Fallout from IQ study ignores barriers to breastfeeding
A recent study linking longer breastfeeding with higher IQ in adulthood seems to be pushing some people’s buttons. The study followed several thousand children, recruited in the early 1980s, through adulthood, and assessed years of education, IQ, and income in their early 30s. Compared with those who were not breastfed, individuals who had been breastfed for at least a year earned about $100 more each month, completed an additional year of schooling, and had IQs that were 3.76 points higher. These estimates accounted for multiple sociodemographic founders, increasing the chance that the differences were due to breastfeeding itself, rather than to other confounding factors.
On its face, this study adds to the ample evidence that how babies are fed is an important predictor of health and wellbeing. Yet several in the media have gone the great lengths to pick apart they study and its methods. The Independent’s Matilda Battersby took on the study with a pointed commentary, entitled “So breastfeeding improves your child’s IQ? Try telling that to the women who physically can’t.”
In her commentary, Battersby writes, “What none of these studies or news reports ever seem to acknowledge is quite how difficult breastfeeding actually is.” She goes on to compare her first weeks of breastfeeding to sitting “for hours at a time with a needle sticking in their nipple.” She writes, “Around 69 per cent of mothers breastfeed their babies at birth, but this falls to 23 per cent at six weeks – and for a very good reason. It is tough.”
I suspect that Battersby wanted to assuage the very real feelings of guilt and regret experienced by women who were unable to achieve their feeding goals. But as Shannon Tierney has so eloquently written, “Things can matter, without being the only things that matter. Breastfeeding matters, and it still matters even for women who cannot do it.”
Battersby goes on to write, “while we’d all like to think we’re doing the best for our bambinos we’re stuck between the Earth-motherish pressure to be constantly attached via a teat to our sprogs, versus the “Put it away, dear” mentality – thank you, Nigel Farage – which suggests that breastfeeding is embarrassing and dirty.”
And here, for me, is where her argument falls apart. The “breastfeeding problem” is not that studies have found that breastfeeding is different from formula feeding – rather, the problem is our collective failure to convert those data into a sustained commitment to provide women with the care and support that they need to achieve their infant feeding intentions. It’s the system that did not provide Battersby with help to resolve her pain during the hours of “needles sticking in her nipples.” It is Nigel Farage, and our collective cultural neglect of – and often open hostility toward – mothers and children.
That hostility was evident in The Atlantic, where Adrienne Lafrance dissected the IQ study’s limitations in a piece headlined, “About That Breastfeeding Study.” Her attention to potential confounding, generalizability, and epidemiologic methods seems incongruous with last spring’s gleeful reporting of the breastfeeding sibling study, which was widely reported as “confirming” that breast-feeding benefits have been drastically overstated.
Indeed, Lafrance references coverage of the sibling study in her essay, noting parenthetically:
Lafrance wants to convince us that breastfeeding really isn’t important, and that studies suggesting otherwise are part of a lactivist conspiracy. What’s missing completely from this analysis is a critique of cultural assumptions and institutional barriers that prevent women from achieving their infant feeding intentions. What if, rather than dissecting the limitations of “that study,” these writers instead explored how the status quo forces so many mothers to choose between their productive and reproductive roles?
Indeed, there’s tremendous irony in Lafrance’s use of the word “politicized,” given the power and influence of the formula industry. According to the Wall Street Journal, infant formula in the US is a $5 billion market, and spending on advertising climbed 70% from 2009 to 2013. Abbott Labs leads the pack with 29% of the market, targeting new mothers and mothers-to-be with clubs, free gifts, and free samples. Every time a baby goes to breast, a formula company loses a sale. It takes little imagination to link formula company interests with political decisions that undermine breastfeeding mothers. I saw it first-hand in Massachusetts in 2006, when then-governor Mitt Romney overturned a Public Health Council decision just days before a major formula-manufacturer announced plans to build a factory in the state. The true “politicization” of infant feeding choices is not lactivists– it’s from vested interests that systematically undermine mothers who want to breastfeed their babies.
As beautifully stated by the Analytical Armadillo in a critique of Battersby’s essay, “It’s precisely because so many women have no choice but to use formula that it becomes a much more emotive issue.”
So why, then, do women in the US tolerate living in one of only two countries in the world that provides no legal mandate for paid maternity leave? When we return to work, why do we settle for unpaid pumping breaks, rather than on-site childcare and babies-at-work? Why do we accept dysfunctional postpartum care that treats mothers and babies like pin balls, bouncing among multiple specialists, none of whom are considering the needs of mother and baby together? Why do we allow companies to distribute infant formula marketing material in hospitals and health care settings, when we know these materials introduce families to costly, branded products that are no better then generics, and when “breastfeeding support” information is crafted to confuse and mislead families? When will we come together to protect every mother’s right to breastfeed for as long as mutually desired by her and her baby?
Rather than minimize breastfeeding, we need to direct our attention to the obstacles that prevent women from achieving their own breastfeeding goals. Our problem is not the evidence that breastfeeding is different from formula feeding. Our problem, as noted in the fabulous book, “Beyond Health, Beyond Choice,” is that “too little serious attention is given to addressing the many social, economic, and political factors that combine to limit women’s real choice to breastfeed beyond a few days or weeks. The result: women’s, infants’, and public health interests are undermined.”
Alison Stuebe, MD, MSc, is a maternal-fetal medicine physician, breastfeeding researcher, and associate professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine and of Maternal and Child Health at the Gillings School of Global Public Health. She is a member of the board of the Academy of Breastfeeding Medicine. You can follow her on Twitter at @astuebe.
Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.