La Leche League advocates breastfeeding.  In my opinion (and the opinion of almost every maternal-child health organization in the world), that’s a good thing, and so I want to like them.  I really, really do.

But they also advocate a whole host of other things, including a parenting philosophy that is culturally elitist, value laden, and sexist.

Here is LLL’s official Mission Statement:

Our Mission is to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.

No big problem here–if a mother wants to breastfeed, support can help her get through difficulties, real or perceived.  If she doesn’t have a lot of social or family support, an outside support group can be crucial in helping her to meet her own goals.  And breastfeeding does help with infant development, such as physical growth, brain growth, healthy gut colonization, and a whole host of good things.  For some mothers, it may help to develop mothering behaviors, though I wouldn’t say that breastfeeding is either necessary or sufficient to a woman’s development as a mother.

In addition to its mission statement, LLL  has a “philosophy,” consisting of 10 statements.  Any woman who wants to become a leader for LLL’s mother-to-mother support groups must, as part of the application process, explain how she agrees with these statements and puts them into practice.  This philosophy also permeates their book, The Womanly Art of Breastfeeding.  LLL has a right to any philosophy they want, but their philosophy extends far beyond their mission of support and education around breastfeeding.  Here are the 10 statements with my commentary following:

  • Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby.

Breastfeeding is certainly natural, but it doesn’t always come naturally.  Every baby is different, and even a woman who has successfully breastfed previously can have problems with a subsequent baby.  As far as effectiveness, wouldn’t this vary tremendously?  How is breastfeeding effective at understanding and satisfying a baby if the baby never develops a latch that allows sufficient milk ingestion?  Or if the mother was sexually abused as a child and finds that breastfeeding leads to flashbacks and panic attacks?  Or if the pair develops a persistent thrush infection that keeps passing between the woman and the baby, causing soreness and bleeding that makes them both cry?  It seems there are any number of scenarios in which breastfeeding would serve to harm the physical and/or psychosocial health of the baby, the woman, or both.

  • Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.

This is generally true regarding milk supply, though a most women can  develop a milk supply with a hospital grade pump if they have to.  And certainly it is easier to establish a relationship with someone when you spend time together.  However, a woman who is separated from her baby because of a critical illness or other unavoidable situation can still develop a satisfying relationship with the baby.  It is heartless and inaccurate to imply that a woman who nearly dies from a postpartum hemorrhage and is in the ICU will never develop a satisfying relationship with her baby because of it.

  • In the early years the baby has an intense need to be with his mother which is as basic as his need for food.

That’s ridiculous.  Babies die if they aren’t fed.  They don’t die if they are cared for with love by responsible people other than their mothers.  What if the baby has two fathers?  Social science research indicates that the gender of a child’s parents is of little consequence.

  • Breast milk is the superior infant food.

This is true.  However the differences between a quality infant milk substitute and breastmilk are not substantial enough to make a notable long-term difference for most children in developed nations.  This is not to say that there aren’t  advantages to breastmilk or that breastfeeding doesn’t have life-or-death benefits for some individual children (and in the developing world, it makes a life-or-death difference for many children).  Still, most formula fed kids come out just fine, so what exactly does “superior” mean here?  That makes it sound like a competition.  I would probably say “ideal.”

  • For the healthy, full-term baby, breast milk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth.

This is true, providing that breastfeeding is going well or that the woman is able to seek timely help if it isn’t.  I have no idea why the feeding of solids causes such consternation in our society.  Generally, the baby will show you when s/he is ready for solids by grabbing food off your plate.  Baby food is a manufactured need and a scam–only infants not truly ready for solid food need their food to be pureed.

  • Ideally the breastfeeding relationship will continue until the baby outgrows the need.

Well, maybe.  What if the mother really wants to stop–is it still ideal to continue until the baby outgrows the need?  And how are we defining need vs. want?  Technically, a baby could have formula from the beginning, so there is no demonstrated evidence that a baby “needs” to be breastfed at all.  Again, I’m all for breastfeeding, but there are some kids who will nurse until they are 5 or 6 if given the opportunity.  Is that a need?  Is it not ideal if the mother would like to stop earlier than that?  Is it always “ideal” to keep breastfeeding longer?

  • Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.

That’s often true, although it’s not necessary or sufficient for successful breastfeeding.  Avoiding an IV may help with excessive postpartum infant weight loss, which often leads hospitals to want to begin formula supplementation. Early supplementation does interfere with breastfeeding if it is not done very, very carefully (e.g. no bottles).  Recovering from a cesarean can make it harder to get breastfeeding started, but I’ve never seen LLL campaign to reduce the cesarean rate.

  • Breastfeeding is enhanced and the nursing couple sustained by the loving support, help, and companionship of the baby’s father. A father’s unique relationship with his baby is an important element in the child’s development from early infancy.

A stable, supportive, loving partner is  helpful in raising a child.  It doesn’t have to be a father.  Any individual has a unique relationship with the baby, as all relationships between two individuals are unique.  To say that a female partner can’t be an important element in a child’s development is sexist and isn’t supported by research.

  • Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible.

What does this mean?  What kind of foods?  How is “well-balanced” defined?  Food norms vary by culture, but kids around the world still manage to grow up.  And a lot of the stuff sold at “Whole Foods” may be organic, but is as processed as it can be, so how are we defining “natural state”?

  • From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.

I tend to agree with this philosophy myself, but people around the word have a lot of different child rearing strategies and still manage to keep reproducing their societies.  Again, what does “need” mean here?

By promoting a child rearing strategy rather than breastfeeding support, LLL alienates a large proportion of society.  Their philosophy is inconsiderate of families formed through adoption, of gay and lesbian parents, of mothers who work outside the home, and of fathers who want to be primary caregivers.  None of those things does anything to support breastfeeding.

Truly supporting breastfeeding is supporting all families who want to breastfeed.  It means holding meetings in places where people who need support can attend (in my area, most of the meetings are held in suburban areas that are only accessible by car and meet in the morning when most working parents are at work).  It means fighting for implementation of the WHO Code.  It means changing structures to support what supports breastfeeding.  If active, alert childbirth helps, work against VBAC bans. If early togetherness is important, raise money for a hospital to renovate the NICU with a family-centered design.  Don’t  indicate that women who have cesareans or postpartum complications or a baby in the NICU won’t breastfeed successfully or form a satisfying relationship with their babies.

If LLL really wants to help mothers worldwide to breastfeed, they might consider dumping a philosophy that shuts most of them out.

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