Putting motherhood on the clock

One of Hanna Rosin's grievances against breast-feeding in "The Case Against Breast-Feeding," her article last year in The Atlantic, is that it prevents women from doing work that would be more productive, or at least more lucrative.

"It is a serious time commitment that pretty much guarantees that you will not work in any meaningful way," she wrote.

Hello? This week alone, as the mother of a 12-year-old at the end of summer vacation, I have spent a morning at the beach, an entire day at a water park, and an afternoon turning Gatorade bottles into papier mache fish. Need I say that no one gave me one shiny dime for any of this activity?

To the extent that women do it themselves, motherhood is a career-wrecker. Six months or so of exclusive breast-feeding at the front end seems hardly worth mentioning.

I have not worked more than 30 hours a week (most years much less) since my older daughter, Nora, was born almost 23 years ago. It was my choice, but I paid a price in diminished salary and less prestigious assignments — in opportunities.

Even so, I would do it again if I got a do-over.

Why is that? Because I can't think of anything I would rather have than time and relationships with my husband and my children. That was true when the girls were little, and it's true now.

Nora has moved 2,000 miles away this summer. When she calls me, I drop everything to talk with her. And even though, if I added up our phone/Skype sessions, the total would probably look like a serious time commitment, I don't ever worry about how much valuable time I'm losing.

(For a twist on this perspective, see "Putting a Price on Motherhood" in today's New York Times.)

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.

A “boob” on the right side of breast-feeding

New mom Gisele Bundchen touched off a firestorm of criticism when she told the British edition of Harper's Bazaar that mothers around the world should be required by law to breast-feed for six months.

Gisele Bundchen/Wikimedia Commons

Gisele Bundchen

Boston Herald columnist Margery Eagan called Bundchen "a silly twit." Mark Marino, writing on CNN Entertainment's Marquee Blog, ventured that the 30-year-old Brazilian-born supermodel "might have made a boob of herself," based on responses from indignant readers of the blog.

Those included one woman identified as "Angela," who said that having "just popped out a kid" seemed to have given Bundchen the idea she "knows what's best for children and mothers."

Eagan admitted that her "catty little heart leaps with joy" to see a woman so "lucky in looks, in love, in life" whose "perfect foot" keeps finding its way into her "perfect pouty mouth," first touting her painless home birth eight months ago, now with her pronouncement that everyone should be legally required to breast-feed. And in that, Eagan probably stands in for a great many of us who can't help but notice that Bundchen's life is not exactly lived in the trenches.

Bundchen did back down from her provocative statement, writing in her blog, "I am not here to judge.... I think as mothers we are all just trying our best."

Of her backtracking, Eagan wrote, "Too late! Too late!"

But here's the thing. Bundchen has a right to her opinion (she did say it was her opinion), and she is in a position where people ask her her opinion and then print it up in glossy magazines.

Here's another thing: She's not wrong. She's not saying parents should hang their kids out the window by their heels; she's saying every mother should breast-feed for six months.

Sure, plenty of women can't breast-feed, others simply don't want to, and working mothers in this country, at least, have to be highly motivated to keep it up for any length of time. And the logistics — and the politics — of enacting a "worldwide law" mandating six months of breast-feeding for every baby make it, let's say, unlikely.

However, the health benefits of breast-feeding are well documented. The World Health Organization and the American Academy of Pediatrics join Bundchen in recommending that infants be breast-fed exclusively for at least six months. The AAP suggests mothers continue to breast-feed, even as a baby begins to eat other foods, for at least a year in all; the WHO recommends two years or more.

"Breast-feeding can decrease the incidence or severity of conditions such as diarrhea, ear infections and bacterial meningitis. Some studies also suggest that breast-feeding may offer protection against sudden infant death syndrome (SIDS), diabetes, obesity and asthma among others (conditions)," the AAP stated in its 2005 position on breast-feeding.

Researchers recently teased out some of the specifics of the good things breast-feeding does for babies, concluding that breast-feeding represents "an intriguing strategy" to maximize an infant's chances for survival.

But breast-feeding still gets a bad rap from a squeamish public, and even, down in those trenches, from doctors.

"It is tragic that a supermodel-mom dispenses better advice than many doctors and most governmental agencies," wrote pediatrician/author Jay Gordon MD on the Huffington Post. "We must listen if her advice and high profile can save babies' lives."

Lastly, I must say that the world is full of women who think that the fact that they popped out a kid or two makes them experts on parenting. Just usually not as big an expert as people who have never popped out a kid.

Image from Wikimedia Commons

“For God’s sake, please breast-feed”

A new study, the subject of a story by Nicholas Wade in The New York Times this week, reveals a little more of the magic of breast milk. It turns out that complex sugars in human milk encourage the growth of "good" bacteria that form a lining in a baby's gut, protecting her from dangerous microbes.

The baby can't digest the complex sugar, but the bifido bacteria can. In an article in the Proceedings of the National Academy of Sciences, Bruce German, Carlito Lebrilla and David Mills and colleagues describe the "intriguing strategy" lactation represents — to nourish microbes that can in turn protect a baby who has not yet developed an immune system of his own.

Dr. German told Wade, "We were astonished that milk had so much material that the infant couldn’t digest. Finding that it selectively stimulates the growth of specific bacteria, which are in turn protective of the infant, let us see the genius of the strategy — mothers are recruiting another life-form to baby-sit their baby."

The researchers used mass-spectometry-based tools to examine the structures of the complex sugars in breast milk. Their findings made the researchers think that milk holds even more secrets, even perhaps some that could help struggling newborns or even older humans.

Said Dr. Mills, "It’s all there for a purpose, though we’re still figuring out what that purpose is. So for God’s sake, please breast-feed."