by Russell Saunders
Few things are as simultaneously joyous and utterly disruptive as the arrival of a new baby. Between the culmination of months of anxious anticipation, hovering family members, sleep deprivation and maternal hormonal fluctuations, for many families it is as full of stress as it is of happiness. Newly-minted parents that come to my practice often have a slightly harrowed appearance as they apologetically pull out lists of questions from their diaper bags.
One of the more pressing issues to address in the immediate newborn period is the baby’s weight. While it is normal for newborns to lose up to 10% of their birth weight in the first week of life, pediatricians need to be vigilant in monitoring the baby’s growth to ensure that it rebounds appropriately. Parents who are already frazzled can become especially concerned when they hear that their infant is in need of even closer follow-up, and I go out of my way to be as reassuring as possible during these visits.
Every so often I encounter a mother in this situation who is trying desperately to nurse successfully, and is having no luck. Many of these new mothers are nursing for the first time, but I have met several who nursed easily with their first child and are having a much harder time with the second. All of them have been committed to breastfeeding their children, and many of them express a deep, profound sense of failure at struggling with something they believe to be the mark of a good mother. Almost all of them are tearful and incredibly frustrated.
The pervasive pressure on mothers to breastfeed is a mixed blessing, at best. I defy anyone to convince me that the mothers I describe are failing because of a lack of commitment or effort. Sometimes it just doesn’t work. While I whole-heartedly support breastfeeding as the optimum nutritional option for newborns, it doesn’t work for every family, and making those who don’t or can’t out to be failures is misguided.
Into this fraught mixture we can now add the contretemps between Michelle Obama and Michele Bachmann. From the Times:
‘Mrs. Obama told reporters this month that she would promote breast-feeding, particularly among black women, as part of her campaign to reduce childhood obesity. The Internal Revenue Service then announced that breast pumps, which can cost several hundred dollars, would be eligible for tax breaks.
Ms. Bachmann lashed out at the campaign on Tuesday on Laura Ingraham’s radio show, saying that it reflected a “hard left” position that “government is the answer to everything.”
While noting that she had breast-fed the five children she gave birth to, Ms. Bachmann said, “To think that government has to go out and buy my breast pump — You want to talk about nanny state, I think we just got a new definition.”
Let us dispense quickly with what Rep. Bachmann is saying, which is absurd on its face. The government is not buying anyone a breast pump. The IRS will allow working mothers whose option is to breastfeed to take a deduction for buying a breast pump. As it is widely accepted that breast milk is the optimal food for infants, it makes sense to support this choice for mothers who also have to work. This strikes me as an obvious good.
However, while I applaud Mrs. Obama’s efforts to support nursing mothers, I also have to dissent from her ostensible purpose in doing so. Breastfeeding may be the best thing for infants, but I also believe its benefits are grossly oversold. With regard to many of the purported benefits of breastfeeding, the data just aren’t there. (Knowing the passion with which lactation advocates make these claims, I will likely skip the comment section for this post.) I remain skeptical that meaningful improvements in IQ, for example, can be attributed to breastfeeding alone. In a similar vein, I am not convinced that being breastfed confers a protective effect for obesity. There are plenty of studies that dispute this effect, and anecdotally I have seen many overweight infants and children who were nursed exclusively for the first six months of life. Promoting breastfeeding as part of an overall anti-obesity campaign is tendentious and scientifically questionable.
This ridiculous kerfuffle will doubtless fade into the ether, and probably few will recall another minor skirmish in the mommy wars. Between Rep. Bachmann’s obvious mischaracterization of the new tax exemption and Mrs. Obama’s overselling a widely-accepted benefit for babies, I’d have to side with the latter. It’s wonderful that the First Lady is doing something small but meaningful to help working mothers. I just wish she weren’t using unsupported claims to do so, and giving parents who bottle-feed something more to feel guilty about.
Well the First Lady is just doing what First Lady’s do; advocating nice causes. I wish we weren’t further complicating the tax code to do it but ehh what can you do? Maybe her husband will come through on his tax reform rhetori; I’m not going to hold my breath.
As for Bachmann, I feel compelled as a Minnesotan(immigrated) to apologize for her even though I can’t vote for/against her. I remain, as a Canadian, baffled that the sensible pleasant people in Minnesota keep her around. Perhaps she’s a plant.Report
Actually from what I understand it’s not complicating the tax code. You can already deduct medical expenses (above 2% of AGI) if you itemize, from what I understand the IRS simply ruled that breast pumps qualify as medical devices so can be included as a medical expense.
