The Case Against Reasoning

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It seems absolutely inevitable, that'll I'll have to post about The Case Against Breastfeeding. The Rosin article is like dog poo - smelly, sticky, but it will not go away, no matter how hard you wipe it with paper towels. Once it's in the fur, only a complete hosedown in hot water and shampoo will suffice, with some nail scissors on hand for the worst bits. So... here goes... hot water on and shampoo liberally spread about the rubber gloves, and some vapour rub smidged on my upper lip, so I can't smell what I'm having to rinse down the drain...

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When Radio 4 asked me what I thought of the Rosin article, my response was pretty clear: this is what you get if you keep banging on about "Breast Is Best". Especially if you keep banging on about it, in a society that's disapproving of breastfeeding in general, and downright paranoid about it in public. The most pertinent point to me, about Rosin's words (as opposed to the screeching that is accompanying them) is that she makes a point about being stuck at home, whilst her husband is out and about in public.

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Speaks volumes: a year at home, whilst he was enjoying public life. Three years at home, actually, as she's had three kids that she each gave a year of breastfeeding too.

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And guess what? Her kids aren't yet Nobel prize winning Olympic Gold medallists? In the playground, she can't spot any difference between her kids, and the other ones... you know, the sickly, frail, dumb formula fed kids, coughing blood spotted phlegm into their dirty unwashed hankies. So she thinks about this lack of difference, and sneaks off into the forbidden treasures of the scientific secrets doctors' know, and voila!... this breastfeeding lark is all a con. A dirty conspiracy to keep women down, and to... well, you know, I'm not sure why Rosin thinks everyone is conspiring to pressure women into breastfeeding: motive is a bit lacking.

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But what is clear, is that everyone is. Not only are they being pressured into breastfeeding, they're not allowed to stop. Ice falls in the soup, and the tumbleweeds haunt the once fertile playground. She mentions weaning and she just knows everyone is disapproving.

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Note, no one actually says anything to her. She reads it in their eyes. How often have you stood in the playground and read it in their eyes, about how much the other mums don't like you, to find they were thinking about what to make for dinner and wondering if they remembered to pay the gas bill? Yes, I thought so.

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So, my take on the Rosin article is; this is what you get if you bang on about Breast Is Best in a society that doesn't support breastfeeding: women who feel duped. Duped that they sat at home and breastfed, when they'd much rather have been out and about, with someone else bottle feeding formula... but they sacrificed for the breastfeeding... and what do they get, a child that's no different from anyone else's! And here's a woman that feel so cheated by her experiences, she sets out to prove how big the conspiracy that oppressed her was. I mean, is.

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Except... well, she's not very good at science, is she? Like all of us, she cherry-picks the bits she likes, and then parades it up front as SEE, YOU WERE LYING TO ME ALL ALONG... THIS DOCTOR SAYS...

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Oh please, give me strength.

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I feel like the early scientists who stood in dumb struck amusement, when Erich von Daniken first started to spout his theories that desert paintings were ancient space runways of the intergalactic race that visited us in their golden chariots. When asked later on, why they'd not stood up and responded to Daniken's theories before he'd sold several million books, and the need to discredit them was great... the scientific community sheepishly replied that they didn't bother as they didn't think anyone could possibly believe what he was saying.

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And that's how it feels... that's so how it feels. That supposedly intelligent, educated and articulate people, mostly women, can read the Rosin article and not apply one jot of common sense, or reasoning, to her conclusions... well, where do you start? How can you start when the person speaking is spouting such nonsense?

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Do you start by pointing out that it's doctors and research scientists in the 'proof' articles, as well as the 'proof against' articles? Do you point out that Doctors are human beings, with their own agendas, and their own personal histories? Do you point to the mile high stacks of medical and research literature that was funded by tobacco companies, undertaken by Doctors, that proved tobacco was not harmful to health? Do you ask her to look into who funded most of the 'research' she cites? Or do you meet her single study on gastro-enteritis not being higher in formula fed babies, with 19 others which prove it is, and ask her to respond?

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No, you don't. For that is just so woefully about letting others set the agenda.. all you do is spread the dog poo further: you're making it worse.

