Tuesday, April 20, 2010

Cause of Death, Not Breastfeeding? The Bias That Won't Die

I was already cranky this morning.  The high pollen count, the cast on my arm, the missing english muffin thanks to last night's small but fearsome toaster oven fire.  And even though my doctor friends insist I couldn't possibly feel it, this headline in the New York Time's Science section raised my blood pressure:

Despite Advice, Many Fail to Breast-Feed

Next came the same old "breast-is-best" schtick thanks to a recent CDC report called, you'll love this, The Morbidity and Mortality Weekly Report.  Breast-feeding, rather NOT breast-feeding, is now officially linked to death.  Forget mere ear infections and bouts of gastro-intestinal distress.  We're talking The Great Beyond.  That Good Night.  The Big Dunkin Donuts in the Sky.   

This week's Vital Statistics column started with the usual American Academy of Pediatric's Antediluvian Recommendations (i.e. babies must be latched to breasts for a year or else risk disease and now undoubtedly death), persisted through the frequencies of breast-feeding and subsequent lamentation that more women don't give it a go.  Shame.  Because although the AAP says it's great, "less than 75% of women breast-feed at all."  Yes, as if 75% is a meek number. 

As if  children who drink formula are neglected, malnourished, in other words, fated to a life of crime, an early death, and suboptimal SAT scores. 

Honestly, I'm impressed that so many women try it.  Here's an idea.  Maybe women don't believe "the advice", don't perceive formula as "failure" or simply after 9 months of housing another person just want their bodies back to themselves. 

By the way, somehow whole generations of babies survived without breast milk, myself, case in point, born at 2 lbs., 6 ozs.  It hasn't killed me yet...

Of course the article didn't stop there.  Not without mention of the nearly beatified benefits of breast-feeding - by now so ingrained in the medical community and the public imagination they need no further explanation .... as if they're the sermon on the mount, a divine revelation from the infallible holy father. 

"The large number of benefits to mother and child" and then, the recent silly Pediatrics study claiming we'd save $13 billion and 911 deaths each year if 90% of mothers would just be good listeners and breast-feed exclusively for 6 months.  As if.

Can you imagine the public health folks?  If we could just convince them the benefits are real.  And that it's easy and free and green!  If we could just convince them they really, really like it.  Hey mommy, you like it!

The agony.  Need I remind myself I haven't lactated in over 3 years?  Yet I am still annoyed over the exaggerated data, the authoritative tone, the needless guilt.  Cranky enough to get me doing the one-handed pecking on the key board.  Thank goodness for the rational and courageous women at The Fearless Formula Feeder, PhD in ParentingScience-based Medicine and Free Range Kids who are not afraid to combat misinformation on this holy topic.  Job well done, ladies.  Thanks for putting the two latest breast-feeding "studies" into perspective.

I'm also thankful I don't have to personally brave the breast-feeding bias any more.  It's a relief to have children who drink out of cups and eat without bibs.

The fixation on the first year of nourishment is bizarre.  It's so intense compared to the second year of life.  It's as if the peril ceases at the first birthday.  Sure, we worry about childhood obesity, food allergies, trans fats, high fructose corn syrup, white bread and fruit without the organic label.  But it's not the same.  Sorry, Michael Pollan, it just isn't.  There's not as much guilt or anxiety involved.  Mercifully, we parents wise up over those early years. 

Thank goodness otherwise I might be even crankier and more distracted thereby setting untold numbers of meals afire.  Now there's a real hazard lurking around meal time.  Nothing like a few flames licking your kitchen cabinets to hone your risk perception.  Breast-feed, formula-feed, bottle-feed, whatever.  But please don't warm the taco shells in the toaster oven.

20 comments:

TheRextras said...

Agreeing with you wholeheartedly, MD - hope that helps your blood pressure go down. (You're too young for that, I think.) Wow. Coming out as a premie! Send my regards to your Mom. (Have you read my post: The NICU in 1978?)

I blame the media, MD. The formula is easily recognizable - the slant is meant to sell 'news' and news is a manipulated commodity. I'm pretty resistive to quoting the media outlet for this article, but you do well to lambaste their articles.

