Breastfeeding and attachment parenting - your thoughts

[awfulpersonme]

I've not posted on this board before but have lurked a lot.

I'm interested to see what you think about two things I have thought about a lot in recent weeks - breastfeeding and attachment parenting.

I breastfeed my 5 month old and as such was on a few Facebook groups for support. On these groups I have seen comments stating that women who ff should not have children, that formula should only be available on prescription for babies who need it medically, and asking for tips on how to persuade their female friends and relatives to breastfeed their babies. These groups are largely AP based.

So:

1. Is pressurising women to breastfeed essentially anti feminist? Isn't it just another way of telling us what we should and shouldn't do with our bodies, another way of making female bodies public property?

2. aren't a lot of the attachment parenting principles essentially quite anti-woman? Every AP group I've seen seems to place a mother's need for outside stimulation, sleep, and good mental health as far, far below the needs of her children (at all ages, not just newborns and young babies). The idea that you must be around your baby 24/7 just seems to me to be another way of keeping women firmly "in their place".

What do you all think??

What would you expect the reviewer to say?

(I am genuinely curious about this. I love reviewing papers.)

furry i have to admit before having DS1 I didn't not know you could formula feed. It sounds really dumb now but in my family babies are breastfeed and the same with all my mums friends. I even remember seeing my mum feed another friends baby.

1. Personally no, I just see it in the same vein as 'eat your five a day', 'see your doctor if you've had a cough for more than three weeks'....its public health advice.

2)Not necessarily, for two reasons...a)after a certain age the dad can stay at home and do the majority of parenting b) AP feels natural to a lot of women, we are mammals after all. I would find it 100% more stressful/unnatural to for e.g. leave my baby to cry.....I'm still at the stage where I don't leave my DS for longer than about an hour (elf) and I get plenty of outside stimulation, we go out together in the day, and in the evenings we invite people round for dinner. I just cuddle/bf DS on my lap while chatting.

Haha I meant ebf, I would love an elf.

My eldest has declared himself a goblin so you may get your elf one day

Furry I think that is the crux of the issue. FF was pushed, hard, for decades as the norm and now the backlash against that is the vilify FF. Neither position is helpful. My MIL extended BF and has been very sniffy about my switching to FF at six months. The message needs to get out there that women's bodies belong to themselves and it is a perfectly good choice to make in a modern, developed society.

I would expect them to say something along the lines of:

1. 20,000 in 3.5 billion is so small a percentage that even the tiniest error in my starting calculations could wipe it out completely. thus it's unwise to a. Even propose that number (what are the margins of error? If you trace them back and enact them does it wipe that number out?) and b. extrapolate out to a population level based purely on a numerical calculation. If I'd based my calls on a study of 100,000 women, 0.006 % fewer cases of bc is just a couple of people. They could easily be non significant. The statistical power to detect a 0.006% increase or decrease needs a study population of tens of millions..,Was that the case?

1. Provide justification for a simple worldwide extrapolation across populations/countries/socioeconomic groups. Breast cancer is a complex multi factorial Etiology - provide the correction rationale for age/socioeconomic status/diet/alcohol intake/all the other factors that are known to influence bc rates.

1. Provide a risk: benefit analysis of recommending universal breastfeeding on the basis of preventing 20,000 cases of bc a year.

I work in clinical trials in a numeric/scientific type role after a long career in scientific research (cancer, genetics, human development.)

I don't doubt that bf and age of mother when they first bf influences bc rates - there is solid data on that. The numbers in the lancet paper don't stand up to scrutiny, it's mind bogglingly complex to extrapolate out from smaller studies to worldwide populations. The potential errors are such that it makes their analysis meaningless.

I am really surprised to hear that an article in the Lancet is apparently so poor. I thought it was a highly respected journal?

Yes I'm wondering how the Lancet has got it so wrong. Particularly since WHP and UNICEF seam to support the articles findings.
This is the quote from the lancet that mentions 20 000
"The scaling up of breastfeeding to a near universal level could prevent 823 000 annual deaths in children younger than 5 years and 20 000 annual deaths from breast cancer. Recent epidemiological and biological findings from during the past decade expand on the known benefits of breastfeeding for women and children, whether they are rich or poor."

I find it interesting that even a thread about 'how do we stop judging each other' has us defensive and paranoid that we're being judged. Even though no one on this thread, on either side has been bitchy.
Just shows how ingrained it is in us as mums!

I sympathise Cosmic. While DM would've been supportive however my DC were fed, aforementioned supportive MIL was very supportive of BF but I'm sure she would've been very judgey had I FF. In her case I think the judgemental approach to parenting is a great deal to do with how absolutely she consumed herself in motherhood, to the point where there was really nothing else in her life, with the consequence that a difference of approach is a criticism of her identity IYSWIM.

Do you have a sense of what happens when such comments are returned to the authors of papers like this?

If I murmur ah, clearly a frequentist, do I risk starting the greatest bunfight MN has ever seen, or am I playing into the hands of the patriarchy, because Fisher and Bayes are both men?

