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Daniel Edwards—the celebrity-obsessed sculptor who has already blessed the world with Britney Spears giving birth on a bearskin rug and Suri Cruise’s bronzed poop—has just announced his latest work: A statue of Angelina Jolie,
enthroned, majestically nude, and suckling a baby at each breast like
it ain’t no thang. Weird? Sick? Magnificent? I can’t really tell ... (Read more in Double X.)
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Today's New York Times hosts a bloggingheads debate on
breast-feeding between me and Dr. Ruth Lawrence, a researcher from from
the University of Rochester and a major breast-feeding advocate. The
occasion was my recent Atlantic story taking issue with the science behind some breast-feeding research. When bloggingheads found my opponent I swallowed hard... (To read the rest of this post, visit our new website at DoubleX.com!)
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Today's paper has a story I knew was coming but have truly dreaded. It turns out that PSAs—the screening test for prostate cancer—may do more harm than good. Most of these cancers are very slow growing, it turns out, and may not need to be treated. Meanwhile, the operations to treat them have serious consequences. So many men have undergone the surgeries needlessly. My father had the surgery, and it really ruined his life. The idea that he may not have needed it kills me.
My takeaway from this story is that when a certain kind of science hysteria takes hold, rational risk analysis goes out the window. When you say "test" and "cancer," the rest of the qualifications and probabilities don't get heard. This is on my mind because of the reaction I've gotten to my recent Atlantic story, "The Case Against Breast-Feeding," where I challenge some of the science supporting breast-feeding.
Of course I've heard from hundreds of grateful moms, and an equal number of people telling me what an evil mother and wife I am. And I've also heard from lots of science scolds. A typical such response is this one from our sisters at Salon.
On closer inspection, we have to conclude that her reporting is biased. She cherry-picked research that suited her agenda, the research suggesting that breast milk isn't really all it's been hyped to be. Yet between us we have interviewed dozens of highly regarded researchers and pediatricians who could offer a point-counterpoint to the research Rosin highlighted.
This is really not good enough. As the latest prostate cancer study shows, it's perfectly possible for the scientific establishment to be in agreement and also wrong. This is like interviewing generals in Iraq about whether the surge is going well. They may be experts, but they are experts with a stake in the outcome. Yes, I highlighted a few studies that support my point. But mainly what I did was critique the research as a whole. And what I found was that if you say "infant" and "health" in the same sentence, no one bothers with the details.
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Sam, you hit us where it hurts. It's true, my generation hasn't found an easy way into Facebook. I have friends who use it obsessively, like teenagers, and I'm sort of embarrassed for them. I have others who use it like Linked In, to make professional contacts. And others who are so ambivalent that in all their photos they hide behind their kids. Most, like me, just start a page and then neglect it. But I guarantee you, once you're in my shoes and actually start the breast-feeding phase of life (see cranky breast-feeding me in my Atlantic story), as opposed to just dreaming about it (see giddy, insouciant Sam on breast-feeding here), you'll neglect/misuse Facebook too.
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I'm still years (and, I hope, a wedding) away from being a lactater, so I've yet to experience the pressure from other mothers or lactation specialists or medical studies about how to nourish my newborn. But I must say, I'm excited to breast-feed (and, I suppose, pumped to pump). As women, we're so often battling our bodies, cursing the way we put on weight or break out or start menstruating years before we actually want to reproduce, and making all sorts of decisions and purchases to try to counteract those truths. Breast-feeding is this one perfect, incredible thing that our body actually does right. Our breasts know when we have a hungry baby, and they make it food! And not just any food—food that's "better than a mango, even." If my breasts are willing to be so intelligent and industrious, I am eager to put 'em to use.
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Ann, here is my best guess about the success of the breast-feeding brigade. Some of it is because of external forces, and some is our own inner craziness. The researchers who helped the American Academy of Pediatrics craft its rigid pro-breast-feeding statement came of age during the '70s. They watched formula companies peddle their product in Africa, where the dirty water turned out to be fatal to babies. They also watched hospitals routinely inject mothers with hormones to stop the flow of milk. To them, this is a war, and there's no middle ground.
