Breastfeeding versus lactation: why a child nursing from a non-lactating mother is not child abuse
Human mammary glands (breasts) are parts of the body designed to nurture offspring. Lactation is the
physiological process by which the mammary glands produce milk to nurture offspring. When the mammary glands
are producing milk, we say that the woman is lactating.
Breastfeeding, or nursing, is the process whereby a child suckles at the breast of the woman and typically receives:
(I) A product, human milk:
A. First and foremost, human milk is a substance produced by the body to ensure the health of the children through its antibodies, living cells, and other chemical constituents; these factors in breast milk have been shown to kill harmful bacteria and viruses, to help the child’s immune system develop normally, and to create the appropriate intestinal flora in the child’s gastro-intestinal tract to support the growth of healthy bacteria such as Lactobacillus. When the
child brings a new pathogen to the mother, via the close contact of breastfeeding, the mother manufactures specific antibodies against that pathogen and gives them to the child through the breast milk within an hour of the
mother’s exposure. Human milk augments the child’s own immune system for as long as it is received. Even a six or seven year old can benefit from the immune factors in human milk. Indeed, even adults benefit from the immune factors in human milk, and human milk from a milk bank is sometimes used in the treatment of cancer and serious gastrointestinal conditions in adults.
B. Secondarily, human milk is a primary source of nutrition for the growth and development of the child, particularly the child’s brain, but also all other parts of the child’s developing body. Human milk meets all of the child’s nutritional needs for about the first six months of its life, and all national and international child health organizations agree that human children should receive ONLY human milk as their source of nutrition for the first six months of life, and continuing thereafter for as long as the mother and child both want. The American Academy of Pediatrics recommends a minimum of one year; the American Academy of Family Physicians and the World Health Organization both recommend a minimum of two years.
(II) A process, breastfeeding/nursing/suckling:
The process of breastfeeding allows the child control over its own regulation of state, including heart rate, blood pressure, respiration rate, and emotional comfort. It has been well-established, through numerous scientific studies, that the physical act of suckling –whether at the breast, or using one’s own thumb, fingers, or a pacifier, helps the child calm down. Suckling, in and of itself, reduces the child’s blood pressure, heart rate, and respiratory rate. Suckling reduces pain and discomfort. Suckling leads to the release of endorphins from the child’s brain that make the child feel better, as well as the release of chemicals in the child that make the child sleepy. This is why “breastfeeding/nursing”is considered so much more than simply a nutritional delivery system. Mothers around the world have long known that breastfeeding/nursing is a way to calm down a child who is injured, sick, tired, frightened, upset or cranky. The ability of breastfeeding/nursing to provide comfort is not contingent upon the transfer of milk. Non-lactating caregivers,
such as fathers, grandmothers, and other relatives and friends can comfort a crying child through suckling at the breast. Pacifiers work adequately for some children as substitutes for the breast, but of course don’t come along with all the other sensory input of actual breastfeeding/nursing, which includes the warmth of the mother’s body, her voice, her smell, her touch.
Lactation (the production of milk) is not required for breastfeeding/nursing to occur, nor does it affect the nature of the relationship between mother and child. There are many instances where a woman may be breastfeeding/nursing but not lactating. For example:
Additionally, there are many instances where a woman may be lactating but not breastfeeding/nursing. For example:
All of which is to say that there is no necessary connection between lactation and breastfeeding/nursing. Lactation
can occur without breastfeeding/nursing. Breastfeeding/nursing can occur without lactation. The presence or absence of milk in the breast is not the distinguishing feature separating the use of breasts for feeding/comfort purposes from the use of breasts for sexual purposes.
People in a few cultures around the world do define the breasts as sexual objects, and involve oral and manual breast manipulation as part of sexual activity. This, however, is a culturally-defined set of beliefs and practices, and is quite rare around the world, even though it is common in the US. If not explicitly taught to view the breasts as sex objects, children will not think of them as sex objects.