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I think it's more useful to look at why this article is being propagated so powerfully. What is happening socially: why it is being so well received. (And which, incidentally, is what I agreed to talk about on Radio 4 yesterday. There, that was a shock to you, wasn't it? ;-) )

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Well, to begin with, there is the 'pressure' that no one in the article, or in the subsequent discussions has touched upon... the commercial interests in making sure that breastfeeding is slagged off at all opportunities. I imagine the corporate headquarters at Modified Cow's Milk Central, wet themselves with glee at this article, and had it posted round the wires and news servers, and to their formula reps, within seconds. I know of an NHS consultant who is sending it out in email to people who've complained about his anti-breastfeeding comments. In facts, he's now sending out both the Rosin article and the Today piece, as EVIDENCE of the... evidence in the Rosin article.

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Huh?

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No, never mind trying to work out the rationale... you'll disappear up your own backside... like he has.

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In a world market of mega-billion dollar profit on formula, it's not too much of a stretch to see that an article by an articulate, privileged, white middle class mother, who feels she's been duped into breastfeeding when she could have been happily - guilt free - formula feeding, might just make it out and about a lot. Especially when she tries to portray it as a reasonable assessment of the available scientific data: a well known device by all commercial companies trying to sell us something that may not be utterly benign and healthy after all.

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Never mind that the actual science being presented, is pitted, flawed, selective and one dimensional. Never mind that the science on display is wholly unsuited for the purpose it's being used for... never mind. Just concentrate on the words 'science', 'doctor', 'medical' and 'research' and take the profits to the shareholders quickly. Smile, hit 'forward all mailbox', and marvel that someone has come along and sucker punched themselves, and others, into completely misunderstanding, and misrepresenting, what evidence based research is all about.

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Forward attachment and laugh all the way to the bank, in fact.

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And, I'm sad to say... we've all contributed to this happening: we've all helped this sad little band wagon selling snake oil and fool's gold along its merry path. Because we're not very good at the science either. We continually misrepresent biology and evidence based research to mothers. We have spent decades talking about the benefits of breastfeeding. As I type, women are sitting in ante-natal classes, all over the globe, listening to the list of benefits to breastfeeding.

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And in the UK, the specific area I was going to talk about in the programme, health visitors and midwives and breastfeeding support workers, will all be talking to pregnant women - particularly first time pregnant women - about The Best For Your Baby. Breast Is Best! Some of those women will be so tired of hearing this party line, they'll start to feel the debate is a bit one sided. They all know formula fed kids who are happy and thriving. And they all hear the horror stories of broken and bleeding nipples. They read the "my baby nearly died from breastfeeding" stories, and shudder. Most of them will have been formula fed themselves, and they don't like the feeling of unease... that their own mother is being slagged off... when the list of benefits is being read out.

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Worse, the second time mothers... well, they remember. They remember being left alone in a side room with newborn twins, and being told to get on with it. They remember saying "This really hurts.." and being totally ignored.. or worse, told to grin and bear it. They remember breaking their hearts when the all knowing all seeing all honourable doctor said "You'll have to give formula, but don't worry, it doesn't matter."

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If it doesn't matter on the maternity ward, how come it matters so much in the ante-natal classes?

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How can it be vital that they breastfeed when they are pregnant, but not matter one jot once they birthed?

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How indeed. Could it be that the NHS knows that breastfeeding saves them money... so they pressure health visitors and midwives to bang on about it... but that proper breastfeeding support costs money... so they don't provide it?

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And isn't this the cruellest joke to play on any pregnant woman? To tell her on and on and on about how she has to breastfeed... and then leave her to it when the slightest hiccup occurs. To give her five minutes support and then say in an exasperated tone "Oh I'm too busy for this, I've shown you how to latch the baby, you're just not listening. I'll see you tomorrow." and walk away. And by the time you return tomorrow, the baby is sated and conked out on too much formula and you look into the tear stained eyes of the mother and say "Never mind, it's just as good you know."

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Or worse... when the mother who has made it, or for whom the wonder happened - totally happy baby totally latched on and feeding despite traumatic birth in the unit.. wanders into the 6 week check up and gets the pursed lips... Or asked to leave the doctors' waiting room for feeding her baby... or told by the entire world she needs to give formula to get a good night's sleep... or.. Well, I needn't go on, do I? You can all fill in the gaps.

