On Saturday, I took Mike Woolridge, former director of Baby Friendly UK, to task over his inability to demonstrate the benefits of breastfeeding that he claims exist.
Mike has written a variety of highly offensive things. In response to the many women commenting whose babies have suffered from insufficient breastmilk, he obnoxiously declared:
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]I will not stay silent so that Mike and other lactation professionals can stay comfortable.[/pullquote]
They’re NOT starving and screaming in hunger, that’s just what you have culturally been indoctrinated to believe…
Referring to the fact that I breastfed my own four children, Mike made this bizarre claim:
Can you not see the profound ‘colonialist’, white-supremacist basis to this view? You’ve gained the benefit, but f**k everyone else.
But Mike feels he has been misrepresented and he has responded in a series of comments on an old Facebook post.
(1) I am NOT responsible for “extrapolation from smaller studies” either in relation breastfeeding or any other branch of Medicine. For the past 20 years, my role/job/paid employment has only ever been to evaluate the methodology of research studies, determine they’re appropriateness to the Null hypothesis being tested; determine whether the published statistics confirm that it is appropriate to reject the Null hypothesis; and whether the authors have limited their conclusions to the findings of their own study, or whether they’ve gone too far in extrapolating. That is the basis of CASP – the Critical Appraisal Skills Programme (UK); personally, I do NOT depart from these maxims, so you are wrong to accuse me of “extrapolation from small studies” in such an underhand way.
In other words, Mike has been extrapolating from small studies or quoting others who extrapolate from small studies. There is nothing underhanded about my claim. In some situations, especially in the early days of researching a particular topic, that’s all that anyone can do. But while that might have been appropriate evidence 25 years ago, we now have 25 years of data on what has happened as breastfeeding rates have risen dramatically. Breastfeeding researchers made a variety of predictions based on their extrapolation from small studies and with the exception of a reduction in NEC in premature babies, those predictions have not come to pass.
It’s not underhanded to continue to rely on extrapolation of small studies when those conclusions are not confirmed by evidence from larger groups followed over longer periods of time; it’s unscientific. The continued insistence by Mike and other lactation professionals that breastfeeding has major benefits for term babies reflects the fact that they view their beliefs about breastfeeding as non-falsifiable; that’s also unscientific.
Mike writes:
(2) You seem obsessed with the notion of there being a ‘Breastfeeding industry’ out there (as opposed to a huge ‘Formula Industry’) – I dispute that assertion and would like to make clear I have never “earned a salary by promoting breastfeeding”.
He then goes on to detail his job and research history that reveals — surprise! — his income comes exclusively from researching and promoting breastfeeding.
Over a 2 year period, 1993-95, I earned half my salary by developing and implementing a strategic plan for introducing UNICEF’s BFHI scheme into UK maternity units, and UK culture (I can supply you with a copy of the multi-faceted strategy I drew up). My job was to implement the initiative, not sell or promote breastfeeding because I had a personal mission to do so.
Mike wasn’t promoting breastfeeding because he had a personal mission or was receiving money for it; it’s apparently a coincidence that he was promoting breastfeeding because he took a job and accepted income for promoting breastfeeding. Does anyone understand the difference between these two things?
The rest of my salary, both before and after, was derived from research grants which I personally competed for.
All of which were predicated on and strove to support the belief that breastfeeding has major benefits.
So far as I can determine 100% of Mike’s income over the past 25 years has come from promoting breastfeeding.
Mike considers that the fact that he has taken money from the formula industry to research and speak about the benefits of breastfeeding as mitigating.
I have been excluded in recent years from speaking at UNICEF BFI conferences and events because of these links to industry, although I have delivered plenary talks to ILCA and ALCA. Additionally, following a recent presentation I made to the Nestlé Nutrition Institute Workshop, my services are no longer required by four international organisations: LLLI, LLL-GB, the Association of Breatsfeeding Medicine, and ILCA (having previously acted as professional adviser to certain of these).
This doesn’t change the fact that 100% of Mike’s income over the past 25 years comes from promoting breastfeeding.
Mike goes on:
(3) I utterly reject your assertion that the “benefits of breastfeeding in industrialised countries are almost entirely theoretical”
Why? Mike offers the logical fallacy Argument from Authority.
I can count at least two dozen national and international agencies, institutions, professional bodies and organisations which agree with my view …
Arguing that something is true because authoritative figures and organizations claim it it true is a valid strategy in most situations EXCEPT when asking whether authority figures and organizations are wrong. For example, 30 years ago I could have argued that episiotomy prevented vaginal/perineal tears because every major obstetrical organization and textbook claimed that it did. They were wrong and they recognized it when they new data was published that questioned and ultimately debunked what had been a time honored principle of obstetrics.
The two dozen national and international bodies that Mike invokes are also wrong. The big difference is that they refuse to recognize their mistake despite the fact that looking at larger populations for longer periods of time reveals that their claims — made because of extrapolation from small studies — cannot be true.
Mike ends in a huff:
This rest of this paragraph amounts to online abuse. “You’ve basically acknowledged…” No I haven’t, neither covertly nor overtly, that “…it doesn’t matter to you what the population data shows…” – it DOES MATTER very much indeed, which is why I only accept the evidence when it has been statistically proven to apply to populations. “…your career and self-image rest firmly on pretending breastfeeding has major benefits and you won’t be moved by mere facts” – this is slanderous and amounts to defamation of character, on which you need to be extremely careful.
I’ll take my chances, Mike.
Right now literally tens of thousands of babies are being hospitalized each year for iatrogenic complications because lactation professionals like Mike routinely exaggerate the benefits of breastfeeding and ignore (and in Mike’s case, actually deny) the fact that insufficient breastmilk is common.
I will do whatever I can to reduce the suffering of babies and mothers. I will not stay silent so that Mike and other lactation professionals can stay comfortable with the harm they have done and continue to do.
