What A Boob

We here at Doc Gurley were hoping, like most people, to just ignore the latest, clearly BOGUS pseudo-science news.

Unfortunately, such was not to be – the Atlantic article by a (self-described as rage-filled-about-the-act-of-breastfeeding) mom, who claims that – really – there’s no good data to support breastfeeding – just won’t die. Go on any

Breastfeeding an infant

message board, and this article, with its blend of strident bias, lack of scientific focus, and mocking rants against other women, is proliferating with Ebola speed like a flat-Earth-believing-virus.

Informed patients/parents are what each of us should strive to be – however, when you seek to make a final, authoritative statement about decades of research, most people would think it only appropriate that you have some knowledge or training about the subject. Or at least about how to analyze the literature. Keep in mind that this author, given a wider platform that almost anyone in America, has no more scientific training than (and here I quote) – “I called my doctor friend for her password to an online medical library.”

Ms. Rosin then, after learning epidemiology and statistics and scientific processes and analyzing the methods and raw data of more than a half-century of literature comprising literally thousands and thousands of studies – oh wait – well, actually, she reports that she “sat up” and read “dozens” of studies and “after a couple of hours” states “the basic pattern became obvious.” With a tone of reproach, she says “the medical literature looks nothing like the popular literature.” Well, no duh. She’s apparently shocked (shocked I tell you) to discover that scientific literature is “more like tiny, unsure baby steps: two forward, two back, with much meandering and bumping into walls.” I hate to be the one to break it to you, Ms. Rosin, but that, sweetie, is the nature of all scientific study. Scientists are NOT SUPPOSED to be rage-filled – they’re not supposed to mingle politics, personal grudges, and conflicted emotions with strident absolute claims.  Millions of babies’ health is at stake, and they’re actually aware of that fact. That’s why it’s different.

The linchpin of her argument (if there is one) is one review article from 1984 – which she apparently doesn’t realize was panned widely at the time for its flawed conclusions. Then, dismissing the lifework of literally thousands of researchers in one sentence, Ms. Rosin authoritatively states, “twenty-five years later, the picture hasn’t changed all that much.” Sheesh. If only someone had told all those people working in this area. Perhaps we should just toss all their superb work and valid conclusions? All of which tremendous effort, I might add, has been needed to off-set just this kind of bias.

So is there a definite answer somewhere? Wouldn’t it have been simpler for all these valiant researchers if there was just a one big, head-to-head trial that laid this issue to rest? Ms. Rosin doesn’t realize that the reason such a trial doesn’t exist isn’t because, as she assumes, feeding is too complicated or intimate an act to randomize (by randomize, we mean – draw a number – you get formula; or you get breast). Actually, that’s perfectly easy to do. All you have to do is find women who are ambivalent (and now there are going to be LOTS more) to be in the study. See, the real reason a definitive comparative trial hasn’t been done is actually because the overwhelming results of decades of data are that breastfeeding (when possible) is clearly superior to formula  – which makes a randomized trial UNETHICAL.

And, in a classic Wizard Of Oz “don’t look behind that curtain!” move, Ms. Rosin never once mentions either the burgeoning total dollar cost of formula (which is not trivial for most Americans), or formula contaminants like melamine, or the fact that once you wean, you can’t change your mind and go back to nursing.

Then, while garnering massive amounts of national news purely by stating there’s no clear data to support breast-feeding’s advantages*, she makes her final, ultimate conclusion – saying shamelessly (and, apparently, without even a touch of irony), “Breast-feeding does not belong in the realm of facts and hard numbers; it is much too intimate and elemental.”

So how did one woman’s deeply flawed, emotional, uninformed and shockingly anti-intellectual rant get so much press? Is it just because of the contrarian nature of news today? Well, one thing is for sure – however you “feel” about this topic, since melamine was found in several brands of America’s infant formula – corporate multi-national formula makers are doing the happy-dance every time this story gets more and more uncritical air-time.

