Is it not entirely possible these are mostly a correlation and not causation? Ie, that a mother’s health problems hinder her ability to breastfeed and not the other way around?

For example, emerging research seems to indicate insulin resistance could be a major contributor of primary low supply. That would go a long way to explaining the purported link between diabetes and obesity in mothers who don’t breastfeed.

Other links might be more indirect. For example, many mothers with persistent hyperemesis gravidarum take high doses of B6 until birth to treat nausea and vomiting. High doses of B6 may inhibit prolactin and increase levels of progesterone, which in turn suppresses prolactin. (In my case for example I was taking doses of B6 safe for pregnancy but 2400% higher than had been established in one study as appropriate for lactation.) If combined with any nutritional deficiencies the HG mother is suffering (especially iron deficiency – another known cause of primary low supply) then it is possible these mothers may go on to have great difficulty making breastmilk. They may also go on to experience long-term adverse effects from HG or conditions associated with it (I have no idea what these might be as HG is severely underresearched). This would then appear in the data as if they were due to not breastfeeding when in fact that was not the case.

Others here have already spoken about the impact difficulties with breastfeeding have on mental health, so that could be another example where correlation is mistaken for causation.

Your feedback would be most appreciated.

I actually completely disagree. Studies show that having a parent at home rather than being in an institutional daycare yields about the same benefits as breastfeeding. Children won’t encounter many of the germs they need breast milk immunity as an imperfect protection against, and study after study has shown that obesity is less likely if the child is not in an institutional setting all day – which is probably partly, as with all the alleged breastfeeding benefits, due to socioeconomic factors but partly also due to the food at all but the very highest-end daycares. Yet I think we can all agree that it would be highly inappropriate to have a “public health level” campaign for stay-at-home parents, just because “improving a community’s” health is “in everyone’s best interest.”

I nursed both of mine exclusively until 15 months of age. My honest opinion is that most of the people who care enough to go to bat for the “cause” of breastfeeding have simply chosen to hang their parenting hat on a parenting factor that made them feel good about their parenting, but that was not actually significant at all in the grand scheme of things. At the expense of struggling new moms who, for whatever reason, are unable to breastfeed or unable to breastfeed without extreme difficulty and an unnecessary, often harmful tension on the parent-child relationship.

Hi Kelly,

Thank you so much for sharing your experience.

Regarding your initial question: It is not appropriate to overly aggressively promote breastfeeding to brand new moms. One should impartially inform and support. On the other hand, advocating for and promoting breastfeeding at the public health level is most appropriate because at a population level, a community will be healthier if its breastfeeding rates are higher. Any one individual’s decision is no one else’s business. But improving a community’s breastfeeding rates is in everyone’s best interest.

Regarding your last paragraph. There are, no doubt, breastfeeding activists who sincerely believe that every new mother should do everything in her power to breastfeed her baby. However, there are plenty of more moderate health care practitioners and breastfeeding advocates who sincerely respect a mother’s choice. I like to think that I treat new mothers in that manner. I would only hire and work with colleagues who take a similar position. We exist … I promise. Perhaps our voice isn’t loud enough.

DF

This position seems nonsensical to me. How on earth do you define and describe the difference between these two issues (breastfeeding as a public health concern, and breastfeeding as individual choice which may or may not be “right” for any given family), and how on earth could the public rhetoric surrounding breastfeeding EVER suggest or describe the existence of such a difference? Really, what would such a conversation sound like, especially to a woman struggling mightily to breastfeed and nearly (literally) killing herself in the process?

Depending on our social/socioeconomic demographic, women hear a thousand times, in a thousand different ways, that breastfeeding is the only responsible, reasonable, loving way to feed their babies–that the benefits are so indisputable and so overwhelmingly positive, that the danger of formula feeding is, quite literally, akin to riding a mechanical bull while pregnant, that all we need to do is educate women about the benefits of breastfeeding and they will make the “right” decision about how to feed their babies, and that any mother who would choose to formula feed her child is too selfish to deserve to be a mother. In what circumstances would the pro-breastfeeding medical establishment admit that formula feeding might be a better choice for a family, and can we PLEASE turn up the volume on THAT particular part of the conversation?

Following my first child’s unexpected and unexplained premature birth, and NICU stay; consultations with four different lactation consultants, an occupational therapist, and my child’s pediatrician; and the discovery of my son’s oral aversion and reflux, I resigned myself to pumping exclusively–more “work” than simply breastfeeding, certainly, but the best choice given our circumstances. My son spent hours every day in his bouncy seat while I cradled my breast pump in my arms instead of him.

The social pressure to breastfeed my child was so monolithic, relentless, and acute that, I believe, it contributed directly to my postpartum depression, which only eased once we finally–with the support of my family and child’s pediatrician–switched to formula when my son was six months old. (A friend of mine told me, “Every woman in my PPD group said that the pressure to breastfeed contributed to their feelings of failure and depression. It makes me wonder about that idea that breastfeeding protects women from PPD; I was lactating, so all of my hormones were doing what they should have been doing, but I have never felt so low, joyless, and hopeless.) Once we switched to formula, though, I finally started to really enjoy being a mother, had time to feel life getting back to normal, and was able to enjoy holding and bonding with my son. That six months I spent in misery, a slave to breast milk and pump, was time I’ll never get back, and if I had to do it over again, we would have made the switch much sooner.

If there is a voice amongst the pro-breastfeeding chorus who is really willing to admit that for some women, babies, and families, breast isn’t necessarily best, I never heard it pipe up–but I sure would have been eager to listen.

Was there any mention in this study about the child having food related allergies? My reason for asking is this; myself and my two siblings were all breastfed. My sister and I have no allergies,,but my. Brother had eczema and hay fever even as a baby, it turned out he has food allergies that were coming through the breast milk. I have heard many cases of this, so could it be the case that the children that were breast fed and had asthma were experiencing allergic reactions to something that the mother was consuming and coming through in the milk?