The GUILT Issue
Nancy E. Wight, MD, FAAP, IBCLC
Breastfeeding provides ideal nutrition, growth hormones and infection-
fighting factors which change over time as the growing infant and child's
needs change; provides it inexpensively, and with no harm to the
environment. Breastfed infants are healthier overall, and research is
indicating that the health benefits may continue into adulthood. Yet
despite this, disappointingly few women choose to breastfeed, and even
fewer choose to continue beyond six months. The issue of "choice" is the
logic artificial baby milk companies use to defend their products. Why
would a rational adult, when presented with the choice between health and
illness, choose illness? The truth is, the "choice" between breast and
bottle is really a sham, with everything in our society pushing us towards
bottle feeding. The combination of calculated misinformation, aggressive
marketing, medical acquiescence (and in some cases misguided collusion) and
the love of consumer freedom has led women to believe that the choice
between artificial feeding and breastfeeding is merely a matter of personal
inclination. Constant comparison of artificial milks to breastmilk has
succeeded in reducing breastfeeding to the one dimensional level of
breastmilk substitutes. 1 The artificial milk companies are experts at the
subtle undermining of a woman's confidence in her own body's ability to
provide what is needed to nourish her infant. They also seek to increase
market share by reinforcing US cultural prejudices that breastfeeding is
only for young infants, breasts are sexual objects not feeding vessels, and
that breastfeeding, like sex, should only be done in private.2 The
literature contains many studies of infant feeding choices. Many women who
choose bottle feeding admit they could have been persuaded to choose
breastfeeding if only someone had cared enough to tell them how important
breastfeeding is.3 Despite the proven health benefits of breastfeeding for
both mother and infant, physicians have traditionally been reluctant to
take a stand for fear of making parents who choose to bottle feed feel
guilty. This is a dissimulation for two reasons. Peggy Robin's book 4 to
the contrary, research studies of breastfeeding promotion programs note
that women generally do not feel guilty for choosing to bottle feed. The
only individuals who ever mention guilt are the older generation whose
daughters are now choosing to breastfeed. "If only she had known .... if
only her doctor had told her ...."3. Second, is guilt bad?5 As
pediatricians we do not hesitate to make our patient's parents feel guilty
about having their children wear bicycle helmets, using infant car seats
and seat belts, obtaining immunizations and fencing in pools. We use guilt
to help adult patients lose weight, exercise more, stop smoking, drinking
alcohol, and taking drugs. Breastfeeding is a health issue, not just a
lifestyle choice. Why is this health issue so different from the rest? As
ethical, caring professionals we owe our patients accurate information,
appropriate guidance and long-term support. Let us continue to promote what
is best for infants and let the guilt fall where it may!
References: 1. Baumslag N & Michels DL, Milk, Money and Madness (1995),
Bergin and
Garvey, Westport, CN.
2. Stuart-MacAdam P & Dettwyler KA, Eds, Breastfeeding: Biocultural
Perspectives, 1995, Walter DeGruyter, Inc, Y, NY.
3. Lawrence, RA, Breastfeeding: A Guide for the Medical Profession, 4th ed,
1994, Mosby Yearbook, Inc, St Louis, MO.
4. Robin P, Bottlefeeding without Guilt, 1996, Prima Publishing, Rocklin, CA.
5. Oski, F, In Defense of Guilt, Editorial, Contemporary Pediatrics 1995,
December, p 9.
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
http://together.net/~kbruce/kbbspin.html
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