Children nurse at the breast for immune factors, for food, and for comfort. Children who breastfeed/nurse may be getting milk or they may not be getting milk. The presence or absence of milk is irrelevant. Children who nurse for normal durations for the human species (2.5 to 7+ years) are not having sex with their mothers.
In terms of parenting, many parents in the US follow attachment parenting concepts, including “extended” breastfeeding (beyond three years), co-sleeping, no pacifiers, no unrelated babysitters, listening to your children, treating them with respect as human beings, not circumcising their sons, etc.
Many other parents raise their children in the dis-attachment parenting style, some in a garden-variety style as exemplified by the standard baby magazines such as Parents and Parenting, which typically endorse formula use and separate sleeping, even in separate rooms.
And some parents raise their children according to the extreme anti-attachment guidelines of folks like Gary and Anne Marie Ezzo (Growing Kids God's Way, Babywise, Toddlerwise, etc.). There is no one set of correct "cultural beliefs about parenting styles" that applies to all Americans. People of all colors, all ethnicities, all religious persuasions, all socio-economic categories, all educational levels -- follow each of the above mentioned parenting styles, and
everything in between.
We can all agree that parenting choices that harm children -- whether physically or emotionally -- SHOULD BE subject to intervention by authorities representing the society at large. We don't want parents to kill their children, or break their arms, or suffocate them, or lock them in the basement, or beat them, or emotionally abuse them, or sexually abuse them. I don't think you would find any Child Protective Service worker in the country who would turn a blind eye to the "cultural practice" of female circumcision --removing a girl's clitoris and sometimes the labia as well, including sometimes sewing the labia shut across the midline. Even though this is a time-honored tradition in many cultures around the world, we don't allow it in the US -- it is against the law. Even though the Fundamentalist Latter Day Saints of Utah and northern Arizona have cultural beliefs that it is appropriate for men to have more than one wife, and to marry girls as young as 11 or 12, the authorities do not agree.
The issue of relevance in this case is not whether or not a Department of Child Protective Service has the authority to investigate charges of child abuse -- indeed, we all agree that they do have this authority, and we appreciate their efforts to keep children safe from abusive parents.
The issue of relevance in this case is whether or not breastfeeding, with or without lactation, constitutes sexual or emotional abuse -- in other words, whether breastfeeding causes any harm to the child.
We can all imagine circumstances in which mothers MIGHT abuse their children emotionally/sexually, by forcing them to suckle at their mother's breast against their will. Children will bow to their parents' wishes if threatened or hurt. And if the child did not WANT to suckle, and the mother insisted, in order to fill some perverted need of her own for sexual
arousal -- that legitimately would be considered child abuse, and the child should be protected from such inappropriate behavior on the part of the parent. I have not ever personally known anyone, or heard of anyone, who abused their children this way.
Consensual breastfeeding/suckling -- when the child and the mother both agree that they want to, and there is no coercion or threats on the part of the parent, and no harm of any kind done to the child -- is not child abuse of any
kind. No research has ever documented any sort of physical or emotional harm to a child caused by consensual breastfeeding, regardless of the age of the child or the presence or absence of lactation.
Katherine A. Dettwyler, Ph.D.
2005
Human mammary glands (breasts) are parts of the body designed to nurture offspring. Lactation is the
physiological process by which the mammary glands produce milk to nurture offspring. When the mammary glands
are producing milk, we say that the woman is lactating.
Breastfeeding, or nursing, is the process whereby a child suckles at the breast of the woman and typically receives:
(I) A product, human milk:
A. First and foremost, human milk is a substance produced by the body to ensure the health of the children through its antibodies, living cells, and other chemical constituents; these factors in breast milk have been shown to kill harmful bacteria and viruses, to help the child’s immune system develop normally, and to create the appropriate intestinal flora in the child’s gastro-intestinal tract to support the growth of healthy bacteria such as Lactobacillus. When the
child brings a new pathogen to the mother, via the close contact of breastfeeding, the mother manufactures specific antibodies against that pathogen and gives them to the child through the breast milk within an hour of the
mother’s exposure. Human milk augments the child’s own immune system for as long as it is received. Even a six or seven year old can benefit from the immune factors in human milk. Indeed, even adults benefit from the immune factors in human milk, and human milk from a milk bank is sometimes used in the treatment of cancer and serious gastrointestinal conditions in adults.
