Public Health, Economics and Breastfeeding Goals

This morning I noticed that at the top of The New York Times' "most-emailed" articles list was yet another post about the hardships of breastfeeding and the bullies in the medical establishment who continue to berate us with the message, "breast is best." This particular one was entitled, "The Ideal and the Real of Breastfeeding," by Jane E. Brody. It closely mirrored the feminist arguments of Elisabeth Badinter's recently published book, The Conflict: How Modern Motherhood Undermines the Status of Women. These authors and their followers commonly suggest that doctors, nurses and public health officials should stop making breastfeeding seem like such an important factor in infant health so as to avoid inducing motherly guilt. It seems not to occur to any of them that perhaps what Americans need instead is a set of laws, government programs, and business practices that support babies and their families.

Telling us that breastfeeding isn't important because in some cases it's rather difficult to accomplish is like saying that, since they are having trouble doing it, our school-aged kids don't actually need to eat more vegetables and fewer fatty foods even though they are suffering from poor health. After all, we wouldn't want to hurt their feelings, would we? No, in this situation, I believe parents generally agree that schools should make an effort to remove nutritionally abysmal food and drink such as French fries and pop from cafeterias. We need to help our children develop healthy eating habits and we know that surrounding them with excellent choices will go a long way toward making this happen.

Why, then, do writers such as Jane Brody insist that we change our stated societal breastfeeding goals instead of doing better to support breastfeeding parents? In part, they argue that breastfeeding isn't really as beneficial for babies as parents are made to believe. After all, Brody says, "No randomized, controlled trials – the gold standard of scientific research – have proved that breast-fed babies fare better, at least in industrialized countries." This is in fact because such a study would be impossible to perform. No parent would agree to breastfeed or formula feed randomly as decided by a scientist. Even if they did, some in the group assigned to breastfeed would fail to do so since not everyone who wants to breastfeed succeeds.

Nevertheless, it's easy to find solid evidence that shows breastfeeding is good for infant health, and, not surprisingly, good for business. Breastfeeding support programs instituted by employers result in 62% fewer prescriptions as well as substantial health care savings and reduced absenteeism, according to the insurance company CIGNA. Companies with lactation support programs also enjoy much higher rates of employee retention than the national average. Of course, insurance companies exist to make money – if they are convinced that breastfeeding saves health care dollars, I'm inclined to believe them.

Another large part of Badinter's argument against breastfeeding concerns the time and energy that it takes on the part of the mother. As a breastfeeding dad, I have certainly experienced firsthand this kind of commitment. However, it has little to do with breastfeeding and everything to do with the fact that human babies are extraordinarily needy, dependent creatures who prefer a consistent caregiver. Infants cannot feed themselves, take care of their elimination needs, protect themselves, or move any real distance on their own. If I don't look after my baby, some other adult must do it for me regardless of whether he's slurping breast milk or formula. Rather than bemoaning what I have "given up" to take care of my baby, I try to consider his needs as an infant. After all, he didn't choose to be here; we brought him into this world. Fortunately for me, being Canadian, I was entitled to one year of parental leave with employment insurance that paid a decent chunk of my previous income.

I wish that these authors would demand longer paid parental leaves. The current US standard six week leave is laughable – it is hardly enough time to get to know and support a new family member. Most of my friends have said they didn't get into the groove of breastfeeding (or parenting!) until at least six months in. To meet the minimum breastfeeding goals outlined by public health officials, Americans need much longer parental leaves as well as workplace lactation support programs for those who choose to go back to work. Let's change our attitudes and programs to support family health rather than redefining good health to mean good enough.