Opinion | New Breastfeeding Guidelines: Helpful or Ill Timed?

To the Editor:

Re “American Moms Need a Break,” by Jessica Grose (Opinion, July 10):

Ms. Grose contends that the American Academy of Pediatrics’ updated policy statement on breastfeeding was poorly timed. We disagree. At this critical time when pregnant people’s autonomy is threatened and parents scramble to find formula, this guidance, based on decades of evidence and best practices, exposes critical policy issues that our government has failed to address.

Ms. Grose argues that support for breastfeeding is disturbingly out of reach for most American women. We couldn’t agree more. We trust parents to make feeding choices that work for their families, while recognizing that it’s critical to advocate for resources so those goals are within reach.

The A.A.P.’s recommendations now echo the consensus of experts, including the World Health Organization and American Academy of Family Physicians, on the benefits of breastfeeding beyond one year. It’s time for the government and health care systems to fulfill their obligation to support the human rights of lactating families.

Breastfeeding has been compromised by weak policies and ignorance by the medical system. There is no bad timing for optimizing maternal and child health through breastfeeding, or for raising the bar on what families and society should expect. If not now, then when?

Jeannette T. Crenshaw
Ariana Komaroff
Michelle Elisburg
Edna Prieto
The writers are all medical professionals, and the letter was co-signed by six other health care providers.

To the Editor:

Jessica Grose’s essay on the A.A.P.’s updated breastfeeding guidelines left me puzzled and frustrated. On the surface, I think we’re in agreement on several of her points. As an international board certified lactation consultant and as a mother who struggled to make milk for and breastfeed my baby, I have seen firsthand just how difficult chestfeeding/breastfeeding can be.

But Ms. Grose sets up an impossible Catch-22, in which, because our society does such a poor job supporting lactation and breastfeeding, professional medical associations should not discuss the importance of breastfeeding and improving lactation support.

Do we drop guidelines on mammograms or other preventive screenings because uninsured people cannot easily access them? Do we give up on nutrition guidelines because many people live in food deserts? No. We write them to encourage better policies, inspire political action and educate health care providers.

It is strange that breastfeeding is treated so differently. Strange, but maybe predictable, given the decades of work that multibillion-dollar formula companies have done to undermine their primary competition.

Rebecca Costello
Ithaca, N.Y.

To the Editor:

I am an experienced pediatric nurse practitioner who has breastfed three children. Mothers need support in making feeding choices early in the baby’s life, and this article could have been helpful in giving mothers strategies for how to manage.

For example, Jessica Grose does not mention that the policy describes in detail the immune-boosting effects of breast milk. Even if the baby is not exclusively breastfed, a working mother’s child in day care would greatly benefit from a feeding of breast milk morning and night. And even though there are no current federal laws giving mothers time to pump at work, I have witnessed many women quietly and efficiently pumping while eating lunch. Where there’s a will, there’s a way!

The medical community is by nature a helping profession, and the guidelines are meant to inform, not pressure, women. Pediatricians and nurse practitioners tell women that the important thing is that babies are well fed and that they grow properly. The choice of breastfeeding or formula is a personal one that is not criticized.

I feel that this piece was a missed opportunity to help and support mother and baby.

Nancy Kotz-Joob
Wilmette, Ill.

Opinion Conversation
The climate, and the world, are changing. What challenges will the future bring, and how should we respond to them?

Mr. Fisher correctly notes that in today’s world “hundreds of millions might live healthier and safer lives than their parents did” — something to be celebrated. But at the same time the economic systems that have greatly increased our overall wealth have also laid a groundwork for potentially extraordinary reversals in our well-being.

This arises because without greatly increased cooperation among nations we quite probably will not meet the challenges of climate change and other environmental health and safety threats. This unpleasant future is made more likely by the decline in the ability of democratic societies to govern themselves.

Ironically, the decline in our democratic institutions is very much the result of the stress and anxiety that the modern economy often produces in large segments of the public. Under these conditions opportunistic leaders arise in many countries who appeal to our worst instincts, with messages leveraging fear and grievance but with an absence of any effort to address genuine threats to our collective security. This is a prescription for a potentially very dark future.

Glenn L. Pierce
Boston
The writer is principal research scientist, School of Criminology and Criminal Justice, Northeastern University.

To the Editor:

I agree that residents of low-income countries tend to be optimistic about the future while residents in high-income countries are more pessimistic. People in wealthier countries no longer believe that their children and grandchildren will lead better lives than they do.

Whether it’s the effects of climate change, pandemics, increases in the cost of living or stagnating real wages, we no longer believe that our children will thrive. This malaise hits very close to home and, yes, it makes us feel that our world is “broken.”

To the Editor:

Re “With Few Able and Fewer Willing, Forces Lack Recruits” (news article, July 17):

The problem of falling military recruitment has an attractive solution: offer to cancel student debt in exchange for military service. For those who qualify for service, offer to cancel 25 percent of their student loan debt for each year of honorable service, payable at the completion of a four-year contract. Those who get sick or injured during military service and cannot complete the four years could get debt relief on a percentage basis.

Those who have already graduated from college and are eligible to serve could become officers; those without a degree could enlist and could be commissioned up from the ranks if qualified.

The armed forces already offer handsome educational benefits after service; this change merely offers direct support for those who have already accumulated student debt, and without the obstacles of existing loan forgiveness programs. It could help address the shortfall of people willing to serve and a portion of the student debt crisis. Two birds with one stone: good government policy.

Richard H. Kohn
Boulder Junction, Wis.
The writer is professor emeritus at the University of North Carolina at Chapel Hill and a former chief of Air Force history for the U.S. Air Force.