Another “breast is best” article this week. By now we all know the data and the perks and benefits to breast feeding. As the expert in the AP report noted:
Formula isn’t as good at protecting babies against diseases, eczema and childhood obesity. Ideally, nearly all mothers should breast-feed their babies for six months or more, said Dr. David Paige, a Johns Hopkins University reproductive health expert.
At the same time, as the same AP report pointed out, many women opt for bottle feeding for many reasonable logistical reasons:
their jobs, the inconvenience, and perhaps because of convincing advertising for baby formula.
OK, I’m not sure I buy that advertising is a “reasonable” reason but it was part of the quote so I included it. However, logistics are important to consider and as a woman who has faced this “breast vs. bottle” crisis twice and as a pediatrician who has counselled hundreds of women in my career through this crisis, I’m become angry and disappointed by the continued guilt of “do it because it is best”.
Women have lives and live within a family. They are not caring for their babies in a vacuum. Whether breast is truly “best” or we are arguing a statistical advantage is not the point. The point is if we are to convince women to exclusively breast feed and not use alternative options such as a bottle we have to make sure that they can do so in the real world. At the moment, that is just not a possibility for most women. At least, not the women I come across.
So, while it is great for the government to come up with goals such as having 60% of women breast feed exclusively for the first 3 months and 25% by 6 months, the government also owes it to these women to sort out very important work place issues and public breast feeding issues. Maternity leaves have to be longer and paid. Work places and public places have to be breast feeding friendly. And, the public has to become more accepting and aware that breast feeding is the norm.
What I find intriguing is that clearly there is a disconnect within the medical field. Just recently a medical resident was not allowed to take her boards because she asked for a way to breast feed her infant. If within the medical field we are not going to support breast feeding how in the world can this work for 6months in the outside world??
Don’t get me wrong. I happen to believe in the benefits of breast feeding as a scientist and physician. But, as a woman and a realist, don’t throw away the bottles just yet. There is a lot of work to be done before this government plan will become a reality and 2010 sounds like a pipe dream for that to ever occur.
BTW, I can’t help thinking of the show “stop the world, I want to get off” whenever the government comes out with proclamations as they have this week! I find it doubly interesting when the researchers interviewed are men. I’ll leave that for now but this is not about academics but real world issues. Let me tip my hat to say that when I talk to a young couple who just had a baby I tell them I’m a “just feed the baby” doc. They don’t need any more guilt than they have. Breast, bottle, both…it is there life and my job is to support them to feed their baby in a way that works for their life. This is where clinical medicine and science often diverge. As compassionate physicians, how can we do any less? I feel it is our job to acknowledge that. Just my 2cents but this government campaign stirred my inner anti-guilt pot!
There truly is nothing better than breastfeeding.
And there truly is nothing worse than being inundated with “breast is best” and finding that even with all the lactation support in the world, you cannot produce enough milk to sustain your baby. Hello, post-partum depression.
Deb:
I’m truly glad it worked out for you!
Anonymous:
You proved the point in my post and I hope the government finds a way to include an ounce of understanding wanting to breast feed isn’t always enough.
Dr. G
In an “ideal” world, all women would be healthy enough to breastfeed and so would their babies. They’d get the time and support necessary to make it possible and they’d all WANT to do it.
We certainly don’t live in an ideal world. Women have many legitimate reasons for using bottles to feed their babies. Thank goodness they’re available. And yes, I breastfed all of mine for a minimum of 10 months, but some days I had to go to work. You get really sick of the pump after a while.
Anonymous 12:47 has it right. I think the metabolic stress of lactation can (under some circumstances) lead to postpartum depression, and if continued can lead to postpartum psychosis.
http://daedalus2u.blogspot.com/2007/08/low-nitric-oxide-acute-psychosis.html
It is simple energy physiology. Mothers living in the “wild”, needed a way to shed metabolic load if they could not sustain their infants. Evolution gave them one.
I was surprised that a lot of the criticism of the Mom who wanted to complete her boards and breastfeed got a lot of criticism from women who were questioning her professionalism and commitment. Goodness knows it is hard enough being a Mom to an infant as well as a professional without attacking eachother!