Sunday, July 02, 2006

The Good Breast

[posted by dinah]

This one doesn't get a graphic.

From the opinion section of today's New York Times, "About Breastfeeding..."

If you want to start an argument, mention breast-feeding. A two-year federally sponsored campaign caused a rumpus when it compared a mother who fails to breast-feed with a pregnant woman who rides a bucking mechanical bull at a local tavern, or, in one official's formulation, with a woman who smokes while carrying a child. Recently, a Times article on the campaign incited a new debate that kept the report in the paper's most-e-mailed list for days. While we hesitate to stir things up again, it seems as if this is one issue where the middle ground makes the most sense.

The original article, Breast Feed or Else, by Roni Robin, was published on June 13th and states:

Ample scientific evidence supports the contention that breast-fed babies are less vulnerable to acute infectious diseases, including respiratory and gastrointestinal infections, experts say. Some studies also suggest that breast-fed babies are at lower risk for sudden infant death syndrome and serious chronic diseases later in life, including asthma, diabetes, leukemia and some forms of lymphoma, according to the American Academy of Pediatrics.

Both the original article and the opinion piece it inspired discuss some practical reasons women can't breast feed: the logistics of expressing milk at work, or the mother's inability to produce enough milk to nourish her infant.

From a psychiatric standpoint, breastfeeding is a good thing; it helps with the mother's bonding to the infant while creating an environment of closeness, warmth, nourishment, and comfort-- what could be better?

Neither article, however, mentioned what happens when a mother must take medications. The trend is to not only encourage mothers to breastfeed, but to demand it, and now to create the dictate that to not breastfeed is yet one more form of (granted, not yet indictable: sorry Clink and Foo) child abuse. The issue comes up in psychiatry over and over again in the treatment of Post-partum depression. In this condition, the depressed mother is already questioning her competence, she is prone to feelings of guilt, she may be struggling with remorse and distress if there was a separation due to her psychiatric hospitalization, and she may well need to be treated with medications. The last thing she needs is to hear she's harming her infant by not breastfeeding and that her inability to do so is akin to exposing her neonate to cigarette smoke or riding any kind of bucking broncho thingamajiggy.

While one jury's still debating the precise wonders of breastfeeding, another is debating the safety of exposing neonates to psychotropic medications via breast milk. I won't go into those studies here-- most of them look at the immediate effects, or those effects that occur up to age 2 so even if it's found to be safe, the utility of these studies is limited: I want to know how the exposed infants are doing at age 20.

Maybe we will find that early exposure does good things for the infant, maybe it will protect against future episodes of mental illness in a new human being who is already at increased risk (remember, this is my rambling, there is no evidence at all anywhere that this is the case!), maybe we will some day realize that prozac should be in the water supply. In the meantime, however, I'll continue to assume that psychotropic meds might do harmful things to the developing brain. Most of the women I see have stopped nursing before they've crossed my threshold-- it's just been too much to handle in their compromised state. All of them feel guilty. And while I agree that breastfeeding is the ideal, our worlds aren't always ideal or anywhere near it, and I'm left to say that generations of people were raised on formula and people turn out as they will. Zooming asteroids, terrorists, bird flu, and all those known & unknown toxins we drink and breathe, mostly we're just doing the best that we can in a world with no guarantees.

In case I messed up the links:

post partum depression:
Breast Feed or Else:
About Breastfeeding from today's opinion section:

[Pic per ClinkShrink]


Sarebear said...

I read somewhere that the health benefits and many of the studies are possibly geared to emphasize the benefits, and often a bit exaggerated. Especially when considering many other factors that affect the well-being, emotionally and otherwise, of the mother and child.

I hesitate to say this, but if a mother would feel too tied down and trapped and "forced" (not forced to breast-feed, but the constant demand feeling like a forcing, of sorts), the negative emotions associated with either of these will be much more impactful on the health or lack thereof, of the child, than all the touted benefits of breast milk.

There are many, especially the militant breastfeeders, who try to shove it down your throat (that you should breastfeed, not shove THEIRS down your throat), who may say, well, then you shouldn't have a child . . . .

And I say, formula was in use for many many years (for many many years formula fed babies grew to adulthood, and led healthy lives, long before what seems like the recent increase in cancers and all sorts of illnesses), and that people came out just fine. Including, most likely, themselves.

I feel like breastfeeding is more a lifestyle choice than health, although of course it's both, but I think the most vociferous supporters of breastfeeding would reject the "lifestyle" component at all.

I say, if it is so difficult to implement, emotionally and lifestyle wise for someone (my meaning of lifestyle for ME being it's a rather inflexible and rigid thing; formula allowing for much more feeding options, and people to feed the child, and many other aspects, and I do not do very well with rigid and inflexible things; in fact, they make me shut down), more power to em for bottle-feeding.

I say a bottle feeder shouldn't have to justify their decision to ANYONE; not the pediatrician, obgyn, b-feeding militia, more reasonable proponents of breastfeeding, doctors, husband even (as it's MY body, yeah it's their child, but it's MY body), etc.

There's a book out there called Bottlefeeding Without Guilt, that has a "quiz" in the back, that actually helped me feel MORE open to breastfeeding; it helps you figure out your attitudes toward your body and other issues that affect the matter.

But it's the only book I saw amidst shelves and shelves of breast-feeding propaganda (give me a book that promotes breast-feeding without looking down on bottlefeeding as a choice, without it being just because they, say, can't produce enough, and I'll be stunned).

Mebbe I should just delete this and go away.

ClinkShrink said...

Do the benefits of breastfeeding sextuple if you're a cat?

Big Lebowski Store said...


There's no question that breast-feeding is better than bottle feeding. How much better? Does it matter? Saying such a thing triggers such defensiveness!

