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From:
Ms Anna Swisher <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 21 Jul 2009 18:22:50 -0700
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Dr. Wolf's profile is listed here: http://wmst.tamu.edu/CVJWolf1.pdf
She has a growing body of work invested in negating breastfeeding. No funding from the artificial baby milk manufacturers is declared, but the International Formula Council (comprised of formula manufacturers) has happily appropriated her work: 

http://www.infantformula.org/research_200807022_g.html

Is Breast Really Best?  A critical analysis of Breastfeeding Awareness Campaign

A critical analysis of the U.S. Department of Health and Human Services (HHS) and the Ad Council’s National Breastfeeding Awareness Campaigns (NBAC) was published in the Journal of Health Politics, Policy and Law by Joan Wolf, Ph.D. of Texas A&M University.  Launched in 2004, the NBAC showed images of pregnant women performing dangerous, irresponsible acts like mechanical bull riding and roller derby skating.  These ads implied that the risks of not breastfeeding one’s infant were as great as the risk of harm of pregnant women engaging in these behaviors.

According to Wolf, the NBAC neglected “fundamental ethical principles regarding evidence quality, message framing, and cultural sensitivity in public health campaigns.”  These messages “consciously attempted to manufacture fear in order to increase breast-feeding rates,” rather than educate women to make the best feeding decision for their babies and for themselves.  Thus, the NBAC capitalized on public misapprehension of risk; this approach, according to Wolf, can have deleterious effects.  

Besides evoking fear as a public health message, the NBAC cited inconsistent, inconclusive science as absolute.  According to Wolf, “perhaps the most problematic dimension of the NBAC was the science on which it was based.  Medical journals are replete with contradictory conclusions about the impact of breastfeeding… the notion that breast-feeding itself contributes to better health is far less certain, and this is a crucial distinction that breastfeeding proponents have consistently elided.” 

The type of studies upon which the NBAC was based are subject to confounding, according to Wolf, which “makes it difficult to isolate the protective powers of breast milk itself or to rule out the possibility that something associated with breast-feeding is responsible for the benefits attributed to breast milk.”  Additionally, breastfeeding studies are subject to publication bias (the tendency for journals to publish studies that find associations over studies that find no association) and the potential bias of the expert review panels, which have preconceived notions about the superiority of breastfeeding.  Given these problems, the “misrepresentation of medical research can lead to exaggerated and unethical claims in public health education.” 

According to Wolf, the NBAC was insufficiently attentive to the psychological, socioeconomic, and political concerns of its intended audience; women whose reasons for choosing not to breastfeed do not appear to have been given real consideration and were treated essentially as an agent of risk to their babies.  In the campaign, unfounded scientific certainty served as justification for breastfeeding at all costs.  Wolf suggests that future public health campaigns would benefit from more diverse review panels and from a greater focus on providing accurate risk information about probabilities and trade-offs in order to enable informed decision making.

Wolf, JB. Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign.  Journal of Health Politics, Policy and Law.  Aug. 2007; 32 (4): 595-636

Yes, the timing of the NHS report (right before WBW) is predictable and sad. 

Anna Swisher, MBA, IBCLC
Abundant Blessings
Georgetown, Texas


      

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