How do we know if a public health campaign works?
That’s easy. We check to see whether the benefits predicted — lives preserved, disease averted, money saved — actually occur when the plan is put into practice. In other words, we don’t accept theory; we demand proof.
That’s how we know that vaccines are a spectacular public health success. Just as predicted, near universal vaccination saved lives, averted disease and saved money on a grand scale. As a bonus, a major infectious scourge, smallpox, was wiped from the face of the earth.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Insist that breastfeeding professionals provide proof that theoretical predictions came true as breastfeeding rates rose and watch them fail.[/pullquote]
That’s how we know that anti-smoking campaigns are successful. Just as predicted, lowering the rate of smoking dramatically lowered the incidence of lung cancer, thereby saving lives, preventing related disease and saving money.
That’s how we know that the campaign for universal postmenopausal hormone replacement therapy was NOT a success. Not only did the benefits fail to occur as predicted, it led to a rise in breast cancer, an entirely unpredicted result.
What about breastfeeding?
Breastfeeding professionals have been promoting breastfeeding ever more aggressively since 1981. They’ve carried out informational campaigns, restricted formula advertising and instituted the Baby Friendly Hospital Initiative. As predicted, the breastfeeding rate rose. For example, in the US, the breastfeeding initiation rate rose from 24% in 1973 to nearly 83% today. Unfortunately, the predicted benefits have failed to occur, and an increase in neonatal hospital readmissions, brain injuries and deaths have been an entirely unpredicted results.
That’s why the most important thing to do during World Breastfeeding Week 2018 is pretty simple: demand proof!
When breastfeeding professionals claim that increasing the breastfeeding rate could save over 800,000 lives per year, demand proof!
Ask them to demonstrate how many lives have been saved as the US breastfeeding rate has tripled. They’ll be able to show you that deaths of premature babies have decreased because breastmilk lowers the risk of necrotizing enterocolitis (NEC), a deadly complication of prematurity. But they won’t be able to demonstrate that the lives of term babies have been saved because they haven’t.
When breastfeeding professionals claim that increasing the breastfeeding rate could prevent serious illnesses, demand proof!
Ask them to show how the incidence of various serious illnesses dropped. They won’t be able to do it because their predictions were faulty.
When breastfeeding professionals claim that breastfeeding saves money, demand proof!
Ask them to show you how many healthcare dollars have been saved as breastfeeding rates in the US have tripled. They won’t be able to do so because no money has been saved. While you’re at it, ask them to explain why hundreds of millions of dollars are spent each year on the tens of thousands of babies readmitted to the hospital for breastfeeding complications like dehydration, low blood sugar and jaundice.
When breastfeeding professionals claim that closing well baby nurseries to promote breastfeeding improves infant health, demand proof!
They won’t be able to provide it because they can’t provide evidence that increasing breastfeeding rates reduce deaths, prevent serious disease or save healthcare dollars. While you’re at it, ask them to explain the increase in sudden unexpected infants deaths from babies who are smothered in their mothers’ hospital beds as well as the skull fractures and deaths that result from babies falling from their mothers’ hospital beds.
Why is there such a tremendous gap between what breastfeeding professionals predict and what actually happens? There are lots of reasons: their predictions are based on studies that are weak and conflicting; their predictions are based on studies that are riddled with confounding variables: their predictions are based on assuming causation for every beneficial outcome correlated with breastfeeding despite the fact that we know that correlation does not equal causation.
Ultimately, though, it doesn’t matter why they are wrong; it only matters that they are wrong and you can prove it for yourself. The most important thing to do during World Breastfeeding Week 2018 is very simple. When lactation professionals claim breastfeeding has major health benefits — lives preserved, serious illness averted, healthcare dollars saved — demand proof. Then watch as they scramble to provide it and ultimately fail because their predictions did NOT come true.
