Best for Whom?
posted by Sarah Waldeck
As an aside, I recently suggested that breast-feeding advocates organize a public information campaign about how breast-feeding can promote weight loss. An article from last week’s New York Times reminds me that such a campaign could point to other potential benefits as well. A recent study of 139,681 women enrolled in the Women’s Health Initiative showed that:
Women who reported a lifetime history of more than a year of breast-feeding were 20 percent less likely to have diabetes, 12 percent less likely to have hypertension, 19 percent less likely to have high cholesterol and 9 percent less likely to have had a heart attack or a stroke by the time they enrolled in the Women’s Health Initiative.
The word “potential” is important. The Women’s Health Initiative study showed an association between breast-feeding and reduced risk; it did not demonstrate a causal relationship. The study was not able to account for all differences in the lives of women who breast-fed and women who didn’t. In this regard, the study suffers from the same deficiencies as those that attempt to evaluate the effect that breast-feeding has on babies. Researchers cannot account for all the differences in the lives of children who are breast-fed and children who are not.
The idea that breastfeeding is beneficial for women is not new. For example, the association between breast-feeding and lower risks of breast cancer, ovarian cancer, and osteoporosis have been known for some time.
All of this brings me to back to the question of why public health organizations that are eager to promote breast-feeding don’t focus more on the potential benefits for women. I suspect that it has something to do with an overly-simplistic take on the maternal mind: mothers want to do what is best for their children, period. The reality, however, is that most maternal decisions involve trade-offs between what is best for the mother and what is best for the child.
To wit, once an acquaintance who was active in La Leche saw me breast-feeding my child, who was then more than a year old. In what was an effort to be encouraging and supportive, she told me she thought it was “just great” that I was still breast-feeding. Because I was so ready to be done with it all, her comment was exactly what I didn’t want to hear. I know I sounded hostile when I said that I was breast-feeding because it was easier than going through the hassle of forcing my child to stop. In other words, the decision to continue breast-feeding was about which of two imperfect alternatives was best for me, not about what was best for my child.
No matter how much a woman loves her child, self-interest doesn’t disappear. Public health agencies that want to increase breast-feeding rates should capitalize on this reality.