To share the benefits of bf and then allow each mother the benefit of choice without pressure is where I fall on this issue. Barbara

PS Glad your fire was put out and hope your cast is off soon.

The Fearless Formula Feeder said...

Polly, once again, you have brightened my day, made me chuckle, and feel less alone in the universe. :)

Like you said, my problem with this latest study (other than the provocation of a few ridiculous, misogynist headlines) is that it is OLD NEWS. One could almost call it punitive. We all know breast is best at this point. Anyone who doesn't is living under a rock, and no amount of scare tactics or propaganda is going to sway these folks anyway.

So, what we're left with is a group of women either 1) determined to breastfeed, which is great, but scared to death that it won't work, and therefore putting a ton of unnecessary pressure on already fragile new moms; 2) already formula feeding, so they feel like bigger failures than they already did - and now they are going to be running to their pediatricians screaming "is my child going to die because I gave him Enfamil??!!" (imagine the added healthcare costs surrounding THAT phenomenon); 3) women who are already breastfeeding, who will just feel better about themselves for doing something that is supposed to be natural, rewarding in and of itself, and "normal" and 4) a bunch of policy makers (ahem, including many men and people without infants) who will be exerting even more pressure on women to breastfeed, without ever personally knowing what it entails.

That was long-winded and bitter, I know. But I feel like we've seen evidence of my theory in just these past few weeks, and it scares me.

Polly Palumbo, Ph.D. said...

Hi, Ladies, always good to hear your refreshing remarks! As you both mention, thanks for reminding me, there are some benefits to breast-feeding. I do believe they're relatively small compared to the hoopla in the media and the AAP. If only more women would hear this! And make their own guilt-free choices - amen. Without the constant BF-is-best mantra and the consequences that you, FFF, documnent so well.

I can't help but think the brouhaha would subside if we hooked up the BF committee at the AAP, maybe a few researchers and journalists (male of course)up to double breast pumps everyday for a week. Do you think they'd changed their tune??

RX, love your new post on the special-needs theme park, sending to a few friends. But can't find your NICU post...will look again.

TheRextras said...

Sorry - usually leave directions but went long on that comment - NICU linked under Brain Food in middle column. Thanks so much for sending friends to me - the park is truly wonderful. Barbara

The Fearless Formula Feeder said...

"I can't help but think the brouhaha would subside if we hooked up the BF committee at the AAP, maybe a few researchers and journalists (male of course)up to double breast pumps everyday for a week. Do you think they'd changed their tune??"

Laughing. My. Butt. Off.

I think this should be mandatory before anyone is allowed to talk about breastfeeding.

Kidding, of course. However, there is this one woman who came on my blog a great deal, and who I am 99% sure is NOT a mother herself. For some reason, I just find it difficult to take breastfeeding advice/testimony from someone who has never experienced it viscerally. Of course, this doesn't mean people aren't allowed to study/research/have opinions on things they don't have personal experience with, but I resent someone telling me how "possible" something is when they haven't tried it.

janetlansbury said...

Thank you for making me smile and feel (a little) less insane in the online world. I have been reading as much as I can, working to come to grips with all the brouhaha, but am still baffled by the breastfeeding obsession. I really don't understand what people believe they are gaining by pushing our breasts down our throats! I am including a recommendation to this article and linking to it from my post about the controversy: Beyond Bottles and Breasts - The Key To Whole Baby Nourishment (Hope that's okay with you!)

Polly Palumbo, Ph.D. said...

Hi Janet! I don't completely understand the obsession either but somehow I cannot stop writing about it.

As you know there are so many other ways parents can nurture and enrich their children's lives. How/what to feed them is quite simple compared to other parenting tasks - especially the more complex and challenging ones like building confident, thoughtful,compassionate children who can follow their dreams and passions...and also live on their own after college.

TheRextras said...

Oh, goody! This is great discussion on social, uhm, stuff! Glad I came to the meeting, but holding onto my behind while I laugh, too.

Sniff. Sniff. I smell a hidden agenda. But perhaps going there will not be as useful as just saying uniformity in all parenting is a bad thing.

