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Breast is best. Or is it?

Posted on 11th March, 2013 | filed under Featured, The Big Debate

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It’s drummed into us that breast is best, but that may not always be the case. Ursula Hirschkorn investigates

Breast is best: the most sacrosanct belief when it comes to feeding a baby. The UK government and World Health Organisation both recommend that babies should be exclusively breastfed for six months. The Department of Health states that breastfeeding helps to protect your baby against diseases including asthma, eczema, obesity, diabetes, ear infections and stomach bugs. It also claims that it helps mothers to bond with babies and that breastfeeding mums regain their figures faster.

This being the case you might wonder why any woman would choose to feed her baby in any other way. Yet despite the decades of effort and millions of pounds spent promoting the idea that breast is best, in the UK only one in 100 mums exclusively breastfeeds for the recommended six months. In fact, while more mums may attempt to breastfeed – though even this figure is open to scrutiny as this simply means that a baby has had a single contact with its mother’s nipple – within just one week following the birth of their baby over half have given up exclusively breastfeeding.

Perhaps the message that breast is best isn’t quite as straightforward as it might first appear. First, let’s take a closer look at those health claims.

‘There is a huge gulf between the definitiveness of these [health] claims about breastfeeding and what you could say on the basis of evidence,’ says Dr Ellie Lee, director of Parenting Culture Studies at the University of Kent and author of the study Health, Morality And Infant Feeding. ‘With asthma, eczema, diabetes, obesity – in fact, everything other than tummy bugs – these claims are made on correlations rather than a randomised scientific trial, so many other factors may come into play other than breastfeeding.’

Lee goes on to say that the promotion of breastfeeding is ‘detached from anything to do with science and instead it has become a political and moral project’.

This is backed up by the findings of Michael Kramer, a professor of paediatrics at McGill University and an advisor to both the World Health Organisation and Unicef, who has said: ‘The public-health breastfeeding promotion information is way out of date. There is very little evidence that it reduces the risk of leukaemia, lymphoma, bowel disease, type 1 diabetes, heart disease and high blood pressure [and] I think some of the advice promulgated on obesity or allergies is false information.’

So it turns out the health benefits of breastfeeding are not so clear-cut after all.

But what about the all-important issue of bonding with your baby? Linda Cohen, who breastfed all three of her children for at least six months – one for two years – says that one thing that motivated her was that she ‘had to go back to work quickly so [breastfeeding] was a way of maintaining a strong bond with my children’.

While no one would dispute that successfully breastfeeding your baby is one way to forge a good bond between mother and child, it is far from the only way to create this relationship. In some ways, the heavy-handed promotion of breastfeeding, which extends as far as charity Save The Children’s suggestion that that formula milk should carry health warnings, could even be detrimental to bonding between a mother and her newborn child.

Lee says that during her study she talked to many women who said their experience of attempting to breastfeed and the guilt they felt if they were unsuccessful ruined their experience of early motherhood.

Liat Hughes Joshi, parenting expert and author of Raising Children: The Primary Years, strongly agrees. ‘The messages about breast being best, while perfectly valid, are pushed onto mothers too far,’ she says. ‘So there’s too little acknowledgement that not everyone can [breastfeed] and then you’re made to feel tremendously guilty. The new mum who can’t breastfeed or is really struggling with it is being given the message “you aren’t doing your best for your baby”, which isn’t an easy one to take.’

This view is even backed up by successful breastfeeding mothers such as Cohen, who agrees that if she had been unable to breastfeed her children she would have felt ‘very disappointed [and] a failure’. Lee says that some of the women she interviewed felt so guilty about bottle feeding their babies that they wouldn’t leave the house for fear of what other people would think of them.

While successful breastfeeding may be a bonding experience, the blanket promotion of the message ‘breast is best’ could be seen to be detrimental to the development of positive relationships between mothers and babies if they struggle or fail to establish breastfeeding.

