by Heidi Green
April 02, 2009

Parents, grab your pencils!

Writing letters to the editor may seem old-fashioned, but that is just what the United States Breastfeeding Committee (USBC) is asking us to do: Write to the editor of The Atlantic in response to a recent article by Hanna Rosin, “The Case Against Breast-Feeding.”

The case
If you haven’t read Rosin’s piece and missed her segment on the Today Show, you may wonder why the USBC—along with signatories from more than thirty other national groups, including the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, the Academy of Breastfeeding Medicine, the American Nurses Association, and many others—has come out so strongly against it. Here are the top concerns:

• Hanna Rosin says that the health benefits of breastfeeding, for child and mother, are meager and don’t justify the “burden of breastfeeding” as she sees it. Leading medical authorities disagree, and the USBC’s own letter to the editor points specifically to a 2007 meta-analysis of high quality studies by the Agency for Healthcare Research and Quality.

• Rosin equates formula-feeding with breastfeeding, noting that the difference is that bottle-feeding is more expedient, is a responsibility that either parent can do, and does not subject the mother to the “bondage” of breastfeeding. In fact, may breastfeeding mothers believe that breastfeeding is easier than formula-feeding, since it requires none of the gear (e.g., formula, sterilized water, bottles) and is highly portable. It’s true that dads can’t breastfeed, but that doesn’t mean they can’t adopt a fair share of parenting responsibilities.

• Rosin strikes back against the negative judgments of breastfeeding mothers against those who are not breastfeeding, claiming that not breastfeeding leaves one ostracized and on the sidelines at the playground. I don’t know where Rosin lives, but according to national data published by the Centers for Disease Control and Prevention, two-thirds of mothers are not breastfeeding their babies at three months. That’s right. In the U.S., breastfeeding is still pretty darn far from being the “norm,” the feeding method of choice for even half of new babies. This in spite of the American Academy of Pediatrics’ recommendation for exclusive breastfeeding to extend to the six-month mark, and breastfeeding alongside complementary foods to continue until at least 12 months. Rosin’s anecdotal account of her particular upper-crust playground full of breastfeeding mothers does not represent the experience of many U.S. moms.

The response
There’s a lot not to like in Rosin’s article. Lines like “[H]ow is it that every mother I know has become a breast-feeding fascist?” really get my hackles up. The idea that the “women’s health movement” is nothing more than a “branch of feminism” irritates me. The notion that mothers choose to breastfeed because they have been brainwashed by Dr. Sears I find ridiculous. The implication that there is no grounds for concern about safety of infant formula (think melamine in China and elsewhere and bisphenol-A) is ill-founded.

But what really gets to me is Rosin’s position that the conflict here is all mother-on-mother: breastfeeders versus non-breastfeeders! According to Rosin, we know who the real losers are: breastfeeding mothers, who (she says) take on the huge burden of feeding their baby because they are seriously misinformed about real science and allow themselves to be bullied into it.

What Rosin ignores—and we would all benefit from considering—are the many real barriers to breastfeeding, including sociocultural, economic, political, marketing, and health care factors. Family members who believe formula-feeding is the only way to know baby is “getting enough,” airlines that ground breastfeeding mothers, jobs that refuse to accommodate breastfeeding mothers with time or space to pump their milk (or better yet, feed their babies), delivery of unrequested formula samples to expectant mothers, pediatricians that still advise mothers of weeks-old babies to supplement with cereal—these are just a few examples of the challenges breastfeeding mothers might face. And that’s just the tip of the iceberg.

The decision about what and how to feed one’s child is an intensely personal one. Let’s respect that. Let’s resist judging each other about how each of us chooses to feed our babies. At the same time, let’s recognize that we, as a society, are still falling flat when it comes to supporting families who choose to breastfeed. Instead of making a “case against breastfeeding,” let’s make “a case against the challenges of breastfeeding.” Let’s do what we can to support the breastfeeding mothers we know, and their babies. In spite of what Hanna Rosin thinks, such effort would benefit us all.

If you want The Atlantic to hear your thoughts on Rosin’s topic and would like to be a part of the USBC’s letter-writing campaign, you can post your letter through the USBC’s portal. Me? I’m heading over to that site right now.