Breast-feeding: “It’s only natural.” It’s a message women may have seen on Facebook or a state health department website, or heard on the radio, as part of a campaign launched in 2013 by the Department of Health and Human Services.
But, according to a pair of experts, this type of campaign could backfire in a big way. When federal and local health departments use the term “natural” to promote breast-feeding, it could inadvertently fuel concerns over other aspects of health and society that are seen as “unnatural,” such as vaccines, genetically modified foods and assisted reproductive technologies, the experts warn.
“We’re not making any statements against the recommendation of breast-feeding overall, but are instead suggesting that the language of ‘the natural’ in breast-feeding promotion is slippery and potentially harmful to other public health goals, like vaccination,” said Jessica Martucci, a researcher in advanced bioethics at the University of Pennsylvania Perelman School of Medicine. Martucci is co-author of an article on the topic that was published on Friday in the journal Pediatrics.
Breast-feeding is recommended by the American Academy of Pediatricians and other major medical organizations because of its many health benefits, such as reducing the risk of infection in infants and helping mothers recover after pregnancy.
Yet if Martucci’s argument is correct, these groups may want to reframe how they talk about breast-feeding. In support of its 2012 policy statement on the topic, the AAP called breast-feeding a “natural and beneficial source of nutrition” for an infant.
The price of pushing breast-feeding
On the one hand, invoking the “natural” side of breast-feeding may have helped create the breast-feeding renaissance we have today. After falling from popularity and losing out to formula milk in the 1950s and 1960s, breast-feeding started making a comeback in the 1970s in response to notions of “natural motherhood,” trends that Martucci has written about on a blog and in her book, “Back to the Breast.”
But is there a price to pay for pushing this view of breast-feeding? Could it lead people to believe that breast-feeding is best because it is free of chemicals and artificial ingredients? The article points to research and anecdotes suggesting that some Americans reject vaccines because they are manufactured and believe that boosting immunity naturally is better or safer.
One study found that the most common reason parents claimed nonmedical exemptions for required school immunizations was concern that the vaccines might be harmful. But immunizations protect children against deadly diseases, and their safety had been extensively demonstrated.
“Part of the reason that some people are hesitant to vaccinate is part of a worldview that has a tendency to like natural things and have a preference for natural risks over manmade risks,” said Daniel Salmon, deputy director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health. The idea that vaccines are not natural could play into the concerns that some people have that they are not safe, added Salmon, who led the study looking at why parents claimed exemptions.
It is possible that promoting breast-feeding as natural could have the inadvertent effect the authors of the current article suggest, Salmon said.
“I think people that develop breast-feeding messages, whether the Centers for Disease Control and Prevention or state health departments, should be — and I’m sure are — aware of that possibility and how their messages could impact other areas of health and public health,” he said.
‘Natural’ doesn’t mean ‘easy’
While promoting breast-feeding as “natural” may be counterproductive and drive some people away from vaccines, there is no evidence so far this is the case, and it would probably only affect a small minority of people anyway, said Dr. Arthur I. Eidelman, a visiting professor of pediatrics at the Albert Einstein College of Medicine in the Bronx, New York.
“(The authors) are using this article to label the breast-feeding group in a very negative way, and to equate breast-feeding with people who don’t want to take immunizations,” said Eidelman, who was lead author of the 2012 AAP policy statement on breast-feeding.
Nevertheless, it is worth having a discussion about the best ways to market breast-feeding, Eidelman said. Up until a couple years ago, the phrase “breast is best” was commonly used, but now it seems to have been replaced with the idea that the practice is “nature’s way,” he added.
Invoking nature may be undesirable in breast-feeding messages for other reasons than that they could support parents’ avoidance of vaccines and other manmade inventions, Eidelman said.
” ‘Natural’ implies it comes easy, but it might not come easy, especially the first time around, in terms of learning how to properly position an infant and the right way for a baby to latch on,” Eidelman said.
