Is describing breastfeeding as “natural” ethically problematic? That’s the claim of a recent article in Pediatrics. Why problematic? “Natural” influences people, say the authors. “Natural” encourages people to believe something’s better or healthier. And that just can’t be!
Pardon the pun, but naturally this got our attention. After all, breastfeeding is a natural function. More, its benefits are well supported by scientific research. It’s proven the best method of infant feeding for a whole host of reasons – nutritional, immunological, and psychological.
There are dental benefits for the child, as well. Dr. Brian Palmer – an expert on the impact of breastfeeding on orofacial development – notes that in contrast to bottle feeding, breastfeeding
- Positively affects the development of the oral cavity and airway.
- Sets a pattern for a correct normal swallow into adulthood.
- Encourages mandibular (jaw) development.
- Strengthens jaw muscles.
- Ensures lower rates of malocclusion (a misaligned or “off” bite).
- Reduces need for orthodontics.
- Forms U-shaped dental arch, reducing issues with snoring and sleep apnea in later life.
With all these benefits, why worry about how it’s described or perceived? And why single out the word “natural” as the problem? Writing about their paper in a guest blog on Philly.com, the authors worry that
invoking “the natural way”…plays into a view that “natural” approaches to health and parenting are inherently better and healthier, an argument wielded by the anti-vaccination movement to the detriment of public health.
And there it is: guilt by association. Looking for “natural” options such as breastfeeding may sway people away from vaccinations. This weirdly sets up breastfeeding as a kind of gateway drug, leading women astray with its seductive appeal to The Natural.
This is insulting to women. And it’s also potentially harmful. The authors of one response to the paper – two pediatricians and a neonatalis – make the point clearly.
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.
“The ideal way to connect breastfeeding with vaccinations,” they add, “is to highlight breastfeeding as the ‘first immunization’ recognizing the abundant immune protective factors present in breastmilk, and especially in colostrum.”
Thus, campaigns like the Office on Women’s Health’s “It’s Only Natural,” which promotes breastfeeding to African-American families – the demographic least likely to breastfeed even as they face the greatest burden of adverse health outcomes. The word “natural” was chosen precisely to convey the achievability of breastfeeding for these mothers.
It’s hard not to see the rhetorical attack on “natural” as an unfortunate attempt to further a pro-vaccine agenda at the expense of promoting breastfeeding. Ironically, in trying to neutralize dissent toward vaccines, the authors’ work may actually result in taking away the “first immunization” benefit infants receive from breastfeeding.
Sadly, this would leave the most vulnerable population of mothers and children at risk for poorer health outcomes.
Image by ohkylel @twitter, via Flickr