Nancy E. Wight, MD, FAAP, IBCLC

Breastfeeding provides ideal nutrition, growth hormones and infection-fighting factors which change over time as the growing infant and child’s needs change; provides it inexpensively, and with no harm to the environment. Breastfed infants are healthier overall, and research is indicating that the health benefits may continue into adulthood.

Yet despite this, disappointingly few women choose to breastfeed, and even fewer choose to continue beyond six months. The issue of "choice" is the logic artificial baby milk companies use to defend their products. Why would a rational adult, when presented with the choice between health and illness, choose illness?

The truth is, the "choice" between breast and bottle is really a sham, with everything in our society pushing us towards bottle feeding. The combination of calculated misinformation, aggressive marketing, medical acquiescence (and in some cases misguided collusion) and the love of consumer freedom has led women to believe that the choice between artificial feeding and breastfeeding is merely a matter of personal inclination. Constant comparison of artificial milks to breastmilk has succeeded in reducing breastfeeding to the one dimensional level of breastmilk substitutes. 1

The artificial milk companies are experts at the subtle undermining of a woman’s confidence in her own body’s ability to provide what is needed to nourish her infant. They also seek to increase market share by reinforcing US cultural prejudices that breastfeeding is only for young infants, breasts are sexual objects not feeding vessels, and that breastfeeding, like sex, should only be done in private.2

The literature contains many studies of infant feeding choices. Many women who choose bottle feeding admit they could have been persuaded to choose breastfeeding if only someone had cared enough to tell them how important breastfeeding is. 3 Despite the proven health benefits of breastfeeding for both mother and infant, physicians have traditionally been reluctant to take a stand for fear of making parents who choose to bottle feed feel guilty. This is a dissimulation for two reasons.

Peggy Robin’s book 4 to the contrary, research studies of breastfeeding promotion programs note that women generally do not feel guilty for choosing to bottle feed. The only individuals who ever mention guilt are the older generation whose daughters are now choosing to breastfeed. "If only she had known .... if only her doctor had told her ...." 3.

Second, is guilt bad? 5 As pediatricians we do not hesitate to make our patient’s parents feel guilty about having their children wear bicycle helmets, using infant car seats and seat belts, obtaining immunizations and fencing in pools. We use guilt to help adult patients lose weight, exercise more, stop smoking, drinking alcohol, and taking drugs.

Breastfeeding is a health issue, not just a lifestyle choice. Why is this health issue so different from the rest? As ethical, caring professionals we owe our patients accurate information, appropriate guidance and long-term support. Let us continue to promote what is best for infants and let the guilt fall where it may!

References:

  1. Baumslag N & Michels DL, Milk, Money and Madness (1995), Bergin and Garvey, Westport, CN.
  2. Stuart-MacAdam P & Dettwyler KA, Eds, Breastfeeding: Biocultural Perspectives, 1995, Walter DeGruyter, Inc, Y, NY.
  3. Lawrence, RA, Breastfeeding: A Guide for the Medical Profession, 4th ed, 1994, Mosby Yearbook, Inc, St Louis, MO.
  4. Robin P, Bottlefeeding without Guilt, 1996, Prima Publishing, Rocklin, CA.
  5. Oski, F, In Defense of Guilt, Editorial, Contemporary Pediatrics 1995, December, p 9.

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