Very, very wrong.

Way back in the mid-1990's I taught 4th grade for a few years.  I used to have my students write a persuasive letter as a writing assignment.  I'll never forget that one of my students started her letter with this sentence:  "You are very, very wrong."

That's is how I felt when when I read this excerpt from the August 7th edition of Parents Magazine:

The claim:  Breast milk is best for babies.

The truth:  Study after study has documented that breast milk can boost a baby's immune system and IQ and lower his risk for diabetes, obesity, even ADHD.  So it's no wonder that the AAP recommends exclusive breastfeeding for the first 6 months after birth.  But not everyone is convinced that mother's milk is a panacea.  "Most benefits associated with breastfeeding probably have as much to do with the child's environment and the family's socioeconomic status," says Parents advisor Darshak Sanghavi, M.D., author of A Map of the Child:  A Pediatrician's Tour of the Body.  "They're not due to some magical substance in breast milk."

The bottom line:  Women who want to should certainly breastfeed, but don't feel guilty about it.

What I find shocking about this is that a doctor of Dr. Sanghavi's stature could fail to recognize that so many studies, which control for the factors he mentions, have concluded exactly the opposite. 

This is especially odd considering that just a few months ago the U.S. Department of Health and Human Services released a huge meta-analysis looking at over 9,000 studies, and selected those that controlled for confounders like family socioeconomic status and other factors related to the child's environment.  This analysis concluded that breastfeeding reduces the risk of these conditions by the following percentages:

• Sudden Infant Death Syndrome (SIDS):  36%
• Type 1 Diabetes:  19-27%
• Type 2 Diabetes:  39%
• Leukemia (acute lymphocytic) :  19%
• Leukemia (acute myelogenous):  15%
• Asthma:  27%
• Gastrointestinal infections:  64%
• Lower respiratory tract diseases:  72%
• Atopic dermatitis:  42%
• Acute otitis media (middle ear infection):  50%

And breastfeeding reduces mothers' risk of these diseases by:

• Type 2 Diabetes:  4-12%
• Ovarian cancer:  21%
• Breast cancer:  28%

So, how could Parents, in good conscience, arrive at its conclusion?  After noting that study after study concludes the opposite, Parents sides with one doctor and reaches its 'bottom line' conclusion that breastfeeding is something you should do if you feel like it.  Kind of like choosing vanilla instead of chocolate.

This is a magazine which I'm sure tells you, without fear of provoking guilt or seeking "the truth" from an uninformed doctor, that you should floss your teeth, eat your vegetables, and fasten your seatbelt.  Why are they so afraid to tell parents to breastfeed?  Is it, perhaps, a question of their advertising revenue? 

I often meet women in breastfeeding classes who tell me that they really want to breastfeed because they want to try to protect their babies from health conditions they suffered from as children.  It's often ear infections or obesity.  Several times I've had women tell me that they were formula fed and that they had chronic ear infections, tubes inserted countless times, and that they eventually suffered hearing loss.  In addition to the 50% reduction in ear infection risk shown above, last year a study found that breastfeeding can protect against ear infections even when there is a genetic predisposition toward them.  Could the author of this article look one of these women in the eye and tell her that it doesn't matter whether she breastfeeds her baby or not?

Interestingly, I do agree with Dr. Sanghavi on one point.  There is nothing magical about breastmilk.  All of the pathogen-specific antibacterial and antiviral properties, all of the white blood cells, targeted immune properties, cancer killing features, the perfectly-tailored balance of nutrition and immune protection which changes constantly to meet the baby's needs, the properties that coat the baby's intestine to prevent pathogens from entering - all of that is actually normal.  It's not magic.  It's a carefully designed system which has evolved over hundreds of thousands of years to give our babies the best possible nutrition and immunological protection.  It is a normal and exceptionally powerful way of protecting infant and maternal health. 

Some of you reading this may be pregnant and thinking about how you'll feed your baby.  For you, I offer this alternative to Parents Magazine and Dr. Sanghavi:

My real truth:  Breastfeeding is an important way of protecting your baby's health and your own.  Anyone who tells you otherwise is wrong, very wrong.

My bottom line:  Get informed, and make heathly choices for your baby and yourself.  Know where to get help, and get support from your family and friends.  It's worth it.

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Comments

[Sarah]

Go Tanya! So informative and well argued!

[Ali]

Tanya, Dr. Sanghavi's got an axe to grind. His wife was not able to breastfeed, so he wrote a charming piece for the Globe about how breast isn't always best. He also wrote a piece for Boston Globe Magazine that characterized women who chose natural childbirth as loons.

[Colleen Newman]

I am very, very angry!! This is so ridiculous. Sometimes I think they just write these things to get a reaction.

[Tanya Lieberman]

Ali,

Yes, I'm learning more about him this week!

The comparison in the Boston Globe was worse than loons - suicide bombers (?!?)

I have no problem with him, or anyone else, saying that breastfeeding can be hard. What galls me is that he can dismiss thousands of studies and make a blanket statement like this. Where's the responsibility as a physician?

Tanya

[Half Pint Pixie]

This dr does have a mighty chip on his shoulder but it's irresponsible of a parenting magazine to give him column inches.

Most women will agree breastfeeding can be hard but I know in my case there was no choice to make, breastfeeding was the way to go.

I think a lot of the debates highlight a current problem in that breastfeeding is still seen as a choice that "long-suffering martyr" moms make while "normal" moms bottlefeed, even down to growth charts being for formula babies etc.. It would be great if this was turned around so that bottle feeding became the choice and breastfeeding the norm.. does that make sense?

I'm rambling.. off I go, great site!

[Tanya Lieberman]

Half Pint Pixie,

Yes, I absolutely think you make sense!

A lot of the problem nursing mothers have has to do with the fact that breastfeeding still isn't treated as the norm, in so many ways. That's why people are so offended when they see a mother nursing in public - if you grow up seeing it as normal you wouldn't think twice about seeing a mother nurse.

And I completely agree that Parents was irresponsible in giving him such a platform. It seems to me that they bear responsibility for giving potentially harmful advice to their readers.

Tanya

[Meredith]

I agree with Half Pint Pixie that breastfeeding should be the norm. I hate that my baby and I have to hide when it's time to feed him. And I certainly don't feel like a martyr for breastfeeding... although I do sometimes feel like a milk machine.