Announcer: Welcome to Stuff Mom Never Told Your from howstuffworks.com.
Cristen: Hello, and welcome to the podcast. This is Cristen.
Molly: And this is Molly.
Cristen: So Molly, since we're talking about breastfeeding today, I thought I'd share a recent anecdote that happened in our How Stuff Works offices to moi. We have a dedicated lactation room. We are one of those offices that does what it can to provide nice facilities for lactating moms. And it's basically, as you probably know, since you work here, it's an old office. Still got a phone in it and everything! And one morning, I needed to use the phone. I just needed a quiet place to use the phone, and the lactation room was open because it was - like I said, it was early in the morning. And what I didn't know was that the door locks behind you. So I went in there and got all my stuff there and tried to make a phone call, and the person wasn't available yet, so I decided to leave and then come back later. So I came back, and lo and behold, the lactation room was locked. I was locked out.
Molly: Oh no.
Molly: Was someone in there using it?
Cristen: No, no, the door was just locked. And so I knew that our office manager had a key. So I went around looking for him, and lo and behold, he is in our break room. And it was in the morning, so it was pretty crowded with people this morning. It was all men, all getting coffee, all talking about football, I kid you not. And so I was just standing there awkwardly in the doorway, trying to telepathically communicate to our office manager that I needed him to come out of the break room and talk to me. And finally he saw me and all the men noticed me standing awkwardly in the doorway. And he asked me what I needed. I said, "Well, Michael, I need to get into the lactation room." At which point, all the men in our office, knowing that I am not a mom, not married, kind of got pretty quiet, and I noticed eyes traveled stealthily or not so stealthily, from my face to my bus, at which point, I said, "It's for the phone, not for these." And blushed and walked away awkwardly.
Molly: Would you say you learned any lessons about using the lactation room for non-lactation purposes?
Cristen: Never close the door behind you in the lactation room. If you find yourself at the How Stuff Works offices and you need to make a phone call in the lactation room, just make sure the door's cracked. Because you're not getting back in!
Molly: A good lesson. A good life lesson for everyone, I think.
Cristen: But I think it's great though that we do have the lactation room for women who do need to use it. I think it's nice because it's really not a - it's not all that common.
Molly: You know it's not. I just wrote an article called Does Breastfeeding Make Better Babies?, which is what we're going to discuss today, and it was kind of disheartening to see around this country how hard it is for working moms to pump their breast milk for later use.
Cristen: Right. Not only is there - are a lot of people uncomfortable with the thought of women breastfeeding in public, which has angered many mothers. I mean I can understand, and women have even had - there was an incident a couple of years ago when Barbara Walters made a comment about how a woman who was breastfeeding next to her on a plane really made her uncomfortable. And as a result, a bunch of women got together and had a - what do they call it? A breast-in, a feed-in, I think, outside the ABC offices because she mentioned this on The View. And it really angered a lot of these women, who were saying, "We're constantly being judged for breastfeeding our children in public. But you know what? Babies don't know where they are. They just know that they need the milk."
Molly: Right, and so when I was researching this, it was amazing just how much judgment there is on every single side of this. And I'm sure we're going to get tons of mail no matter how we phrase this podcast, Cristen because it seems like right now, women who do breastfeed are judged for doing it in public, for not doing it in what other people deem an appropriate place. Women who don't breastfeed are judged for maybe not doing what's best for their babies, which was sort of what this article goes into, whether it really is best for our baby. And I think it's kind of sad that moms who are already stressed out enough have to deal with all this judgment just by feeding a child.
Cristen: Yeah. I mean I would venture to say that breastfeeding is the No. 1 most contentious issue involved with motherhood today.
Molly: Right. So let's just get into whether it's really something to be contentious about. I was really struck by learning that the U.S. Department of Health and Human Services ran these public service announcements in 2004 and 2006 that showed pregnant women riding mechanical bulls, and then they'd fall off. And then the commercial would be like, "You wouldn't take risks when you're pregnant. Why take risks when you're having a new baby," saying basically that the risk of riding a mechanical bull while you're pregnant is the same as the risk that not breastfeeding your child incurs.
