A Case Against Hanna Rosin: Breastfeeding’s Risks and Benefits

Women across the blogosphere have responded to Hanna Rosin in droves, but I haven’t seen some of my thoughts, so I am posting them here.

I agree with Rosin that people such as Dr. William Sears hype breastfeeding out of proportion to its proven benefits.  However, that doesn’t mean that breastfeeding doesn’t have very real benefits.  Rosin’s attempts to distort science in the other direction are weird and sad.  She makes herself out to be someone who cannot understand the concept of statistical significance.  There is NO experimental data with human controls that exactly match the experimental group–you’d have to have a parallel universe.

Rosin points out that breastfeeding’s benefits come from feeding the
baby at the breast, not just from breastmilk.  Rosin’s bizarre response
to this idea is that this makes breastfeeding less important.  Wouldn’t
that make it MORE important?  How many formula feeding moms open their
shirts and hold the baby skin to skin against their heart at every
feeding?  How can you possibly replicate the sucking action at the
breast (which helps with jaw and palate development) with a rubber
nipple?  If the breastfeeding process and the breast milk are BOTH
important, why would formula feeding with a bottle be a better idea?

Every decision a person makes has risks and benefits.  There was a
debate on Feministing a few months ago about whether a woman planning
breast reconstruction surgery should consider its impact on her ability
to breastfeed–it comes down to how much damage she is doing to herself
by living for an extra X number of years with problems caused by her
large breasts.  Of course she should have the surgery if she feels she
needs it now.  As for Rosin, there is real damage to her psyche and her
relationship to her son if she seethes with anger through every night
feeding.  I think that in her case, it’s to her benefit and her son’s
to use formula.  But why does that mean that breastfeeding doesn’t have
very real benefits?

Rosin is all wrong about the breastfeeding ad campaign.  The
dandelion and ice cream ads were so ridiculous that the people who
originally designed the bottle-with-inhaler ads withdrew from the
campaign.  The people who “thought the better” of the inhaler ads were
formula companies, who lobbied vigorously to have them axed.  I
disapprove of guilt and shame as a means to public health, and I agree
that the ads Rosin describes are offensive.  But the more effective
offensive ads were pulled because of corporate interests, not feminist
consciousness.  Here’s a link to a WaPo article about it:
 http://www.washingtonpost.com/wp-dyn/content/article/2007/08/30/AR2007083002198.html

Rosin spends her whole piece railing about upper and middle class
mothers enslavement to breastfeeding, but when it comes to pumping, she
suddenly takes up the plight of the working poor.  I agree that pumping
is especially difficult for women with low job flexibility.  It’s
generally an unpleasant experience to begin with. But many women stop
breastfeeding long before they return to work, and many mothers who do
not work at all never even start breastfeeding.  Pumping is another
risk-benefit analysis.  A mom can decide to partially breastfeed, using
formula only when she is at work.  The employed mothers I work with at
WIC all have jobs like custodian, waitress, or Wal-Mart employee.  The
ones who have fully breastfed by pumping in closets or their cars are extremely proud of their decisions.

When it comes to health, Rosin doesn’t think about poor mothers at
all.  She touts having a prolonged episode of diarrhea in infancy as no
big deal.  She says that most U.S. babies do not die from diarrhea.
 Well SOME do, and most of the ones who do probably do not have private
health insurance.  Let’s also not forget what a hospital bill can look
like, even for a simple rehydration procedure.  If Rosin’s family even
notices such an expense, paying that bill may mean they forgo a few
restaurant meals.  For a lower-income family, an emergency room visit
could cost several month’s rent.  A prolonged hospital stay could cause
bankruptcy.  And even if the baby doesn’t die, does that mean it
doesn’t suffer?

Rosin doesn’t mention the long-term benefits of breastfeeding for a
mother’s health.  Breastfeeding significantly reduces a woman’s risk of
breast cancer and some other reproductive cancers.  It also helps with
post-pregnancy weight loss.  Some women may feel that inconveniences
associated with breastfeeding may be worth lowering their cancer risks.

Finally, while others have made this point, I am compelled to ad my
two cents.  The idea that breastfeeding inherently leads to
gender-based and unequal parenting is just not true.  She says there’s
no point in her husband getting up in the night to help with feeding.
 Why not?  If he brought her the baby, changed the diaper, and put the
baby back to bed (assuming he doesn’t sleep with them), then she’d get
more sleep.  Or she could pump milk for night feedings.  If her husband
is an ass, or if the two of them lack creativity, that is not the fault
of breastfeeding.  The majority WIC moms I work with formula feed.
 Believe me, that is not lending equality to their relationships.  The
entire institutional structure of our society assumes that the mother
will be the primary parent.  Breastfeeding may not promote gender
equality, but it’s hardly a culprit against it.

So for heaven’s sake, don’t breastfeed if you don’t want to.  And if
you can’t, we should all be grateful that modern substitutes generally
preserves a baby’s life and health.  But don’t pretend that
breastfeeding doesn’t have tangible benefits over formual feeding for
most mothers and babies.