Another claim made in favour of breastfeeding and quoted by breastfeeding support organisation La Leche League is that ‘breastfeeding has a positive effect on the intelligence of a baby’. But this theory has been debunked in a study entitled Effect Of Breast Feeding On Intelligence In Children published in the BMJ. It found that when the mother’s characteristics where taken into account, all IQ differences between breast- and bottle-fed babies were eliminated. It also found that in households where one sibling was breast fed and the other bottle fed there was no difference in their IQ levels.

The one area where it would appear that breastfeeding obviously trumps bottle feeding is cost. It is often declared that breastfeeding is free, while bottle feeding is estimated to cost more than £600 for the first year. However, US academic and author of Is Breast Best? Joan B Wolf declares: ‘One of the greatest lies promoted by breastfeeding advocates is that breastfeeding is free. It’s not free if you count mother’s labour. For many, you could say it has an extraordinary cost and is probably not worth the effort of continuing to do it.’

This is supported by the findings of US study Is Breastfeeding Truly Cost Free? Income Consequences Of Breastfeeding For Women, which revealed that, on average, mothers who breastfed their children for a period of months or years experienced much steeper and more prolonged earnings losses than mothers who breastfed for shorter durations or not at all.

Oh and if you think that breastfeeding will help you shed the baby weight faster, then you will be disappointed, too. A study carried out by Cincinnati Children’s Hospital found that women who breastfed shed 2.5lb less than those who bottle fed, as they tended to exercise less and their higher levels of the hormone prolactin stimulated their appetite to aid milk production.

While no one would suggest discouraging women from breastfeeding, it is perhaps time that a more measured approach was taken to the question of how to feed a baby. ‘It’s really quite simple,’ says Lee.  ’It’s just about finding the best way to get milk into your baby. That women have options about how to do that is a good thing.’

Breast is best. Or is it? was posted on 11th March, 2013 by Ursula Hirschkorn under Featured, The Big Debate

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Ursula Hirschkorn

About the author: Ursula Hirschkorn

While I have rather more years of experience of writing for magazines and newspapers than I might like to admit, I suspect that my most recent challenge of attempting to bring up four little boys qualifies me far more than any journalistic achievements to pontificate on child rearing. That said my years of contributing to titles as diverse as The Daily Mail, Parentdish, The Independent, NHS Choices, Conde Nast Bride, Woman, Ready for Ten and Made for Mums, has at least gifted me the ability to string a sentence or two together. I have also graced the GMTV sofa and held forth during many a radio debate on LBC and BBC Five Live, proving I can talk as well as write.
  • http://twitter.com/MiekaSmiles Mieka Smiles

    What an unbalanced piece of journalism.

  • https://twitter.com/littlephoebus Gemma

    I agree that a more balanced education on breastfeeding is needed. Before having my daughter, I never thought that breastfeeding was not an option. I assumed that after she was born, she would be put on my breast and everything would be as it should. The way it actually happened was she flat out refused to breastfeed! This, combined with some minor health issues that required her being in the NICU for a couple of days (and being introduced to formula), and I went into a tailspin of depression.

    I spent the next 2 weeks trying everything: taking supplements, using contraptions, and finally paying out for a lactation consultant (meanwhile missing out on many bonding opportunities as I refused to feed her from the bottle, making my husband do it while I sat pumping in tears), before we managed to get Phoebe successfully nursing.

    Now that we’re doing it (entering the 9th month) I would not give up breastfeeding for anything, and I am so glad I pushed for it, but I didn’t push for it for any of the right reasons… I was terrified that I was failing her as a mum if I didn’t get that right because throughout my pregnancy I was told that breastfeeding was best for her, whereas if somebody had warned me and talked to me before about the REALITIES of breastfeeding and that it doesn’t always come naturally, and that she won’t be harmed if she gets her nutrition from formula, I could have avoided a lot of heartbreak and let myself make the decision with a level head and be ok with the possibility that it might not happen for us.

    I love breastfeeding, but women need to know it is not the only option, and the alternates don’t make you a bad mother… you just need to listen to your baby and do what feels right for the two of you… if breastfeeding is really what you want to do, it is worth pushing for and your baby can learn how to do it and love it, but don’t feel guilty if you go with another option.

