SOCIETY TODAY

Medicine

The decline and fall of the breast

John Linklater

Some 500 bottlefed babies still die annually of enteritis almost always due to the presence in the bowel of escherichia coli, which is suppressed and replaced by the natural lactobacillus if the baby is breastfed. The mother will detect the change of bacterial flora by the fact that the pleasant motions Of a breastfed baby smell nasty as soon as it goes on the bottle.

The remaining superficial arguments in favour of breastmilk are well known. It is delivered at body temperature, sterile, of suitable standard composition ;'containing maternal antibodies and human vitamins and, as every medical student will add, the cat can't get at it.

When the newly-delivered infant tugs at the breast, a neurohormonal reflex in the mother releases oxytocin from her anteviol' pituitary gland and contracts the empty uterus to prevent haemorrhage. Nowadays we give oxytocin and ergometrine by itijection instead of the baby to the breast, but what we cannot give, either through a teat or by injection, is the full development of almost sensual love that a mother feels when suckling hechild, and the loving and comforting dePendence and security experienced by the child at the breast, Experimental animals, even -n of oddly assorted species, form an instant and protracted reciprocal affection at this first intimate contact. , To understand the genesis and trnPortance of the traditional relationship between mother and child, we have to consider briefly the primitive roles of the male and female mammal. Each sex requires distinctive physical and mental attributes having survival value, Natural selection of the fittest, in whom these attributes naPPen to be best developed, ensures in the course of generations that most of the offspring will be ,uorn with most of these attribu;es, innate, and practically sex Thus the male, who spends More time hunting and at war, is usually bred with superior skills, alertness and intellect. He is acttiv,e and outgoing and has a cerrrin good natured tolerance de Yed from usually not actually killing a marauding male of his wn species who approaches his territory, providing that the in

vader leaves it swiftly if chased. The female, on the other hand, is more receptive, more passive, gentle with her young, suckles and comforts, licks or washes and cares for them but, as Kipling has pointed out, demonstrates a savage single-minded ruthlessness in their defence.

Of all the natural symbols of woman's authority in the home, the breast is probably most important. There is not one of our direct ancestors for some 200 million years who has not begun his extrauterine life in the warm, allproviding, milky aura of maternal 'mammary glands. Nor does there exist today a man whose ancestors for a million years were not swung, cradled, carried and cuddled at their mothers naked breast. Racial, atavistic memory dwindles as the cortex develops, but we all have deepseated phyletic memory traces of these ageless first impressions of comfort and security. Throughout the world infants first cry " Mamma ": this gave us the Latin word for breast,' and thus for our own class within the animal kingdom,

In recent years, however, man has discovered how to feed his children successfully on modified cows' milk, delivered from a bottle through a rubber teat, thus introducing an unprecedented revolution into the human way of family life, Introduced at first as a poor substitute for women whose own milk had failed and who could not afford a wet nurse and when, indeed, it was almost a disgrace not to be able to feed one's own baby, the habit has now spread to all classes of society to the extent that most women in this country now bottlefeed their infants as of choice, and will often seek medical help and take oestrogens to suppress their own plentiful supply. A potential 300 tons of human milk are thus suppressed and wasted annually in each maternity home of modest size.

The breastfed infant has to wait until hungry and makes much noise before it gets its first meal. It also has to work hard for its food, and thus learns the first fun damental lesson about the world we live in. No food without work.

I believe that we do humanity a great dis-service by pouring nourishment into the infant mouth through an easy teat almost before it is ready to accept it. The full effects of the bottlemilk habit upon the family and upon society as we know it, will not be apparent for many generations to come. It is too early, yet, even to speculate.