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"You're still breastfeeding?"!!!!!!

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Mothers are going to feel pressured, if we're not honest with them: and we're not. Health visitors totally misrepresent both the realities of breastfeeding (damn hard work for most, for the first few weeks) and the science. So totally unable are they to present normative biology to a mother, as they are so totally unable to speak the truth, they perpetuate myths, and bang about the benefits of breastfeeding.

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Guess what? There are no benefits to breastfeeding.

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None.

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It's the normal thing to happen. All that oxytocin bonding, the immunities, the perfect growth medium for human beings, the added hormone hits to combat stress and sleeplessness, the brain building chemicals, the oral-facial development... it's all normal stuff. It's what nature designed. Glorious, complex, mind-boggingly brilliant... and commonplace and everyday.

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It's the biological norm.

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It's what you do, to produce a perfectly wonderfully normal child. Just like Rosin's normal kids.

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If you have a gene inside your family, that reacts to environmental stress for cancer.. breastfeeding won't stop it developing.

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But more cancers will be triggered, in a cohort, if the children with the gene aren't breastfed.

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Breastfeeding won't stop asthma, or autism, developing, in a child with a genetic, or environmental trigger for it.

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But more asthma, and more autism, will be triggered, in a cohort, if the susceptible children aren't breastfeed.

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Breastfeeding won't prevent salmonella triggering food poisoning in a newborn.

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But breastmilk doesn't contain salmonella: some formula does contain it.

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Breathing fresh air doesn't cause cancer: but breathing smoke can trigger it.

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See the difference?

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Health visitors speak to pregnant women with a gag on: the gag that prevents them presenting the actual scientific matter at hand. A gag that prevents them from putting formula feeding into context: that not to breastfeed, increases health risks.

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No one has the courage to say it. Even the nice doctor they had on at the beginning of the slot, couldn't say it. When asked to defend breastfeeding against attack, he talked about breastfeeding decreasing illness. Breastfeeding does not decrease illness. Lack of breastfeeding increases it.

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The other side of the Breast Is Best coin is... Formula is Fine. Formula is not Fine. Formula is Flawed. Just like Rosin's article; it lacks essential ingredients. And has a few you might not like.

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There is less in formula milk, than there is in human milk. There is less physiological growth in bottle feeding, than there is in breastfeeding. Combine the two, and add in that modified cow's milk destroys the natural flora in the new born gut.. and you have an activity that increases health risks in homo sapiens: formula feeding.

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And until we start telling pregnant women up front and honestly about this - they are always going to feel pressured about Breast Is Best.

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And until we give them a society where breastfeeding is upheld as a normal, everyday activity, some women are always going to feel sold short for doing it.

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Until children are welcome in public spaces, attached to the breast openly and with no censure... some women are always going to feel that breastfeeding reduces their options.

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Until breastfeeding is presented in the medical and academic literature as the baseline norm... that from which the intervention is measured, some women are going to stay confused. Making sense of masses of hard line research isn't easy: results need highlighted. Whilst reports still say "Breastfeeding protects against SIDS", and whilst women aren't reading "Formula feeding increases the risks of SIDS", women are still going to see breastfeeding as the 'added on extra'.

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And if the 'added on extra' doesn't result in a super human uber child - just a lovely normal healthy one - some are always going to feel cheated. This is no more pertinent than in the totally back-assed way of presenting the evidence on breastfeeding and intelligence. Whereby for years, women have been told that breastfeeding make their kids smarter.

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No, it doesn't.

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For 90% of the population, breastfeeding makes their kids as smart as their genes and environment can make them. It gives them all their genetic inheritance. (The remaining ten percent have a faulty gene, that prevents their uptake of the brain building chemicals in breast milk.)

