Hanna Rosin in the Atlantic.
One day, while nursing my baby in my pediatrician’s office, I noticed a 2001 issue of the Journal of the American Medical Association open to an article about breast-feeding: “Conclusions: There are inconsistent associations among breastfeeding, its duration, and the risk of being overweight in young children.” Inconsistent? There I was, sitting half-naked in public for the tenth time that day, the hundredth time that month, the millionth time in my life—and the associations were inconsistent? The seed was planted. That night, I did what any sleep-deprived, slightly paranoid mother of a newborn would do. I called my doctor friend for her password to an online medical library, and then sat up and read dozens of studies examining breast-feeding’s association with allergies, obesity, leukemia, mother-infant bonding, intelligence, and all the Dr. Sears highlights.
After a couple of hours, the basic pattern became obvious: the medical literature looks nothing like the popular literature. It shows that breast-feeding is probably, maybe, a little better; but it is far from the stampede of evidence that Sears describes. More like tiny, unsure baby steps: two forward, two back, with much meandering and bumping into walls. A couple of studies will show fewer allergies, and then the next one will turn up no difference. Same with mother-infant bonding, IQ, leukemia, cholesterol, diabetes. Even where consensus is mounting, the meta studies—reviews of existing studies—consistently complain about biases, missing evidence, and other major flaws in study design. “The studies do not demonstrate a universal phenomenon, in which one method is superior to another in all instances,” concluded one of the first, and still one of the broadest, meta studies, in a 1984 issue of Pediatrics, “and they do not support making a mother feel that she is doing psychological harm to her child if she is unable or unwilling to breastfeed.” Twenty-five years later, the picture hasn’t changed all that much. So how is it that every mother I know has become a breast-feeding fascist?
At some point, when I was a little bit obsessed with this topic myself, I looked a handful of studies and my experience was like Roisin’s; they all showed very small benefits, but I noticed that none of them tried to control for the socio-economic status of the mothers. Ever since I have been rather skeptical about the benefits, but have dutifully supported the breastfeeding of my kids, despite the difficulties that both they and their mother endured. Breastfeeding meant that for the first several months of each of their lives their primary relationship was with their mother, and everything I did with them had to be scheduled around the need for them to feed. With the first two, both of whom screamed pretty much constantly while awake for 4 months, I—and my wife—frequently went against our instinct that they were hungry, and refrained from giving them any formula (as the books tell you to), causing, I suspect, far more misery for all of us than was necessary.
My favourite La Leche League story (frequently referenced in Rosin’s article) is a from a friend who teaches high school. She asked a La Leche League counsellor how she could pump, given the brief breaks between classes, and the time it takes to let down. “well”, said the counsellor, “that’s easy, you just massage your breasts for 10 minutes before you pump”. “But I’m teaching in front of 30 teenagers in that 10 minutes before I pump, I can’t massage my breasts in front of them”. “Oh yes you can, they’ll soon get used to it”.
Siobahn, to whom I owe the link, says that her favourite line of the article is this:
“This is why, when people say that breast-feeding is “free,” I want to hit them with a two-by-four. It’s only free if a woman’s time is worth nothing.”