Friday, March 20, 2009

Responses to Breastfeeding Article

As many people are already aware, a lot of attention has been given to a recent article in The Atlantic called The Case Against Breastfeeding. The article was then covered on The Today Show. The article's claim that there is a little evidence truly supporting breastfeeding is a disturbing one--and also quite incorrect. The Academy of Breastfeeding Medicine has issued a press release about the evidence basis and it is available here.

I was happy to see that the AAP also responded to the Atlantic article with the following:

AAP Responds to Breastfeeding Article in The Atlantic

You may have seen an interview on the Today show about breastfeeding based on an article that appears in the April issue of The Atlantic, entitled "The Case Against Breast-Feeding" by reporter Hanna Rosin. AAP President Dr. David Tayloe Jr. submitted the following letter to the editor of The Atlantic in response.

Letters to the editor
The Atlantic
Submitted via email
In the article, "The Case Against Breast-Feeding" by Hanna Rosin, the author skims the literature and has omitted many recent statements including the 2005 statement of the American Academy of Pediatrics which supports the value of breastfeeding for most infants. This policy references every statement with scientific evidence from over 200 articles which meet scientific standards for accuracy and rigor. The statement was meticulously reviewed by the Section on Breastfeeding, the Committee on Nutrition and numerous other committees and approved by the Board of Directors of the Academy. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, a study released by the Agency for Healthcare Research and Quality (the AHRQ Report) strongly supports the evidence of benefits demonstrated in the breastfeeding research. The evidence for the value of breastfeeding is scientific, it is strong, and it is continually being reaffirmed by new research work.

The American Academy of Pediatrics encourages women to make an informed decision about feeding their infants based on scientifically established information from credible resources.

David T. Tayloe, Jr., MD, FAAP
President
American Academy of Pediatrics


Since the evidence actually is quite clearly on the side of breastfeeding, the article made me more sad about the feelings and attitude of the author. She references feeling a good deal of pressure to breastfeed and that this is the new "problem that has no name." I feel for her. Mothers today have a LOT on their plates and a lot of pressure from every direction about every subject. Whether or not the pressure she felt about breastfeeding is real, her feelings are and I grieve for her.

Also, as happens whenever I read articles about breastfeeding, I have to marvel that the "burden of proof" rests on breastfeeding--why do we need to continually prove a physiological, specific-specific fluid superior to an artificial product? The science is reversed--researchers should be asking whether formula has any support or evidence and also for evidence that this non-physiologic substitute product does no harm. As Dia Michels says, the marketing task for formula manufacturers is to get women to withhold from their infants that which they already have and could freely give. This seems like it would be remarkably difficult to achieve (I often use an analogy about blood--it would be difficult to convince most people to have their naturally occurring blood removed from their bodies and a blood-substitute piped in instead...). However, as we are all aware, the marketing actually works very well. When reading the article above, I see again that answer as to "why withhold" is often cultural and social--mothers in the U.S. often do not live in an environment/life structure that is conducive to happy breastfeeding. And, bringing this on-topic, most do not give birth in settings, or with practitioners, or with birth practices that support breastfeeding as the normal, healthy, biological next step after giving birth (instead, over 30% of mothers are potentially launched into trying to create a breastfeeding relationship as they also try to recover from major surgery. Even more women are trying to do so after other less-than-ideal birth experiences and medical practices).

--
Molly
CfM Blogger

1 comment:

Jill said...

The whole article was almost one big ad ignorantum argument, but then she concluded that breast is probably best but formula is not that bad. What seemed to be one big "prove me wrong!" ended up as no solid case against breastfeeding at all.

The case against pumping was loud and clear. I had no hate relationship with my Medela.

I didn't feel sad, exactly, but I really empathize with the conflicted feelings that were the underlying and primary premise of the article. It was sort of about the milk, but not really.

Great tie in to the current situation in which 31.8% of women in this country are statistically at a disadvantage for breastfeeding right from the moment of their child's birth.