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.