That latter was tongue-in-cheek, by the way. It sounds as if you have more experience at this than I do. Maybe we should take this conversation to Academics' Corner as I fear I am totally derailing the thread and coming across as massively superior to everyone, which is far from my intention.

as if I see myself as massively superior to everyone, that should say.

Where's Buffy?

The lancet is an ok general medical journal. The editors are good on general/internal medicine and not so good on anything more molecular.

I want to see their maths - any calculations that are used to recommend universal anything on a 0.006% decrease in a disease are a tad suspect. Think about it - a tiny, tiny margin of error could take that number out.

Anyway, I'm derailing. BF is good for reducing bc rates on a population level. That does NOT mean we browbeat women as individuals into it. If we go down that route then the best way to reduce bc rates would be to do all the things that are proven to reduce bc.

Every woman should reproduce early - marry 'em off as young as you can.
Every woman should reproduce often - let's get back to us all being pregnant from me at be to menopause
No woman should drink, ever.

Now I bfd and I don't drink but they are my individual choices . The point I'm trying to make here, which I don't think I'm doing well, is that what's epidemiologically best on a population levels is not necessarily best on a feminist level for the individual.

If you wAnt to reduce your chances of getting breast cancer your best options are to be lucky genetically, get pregnant and breast feed as young as you possibly can (because that leads to the terminal differentiation of the epithelium that reduces your chances of getting it.) also to be pregnant/bfing most of your reproductive life. Not to drink or be overweight or smoke. I think we can accept that a woman has the right not to get pregnant young and to control her fertility?

No don't hide the academic. Why can;t we talk motherhood and journals all at once. Why can't women with skills and knowledge share and discuss them.

Reviewers can be absolute fuckers erinaceus
I have been reduced to tears by them before...

Not meaning to start a bunfight here at all, nor derail. My apologies if I've come across as tetchy. Ironically I've been up half the night (again) breastfeeding a cot dodging ten month old.

I think what I'm trying to say is that choice is the key. We can't bash women over the head with stats that, while they may be true for a population, don't always relate to them as a woman trying to do what's best for her and her baby.

The point I'm trying to make here, which I don't think I'm doing well, is that what's epidemiologically best on a population levels is not necessarily best on a feminist level for the individual.

The Lancet strong on the history and sociology of medicine, in my lay opinion. I have some links to stuff about the history of clinical trials which were eye-opening to me.

I wonder then and this is huge but how do we make breastfeeding support more feminist and improve rates at the same time?

Is advocacy important?

How can we have conversations around improving rates but still supporting mothers to make choice?
Are we (and I mean breastfeeding supporters) struggling to get our support across when we try to make systemic changes?
Can can we make system changes while supporting women who are currently being failed by the system?

And if we can;t trust the Lancet for research and evidence who cna we trust?

It's a chequered history for sure. Some pretty horrendous events have lead to the (very very rigorous) trial rules we have now.

I was thinking about this thread last night. Ds has serious sleep issues and we've ended up co sleeping and feeding him back to sleep. I'm annoyed with myself because I'm sure that pressure to bf (no matter how thick skinned i think I am) lead to me dropping his nightly top up bottle. Perhaps that bottle could have helped me to continue mix feeding g and not be the sleep deprived zombie I am at the moment. Breast feeding is great but it can also be a kind of tyranny - it's constant and I'm tired, physically and mentally. I think this thread has touched a nerve.

I wonder then and this is huge but how do we make breastfeeding support more feminist and improve rates at the same time?

Good question. I'd say detatch the two. Support the individual mum. Don't try to improve rates at the expense of the individual.

Hubble you come across as a model of clarity and sense. I am glad you have the skills to articulate a position that chimes with me - stats can be used to guilt trip and make women feel bad about parenting choices they should not have to defend.

I hope your reasoned posts will give pause for thought to BF promoters who merrily trot out statistics to denigrate FF without consideration of the context in which women are making choices and that women's rights to bodily autonomy should over ride any other consideration. I am someone who BF but don't see myself as any better or worse than FF friends. Their body, their life, their choice.

Does that mean that the Lancet shouldn't put forward articles like this one because their conclusions don't matter?

The bottom line of all of this is that women should choose what it is they want to do and when they've made that choice they are entitled to all the supports out there for them.

I have never once IRL seen either a BFing woman or a bottle-feeding woman being talked down to for her feeding choice. I've seen it happen plenty on FB forums but that is often from keyboard warriors.

I agree. Thank you for posting Hubble.

" what's epidemiologically best on a population levels is not necessarily best on a feminist level for the individual. "

This a million times over.

I certainly have seen women's feeding choices talked down in public places, and I felt it myself. Breastfeeding in Ireland is very contentious in public places - but that reflects the deeply patriarchal nature of public discourse about women's bodies in general here.

I would also agree that in ALL areas of public health promotion and prevention that individual choice and autonomy is respected without shaming and coercion.