Have you heard the phrase “best is best?”
I’m here to say that breast is *not* best, or even *possible* in all circumstances, and to say otherwise is outright ableist.
I find it curious that throughout the pregnancy and birthing process, many families are educated that the human body doesn’t work perfectly 100% of the time.
First of all, 1/4 pregnancies end in miscarriage, and many women struggle with fertility.
In childbirth classes women are also taught that they can control many aspects of how they approach childbirth, but at the end of the day, emergencies can happen, things can go wrong that are out of their control and that it’s OK if their birth doesn’t go according to plan.
But all of that realism and balance seems to go out the window when it comes to breastfeeding – suddenly, breastfeeding is posed as the most natural thing in the world, something that all women can “achieve” if they just try hard enough, and obviously they CAN and SHOULD because it’s the BEST! 🙂
Hmm. Does anyone else see the problem here?
NO, not all women can produce adequate milk for their babies (for thousands of health reasons – breast cancer, medication side effects, etc).
NO, all women who are physically capable should NOT be pressured/coerced into the extremely time and energy consuming task of breastfeeding.
NO, breastfeeding is not the “best” choice in the CONTEXT of all family systems.
YES, in a vacuum, *all other things being equal,* breastmilk is the best nutrition source for infants from a public health standpoint.
But all other things are NOT equal for moms with chronic illnesses, or ANY moms for that matter!
Feeding choices need to be seen in the greater context of a mother and child’s *full* lives, in the context of the intense biopsychosocial demands of postpartum and parenting.
The Journal of Maternal and Family Medicine put it this way in their June 2018 article ” Is the “breast is best” mantra an oversimplification?” (Volume 67, No 6): “The “breast is best” mantra is likely true at a public health level; for the individual mother–infant dyad, however, that mantra is oversimplified.” https://fedisbest.org/wp-content/uploads/2019/03/BenefitsOfBreastfeedingFamilyMedicine-1.pdf
And here’s the kicker: the evidence is actually pretty thin for the long term benefits of breastfeeding. Many of the alleged benefits of breastfeeding are actually correlated to maternal socioeconomic status (citation: Cohen & Ramey, 2014 – https://pubmed.ncbi.nlm.nih.gov/24698713/).
According to Cohen & Ramey: “Our results suggest that much of the beneficial long-term effects typically attributed to breastfeeding, per se, may primarily be due to selection pressures into infant feeding practices along key demographic characteristics such as race and socioeconomic status.”
As a licensed health provider, nowhere else in medicine have I seen such a myopic focus on something that has such unremarkable long term outcomes. For example, 2 or 3 babies need to be breastfed to prevent 1 ear infection before two years of age. After 2, this effect disappears. 6-7 babies need to be breastfed to prevent 1 upper respiratory infection (citation: https://fedisbest.org/2019/03/an-evaluation-of-real-benefits-and-risks-of-exclusive-breastfeeding/ )
There’s so much more I could say about this issue, but I’ll just leave you with a quote from my interview on episode 51 of the AiArthritis Voices 360 Podcast.
“I never doubted I was going to try to breastfeed because..it was “best.” I ended up having difficulties like many women…severe fatigue, postpartum flaring and I felt like my life started revolving only around feeding…I found the “Fed is Best Foundation” to be a huge source of support.
Breast is best in a vacuum, all other things being equal…but none of us with chronic illness live in a vacuum! – Cheryl Crow, on
AiArthritis Voices 360 Podcast, Episode 51: Oh Mama!
Listen to the full episode at the link in my bio or at: https://www.aiarthritis.org/talkshow-ep51
