To Doubters of The Importance of Breastfeeding

The following are my responses to comments on the blog post, “The Myth of ‘Breastfeeding is Optional.’” The comments are sectioned (and in italics) with my responses following.

Here is the context. My work overall tries to figure out why contemporary humans in dominant societies have general ill health, lower receptive intelligence, are divorced from living with the earth and its entities, and are destroying virtually every ecosystem on earth. The Western world’s dominant culture is only a few hundred years old and in that time has made a wasteworld of much of the earth. In contrast, there are a number of societies who existed for tens of thousands of years, living sustainably within their landscapes. Why are “moderns” crazy in comparison to our ancestry, 99% in small-band hunter gatherer communities (some of which still exist)? I suspect it begins with early childhood, when the brain needs extensive supportive care to develop well. My lab studies the Evolved Developmental Niche and we find that each of the components has an effect on child wellbeing, sociality and morality. Every move away from our inherited nest appears to be a risk factor for fostering a human with ill social, physical and mental health.

The Evolved Developmental Niche for humans from their inception and based on social mammalian practices over 30 million year old that include soothing birth experiences, responsiveness to needs of the child, extensive breastfeeding, touch, play, positive social support and multiple responsive caregivers.

COMMENT: Breastmilk is perfectly tailored to each child’s changing needs? Please. How do you explain the women whose breasts don’t make enough milk? Or those with oversupply? Or the breastfed babies that become iron, iodine, or vitamin D deficient? Or the breastmilk that contains PCBs and other environmental contaminants? Or viral transmission through breastfeeding? Doesn’t sound very perfect to me.

RESPONSE: The science of breastmilk is a burgeoning one so there is much new information to learn. Katie Hinde and others are doing some great work on the interaction between baby needs and milk content. The baby’s saliva and rate of suckling communicate to the mother’s body what is needed and she produces it.

Lactation is an art and a science. After birth, mothers need to feed immediately and frequently (and a breast fully utilized) to signal to their bodies that they should prepare for long term breastfeeding. Otherwise they may “run out of” milk (though “power nursing” can reverse this problem).

There are multiple factors involved in baby deficiencies (e.g., clamping the umbilical cord too soon after birth leads to iron deficiency) and to baby exposure to toxins (umbilical cords have many toxins in them due to the toxic environment we have created).

Mothers whose milk is deficient in vitamin D need to increase their levels of it (for their own health too) rather than resort to formula where it has been added. Although breast milk might contain contaminants it has thousands of other body/brain building ingredients making it preferable to formula with its minimal ingredients that keep babies alive but not thriving.

Taking the baby’s perspective, formula is a good emergency food for extreme situations but breastfeeding should be the default if we want to develop baby optimally. I think this is a matter of justice and baby rights. We need wet nurses and milk sharing in every neighborhood to make this possible for every baby. Yes, it will require some changes in attitudes and practices.

Children in our 99% were raised communally (the anthropologist, Sarah Hrdy [correct spelling], calls it “cooperative breeding”) so that even breastfeeding was sometimes shared.

COMMENT: But then, any actual evolutionary biologist will tell you that static perfection is not an outcome of evolution. It’s about being well-enough adapted to the present environment that you survive long enough to reproduce, nothing more.

RESPONSE: This is a common misconception. Natural selection does not operate on one generation (getting to reproduction) but over multiple generations. An individual’s mutation has to outperform those of their rivals over generations. So, the individual has to survive, thrive, and reproduce but so do the great-grand-offspring. We can see that subsequent generations of a well-cared for child will outcompete a child poorly cared for. The subsequent generations of a breastfed baby are more likely to outcompete a rival fed on formula because the species-typical nest (of which breast milk is a part) is set up to match the needs and maturational schedule of a baby, and thereby optimize development. And we can see from the data we have that breastfed babies are healthier in all sorts of ways (see Surgeon General report and list of breastfeeding benefits).

Genetic selection is one narrow theory of evolution. There are bigger, broader theories of evolution. Check out Developmental Systems Theory (Susan Oyama and others) or Jablonka & Lamb’s work. They, like others, point out the many inheritances we have beyond genes. These include the evolved developmental niche (nest) whose effects my lab investigates.

Breastfeeding is part of the species-typical nest. Whenever offspring are raised outside of a species-typical nest, they correspondingly become species-atypical individuals.

COMMENT: Two to eight years of breastfeeding might make sense in an environment of periodic drought and food insecurity, with no access to birth control, and where your child must stay with you at all times by necessity. This is very much not the situation a typical mother finds herself in these days in the industrialized world. Indeed, outside the Kalahari, a woman who spends up to 2-8 years breastfeeding and child care exclusively for each child she bears is probably either unusually privileged or placing herself and her children at a disadvantage in today’s environment, in which several years absence from paid work comes at a very high cost, both economically and in terms of career development and personal satisfaction.