Cristen: Yeah, and the American Academy of Pediatrics currently recommends that mothers feed their babies exclusively with breast milk. Now that's not necessarily breastfeeding, that's just breast milk, for the first six months of life. So we've got these big government health institutions saying breast milk is best.
Molly: Yes. And I think the reason that we needed such a big campaign about this in the United States, is I think that more than any other country, two things happened. One, we sexualized the breast to the point that people got freaked out at certain points when a woman would whip it out to feed a child. And two, I think that our society is more susceptible to sort of the formula arguments that came about in the late 1880s.
Cristen: Right. Like you said, in the late 1880s, baby formula arrived on the market. And women started to think that they were unable to breastfeed, and it might have been because doctors were actually paid off by formula manufacturers to tell this to these new mothers.
Molly: Right, and so it became kind of a lower class thing to breastfeed because if you could afford the formula, then you would give formula to your child. And it seemed to be a very scientific thing. Some doctors were telling women that the children weren't getting enough to eat when they breastfed, so they'd say measure out exactly this many ounces of formula and that way, you can be sure that children get enough to eat.
Cristen: Mm-hm. And even before formula came around, a lot of the upper class women would have wet nurses who would breastfeed their children for them. So there was still this kind of societal stigma involved with breastfeeding in the U.S.
Molly: Right. So the shift back to the breast comes around the 1950s to the 1970s. In 1958, we've got the formation of La Leche League, a famous support group for breastfeeding women. And it was a group of Catholic moms who said, "You know what? God wants women to use their bodies to breastfeed." And then just a few years later, 1971, the famous book, Our Bodies, Our Selves comes out and shows women that their bodies are not to please men. That breasts aren't just sexual objects, that they are endowed with a purpose, to give breast milk to babies. So I think that that was sort of the real revolution, a combination of Catholic moms and feminists.
Cristen: Mm-hm. So we have this cultural history with breastfeeding, but what do studies say? Because this is where things kind of start to get tricky because, as we'll find out in a few moments, a lot of these studies seem to say that breastfeeding is the best! You know, it's going to prevent all the host of diseases from your infant. But at the same time, when you look closer at all these studies, they aren't as ironclad as you might think.
Molly: Right. And when I started researching all these studies, it was just amazing all the benefits that get promised women. I mean it really does seem like this magic elixir of life. The TSA, you can only carry 3 ounces of liquids on board a plane, they classify breast milk as liquid medicine, so that women could carry more of it. And so there's this big shift that what's in that milk is the absolute best thing, the most nutritionally balanced meal you can give an infant. Now the things that, the diseases and conditions that breast milk promises to prevent, are Sudden Infant Death Syndrome, respiratory infections, meningitis, pneumonia, diarrhea, ear infections, asthma, diabetes, autoimmune diseases such as Crohn's and leukemia. Just to name a few.
Molly: I mean it is study after study of diseases that are promised to avoid. Now I will say, Cristen, when I started reading all these studies, I felt a little bit biased because I know that I was not breastfed.
Molly: And I'm a healthy person, I think. I think I'm a superior specimen of human being. And so I really started to kind of dig deeper because I was like, surely my mother would not disadvantage me so much just by feeing me a bottle. Is this true? Beca use the American Academy of Pediatrics is saying that if all babies are breastfed, we would save $3.6 billion in annual healthcare costs.
Cristen: Right. And Molly, I was a breastfed child and because of that, according to research, I was given a rich formula of natural antibodies, hormones, neuropeptides and natural opioids. So right now formulas can't necessarily replicate, and that is why they think that breast milk has all of this life-giving magical properties.
Molly: Right. And you know, it's not just good for the baby. There's tons of stuff about how good it is for a mother too. It probably lessens depression in the mother, thanks to the oxytocin that's in the breast milk. It can help you heal after childbirth, and you have a lower risk of heart attack, stroke, diabetes and osteoporosis. But the thing about it is that all these studies are not as ironclad as they might seem.
Cristen: Right because it comes down to this whole issue of correlation versus causation. And there was an article written by Hannah Rosen earlier this year in The Atlantic. I was highly controversial, and she basically said that - well, I think she does breastfeed her children -
Cristen: - but she said that all these studies heralding the amazing benefits of breast milk are not very consistent, and that they can only show an associative relationship and not a causal relationship. In other words, you can't say that the actual breastfeeding, the milk coming from the breast directly into the child's body is causing all these beneficial outcomes. In fact, it might just be more of the time spent with the child and that closeness to, physical closeness to the mother.
