When I was pregnant with my first daughter, I became all too familiar with the now ubiquitous mantra "breast is best." My nurse-midwife and the American Academy of Pediatrics both recommended that I exclusively breastfeed my firstborn for an initial six months and continue nursing her for a year or beyond—so that's what I planned to do.
I'll admit, though, that I wasn't really "feeling it." Did I really want to let some alien child glom onto my nipples for untold hours each day for months on end?
But my world was forever changed the day I received a maternity marketing "gift" package in the mail with a large canister of infant formula inside. For the first time, I considered its ingredient list—corn syrup, soy oil, a plethora of unpronounceable vitamin additives—and suddenly realized: Hey, this is what I was fed as a baby! Those manufactured ingredients had been the building blocks of my life.
Questions about how my formula-fed childhood may have affected my later health (I've always struggled with health issues) loomed suddenly before me. They were only compounded by perpetual breastfeeding "controversies" I had observed in the media and confronted myself later on as a nursing mother.
So it wasn't long before I set off on a worldwide journey to uncover what I never knew and write my new book, Unlatched: The Evolution of Breastfeeding and the Making of a Controversy. Here are 10 key things I learned about breastfeeding in my three years of research:
1. Breast milk is not a food. Today, doctors and public health experts emphasize the nutritional aspects of breastfeeding. But breast milk isn't actually a food; it's an extremely powerful human tissue—an elixir of complex nutrients, hormones, bioactive molecules, ancient microorganisms, and thousands of other barely understood (or yet to be discovered) compounds.
By contrast, commercial infant formulas contain about nine components.
2. Human milk is still a mystery. The entire human genome was sequenced more than 10 years ago, yet we still don't have a comprehensive library of what's in breast milk. Recently, a group of researchers used a new type of molecular analysis to examine just one human milk component, proteins, and discovered more than 1,600 distinct types!
Here's the oversimplified version of what the greatest minds in lactation science reiterated over my course of research: We don’t fully know what's in breast milk. We don't fully understand how these thousands of components affect a baby's development. We need more research.
3. The federal government doesn't test or approve infant formula. The Food and Drug Administration must approve drugs and food additives before they can be sold to the public. Not so for infant formula: Manufacturers instead provide documentation that their proprietary products meet federal nutrient requirements and that the ingredients have either already been approved by the FDA or fall into in a category known as GRAS. GRAS stands for "generally recognized as safe"—basically, innocent until proven guilty.
4. There are risks to not breastfeeding, even in the United States.There is a perception that the health risks associated with infant formula apply only to Third World countries, where bottle-feeding combined with contaminated water supplies can prove deadly.
But even in the developed world—where we tend to emphasize the "benefits" of breastfeeding—there are scientifically validated risks to not breastfeeding. For the infant, that includes increased incidence of gastrointestinal and respiratory infection, obesity, type 1 and type 2 diabetes, leukemia, and SIDS.
5. Breastfeeding in public is legal*. You wouldn’t know it—given how often American mothers are kicked out of restaurants, off of airplanes, and even berated in Target for nursing their children—but breastfeeding in any public or private location is legal in 49 states (*except in Idaho).
The problem is, many states don't have enforcement provisions for their laws. We could learn a lot from Taiwan, where, in 2010, lawmakers instituted hefty fines for those trying to oust breastfeeding moms.
6. The breast isn't a sexual organ. Why are we Americans so squeamish about breastfeeding in public? Undoubtedly, it's because we equate breasts with sex. So I was surprised to learn the breast isn't a sexual organ; it's not directly involved in reproduction (sperm or eggs). It's not even a secondary sexual organ, like the penis or vagina.
Mammary glands are classified as a secondary sex characteristic—their biological purpose is to differentiate males from females and to signal sexual maturity to a potential reproductive partner. (Other characteristics in this category: body hair and the Adam’s apple.)
7. Throughout history, human beings could remember being breastfed. In the U.S., we've termed any breastfeeding beyond 1 year "extended breastfeeding." Yet anthropological evidence indicates the biological weaning age for children was probably 2½ to 7 years of age—even as late as 1880 in the U.S. That length of time is still commonplace in many parts of the world. It raises the questions, are human beings supposed to have memories of breastfeeding? If they don't, does this affect their emotional development?
8. Your doctor probably doesn't know a lot about breastfeeding. In centuries past, we would have turned to our mothers and grandmothers for nursing know-how. But now, most of us look to our obstetricians and pediatricians for feeding advice. So here's a shocker: Doctors are taught almost nothing about human lactation in medical school—including the mechanics of how to breastfeed.
Unless your M.D. is a member of the Academy of Breastfeeding Medicine or one of the few with lactation consultant credentials, you'll need to seek out a lactation consultant or educator for assistance, now covered via the Affordable Care Act and accessible through the federal Women, Infants and Children (WIC) program.
9. There are no tests for breastfeeding normality. Only an estimated 1 to 5 percent of women are physically unable to produce breast milk, and yet the problem of insufficient milk is nearly epidemic: In one recent study, around 50 percent of mothers cited low milk supply as the reason they had stopped breastfeeding
Alas, no test currently exists to screen the breasts and determine if their function is actually normal. According to lactation scientist Peter Hartmann, we should be able to give nursing mothers the same medical care we would for any other organ in the body.
10. "Mommy wars" are only a distraction. Eighty percent of American mothers now start off fully breastfeeding their babies—yet half will give it up entirely (or start supplementing with formula) within a few weeks. Is this due to a breast-versus-bottle "mommy" battle?
In my research for Unlatched, I discovered otherwise: Our society is simply unequipped to support American mothers. That deficit extends to scientific knowledge about one of mankind's most essential biological processes, fundamental breastfeeding medical care, the right to nurse our babies anywhere, paid maternity leave (the U.S. is one of few countries in the world without it), and so many other vital issues. I wasn't equipped with this knowledge to guide me during those first critical months and years of nurturing my children. But now we have the chance to change that picture for our daughters.