benefits claimed for breastfeeding? Nearly all have been thoroughly debunked by careful studies that revealed that it is the higher maternal socio-economic status of breastfeeding mothers that accounts for benefits of breastfeeding, not breastfeeding itself.
I’m hardly the only person to point this out. Joan Wolf wrote in yesterday’s New York Daily News:
But, the WHO and myriad pro-breastfeeding groups will claim, the science on infant feeding is virtually unanimous. Breastfed babies are healthier, smarter and more socially successful than those who were formula fed throughout the life course, and formula feeding is dangerous. So they say.
The problem, as I have demonstrated in “Is Breast Best: Taking on the Breastfeeding Experts and the New High Stakes of Motherhood,” is that this research is poorly designed, executed and interpreted — and then grossly misrepresented among scientists and between researchers and the public.
Courtney Jung pointed the same thing out in her book Lactivism and an her op-ed in The NYTimes Overselling Breastfeeding:
Oddly, the fervor of breast-feeding advocacy has ramped up even as medical research — published in The Journal of the American Medical Association, BMJ in Britain and The American Journal of Clinical Nutrition — has begun to report that the effects of breast-feeding are probably “modest.”
Some sobering results have come from Dr. Michael Kramer’s Probit trial, which has studied a wide range of outcomes among about 14,000 mother-infant pairs for 16 years… While Probit found that breast-feeding had some benefits, including for cognitive development, it did not reduce the risk of obesity, asthma, allergies, dental cavities or attention-deficit hyperactivity disorder.
The benefits associated with breast-feeding just don’t seem to warrant the scrutiny and interventions surrounding American infant feeding practices… [A] meta-analysis of the research on breast-feeding done by the United States Agency for Healthcare Research and Quality in 2007 concludes that much of that research is weak: Some studies are too small, or they fail to control for confounding variables. The findings themselves are often inconclusive. One study will find evidence of an effect and another won’t — so we just don’t know which results to trust.
So why do we believe that breast is best? For the exact same reason we believed that tobacco was safe: marketing!
A new Surgeon General’s report might finally convince people that they’ve been duped by excellent marketing and that breast is NOT best for every mother and every baby.
I don’t see that on the horizon since most doctors of the early 21st Century are as enthralled by breastfeeding as the doctors of the early 20th Century were by smoking. I suspect that it will be insurance companies that will lead the way on this issue. Health insurers will realize how much they are spending on infant hospital readmission and will stop paying for it; as a result hospitals will revert to common sense in formula supplementation instead of aiming for lactivist ideological purity. Furthermore, malpractice insurers will look at the millions they are spending on babies falling from and smothering in their mothers’ hospital beds and pressure hospitals to bring back well baby nurseries instead of knuckling under to lactivist insistence on mandatory rooming in.
No matter how desperately lactation professionals continue to exaggerate the benefits of breastfeeding (the microbiome! epigenetics!) it simply costs too much in infant illness and death, maternal anguish and money to maintain the fiction — breast is best — that has been created through marketing.
Don’t believe me? I’d be happy to publicly debate (in print or in person) any well known lactation professional on this issue. Don’t hold your breath waiting for that to happen, though. No lactation professionals would dare subject their claims to a public debate; they know they would lose.