  • Lisa

    This seems dangerously irresponsible. Study after study show cognitive and health advantages among breastfed babies. This article cites ONE that differs. And what kind of biased opinion says the “extraordinary cost [of pumping] is probably not worth the effort of continuing to do it”? Are you kidding me? The health benefits and the immune-building antibodies are worth ANY price. What an absolutely selfish statement!

    Is the point of the article mainly to assuage the guilt of mothers who choose not to breastfeed? If so, mission accomplished.

    • Ellie

      Any price?
      Post natal depression? Self harm? PTSD? Not wanting to have anything to do with your baby because breastfeeding is so excruciatingly painful? Babies needing to be admitted to hospital because the first time mother doesn’t realise she doesn’t have enough milk and her baby is starving to death?
      Be realistic.

      • Hermina Duratovic

        Yes any price! I had a tough time of it, struggled with a colicky baby got pts from it all but I continued!! And now at the end of it I am so proud of myself and have an amazing advanced for his age healthy boy!! I did suffer for months but non of that matters coz he is the most important thing at the end of it! Being a mother is being selfless and doing what’s best for your child! How do some mothers not understand that?

        • Whatever

          You made one statement there that I completely agree with – Being a mother is being selfless and doing what’s best for your child.
          Sometimes, the best thing is to swallow your pride, dismiss your ideals, hopes & dreams, and do what they need – and that could very well be formula.

    • Not Paying That Price

      How about the price of starvation? That is the price my son was paying every day that my milk DIDN’T come in, despite the medicines, despite the pumping for hours upon hours, despite the attempts to feed him straight from my breast, despite the different holds, the different massages, the different shields, the different foods, the different everything. He got so sick I had 2 lactation consultants tell me to give him formula, or take him straight to hospital for treatment. Or how about the cost of our bond – he had to lay beside me or on me or near me and cry and cry for the food I could not give him. I sat beside him or holding him or near him and cried and cried for the food I wanted so badly to give him. Those days are my only regret.
      For me, all of that price was far too high.

    • Theloadedjuggler

      Lisa, I ‘chose’ not to breastfeed to retain my sanity and to make sure that my baby was receiving proper nutrition which my breastmilk was not providing. No guilt on my behalf:) My children are all incredibly smart, healthy and have an excellent bond with me:) My sanity and my childrens wellbeing are more important than breastfeeding. Formula is fantastic:)

  • Carolinechatwin

    I wish an article like this appeared in 2009 when my first baby was born. Breast feeding was excruciatingly painful for me and I later discovered that my baby was tongue-tied. I pushed myself to the brink of depression and I felt guilty bottle feeding my child. The first few weeks were hell and in fact it wasn’t until I gave her formula, at 5 weeks old, that I truly bonded with her….no more pain or dread of feeding. Yes I think breast is best if you have a healthy diet and are able to do it, but we need to also say to new mums that it is ok to bottle feed too.

  • http://twitter.com/carovioletfizz Caroline Campbell

    I wonder how much Aptamil paid her to write this one sided, unhelpful article.

    • Theloadedjuggler

      I don’t think Aptamil paid her a cent

  • Andy

    Sensationalist poorly-argued nonsense, and most certainly not investigative journalism. I’d be very interested to know what paediatric or midwifery qualifications Ms Hirschkorn holds? Unsurprising when you consider her pedigree as a contributor to the Daily Mail. She says “… no one would suggest discouraging women from breastfeeding” yet spends the preceding 1094 words doing exactly that. Shockingly bad journalism.

    There is extensive scientifically accredited and empirically verified evidence (which can be found on both the World Health Organisation website and in the British Medical Journal) that supports the theory that breastfeeding babies for the first 4-6 months of their lives creates the best outcomes for both mother and child.

    The UK government should be congratulated on its policy to encourage new mothers to breastfeed their babies, despite the fact that this is not always the easiest or most convenient option in the days and weeks after birth.

