The Case Against Breastfeeding– A Review

“One afternoon at the playground last summer, shortly after the birth of my third child, I made the mistake of idly musing about breast-feeding to a group of new mothers I’d just met. This time around, I said, I was considering cutting it off after a month or so. At this remark, the air of insta-friendship we had established cooled into an icy politeness, and the mothers shortly wandered away to chase little Emma or Liam onto the slide. Just to be perverse, over the next few weeks I tried this experiment again several more times. The reaction was always the same: circles were redrawn such that I ended up in the class of mom who, in a pinch, might feed her baby mashed-up Chicken McNuggets.”

Thus begins Hanna Rosin’s controversial article with it’s super-charged title, “The Case Against Breastfeeding” in this month’s issue of The Atlantic.  And judging by some of the reaction to it, you’d think she had fostered an article titled “The Case for Disposing of Your Elderly Parents in Nursing Homes in Chad.”

She starts the article by describing her own journey from cheerful, diligent first-time mom, breastfeeding her babies for the full year recommended by the American Academy of Pediatrics, to third-time mom: “launching a new Web site and I had two other children to care for, and a husband I would occasionally like to talk to. Being stuck at home breast-feeding as he walked out the door for work just made me unreasonably furious, at him and everyone else.”

She goes on to describe how she and her middle to upper-class sisters, from Angelina Joli to the other playground moms, have been sold a bill of goods; told they can have equality with their husbands in all things– marriage, career and child-rearing– and then told by the same feminists, that ”breast is best” and nothing less than 6-9 months of it will do.  In an ironic twist of history, it was the  branch of feminism known as the women’s-health movement, started in 1971 with the publishing of  Our Bodies, Ourselves, that helped establish breastfeeding as the informed, strong, autonomous woman’s only responsible choice.  And, Rosin argues, it is this mind-set that starts the shifting of the burden of child-rearing gradually to the mother.  After-all, if she’s the one who feeds the child round-the-clock, she’s best suited to comfort him, should probably be the one to stay home from work when he’s ill, etc., etc.

Then the epiphany.

The writer says she was “sitting half-naked in public for the tenth time that day, the hundredth time that month, the millionth time in my life” when she happened across a Journal of the American Medical Association in her doctor’s office with an article about breast-feeding that planted the seed in her mind that the evidence for breastfeeding might be less conclusive than she had been led to believe.

“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…”

 She proceeds to review the evidence, the literature, the pop-culture ads and articles and comes up with one theme about the breastfeeding vs formula debate: the evidence is inconclusive, but what we are being told in popular media is not.

 She covers several topics from “the national obsession with breast milk as liquid vaccine”, the ethical roadblock to conducting truly randomized studies resulting in less than hard-science conclusions, the championing of breastfeeding by American Academy of Pediatrics in the ’90′s and the 2004 Department of Health and Human Services National Breastfeeding Awareness Campaign, and the incremental changes that have resulted in a preachy attitude of ”formula as public menace”.

“The ads came out just after my second child was born, and were so odious that they nearly caused me to wean him on the spot. One television ad shows two hugely pregnant women in a logrolling contest, with an audience egging them on. ‘You wouldn’t take risks before your baby is born,’ reads the caption. ‘Why start after?’ The screen then flashes: ‘Breastfeed exclusively for 6 months.’ A second spot shows a pregnant woman—this time African American—riding a mechanical bull in a bar while trying to hold on to her huge belly. She falls off the bull and the crowd moans…..What’s most amazing is how, 50 years after La Leche League’s founding, ‘enlightenment from the laboratory’—judgmental and absolutist—has triumphed again.”

Some of the critiques of Rosin’s article I have reviewed are that she comes across as an angry feminist and doesn’t do an andequate job of weighing all the evidence.  While I haven’t done much research into the science behind the breast/bottle debate (and without kids I don’t have a dog in the fight), I think the angry femenist argument is a cheap shot.  Hanna Rosin is simply too talented a writer for that type of dismissal.  While her article does come across as passionate and sarcastic at points, the deeper reality is that it is altogether human.  Even non-feminists who cherish their role as mother must have surely felt overwhelmed by the 24/7 responsibility of it all now and then, or wished they could be the one rolling over and falling back asleep after that waking cry at 2am.  And while the reader might not appreciate the sentiments that prompted her to review the evidence against breastfeeding, reviewing the science behind what the media and other establishments are pushing as the moral/scientific high-ground is never a bad idea.  (Did someone just say “global warming”?)

Rosin finishes the piece off by saying that despite her scientific findings and her underlying desire for an equal sharing of child-rearing responsibilities between parents, she continues to breast-feed Baby Number Three part-time, admitting that she doesn’t even know why she doesn’t just stop.  “I know it has nothing to do with the science; I have no grandiose illusions that I’m making him lean and healthy and smart with my milk. Nursing is certainly not pure pleasure, either; often I’m tapping my foot impatiently, waiting for him to finish…. My best guess is something I can’t quite articulate. Breast-feeding does not belong in the realm of facts and hard numbers; it is much too intimate and elemental. It contains all of my awe about motherhood, and also my ambivalence. Right now, even part-time, it’s a strain. But I also know that this is probably my last chance to feel warm baby skin up against mine, and one day I will miss it.”