RESPONSE: I didn’t advocate a particular length of breastfeeding but would agree with the World Health Organization’s recommendation for a minimum of two years of breastfeeding, which is the lower limit among small-band hunter-gatherers. It seems like a reasonable minimum.

Certainly “cost” is an issue—but what cost to whom, according to what standards? Putting economics first is problematic for any aspect of living a good life. My focus is on optimizing human potential and not denying babies what they evolved to need. We undermine a child’s wellbeing and the child’s potential descendants when we don’t provide a species-typical nest. It’s easy to rationalize away with concerns for parent wellbeing over the child’s wellbeing. But adults have all sorts of options that can support breastfeeding. The child has no options as to what is most beneficial for him or her.

COMMENT: You romanticize hunter-gatherer societies and embrace the practices you agree with while disregarding those you presumably don’t. Do you also endorse infanticide, constant inter-clan warfare, rape, polygamy, or pedophilia? These are all practiced in at least one “traditional society,” yet for some reason they don’t merit a mention. Don’t get me started on primate behavior…

RESPONSE: You are confusing societies. Small-band hunter-gatherers did not have warfare or rape. There is no coercion in those societies, even by adults towards children. See the work of anthropologists like Douglas Fry, Tim Ingold, Richard Lee, James Woodburn. Human genus spent 99% of its existence in small-band hunter-gatherer communities. Many of these lived lightly on the earth. Complex hunter-gatherers, tribes, chiefdoms are different. Unlike small-band hunter-gatherers, they have possessions to fight over, though no level of society is necessarily violent. Breastfeeding is one of the characteristics that leads to a peaceful society.

One might argue that you are romanticizing modern life. Often people romanticize the modern world, as if humanity can surpass nature and create its own paradise. But look around and attend to the data. Modern ways are creating a wasteland of the earth (Millennial EcoSystem Assessment, 2005; World Wildlife Fund, 2014). There is so much stress that people are violent, reckless and shortsighted. Where money prospers, life withers (Korten, 2015).

Of course we don’t want to and can’t go back to living as foragers, but we can pay attention to what is species-typical for human development and try to remedy the now-terrible consequences of early undercare: species self-destruction of health and wellbeing, as well as vast earth-destruction because we are ‘half out of our minds’ from early underdevelopment.

COMMENT: Your whole argument is deeply sexist, as well as insensitive and needlessly inflammatory. Women are more than just biological entities for bearing and rearing babies. How dare you suggest that women who don’t breastfeed for an absurd 2-8 years are not providing adequate mothering to their children? What of their careers, their financial stability, their mental and emotional health (which, unlike breastfeeding, seems to have a robust effect on infant outcomes)? Why can’t nurturance also be provided by fathers, grandparents, child-care providers? Why can’t an intelligent woman look at the information on infant feeding and make up her own mind about the value versus the costs that it may have for her own personal situation?

RESPONSE: The challenges of breastfeeding are cultural and community issues, and not intended to be placed on mothers alone. We need to change the culture of support and not give into profiteering by those who want us to give babies artificial foods.

Of course, the evolved developmental niche is a village affair. In anthropological studies of small-band hunter-gatherers, half the time a baby is being cared for by adults other than the mother.

You are right that mothers get to choose whether or not to breastfeed. My point was that to optimize a child’s health under normal circumstances, formula is not an option. In the USA the baseline for infant feeding has shifted over to “formula is good enough” for every baby. It is absolutely false. If you want the best for your child and your descendants, breastfeeding is vital. It might be easy to believe that formula is good enough is because of the power of advertising and free samples after a hospital birth—not permitted in other advanced nations—that give the impression of its value for every baby.

COMMENT: I look at my 3 children, who were all breastfed much less than the 2-8 years you want to impose on people, and even supplemented with formula when necessary, and I can’t imagine how they could be healthier or smarter. The eldest is in college and I’ve had the pleasure of following her group of peers from early childhood to early adulthood and seeing how they turned out. Infant feeding was the least of it!

RESPONSE: I’m glad to hear that your children are healthy. There are many dynamic factors involved. You sound like a caring responsive mother and research shows that responsiveness is fundamental. As I said before, my lab studies all the elements of the species-typical nest (the evolved developmental niche; EDN): not only breastfeeding, but touch, play, responsiveness, multiple adult caregivers, positive social support and birth experience. All these play a role in positive child outcomes. You can see more here. Each move away from the EDN is a risk factor for health, sociality and morality for life.

I think it is unethical to promote infant formula for anything other than extreme emergencies.

As I also indicated, we are in the midst of learning more about breastmilk. Here is a recent study showing the different gut bacteria fostered by exclusive breastmilk versus formula fed infants. The gut is the center of the immune system and even influences personality! This is the century, I am told, of probiotics (promoting good bacteria instead of antibiotics—killing off the “bad” bacteria). Among its thousands of ingredients, breast milk has ingredients that feed the good bacteria.

