Talk about tackling a taboo. In her upcoming book, Is Breast Best?, Joan B. Wolf takes on the American Academy of Pediatrics, the American Public Health Association, officials at the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality, doctors, and many, many parents. Not to mention the La Leche League.
To her title question, the assistant professor of women’s and gender studies at Texas A&M University, answers, breastfeeding advocacy (at least as far as the developed world is concerned) is all hype and hyperbole. There is no scientific reason to prefer the breast to the bottle. The evidence is unclear, the relation between cause and effect in statistical studies murky, and the biological mechanisms by which breast milk supposedly provides benefits cloudy.
Wolf first became interested in a more limited question: Why have feminists avoided the issue? After all, it can be difficult to balance babies, feeding schedules, breast pumps, and job demands. “It’s hard not to notice the veritable tsunami of conflicting advice that greets women from the moment they try to conceive.” Every detail of their lives, they are told, can be manipulated to optimize pregnancy and childbirth.When it comes to feeding, however, there is virtually no debate. Even formula companies, which have a vested interest in getting women to bottle feed, say openly that ‘breast is best’ and try to make the case that their products are closest to breastfeeding. That is the equivalent of Nike telling people that it’s always better to go barefoot, but if they choose to wear shoes, Nikes are better than Reeboks. So I wondered how feminists, who have been highly critical of so many aspects of reproduction, made sense of medical advice that seemed irrefutable and that essentially told women that infant feeding was solely their responsibility,” Wolf told The Chronicle..
“A few academic feminists have written critically about breastfeeding, but because scientific claims about the virtues of breast milk have gone largely uncontested, feminists, like most everyone else, have assumed the case for breastfeeding was airtight.”
Wolf, who has a Ph.D. in political science, began combing through the social-science and epidemiological literature on breastfeeding, finding the evidence for its benefits less than compelling.
So what explains the overwhelming support for the practice?
The author thinks that it evokes deep-seated cultural anxieties of the late 20th and early 21st centuries: anxieties surrounding what she calls “total motherhood.” Women, in particular, are afraid to give their children anything less than the best—prenatal care, preschool, toys, food, stimulation, school … . The anxiety goes beyond gender, however. It’s not just about motherhood, but feeds into the assumption that all things natural are good, as well as the authority accorded to anything supposedly backed by science and the power of institutional medicine. All told, it may come down to our collective fear of risk—and our willingness to assume the burden of keeping it at bay. “The more sophisticated humans become, the more we know and are able to manipulate, the more we think we can control everything. We are so enamored with what science has accomplished that we forget how much remains to be understood. And so we have a terribly inflated sense of our ability to prevent bad outcomes,” Wolf says.
Pricking established wisdom can be downright unpleasant. Wolf published an early article on her research in the Journal of Health Politics, Policy and Law in 2007. Online debates ensued, blogs posts took off. “Many people were and remain very angry with me,” she says. “Perhaps more surprising has been the number of women, including some lactation consultants and women who successfully and happily breastfed, who expressed gratitude that I was challenging what they believed to be the excesses of breastfeeding advocacy,” she adds.
Come January, she’ll see what the full account of research stirs up. New York University Press will publish Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood right after the new year.—Karen Winkler