Correct me if I’m wrong…Report
Well if you’re right so much the better.Report
It wouldn’t matter what FLOTUS said or did: Michelle Bachmann would have nothing good to say of her.Report
Russell:
Sure, lots of things are good for kids (and adults for that matter) but that doesn’t mean that the gov’t has to provide tax breaks for everyone of them. Or does it? I think that is the real point of Rep. Bachmann’s statement, that you seem to so glibly dismiss.Report
The point of Bachmann’s statement is that she’s
1. Reflexively opposed to anything the Obamas do, and
2. Very, very dim.Report
3. Crazy as a catfish.Report
She maybe all three but that does not mean that in this particular case that she is wrong. Besides, if you can afford to have a baby, surely you can afford a breast pump.Report
It does mean Michele Bachmann is a mean-spirited weirdo with nothing better to do with her time than raise a hue and cry over a breast pump tax deduction.Report
BlaiseP:
So she is mean spirited b/c she thinks that the gov’t shouldn’t provide silly deductions for every feel good thing of dubious efficacy?Report
When it comes to Dubious Efficacy, the GOP has much to say about Silly Deductions. While the public tit is hanging out for all their supporters, especially all those good-for-nothing Red States who take in more Federal Dollars than they contribute, their complaints fall on deaf ears.Report
Unless I’m mistaken, there is no new deduction. It’s the old deduction you can take for medical expenses (if you itemize). The question was whether or not a pump qualified as a medical expense.Report
… and surely, if you’re a farmer, you don’t need price supports. Michele Bachmann’s farm got a quarter million dollars in corn and dairy price supports.Report
BlaiseP:
I agree but legislators of BOTH parties continually vote for farm subsidies. So what is your point then?Report
That all this Tax Cut hooey is for public consumption only, so much hypocritical flimflam for the rubes. When it comes to nursing from the public tit, Michele Bachmann ought to take some of that money from her PAC and repay the government for those price supports before anyone ought to take her seriously.Report
BlaiseP:
So the fed gov deficit is really just an imaginary problem being used to scare all us rubes into voting republican? Thank goodness we have folks like you to save us from ourselves.Report
Woo! (wiggles fingers scarily) deficits! Gosh, it’s so good to see the GOP finally concerned about deficits. Fiscal responsibility, thrift, mhm.
Now here’s what I propose: Red States can fund their own states. Mississippi currently gets 202% of every dollar they pay, West Virginia get 176%, Arkansas gets 141%, South Carolina gets 135%, and Kentucky gets 151%. There’s some mighty deficit reduction right there.
That way, in the Blue States, where things are somewhat more prosperous, we can fund our own people and leave you Red Staters to scratch. Your own states can’t fund themselves, because your policies are regressive and simply don’t work.Report
BlaiseP:
You must be right as CA, Ill., NY and NJ are all such shining examples of prosperous fiscally responsible blue states.Report
Well now, California had a bunch of Republicans who decided they weren’t going to pay taxes. That’s true to form for homo republicans, they don’t want to pay for anything. However, they’re not much on actual deficit reductions, case in point, that little harpy Michele Bachmann.
I think we ought to take the GOP at its word. Less taxes? A fine idea, really. Eliminate all federal subsidies for a given state to the tune of their disproportionate benefit from federal dollars.Report
BlaiseP:
So CA’s problems are really all the fault of Repubs as well? It must be a nice fantasy land you live in where Dems can do no wrong.Report
California is the textbook example of why Republicans screw things up at a state level. This isn’t as true at a Federal level, but it is true at the state level.
In California, the GOP refused to pass any tax increases, so Ahnold was forced to gut the state government. No problems. I know LA and the Santa Monica area rather better than I would like: this isn’t a fantasy world. It’s the world where you get what you pay for, not the GOP world where the God-given right to low taxes stands paramount over every other concern.
Now you’ve tried to pull his away from Michele Bachmann and the Public Tit, but you haven’t shown me how her own hypocritical sucking on that tit is anything we should admire.Report
BlaiseP:
I’m the one that pulled this discussion away from Michele Bachmann and the Public Tit, really? Who brought up farm subsidies? You did! Who brought up how red states take more than they contribute. You did! Who brought up how it was the Repubs that ran CA into the ground. You did! At least get your facts straight before you distort them.Report
The Public Tit is a bountiful boob and many are the little piggies which nurse from it. Based on my experience with USDA, I have watched that tit with very considerable interest, for it was the first time I ever had to write report with four commas. DoD was the second time, and there are other grunty piglets who nurse from that gigantic tit.