B. Secondarily, human milk is a primary source of nutrition for the growth and development of the child, particularly the child’s brain, but also all other parts of the child’s developing body. Human milk meets all of the child’s nutritional needs for about the first six months of its life, and all national and international child health organizations agree that human children should receive ONLY human milk as their source of nutrition for the first six months of life, and continuing thereafter for as long as the mother and child both want. The American Academy of Pediatrics recommends a minimum of one year; the American Academy of Family Physicians and the World Health Organization both recommend a minimum of two years.
(II) A process, breastfeeding/nursing/suckling:
The process of breastfeeding allows the child control over its own regulation of state, including heart rate, blood pressure, respiration rate, and emotional comfort. It has been well-established, through numerous scientific studies, that the physical act of suckling –whether at the breast, or using one’s own thumb, fingers, or a pacifier, helps the child calm down. Suckling, in and of itself, reduces the child’s blood pressure, heart rate, and respiratory rate. Suckling reduces pain and discomfort. Suckling leads to the release of endorphins from the child’s brain that make the child feel better, as well as the release of chemicals in the child that make the child sleepy. This is why “breastfeeding/nursing”is considered so much more than simply a nutritional delivery system. Mothers around the world have long known that breastfeeding/nursing is a way to calm down a child who is injured, sick, tired, frightened, upset or cranky. The ability of breastfeeding/nursing to provide comfort is not contingent upon the transfer of milk. Non-lactating caregivers,
such as fathers, grandmothers, and other relatives and friends can comfort a crying child through suckling at the breast. Pacifiers work adequately for some children as substitutes for the breast, but of course don’t come along with all the other sensory input of actual breastfeeding/nursing, which includes the warmth of the mother’s body, her voice, her smell, her touch.
Lactation (the production of milk) is not required for breastfeeding/nursing to occur, nor does it affect the nature of the relationship between mother and child. There are many instances where a woman may be breastfeeding/nursing but not lactating. For example:
- When a mother has just delivered, but milk is not yet being produced in her breasts
- When a mother has adopted a baby and is working to establish a milk supply using a breast pump and drugs to induce lactation, and nursing the baby, while using a supplemental nursing system (SNS) to provide formula or donor milk at the breast
- When a mother has stopped lactating because the child is nursing only occasionally (say at age 3 or 4 or 5 years), but the child continues to nurse for state control and emotional comfort; should the child start to nurse more often again, lactation may resume
- When a mother has stopped lactating because her child weaned, but then the child starts to nurse again, and lactation eventually resumes
- When a mother has stopped lactating because of a subsequent pregnancy, but the child continues to nurse and once again receives milk during tandem nursing after its younger sibling is born and milk is again being produced (some women do continue to lactate and breastfeed/nurse throughout pregnancy, others do
not; some women wean temporarily during pregnancy when they are not lactating, for their own comfort, but then allow the child to nurse again once they have delivered the next sibling) - When a woman is comfort-nursing a child she is caring for, because the lactating mother is not available (this is common in the US and very common around the world, especially among grandmothers, and some women will begin to lactate again if they nurse a baby frequently)
Additionally, there are many instances where a woman may be lactating but not breastfeeding/nursing. For example:
- When a mother’s newborn is in the NICU for weeks or months, and she is using a breast pump or manual expression to extract her breast milk and provide it to the child, even though the child is not able to breastfeed/nurse directly at the breast
- When a mother’s child has died, but she continues to pump and express milk for donation to a milk bank to help other children in honor of her dead child’s memory (this has happened on a number of occasions – ask at any milk bank)
- When a mother must travel for work or other reasons, without her child; it is possible for the mother to continue lactating even without any removal of milk from the breasts for anywhere from a few days to a few weeks and even longer in some women
- Some women will continue to lactate for months or even years after their child has weaned – they can express fluid from their breasts even in the absence of breastfeeding/nursing
- Some adult women induce lactation through the use of breast pumps and drugs because their significant others (same or opposite sex) find lactating breasts sexually exciting – there is an entire sub-genre of pornographic materials devoted to this particular fetish/paraphilia
All of which is to say that there is no necessary connection between lactation and breastfeeding/nursing. Lactation
can occur without breastfeeding/nursing. Breastfeeding/nursing can occur without lactation. The presence or absence of milk in the breast is not the distinguishing feature separating the use of breasts for feeding/comfort purposes from the use of breasts for sexual purposes.
