There’s plenty of conflicting guidance on child-rearing, but it doesn’t mean parents should just give up
Oh dear, Zoe Williams. Shouldn’t you get your facts straight before you “welcome us to parenthood“?
The scientific evidence for the benefits of breastfeeding, Williams asserts, “is not that strong”. In fact, it’s overwhelming. The last two books that I’ve written have been on climate change and breastfeeding respectively, and it amazes me that journalists can boldly state that we don’t have scientific consensus on these issues, when we do. Sure, it’s possible to pick one piece of research, among many, that is equivocal – science is like that: cautious, piecemeal, ever ready to point out its own methodological flaws – but the main thrust of the evidence all points in the same direction.
Does she really think that the Department of Health, the NHS, Unicef and the World Health Organisation are lying about this? Williams castigates the charity Best Beginnings for informing parents that formula-fed babies suffer five times the rate of gastroenteritis of their breastfed peers. She assumes that this is based on data from the majority world, “where they might not have an assured water supply or sterilising equipment”. In fact, it’s sourced from a longitudinal study of infant development in Dundee. Last time I checked, Scotland wasn’t a third-world country.
Williams seems to think that (like climate change!) formula feeding is something that really only affects people in the developing world. Recent studies prove her wrong. Take, for instance, The Burden of Suboptimal Breastfeeding in April’s edition of Pediatrics. It finds that if 90% of US mothers could breastfeed their babies exclusively for the first six months, more than 900 lives would be saved a year. Only 12% of US babies are exclusively breastfed to six months. Here in the UK, it’s less than 1%.
Then Williams claims that none of the studies linking breast milk to reduced rates of ear infections, eczema, obesity and asthma have been adjusted for social class and environment, which is a basic requisite of peer-reviewed research. It’s hard to know why, because she doesn’t state her sources. But one acknowledged problem with breastfeeding research is that it isn’t ethically possible to create two groups of babies, match them for every confounding variable, and then force one group to drink formula. This is the same problem that bedevils climate change research – we have only one planet upon which to conduct our uncontrolled experiment, not two. It gives the critics a convenient platform from which to nitpick holes in the methodology, but it doesn’t invalidate the overall results.
And now to the debate about routines. Williams contrasts the structured feed and nap times advocated by popular babycare books with “an unscientific swarm of maternal opinion that just says, ‘Sod that, I would rather give [the baby] a cuddle.’” But there’s no scientific basis for regimes such as Gina Ford’s. They gain authority by virtue of being popular, and there’s surprisingly little research into whether or not they harm babies’ development. The one study that Williams cites isn’t really about “hugger mothers v schedulers”. The biggest observable difference in that trial was between the control groups of “unhugger mothers”: the ones in the UK who tend to leave their babies to cry for up to an hour a day, and the ones in Copenhagen who seem culturally more predisposed to pick their babies up. The UK babies quickly learn to cry a lot more, but the trial doesn’t record whether they’re “in a routine” or not. That research hasn’t been done.
Which is surprising really, because developmental psychologists have spent the last 50 years qualitatively evaluating early-years parenting. They conclude that children can either be classed as “securely attached” to their caregivers (happy, trusting, enquiring souls) or “insecurely attached” (whiny, depressive and slow to learn). Insecure attachment happens when mothers, even loving mothers, consistently ignore their babies’ cues. Advances in neuroscience have taught us about stress hormones and biofeedback loops in the developing infant brain. But no one has seen fit to apply that knowledge to the childcare regimes that parents adopt. Williams might be right: maybe “it doesn’t make any sodding difference” what you do as the parent of a small baby. But it would be nice to know for sure.
I broadly sympathise with Williams’s despair at the “binary arguments” that parents are embroiled in. Obviously, there’s no one right way to raise a baby, because there are an awful lot of different babies and parents out there. When mothers are genuinely happier feeding formula and scheduling naps, that is, overall, going to help them to bond with their babies, which is definitely the most important thing. But supporting the mothers of young babies also means empowering them with accurate information. Something is wrong with our society when 34% of parents believe that there’s “not much difference” between formula milk and breast milk. The jury hasn’t even been called on whether controlled crying or routine parenting could adversely affect a baby’s brain. We’re a long way from knowing the truth about babies, and however amusing Zoe Williams’s article is, it isn’t going to help.
• Kate Evans is the author of The Food of Love: Your Formula for Successful Breastfeeding and Funny Weather: Everything You Didn’t Want to Know about Climate Change but Probably Should Find Out, both published by Myriad Editions