Book Review: Milk, Money, and Madness

Title: Milk, Money, and Madness: The Culture and Politics of Breastfeeding
Authors: Dr. Naomi Baumslag and Dia L. Michels
Published: 1995

Milk, Money and Madness explores the cultural, historical, economic, political, and medical impact of breastfeeding. Throughout the book, the authors repeat their theme: "breastfeeding is the single largest determinant of whether an infant lives or dies" (70). Additionally, they discuss variants in society norms surrounding breastfeeding around the world and throughout history, the tragic history of artificial feeding of infants, the impact of breastfeeding on the mother and the family, and balancing breastfeeding and the workplace.

Throughout the world, there is a wide variety of breastfeeding traditions and positions. Milk, Money, and Madness shows breastfeeding as an ancient tradition that has ensured the survival of human babies. The authors point out that there has always been an occasional need for babies to be fed by some other means that at their mother's breast. Historically, the most successful substitute was a wet nurse, but other options were explored. Until the 20th century, the majority of babies who were fed anything other than breastmilk died. Additionally, the predecessors to the modern baby bottle were often unsafe - difficult to clean and contaminated with bacteria.

Baumslag and Michels admit that while formula has come a long way and can be safe for babies, it is often aggressively marketed to people in developing nations without means to correctly prepare it or clean bottles. Also formula does not have the immunological effect of breastmilk and is clearly inferior to breastmilk. They say, "infant formula companies have succeeded in undermining the confidence of mothers" (148) and "the availability and promotion of alternative foods usually has a demoralizing effect on both the individual and social confidence in breastfeeding" (126). Interestingly, until the 1980s, formula companies did not advertise directly to the consumer. On formula packaging it recommends that you talk with your doctor before use, but is so common that it is not generally thought of as the last resort in infant feeding.

In conclusion, Milk, Money, and Madness explores examples of ways breastfeeding is encouraged and promoted around the world. Then it presents a plan for expanding this promotion through federal subsidies, education, and regulation of formula companies. Clearly most women find working and breastfeeding to be incompatible. In the United States only 1 in 5 babies are still breastfed at 5 months of age (108).

In general, I found this book to be very encouraing of my own decision to breastfeed. The authors spared no detail to discuss the incredible superiority of breastmilk compared with formula. Also I agreed that the current trend of working mothers does not encourage long term breastfeeding (at least one year) as is recommended by the American Academy of Pediatrics.

However, I am always a little suspicious of a book that engages me emotionally. I am torn on whether or not a woman should feel guilty on her decision not to breastfeed. I personally feel they do not realize their own sacrifice of joy and closeness to their baby. And I feel that many women I know have been told their milk is not good enough for their baby when this is probably not the case. Baumslag and Michels say, "There are clearly times when withholding breastmilk is in the best interest of the child, but these times represent the exception, not the rule" (100). They even present a case that women involved in moderate use of illicit drugs could still breastfeed without harming the child. In developing countries where clean water is not always available, they contend that an HIV-positive mother can breastfeed and the baby will have a better chance of survival (98-100).

Baumslag and Michels say, "breastmilk is superior to artificial feeding in all places, at all times, and for all women" (93). Notice that they do not say "breastfeeding is superior...for all women", the authors are in favor of milk banks where mothers might be able to obtain milk from another woman to feed their baby.

Despite the superiority of breastmilk, there must be some reason why 4 of 5 American babies are breastfed for such a short time. Baumslag and Michels say that it is because of work. They give examples of several European nations that require certain compensation and time off for maternity leave. My major problem with this information is that many of these nations have a socialist government. In fact as the book neared the end, it became more a political statement. I disagree that government intervention will solve all the world's problems. However, Baumslag and Michels seem to be motivated by what is best for the family (rather than "what women want").

I am concerned with growing social programs and feel it would be unfair to hold small businesses to standards this book suggests. (98% of American businesses are classified as "small businesses" employing 50 or fews individuals http://econ4u.org/econ4u_topic.cfm?topic=10). These businesses usually can't afford to hold jobs for a year or two and/or compensate an employee for a long term absense.

This book is now 10 years old and times are changing. France, which the book heralds as having a superior system, is now showing signs that their socialist government is over weighted. The baby boomer generation is beginning to retire and be replaced with a smaller generation. As the work force shrinks some, hopefully larger corporations will adopt the suggestions of this book as incentives for employees. In the end, I hope more families will stay together and more women will decide that there is no amount of money worth more than the value of staying home with their babies and young children and that breastfeeding will be a part of investing in the future or their family.