People in a few cultures around the world do define the breasts as sexual objects, and involve oral and manual breast manipulation as part of sexual activity. This, however, is a culturally-defined set of beliefs and practices, and is quite rare around the world, even though it is common in the US. If not explicitly taught to view the breasts as sex objects, children will not think of them as sex objects.
Children nurse at the breast for immune factors, for food, and for comfort. Children who breastfeed/nurse may be getting milk or they may not be getting milk. The presence or absence of milk is irrelevant. Children who nurse for normal durations for the human species (2.5 to 7+ years) are not having sex with their mothers.
In terms of parenting, many parents in the US follow attachment parenting concepts, including “extended” breastfeeding (beyond three years), co-sleeping, no pacifiers, no unrelated babysitters, listening to your children, treating them with respect as human beings, not circumcising their sons, etc.
Many other parents raise their children in the dis-attachment parenting style, some in a garden-variety style as exemplified by the standard baby magazines such as Parents and Parenting, which typically endorse formula use and separate sleeping, even in separate rooms.
And some parents raise their children according to the extreme anti-attachment guidelines of folks like Gary and Anne Marie Ezzo (Growing Kids God's Way, Babywise, Toddlerwise, etc.). There is no one set of correct "cultural beliefs about parenting styles" that applies to all Americans. People of all colors, all ethnicities, all religious persuasions, all socio-economic categories, all educational levels -- follow each of the above mentioned parenting styles, and
everything in between.
We can all agree that parenting choices that harm children -- whether physically or emotionally -- SHOULD BE subject to intervention by authorities representing the society at large. We don't want parents to kill their children, or break their arms, or suffocate them, or lock them in the basement, or beat them, or emotionally abuse them, or sexually abuse them. I don't think you would find any Child Protective Service worker in the country who would turn a blind eye to the "cultural practice" of female circumcision --removing a girl's clitoris and sometimes the labia as well, including sometimes sewing the labia shut across the midline. Even though this is a time-honored tradition in many cultures around the world, we don't allow it in the US -- it is against the law. Even though the Fundamentalist Latter Day Saints of Utah and northern Arizona have cultural beliefs that it is appropriate for men to have more than one wife, and to marry girls as young as 11 or 12, the authorities do not agree.
The issue of relevance in this case is not whether or not a Department of Child Protective Service has the authority to investigate charges of child abuse -- indeed, we all agree that they do have this authority, and we appreciate their efforts to keep children safe from abusive parents.
The issue of relevance in this case is whether or not breastfeeding, with or without lactation, constitutes sexual or emotional abuse -- in other words, whether breastfeeding causes any harm to the child.
We can all imagine circumstances in which mothers MIGHT abuse their children emotionally/sexually, by forcing them to suckle at their mother's breast against their will. Children will bow to their parents' wishes if threatened or hurt. And if the child did not WANT to suckle, and the mother insisted, in order to fill some perverted need of her own for sexual
arousal -- that legitimately would be considered child abuse, and the child should be protected from such inappropriate behavior on the part of the parent. I have not ever personally known anyone, or heard of anyone, who abused their children this way.
Consensual breastfeeding/suckling -- when the child and the mother both agree that they want to, and there is no coercion or threats on the part of the parent, and no harm of any kind done to the child -- is not child abuse of any
kind. No research has ever documented any sort of physical or emotional harm to a child caused by consensual breastfeeding, regardless of the age of the child or the presence or absence of lactation.
Katherine A. Dettwyler, Ph.D.
2005
