The battle of breast milk

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In the 1970s, about half of new mothers breastfed their newborn babies. Today, more than three quarters of new mothers in England do.

78% of women in England and 70% in Scotland breastfeed

The message "breast is best" appears to be gaining currency. But a magazine article that questions whether too much pressure is put on mothers to breastfeed has caused uproar in the US.

It questions the health benefits of breastfeeding, but also how mothers who choose not to breastfeed are treated by society.

"It was not the vacuum [cleaner] that was keeping me and my 21st Century sisters down, but another sucking sound," writes Hanna Rosin in The Atlantic magazine.

The article, which argues that women have become "breastfeeding fascists" and is sceptical over "magical thinking" in relation to the benefits of breast milk, has provoked pro-breastfeeding groups, fuelling "mommy wars" on blogs in the US.

Breast isn't best, breast is perfectly normal, it is perfectly common, it is everyday. Morgan Gallagher, "Lactivist" campaigner

The United States Breastfeeding Committee, in an open letter to the magazine, responded by stating that "we perform a disservice to American families by perpetuating the myth that feeding human infants artificially created formula is equivalent to breastfeeding".

No big deal

For Guardian columnist Zoe Williams, who writes a blog about her experiences as a new mum, the article is right to highlight some of the research that is used to validate breastfeeding.

"The scientific benefits of breast milk are massively overstated," she says.

"You've got an awful lot of health benefits conferred by being middle-class and an older mother and those mothers tend to breastfeed.

"So you say there is a correlation between a lack of allergies and breastfeeding. That correlation doesn't stand up to closer examination."

In reality, she says, whether or not you breastfeed is "no big deal".

"It's a personal thing. The health benefits are not so enormous that anybody else has a right to intervene on your children's behalf."

On the other side of the debate, breastfeeding activists, or "lactivists" as they describe themselves, are forthright in their support for breastfeeding.

"Nobody is asking what babies want in this," says Morgan Gallagher, blogger and lactivist campaigner.

"Breast isn't best, breast is perfectly normal, it is perfectly common, it is everyday.

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"Formula [powdered baby milk] is lacking. Lack of breastfeeding harms the health. It significantly increases baby's chances of getting ill between the time they are born and the time they die.

"You need to make an informed choice about what you do.

"But it doesn't matter what you choose, it will be the wrong answer for society because we don't like children."

For Rosie Dodds, senior public policy officer at the National Childbirth Trust (NCT), which provides breastfeeding counselling to over 65,000 parents every year, the argument over specific aspects of research takes away from the bigger picture.

"It is important to be clear about the evidence," she says.

"But we don't question whether teeth are a good idea or eyes are a good idea.

"We should think of breast feeding as a normal human function and not as a substitute to formula milk.

"We know it is a good idea, that is not in question. It is about more supporting the women who want to do it and those who don't."

The World Health Organisation and the NHS both support breastfeeding

Difficult science

One of the problems with the debate is that scientific evidence reached through objective medical trials is, by definition, very difficult to come by. Persuading a mother not to breastfeed in the name of medical research has certain ethical drawbacks, after all.

"Interpreting the scientific evidence is really complicated," says Maria Quigley of the National Perinatal Epidemiology Unit at Oxford University.

"The problem with breastfeeding is that hardly any of the studies are randomised.

"Whenever you interpret the information from non-randomised studies you have to be very careful."

Ms Quigley points to a review of 9,000 research papers conducted by the Agency for Healthcare Research and Quality in 2007. It found evidence for a strong link between breastfeeding and lower risk of obesity, diabetes, childhood leukaemia and sudden infant death syndrome.

But the review also found no relationship between breastfeeding and future intelligence, and it was unclear as to whether it lowered the risk of heart disease.

Nevertheless, from the World Health Organisation, to the UK government and the NHS, the message is the same: breastfeeding is good, and should be encouraged.

"Human breast milk is designed to feed human infants and cows' milk is designed to feed baby cows," says Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health.

"Women should have choice, and cows' milk has been humanised in modern formula.

"It closely mimics breast milk, but it is not the same. What it is particularly lacking in are the live parts of breast milk - the cells and the antibodies that help fight infection.

"They will never be present in formula milk."