Whatever may be the structure of the future society composed of generations of bottlefed men, it is certain to be very different from ours. Whether we will actually breed a race with a deeprooted love of the rubber teat I cannot tell, but those of us who like things as they are, or were, should examine in detail the reasons for which women have taken to bot tlefeeding, using milk substitutes and powders and canned cows' milk which aspire to have a formula as close to breastmilk as possible. It always astonishes me that a woman who has decided to bottlefeed remains totally unmoved by the news that the oestrogens given to suppress unwanted lactation will be liable to cause thrombosis of her leg veins although she may spend sleepless, anxious nights when making a decision to take one hundredth of the dose in an oral contraceptive. Neither do bottlefeeding women pay attention to reports which suggest that the increase in cancer of the breast may well be related to lack of proper use of that organ. When told that they could probably lose the extra fat of which they complain post-partum, by turning it into breastmilk, they shrug their shoulders and say, " I'll diet instead. Can you give me some slimming pills?"

Current fashion, which upholds the amammalian ideal of the Twiggy figure, may have something to do with bottlefeeding, although Iwould not like to have to say which is cause and which is effect. Do women perhaps have a haunting fear that constant tugging will convert the dainty, firm, upstanding milk glands of girlhood into billowy balloon-like boobs or, perhaps even worse, into the dangling dugs so common in central Africa, and that they will then come down like venetian blinds if the bra breaks? It is of interest that the vast and skilful dried milk advertising campaign is having some success even in Africa, with reckless disregard for the fact that the natives are often too poor to give the dried milk at its proper dilution and so unwittingly starve their infants whilst believing that they are giving them the IN.st, most modern, civilised diet.

Recent changes in the structure of society, in which diluted inflationary wages force women to go out and earn, certainly curtail their breeding and suckling role. The part-time mother, part-time breadwinner can have little en thusiasm left either for suckling or for selective shopping, and so falls easy prey to the consumer society type of pre-packed, gaily labelled, pre-cooked, tasteless rubbish that adorns the chain store counters, and she probably throws a few of the brightest tins of milk into her trolley in an auto matic almost reflex gesture. She began her bottle-feeding ,in the hustle of a busy maternity ward,

whilAt In hei—labile emotional post-partum phase before her

milk began to flow, when an over worked midwife solved her anxieties about whether she would be able to breastfeed or not, by handing her a nice warm baby and a nice warm bottle and departing with a terse injunction to " put that end of this into this end of that." She now continues the habit out of inertia.

Indeed, it may be that the greatest attraction to bottlefeeding is, after all, merely selfish convenience. In a society in which industriousness and devotion to duty are no longer valued as cardinal virtues, and which has legalised the killing of the unwanted foetus for convenience, convenience is certainly a prime mover. Convenience is, in this sense, closely allied with the rejection of the burden of responsibility, demonstrated by the woman's liberation movement with its incoherent emotional appeal which sees men and women, not as partners in a joint enterprise, but as competitors. Women's liberationists will interpret bottlefeeding as a form of liberation and will, no doubt, become the ardent partisans of any test tube gestation experiments to complete their final liberation from all that is revered in womanhood.

I recall last year discussing breastbeeding with a young mother who put an end to my efforts to find out why she did not want even to attempt it, when she shuddered and explained " It's so un-natural."

When the breastmeal ends, there always remains a continuing, licky dribble on which the baby snuggly snoozes. The end of the bottle, however, comes with an abrupt bubbly airswallowing shock, so the baby shrieks and mother gives him more. This is probably one reason why hottlefed babies tend to obesity while the breastfed baby tends to remain wriggly and active. Advertisements, of course, portray the fat, sessile baby as the coveted ideal, although retrospective research projects show that the overfed baby is most likely to develop into an overweight, hypertensive, atheromatous adult. Nothing seems able to stop the trend: bonny bouncing obesity is all the rage. Our breasts grow flatter and our infants fatter.

If the Director of Health and Social Security truly means to promote health rather than merely to cure disease, then he might, in the modern idiom, pay women a tax free breastfeeding allowance. This would not be any more improbable than the existing tax free allowances now paid to a man for looking after his own aged, incapable mother.

But if 'a breastfeeding allowance is too costly a project, what with Maplin and the tunnel, then the Government might, at virtually no cost, ask the post office to refrain from covering our envelopes with that outrageous lie telling us how cheap it is to telephone, and overprint instead a terse and truthful slogan such as " Breast is best."