The Great Breast-Feeding Guilt Trip

Franco Vogt/Corbis

At a neighborhood children's fair this month, a friend who had just had her third child six weeks earlier ran into another mother.

"Are you breast-feeding?" the woman immediately asked my friend. My friend answered that she was not, for a medical reason. The other woman expressed her horror. And 15 minutes later, she found my friend once more.

"I can swing by your house and drop off some breast milk," she offered.

Stunned, my friend thanked her, but told her it would not be necessary.

In the era of competitive parenting, my friend is among many mothers socially shunned for offering her children FDA-approved formula. Public policy to encourage breast-feeding has also piled on the guilt, with New York's "Latch On NYC" urging hospitals to "restrict access to infant formula by hospital staff, tracking infant formula distribution and sharing data on formula distribution with the Health Department."

But a new research paper published by the World Health Organization reviewing the scientific evidence shows that over the long term, breast-feeding may not possess the positives often ascribed to it.

So is this a sea change in the milk wars? Not exactly. Beanstock Images/Corbis

The paper opens by noting that breast-feeding "has well-established short-term benefits" before turning to the long term and finding:

● On blood pressure, "small studies provided estimates that clearly overstated the benefits" of breast-feeding.

● On cholesterol, breast-feeding "does not seem to protect against total cholesterol levels."

● On diabetes, there are some benefits, but the data are wanting, and "further studies are needed."

● On obesity, breast-feeding "may provide some protection," but bias and selection issues in the study remain.

Even on IQ, where the authors found "there is strong evidence of a causal effect" of breast-feeding, they note that "the magnitude of this effect seems to be modest" and that the "practical implications of a small increase in the performance in intelligence tests may be open to debate."

So is this a sea change in the milk wars? Not exactly. The doctors who led the review stressed that they are not paid for by the formula industry, and they are about to publish another paper showing breast-feeding's short-term benefits in fighting diarrhea and pneumonia.

"Even if the long-term effects of breast-feeding are not as substantial as formerly believed, there are massive benefits for young children," writes study co-author Dr. Cesar Victora.

But while the WHO paper may offer intellectual ammunition for all sides, those who say the pressure on women like my friend is uncalled for find much to agree with in it.

"The science shows there are some small short-term benefits to breast-feeding that you can see over entire populations, but that on an individual basis it makes really little to no difference," says Dr. Amy Tuteur, an obstetrician with a website called the Skeptical OB. "A lot of women are made to feel very badly about this, and it is completely unnecessary."

GAYLE TZEMACH LEMMON is the author of The New York Times bestseller The Dressmaker of Khair Khana and a fellow at the Council on Foreign Relations.