Like Will Rogers, who famously said “All I know is what I read in the newspapers”, all I know about the Public Tit is designing the databases and writing the reports, none of which reach the Public. All these systems have tables containing information on elected officials, each of whom has his own little herd of piggies, especially USDA.
Now the government does more than provide silly deductions for every feel good thing of dubious efficacy. It funds them directly. I am no tax specialist; that I leave to my tax guy. But when it comes to the Public Tit, few are more informed than me when it comes to the enumeration of the piggies who feed upon it.
Michele Bachmann is a nasty creature who feeds on the Public Tit, taking farm subsidies. But when it comes to human tits, she sees breast pumps, which would allow a woman to provide for her own infant, how did you put it — a silly deduction for every feel good thing of dubious efficacy.Report
Hahaha… good one.Report
If it were the case that Michele Bachmann were remotely interested in anything but tax cuts for her Club for Growth buddies, the glibness quotient might be reduced yea very considerably.Report
I’m actually curious why, given all the breastfeeding frenzy and the backlash against infant formula, there hasn’t been a resurgence of the independent nursemaid market.Report
I would bet its real hard on a body to nurse for years. I’d also think people are no longer cool with their babies drinking from others: seems like a serious ick factor, since you don’t know what that person eats and who else might be …umm… stepping up to the barReport
Yeah definitely. This suggests that the ick factor of having one’s child drink from someone else’s nipple outweighs whatever losses our children might get from consuming formula, which is very interesting to me, given the widespread belief that breastfeeding is superior to formula.
And that is in regards to formula today. There was a time when formula was terrible, before we knew about amino acids and vitamins and such, when formula-consuming infants actually died of malnutrition, when there still wasn’t a thriving nursemaid market.Report
Just the possibility of commercials and advertising for nursemaids in this day and age offers considerable possibility for amusement.Report
I am not sure Chris but I suspect that a large part of the appeal of breast feeding is the bonding experience with the child. That same consideration would work in reverse against the idea of paying someone else to breastfeed junior.Report
Fair enough. but for families where both parents want to continue working, which I have heard is increasingly common after having a new baby (no one wants to work in my family.), it would make sense to just pay some wet-nursemaid to take care of and feed the child during the day.
Plus, correct me if I’m wrong, but don’t infants get the full benefits of breastmilk even if the majority of what they consume is formula?Report
Yes I’d guess so and my quick clumsy google search agrees.Report
The really important part of breastfeeding is at the start, the colostrum transfers the mother’s immunities to the child via immunoglobulin. Beyond that, it’s a wash: modern formula is really good. It wasn’t always as good as it is today: the old complaints aren’t valid anymore. Still, you have to make it up with clean water, and that’s where the formula solution sorta falls down in the Third World.
The nursemaid wouldn’t work out today: the only reason it ever worked was because unpasteurized cow’s milk was unsanitary. And cow’s milk was never as nutritionally appropriate as human milk.Report
Yeah. I’ve heard that. Still, there is a part of me that is deeply suspicious of modern formula. Our first few attempts at infant formula were complete disasters. We now have a formula which doesn’t result in dead babies, and we seem to have concluded as a society that that:s good enough. So we have widespread consumption of infant formula. We also have widespread diet-related public health problems that are far more difficult to explain than the media and most Americans imagine. There has been a link between these problems and infant formula. It makes intuitive sense that there is something that modern formula is missing, just as previous incarnations missed essential vitamins and amino acids.Report
You bring up an important point: there’s far more to this proposition than a few corrections to the formula. There’s also prenatal nutrition: we’re just now finding out how important folic acid is in preventing anemia. Now anyone who eats green leafy vegetables will never encounter this problem but it’s a surprisingly common condition, due to our screwed-up diets these days.Report
This is why I generally sympathize with the organic food movement, although I will stop short of committing the literal version of the naturalistic fallacy.Report
It’s really simple. Look at human dentition. We’re set up to eat some meat and a whole lot of vegetables.Report
The other issue for formula in the Third World that I’d heard BlaiseP is that sensibly economic minded mothers who didn’t really understand the principles behind formula would simply dillute it down beyond the reccomended level in essence starving the kid.Report
There were a lot of excuses bandied about by the formula companies, this was one. Fact is, formula was touted as a miracle food. It wasn’t.Report
Which reminds me of a story from The Treasury of Jewish Folklore.
