Tuesday, April 07, 2009

The mommy war over breast and bottle

What's up with the articles lately against breast feeding and breast pumps? Don't you just love these media-generated mommy wars?

If Judith Warner found her breast pump so painful, perhaps she should have bought a different one. I have heard many mothers say that breast feeding is painful, but I never heard anyone else complain about painful breast pumps.

I also do not understand why she found pumping so onerous. I didn't, except when I flew cross-country for a conference and had a difficult time finding a place to pump. Otherwise, I didn't have any major problems. After all, desk jockeys like myself and JW should be able to work and pump at the same time.

I agree with Hanna Rosin that women should not be put on the defensive for their choices. She does a credible job explaining the science. The differences are smaller than breast milk advocates claim. (This is a prime example of "correlation does not imply causality".)

In addition, just because breast fed babies have, on average, one fewer bout of diarrhea than bottle fed babies, doesn't mean your baby will have one more/less bout if you chose differently. After all, who has an average baby?

I was breast fed. My mom, a nurse in a developing country at the time, saw the dangers of bottle feeding first hand. My aunt brought me to the hospital during my mom's breaks for feeding. By all accounts, I was a fat and happy baby that slept a lot. Breast milk had a narcotic effect upon me; mom says it never failed to put me to sleep. Iris inherited this trait.

My mother in law, a stay at home mother of three with full time help (her mother), bottle fed all three of her children. She said that doctors discouraged breast feeding in the 1950s and 1960s. Her kids, especially the middle one (Bad Dad), suffered from frequent bouts of diarrhea. No matter how much she boiled and sterilized the bottles, they got sick. All babies did. That was just an accepted fact of life. Her friends' children were no more or less sick than hers.

All of my MIL's grandchildren were breastfed (one for only a short period, 3 for a year or more). She was surprised to observe that none of her grandchildren ever had bouts of infant diarrhea. None.

Susceptibility to diarrhea is influenced by both environmental and genetic factors. We were worried about Iris because Bad Dad certainly has genetic susceptibility. Iris avoided that problem. What made the difference? We can't say for certain but my MIL thinks it was breast feeding. YMMV

Now the new mommy scare is perchlorate (perc) in baby formula. Combine the low, but detectable, levels of perc found in baby formula, add perc from tap water, and babies in some parts of the country can get hazardous amounts of perc in their diet. Though perc was detected in many formulas, ones made from cow's milk had higher levels than those made from soy. (I supplemented my milk with soy formula after the first 6 months because I couldn't keep up with her calorie demands.)

Curiously, no one measured the levels of perc excreted in mothers' milk. I wouldn't be surprised if humans, as well as cows, excreted perc. After all, there are more dry cleaning establishments in residential neighborhoods than on farms. (And, unless you live on or near a place that spills jet and rocket fuel, the perc contamination in your water comes mainly from dry cleaning.)

Don't you just love the headlines that refer to perc as "a chemical found in rocket fuel"? It is also a common solvent and industrial cleaner. Until recently, it was the most common dry cleaning fluid. That's why they tell you to take the plastic cover off your dry cleaning and leave it outside to off-gas. You wouldn't want to breath more of that stuff than you have to. Though it is kind of hard not to breath in whatever is off-gassing from the clothes you are wearing. And does your baby chew on your clothes? I digress.

Did you know that hydrazine is also a chemical found in rocket fuel? And that rocket scientists test if a hydrazine detector is working by putting shitake mushrooms up next to it? Seriously, they buy the mushrooms at the supermarket, put them in a plastic bag in the sun, and then open up the plastic bag right up next to the hydrazine detector. Through trial and error, they discovered that shitake mushrooms give the strongest signal. I know one rocket scientist that refuses to eat mushrooms.

I take the middle road with Andrew Weil. He acknowledges the dangers of hydrazine in mushrooms. But they are also delicious and contain beneficial compounds as well. He points out that hydrazine is a volatile compound and most of it evaporates in cooking. He eats cooked mushrooms. Unless you have one hell of a range hood, it would be best to cook them outside. Call me overprotective, but I wouldn't feed mashed mushrooms to babies, either.

9 comments:

  1. Both Judith Warner's and Hanna Rosin's articles made me pretty angry. I was particularly offended by Hanna Rosin's assertion that breastfeeding prevents women from doing "meaningful work". I was offended for myself and the 20 months during which I worked outside the home as a nursing mother. And I was offended for the women throughout the ages who have breastfed while taking care of children at home. That is also "meaningful work".

    I do know other people who found pumping painful. I certainly don't care if anyone else pumps. But to suggest we should ban them is ridiculous. I was grateful for the machine that allowed me to work outside the home AND breastfeed. And I was really, really grateful to take the pump with me on the occasional nights away my parents gave us. The pump made it possible for me to get a good night's sleep!

    I actually thought Ms. Rosin's review of the science was haphazard. If she did a thorough review of the literature, it didn't show in her article. Its not that she misinterprets the studies she does cite, but that she only cites a few studies that seem to be handpicked to support her argument. The thorough reviews I am aware of all come to the opposite conclusion. However, I agree that she shouldn't be judged for formula feeding. I don't think it is anyone else's place to judge how a family chooses to feed their baby.