Molly: And also just other factors that might lead a woman to breastfeed. Right now in this country, the women who breastfeed are largely upper class. They have really great educations. They're probably in good shape themselves. So let's take something like obesity. The study says that breastfeeding lowers the rate of childhood obesity. Does the breast milk do it, or does the fact that you have a health, educated mother who knows what to serve for dinner so that you get a balanced meal, and takes you out for walks? Does that - is that what makes the difference? Is it just being born into a house where a woman takes the time to educate herself about breastfeeding versus a woman who is busy and works and may not be around as much when you're an infant?
Molly: It's just impossible to separate out all those factors.
Cristen: Mm-hm. And I will say, you know, I worked in daycare for a couple of years, a lifetime ago it seems like now. And I worked in the infant room for a while. And you could definitely see the difference between the children who received a lot of parental interaction when they weren't in daycare and the ones who might not have. I mean I think there really is a developmental curve with that. I mean I say that from just a very anecdotal perspective. But still, I think one of the most telling studies to talk about when we're discussing breastfeeding is this thing called Probe It.
Cristen: And it was conducted in 2001 by Michael Kramer of McGill University. And basically, he evaluated the breastfeeding effects on 17,000 children in Belarus.
Molly: Yeah, and the thing that really is kind of unique about this study is all the other studies, in addition to not being able to separate out those coinciding factors, it's also people who are self-selecting into a certain study. You know, you're saying, "Okay, I'm already breastfeeding. Study me." And women are saying, "Okay, well I'm not going to breastfeed, you can study me." So it's not very random, which is usually a factor we like to see in scientific studies. And also scientific studies really don't have the ethical ability to tell a woman what to breastfeed - I mean how to feed a child. So they can't say, "Hey, you breastfeed and you don't." So these groups aren't really random. You're getting kind of a biased group to start with. So that's what Kramer tried to address in this study because rather than telling a woman how to feed their children, he just followed women who had been breastfeeding, and some of them received this intervention where they were told, "Hey, breastfeed more. It's the best thing for your baby." And the other women were just sort of allowed to stop when they were going to stop anyway. And so then he compared those two groups, the women who didn't breastfeed as long as the group that received an intervention and did breastfeed longer.
Cristen: So in a nutshell, Kramer's research showed that yes, breastfeeding is a little bit better than formula feeding. But it's not necessarily - and these are in your words Molly, from your article if I may quote you.
Cristen: The universal panacea that its supporters claim - because they said that extended breastfeeding can reduce the risk of eczema and also reduce the risk of gastrointestinal infection by 40 percent. And in addition, Kramer found that breastfed babies scored 7.5 points higher on IQ tests than other babies. But he said that those results really weren't that statistically significant.
Molly: Right, and those are just verbal tests. 2.9 tests on nonverbal intelligence. One of my favorite quotes when I was writing this article was Kramer says yes, 7.5 points higher on IQ tests, which I saw just duplicated on all sorts of breastfeeding sites. But Kramer says it's not like this is the difference between a genius and a mentally retarded child. That's a direct quote. That wasn't mine. And he actually likened them to the difference between a firstborn child and a second-born child. Because think of how much extra time you have to devote to that firstborn child. And then when you have the second child, it's not like you give them any less care, but your attentions are divided somewhat.
Molly: And so studies have shown that birth order matters. And it may just be - that may be the only difference that breastfeeding maybe comes down to, is just that difference between a firstborn child who's continually followed around to make sure that everything is stimulating and nothing is painful versus a second-born who admittedly maybe falls down a little bit more and is less deemed precious, you know?
Cristen: Molly, were you a second-born?
Molly: No, I was a firstborn. Which is why I'm talking about how smart they are? But you know, you just have more time with that firstborn, and maybe that's the difference in the IQ and the breastfeeding thing.
Cristen: Mm-hm. Yeah, and I thought it was interesting that they scored higher on verbal intelligence because Kramer suggested that those benefits are coming from the time spent with the mothers, and you would think the mother is going to be sitting there, she's probably going to be talking to her baby, maybe - I don't know, maybe they just pick up language a little quicker because of that extra time.