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So, that means.. for 90% of the population.. formula feeding makes their kid slightly less smart that they could have been. It's not a lot, actually. On average, it's only 5 IQ points. 5 IQ points are neither here nor there, if you're a smart kid with smart parents and a good home background. Most smart kids with excellent intellectual development and good nutrition, can afford to lose dozens of IQ points before it shows up in testing. That's why formula fed babies can grow up to be world renowned scientists, physicists and doctors: they were born smart. Smart enough that even a deprived background, with low stimulus and low educational standards, and no breastmilk.. didn't hold them back. Even those fed on evaporated milk and karo syrup. They had drive, and determination, and enough raw brain power in place to succeed. They also have higher rates of heart disease, cancer and diabetes, than the ones lucky enough to get the breastmilk, but not the Nobel prize as they weren't that smart to start with.

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But.. and oh this is such a big butt in Rosin... if you are not privileged and middle class and already born smart... 5 IQ points can be a huge deal. If you're poor, undernourished, living in the slums and born of parents who were born poor, and in the slums themselves as babies and aren't that smart... those 5 IQ points could mean the difference between a pass and fail, at basic literacy. Those 5 IQ points, could mean the difference between escaping poverty, and staying in it to breed another generation to the slums.

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And this is where my real anathema to Rosin's article comes from: why the stench of dog shit is filling my nostrils. Because I believe it is simply unforgivable, for Rosin, and women like her, to bang on about breastfeeding as if it's an add on luxury in our lives. For them to quite simply overlook the lack of breastfeeding, and its effects, on the majority population of women and kids on this planet. For women like my learned opposition yesterday, to state blithely that formula is only dangerous in the dirty water places, and then rant on about how there is no difference to the nice white clean and well heeled chattering classes. Even if that was true - and it's not - it is such a totally ignorant and arrogant position to take. Where, in Rosin's article, is the cost of formula feeding? Where, in Rosin's article, is the never ending pressure to formula feed from advertising? She's in the USA, where there is no paid maternity leave and the market is flooded with Code breaching adverts with happy little babies chugging down formula? But the article is about the pressure to breastfeed, as if she lives in an isolated social bubble where all that pressure to formula feed doesn't exist?

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Maybe she thinks advertising, marketing and promotion doesn't work and doesn't change behaviours? In that case, what is she complaining about? She breastfed because...?

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We so have to stop shooting ourselves like this... next person to say Breast Is Best in front of me, gets made to drink a pint of formula made with cold water...

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The flaws in Rosin's argument are so fundamental, so obvious... I could spend hours on it. She bangs on about breastfeeding meaning women have no time to themselves, they don't get shared parenting support from their feckless partners, and not getting out and about enough. That breastfeeding gives them unequal status as women, in public, in private and as mothers.

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Yet.

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She never addresses these points as being the issue? The feminist agenda that these are real issues, and they need to be addressed, is simply absent. Problem: society doesn't support breastfeeding and women who do it end up with a raw deal. Solution: formula feed.

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Huh? She doesn't even talk about the cost of formula, and how just buying enough might be a problem for some of her oh-so-oppressed peers. Really, of course, she's pointing out all her peers can afford it... so it's a non-issue. She talks about breastfeeding being a sign of over-achievement? Not the wealth to pick and choose between several formulae with their 'added scientific wonder ingredients'?

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WTF?

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Oh yes, and while we're at it, she tells women who do breastfeed happily, willingly wholeheartedly... to stop going on about it.

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Why should we? We're doing the normal everyday thing. The thing that you do if you have children: you give them access to your breast. That's the way it works! If you don't like that - fine, it's your breast. But don't tell the rest of us to shut up about how much babies need breastfeeding. And certainly don't demand we prove they need it.

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Find me the evidence, scientifically documented and well reasoned with a thousand independent articles on how the human body needs kidneys, and I'll happily find you the same on how human babies need breastfeeding. Of course, you can always buy your own dialysis machine... just as good, no different. Not convinced? You find me research articles that prove that dialysis machines are not as good as kidneys. Can't find them? But you've found a few that point out that those on dialysis don't die when their kidneys have failed? Well then, case proven - they're just as good.

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No. Does not compute. Bad science. Such very very bad science. You make an intervention - you change the normative biology - you prove its efficacy and how benign it is to the complex biological system your putting it into. Not the other way around.

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But yes, we have to put our hands up, and own that this approach - trying to prove the norm is 'better' is our own damn fault. And we have to cut through all this emotional baggage and get to the heart of it: to reason. To look at the issues around us, and think with our brains and reason out the answers, not make knee-jerk emotional reactions.

