The Redbook Controversy

Erin Ruddy (“No, you don’t have to breastfeeding“Redbook, May 2010) correctly points out that breastfeeding mothers all too often encounter serious obstacles to successfully breastfeeding their infants.   A more productive approach to this problem, however, would have been to identify what those obstacles are and try to eliminate them, rather than simply to launch into a pointless tirade against the practice of breastfeeding, and those who support it.   Nothing productive can be gained by such an exercise.

With respect to any matter of health, the first question we should ask is: what is in our own best interest, and the best interest of our families? There is no longer any serious doubt about the answer as it pertains to infant feeding.   Breastfeeding is clearly and compellingly superior to formula feeding.   There is not a single professional health society in the nation or in the world today that would declare otherwise.   So strongly has this position been established that most professional health societies now recommend breastfeeding for at least the first full year of life, and exclusive breastfeeding for the first six months of life.   Ms. Ruddy chooses to single out the American Academy of Pediatrics, but she could have also mentioned the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, the Academy of Breastfeeding Medicine,  the World Health Organization, the American Public Health Association, and many other organizations.

Such recommendations are not made lightly.   There are tremendous benefits to breastfeeding, and much as Ms. Ruddy may not care to admit it, there are hazards to not breastfeeding.   According to a recently published study in the journal Pediatrics, $13 billion dollars and 911 infant lives could be saved in the United States every year if 90 percent of mothers were to breastfeed in accordance with the above recommendations.

Ms. Ruddy points out the horrors she and others have encountered while trying to breastfeed their infants.   The truth is that these problems can be corrected or even prevented entirely in the overwhelming majority of instances, given proper support of the breastfeeding mother and infant.   Cracked and bleeding nipples, breast engorgement, mastitis, and abscess formation do not have to happen, and breastfeeding does not have to be innately difficult.   What makes breastfeeding difficult are the obstacles our society has thrown up against it, such as poor maternity care practices, hostile employment conditions, and antiquated social mores.   It is time we address these issues.   Rather than wasting our time blaming one another for choosing to breastfeed or to formula feed, we should focus our energy on helping mothers to make an informed decision about infant feeding, and lowering the barriers that prevent them from achieving their goals, whatever those goals may happen to be.  It goes without saying that all of us should respect the right of a mother to decide how she is to feed her infant.   But again, this decision should be a well-informed one.  

We should take care not to throw the baby out with the bath water.   If there are problems with breastfeeding, let’s fix them; but let’s not abandon the practice or minimize its profound importance by deluding ourselves into thinking that everything would be fine if only those crazy breastfeeding advocates would just go away.

Jerry Calnen, MD, is a pediatrician and is president of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.