Shall we wave the flag of 'natural consequences'? BF experts canNOT show significantly different outcomes in children based on how they were fed as infants - esp in the long term outcomes that Polly states so well.

Pressed uniformity IS bad for all the 'natural' consequences that FFF said in her first comment.

What kind of commentary did NYT get on this article?

Barbara

Polly Palumbo, Ph.D. said...

Funny you should ask about the NYT comments - no comment section for this column. Annoying. As for the social/behavioral directions (i.e. anything not genetic) - well, I am a psychologist! Granted I've done a fair share of research in the intersection of health and education and psychology, I love neuropsychology but I'm always thinking (and worrying) about issues that don't lend themselves to simple studies, even with our new software and statistical methods.

The things some folks in the harder sciences diss until their kid needs a diagnosis or their career derails or their spouse leave them. Or they wonder why a gang of teenagers bullies another into suicide or beat immigrants to death.

Was there an agenda? Is it too hidden?

Polly Palumbo, Ph.D. said...
This comment has been removed by the author.
Polly Palumbo, Ph.D. said...

Along the same lines, health professionals and journalists and lactivists tend to forget the messy social (non-genetic)factors why women don't breastfeed for a year. Things like personal preferences, personality, lifestyle, the needs of other siblings, marital relationships, work assignments, who cooks,helps with homework, - all those messy, not so easily quantified (and thus studied and controlled) factors.

In other words, the factors that are nearly omitted in the health recommendations, the medical benefits of breast-feeding trumping the more social/cultural considerations.

Polly Palumbo, Ph.D. said...

Opps, somehow I posted my same comment twice. So the above deleted comment wasn't an inappropriate remark ripe for censure...but there's still time.

janetlansbury said...

Polly, I couldn't agree with you more! I sometimes get the feeling -- not trashing anyone -- that there is an attitude that if we give the breast 24-7, we've done our job. "We've got to use our mammalian instincts," HUH?! Mammalian instincts are great and all, but they only take us so far. Then we've got to kick-in the human ones! (If we want to raise a human child, that is.) We've got to use our brains, not just our boobs. :-)

Polly Palumbo, Ph.D. said...

Janet, very funny! Give them the boob and our job is done, amen. Too bad we're not hogs or chimpanzees...though even they display some parenting skills.

Estherar said...

Along the same lines, health professionals and journalists and lactivists tend to forget the messy social (non-genetic)factors why women don't breastfeed for a year. Things like personal preferences, personality, lifestyle, the needs of other siblings, marital relationships, work assignments, who cooks,helps with homework, - all those messy, not so easily quantified (and thus studied and controlled) factors.

I don't think they're forgetting those factors - it's just that a GOOD mom is supposed to suck it up and do it anyway, despite the hardships, because that's what good mothers are supposed to do. If they don't want to be lumped in with the bad, uncaring moms, that is. And

*sigh*

Great post!

Polly Palumbo, Ph.D. said...

Hi Estherer (Esther?)! Ah yes, The Good Mother. Which makes me wonder about all my fellow Women's Studies certificate holders (thanks to a truly liberal arts education) -are the all Good Mothers or do they see the ridiculous BF bias?

sarah said...

