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.