Breast is best -- have you heard? Only this time, they're saying breastfeeding is best not (just) for the kid, but for you. According to the New York Times, a large new study suggests that "women who have breast-fed are at lower risk than mothers who have not for developing high blood pressure, diabetes and cardiovascular disease decades later." Quoth lead author Dr. Eleanor Bimla Schwarz, assistant professor of medicine at the University of Pittsburgh: "We've known for a long time that it's important for the baby's health, but we now know it's important for mothers' health as well." (Other recent studies suggest nursing may also reduce the risk of osteoporosis, breast and ovarian cancer, and Type 2 diabetes, the Times notes.)
Good to hear, yes. But there are a couple things about studies like this -- or at least the message from them that people run with -- that positively sour my milk.
First, correlation ain't causation. "Women who breast-feed may simply lead more healthful lives than those who do not," other experts (paraphrased) told the Times, noting that the new analysis might not have been able to account for all the differences between the two groups. And: breast-feeders "may be healthier women who take better care of themselves," said Dr. Nieca Goldberg, medical director of the NYU Women's Heart Center. (This particular study, it should be noted, did at least try to account for this, adjusting for variables such as age, race/ethnicity, income, education, and risk factors for disease.)
Still, here's where I channel (so-called) anti-breastfeeding bugaboo Hannah Rosin: the same kind of loophole does pop up in study after study on the benefits of breastfeeding for children -- which, regardless of their merit, are often used in facile ways to exhort women to breastfeed.
As Marjorie Ingall wrote, pre-Rosingate, at Babble.com: "Women who breastfeed tend to be wealthier and better educated than women who don't, so it's hard to tease apart how much of the benefit to their children comes from breastfeeding and how much comes from other factors correlated with money and education."
One of Ingall's examples: "A large study recently...found that breastfed babies do indeed tend to be smarter than formula-fed babies. But it also found that mothers who breastfeed also tend to have higher IQs and more education, and tend to provide more stimulating home environments than formula-feeding mothers. Once the numbers were corrected to account for the mom's IQ, the relationship between breastfeeding and intelligence disappeared. (And there was no statistical difference between siblings when one was breastfed and one wasn't.)...Previous studies, for the most part, hadn't factored in the mom's IQ when declaring that breastfeeding made babies smarter." ("Certainly the Scottish study indicates it's unlikely that breastfeeding will make my baby smarter," she adds. "[The fact that I am a total mega mongo genius will."])
I'm not saying they ought to quit studying breastfeeding, or finding out potentially great things about it. (Though -- while nature does often work in odd ways, and science has been known to improve upon it -- I'm still not sure why anyone is particularly impressed that nursing turns out to, like, work.)
But...ugh, another breastfeeding study. While each contributes to a valuable body of research, each also (not by design) contributes, and not always constructively, to the ongoing pro-/con- debate -- a debate that, while interesting on its face, is just not so relevant to women's lives. In other words, as I've said before, we don't read the Journal of the American Medical Association to decide whether or not to breastfeed. We decide whether it's physically, logistically or economically possible in the first place. ("[S]how me how the girl working the fry-o-later at the fast-food place on the corner is going inform her manager that she's going to take forty minutes off every four hours to haul her electric pump into his office, which he should obligingly vacate for her, then provide facilities and opportunity for her to sterilize her equipment and store her milk," writes Ingall. "Not on this planet.")
More often than not, in books, on blogs, and elsewhere, studies are cited -- even with the best of intentions -- to encourage women to breastfeed. Fine. Problem is, these studies could in fact be perfectly executed, utterly without flaw or exception, and it'd still be nigh on impossible for so many women to nurse for more than several weeks, if at all.
"We tell women that breast is best, we tell them to breastfeed exclusively for the first six months, we even tell them it will raise their kid's IQ (and we should give that a rest), and then we send them home with formula samples, or with a baby whose throat is too sore to suckle, or a mom whose milk is delayed because of surgery, and we don't teach technique, and we are offended when a woman breastfeeds in public, so we make her feel housebound, and we don't give a mother and her partner paid leave, and we send her to go back to a workplace without on-site childcare, and so her only alternative to formula is to plug her nipples into a machine, and if she's lucky she gets periodic breaks and a 'non-bathroom lactation room' in which to pump, and if she's not she gets a toilet, and so on and so forth," writes Jennifer Block in a recent story on Babble.com. "It's no wonder women are ready to burn their nursing bras."
She's on a roll here, so I'm just going to keep quoting.
"...[S]cience is validating the physiology of the mother-baby dyad -- that is, both are healthier when they remain close to each other during the first several months postpartum. It's not simply the milk that's inimitable; it's the mothering. (Indeed, "We actually don't know if feeding infants human milk has the same benefits as breastfeeding," says Labbok [ID below].) And mothering is something that our culture does not value enough to support. It is this dissonance between physiology and culture that has women so frustrated, and feminists like Rosin grasping at the bottle as a proxy for equality...
"Why are we so willing to surrender the parts and processes that makes us female rather than demanding that society support them? We've broken down doors and cracked glass ceilings, when what we need to do is redesign the building."
Here, Block quotes Miriam Labbok, MD, a professor of public health at the University of North Carolina, who has over three decades of experience in the field of maternal and child health, including a stint as senior advisor to UNICEF on infant feeding. "There's an understanding of human rights outside the U.S. that includes the right of women to breastfeed. And that means women shouldn't be expected to do it unless everyone is fully supporting it -- her family, her society, her workplace, everybody all the way down the line to her government," Labbock says.
Block again: "In the podcast accompanying the Atlantic story, Rosin reveals her pessimism: 'We are never going to be Norway,' she says, rolling her eyes. 'There will never be a situation in America where women . . . will have six months time to exclusively breastfeed their children.' Really? Did we ever envision an organic garden being planted at the White House by the nation's black first family?"
I'm nursing my second child now, and I love it. Of course, I am self-employed, and my boss is a total mega mongo genius.