May 20, 2009
FAMILY MEALS FOCUS #37
Interpreting the news and research about feeding and eating

You will enjoy getting in on this debate if you haven't already. Well-known writer Hanna Rosin kicked it all off with an article in the Atlantic called The Case Against Breastfeeding. ''In certain overachieving circles, breast-feeding is no longer a choice - it's a no-exceptions requirement, the ultimate badge of responsible parenting. Yet the actual health benefits of breast-feeding are surprisingly thin, far thinner than most popular literature indicates.'' Rosin first flashes her breastfeeding-mother credentials, then goes on to say that, ''given what we know so far, it seems reasonable to put breast-feeding's health benefits on the plus side of the ledger and other things - modesty, independence, career, sanity - on the minus side, and then tally them up and make a decision.''

Others weighed in to support Rosin's point of view. Consider Dr. Esther's blog Breastfeeding Advocacy versus Lactofanaticism. As seems mandatory in this debate, MD Esther first shows her credentials as a breastfeeding mother and as a physician who supports breastfeeding. She states her carefully researched conclusion that ''As health measures go, breastfeeding is effective, but only moderately so,'' then gets to the heart of the matter: ''I believe in informing women and trusting them to make their own decisions, according to their own priorities and their own unique circumstances. I hate lactofanaticism [her word] it makes my job that much harder. It may initially guilt or scare women into breastfeeding, but once they run into the cold, hard wall of reality, false 'campaign promises' make it that much harder to persevere.''

After flashing her breastfeeding credentials, Judith Werner wonders in her New York Times blog Domestic Disturbances whether what's key about breastfeeding is the breastmilk or the act of breastfeeding. She decries the breast pump, Rosin's ''least favorite thing I ever did in my whole life.'' ''The grotesque ritual carried out behind closed office doors nationwide by beleaguered working mothers who are fully 'committed' (as the lactation consultants put it) to the goal of long-term, exclusive breast-feeding.''

The National WIC Association's Breastfeeding Committee partnered with sister organizations of the United States Breastfeeding Committee in a letter (click here) labeling Rosin's article ''highly problematic.'' After arguing that breast is best, the letter concludes, ''Ensuring that all women and families have the clear, balanced information about infant feeding choices to make informed decisions, and providing support through our health care system, workplace, and society, will ensure that all children can begin life in the healthiest way possible.''

Which brings us to, well, me. My credential: I breastfed three infants and have 8 breastfed grandchildren. In pro-breastfeeding committees and agencies, I am considered anti-breastfeeding. My books and handouts indicate that breastfeeding has a modest health advantage over formula feeding. More importantly, they support informed decision-making about breastfeeding. To my regret, I have found that breastfeeding enthusiasts do not welcome such informed decision-making. They are only satisfied with breastfeeding advocacy.

In my view, formula is good for babies. Breastmilk is better. Properly conducted, both breastfeeding and formula feeding support good health and appropriate growth. However, to thrive on either breastfeeding or formula feeding, the feeding relationship must be positive. If the mother feels uncomfortable with breastfeeding, the feeding relationship is impaired.

From my perspective as a specialist in parent-child feeding dynamics, I am most concerned about the impact of breastfeeding advocacy on equal access to health care. Whether the infant ingests formula or breastmilk, the bottom line is helping parents establish a positive feeding relationship with their baby. Parents who formula feed need just as much help getting on the same wavelength with their baby as do breastfeeding parents. To my sorrow, the needs of formula-feeding parents and their infants are generally overlooked. Almost without exception, breastfeeding parents get education and support. Formula-feeding parents get subtle or right-out-loud messages that they are giving their baby inadequate care.

Copyright  2009 by Ellyn Satter. Published at www.EllynSatter.com.

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DISCLAIMER: The information contained in Family Meals Focus is intended to inform our readers about issues relating to feeding dynamics in general and family meals in particular. It is not intended to replace specific advice from a health care professional. Copyright 2009 Ellyn Satter

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