A rabbi is telling his students a story about the miracles God performs. “Once, there was a woodcutter who, deep in the forest, found an abandoned infant. It was crying from hunger, but the woodcutter had no way to feed it. He prayed to God to help him and God caused him to grow women’s breasts.”
“That’s amazing, rabbi, but why didn’t God just cause the woodchopper to find a lost five-ruble coin, so he could hire a wet-nurse?”
The rabbi gave the student a glance of pure pity. “If God can cause a man to grow women’s breasts. why would he need to lay out five rubles in cold cash?”Report
There is a big growth in milk-sharing. Many jurisdictions are setting up milk banks, and there many small networks of mothers who will donate milk to one another when necessary.Report
Breastfeeding your baby is going to make it grow up to be less obese? That seems like a hard claim to substantiate through controlled testing. Diet, exercise, and genetics strike me as much more likely candidates to be significant factors in obesity.
That’s not to say that FLOTUS is doing anything wrong, or that Bachmann is not daffy. But this is as good an example as any of which I could conceive, on both sides, of A Desperate Search For The Silly Outrage Of The Week.Report
Breastfeeding your baby is going to make it grow up to be less obese? That seems like a hard claim to substantiate through controlled testing. Diet, exercise, and genetics strike me as much more likely candidates to be significant factors in obesity.
It’s not easy, to be sure, but several studies (I can link you to some lit reviews if you’d like) have shown a connection between breast feeding and risk of obesity, controlling for a wide variety of potentially relevant factors.Report
Thanks for this post. Our first kids were twins, and my wife suffered through a terrible delivery. She was incredibly sick. She gave breast feeding a shot, but even under ideal circumstances, twins are hard. But she tried and tried and finally, trying to be as supportive as I could, I said, “Just let it go.”
Letting go isn’t hard. With kids, you aren’t “allowed” to face any risk, however miniscule, without a ton of emotional baggage being foisted on you. “Well,” they say, “if something DOES go wrong, you want to know you did EVERYTHING you could.”
So even though you have to guzzle a ton of Wild Turkey to have an impact, people look at a pregnant lady who has one glass of wine with her Sunday meal like she’s some kind of monster. God help the lady who lights up a cigarette!
It’s all so… fraught. And I have noticed that the truly forbidden fruits are those that might conceivably, in any way, provide any sort of pleasure whatsoever to the mother. And that any sacrifice, no matter how terrible the torture or how slight the risks involved, is too much to demand.
If I could get pregnant, I’d be tempted to go smoke a Marlboro on my porch just to give people the vapors.Report
Most of the moms in my parent’s generation both smoked and drank when heavy with child. I remember very clearly watching neighboorhood ladies sitting out on their porches on a hot, summer night lighting up Lucky Strikes, Winstons, or unfiltered Camel cigarettes while drinkng a bottle of Iron City.
But them was real women and they didn’t need no stinkin’ gummint telling them what to eat, or not eat, or how to raise kids. Hell, most of ’em were Democrats ’cause Roosevelt won the war.Report
Hey Bob, great to hear from you! Sinister thoughts of abduction from Exterrestrials did cross my mind as well as Left Wing Anarchists carting you off to “get your mind straight” in one of their underground tunnels. They actually have successfully completed tunnels that go clear across the U.S., coast to coast. This is to hide out and wait for the Rapture–The Second Coming, L. Ron Hubbard. Just amazing the extremes that mental misfits will go to, no? Must run. So long for now. (Iron City–great beer)Report
“That explains the brain damage of the baby boomers!”Report
Although you didn’t name La Leche League specifically, I understand why you’d want to skip the comments and avoid the…enthusiasm…of lactation advocates. The League of Evil Breastfeeding Advocates showed up shortly after the birth of my first son and absolutely terrorized my wife, who’d delivered by Caesarian and was having a rough time of it.They spent some time bullying my wife and making her feel terrible because our son wouldn’t latch. It was with great pleasure that I threw them out of our room, and when our second son was born, we both made it clear to the hospital staff that we wanted La Leche nowhere near us.Report
They’re trying to push breast-feeding in Japan right now by pointing out that it’s a great way to lose weight.Report