Wednesday, September 17, 2008

Is Breast Really Best?

Let's take a stick to the hornet's nest, shall we? Let's call into question the tenet, the slogan, the moral high ground. Could formula be okay? Might it not really matter to babies if they are breast fed or not?

One academic thinks so. Joan Wolf is going head to head with La Leche League on the website Opposing Views (a neat concept in itself).

Before villifying Wolf, read what she has to say. She raises excellent questions about biases and omissions in the studies that have been used to label breastmilk the preferred baby food.

Better yet, read her complete article, "Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign." It will likely make you uncomfortable. It will challenge your fundamental assumptions about breastmilk, mothers, and public health campaigns.

The author and I were randomly assigned college roommates. She was a feminist, an honors student, a spitfire. I was not at all surprised she became an academic.

I read and commented to her on an early draft of the breastfeeding article. It shook me. I was surprised to learn how little is really known about the benefits of breastmilk over formula. So many of the studies that compare groups of babies who are breast or formula fed cannot control for other confounding factors.

I do not think Wolf is trying to undermine breastfeeding. Rather, she is saying that before we launch a national health campaign, we should make sure there is sound science to support it.

Obviously, I am a breastfeeding supporter. In part this is because of the very research Wolf questions. But it is also because I have a fundamental faith in the superiority of evolution over chemical engineering. I do not believe a feeding system that has sustained mammals for hundreds of thousands of years could be improved upon or even equalled by a few decades of tinkering in the lab.

I also find it more cosmically "right" to have mothers feeding babies from their bodies than from bottles.

But these things are arguments of faith, not reason.

Read for yourselves. Keep an open mind. Whether you end up persuaded or not, it is good to know the rational and scientific arguments for and against.

Even if in the end you return to faith.

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2 Comments:

Anonymous stephanie@yarnharlot.ca said...

It's very interesting to see this debate raging in the face of 700 tons of recalled baby formula in China, or 2006 - Abbott recalled about 300,000 bottles of Similac Advance and Similac Alimentum Advance baby formula - or 2005... when the same thing happened with a Similac with iron.

People can say what they like about the research, but breastmilk has never been tampered with or recalled and is immune to corporate greed and parental error. That's worth something.

The only other point I'd like to raise (and I feel like I'm attacking the author, which I'm not... I just think her view, while well researched is very narrow) is that she is only speaking for the US- and the well-fed, well cared for US at that. There is absolutely no debate what so ever that the risks of formula go up, as standard of living goes down. (People with unreliable water, power or finances - for example.) I find it irresponsible to make universal statements ("formula does not make babies sick") when we can find millions and millions of examples where that is precisely true.

Perhaps the author would like to amend her statement to "formula does not make babies sick as long as nothing goes wrong?"

10:38 AM  
Blogger Heather Lerner said...

I haven't read the article yet, if Evie starts sleeping for longer than 1.5 hours in a row I'll get more on top of things, but I do have to say one thing: I am not an adaptationist. I do not believe that the many traits we see in species are there because they are adaptive or beneficial. Breast milk is only as good as it can be with respect to the many other constraints a mother faces. Historically, the human mother was pressured to maximize her fitness, which means both giving her baby enough to allow it to grow and also saving something back for herself so that she could bear more offspring later. So, it is possible that food besides mother's milk may actually be formulated some day to provide superior growth or brain development or muscle strength or even all three.
Take, for example, the many wild animals that live longer lives, reach larger sizes and are generally healthier when fed a formulated diet in captivity. The food that is available in the wild that the animals are supposedly "adapted to eat" does not necessarily provide the best nutrition for the maximal growth. It only has to be good enough to get the animal to reproduce and pass on its genes. It is not survival of the fittest per se, it is survival of the fit enough.
So, breastmilk has to be just good enough. But, please don't think that I believe currently available formula is superior to breastmilk. I don't think there has been enough long-term study to know that and I don't think the historical context out of which formula arose is the kind of thing that leads to a superior product anyway. Apologies for letting the evolutionary biologist in me reach the surface:)

9:29 PM  

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