Now, why do they have a receptive audience? Breast-feeding gets us where we are vulnerable; if you are a working mother, it's the one thing you can do that your nanny can't. Also, it fits in perfectly with this current moment in parenting, where the child is an improvement project, and no amount of tinkering is too much. It is an odd thing, of course, that this intensive form of parenting thrives at exactly the historical moment when women have the least time for it. I'm sure you could shed light on that conundrum, Ann.
I also think the green/farmer's market obsession has something to do with this. Feminists chucked natural childbirth without much guilt long ago, but breast-feeding is riding the tails of the organic food movement. If they could only find a way to make formula look less like Hi-C and smell less like an old tire, we'd be golden.
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I just wanted to chime in in support of Hanna's great Atlantic article. Like Hanna, I happily nursed my first two children for a year. With my second, I had the great luxury of working from home, so I rarely even had to pump. I'm planning to nurse my third. (For one, it's free; for another, it's a lot easier to get back to sleep after those 2 a.m. feedings if you're nursing than if you have to schlep downstairs to the kitchen to make bottles.)
But I think it's crazy for women to guilt one another into breast-feeding, or for women to feel like they have to exclusively breast-feed. Two anecdotes from my older son's first few weeks hammered it home to me. First, while I was still in the hospital, recovering from an emergency C-section and trying to grasp the whole concept of motherhood, the "lactation specialist" visited our room. She handed me a bottle of glucose water and said, "Now, if baby gets hungry, just give him this, not formula." When my nurse saw it, she flipped and ordered me to hand it over. Turns out the lactation specialist hadn't bothered to inquire about my son. I'd had that emergency C-section because he weighed 10 pounds, and the doctors suspected I'd had undiagnosed gestational diabetes, so he was also dealing with blood-sugar issues. Glucose water was the last thing I should give him.
Still in new-mother mode, I tried to avoid formula when we went home, but I still remember the night Brandon cried, and I tried to feed him. And he cried, and I tried to feed him. And so on. Until we gave in and gave him just an ounce or two of formula. And then we all got four hours of sleep.
To me, it seems like breast-feeding is just another front in the "Mommy wars"—whether to work or stay at home, whether to live in the cities or the suburbs. I'm not sure why women feel compelled to guilt one another over such decisions when there is never one right answer that applies to every woman. But consider me Switzerland.
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I've been waiting for your breast-feeding article, Hanna, so thanks for the alert that it's now out in the Atlantic, Emily. The piece is great, and persuades me that nursing isn't the secret to thinner, smarter, healthier babies—certainly not among the well-off set that swears by the practice. It also reminded me of the many reasons nursing isn't exactly the secret to well-rested, maritally contented, productively employed mothers, either. Which leaves me with a question: Why is it that the pro-breast-feeding brigade has had such success peddling its message at precisely the moment when you would think women would be least receptive to it?
Clearly the audience is complicit here: At the turn of the 20th century, the newly scientific experts peddled their intricate formula recipes not because they were better or safer (back then, when cow milk supplies were dicey, they were anything but). They peddled them because they were well-aware that middle-class "modern" mothers were eager not to be tied down all day the way their mothers had been. So how do you read the peculiar eagerness among mothers recently, as they stream into the workforce, to, well, swallow the opposite, highly inconvenient expertise? In the video accompanying your piece, you and your friends touched on this, confirming my sense that nursing isn't about helping our kids to ace their SATs. Isn't it more about helping to reassure ourselves that we mothers really are indispensable?
