March 16, 2009
A storm is brewing against breastfeeding with tomorrow’s publication of Hanna Rosin’s The Case Against Breastfeeding. Rosin was also featured on the Today show this morning, along with Dr. Nancy Snyderman deriding the medical research on breastfeeding. Their discussion points to a much bigger issue: it can be very challenging to breastfeed in the United States.
The CDC recently found that 60% of women do not even meet their own breastfeeding goals, and even fewer meet the universal medical recommendation to breastfeed exclusively for 6 months with continued breastfeeding for the first 1-2 years of life. These recommendations are for all women and babies, including the waitresses and bus drivers whom Rosin discusses. The US is the only developed country in the world without paid maternity leave. In the few states where they are in place, worksite breastfeeding laws help mothers in all kinds of jobs, but in most states, women must do without any support, and currently most women can’t afford just to stay home.
Both the Atlantic and the Today Show focus solely on breastfeeding as something mothers feel pressured into doing for the good of the child. Neither source notes that breastfeeding is important for a mother’s health as well: early cessation of breastfeeding is linked with increased rates of breast cancer, ovarian cancer, diabetes type 2, and coronary artery disease.
Rosin’s selective citing of the scientific literature suffers from a serious lack of fact-checking from the Atlantic editorial staff. The most recent comprehensive, objective analysis on the risks of not breastfeeding comes from the Agency of Healthcare Quality Research (2007). This report conclusively links early weaning to increased risks of maternal and childhood disease, including childhood obesity. “With an epidemic of obesity in this country threatening our collective health and our economy, now is not the time to make the case against an effective preventative measure,” says Dr. Melissa Bartick, an internist and chair of the Massachusetts Breastfeeding Coalition (MBC).
The expert scientists of all major medical organizations recommend breastfeeding based on their organizations’ review of the literature. Says Marsha Walker, a nurse and Board member of MBC: “These folks are the MD’s and the PhD’s who know their way around meta-analyses, Odds Ratios, Hazard Ratios, p-values, and Relative Risks, and who can tell us a lot more than one ‘paranoid sleep-deprived mother of a newborn’” which is how Rosin describes herself in the article. “Medical authorities aren’t always right about everything,” says Bartick, “but for now, the best information we have about breastfeeding suggests that the US needs to do a whole lot more to support it than we currently offer,” says Bartick. “Instead of pitting women against each other, we should be using that energy to advocate for giving all families meaningful support, from the hospital to the worksite.”