Molly: Yeah, I think that you sit there and you coo at the baby. Now I'd be interested to see a study where like a woman just focuses exclusively on breastfeeding versus a woman who breastfeeds, but like watches TV at the same time or talks on the cell phone at the same time. Like I wonder how much of it has to do with like looking at the baby and talking to the baby.
Molly: So I don't know. That's a big question for me.
Cristen: But obviously, with working mothers today, we don't all have time to breastfeed our children. We have a lactation room in our office for working moms who can't breastfeed, but they still want to give their children breast milk. And so they use this thing called a breast pump!
Molly: Right. And this, despite being a very common accessory for women in the workplace today, only really came on the marketplace in the 1990s. Previous to that, it was mainly just a hospital accessory. But now that maternity leaves in the United States are so short, women are buying them and taking them to work and using the lactation room when Cristen isn't it making her phone calls. So just reading this research when I was writing this article, where it seems that breastfeeding's benefits come more from the time you spend with your child, I just wonder if women are going through a lot of unnecessary pain to pump out breast milk.
Cristen: But there are, like we said earlier though, there are certain antibodies and chemicals in your breast milk that formula cannot replicate -
Cristen: - right now.
Cristen: That could be beneficial for the child.
Molly: When I was researching this article, I came across a few things that compare breasts to placenta in that they take over the role that the placenta serves when the baby is in the womb in terms of delivering all these essential nutrients to a child. But I did find a pretty interesting piece on Salon that talked about how, while most people think that the breast milk pumps all these antibodies into the bloodstream like the placenta does, it actually just feeds all those nutrients into the gastrointestinal tract, which makes sense when you think about how many digestive ills might be prevented by breast milk as Kramer found.
Cristen: Yeah, he points out that, the author points out that basically once the baby's in the placenta, they're receiving all the antibodies from the mom that they ever will, even after birth. But he also points out that breast feeding can protect against diarrheal ailments in three ways because we always see those study results saying that breast feeding can benefit their gastrointestinal health. And he says that it's preventing the chance that formula could be mixed with contaminated water, and they're also not taking in contaminated food, and then finally because like you said, the maternal antibodies are going straight into the gut, those antibodies actually deactivate swallowed bacteria and viruses that otherwise would infect the cells.
Molly: Right. So maybe the baby is exposed to the flu virus, which would manifest itself with a lot of vomit, diarrhea, other gross things. Because the antibodies are straight to the gut, as opposed to the bloodstream, that might be what prevents the actual infection.
Cristen: But didn't Hannah Rosen in the Atlantic piece also point out that those results would in real world terms shake out to maybe a baby having one less case of diarrhea every year.
Molly: Right, 1 in 40 babies, I think, would have one less day of diarrhea, which doesn't sound that conclusive. I mean it doesn't sound that exciting in real world terms, but I guess when it's your baby and it's one less day of diarrhea, that's something.
Molly: But I did think that that piece, that by Sidney Spezel that we were talking about with how the milk goes straight into the gut was interesting because it was talking about how babies know they're full by the precise way in which breast milk comes out of the breast. There's fore-milk, there's hind-milk, and it teaches the baby that they're done feeding when the hind-milk comes out. And so by pumping, it all gets mixed together and it's possible that when you put it in a bottle, the babies don't know when they're done quite as well. And bottle-fed babies might not know when they're done quite as well, and that may be the difference in the case of childhood obesity. You know, it seems that there's a study from Temple University that showed that when you feed a baby from the breast, everyone's more in tune, the baby and the mother, to knowing when the baby is full. Whereas if it's a bottle of milk that you painstakingly pumped in the lactation room, you might be inclined just to say, "Drink it all, baby."
Molly: I mean you worked for it, you gotta use it. Use it or lose it.
Cristen: And then finally, just to kind of toss one more study in here that questions this whole correlation causation factor that keeps coming up, there was one that was published in the British Medical Journal that suggests that breastfed babies would cope better with stress than bottle-fed babies. But once again, the researchers question whether or not that was the role of the breast milk or the mother-child interaction in shaping t hose neural pathways. So I think with this whole, does breastfeeding make for a better baby argument or debate if you will, it's still so - I think it's just still such a shady area. And it seems - the only thing that seems conclusive from all these studies, the one strand that runs through all of them is the importance of time spent with the infant.