The tragedy is that, in the end, most Americans will now vaguely remember that there’s some “doubt” about the breastfeeding issue, even when there’s not.

So who would do such an irresponsible thing as tout this piece of misinformation – and never once even mention the little melamine “problem”? Well, no less than the Today Show and NBC news gave this article a national platform it didn’t deserve. They even buried Dr. Nancy Snyderman’s assessment that “breastfeeding is best” way after headlines , pictures, and captions that undermined her conclusion, and Dr. Snyderman then took the appalling stance that the “data isn’t so strong.” Hello? Compared to what? Where’s the study (any study?) showing formula is best? Ever?

For that, we award NBC news, and the Today show a HUGE raspberry of Biased and unObjective -  Grudges Undermine Science (BOGUS) Award. Hey, BTW, who are their corporate sponsors?

*This claim would be called, scientifically, NOT TRUE – and itself wins not only a BOGUS Award, but a Flat Earth Award too. In fact,  in a release that could be seen is a direct salvo to Hanna Rosin’s rant, a well-designed, major study this week in the journal Pediatrics shows that breastfeeding may reduce risks of  SIDS by half throughout infancy, even when all other factors and interventions are controlled for. But hmm, that didn’t get much press, now did it? Are you listening, NBC news?

Concerned about misinformation when it comes to babies? Be sure and forward this article to anyone you think might benefit. Add your insight to the comments section below.

Related posts:

  1. Wet Nurse Rising

4 comments to What A Boob

  • PinchingAbe

    All I have to say is that God does give you an instruction manual to get you going…. breast milk. God didn’t send you a baby and a case of formula with an Aloha and a shove out the door to figure it out yourself. I can’t believe any sane person would refute what God gives you. It is a wonder how humankind survived (gasp) before formula. I nursed both of my kids as long as I could (or they would) and saved myself at least $1,500 in formula costs upfront, less copays for doctor visits as toddlers… etc. etc. I nursed mainly for health benefits though, not for financial reasons. But as more and more health problems get connected to formula feeding, I am more and more grateful that I nursed them.

  • Xak

    Awesome rebuttal, with one small inaccuracy–nursing CAN be resumed after weaning. It’s called relactating and if more women knew about it, more babies could be getting the nutrition they biologically need after “nursing strikes” (which are when baby suddenly stops nursing, often confused for weaning, but true weaning happens gradually, over a period of several weeks to months at least) pass or mom weans and regrets it.

    Other than that, bravo!

  • just wondering

    Ahhhh… thank you for that Dr. G! Quite cathartic.

    Only wanted to make two brief corrections. The first being that you absolutely can go back to breastfeeding once you’ve stopped. Heck women who have never breastfed (and even never been pregnant) have lactated. Relactation is quite doable with a bit of support (IBCLC, Le Leche League, a well informed friend).

    The second is that breastfeeding isn’t best – formula is inferior. As with all science we should be comparing the biological norm (breastfeeding) with the intervention (formula feeding). IBCLC Diane Weissinger first brought this to my attention – her argument is summarized here http://breastfeeding.suite101.com/article.cfm/choosing_breastfeeding_language.

    Keep up the good work!

    • Doc Gurley

      Great points and I agree with both. Relactation is possible, but very rare if the mother decides in the peri-newborn period to not nurse (or if she did not ever attempt to nurse) – that is the exact group that I think this kind of negative media coverage most impacts – those moms who are ambivalent prior to giving birth and are post-partum exhausted. The concept that formula is an intervention is absolutely accurate – both clinically and epidemiologically. The norm is nursing and outcomes for formula (the intervention) are inferior in almost all studies. I really enjoyed the linked article about language – I feel the author’s assessment is true about the impact of how we phrase this topic. Definitely gets you thinking! Thanks for the great comments.

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About The Author

Doc Gurley is a Board-certified Internist physician and the only Harvard Medical School graduate to have been awarded a Shoney’s Ten-Step Pin for documented excellence in waitressing. Find out more.

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