There's something that's been nagging at me that I feel I need to say in
relation to recent posts about the health benefits of breastfeeding.  The
whole thread on the Pakistani twins picture, whether or not such extreme
differences can be seen in an industrialized  country.  And the 14-year old
telling his teammates that his excellent health was due to being breastfed
(which, by the way, I think is wonderful!).

First, let me make it clear that I firmly and passionately believe in the
health benefits of breastfeeding, that it's a vital public health issue, that
both short and long-term benefits are real and important.  But I think it
really is not as obvious to those who have not studied it as we have, and that
if we're not careful how we phrase things, we can turn people off and lose
credibility.

My family is a living example of exceptions to the protective effects of
breastfeeding.  Unlike the 14-year old in the recent post, my 16-year old son
gets sick constantly.  If he goes somewhere - camp, retreat weekend, anything
- and one person in the whole place is sick, he will inevitably catch it.  I
don't think we've ever taken a trip when he hasn't gotten sick.  He misses so
much school, it makes it hard for him to keep up.  And, yes, it has been
checked out with his doctor.  He just seems to get things exceptionally
easily.  And yes, he was breastfed for over 4 years.  My daughter has
diabetes, despite being breastfed for 2 1/2 years.  She also needed
orthodontia.  And I had breast cancer despite all those years of
breastfeeding.  I also have friends who have  long-term breastfed kids who
have allergies, asthma, etc.

Yes, I still believe strongly in the evidence that lack of breastfeeding
increases the risk of all the above, and that breastfeeding decreases the
risk.  We all understand the difference between "increased risks" and
"guaranteed to happen in all cases".  And we all know that sometimes other
factors, such as genetics, can overwhelm the effects of breast or
bottlefeeding.  But by and large people are much more convinced by what they
have experienced in their lives than by studies and statistics.  What about
the woman who has bottlefed three kids who are all perfectly healthy, thank
you?  And her cousin has a breastfed baby that gets lots of ear infections.
It does happen.  It's going to be very hard to convince her of the health
benefits of breastfeeding.

We do see lots more bottlefed babies with allergies, constant ear infections,
asthma, NEC, etc.  We hardly ever see a breastfed baby hospitalized for
diarrhea.  These things are dramatic and obvious to those in the health care
community if they bother to look.  But I think we have to admit that there are
many people out there who have been bottlefed or have bottlefed without any
dire effects.  Or, if there are effects later in life, the connection is
difficult to prove.

I worked briefly with a WIC  nutritionist and was telling her why
breastfeeding was an important public health issue and should be actively
promoted, that worrying so much about "making women feel guilty" was the same
as if we didn't try to convince them to stop smoking during pregnancy because
we didn't want to make them feel guilty.  She said, "Oh, but there's not
nearly as much difference between a breastfed and a bottlefed baby as between
babies whose moms smoked and those who didn't".  I tried to tell her what some
of the big differences in fact were, but I think for someone who's skeptical
to begin with, they're not as obvious as the difference between birthweights
that happens with smoking.  Or as obvious as the picture of the Pakistani
twins.

This is not in any way to suggest that we stop talking about the health
benefits of breastfeeding or spreading the word on the research-based data.
Just some food for thought on why it's sometimes so hard to convince people
it's important.

Miriam Levitt RN, IBCLC