Is Breast Feeding Always Best?

Yes! is the simple answer when you read news reports about the considerable amount of research that supports this conclusion.

Breast feeding has been shown to pass maternal antibodies to the infant, supplementing those passed while the baby is in utero (in the womb). This helps the breast fed baby fight infections while its own immune system is still becoming more efficient. Breast fed babies and their mothers have been shown to, in at least some cases, attach (or bond) more securely, thereby decreasing the chances for problems related to less than optimal bonding and attachment. Oxytocin, a hormone dubbed by some as "the cuddle hormone" plays a key role in the flow of breast milk and may play a role in facilitating attachment. There has even been a recent study which has been portrayed as showing breast fed babies have higher IQ’s. Some physician groups and some other organizations have come out strongly in favor of breast feeding. This is not a new trend; the movement to breast feeding has been increasingly encouraged by physicians for at least 25 years. Breast feeding has become the right thing for good parents to do.

Now, let’s look into this deeper. The study promoting the notion that IQ is increased by breast feeding is the most flawed. The sample of mothers and babies was biased toward educated parents, highly motivated toward doing what the professionals told them is best for their children. People who seek and follow experts’ advice tend to score higher on such tests and rear children who also tend to score higher on such tests. In other words, it is likely that the slightly higher than average scores in this study are explainable by non-breast feeding mechanisms.

There is no doubt that breast fed babies have more maternal antibodies while breast fed than non-breast fed babies. But how important is this? Far more important is, to how many sources of infection is the baby exposed? Other factors matter too. For example, are the caregiver’s hands washed frequently? If there is day care, how many kids are at the day care, and are kids or staff allowed there while being ill? Does the baby go to other places where illness is spread like grocery stores, the mall and to other people’s homes while people there are ill?

Attachment and bonding are crucial, but there is far more to this than breast feeding.

Breast feeding may help develop the early mother/child dyad connection stronger quicker for many, but is frustrating and difficult for a smaller number of others. Bottle fed babies can also be held closely, cooed to, cuddled and lovingly nurtured, resulting in an equal bond and attachment.

There are other practical matters to be considered in each family’s decision about feeding. These include the cost of bottle feeding, the mother’s schedule and relevance of breast pumping, the important decisions on the father’s involvement and role(s), the frequency of bottle fed babies sleeping more hours at night sooner, and the success at starting and maintaining breast feeding; among other factors.

In summary, breast feeding is to be encouraged but not forced; there is no justification for guilt-tripping young mothers into an endeavor they are not comfortable with or wanting. As a child, adolescent and adult psychiatrist, as well as a parent, I continue to be concerned about misunderstandings and overemphasis on the birth experience and initial bonding, while under-emphasizing the total picture of parenting.

A "natural" versus assisted childbirth, or being breast versus bottle fed, are important decisions but do not determine the future. More central is the overall nurturing, security, and support provided and tuned to the developmental needs and strengths of that individual child in his or her family.

In each of these towns a student has brought a gun to school this school year and shot someone; in some cases several students and teachers. There have been 8 widely publicized such incidents in the last 15 months. These incidents have occurred mostly in high schools but also in middle school. Yes, it has happened here in Tucson also! Tucson’s incident was less heinous because the two boys brought pellet guns, thus resulting in no deaths. However, the two boys were only elementary school students! So, what is wrong?

Our youth have simply become desensitized to killing, maiming, and other disrespectful behaviors not only by the unrelenting violent messages of the media (television, radio, music, newspapers, magazines, videos, video games, computer games, and the internet) but also by the very poor role modeling they receive from sports and entertainment stars, elected and appointed officials, other adults, other peers and, too often, even in their own families. Our society is sadly mesmerized by themes and acts of violence.

Vulnerable kids learn that anger equals the right to resolve problems not by conflict resolution but instead by violence. Youth often do not learn that anger is only a feeling which is normally felt every day by everyone and can be managed without requiring destructive or hurtful action. Our youth are too often left alone with their hurts and their humiliations, so that the resulting anger grows inside until they explode in rage; turning their inner pain outward to inflict that hurt

and humiliation on whoever may be in their way. They see and too often experience little if any consequence from adults or the law. They have learned in the media for years about adults who go to work and shoot their co-workers, resulting in lots of fame. They do not see the legal consequences or the grief of the victim’s family and friends. Why wouldn't kids imitate this behavior at school; isn’t school simply the work of kids?

Firearms complicate this problem immensely. There is no second chance when a gun is used to harm another or oneself. The fact is that guns are far too easily available to youth (and adults). Guns are the method of killing in most homicides and suicides. If the above youth had used fists, clubs, even knives, there would have been no or almost no deaths and very few other injuries at all. The offenders and victims would not be facing ruined lives, not to mention the avoidance of all the traumatized extra victims, friends, families, and communities.

At least five children are killed by guns every day in the US.

Every year there are over 20,000 homicides in the US.

Every year there are over 30,000 suicides in the US.

Did you realize there are actually 50% more suicides than homicides every year in the US?
Which do you hear more about? Why?

Over 60% of all completed suicides in the US are by firearm. This is true even though there are at least 50 times more suicide attempts by cutting or overdose than by guns. The problem is that guns are so much more lethal. With a gun there is no second chance or time to change your mind. The same is too often true for hanging which is most common (still less than firearms) in 11 — 14 year olds. In Arizona 80% of suicides in our youth are by firearm.

Arizona ranks between second and fourth in suicide rate every year. The highest rates of suicide are in the Rocky Mountain states, especially Nevada, Arizona, Montana and New Mexico. Females make four times as many suicide attempts as males. Males complete four times as many suicides as females. The main reason is that far more guys go for guns. More gun deaths are suicides than homicides, accidental shootings are far less. Suicide rates increase with age. The highest rate is in the elderly. Suicide is the number 2 or 3 killer in our youth, ranking only behind accidents in whites and behind accidents and homicides in blacks and Hispanics.

Accidents (mostly motor vehicle) account for 50% of youth deaths while suicides and homicides account for another 25% together. This means that illnesses such as cancer, heart disease pneumonia, AIDS, etc. all added together cause only 25% of youth deaths. Death by gun (homicide and suicide added together) has become the #1 killer in black youth, even more than accidents.

The US homicide rate, but not the suicide rate, far exceeds that of all other developed countries. What are the biggest predictors of suicide for all ages? Increasing age, being male, white or Native American, attempts, isolation and loss of connections to people and meaningful interests, alcohol and drug problems, incapacitating illness, depression, other serious mental illness, legal problems, aggression and violence, family history of suicide, identity and life direction crisis (including about sexuality),lack of religious or other belief that suicide is not an option, current suicidal ideas with intent and a feasible lethal plan.

Although this listing is not to be used as a checklist, the risk may increase with the more of these features that are present. Persons with few of these features may still be at risk.

Females have about 10 to 25% of the risk of males. African-Americans and Hispanics have about 50 to 60% of the risk of whites; nonetheless young black males are the group with the fastest rate of increase.

Remember, the suicide rate per year is only about 10-50 per 100,000 persons. Therefore, if someone is at 100 times the risk of the average person their risk of suicide is still less than 1%. Suicide is very difficult or impossible to predict with any accuracy. Lessening the risk factors, when possible, is usually the best treatment strategy.