    One last thing- there was a study a while back looking at industrial chemicals in human breastmilk. It made quite a splash, because they found reasonably high levels of some things. I can't remember if perc was among them. You're right that the perc study is another example of a study that fails to include the most appropriate control to test the conclusions that the mainstream media draws from it. (I haven't read the study itself, so I don't know what conclusions the author draws.)

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  2. It's been several weeks since I read HR's article, and I forgot the part about "meaningful work". That was offensive. I was surprised that she made staying at home such a zero sum game.

    I don't see why the father can't be at home with the mother. One academic friend with a work at home husband used to nap or catch up on journal reading while breastfeeding. Her husband took greater responsibility for the housework while she breastfed. After all, when the total amount of home work goes up, the burden needs to be redistributed.

    Thanks for pointing out that HR's survey of the science was haphazard. I was wondering why the overall reduction of diarrhea was so small. If she did cherry pick her research, I wouldn't be surprised.

    Her editor is fond of dramatic pronouncements. He made a star out of Caitlin Flanagan. Read Virginia Postrel's article about healthcare if you want to get mad. There are so many holes in her argument.

    I, for one, would welcome comparative effectiveness studies for chronic diseases. The one conducted by British National Health for my condition was a model of clarity and helped me pick my strategy. Why doesn't my government do that?

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  3. I think you can selectively cite literature to prove pretty much any argument you want to make. So few of us actually bother to go look at the source material.

    And the "meaningful work" comment made me angry as well. But I do have to concede that I have a job where taking breaks to pump is not too big a hassle. Too many articles that support pumping assume that everyone has a work situation that is conducive to pumping.

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  4. I'm certainly not a true expert on the breastfeeding literature- I made the decision to breastfeed based more on what I wanted to do than on the evidence that it is better for the baby, so I follow the literature just as an interested bystander, not as someone trying to make a decision. If I have time over the next couple of days, I'll see if I can find the good survey reviews I remember seeing. If I do, I'll post a link here. The studies I was surprised Rosin didn't mention were about ear infections. I seem to remember that the evidence of ear infection reduction from breastfeeding was pretty solid. The opinion I've come away with from the reviews I've seen is that none of the individual benefits to breastfeeding are overwhelming, but that the sum of all the benefits is pretty convincing.

    On the household equality front, I recognize that I'm probably not the most representative person. I sometimes feel that I live in a little bubble of household equality, because my husband really does do at least 50% of the work around the house. He certainly picked up the amount of other things he did to make up for the time I spent breastfeeding. He has recently stepped up again to cover the first trimester wipe out I've been going through. I think we have a fairly equally division of child care, too.

    Some of my friends have asked how I got my husband to take on so much around the house, and I don't really have anything to tell them. He just came that way.

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  5. I like nursing my baby, but I hate the pump.

    Pumping is not painful, but it is certainly not the pleasant sensation of nursing either. My job is very flexible in allowing breaks, but it is frustrating to interrupt my train of thought in order to pump. I hate cleaning its fussy little parts. I hate its little 70 Hz whooshing noise.

    Yes, in a way I am grateful for this magical machine that allows me to leave the home to do my "meaningful work." On the other hand, my sisters-in-law in the UK get a full year of maternity leave, after which they can return to their "meaningful work," presumably without having to worry so much about pumping. Wouldn't that be nice?

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  6. @Smart Bohemian- I think every woman and family is different, and what we really want is a society that gives them the flexibility to set up the arrangement that will work best for them. I know that for me personally, a one year long maternity leave probably would have required some mental health intervention to help me deal with the feeling of incompetence that days alone with my baby gave me. Those feelings were significantly reduced when I went back to work and remembered that I was, in fact, competent and that "mother" was only part of my identity. It gave me the perspective I needed. I still think that being a work outside the home mom makes ME a better mom.

    So what I really want is more access to part time work- I had a 35 hour work week for a long time, and that was perfect for me. I can no longer have that arrangement, so I make do with second best, which for me is a 40 hour work week.

    That said, our current national standard of 6 weeks paid leave as disability is laughably inadequate. Even the three months of partially paid I'll get here in California is pretty paltry.

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  7. smartbohemian17:01

    All I'm saying is that if TPTB think we should nurse our babies for a year, they should offer us adequate opportunity (extended leave, part time work, whatever) to do that without having to hook ourselves up to a machine.

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  8. You know, I pumped twice a day while at work for 10 months with my first and 15 months with my second child. I used a simple manual pump; it was hard to *learn* to use, but easy once I had practice. I was producing an 8-ounce bottle in 15 minutes, twice a day, after a couple of weeks. The manual pump was also easy to clean and disinfect (you could boil the whole thing, I think it had all of 3 pieces including the gasket). I was working full time (that is, a 40-hour week) as a secretary.

    Granted, because it was manual labor requiring both hands, I couldn't do anything else. But I think I benefitted from 15 minutes of sitting still and thinking twice during each work day.

    I was pathetically glad to be able to do this for my children, since I had to be away from them so much to earn a living.

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  9. I would never call it a war or something as no mom is bad, it's just the way things are taken care of by some moms!

    Nicole

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