Dinah's argument about women who can't breastfeed because they are taking medicines is a straw man. No one in his right mind would suggest that the fact that a woman cannot breastfeed is prima facie evidence of her inferiority!

After all, the pro-breastfeeding argument is not meant for the mothers who can't do it, it is meant for the mothers who can but choose not to.



Dinah said...

Thank you for your comments.

If only it were so....but the pressure is there and it comes from all directions, it's not a simple, Do it if you
Can, and if you can't, it's okay. Talk with any woman who wants to but can't (meds, insufficient supply, etc) and see how far down you have to scratch before you get to the guilt, the fear that they are inadequate mothers who are now raising immune-deficient, poorly-bonded children. I won't even begin to mention the fears the gung-ho lactation folks put into women's heads about the dreaded Nipple Confusion.

If the issue is one of making the practice acceptable and preferred among groups of people who previously wouldn't have considered it, then I'm all in favor. The women I see all want to, and feel expected to, breast feed, and when they can't , they feel they've failed in yet one more way. The message is out there.

Spiritual Emergency said...
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NeoNurseChic said...
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NeoNurseChic said...
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Dinah said...

Let me quote Judith Warner from her blog, Domestic Disturbances, tied to the NYTimes, she says it better than I possibly could:
"Rather, I think — and let me not mince words here — that bullying women into breast-feeding and vilifying those who don’t is disgusting. It is, I believe, profoundly wrong to make mothers feel that because they bottle-feed or bottle-fed their babies — from birth, as a supplement or after a return to work — they are unnatural, negligent, selfish idiots."

See her blog, with the 153 comments, if you want more:

The question is not one of what's better, but of both the Bullying factor, and the statement that to NOT breast feed is akin to purposefully put your child at risk.

Spiritual Emergency said...
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Serendipity said...

I think the problem with breastfeeding campaign is that women who bottlefeed thinks of it as an attack to them and they get very defensive about it.

I admit a broncho-riding-pregnant woman is rather harsh. Some women cannot breastfeed no matter how hard they tried.

I breastfeed all my five children. However, I never can sustain this form of feeding for longer than 12 months maximum, but mostly up to 5 months. I wouldn't want to be compared to that broncho-riding woman simply because my breast refuse to give any more.

The campaign should be focus on making it more comfortable for women to breastfeed in public instead of being looked on as a pervert.

Icaria said...

This is a rather old post, but as I read it, I had been hoping to see comments about extended breastfeeding and weaning. Particularly, I'd like to know what you all think about extended breastfeeding. I've done a little reading and it seems that in other similar animals (ie. non-human primates) that, based on a number of different factors such as size, etc, the offspring isn't weaned until between 2 to 7 years of age, often times.

In what I've read, a lot of women seem to reference this in support of extended breastfeeding and state that average weaning ages are closer to around 4-6 years, as opposed to the much younger ages that we often find today in the U.S.

I do recognize the benefits of breastfeeding, both biologically and psychologically, and I support breastfeeding if there aren't any other complications. That being said, I really feel that some of these weaning ages are just too old. A child of 4, 6, or 8 years of age takes full meals throughout the day, could even buy a meal if given money, is very active, and, typically, fairly capable of holding their own. Most children in the U.S. are not breastfed for such an extended length of time, and yet we turn out well enough. Sure, our country is obese and has a number of other health problems, but I have yet to hear that too brief periods of breastfeeding have been the root of these conditions. I honestly don't think breastfeeding is necessary at that late age.

Many women who support extended breastfeeding have, to some extent, blamed modern culture for placing the stigma on something so natural. There are a lot of ways of living that are natural. We wear excessive amounts of clothing and adornments and are surrounded by computers and machines. This is, in a sense, very unnatural. When we want to be natural, we go camping. On most other days, we sleep inside and use the microwave/stove/oven/grill, etc. We aren't in the wild and subject to invasion by countless pathogens with no way of defending ourselves. And we aren't starving either. That 8-year-old is just fine.

But I think part of the issue is also tied to sexuality. Personally, I do feel a bit weird when I see a woman breastfeeding her child in public (actually, even if I'm in her own house, haha), because it seems like such an intimate thing to do and I feel that I'm kind of invading that intimacy with her child. While these two are not on the same level, I kind of liken it to giving birth. Most women don't want just anyone watching them give birth. They're probably a bit sweaty, in pain, and overall not looking their best. At the same time, I don't really want to see every woman giving birth because there are a few parts of her body that I think are best kept between her and those who would make better use of them (partner, doctor, fetus-now-turned-newborn).

Icaria said...


Some say that today's culture has oversexualized the female body and that is why we are opposed to the whole idea. The woman's body may, indeed, be oversexualized, but I don't necessarily think that is something new. Throughout western history, a number of things have been attributed to the female form, including some element of sex, for quite some time. Perhaps, in the past it was associated more with purity and innocence and chasteness (or, at least, in terms of how it was described publicly, whether or not this was how it was thought of behind closed doors) and so such scenes were widely accepted. Today, I think our culture's view of the female body has changed quite a bit, and so seeing a woman's exposed breast, even though she is feeding her child, is more sexualized. Then, to see her publicly breastfeeding her child who is no longer a toddler, becomes unnerving, perhaps because now we are faced with a scene in which sensuality and a young child (which we, likely, view as a symbol of innocence and purity) are melded into one. Sex + child = bad and so... now we're having these discussions about what and what is not an appropriate place and length of time age-wise to breastfeed.


If it makes anyone feel better, I'm not a huge fan of all of the sex on tv/film, in music, and how openly sexualized modern culture is, but that's a different discussion entirely and this comment is already far longer than I had intended it to be. My apologies for that, by the way.