Friday, March 27, 2009

A response to "The Case Against Breastfeeding"

I'm sure you've seen this Atlantic article making the rounds: "The Case Against Breast-Feeding" by Hanna Rosin, who decries breastfeeding as anti-feminist and overhyped.

It's engendered a lot of vitriol, much of it deserved and some maybe a little exaggerated, and it's also (on non-breastfeeding-centric sites) gathered a lot of accolades, that someone is finally saying what every mother thinks: that breastfeeding kinda sucks (more on my disagreement with that later).

First of all, the tone rubbed some people the wrong way: It's a sarcastically written article, which alternately amused and irritated me. When she describes how "the urban moms in their tight jeans and oversize sunglasses size each other up using a whole range of signifiers: organic content of snacks, sleekness of stroller, ratio of tasteful wooden toys to plastic," it's clearly a hyperbolic artistic illustration, but it comes across as ├╝ber-judgmental. If you're a friend of Hanna Rosin, you're probably wondering now what she thinks of you — and what she writes about you in The Atlantic! As a fellow sarcasmo, though, I did feel like defending her right to express herself in a creative, if snarky, style.

But of course, beyond the tone was the message. Rosin thinks breastfeeding keeps women at home all day and night with their shirts half-off, while their menfolk and their lucky formula-feeding sisters go off and have fulfilling lives without them — or, as she puts it: "It is a serious time commitment that pretty much guarantees that you will not work in any meaningful way."

There's a lot to unpack there. For me, breastfeeding has not kept me at home or indecent or unfulfilled. I've been able to write a novel while breastfeeding. I've made friends and volunteered and traveled. I've worked in our home business. It's raising a child that's curtailed some of my activities, but not breastfeeding by itself.

On the other hand, I personally dislike pumping. Unlike breastfeeding, where the baby does all the work, pumping is inconvenient to me, and it feels contrived. So, for mothers who work outside the home, I can understand the reluctance to go through the trouble of pumping when an artificial milk substitute is available. I give props to all the pumpers out there (unlike Rosin, who just kind of derides them: "One of them sat on my couch the other day hooked up to tubes and suctions and a giant deconstructed bra, looking like some fetish ad, or a footnote from the Josef Mengele years. Looking as far as humanly possible from Eve in her natural, feminine state."). But mostly I just wish that pumping weren't necessary. I wish that our economy and culture allowed for women (and men!) to take the time they need to be parents, to have families, and to enjoy meaningful work. We made a choice to work from home, but I acknowledge that not everyone can or does do the same, and meanwhile the system as it stands is incredibly harsh toward parents, and mothers in particular. I wish Rosin had addressed that instead of blaming breastfeeding as the cause of the death of feminism.

The other main thrust of Rosin's article is that breastfeeding isn't so great, anyway. She's examined the research, she says, and "the actual health benefits of breast-feeding are surprisingly thin, far thinner than most popular literature indicates."

Here I direct you to a lactation consultant who knows of such things. (Lactation consulting also rated a snicker in Rosin's article.) Tanya at the Motherwear Breastfeeding Blog gave a response to Rosin's article that focused on her selective reading of the literature on breastfeeding's benefits. One thing that struck me as I read the Atlantic article was that Rosin referenced a meta-study on breastfeeding that came up with lukewarm results for breastfeeding's superiority — done in 1984. I thought, There must be something more recent than that! And I therewith resolved to research that. Fortunately, I came across Tanya's post and realized she'd done it for me. Hooray!

The Motherwear Breastfeeding Blog post points to a 2007 meta-analysis that "found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis." So Rosin can poke fun: "And when I look around my daughter’s second-grade class, I can’t seem to pick out the unfortunate ones: 'Oh, poor little Sophie, whose mother couldn’t breast-feed. What dim eyes she has. What a sickly pallor. And already sprouting acne!'” But, the thing is, she's wrong. So there.

Here's what also bugged me about the article. It kept comparing breastmilk to formula. Not breastfeeding, the act of transmitting the breastmilk, but the precious "milky elixir" (read in snide tone) itself. When she does mention breastfeeding, she dismisses the holistic benefits:

"In his study on breast-feeding and cognitive development, Michael Kramer mentions research on the long-term effects of mother rats’ licking and grooming their pups. Maybe, he writes, it’s 'the physical and/or emotional act of breastfeeding' that might lead to benefits. This is the theory he prefers, he told me, because 'it would suggest something the formula companies can’t reproduce.' No offense to Kramer, who seems like a great guy, but this gets under my skin. If the researchers just want us to lick and groom our pups, why don’t they say so? We can find our own way to do that. In fact, by insisting that milk is some kind of vaccine, they make it less likely that we’ll experience nursing primarily as a loving maternal act—'pleasant and relaxing,' in the words of Our Bodies, Ourselves and more likely that we’ll view it as, well, dispensing medicine."

This reminds me again of In Defense of Food, by Michael Pollan, where he discusses nutritionism's deconstruction of food into discrete nutrients, each having more or less value depending on the current dietary whims. Ever since I read that book, I've seen nutritionism's hold everywhere. I hear well-meaning diet gurus rejecting, for instance, grapes because of the type of sugar in them. They're grapes! They're good for you. People in the Roman Empire already knew that. What have we learned since then? That we're kind of stupid when it comes to eating, that's what, and that we should stop thinking so hard. It's not each separate part of each separate food that's important — it's food itself. It's the entire package — eating a variety of fresh, whole foods. Of course grapes can be part of that!

