There’s nothing wrong with breastfeeding. There’s a tremendous amount wrong with the lactation profession.
How can that be? Aren’t lactation professionals simply promoting breastfeeding?
That was probably how it started out, but they quickly became obsessed with exclusivity; that fetish is harming babies and mothers.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There’s one infant feeding goal that eclipses all others: the baby’s goal to be fully fed.[/pullquote]
I can’t tell you when the obsession started; it certainly didn’t exist when my children were born in the late 1980’s and early 1990’s. But I can tell you when it became codified: 1996 with the publication of Diane Weissinger’s seminal paper Watch Your Language.
Weissinger drew the battle lines:
When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding…
That isn’t quite accurate — breastfeeding is a great, but not the best possible, way to feed babies — but it does highlight a central insight: lactation professionals recognized that when they tell the truth about breastfeeding, many women will choose not to do it.
Therefore, Weissinger encouraged lactation professionals to exaggerate the benefits of breastfeeding and massively exaggerate the “harms” from formula feeding. Her goal — and it became the goal of the profession as a whole — was to give women no choice but to breastfeed.
Why?
Weissinger was startlingly honest:
We cannot expect to create a breastfeeding culture if we do not insist on a breastfeeding model of health in both our language and our literature.
And:
All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances.
Do you see anything there about what’s good for babies and mothers? I don’t. I see an effort to create full employment for lactation professionals.
Lactation professionals did more than merely exaggerate the benefits of breastfeeding and concoct “risks” of formula feeding; they became obsessed with exclusivity.
Prior to the 1990’s the thinking went that if some breastfeeding is good, more breastfeeding is probably better. But that practical position hardened into the fabricated claim that “even one bottle of formula” can harm an infant.
Where was the evidence for that position? There wasn’t any. There wasn’t even a theory; the claims about the microbiome came a generation later.
Indeed, to the extent that research had investigated the issue, it was difficult to find any dose-response relationship for breastfeeding. Some minimum amount of breastfeeding (two months, for example) appeared to convey many of the SAME benefits as longer duration of breastfeeding.
No matter. Exclusivity has been fetishized and that obsession is responsible for the harms of breastfeeding promotion we see to day.
Exclusive breastfeeding is the LEADING risk factor for newborn re-hospitalization. It results in approximately 40,000 preventable newborn hospitalizations a year at a cost of hundreds of millions of dollars. Breastfeeding isn’t the problem; exclusive breastfeeding is.
How can that be? Breastfeeding, like any natural process, has a significant failure rate. Up to 15% of mothers may be unable to produce enough breastmilk to fully nourish a baby, at least in the days immediately following birth. That might sound high until you consider that fully 20% of established pregnancies end in miscarriage. Nature doesn’t do perfection; it does “good enough.”
Imagine how different the experience of breastfeeding could be if lactation professionals didn’t fetishize exclusivity: the benefits — medical, psychological and economic — could be enormous.
No baby would be forced to experience agonizing hunger; any mother who felt her baby needed formula could offer it.
Once home, women could both reduce pressure on themselves and get more sleep by allowing partners and family to feed the baby one or more bottles per day.
Women could more easily return to jobs and careers knowing that they don’t have to pump every two or three hours because the baby sitter or daycare provider can give formula if there is not enough stored breastmilk.
It’s not breastfeeding that is causing dehydration, starvation, maternal exhaustion, maternal guilt and shame; it’s the fetish for exclusive breastfeeding.
But wait! Aren’t lactation professionals merely helping women meet their breastfeeding goals?
Prof. Amy Brown asks What Do Women Lose if They Are Prevented From Meeting Their Breastfeeding Goals?
Many women stop breastfeeding before they are ready, often leading to feelings of anxiety, guilt, and anger. Critics of breastfeeding promotion blame breastfeeding advocates for this impact, claiming that if the focus were merely on feeding the baby, with all methods equally valued and supported, maternal mental health would be protected. Established health impacts of infant feeding aside, this argument fails to account for the importance of maternal breastfeeding goals …
But who made exclusivity a goal? It wasn’t mothers. Prelacteal supplementation is common in cultures around the world. It is lactation professionals who fetishize exclusivity.
But that reality doesn’t stop Brown:
The purpose of this article is to highlight the importance of recognizing and valuing women’s individual breastfeeding goals, and not dismissing or invalidating their experience if they do not meet these by telling them that they do not matter.
Brown seems to have forgotten the most critical goal of all, the one that eclipses ALL other goals: the baby’s goal to be fully fed.
The bottom line is that the obsession with breastfeeding exclusivity is a fetish of lactation professionals. There is very little if any scientific support for it; it is harmful to babies and mothers; and the only ones who appear to benefit from it are lactation professionals themselves.
