Busting myths about evolutionary biology and breastfeeding
| # | Myth | Updated evolutionary science |
|---|---|---|
| 1 | Breastfeeding is natural | This concept does not align with evolutionary biology, which demonstrates the fundamental and unique role of cultural heredity in the evolutionary development of Homo sapiens. Caring for an infant draws on cultural repositories of knowledge developed up over many generations, and available to contemporary mothers from family, friends, health professionals, and a wide range of other sources. It is, however, important that cultural knowledge imparted to contemporary women, and environmental factors, don't disrupt her capacity to experiment with responding to her baby (a common contemporary problem). The idea of the 'natural' is often quite unkind to mothers, who then feel 'unnatural' when they strike infant care challenges. For this reason, the idea of the natural is not used in the Possums programs. |
| 2 | Frequent flexible breastfeeds are too burdensome for women, and worsen occupational fatigue | Frequent flexible breastfeeds make a 21st century woman's life easier, not harder. |
| 3 | "There is no right way to breastfeed, only your way” | See above. This belief is not evolutionarily aligned, because it ignores the foundational role of cultural heredity of knowledge in the evolution of Homo sapiens, including in birth and lactation. Normative human breastfeeding cannot be understood as somehow innate, split off from intergenerational cultural knowledge systems (though that would be true of other primates like apes or chimpanzees). Knowledge systems are foundational to the nature of our species, and have replaced natural selection (and anatomic adaptation) as our brilliant, unfolding, unique evolutionary power. You can read more about this here. |
| 4 | The incidence of tongue-tie has increased due to the effects of folate supplementation on midline anatomic development, resulting in abnormality | This theory (often shared with parents as fact) has been popular amongst ankylofrenula professionals, as explanation for exponential increase in rate of ankyloglossia diagnoses. However, this theory has no basis in developmental anatomy or embryology. Human morphology has been remarkably stable over tens of thousands of years of evolution - our evolutionary adaptations and developments have been in the realm of cultural use of tools, knowledge and technologies, not anatomic. Societies that have not had access to antenatal folate supplementation have not shown the same increase in incidence of ankyloglossia diagnoses. |
| 5 | Breastfeeding women are best wearing bras day and night This belief is stated in Academy of Breastfeeding Medicine Clinical Protocol #36, for example, but is culturally constructed. | Whilst a sociocultural necessity in many environments, women have the right to be educated about the risks inherent in bra-wearing whilst breastfeeding. |
| 6 | Many breastfeeding infants need bodywork therapy because birth trauma or physical birthing stressors interfere with neuromusuclar pathways and cranial and joint alignments, affecting capacity to suck normally | This theory is the basic rationale underlying the use of traditional bodywork therapy for babies with breastfeeding problems. However, it is not a scientific or evolutionarily aligned belief. First Peoples' cultures or cultures in both the West and non-Western world historically had very high rates of breastfeeding - much higher than rates in high income countries today - yet also experienced much higher and also fatal rates of birth trauma, for both mother and infant. For example, pelvic floor disorders subsequent to birth occurred at high rates and were often severely detrimental (and this is still the case in low-income countries today). Birth-related maternal and infant mortality rates were much higher historically, and remain much higher in disadvantaged contexts with inadequate access to healthcare (e.g. low income countries), and yet breastfeeding rates were or are much higher. |
| 7 | Formula is bad | Commercial milk formula is another remarkable human tool or technology, created through humanity's cumulative collective intelligence and now a relatively safe compromise in the absence of human milk (with safety developed over time by both scientific advance and the gathering of data on the effects of experimentation over the previous century - which unfortunately has been the case with development of many medicines e.g. oral contraceptive pill). When considering how to improve breastfeeding rates, a focus on commercial milk formula marketing in advanced economies distracts advocates from examining the clinical health system failings which mothers report actually impact their capacity to breastfeed, and therefore impact breastfeeding rates. The key considerations are why governments and health systems fail to prioritise 1. research into effective clinical interventions for breastfeeding problems; 2. funding of milk banks so that human milk is free, safe, and accessible; 3. regulation of multinational corporations, which are increasingly coopting and controlling health systems globally, including in Australia (of which formula companies are just one small player). |
Recommended resources
Evolutionary biology basics for health professionals who work with parents and infants
Busting myths about evolutionary biology and infant care generally
Breastfeeding durations in ancestral environments. A little extra something - part 3
A timeline of relevant evolutionary events for health professionals who care for parents and infants
Breastfeeding medicine research in context: a relational evolutionary process
Selected references
Bartlett A. Breastwork. Sydney: New South Wales UP; 2005.
Douglas PS. Does the Academy of Breastfeeding Medicine Clinical Protocol #36 'The Mastitis Spectrum' promote overtreatment and risk worsened outcomes for breastfeeding families? Commentary. International Breastfeeding Journal. 2023;18:Article no. 51 https://doi.org/10.1186/s13006-13023-00588-13008.
Grunstra NDS, Betti L, Fischer B. There is an obstetrical dilemma: misconceptions about the evolution of human childbirth and pelvic form. American Journal of Biological Anthropology. 2023;181:534-544.
Martucci J, Barnhill A. Unintended consequences of invoking the 'natural' in breastfeeding promotion. Pediatrics. 2016;137(4):e20154154.