COMMENT: People like you focus rigidly on the really minor points of childrearing and make it as difficult and miserable as possible, and for no good reason! Leave women alone with this garbage. We have enough to worry about without being made to feel we have to emulate hunter-gatherers in 2016.

RESPONSE: I am sorry you are distressed by the information (it was distressing–shocking–to me to learn it too). But the point is to educate people about what is an appropriate baseline for baby care. We need to shift our baseline assumptions. People need to understand what babies and young children need. Sometimes the information is hard to hear, especially for parents who did things against their instincts or were treated harshly as children themselves.

Breast milk is NOT a minor factor in health, nor are the other components of the evolved developmental niche (see more in Narvaez et al., 2013; Narvaez et al., 2014). For example, breast milk has all the immunoglobulins one needs to build the immune system, which does not reach adult levels till about age 5.

The goal is not to condemn anyone but to advocate attention to baby wellbeing. It’s a cultural issue. Our culture has forgotten what babies need for proper development. It used to be a very pleasurable thing to give this care but our culture has made it very difficult. Instead we live in a system that glorifies work and expects work to be adults’ primary focus and shames or punishes those who do not make work a priority. We need to change things around to make baby raising easy and pleasurable again. This requires lots of support systems and making sure no trauma happens along the way.

Changes are happening. Even though the USA has abysmally high maternal and infant mortality rates (in part because they count things differently), the Baby-Friendly Hospital Initiative started in the USA officially in 2011 is moving in this direction. Last I heard in 2015, only 12% of hospitals were deemed “baby friendly” (which mostly means breastfeeding friendly). Unfriendliness refers to separating mom and baby after birth (immediate skin-to-skin is preferred to support deep bonding and breastfeeding success), giving babies sugar water to keep them quiet or formula for no medical reason. Baby-to-work initiatives are also becoming more available.

References

Fry, D. P. (2006). The human potential for peace: An anthropological challenge to assumptions about war and violence. New York, NY: Oxford University Press.

Hrdy, S. (2009). Mothers and others: The evolutionary origins of mutual understanding. Cambridge, MA: Belknap Press.

Ingold, T. (1999). On the social relations of the hunter-gatherer band. In R.B. Lee, R.B. & R. Daly (Eds.), The Cambridge encyclopedia of hunters and gatherers (pp. 399-410). New York: Cambridge University Press.

Ingold, T., Riches, D., & Woodburn, J. (1988a). Hunters and gatherers, Vol. 1: History, evolution and social change. Oxford, England: Berg.

Ingold, T., Riches, D., & Woodburn, J. (1988b). Hunters and gatherers, Vol. 2: Property, power and ideology. Oxford, England: Berg.

Jablonka, E. & Lamb, m.J. (2005). Evolution in Four Dimensions: Genetic, Epigenetic, Behavioral, and Symbolic Variation in the History of Life. Cambridge, MA: MIT Press.

Jablonka, E., & Lamb, M. J. (2006). The evolution of information in the major transitions. Journal of Theoretical Biology, 239(2), 236–246.

Korten, D. (2015) Change the story, change the future. Oakland, CA: Berrett-Koehler Publishers, Inc.

Lee, R. B. (1979). The !Kung San: Men, women, and work in a foraging community. Cambridge: Cambridge University Press.

Lee, R. B., & Daly, R. (Eds.). (2005). The Cambridge encyclopedia of hunters and gatherers. New York: Cambridge University Press.

Millennium Ecosystem Assessment (2005). Ecosystems and human well-being: Synthesis. Island Press, Washington, DC.

Narvaez, D., Panksepp, J., Schore, A., & Gleason, T. (Eds.) (2013). Evolution, Early Experience and Human Development: From Research to Practice and Policy. New York, NY: Oxford University Press.

Narvaez, D., Valentino, K., Fuentes, A., McKenna, J., & Gray, P. (Eds.) (2014). Ancestral landscapes in human evolution: Culture, childrearing and social wellbeing. New York, NY: Oxford University Press.

Oyama, S. (1985). The ontogeny of information: Developmental systems and evolution. Cambridge: Cambridge University Press.

Oyama, S. (2000). Evolution’s Eye: A Systems View of the Biology-Culture Divide. Durham, NC: Duke University Press.

Oyama, S., Griffiths, P.E., & Gray, R.D. (2001). Cycles of contingency: Developmental systems and evolution. Cambridge, MA: MIT Press.

World Wildlife Fund (2014). Living Planet Report 2014: Summary. [McLellan, R., Iyengar, L., Jeffries, B. and N. Oerlemans (Eds)].WWF: Gland, Switzerland.