Don’t Call Breastfeeding “Natural” says Peds Journal

A recent article in the American Academy of Pediatrics‘ journal is urging physicians to nix the word “natural” when talking to new mothers about breastfeeding.

Authors Jessica Martucci and Anne Barnhill, of the Department of Medical Ethics & Health Policy, University of Pennsylvania, are not disputing the fact that breastfeeding is natural. Nor are they challenging the idea that breastfeeding is healthy.

BreastfeedRather, they are concerned that the word “natural” has certain problematic connotations, and that by using it, doctors are unwittingly leading their patients down a primrose path of thoughts that lead to things like concern about GMOs in food, questions about the safety of vaccines, or worries about environmental toxins……things that Martucci and Barnhill don’t think doctors or their patients should be thinking about.

“We are concerned about breastfeeding promotion that praises breastfeeding as the “natural” way to feed infants. This messaging plays into a powerful perspective that “natural” approaches to health are better,” write the authors. “Promoting breastfeeding as “natural” may be ethically problematic, and, even more troublingly, it may bolster this belief that “natural” approaches are presumptively healthier. This may ultimately challenge public health’s aims in other contexts, particularly childhood vaccination.” (Martucci J, Barnhill A. Pediatrics. 2016; 137(4)).

In other words, to Martucci and Barnhill, “natural” is a gateway word.

They base their view on internet searches showing a large overlap between parental interest in complementary/alternative medicine and natural foods, and anti-vax sentiments. They argue that people who want a more “natural” lifestyle–which includes breastfeeding–are also more inclined to challenge institutional authority, to question the intentions of corporations, and to seek cultural alternatives like home births, home-schooling, organic GMO-free foods, and non- fluoroidated water.

“If doing what is ‘natural’ is best in the case of breastfeeding, how can we expect mothers to ignore that powerful worldview when making choices about other health practices, like vaccination?” they ask.

Martucci and Barnhill are right, to a point. The term “natural” has come under a lot of scrutiny lately. Some people do automatically assume that anything “natural” is by definition “healthy.” And in the context of consumer product marketing, the term is vague enough to mean almost anything but emotionally charged enough to conjure a specific set of ideals and values.

It is widely used–though poorly defined–in food marketing, and many products promoted as “natural” foods are, in fact, highly processed and unlike anything found in the natural world. Absent any consensus on what the term should mean, and absent any strong federal regulation of said definitions, the loose and fast use of the term will continue.

When it comes to breastfeeding, however, the facts are quite clear. It is as natural as anything gets, and it is generally quite healthy. It is certainly not the only healthy way to feed an infant, and practitioners should avoid stigmatizing mothers who, for whatever reason, do not breastfeed.

But Martucci and Barnhill’s call to squelch physicians’ use of the term, “natural,” when discussing breastfeeding is misguided and, frankly, Orwellian. Practitioners should not have to censure truthful communication (ie, breastfeeding is truly natural) out of fear of “implications.”

People seek natural alternatives for a reason; it is a signal that they want to optimize their own health and that of their children. Honest dialog around how best to do that should be encouraged, not suppressed.

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