Unintended Consequences of Invoking the “Natural” in Breastfeeding Promotion

Medical and public health organizations recommend that mothers exclusively breastfeed for at least 6 months. This recommendation is based on evidence of health benefits for mothers and babies, as well as developmental benefits for babies. A spate of recent work challenges the extent of these benefits, and ethical criticism of breastfeeding promotion as stigmatizing is also growing.¹ Building on this critical work, 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, a view examined in a recent report by the Nuffield Council on Bioethics.² 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.

The measles outbreak of 2014–2015 sparked intense, condemnatory discussion of vaccine refusal. This public discussion often emphasized that some in the antivaccine camp believe that vaccines cause autism or contain harmful levels of toxins and impurities. Beneath the concern of many Americans over vaccine safety, a specific …

Address correspondence to Anne Barnhill, PhD, Department of Medical Ethics and Health Policy, Blockley Hall 14th Floor, 423 Guardian Dr, Philadelphia, PA 19104-4865. E-mail: anne.barnhill{at}gmail.com