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‘Militant lactivism’: question it at your peril

A US journalist caused a storm when she dared to challenge some of the scientific claims of the breast-is-best lobby. She talks to spiked.

Nancy McDermott

Topics Politics

Hanna Rosin is an unlikely heretic. She’s an American journalist and a relaxed, down-to-earth ‘new mom’ with two school-aged children and a newborn boy. Yet in the eyes of some in the parenting lobby, she has committed a cardinal sin: she wrote an article arguing against breastfeeding. It was actually called that: ‘The Case Against Breastfeeding.’ Published in the April issue of the influential US journal, Atlantic Monthly, the article quickly caused a storm.

Yet despite the article’s headline, Rosin tells me now that she is not actually against breastfeeding. She is not advocating that women stop breastfeeding entirely; she is still nursing her infant son. She says she accepts the evidence (and expects there will be more) showing that ‘breastfeeding is better’ than bottlefeeding. ‘But the question’, she says, ‘is how much better?’.

The gist of Rosin’s argument, and the thing that has got tongues wagging from the playground to the halls of the American Academy of Pediatrics, is that the science used to make the case for breastfeeding has been oversold.

In her article, she describes how, one day, while she was sitting in the paediatrician’s office, she happened to catch sight of an article about breastfeeding in the Journal of the American Medical Association. On the question of whether breastfeeding prevents kids from becoming obese – one of the apparently scientifically proven benefits of breastfeeding that is promoted by the breastfeeding lobby – the article concluded: ‘There are inconsistent associations [between] breastfeeding, its duration, and the risk of being overweight in young children.’

‘Inconsistent?’, wrote Rosin. ‘There I was, sitting half-naked in public for the tenth time that day, the hundredth time that month, the millionth time in my life – and the associations were inconsistent?’ (1)

It was then that she decided to look into the ‘case for breastfeeding’. What she discovered is that for full-term infants living in the developed world, there is clear and strong evidence to show that breastfeeding helps to prevent ear infections and respiratory and gastro-intestinal infections. As for other claims – such as breastfeeding’s positive effect on IQ levels or the claim that it offers protection from leukaemia, asthma, allergies, diabetes and obesity – the evidence is not as strong. In some cases, it is not even statistically significant.

Everything Rosin read pointed to the same conclusion: the evidence shows that breastfeeding is better for infants than bottlefeeding… but only a little better. Not so much better that mothers should feel they are endangering their children, or depriving them, if they choose not to breastfeed exclusively, or even at all.

She then went on to explore how much making a commitment to breastfeeding requires of women, what it does to the division of labour in the family, and how it affects women’s ability to work outside of the home. Breastfeeding can, and frequently does, complicate all of these areas of women’s lives in a very personal way – and Rosin argued that the all-or-nothing approach to breastfeeding, where new moms are intensively advised to breastfeed exclusively, helps no one.

Her article hit a raw nerve. She has appeared on radio and TV debate shows, and the blogosphere is choked with cases against her ‘case against breastfeeding’. She has been attacked and abused on some blogs. David Tayloe, president of the American Academy of Pediatrics (AAP), wrote to Atlantic Monthly to accuse Rosin of having skimmed the literature and to chastise her for failing to mention the AAP’s statement of 2005, which flagged up the benefits of breastfeeding for the vast majority of infants.

The hostility is not really surprising. In today’s sometimes shrill pro-breastfeeding climate, even a relatively ambivalent remark about breastfeeding can spark angry demonstrations – as American TV presenter Barbara Walters discovered in 2005 when she made the mistake of saying that nursing in public made her feel uncomfortable. Some pro-breastfeeders even describe themselves as ‘militant lactivists’ and challenge anyone who questions their arguments. What makes Rosin’s article unique, however, is not simply that she has challenged breastfeeding orthodoxy; rather it’s the way she has challenged it.

We’ve come a long way since the days of Betty Friedan’s The Feminine Mystique (the 1963 book which attacked the gender roles assigned to women in 1950s America). No one openly argues that ‘A Woman’s Place Is In The Home’ these days, and most formal barriers to women’s participation in employment and wider society are long gone.

But the notion that ‘breast is best’ – and its implications for women’s role in the family and even society – goes unquestioned today. And it goes unquestioned because it is presented narrowly as a matter of science, as a proven ‘fact’ that cannot be challenged except by anti-science deniers or twisters of ‘the truth’. By taking a critical look at the scientific case for breastfeeding, Rosin has blown the lid off a whole host of awkward questions about what the focus on breastfeeding means for women’s lives.

Most men and women today approach marriage and family life with an expectation of equal partnership and shared domestic responsibility. But the arrival of children has a drastic impact on the division of labour in the home and on women’s fortunes at work. This is not simply a matter of America’s pitiful employment policies, its miserly six weeks of maternity leave or the lack of affordable childcare; alongside these things, the pressure to breastfeed has become a new, apparently science-led way of making women accommodate to a more domestic role in their children’s early years.

Breastfeeding is the last biological link between women and their traditional role in the family; it is something only they can do. Whether it means being physically available to nurse or pumping milk while at work, it drastically tips the scale towards a situation in which women take on primary responsibility for domestic life in a way that is not totally different from in Friedan’s day. Unlike in the past, however, when it was assumed that women would stay at home and attitudes to breastfeeding were relatively relaxed, today the decision to nurse is imbued with moral significance. After all, if the science is clear and breastfeeding is best, what does it say about women who choose not to breastfeed? What is wrong with them?

From the emphasis of bodies like the AAP, which insists on the importance of breastfeeding, you might imagine that America is on the verge of a public health crisis as a result of many women’s desire to bottlefeed rather than breastfeed. Yet Rosin’s dispassionate look at the evidence reveals nothing of the sort. Rather, the fixation with breastfeeding reveals a widespread uneasiness about women’s role within the family – an uneasiness that women experience in a very personal way, and which has led to the heightened politicisation of breastfeeding in public life.

The reaction to Rosin’s article hasn’t been entirely negative. She tells me that about half of the responses she has had are from women who loved what she had to say – ‘each with her own story to share of how she quit breastfeeding’. Does this mean women are lightening up and feeling more relaxed about the choices they make in relation to feeding their children? Rosin says: ‘It’s hard to tell. If they are, I don’t see any sign of it. New mothers I meet seem just as worried about these things as ever.’ Time will tell.

Nancy McDermott is a writer and mother based in New York.

Previously on spiked

Nancy McDermott attacked the self-righteousness of breastfeeding mothers. Brendan O’Neill told militant lactivists to get their hands off Jordan’s breasts. Jennie Bristow denied the idea that pregnancy will damage your child. Jane Sandeman asked: Do we need the ‘right to breastfeed’? Ellie Lee asked: Is bottle-feeding a mark of bad motherhood? Mick Hume said you shouldn’t lose your bottle in the face of militant lactivism. Or read more at spiked issue Breastfeeding.

(1) The Case Against Breastfeeding, Atlantic Monthly, April 2009

To enquire about republishing spiked’s content, a right to reply or to request a correction, please contact the managing editor, Viv Regan.

Topics Politics

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