Bachmann, Obama and lactation hysteria

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.