I'll try not to be TOO personally offended that someone would call my
morals/ethics into question. . . . . and provide some more information to
help you understand why I say what I say about a few dead babies being a
small price to pay for more women/children breastfeeding.
If all you count is dead babies, then clearly WIC formula handouts prevent
some infant deaths. But you can't just look at how many infant deaths are
prevented by WIC formula handouts and declare the program a success. On
one side of the ledger you have "deaths PREVENTED BY formula handouts" but
on the other side of the ledger you have "deaths and other health problems
DUE TO formula handouts." How many sick babies = one dead baby? I'm sure
I don't know. But you can't just "not count" the sick babies. You can't
just "not count" the cognitively impaired babies. You can't just "not
count" the life-long health problems of the babies who were not breastfed
because WIC was giving out formula and not supporting breastfeeding. You
can't just "not count" the mothers who get breast cancer or uterine cancer
or osteoporosis because they didn't breastfeed.
Let's put in some hypothetical number values for 1000 newborns
Program A (WIC)
600 babies formula-fed from birth, 400 breastfed for a few weeks-months
Advantages due directly to provision of formula:
0 babies die from starvation/dehydration/lack of breast milk, or other
problems that might have happened if the parents gave them Kool-Aid, root
beer, water down cows' milk, etc. (best case scenario)
Disadvantages due directly to provision of formula/lack of breastfeeding:
50 babies have life-long allergies
20 babies end up with asthma
2 babies die of SIDS
10 children get diabetes
2 adults get multiple sclerosis
1 child gets lymphoma
1 adult dies early of coronary heart disease
1 adult suffers from Crohn's disease
3 preemies die of necrotizing enterocolitis
Average IQ deficit of 5-8 points, enough to push 10 kids over the border
from "dim" to Mentally Retarded
50 end up poorly bonded with mother, with life-long emotional problems
10 children end up with ADHD
Net result: widespread suffering and ill-health, both physical and mental,
widespread cognitive impairment; babies die from being fed formula
Program B (No formula give-aways, money spend on breastfeeding promotion
and support)
300 babies appropriately formula-fed from birth, 650 breastfed for at least
6-9 months, 50 given Kool-Aid/root-beer, diluted cow's milk and other
inappropriate substances
Disadvantages due not providing formula:
30 babies die from starvation/dehydration/lack of breast milk, or other
problems (worst case scenario)
20 babies grow up with health problems from Kool-Aid diet, but don't die
some babies still die or have life-long health problems from being
formula-fed or not breastfed long enough
Advantages due to breastfeeding:
many fewer babies with allergies, asthma, SIDS, diabetes, multiple
sclerosis, lymphoma, coronary artery disease, Crohn's disease, necrotizing
enterocolitis, "normal" IQs among those who are breastfed, "normal" bonding
with mothers among those who are breastfed, less emotional problems, less
criminal activity
Call me names if you like, but I'd gladly see some babies die in exchange
for "much closer to normal" breastfed health and cognitive ability in the
vast majority of children. It is only when you completely discount all the
pain and suffering caused by formula that you can conclude that formula
giveaways are a good idea, or that preventing any infant deaths should be
the only goal.
-----------------------
This is, unfortunately, a very typically American way of thinking -- look
only at one outcome measure, and ignore the costs to others. Several more
examples:
A. An attitude of: We don't want any babies to die of AIDS from
breastfeeding from an HIV positive mother, therefore we won't allow ANY
women to breastfeed. By definition, that will reduce to ABSOLUTE ZERO the
number of babies who die of AIDS that they contacted from breastfeeding.
And for many people, that is the goal, the only goal. They ignore the fact
that this will mean a much higher number of deaths due to not
breastfeeding, and even where children don't die, all children will have
much higher rates of illness, all children will be at risk of cognitive
impairment, all children will be at risk of poor bonding, all mothers will
have higher rates of cancer and osteoporosis, not to mention missing out on
the breastfeeding relationship, etc. But all that is discounted if all you
care about is preventing any deaths of AIDS due to breastfeeding. It is a
very narrow and short-sighted view.
B. We don't want ANY babies to die of fetal distress during labor.
Therefore, we will monitor all laboring women with fetal monitors, give all
laboring women an intra-venous drip line, and we will perform Cesaerean
sections at the slightest signs of fetal distress (up to 30+% in some US
hospitals). This will theoretically greatly lower the rate of fetal deaths
during labor (in fact, it doesn't). But even setting aside for the moment
that fetal monitoring doesn't lower the death rate -- even if it DID, this
would still discount all the harm done by routine fetal monitoring and high
Cesaerean rates. No one counts in the debit column all the extra pain and
suffering of the mother who must lie flat on her back during labor, who
can't move around or squat or assume different positions to be more
comfortable. No one counts all the extra drugs given to speed up labor or
to counteract the extra pain caused by laboring on your back. No one
counts all the pain and suffering from having an unnecessary Cesaerean --
which is major abdominal surgery. No one counts all the babies who end up
with lung problems from not being delivered vaginally. No one counts all
the lost experience to the mothers who feel forever afterward that they
"failed" to deliver the baby naturally. No one counts all the babies who
end up not breastfeeding because of all the drugs their mother got during
labor. Again, I have no way to weigh these costs. How many unnecessary
C-Sections equals one baby who didn't die? But no one (besides me and
anthropologist Dr. Robbie Davis-Floyd) seems to be asking these questions.
Why should all women have to have IVs and fetal monitors and longer, more
painful labors so that a few babies don't die? And, as I said, study after
study has shown that you get the very best fetal outcomes when you have
women deliver with the assistance of a trained mid-wife, NOT when you use
the American system of everyone having to have an IV, a fetal monitor, and
a high rate of C-sections.
Off of soapbox for today.
----------------------------------------------------------------------------
-------
Katherine A. Dettwyler, Ph.D. email:
[log in to unmask]
Anthropology Department phone: (409) 845-5256
Texas A&M University fax: (409) 845-4070
College Station, TX 77843-4352
http://www.prairienet.org/laleche/dettwyler.html
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