| by Peggy O’Mara, Editor and Publisher
REEVE TAYLOR
Rosin’s article, and an interview with her on The Today Show, divide women by mocking our national health goals and defaming breastfeeding.
Yesterday I received an e-mail, signed “Wavering Somewhat,” from the nursing mom of a 26-month-old daughter. The mom had read Hanna Rosin’s “The Case Against Breast-Feeding,” an article published in the April 2009 issue of The Atlantic Monthly, and was now questioning the benefits of breastfeeding over formula. Rosin’s article, and an interview with her on The Today Show (March 16, 2009)—in which NBC News chief medical editor Nancy Snyderman, MD, said, “Formula is wonderful”— divide women by mocking our national health goals and defaming breastfeeding.
In her article, Rosin describes her cursory review of the medical literature on breastfeeding to shore up her personal decision to possibly forgo it, and concludes that all the talk about the benefits of breast-feeding is just “magical thinking.” But it’s irresponsible to imply that such a brief and biased analysis of the medical literature could somehow trump the conclusions of the world’s leading health organizations and medical authorities. By now, the superiority of breastmilk to formula is axiomatic.
While we don’t really need studies to tell us that the milk of our own species is superior to any other infant food, such studies abound. One of them, “Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries,” published in 2007, reviewed the evidence on the effects of breastfeeding on short- and long-term infant and maternal health outcomes. This study looked at systematic reviews and meta-analyses, randomized and non-randomized comparative trials, and prospective cohort and case-control studies, and rated them for methodological quality. Nine thousand abstracts were reviewed. Forty-three primary studies on infant health outcomes, 43 primary studies on maternal health outcomes, and 29 systematic reviews or meta-analyses representing approximately 400 individual studies were included. (Only reviews published in English were considered.)
This review of the medical literature showed that “a history of breastfeeding was associated with a reduction of the risk for children of contracting acute otitis media, nonspecific gastroenteritis, severe infections of the lower respiratory tract, atopic dermatitis, asthma (young children), obesity, type 1 and type 2 diabetes, childhood leukemia, sudden infant death
syndrome (SIDS), and necrotizing enterocolitis.” For mothers, a history of breastfeeding was associated with reduced risk of type 2 diabetes, and cancers of the breast and ovaries. Ceasing breastfeeding early or not breastfeeding at all was associated with an increased risk of postpartum depression.
What Rosin calls our “national obsession with breast milk as liquid vaccine” turns out to be an international obsession. In Global Strategy for Infant and Young Child Feeding, the World Health Organization (WHO) and UNICEF define optimal infant feeding as six months of exclusive breastfeeding, with continued breastfeeding (along with age-appropriate complementary foods) for up to two years or longer. A description of optimal infant feeding as exclusive breastfeeding for six months has also been adopted by the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, the Blueprint for Action on Breastfeeding in Europe, the International Federation of Gynecology and Obstetrics, and the International Pediatric Association, among other important organizations.
Encouraging breastfeeding is also a key strategy of the US Centers for Disease Control and Prevention (CDC) in meeting their goal of improving the health of mothers and their children. To follow the progress of breastfeeding, the CDC has created the Breastfeeding Report Card, which tracks the Healthy People 2010 breastfeeding objectives by state.
The breastfeeding goals of Healthy People 2010, a national initiative of promoting health and preventing disease managed by the US Department of Health and Human Services (HHS), build on health initiatives pursued for several decades. The breastfeeding goals for both 2000 and 2010 call for 75 percent breastfeeding initiation, 50 percent breastfeeding at six months, and 25 percent at one year. However, the US did not meet these goals in 2000, and we will not meet them in 2010.
It is this slow growth in the rate of breastfeeding that explains the zealousness of advocates Rosin portrays as “breastfeeding fascists.” As of 2005, less than half of the states had met the Healthy People 2010 goal of 75 percent initiation rate, according to the CDC. Only ten states had met the goal of 50 percent breastfeeding at six months, and 25 percent of infants
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