Does Calling Breastfeeding "Natural" Make Moms Choose NOT to Vaccinate?

by Glenni Lorick, IBCLC

I was at Rick's Barbecue Thursday night with my son when I saw Tucker Carlson interviewing Cathy Areu about an article that had been published in Pediatrics, the professional journal of the American Academy of Pediatrics about a year ago. That interview, in which Ms. Areu argued that finally there was a study showing that breastfeeding isn't natural and that fathers can just as easily feed their babies as mothers can, made me go in search of this ridiculous study. When I found it, I realized that it was highly likely that neither Ms. Areu nor Tucker Carlson had actually read the manuscript which was not a study at all, but rather a piece posted in the Perspectives section of Pediatrics. I don't know what Areu and Carlson were discussing, but it certainly wasn't the article I read!

Dr. Jessica Martucci

 The piece, entitled "Unintended Consequences of Invoking the 'Natural' in Breastfeeding Promotion" is authored by two PhD's. Anne Barnhill, PhD is an Assistant Professor in the Department of Medical Ethics and Health Policy at the University of Pennsylvania. Jessica Martucci, PhD is a Fellow of the Department of Medical Ethics and Health Policy at the same university. She was a faculty member in the History department at Mississippi State University, but a recent employee search indicates that she is no longer there. In 2015, Mantucci published an interesting history of modern breastfeeding called Back to the Breast: Natural Motherhood and Breastfeeding in America. She recounts the struggles that mothers had in the middle of the 20th century to breastfeed, the emergence of La Leche League as a voice for mothers, and the resurgence of breastfeeding in recent years. One breastfeeding advocate who heard Mantucci speak in 2013 came away from the evening with the sense that she was not a proponent of breastfeeding. It is worth noting that her primary area of interest is in relationship to how history and policy affect women's and LGBT health.

Knowing who authored the piece does shed some light on it. However, the authors are NOT saying that breastfeeding isn't natural. Rather, they are concerned that the use of the word "natural" to promote breastfeeding could have some unintended ethical consequences. They discuss two areas of particular concern.

Vaccinations

Their first argument has to do with their fear that parents will equate "natural" with not vaccinating. She seems to think that hearing the word "natural" applied to breastfeeding will inevitably lead some parents to think they should avoid anything not "natural." Somehow that word will turn everybody into some kind of crazy fringe anti-vaxing hippie:

Breastfeeding actually is baby's "first immunization"

"Studies have shown that parents who resist vaccination tend to inhabit networks of like-minded individuals with similar beliefs. These pockets of antivaccination sentiment tend to overlap with reliance on and interest in complementary and alternative medicine, skepticism of institutional authority,  and a strong commitment and interest in health knowledge, autonomy, and healthy living practices."

Dr. Mark Sloan, a pediatrician in Petaluma CA says this in response to that argument:

"The idea that the use of 'natural' to promote breastfeeding will lead parents to question the 'unnaturalness' of vaccination hinges on a false dichotomy: that parents considering vaccination are faced with a binary choice between the natural (probiotics, herbs, nutritional supplements, etc.) and the unnatural (manufactured vaccines). In reality, parents often choose a mix of these measures, none of which are completely natural in the Oxford Dictionary sense. The drive to protect our children from infectious diseases—whether by amulets, prayer, vaccination, or the harvesting, processing, packaging and sale of herbs, supplements and the like—has always involved a substantial degree of human intervention."

 Dr. Joan Y. Meek, a pediatrician at the Florida State University College of Medicine, together with colleagues Dr. Julie Ware and Dr. Lawrence M. Noble, offers us the ideal way to juxtapose vaccinations and breastfeeding:

"The ideal way to connect breastfeeding with vaccinations is to highlight breastfeeding as the 'first immunization' recognizing the abundant immune protective factors present in breastmilk, and especially in colostrum."

Gender Roles

Breastmilk really is nature's perfect infant food.

The second area of concern they raise has to do with the ethics of promoting a gender role by saying that breastfeeding is natural. They argue that when we talk about breastfeeding in terms of it being a "natural" function, we are entering into a controversial area where public policy does not belong.

"Coupling nature with motherhood, however, can inadvertently support biologically deterministic arguments about the roles of men and women in the family (for example, that women should be the primary caretakers of children). Referencing the 'natural' in breastfeeding promotion, then, may inadvertently endorse a controversial set of values about family life and gender roles, which would be ethically inappropriate."

So apparently if we say that breastfeeding is the natural way to feed our babies, we are politically incorrect misogynistic throwbacks to a bygone era where June Cleaver stayed home dutifully caring for Wally and the Beaver.

Breastfeeding is a pure, natural act of love

THAT IS RIDICULOUS! I have had the privilege of meeting families in all kinds of situations during my time at A Nurturing Moment. We have mothers who are the breadwinners in their families who take their breastpumps to work so that Dad will have plenty of NATURAL breastmilk to feed baby the next day. We have families where both parents are working outside the home and Mom is pumping each day. We have families where Dad works outside of the home and Mom works in the home caring for their children. We have families with two mothers. I have seen it all and supported each type of family in their specific situation. I cannot imagine a single one of these mothers being offended that breastfeeding has been called natural.

Dr. Meek and her colleagues say it best:

"Choosing our words carefully in health promotion is important, but even more important is the effect our words have on the desired health outcomes. Just as the authors are concerned about a theoretical effect of breastfeeding promotion on vaccine rates, we are concerned about the effect of their article, and other similar articles, on breastfeeding promotion and rates. Let us state clearly that breastfeeding is the normative standard for infant feeding, and other feeding methods put mothers and children at risk for both short and long-term adverse health outcomes."