    The attitude that if something is too difficult to attain, or there is a risk of failure, then it shouldn’t be attempted is one which is gradually proliferating our culture, and threatening to erode yet more of what is left of our national identity and ‘Britishness’. The move away from competitive sports in schools so that children aren’t left feeling disappointed when they lose, extreme risk reduction in every aspect of our lives, people encouraged to accept mediocrity.

    My wife persevered with breastfeeding after a difficult birth. Despite the pain and discomfort, and the fact that it didn’t come naturally to mother or baby, she showed real determination and resolve, and after much hard work and discomfort eventually both she and our daughter got the hang of it.

    Despite mastitis and painful swelling, she carried on breastfeeding through the early weeks, when emotion and sheer tiredness were threatening to overwhelm her. After a few weeks, it became second nature to both mum and baby, and as she grew more confident and life became easier, our daughter thrived in every sense and their bond developed into something that is an absolute pleasure to behold, and I couldn’t be more proud of her courage and tenacity.

    And why did she persevere? Because she knew that despite the tears and the pain, the long-term benefits of breastfeeding would vastly outweigh the short-term difficulties. And it is exactly this attitude that the UK Government are entirely right to support and Ms Hirschkorn is entirely wrong to undermine.

    • http://twitter.com/carovioletfizz Caroline Campbell

      Well said…this article is nothing but poorly argued anti-breastfeeding propaganda.

    • Whatever

      Andy, did you actually read the article or did you just jump upon this as an opportunity to get on your soapbox? Give one specific quote where the author discourages breastfeeding – there is a huge difference between balancing out some of the hyperbole regarding breastfeeding, and actually criticising it.
      I’m glad your wife experienced success at breastfeeding, and good on her for sticking at it so long. That doesn’t make the challenges anyone else faced when they tried (note: Tried, not Didn’t Attempt, as you claim) any less valid, or any less of an obstacle. Sure, if they stuck at it longer, it *may* have worked, but to what cost? A starving child? Permanent injury to the mother (speaking as a woman who literally had her nipple sucked off her body in her struggles with breastfeeding)?
      The benefits you claim for your daughters are based on shoddy research methods, I only hope your parenting is more compassionate than your attitude towards other adults.

      • Theloadedjuggler

        Hear, hear to ‘whatever’, you understand what I was trying to say. I have never directed anger at breastfeeding mothers – many of my close friends breastfed their children – but they did not guilt trip other women into feeling they were poor mothers because they couldn’t breastfeeed or criticise or accuse them of being ‘lazy’ when it didn’t work. That is being a breastfeeding ‘nazi’ or ‘ zealot’. Telling women to persevere with breastfeeding despite serious health ramifications for both mother and child IS lunacy. And yes, going on about what a fantastic, selfless mother or wife a woman is when she perseveres IS gloating and putting down women who tried very hard but couldn’t ‘persevere’ for their sake and that of their baby. There is no other way to put it. So many women can’t or don’t wish to breastfeed for many valid reasons and their babies turn out perfectly fine. Instead of worrying about how babies are fed, worry about the children who are abused or neglected. It does not matter how a child is fed as long as that child thrives and is loved and nurtured. That is what makes a good mother, whether she breasts OR bottlefeeds.

        • Theloadedjuggler

          And I never said the benefits of breastfeeding were rubbish…what is ‘rubbish’ is extremists telling women to breastfeed and persevere no matter what. That their child will be infinitely smarter or healthier than a bottlefed baby. That the bond they share will be better. That is rubbish. And I also believe that many of the benefits of breastfeeding are quite hyperbolic in their description snd some are very biased and poorly researched. Just because not everyone believes a breast fed child will turn into some super human being does not mean they are anti- breastfeeding.

          • Jordan

            Completely agreed. The higher IQ is the biggest nonsense in my opinion. The genes you pass on and the extent you work to instill good work/academic habits are what will make the difference.

        • Whatever

          Couldn’t have put it better myself, Theloadedjuggler.

