A skeptical look at breast-feeding

The anger and ridicule Gisele Bundchen attracted when she advocated a "worldwide law" requiring new mothers to breast-feed for six months mostly has to do, I would say, with the fact that mere mortals perceive she shares very few of the frustrations the rest of us deal with us on a daily basis.

But I think some of the rage comes from a certain rancor around the topic of breast-feeding, which has been presented in the last several years as the only acceptable choice for nourishing an infant, not only from a health standpoint, but also from a moral one. Not breast-feeding — for whatever reason, including such a worthy and often necessary one as a full-time job — has come to be regarded as thoughtless at best, abusive at worst.

But do women who reach for the formula deserve the sneers they get from breast-feeding partisans? Writing in The Atlantic last year, Hanna Rosin, journalist and mother of three, made "The Case Against Breast-Feeding," and an intriguing argument it is.

First, let it be said that Rosin did breast-feed her children. However, by No. 3, some of the negative aspects of breast-feeding — the huge investment of time it requires, and the toll Rosin believes it takes on the ideal of co-parenting with Dad, to name a couple — were making her wonder if the health benefits were really all they were cracked to be.

Rosin found evidence that they aren't. She writes:

Most of the claims about breast-feeding’s benefits lean on research conducted outside the lab: comparing one group of infants being breast-fed against another being breast-fed less, or not at all. Thousands of such studies have been published, linking breast-feeding with healthier, happier, smarter children. But they all share one glaring flaw.

The flaw is that the studies are observational, not randomized controlled trials, Rosin writes. Other variables than just breast-feeding might more easily affect the conclusions drawn from an observational study.

Exploring some of the studies that have given breast-feeding its good reputation, Rosin concludes that there are "clear indications" breast-feeding protects against gastrointestinal disease, at least in some cases, but only "murky correlations with a whole bunch of  long-term conditions." The evidence on enhanced intelligence in breast-fed individuals suggests "a small advantage," Rosin writes.

She writes:

So overall, yes, breast is probably best. But not so much better that formula deserves the label of “public health menace,” alongside smoking. Given what we know so far, it seems reasonable to put breast-feeding’s health benefits on the plus side of the ledger and other things—modesty, independence, career, sanity—on the minus side, and then tally them up and make a decision. But in this risk-averse age of parenting, that’s not how it’s done.

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