Breast is no longer best..

There have been a couple articles lately in the press about breastfeeding not being the best… that studies that show benefits to breastfeeding are weak, limited, etc. Interesting that this comes right before World Breastfeeding Week… Oh well, that’s to be expected, I guess.

But… one thing they probably did get right was that breastfeeding is NOT best. Shocking? Well, it’s true. It’s simply the biological norm. It’s an extension of pregnancy and birth that is the designed or hardwired expectation for both the mother and the infant. The “normal” way to feed babies. Other infant foods need to be measured against breastmilk. Period. Because breastfeeding is normal.

Ack! But then we have to talk about the downsides to NOT giving breastmilk to a baby and that makes MANY people uncomfortable. Because it’s not common for people to breastfeed, or at least to breastfeed for more than a few weeks. We’ve been indoctrinated for decades to believe that alternatives to breastmilk are safe and risk-free and so we see no real harm in using them if it becomes inconvenient or sadly impossible for us to breastfeed. But formula is not risk-free, even though it is quite common. And most people equate common with normal. The exception has literally become the rule in this case. Common and normal have two entirely different meanings.

Merriam-Webster definition of Normal and Merriam-Webster definition of Common.

Contrary to what the sensationalist news items say, the studies about the risks to not-breastfeeding are numerous and quite well documented. See the American Academy of Pediatrics Policy Statement on Breastfeeding and the Use of Human Milk. Every time they give a reference to a study there is a little number link that you can click on which will show you the study(s) it came from.

Let’s face it deciphering studies isn’t easy. A quick tip on putting information into real life application. ANY study is based on statistics. Percentages. How many times this happens if that occurs. For example, what is the risk of my getting hit while crossing the street? Does that risk go up if I cross on the crosswalk or between intersections? What is my risk of getting breast cancer? How does that increase? Or decrease? So when I see a study that says that babies who aren’t breastfed are at higher risk for ear infections… does that mean that any child who is not breastfed will get an ear infection? NO!!!!! Does that mean that if I breastfeed my child they will never get an ear infection? NO!!!! These studies determine relative risk. And studies help us determine what risks we want to take in our life. Sometimes they shape public policy (think smoking in public places and car seat usage) But they don’t determine INDIVIDUAL outcomes. Sometimes individuals “get lucky” and “beat the statistics”. An example of this is the oft repeated phrase, “But I did such and such, and I’m just fine!”. That’s great for them! But not a reason to dismiss the statistics on risk. How lucky are YOU? How about your child?

What is even more disturbing (at least to me) is that the studies have been out there for DECADES!!! Not just in the last few years. The health care industry has known about the risks to formula feeding for years and years and years… and yet you still hear that breast is best and the “benefits” to breastfeeding. Well, I’d like to say that there are NO benefits to breastfeeding. Zero, Zilch, Nada. Breastfeeding is just average, normal.

I guess I look at it like…. well, eating right for grownups. Eating home-cooked meals, made from real ingredients is physiologically normal, natural. Cooking from a box with processed ingredients is common, but not normal. And hey, I’ll admit it, I’ve done it myself. That doesn’t mean I don’t know the difference. And I make my decision on what to cook based on facts, convenience, mood, and let’s face it price. So… hmmmm, should I feel guilty that I have cooked processed foods? Well, yes, I guess. But if no one had ever told me how unhealthy it was… If there weren’t a million or so studies to show that processed foods are bad for my and my families health… why would I feel guilty? I would have the right to feel angry, betrayed, sad, regretful.. all those things. But, I DID and DO know. And if I choose to make a decision that I KNOW is not healthy…. well, I guess a certain amount of guilty feeling is entirely appropriate. But, I make my decisions for my own reasons and I live with them. It’s called personal responsibility. I shouldn’t rail at the health care community for making me feel guilty for not making healthy choices, should I?

I have the same philosophy for breastfeeding vs formula feeding. Every mother makes her decision based on her own criteria. One of my primary goals as a lactation consultant and health care professional is to make sure that a mom considers ALL the info when making that decision. Then… she’s a grownup and she can make her own choices. But if she KNOWS that there are risks to giving formula and she makes the decision to formula feed based on personal convenience or lifestyle or any non physical reason, then she is responsible for that decision and yes, a certain amount of guilty feelings might be appropriate. It certainly won’t be the last time ANY mother makes a decision that she feels guilty for later. Seriously! When you make a decision that you feel guilty for, that’s something to think about, not necessarily something to obsess over. Change it if you regret it and if you can. Move on if you don’t or you can’t.

What I can’t fathom is the paternalistic, we-don’t-want-moms-to-feel-guilty-so-we-won’t-tell-them-the-truth mentality that many, many health care providers have. It really irks me! I am a woman. I can take it. Tell me the truth and let me decide. I am not a child, so don’t treat me like one! I am able to make decisions by weighing the facts. I might not always decide what someone else thinks is best for me or my family. But I CAN make that decision, thank you very much. And as an IBCLC I promise to tell you the facts about breastfeeding, even if knowing the facts might make you uncomfortable with any future choice. I also promise not to put you down for those choices even if I might not agree with each and every one. (so far, I haven’t won the mother of the year award, hmmm…)

So if a woman decides to formula feed, after knowing all the facts and the risks, then she has to live with that decision, make peace with it, without rationalization. Take responsibility and move on. Just as we take responsibility for decisions on whether to vaccinate, send our kids to private/public school, let (or make) them walk to school instead of driving them, and a million other decisions we as moms will have to make in our kids lives.

On the other hand, if a woman has to give formula to her baby even though she would rather breastfeed, whether through misguided advice from her medical advisers or mismanagement of her milk supply due to getting the wrong info, or a physical reason — well, she might grieve, she might be angry, upset, sad… but why in the world should she feel guilty? What other choice does she have? Why would we withhold information about the risks of formula to her? Telling her there’s no risk and that it’s not a big deal? Wouldn’t that be treating her like a child? Protecting her from the cold, cruel world? Taking away her right to grieve for something lost? Belittling her desire to protect her child from harm?

Wouldn’t it be more honest to simply explain about the risks, explain the necessity to take the risks (ie, feed formula or baby starves.. helloooo which would YOU choose?) and help her come to terms with the loss or BETTER YET, if at all possible help her make it possible so she doesn’t HAVE to give formula if she doesn’t want to? What about donor milk? Why isn’t that more available? Why should any woman have to give formula if she doesn’t want to take that risk with her child? Shouldn’t health care providers be pushing for donor milk to be available and actually used???? Instead of giving free formula bags in case it doesn’t work out and which statistics show actually increases the chance that it won’t!.

Well, finally, I’d just really, really, really like you to think about the language you use when you talk or even think about breastfeeding… it’s normal, there are no benefits, it’s not “BEST”. It’s just in the design to breastfeed your baby.. Commiserate with those women who are let down by the health care system and were not able to breastfeed. Acknowledge the difference in anger, regret, betrayal, sadness, grief, loss and GUILT. Realize that if your neighbor/sister/mother/co-worker makes a choice that is not what you believe to be “right”, that it’s HER decision and not your business. Recognize your personal responsibility for your OWN choices. And most of all, ENJOY your baby and family!

Now, below is a You-Tube video clip which you might find interesting on the same subject…