Is Breastfeeding Truly Best?

by Barbara L. Behrmann, Ph.D.

If you're expecting a baby you've undoubtedly heard that "breast is best." Breastfed babies are healthier. They are less likely to have diarrhea, suffer from ear infections, develop allergies. They have better immune systems, better protection against SIDS, and are less likely to need braces, become obese, or develop certain childhood cancers. They are even smarter. Approximately 13,000 studies document these and other benefits of breastfeeding.

But Diane Wiessinger, an internationally board certified lactation consultant in upstate New York, argues that these statements are actually wrong. When we say breastfed babies are healthier, to whom are we comparing them? To formula-fed babies, of course. But although formula feeding may be the cultural norm, it is clearly not the biological norm.

Think about it. Everyone knows the risks of smoking and obesity. People who smoke are more likely to develop lung cancer. People who are obese are more likely to suffer from heart disease and diabetes. But more likely than whom? Than non-smokers and people of normal weight. In both of these examples, the biological norm is the basis for comparison. The researchers who design the studies always take non-smokers and people of normal weight as the control groups.

But this isn't the case with breastfeeding. Here, for example, is a paragraph I came across recently in an issue of a popular parenting magazine:

If someone told you there's an elixir that could help protect your new baby from bronchitis, ear infections, pneumonia, diarrhea and urinary tract infections, would you want to know more? If you knew that the effects of this concoction would last into your child's teenage years, reducing his risk for diabetes, allergies and high blood pressure, would you just have to have it? If the same potion might boost his IQ, wouldn't you rush out to find it as soon as you could?

What if the same paragraph were written comparing formula-fed infants to breast-fed infants? It might read something like this:

If someone told you there's a concoction that would reduce your baby's protection from bronchitis, ear infections, pneumonia, diarrhea and urinary tract infections, would you want to know more? If you knew that the effects of this mixture would last into your child's teenage years, increasing his risk for diabetes, allergies and high blood pressure, would you insist on avoiding it? If the same potion might lower his IQ, wouldn't you stay away from it, if at all possible?

To be sure, the message sounds more severe. And this is exactly what health care providers, magazine editors and formula manufacturers want to avoid.
Often times, people are afraid of making women feel guilty so they soften the message. A first-time mother, for example, told me about the approach her doctor took. My ob-gyn didn't push breastfeeding, she recalls, but he didn't not push it. He gave me a free Enfamil diaper bag with formula inside.

It is this kind of "objectivity" that prevents us from making fully informed choices. Plain and simple, breast milk and formula are not equivalent substances.

To be sure, the media is full of stories from women who feel guilty for not being able to breastfeed. But anthropologist and breastfeeding advocate Katherine Dettwyler asserts that guilt and regret are two separate emotions. If we make the best decision with whatever information and resources we have at the time, we have no reason to feel guilty.

Psychologist Harriet Lerner, cautions against internalizing guilt. Try to remember, she writes, that our society encourages mothers to cultivate guilt like a little flower garden, because nothing blocks the awareness and expression of legitimate anger as this all consuming emotion.

And without accurate information, women have every right to be angry. What if you have a history of colitis in your family, you chose to feed your baby formula, and nobody told you that formula-fed babies are more likely to suffer from it than breastfed babies? What if you have a history of allergies, you use formula, and nobody told you that breastfeeding could reduce the likelihood that your baby would have allergies? The list goes on. If it were me, I wouldn't feel guilty for my decision to use formula. I would feel angry that nobody had told me.

Not every woman is able to breastfeed (although most are) and not every woman wants to. But just like we have the right to know the benefits and risks of other substances we put into our bodies, we deserve the right to make fully informed decisions about how we feed our babies.

So as you read about breastfeeding, remember: breast is not best. It is simply normal.

Barbara L. Behrmann, Ph.D. is a writer, researcher, and author of The Breastfeeding Café: Mothers Share the Joys, Secrets & Challenges of Nursing, University of Michigan Press, 2005. She is a frequent speaker around the country and is available for talks, readings, and conducting birthing and breastfeeding writing circles. The mother of two formerly breastfed children, Barbara lives in upstate New York. Visit her website at www.breastfeedingcafe.com.

Copyright © Barbara L Behrmann. Permission to republish granted to Pregnancy.org, LLC.