Dear Editors,
        I have a number of comments to make about Jane Eisner's column in
response to the AAP guidelines.  I think her editorial is misguided and in
some ways irresponsible.  I am a biocultural anthropologist, and the
country's foremost researcher on US attitudes towards breasts and
breastfeeding, so I am not an unbiased commentator.

Ms. Eisner writes: "imagine what our modern-day culture would have to face
if we took the latest medical advice to heart."

Yes, just imagine a world where all children have NORMAL immune systems,
NORMAL brain development, NORMAL emotional development.  Imagine the
benefits we would all reap with much lower incidences of gastrointestinal
illness, upper respiratory tract infections, hardly any ear infections, less
cancer, less SIDS, less asthma, less allergies, less diabetes, less multiple
sclerosis, less attention deficit hyperactivity disorder, and the list goes
on and on and on.  The cost to our country and our children from the risks
of infant formula is enormous.  Imagine is all children grew up with the
warmth and security of being cuddled and nurtured in their mother's arms.


Ms. Eisner writes:
"The American Academy of Pediatrics last week issued guidelines urging
mothers to breast-feed for at least a year, twice as long as previously
advised."

This is an inaccurate description of the relationship between the new and
old guidelines.  The previous guidelines recommended 6-12 months as a
minimum.  The new guidelines recommend 12 months as a minimum.  There has
never been a maximum recommended duration of breastfeeding, although the old
guidelines were often characterized as saying 12 months should be the
maximum (not what was intended by the AAP).  That is one reason the new
guidelines are very clear and explicit that is there is no upper limit on
the duration of breastfeeding, to avoid confusion.

Ms. Eisner writes:
"Not only that, but the pediatricians recommended that babies be nursed
exclusively for six months, as frequently as 12 times a day, and that
breast-feeding continue even past the time that first birthday candle is lit."

Again, this is an inaccurate description of the guidelines.  The
recommendation for nursing up to 12 times a day refers to NEWBORNS.
Children 12 months of age usually do not nurse that often.  In reality,
human breast milk composition suggests that several times every hour is the
physiological norm for the species, with many small feedings per day, rather
than big feedings at 2, 3, or 4 hourly intervals.  In addition, my research
on the species-normal duration of breastfeeding for modern humans suggests
that it is between 2.5 years and 6-7 years.  A minimum recommendation of
breastfeeding for 12 months is quite modest, when seen from the perspective
of what the children have been designed to expect.  The new AAP guidelines
recommend only HALF the minimum duration that the World Health Organization
has been recommending for all children since 1979 -- two years.  There are
thousands of women in the US today who are nursing, or who have nursed,
children until well beyond 2 years of age.  This is not something one only
finds in remote New Guinea tribes.

Ms. Eisner writes:
"But . . . breast-feeding is also exhausting, confining and often painful.
Any new mom, if she's honest, will admit to feeling like an over-milked cow
for months on end."

I'm sorry Ms. Eisner's experience breastfeeding her daughter was so
disappointing.  However, most women do not find breastfeeding to be
exhausting, confining, or painful -- especially if they are well-educated
about proper positioning, and have the support of family and friends.  And I
don't know of a single one who reports feeling like an "over-milked cow" for
months on end, and through my research I am in contact with many thousands
of breastfeeding women.  The dairy industry in this country would like us to
believe that only cows make milk, but in fact all mammals make milk.  I
breastfeed my three children for a total of more than 9 years, and I never
found it to be exhausting, confining, or painful, nor did I ever feel like
an over-milked cow.  I felt like a MOTHER.


Ms. Eisner writes:
"Is the country ready to accept mothers baring their breasts at a mall or
restaurant?

I have only one word in response to this: HOOTERS.  Yes, the country is
ready -- bare breasts are everywhere -- at the beach, at bars, at the
Academy Awards, on the cover of Cosmopolitan, in beer ads, lingerie ads, not
to mention clearly pornographic venues.  I think the country is grown-up
enough to accept that the primary function of breasts is for breastfeeding
children.  I've lost count of the number of states that now have laws
protecting the rights of mothers to breastfeed in public -- more than 15 --
including Delaware, New York, Texas, and Nevada.

Ms. Eisner writes:
"Are employers willing to make the time and space available for working
mothers who want to pump breast milk during the day?"

They certainly should be, as study after study has confirmed that mothers
who are breastfeeding miss less work time due to sick children than mothers
who are bottle-feeding.  And pumping at work takes less time than going
outside to smoke a cigarette.  Federal laws mandate scheduled breaks during
the day.  With a good pump or hand expression, it takes 15 minutes or less.
There is nothing necessarily "unprofessional" about pumping at work, or even
having your child with you at work.  I took my youngest to faculty meetings,
dissertation defenses, and office hours.  I did so unapologetically, which
is perhaps the key.

Ms. Eisner writes:
"Nursing mothers have to become more attuned to the awkwardness they
engender when unbuttoning their shirts in public."

I have never engendered any awkwardness while nursing in public.  Most
mothers simply pull up their shirt and latch the baby on.  Nothing shows.
It is truly not the big deal Ms. Eisner seems to think.  Most people never
even notice when a mother is nursing her baby.  The most typical response
from those who do notice is a sweet smile.  Of course, the media only gives
attention to those cases where someone complains and the breastfeeding
mother is asked to leave.  It isn't "news" when, thousands of times a day,
all over the country, women lock eyes with a breastfeeding mother and share
a special moment of tenderness.

I strongly recommend that Ms. Eisner (and her husband) read my chapter
"Beauty and the Breast: The Cultural Context of Breastfeeding in the United
States," from the book Breastfeeding: Biocultural Perspectives.

Ms. Eisner has done breastfeeding mothers and their babies a great
disservice by suggesting the breastfeeding is some huge issue and that the
health of the country's children is less important than the comfort of a few
men who have never grown up.  I agree that we have a long way to go before
*all* employers are breastfeeding friendly, and before all women feel
comfortable breastfeeding in public.  But to moan and groan about how
difficult it will be gets us nowhere.
Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University