A note on Is Breast Best? by Joan B. Wolf

Just yesterday, I submitted a review of the book I mention in the title to The F Word. I don’t want to cover the same ground, or pre-empt that article (although if published it’s obviously going to be read by far more people there than here), but I do want to make a few notes about the book.

One of the problems with reviewing a book that basically says there is a big question mark over the reliability of evidence that a) breastfeeding confers any great benefits on babies, b) not breastfeeding is actually, really risky and c) even the proven benefits of breastfeeding (such as they are) don’t necessarily override the trade-offs for some mothers is that people have two reactions:

1. This is nonsense! It is what nature intended! 

2. She must be sponsored by the formula industry. [Insert conspiracy theory here]

So here, because frankly there isn’t room for this in the review and I might explode if I don’t get them out, are several points about this book that you should note, preferably before you read it:

1. It is not a defence of formula feeding. In fact, it doesn’t really talk about formula much at all except to talk about how it developed, which is hardly flattering. There are certainly some perfectly good political and ethical objections to supporting the formula industry, as suggested by its origins, and that’s that, really.

2. It does not suggest that women should not breastfeed, and indeed talks about making it easier for women across the social spectrum to do so if they would like to.

3. It makes some excellent and very important points about understanding scientific research and the way it is published. For example, a 40% reduction in what sounds like quite a serious risk can really be a 4% reduction of something quite trivial in the developed world, and overall the risk is incredibly low to begin with, so the difference is statistically significant, but actually not significant at all, socially speaking. If you refuse to let Wolf make these points, or prefer to read them without having to think about breastfeeding, then perhaps you could just read Bad Science instead.

4. It makes some excellent points about understanding risk, living in a risk culture, and how much pressure we put on ourselves as mothers to be all-powerful agents of total control over our children and eradicate all risk, even if it’s semi-imaginary.

5. It is not anti-breastfeeding. I really can’t repeat this enough. IT IS NOT ANTI-BREASTFEEDING. It is just questioning the scientific basis of breastfeeding campaigning zealotry.  And really, someone should.

I am, most definitely, not anti-breastfeeding. I believe women should be able to breastfeed freely wherever they need to, without gawping or tutting, and that it’s a lovely thing to do if you can get the hang of it and enjoy it. I will shout long and hard for this, and believe that – especially if we’re going to keep thundering out the breast is best line – there should be considerably better and more coherent support for struggling mothers, with proper lactation specialists available at every single hospital, and proper training about breastfeeding given to every midwife. Because I don’t think anyone should be made to feel a failure for not getting it right first time (for a lot of people it is extremely bloody difficult), and that everyone should have a chance to have a fair shot at it.

But have I long wondered whether breastfeeding is really all it’s cracked up to be? Yes. And if someone like me who thinks HypnoBirthing is the best thing ever and had the natural drug-free home birth of her dreams can question it, I dare say others have too. Wolf just used the tools at her disposal to crack on and try to answer her questions.

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6 responses to “A note on Is Breast Best? by Joan B. Wolf

  1. Breastfeeding isn’t all it’s made out to be. But everybody is too scared to say it in case they get shot down by the breastfeeding brigade.

    What advantages there are – which I’d argue are mainly practical – quickly get cancelled out by the disadvantages. No one tells you that you can lose days to doing nothing but feeding. Or that you can’t go out for more than four hours before you have to either go home or find somewhere to pump the milk out of your extremely swollen and achey boobs. Or the resentment that builds (even though you don’t mean it to) when you’re the one that always has to wake up during the night and do the feed even though you’ve only managed to snatch 15 minutes sleep since the last one. Not to mention the resentment from the dad that you are the only one who can feed the baby and he feels left out (even though you don’t mean him to).

    And then there’s trying to stop. NO ONE talks about this. Ever. It’s like it happens by magic. It doesn’t. It’s more frustrating than trying to start and you feel even more alone.

    Very good points though – look forward to the day when women can just be left alone to make their own decisions…. if that will ever happen!

    • Thank you for this! There is a fear when I write things like this that people will write me off as a bitter failure. I am sorry I couldn’t do it because there are times when it would be great not faffing with sterilisers etc (though now she’s much happier with formula cold out of the fridge and I don’t have to heat bottles we’re both a lot more relaxed). And at first I really believed that there were these huge health benefits, and then I started poking around… and there just aren’t.

      I’d still like to give it another shot if I have another one, if only to give myself the other side of the picture (though I have had a very good example in my sister, who formula fed the first and breastfed the second!). And like you say there are some practical advantages. But I no longer feel worried that there is a substantive difference between the two in health terms.

      And I’ll be coming to you for advice about stopping. 😉

  2. I am so happy to read this post. I am so frustrated at the response to Wolf’s book, which is exactly how you describe it. Unfortunately people seem to be freaking out about it without actually reading the book, which you know, kind of helps. 😉 I did a little Q&A with her some months ago and she has been really mistreated in the press. It’s a shame, because the book could really change this discourse for the better.

    Anyway, I think it’s awesome when people can think freely and independently, rather than following some party line, and you exemplify that. Glad to have found your blog!

    • Thanks so much for commenting; I found your Q&A shortly after I wrote this (I figured SOMEone must have read it in a calm, measured fashion!) and it was excellent. Have bookmarked FFF for further reading!

  3. What bothers me most about Wolf’s book is her assertion that studies re: the benefits of breast feeding are flawed and not backed by cogent research, yet her own hypothesis is backed by ZERO research itself.

    She is touting the book as providing proof of this great over-hype supporting breast vs. formula and then provides NO data to back her claim. Pot calling kettle black just a little? Clearly!

    The second glaring failure of her book is to thoroughly examine and give analysis of infant formula in any quantitative way.

    In total I was really disappointed at what the book failed to provide. I went away feeling it was more opinion and hype (the chunck of wood in her own eye) and little to no evidence to support what I can only surmise are her opinions. Not all that scholarly.

    As far as people who feel they ‘failed’ at breast feedIng needing a book like this to get over their perceived persecution, I must say get over yourself first! I am horrible at math. Fail at it in numerous ways. But I don’t take out my own feelings of inadequacy by suggesting that the benefits of mathematics in our world are ‘hype’.

    • Alexandra Roumbas Goldstein

      Hi Maria,

      Thank you for your comment.

      As I read it (and it was a while ago, so forgive me if I can’t remember fine details), Wolf was undertaking an analysis of whether breastfeeding research was flawed, and concluded on examination that it was – not claiming that formula feeding was better, or even equivalent. So she only needed to address existing bf research, and even pointed out the strongest evidence FOR breastfeeding’s advantages. She stated her reasons for coming to her conclusions, and you’re under no obligation to accept them, and are welcome to carry out your own review in response. I don’t believe there’s any way to deny that a great deal of money has been spent and campaigning carried out to make bf seem like the only MORAL choice, and it’s perfectly legitimate to question whether that’s appropriate, even if you are – as I am, and always will be – essentially pro-breastfeeding.

      It’s not exactly fair to compare breastfeeding – something that is heavily touted as being the best possible thing for the health of the most important people in your life – as being equivalent to an academic subject. You can get remedial help with maths at any time, and no-one will claim that you’re damaging your children if you bugger up an equation; if you screw up bf the first time, or can’t do it due to a physical problem, you don’t get a second chance and do need to know what – if any – the longer term consequences of your situation might genuinely be.

      By all means, disagree with the science – but do try to put yourself in the shoes of someone who has approached this from the other side when it comes to the social implications. A little bit of empathy goes a long way.

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