It's kind of weird, because I do agree with Rosin in the above quote that it's pointless to think of breastmilk in such medical terms, because such deconstruction misses the point of feeding our young. But I disagree with her conclusion that it's some other disparate action instead (cuddling). It's all of it! As she's scrambling to prove that it's not the breastmilk alone that confers the "magical" benefits of breastfeeding, with the air of someone debunking the "secret" of breastfeeding's powers, I want to say: "So?" What's wrong with that? Why can't it be everything together — the milk, the antibodies, the fats and proteins, the sugars, the warmth, the closeness, the hormones, the time investment, the cuddling? None of those things by itself is enough — babies crave it all. And there are probably even more factors than that. Why think so hard about it when it should be perfectly obvious that feeding our babies the way mammals have fed their young for millennia just makes good sense?

Now, as to some people's positive responses to this article — I've been fortunate that breastfeeding has come, mainly, so easily for Mikko and me. I have heard of other mothers' struggles through mastitis and low milk supply and premature births, and I hear their disappointment that they were unable to breastfeed the way they wanted, or sometimes at all. I can understand that, for those women, an article like this might help them feel less guilty, and that's cool. Why judge yourself for a medical condition and a good attempt? And I don't mind someone telling it like it is for them, even if that means popping the rosy bubble of beautiful mommyhood (especially then). What worries me most about this article is that I foresee women who were wavering on the subject of "to breastfeed or not" will read a blurb of "breastfeeding isn't all that hot after all" and will swing toward not, without ever looking into it further.

As a final thought, it bemuses me that Rosin seems to be stuck in an (admittedly very fashion-conscious) attachment-parenting crowd out there on the East Coast, and here I am stuck in a conventional-parenting crowd on the West Coast. She would never hear condemnation of her formula-feeding ways in my group. Maybe we should switch places?

I'm going to need some tight jeans and oversize sunglasses, though.


Jenny said...

Good post! I agree--it seems unlikely that Rosin is really surrounded by breastfeeding fanatics and nothing else. There was recently a New York library in which a mom was insulted by a guard for nursing her child in an empty reading room, and I read an article about how the guard was transferred. You wouldn't believe all the ugly, ignorant comments! And this was in New York. I live in South "Cackalacky" and I thought the people up there were supposed to be, I don't know, enlightened or something. I thought they'd be more accepting of breastfeeding than the people down here, seeing as how there's a greater variety of lifestyles in general. Apparently I was wrong. Maybe Rosin just fell in with the wrong set of moms. I go to a babywearing group, and occasionally someone will come to a meeting who formula feeds and follows the cry-it-out method. They usually don't ever come back. There are other playgroups in which the members share their views and they can support each other. It seems like Rosin must be doing this to herself on purpose because she loves to play the victim or because she just wanted to use the women she spoke of in her writing. I think it's a cheap, dirty way to get attention as a writer--but it worked, didn't it? I guess she had no choice but to do it, because since she breastfeeds, she CAN'T work in any meaningful way. Silly little twit.

Lisa C said...

Oh my goodness, you said it all so perfectly! That article got under my skin, too. I asked myself after reading it, what are my REAL reasons for breastfeeding, and I thought back to why I decided to bf in the first place, and it had nothing to do with nutrition and development. I wanted to do it because it instinctively felt right and I wanted that closeness with my baby. I also later decided that I wanted to be "free" from bottles--I wanted to be able to nurse my child whenever he needed it, with no bottle to fix, no formula to tote around with me anywhere. If he has me, then he has everything he needs.

As far as nutrition goes, though (I'm all about being healthy, and I agree that all we need is a variety of fresh, whole foods), I see formula as equivalent to a "nutrition drink." Sure, all the main nutrients are there, but it isn't real food. We can drink "Ensure" and our kids can drink "Pediasure" and we can live off of it, but we aren't going to thrive off of it. We need real food and so do babies. No formula can match breastmilk. I consider breastmilk a "whole food" and I consider formula a "processed food."

My baby is such an active little guy that the only time I get a "real" cuddle with him is when he is nursing. I would miss out on so much cuddling if we didn't breastfeed! And it has truly become a relaxing activity for him. I've seen babies gulp down bottles and cry for more--not because they were still hungry, but because they didn't get what they needed from a bottle. It really does make a difference.

And, actually, it sounds like her group of mothers are stuck up yuppies, if you ask me! The AP parents I know are a lot more accepting than that!

Lisa C said...

Oh, yeah, and pumping DOES suck. I had to do it 90% of the time the first month and about 50% of the time the second month and I HATED it. I know a mom who gave up nursing because it hurt all the time, but she pumped for SIX MONTHS! I do not blame her for switching to formula after that. I say shame on anyone who complains about women pumping. It really sucks but it's done out of love.

Olivia said...

Oh yes, pumping sucks. I've been doing it for 7 months (no maternity leave, yay USA) and when I really think about it, it's not the nutritional benefits that keep me going, it's the actual act of nursing my daughter.

I believe formula is adequate, and plenty of babes survive on it. But the reason I continue to pump, the reason I believe breast is best, is not just because of the nutritional benefits, but because I love physically nursing my baby. It's the whole package that makes breastfeeding wonderful for mom and baby.

Lauren Wayne said...

Huh, well, I never responded to the comments back in March, but I appreciated them and thank you for adding value to the conversation!

Olivia: Thanks so much for your response and reminder. I totally agree. It really is the whole act of breastfeeding that's so beautiful, and you can tell how much the baby appreciates it. And, as you were saying -- in the same way it's not the nutritional benefits that are most compelling to you, the same holds true from the baby's perspective! Best wishes in your continued pumping and nursing. I really do admire the perseverance of any working & breastfeeding mother who has to contend with US maternity leave policies!

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