Molly: Right. Which I think is why it's so disheartening that there is so much judgment around this issue. If a woman decides not to breastfeed or is unable to breastfeed for some medical reason, if she goes home and spends all that one-on-one time with the infant, I think it's really hard to make the argument that that baby will be disadvantaged or not as smart down the road as the baby that was breastfed. And so I think that this is just an issue where it would be nice if there was a little less judgment.
Molly: And I do think that breastfed women don't need that guilt of feeding when they have to.
Cristen: Yeah, I think that there is - it's only 21 states, along with Puerto Rico and DC that require employers to make a "reasonable effort" t o accommodate nursing mothers. And not to mention just the problem - I think there was a case with Starbuck's where women wanted to go into the bathroom to breastfeed - or no, women were breastfeeding in a Starbuck's, and the employees would come up and ask them to go into the bathroom. And because of that, there was this huge letter-writing campaign to Starbuck's, and now Starbuck's is very pro-breastfeeding. But I think that yeah, on all sides of whether you're breastfeeding or not, I mean there's judgment from all sides, which I think is very unfortunate.
Molly: Yeah. But let us know what you guys think. Thoughts on breastfeeding! We welcome them.
Cristen: Yeah, guys, we want to hear from you too. You might not be able - you might have vestigial nipples, but your opinions are not vestigial.
Molly: Ooh, Cristen.
Cristen: How about that?
Molly: So now that we have officially welcomed your opinions to email@example.com, we'll read a few people who have already written to us. And since we just talked about breasts, I'm going to read email from Joe that talked about our bra episode, Do Bras Serve Any Purpose?
Cristen: I had one of my favorite subject lines in a while called "What Up Bra?"
Molly: That is true. He says, of course, that he doesn't have any firsthand experience with bras, but he understands that we women have it tough. He writes, "It's not just men constantly staring at your chest, but there are also stigmas among women," - again, the judgment - okay, sorry, that was my aside, not Joe's. Joe writes, "If it's okay, I'd like to share a little story about a friend of mine. We'll call her M. And my boss at the time! We'll call her B. About seven years ago, I worked at a jewelry store in a small suburban rural town northwest of Atlanta. The manager was a woman in her 60s and my friend was in her 20s. Being that it was a jewelry store, especially one in a rather conservative small town, professional dress was expected and enforced. M had no problem with this and always wore a bra, a top and a cardigan or business jacket. But she was a skinny girl who was naturally well endowed. B, a conservative woman whose concern was often about appearance and propriety in front of the customer, had been making comments to cover those things up to M over several weeks. This was in reference to M's nipples, which in our cold work environment had the habit of prominently poking out through three or four layers of clothing. M tried to comply with what she told me were thicker bras and an extra top, but she didn't make enough to change her entire wardrobe, even though her dress has always followed the guidelines set by the company. The harassment by the older lady put M at her wits' end. Things came to a head when B, frustrated that M's nipples were again visible, went up to M and flicked her nipple through her shirt, hard."
Molly: "I can't imagine why the conservative woman would be driven to the point of madness and think this was an appropriate action, but when I saw her do what she did, my jaw hung open in utter shock. The event humiliated my friend to the point that she sued the company for sexual harassment, but ended up settling out of court and getting a transfer to a different branch." I suppose the point of this story is that while you advise your female listeners to go with that if they feel comfortable enough to do it, it is probably best to do it with discretion. There are still social stigmas in place today that can cause forward-thinking, bright young women humiliation and harassment for no other reason than adherence to antiquated ideas of Victorian era propriety."
Cristen: Whew, what a story, Joe.
Molly: I know. So again, another example of how judgment can just affect our daily lives.
Cristen: Breast judgment.
Molly: Breast judgment, the name of my first book.
Cristen: A memoir by Molly Edmunds. Well, if you guys have any thoughts you want to share with us again, our email is firstname.lastname@example.org, and if you'd like to head over to our blog, it's called How To Stuff, and if you want to read Molly Edmunds' wonderful article, Does Breastfeeding Make for Better Babies?, which will include all of the studies and references, etc. that we made today, if you want to fact check us, head on over to howstuffworks.com.
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