  • Hermina Duratovic

    I wonder how much Danone et al have paid you to write that article, breast is best and I have seen it first hand. To try and negate something that is natural to help mums who don’t breastfeed overcome their guilt is absolutely diabolical! Your research is based on a few doctors not the general consensus in the medical field! It isn’t even effectively researched! Don’t trash on women who breastfeed their children and attempt to make them feel as if what they are doing for their child isn’t worth it just to mend some kind of guilt for a mum who found it too painful or couldn’t be bothered!

    • Theloadedjuggler

      Too painful? Couldn’t be bothered? You are pathetic. And the same goes for the moron Andy above. Breastfeeding at the risk of your baby dying from malnutrition?! Breastfeeding at the risk of developing such severe post natal depression that some women could end up suicidal or hurting their babies?! Are you people INSANE? And why do you think all mothers that formula fed their children feel guilt? I don’t, never have as I know I did what was best for my children and that was formula. Good on you that you persevered through your pain or whatever you want to gloat about but that doesn’t impress me or convince me that breast is best for all mums and babies. I highly doubt your children are any more healthier or smarter than mine or any other formula fed baby. You people are utter lunatics.

      • Theloadedjuggler

        No wonder I’ve seen so many scrawny, screaming in hunger breastfed babies with their miserable mothers who look utterly exhauasted in shopping centres…it’s because they read and and are told rubbish by zealots like these. Feel truly sorry for these women and their babies who are suffering. Glad I wasn’t sucked into this breastfeeding nazi lunacy.

        • http://twitter.com/carovioletfizz Caroline Campbell

          It’s so sad that no one seems to be allowed to extol the benefits of breastfeeding without being abused and insulted and called a zealot or a Nazi. Mothers who have succeeded in breastfeeding are not ‘gloating’. Breastfeeding is not Nazi lunacy, it is a normal, natural way of feeding your baby.

          The benefits of breastfeeding are not rubbish. If they were, why would it be promoted by governments and major health organisations worldwide?

          Instead of feeling angry at women who have breastfed and those who support breastfeeding, direct your anger towards the systems that prevent women who want to to breastfeed.

          • Whatever

            There is a difference between extolling the benefits of breastfeeding and criticising those who don’t breastfeed. I didn’t take Theloadedjuggler’s opinion to be anger towards breastfeeding mothers at all, but rather frustration with the extremists who use guilt and manipulation to share their message about breast is best.
            Anger is a waste of energy, especially when aimed at ‘systems’ that stop women breastfeeding – I’m pretty sure last time I checked Mother Nature really wasn’t all that phased that someone was pissy with her.

    • KATE WARD

      I don’t believe this article is “trashing” on people who breastfeed, I think it allows women, who have been given so much pressure to do it, to see another view. I think anyone who is so A line one way or another is missing the point. As I have shown the evidence doesn’t stack up re the benefits, this doesn’t mean I am anti-breast feeding but I think the pressure to do so is ridiculous and wrong.

  • Alexannoa

    Utter non-sense. How much did you get paid by the formula industry to write this? Totally feeling sorry for your children.

  • KATE WARD

    My mother breast fed me for over 6 months, I got type 1 diabetes at the age of 4. After my caesarean I needed blood thinning drugs, 4 midwives crowded around a women opposite who couldn’t breast feed, I didn’t get the drugs until 3 hours after I was meant to. I don’t care whether people breast feed or not but I wish it wasn’t pushed so far down new mother’s neck that they felt terrible if it didn’t work for them. My hub was adopted and was bottle fed, he went to an Ivy League University so clearly another “fact” that carries little to no weight.

  • http://www.parentingintheloop.com Lorette Lavine

    Thank you for another perspective on “Breast is best” and for not trying to make moms feel guilty if they do not breast feed.

  • Emily

    If you’re too selfish and stupid to make an attempt to feed your human the proper food, that’s your own problem. But please refrain from spewing your speculation and lies around to encourage others to make the same poor choice.

  • Ami

    What a load of rubbish! People will say anything!

  • loop87

    This seems like a really badly researched article with no real evidence. It isn’t balanced and so does neither side any favours