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We have to stop seeing formula as angel's tears: a sanctified liquid that is dropped gently from the heavens to feed our poor oppressed masses. When you mention women, infant feeding and formula risks, a blinding spasm of defensive shielding flips up... How Dare You Suggest.... how dare I suggest what..? That a commercially made industrial food source, churned out in massive factories in exactly the same way as pies, sausages and cream cheese, is somehow Less Than Perfect?

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The huge emotional reaction people get on hearing these simple, reasoned, facts, is quite alarming. Consider your own reactions to the following two statements; pretend I'm reading out a health protection broadcast:

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"Raw chicken may contain salmonella. Cook this product thoroughly in order to prevent food poisoning."

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Now try this...

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"Formula may contain salmonella. Prepare this product thoroughly in order to prevent food poisoning."

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Now, in the first one, I'm a hero of food protection! In the second one, I'm apparently saying "Formula is poison you stupid bitch and you are a terrible mother for feeding it to your child don't you feel guilty?"

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Try these two:

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"Nutrition is best derived from natural food sources. Processed foods made commercially from factory farmed foods with a high level of chemical additives may not provide adequate nutrition."

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Common sense? Reasonable? Reasoned and balanced?

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"Formula is a processed food made commercially from factory farmed food sources with a high level of chemical additives."

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Have you gone nutso back there? All reason flown out the window in an emotional screech of "ohmygohdyoucan'tsaythat.."

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We have to apply reason to this whole infant feeding thing. Recognise that normative biology is just that - normal. That when we play around with it, we have to be careful, and assess the effects of the intervention, not the norm. We also have to strip off this uber-protective wrapping from discussions of formula - and talk about what it is: a commercial, for profit, highly processed industrial food compound. It's so ironic that the very middle class women chattering on about The Great Breastfeeding Conspiracy, would not feed their kids a yoghurt with the list of ingredients on the average formula tub.

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And the yoghurt probably would only contain those ingredients.

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Here in the UK, if we want articles like Rosin's never to appear again, we have to stop banging on to individual women about Breast Is Best. We have to recognise that a breastfeeding culture will save the NHS money, not an individual breastfeeding woman. If we want more women to breastfeed, we have to address the feminist issues that it raises: breastfeeding has to be accepted, and supported anywhere and everywhere, and mothers who wish their babies and children with them, have to be accommodated in public life. Crucially, in ante-natal classes, we have to stop talking about the benefits of breastfeeding, and highlight the risks of not doing so: we have to start talking about the increased health risks to those who are not breastfed.

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We also have to support all woman as individuals. Changes in breastfeeding will occur when society supports breastfeeding: pressuring an individual woman to carry all this for us, is just not acceptable. Mothers to be need to hear, and understand the risks to the cohort... not be told their child will be harmed by formula feeding. Many many kids will not be harmed one jot from formula feeding: it's that you don't know which ones will, and which ones won't. Which ones are going to develop the cancer that they wouldn't have got, if they had been breastfeed normally. Which mother is going to go on and develop the breast cancer, that breastfeeding would have allowed her to avoid. Understanding the nature of risk, is quite complex: health professionals need to have proper training to do this, so the message can be heard clearly, plainly, and openly.

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Breastfeeding support has to be put in place. Every woman who wants to accept her baby to her breast, is entitled to the care that ensures that happens.

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And every women needs to be protected from the overwhelming commercial pressure to formula feed. Something we are failing on in the UK, badly. If I could find the low down weasly cowards at WHO who are letting follow-on milk advertising through as not formula advertising, I'd rip them a new one.

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Not every woman will breastfeed you know. Some women have always refused their baby their breast: some always will. Stop seeing 100% breastfeeding rates as the nirvana: it will never happen. But we need to give every woman a fair chance: every baby deserves we speak up for them.

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Finally, a message to all those nice comfortable and secure middle class women, who are so cheered and heartened by Rosin and her message of wealth and privilege overtaking both common sense and normative biology, and who are celebrating her inability to read scientific research whilst walking and chewing gum. A message for those screeching "It's the woman's choice, no one but her should be getting involved. It's no one else's business. There is no difference!"

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My message to you all is this:

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Grow Up

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