06 Oct

Dear Doctor

Views expressed here are my own, and do not represent the views of NCT.

This weekend, Dr Ben Goldacre stood on a stage in front of hundreds of NCT Practitioners, volunteers and staff, and told us that we “push” breastfeeding. “Because you do,” he said, with a cheeky wink. “You’re the breastfeeding nazis.”

There was a sort of silent stunned gasp, followed by a burst of laughter; it was the funniest thing, a great ironic deconstruction of the name-calling rubbish (with acknowledgement to my colleague Kerry from whom I pinched that description). It was funny the second time he said it, too. After a while I was much reminded of my eight year old son and how he repeats the joke until you have to sit him down and explain that we’re really over it now.

We were treated to Goldacre’s standard comedic romp through the Daily Mail’s war on cancer, his low opinion of Gillian McKeith, and a selection of amusing headlines that can be achieved by cherry-picking statistics. Lucky us, we got a little extra bit on research statistics, and then a worked example using Brion et al’s 2011 article entitled What are the causal effects of breastfeeding on IQ, obesity and blood pressure? This study does contain flaws, and I wondered if Goldacre had also read this commentary, though on reflection if he had read it, its conclusion might have helped him to write a conclusion of his own:

Although the collective evidence suggests that breastfeeding—initiation, longer duration or exclusivity— may very well exert a modest protective effect on childhood and adolescent obesity, it no longer appears to be a major determinant. Nevertheless, because breastfeeding also reduces infection and allergy-related outcomes and probably increases IQ, World Health Organization recommendations for 6 months of exclusive breastfeeding remain a just and justifiable policy around the world.

By the umpteenth repetition of the breastfeeding nazi joke, I had the impression that Goldacre did not quite understand what NCT does, and while I have no evidence for this assertion, I’m pretty sure he hasn’t read our excellent Infant Feeding Message Framework [pdf]. Reading through the reasons women give for stopping breastfeeding, it would appear that for mothers, the evidence itself is not the highest priority when it comes to evaluating the experience, and that is where NCT comes in, to support parents in the situation they are in: non-judgemental, respectful support where support is asked for.

Ben Goldacre told us he doesn’t care about breastfeeding, he cares about misuse of evidence, and nobody in the room would have disagreed with that. But I would have liked him to have been a bit more thorough in his own research and understanding of how NCT supports parents.

4 thoughts on “Dear Doctor

  1. Well-written as ever, Karen. I wonder if the selection of speaker was not well-matched with the needs of the audience. Now, if he had come on and criticised the lack of evidence-based advice from medical professionals (such as himself) on birth and breastfeeding, that would’ve been something… And am I wrong to feel slightly concerned that, as a medical doctor, an epidemiologist and the husband of a consultant in public health, he had “no feelings on breastfeeding either way”? As a dad of fairly young twins, I’m guessing there are personal factors overriding his rational, evidence-based beliefs. Would be good to see his acceptance of this part of the equation, our everyday reality.

  2. I wonder if I could get funding to research my hypothesis that the further up the medical tree a practitioner is, the less confidence in and understanding of normal breastfeeding they have.

  3. I was not at the conference as it was the Jewish day of Atonement but having heard about his talk and his repeated mention of ‘breastfeeding nazis’ I am simply horrified and appalled at the equation that supporting women to breastfeed their baby is similar to the murderous regime of the Nazi’s. His comments were not even confronted by anyone in the audience.

    I will be escalating this further

    Ruth Tamir
    NCT Practitioner
    IBCLC Lactation Consultant

  4. In fact, Ruth, there were comments from the audience; and Sue Saxey was very direct in her disapproval both on stage following his speech, and to his face later. I witnessed several people speaking to him about it afterwards.

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