Why breast isn't always best

The evidence suggests the health benefits of breastfeeding are negligible at best. What does the taboo around saying so tell us about attitudes to parenthood today?

Share

In the modern pantheon of Things You Can't Say, “it's okay not to breastfeed” has a prominent place. Breastfeeding, the story goes, makes babies happier, smarter, and healthier. Breastfed babies have higher IQs and more social mobility and are less likely to develop everything from ear infections and allergies to diabetes and leukemia. They're skinnier. They even wet the bed less in adolescence.

Sure, the vast majority of parents end up turning to infant formula at some point during the first six months. But this usually follows some effort to breastfeed and is almost always accompanied by an explanation of why breastfeeding was not possible under the particular circumstances.

Even formula companies, which have a vested interest in reducing breast feeding rates, concede that breastfeeding is better for babies and claim that their particular brand most closely approximates breast milk.  It's quite remarkable, when you think about it.  Imagine Coca-Cola advertising, “it's healthiest to drink water, but if you choose to drink soda, drink Coke.”

Three falsehoods

The “breast is best”mantra is all the more striking if you actually read the research comparing breastfed and bottle fed babies in the developed world. Almost all of it finds the health benefits of breastfeeding to be nonexistent, marginal, or impossible to disentangle from other aspects of a baby's life. The better a study is designed — the more it accounts for other health-promoting behaviors breastfeeding mothers and their partners are likely to engage in — the less breast feeding seems to matter at all.

And yet, in the moral crusade that breastfeeding promotion has become, formula is likened to nicotine and mothers who formula feed are essentially blamed for raising children more likely to be sick and a burden on public resources. How did we arrive at such a miserable state of miscomprehension and self-righteousness?

The answer rests on three fundamentally false beliefs: that every time scientific research finds a relationship between two phenomena, one necessarily causes the other; that people who behave responsibly and are willing to make difficult choices can prevent virtually all risk, including health risks; and that breastfeeding is free.

The truth is far more complicated. The overwhelming number of statistical relationships in epidemiological research are not causal. Personal responsibility is unobjectionable, in theory, but much more difficult to define and exercise given the structural constraints that limit people's choices, our limited knowledge of what actually constitutes healthy behavior, and the inevitable negotiation of trade-offs that is modern life.

Breastfeeding, moreover, can be expensive. Extensive evidence demonstrates that many women feel guilted into breastfeeding and that the process often entails profound physical, emotional, and economic costs for mothers and families. But we tend not to recognize these costs because we think it's just a mother's job to eliminate all risks, including those that are small, unlikely, and costly to prevent.

What science can't do

In Is Breast Best?, I invite readers to imagine if men had functioning mammary glands. Would breastfeeding seem as urgent? Or would we say that its benefits were marginal, at best, and that they certainly did not warrant the kinds of sacrifices breastfeeding demands? Would we say that breastfeeding is convenient and free, or would we be acutely in touch with its disruptions and costs?

When I've suggested that both breastfeeding and bottle feeding involve risks and benefits and that these must be weighed in individual context, I've been compared to Holocaust deniers and advocates of cold fusion. I've been called a lesbian and a feminist, as if these terms signal some pathology that automatically disqualifies anything I argue. I've been told, effectively, “you can't say that.”

The trouble is, we'd like to believe that science gives clearer instructions than it can and that mothers have a lot more control than they actually do. But there is no universal, low-risk way to feed babies or parent (or to live, for that matter). Transferring “it's okay not to breastfeed” to the pantheon of Things Every Parent Should Know might help us begin to understand that.

Joan Wolf is author of 'Is Breast Best?' and Visiting Fellow at the University of Kent's Centre for Parenting Culture Studies. She is giving an Open Lecture at the University of Kent on Wednesday at 6pm.You can find details here.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Tradewind Recruitment: Phase Co-ordinator for Foundation and Key Stage 1

Negotiable: Tradewind Recruitment: Phase Co-ordinator for Foundation and Key S...

Tradewind Recruitment: SEN Teacher

Negotiable: Tradewind Recruitment: SEN Teacher We have a fantastic special n...

Tradewind Recruitment: History Teacher

Negotiable: Tradewind Recruitment: My client is an 11-18 all ability co-educat...

Tradewind Recruitment: Year 6 Teacher

£100 - £150 per day: Tradewind Recruitment: Year 6 Teacher Birmingham Jan 2015...

Day In a Page

Read Next
 

If I were Prime Minister: Every privatised corner of the NHS would be taken back into public ownership

Philip Pullman
 

Errors & Omissions: Magna Carta, sexing bishops and ministerial aides

John Rentoul
Isis hostage crisis: The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power

Isis hostage crisis

The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power, says Robert Fisk
Missing salvage expert who found $50m of sunken treasure before disappearing, tracked down at last

The runaway buccaneers and the ship full of gold

Salvage expert Tommy Thompson found sunken treasure worth millions. Then he vanished... until now
Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Maverick artist Grayson Perry backs our campaign
Assisted Dying Bill: I want to be able to decide about my own death - I want to have control of my life

Assisted Dying Bill: 'I want control of my life'

This week the Assisted Dying Bill is debated in the Lords. Virginia Ironside, who has already made plans for her own self-deliverance, argues that it's time we allowed people a humane, compassionate death
Move over, kale - cabbage is the new rising star

Cabbage is king again

Sophie Morris banishes thoughts of soggy school dinners and turns over a new leaf
11 best winter skin treats

Give your moisturiser a helping hand: 11 best winter skin treats

Get an extra boost of nourishment from one of these hard-working products
Paul Scholes column: The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him

Paul Scholes column

The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him
Frank Warren column: No cigar, but pots of money: here come the Cubans

Frank Warren's Ringside

No cigar, but pots of money: here come the Cubans
Isis hostage crisis: Militant group stands strong as its numerous enemies fail to find a common plan to defeat it

Isis stands strong as its numerous enemies fail to find a common plan to defeat it

The jihadis are being squeezed militarily and economically, but there is no sign of an implosion, says Patrick Cockburn
Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action

Virtual reality: Seeing is believing

Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action
Homeless Veterans appeal: MP says Coalition ‘not doing enough’

Homeless Veterans appeal

MP says Coalition ‘not doing enough’ to help
Larry David, Steve Coogan and other comedians share stories of depression in new documentary

Comedians share stories of depression

The director of the new documentary, Kevin Pollak, tells Jessica Barrett how he got them to talk
Has The Archers lost the plot with it's spicy storylines?

Has The Archers lost the plot?

A growing number of listeners are voicing their discontent over the rural soap's spicy storylines; so loudly that even the BBC's director-general seems worried, says Simon Kelner
English Heritage adds 14 post-war office buildings to its protected lists

14 office buildings added to protected lists

Christopher Beanland explores the underrated appeal of these palaces of pen-pushing
Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Scientists unearthed the cranial fragments from Manot Cave in West Galilee