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XX Factor's Hanna Rosin has a fascinating piece in the latest Atlantic on the breast-feeding myth. She writes that after nursing her first two children for a year each, she finds herself longing to free her breast early from the mouth of baby No. 3. Hanna looks at the studies we've been spoon-fed over the years about the incalculable superiority of breast-feeding and finds that when you actually examine the numbers, most fade to statistical insignificance. She is not making a case against breast-feeding (despite the fact that's the title of the piece!): She acknowledges its many benefits, and she is saying there is a rational choice to be made to not breast-feed and those mothers shouldn't be treated as if formula is laced with anthrax. As Hanna points out, a miserable breast-feeding mother is not an optimum mother. I know we all should support whatever good choice women make for themselves (I happily breast fed for a year), but her piece made me think of the alternate phenomenon. I confess something bothers me about when I see mothers who won't stop breast-feeding. These are the women whose 4-year-olds walk up to them and demand a slurp. I always wonder if these mothers are going to be waiting in the wings, nursing bra at the ready, when their kids need a boost during the SATs.
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Rachael, here's a partial answer to your good question: Breast-feeding rates vary in this country by income and race and maternal education. According to this from the Motherwear Breastfeeding Blog, which cites CDC stats, in 2005 "women living below the federal poverty line breastfed at the rate of 63%, and women living at 350% of the poverty level breastfed at the rate of 82%." Also: "Rates of breastfeeding were 81% for Asian Americans, 79% for Hispanics/Latinas, 75% for Whites, 67% for Native Americans, and 59% for African Americans." And 85 percent of college-educated women breast-fed, compared with 63 percent of women with less than a high school diploma.
What's going on here? The answer must involve culture--whether you know about the health benefits, whether a nurse at the hospital where you had your baby has the time to help get you started, whether your mother and sisters and other women you know breast-fed, themselves, and can help you over the rough patches, whether it's regarded as expected or weird in the community you live in. This article from the CDC blames low rates on "lack of social support" and lazy hospitals and lack of follow up. This article in Pediatrics found that immigrant women are more likely to breast-feed than native-born women in their ethnic groups, which suggets that the cultural push against breast-feeding happens here. Amanda's point about the relative ease with which white-collar, as opposed to other, jobs accommodate nursing is well taken.
But I suspect there's more than job-related obstacles at play. And in fact, the rate of breast-feeding has risen dramatically among some of these groups--26 percent among African-American women in the last 10 years.
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Rachael, isn’t part of the issue that white-collar jobs tend to accommodate pumping and breastfeeding more than blue-collar or service industry jobs do? This piece, for instance, paints a stark contrast between female Starbucks execs who get to use a lovely “Lactation Room,” and women working behind café counters who have to pump in bathrooms during quickie breaks. Anything that makes it easier for women to pump at work (or during their medical boards!) seems like a good idea to me – and not paternalistic.
Meanwhile, speaking of Emily’s great piece, I wanted to mention another mind-bending example of how environment can influence gene expression. This one comes from a UC Davis psychologist named Brian Trainor, who’s done fascinating work on the relationship between estrogen and aggressive behavior in mice. Last year, Trainor found that estrogen can have completely opposite effects on aggression depending on the length of daylight. Specifically, the hormone made mice less aggressive when daylight hours were kept long, simulating summer. But it made them more aggressive when daylight hours were short, simulating winter. (The pathways involved were probably different, too.) No one knows whether similar effects will be found in humans. But isn’t it wild to imagine estrogen making us docile in summer and assertive in winter, too?
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Emily, I noticed while reading your piece on breast-feeding and IQ that you touched on a point that has always been mind-boggling for me:
Previous studies have also linked breast-feeding to higher IQ, but they generally haven't ruled out the fact that breast-fed kids are also more likely to come from wealthier and better-educated families than formula-fed babies. [italics mine]
You've written on this topic frequently, so I wonder if in your research you've seen anything that explains why mothers who are less well-off are more likely to use formula. It seems like a contradiction to me. I nursed both my sons for all the reasons you cite--it's nurturing, it's practical, it's portable!--but also for the fact that it's just plain cheaper.
I realize that WIC lessens the financial burden of formula to some extent. But WIC also tries to promote breast-feeding and rewards moms who make that choice. And, while breast-feeding might not offer an IQ boost for everyone, it still seems that in almost all cases the pros outweigh the cons. Should we be doing more to encourage low-income moms to breast-feed, or is that paternalistic?