The Battle of the Boob and Poor Professionalism

The exact words printed in the magazine, in quotation marks to show that they were being reprinted verbatim, were: 'Breast milk boosts a baby's immune system, but only for the first six months. After that, it has no effect.

Several memes of the same image whipped around social networking sites with a rapid and determined certainty on Wednesday evening. The image was a short excerpt from Closer magazine, featuring advice to parents from sexual health campaigner Dr Christian Jessen. The topic was breastfeeding; the stance: it's weird. The thinly veiled undertone: don't do it.

The exact words printed in the magazine, in quotation marks to show that they were being reprinted verbatim, were: 'Breast milk boosts a baby's immune system, but only for the first six months. After that, it has no effect. As long as the child is having a healthy diet, there's no harm in breastfeeding. But breastfed older children risk becoming psychologically dependent on the mother. This could result in behavioural problems as they grow up.'

Surprised by Dr Christian's brash statement at a time when there is a lot of concern regarding low breastfeeding figures in this country, I took to twitter to ask him why he wrote such a misguided, unscientific piece of advice. It turned out that many other parents felt the same way, which Dr Christian had apparently not anticipated. Initially he sent a standard defense into the twittersphere:

For those tweeting about my comments in @CloserOnline magazine -they were taken completely out of context! Was referring to 1 specific case.

I replied:

@DoctorChristian You made a big sweeping generalisation based on ONE case? Err.. #badresearch

Jessen replied:

It turns out that Closer magazine did in fact put words in Jessen's mouth, and failed to print an explanation of why they did this, or apologise for the error. Nor did Jessen demand an apology from them, despite my suggestion that he might have a winning lawsuit on his hands. But let's put this issue aside for a moment, and look at what Dr Christian actually said in the misquoted, original interview:

'Advice on breast feeding is always changing. The World Health Organisation recommends breast feeding for up to two years, while the NHS recommends breast feeding for the first six months.'

Unfortunately for him, this is not actually true. The exact guidelines do vary slightly between organisations, but the only notable change over the past few decades has been for official recommendations to increase the length of the exclusive breastfeeding period from 4 months to 6 months.

The World Health Organisation recommends breastfeeding for at least two years:

'Over the past decades, evidence for the health advantages of breastfeeding and recommendations for practice have continued to increase. WHO can now say with full confidence that breastfeeding reduces child mortality and has health benefits that extend into adulthood. On a population basis, exclusive breastfeeding for the first six months of life is the recommended way of feeding infants, followed by continued breastfeeding with appropriate complementary foods for up to two years or beyond.'

The above quote is taken, word for word, from the WHO website, here.

The next part of Jessen's comment is:

'Breast milk is beneficial to a baby's immune system for the first six months, but there is no harm in continuing to do it as long as the child has a healthy diet.'

Unfortunately there is a subtle use of language here that suggests the presence a fact. To say that 'there is no harm' in continuing to breastfeed a six month old implies that there is harm in doing so if 'the child [does not have] a healthy diet'. According to the science (you know, that thing upon which medicine is founded), this study by the Augusta Mental Health Institute and Family Research Laboratory concludes that:

'No empirical study to date has demonstrated that extended nursing is harmful, but a number of previously cited studies have found benefits. Therefore, practitioners can be confident in supporting mothers who choose to nurse their children into toddlerhood and beyond.'

Next, Jessen states that:

'If a child is being breast fed until eight, this may make them overly dependent on their mother. However if they are being breast-fed at four there is no harm in this.'

Again, the misleading word here is 'may'. It 'may' cause over-dependency, in the same way that reading Jessen's professional advice 'may' cause horns to grow out of your head. There's no saying what 'may' happen in any instance, really.

But, in case you think the magazine deserves all the blame, Jessen did clearly maintain that:

THAT WAS WHAT MY 'MAY CAUSE PSYCHOLOGICAL PROBS' COMMENT REFERRED TO @WelshGasDoc: @DoctorChristian Breastfeeding a 6year old is just weird.

I asked him repeatedly for evidence of this psychological harm, but he chose to ignore those specific tweets, instead saying:

'So here is what I ACTUALLY said to Closer. You can stop with the aggressive tweets now.'

It seems that Jessen felt like he was being attacked by all these angry mothers. Shame on them, for feeling attacked for being told that extended breastfeeding is weird.

While we were battling ethics and morality via 120-character bullets, a few other male voices piped up in defense of Jessen, arguing that he's a doctor, and therefore, he's entitled to his opinion. Yes and no - he is entitled to his own personal opinion at all times, of course, but he is not entitled to give false information regarding medical matters, in a medical professional capacity. He is not entitled to advise readers of a magazine column as a medical professional based on unscientific claims.

Nor is Dr Christian a specialist in the area he was discussing, ie child psychology, or the relation of child psychology to extended breastfeeding. His specialism is actually sexual health.

One tweeter argued that I was turning the entire issue into a feminist issue, when really it should be about the children. Silly me, thinking that women grow, carry and nurture these small people, and should have a say in how long they choose to breastfeed them. Men should certainly have the final say in what women do with their bodies. #notafeministissueatall

Jessen's original interview with Closer ended with:

'I support women who want to breastfeed and would never wish to discourage anyone from doing so.'

Perhaps this is the only part of the statement with a grain of truth behind it, but unfortunately the aforementioned two professional errors have conspired to undermine breastfeeding, whether that was intended or not.

So there you have it. Another negative representation of breastfeeding in the press, another professional making unscientific claims to support his own prejudice, another woman gives up the mammoth task that breastfeeding has become in the UK. Overall the blame points to poor professional practice, by a doctor, a journalist who misprinted what he said, and perhaps even an editor who failed to look over it before printing or ensure that an adequate apology was printed. No one is personally to blame, but the subtle and strong campaign against normalising breastfeeding in the UK, where rates are still appallingly low, is free to continue.

It's enough to make any mother hit the bottle.

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