WOW .....you were very sarcastic and nasty and bitter......THis whole thing about feeding our pure innocent babies should not be about 'choice choice choice'. It is best for mom and baby and nature's perfect design so don't you think baby deserves mom's every last effort with breastfeeding ? That formula should be used when it is literally medically necessary? I hear the same thing about abortion....oh yah that's a choice. Do I wanna kill this baby or allow it to live ??? How about your 'choices' are what led you to become pregnant with baby,and you now have a responsibility to nurture and love baby as much as you possibly can....and a big part of love is making a 'choice' to do what is best for your baby,even if you are annoyed or inconvenienced by it.If you know the differences and you 'choose' to bottle feed without giving it everything you've got b/c well, you want your body back after being pregnant 9 months (again,your 'choice' and presumable we all know this includes 9 months of pregnancy, it's not something the baby is 'doing' to you it's just the way babies are made right ?)Well sorry baby ..even though I know all the risks of giving you this lab concoction that has hydrogenated oil and high fructose corn syrup and a 100 things I can't pronounce.....I'm gonna give it to you anyway cause well....it's 'MY' choice and 'I' don't want to breastfeed cause 'I' don't like it. There are a lot of very complex,confusing choices we face as parents and this one is kind of black and white.You have 2 basic choices...breastmilk or formula and the difference is clear and all the time they find out more and more about yes !!!! the risks of formula/not breastfeeding. I know a lot of women face a lot of complications etc with nursing ....but this whole ridiculous,selfish 'it's my choice and I don't WANT to' argument is horrible,shameful.Every woman ought to be giving it her all,it IS that important....every FF kid I've ever known has had some problem from it either straightaway or down the line.By the way if you look at the exact rate of FF increasing/breastfeeding decreasing since it was first introduced to our cluture...you will find that the rate of tonsssss of disease/sickness/obesity and other health and wellness complications have risen along with it, almost on a parallel.Silly studies ??? Who are you trying to kid ? Yourself I think.Why would they care to make this stuff up ? What do they have to gain from it ??? That would be a big fat 'nothing' !! Noone makes much money from breastfeeding increasing except the parents over time in what they save with health problems and other ff expenses they don't have.Formula is a biggg business making billions every year and they pay off ppl to help them out...politicians and the medical community are the biggest folks that are paid to shush and help continue the facade going that it's no big deal.Keep people like you fooled and convinced of utter nonsense...and spreading that misinformation to other women.Shame on you for helping to keep this lie going.Being a parent entails trying to conciously make decisions and to make this decisions based on what is the best for your baby's health and well being....NOT personal preference.....I mean....'choice'.......fight the good fight.It is a bad choice to choose formula ,plain and simple.If you tried your best and it didn't happen then that's one thing ,then it's a blessing....WHEN IT IS TRULY NEEDED !!!!!! Selfish.

Polly Palumbo, Ph.D. said...

Sarah,

Ordinarily I probably wouldn't publish your comment (in part bc it verges on a personal attack on not just me and those who actually question the current stance but others who use formula) but today I am because it think it shows how very far off actual facts and science this breastfeeding discussion has veered. Thanks for sharing.

sarah said...

The original post felt like an attack when I read it and it's detrimental to women who are still undecided about breastfeeding to say hey....you want your body back ???? you go ahead ,no big deal your baby will be fine really,just give em' the formula. The whole attitude of the post was disgusting.It's something that should be used when it is needed....after our best efforts to breastfeed.We need support,education and confidence.....everyone goes around telling women how harrrrd nursing is ans I think that perpetuates the difficulties !!! HAve resources and be prepared with support but don't expect it to be hard cause then you get nervous/worried/not relaxed and your body will be affected by this and likely not produce milk at its best.There is a strong connection between your mental/emotional state and the process of lactating and the baby latching well and all that.All the FF babies I know are overweight( some almost double !!)and have health issues.Time to stop pretending there are no risks and health complications from (not needing to but :choosing) to use something made in a lab to feed babies.The guy who created this stuff in the first place for women who really had issues with breastfeeding that could not be remedied or overcome..is probably rolling over in his grave at how many women use it when they don't need it.TEll yourself whatever you want todeny and ignore the truth about it so you don't feel guilty.....you all know in your guts that it is not right to ff when you don't truly need to.Period.I'm sure your instinct and gut tell you that if you don't shush it. We can do anything and live with it if we don't think about it too much and just put it out of our minds,instead listening to others who are doing the same patting you on the back saying it's ok !!! KEep telling yourself that.I'm not talking about women who have really given it a great effort and it's not working out(if it's not a physiological issue these women really needmorelove andsupport) I'm talking about the women who are putting other,significantly less important factors ahead of their child's lifelong health and wellbeing/development in their 'choice' to formula feed.I can't believe your a doctor...what about the hippocratic oath ???? hmmmmmm

Polly Palumbo, Ph.D. said...

Formula is hardly jeopardizing children's health - the data don't show but a handful of meaningful benefits. End of story.