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Book review of “Milk, Money, and Madness” by N. Baumslag

With overwhelming evidence, Dr. Baumslag explains how important breast-feeding is and why baby formula is problematic—something an expecting mother should know!

Collage book "Milk, Money, and Madness" and text to the right.© CC-by-sa 2.0, Collage Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland

Conclusion

Based on scientific studies, this book documents the importance of breast-feeding infants for a longer period of time than is customary in our society. It would be optimal for infants to be breast-fed for one year; however, they can be given supplementary food after a few months.

This book doesn’t deal with the transition period that a woman who has just given birth goes through (postnatal period, postpartum period), but instead describes the importance of colostrum and of breast milk, which is specially designed for the child.

In addition, the supplementary food should not contain any milk or milk products from other animals. Professor Baumslag emphasizes the fact that “Cow’s Milk is for Cows.”

We also learn much practical information about breast-feeding.

If you want to learn about the health problems that milk and dairy products can cause in children and adults, you should read the book "Milch besser nicht!" (Milk, better not) by Maria Rollinger — or at least this book review of her book.

Collage with two paintings: The two very different meanings of the female breast.© CC-by-sa 2.0, Collage Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland

1. Summary

The authors draw from 190 books and articles, which they list by chapter in the reference section at the end of the book. Professor Naomi Baumslag is a pediatrician who, along with her position as a university professor, works in international organizations such as USAID, UNICEF, and WHO. For many years, she has been the president of WPHN, the very successful Women’s International Public Health Network. She has also gained extensive practical experience in numerous countries around the globe.

The book examines practically all aspects and practices related to breast-feeding (nursing) and bottle-feeding (baby formula, infant formula, and “follow-up” milk) babies and toddlers.

It shows the reasons behind the very different traditions when it comes to the female breast, breast-feeding, and infant nutrition. A related topic is sexual behavior during both pregnancy and breast-feeding in different cultural areas, ethnic groups, and times (philosophy of space and time and arrow of time).

It is interesting that social behaviors usually don’t reflect our natural needs. Depending on the zeitgeist (spirit of the time) and religion, there are a number of very different customs. However, unnatural practices are often linked to a higher and unnecessary infant mortality rate. The book describes poor options for infant nutrition and the serious consequences of such. We also learn how important it is to have flexible breast-feeding times.

The book also covers reasons why it is important to breast-feed for a longer period of time and for the baby to be close to the mother (cosleeping). This helps to synchronize the sleep patterns (wakefulness, sleep, and sleep stages) of the mother and child. The child doesn’t have any reason to cry, and the mother and child can sleep longer in the morning without disturbing the rest of the family.

The text also describes the different ways to stimulate milk flow. These and other aspects are difficult for the Western world to understand at the current time.

Various practices such as having wet nurses lead us far back in history and introduce us to customs other than our own. We read about practices still carried out today as part of breast-feeding that we would never have believed existed.

The book and this text show readers why formula milk has experienced and continues to experience such great popularity, even though it does not offer the same quality and can never completely replace breast milk. There are very logical reasons supported by scientific evidence for the superiority of breast milk.

We also read the story of the boycotts against manufacturers with information about how infants who receive formula have much higher sickness and death rates.

And finally we learn why paid maternity is so important and that up until at least the middle of the 1990s the majority of women did not receive this in the United States.

About the authors

Naomi Baumslag, M.D., M.P.H., is a Clinical Professor of pediatrics at Georgetown University Medical School in Washington, DC. She is president of the Women’s International Public Health Network (WIPHN) (for 2015 as well) in Bethesda, Maryland.

She has also served in an advisory capacity for the USAID, UNICEF, and WHO, the Georgia Department of Human Resources, the PAHO Foundation (prev. PAHEF), and for government agencies in many developing countries, as well as on the Health Council of La Leche League International (LLLI) and the World Alliance for Breastfeeding Action (WABA).

Professor BAUMSLAG has written more than 100 articles und eight books. She also gives lectures, both internationally and in the United States. Please see her website baumslag.com for more information.

DIA L. MICHELS is a science writer for newspapers and magazines around the world. Her commitment to breast-feeding stems both from her own research and her personal experience of breast-feeding her own children over the past six years.

This is the second book she has coauthored with Professor BAUMSLAG. In 1992, the authors published "A Woman’s Guide to Yeast Infections", Pocket Books (288 pages).

Redaction comment

According to Open Library, the author Dr. Naomi Baumslag also wrote the following books:

  • Murderous Medicine (2005),
  • Primary Health Care Pioneer (1986),
  • A Woman’s Guide to Yeast Infections (1992),
  • Family Care (1973).

2. Book review

It is generally thought that breast-feeding is an instinctual process that is driven by hormones. However, the authors explain how breast-feeding is actually something that has to be learned. Other primates also have to learn how to breast-feed. Changing views on the subject also play a role. The female breast has been transformed into a sex symbol in many time periods (zeitgeist) and societies.

Section 1: Breastfeeding Beliefs and Practices

Section 1 is divided as follows:

Part 1 (here 2.1):
Breastfeeding Customs around the World; Breasts as Sex Symbols; Intercourse Taboos; Diet during and after Pregnancy; Cravings in Pregnancy; The Fear of Labor and Delivery; Childbirth Assistance; Mothering the Mother; Galactagogues (substances that promote lactation); Beliefs about Colostrum (first milk); Premature and Small Infants (preterm birth and neonatology); Is the Milk Good Enough? (breast milk); Feeding Styles; Carrying Baby; Swaddling; and Duration of Breastfeeding

Part 2 (here 2.2):
Wet Nursing, Surrogate Feeding, and Healing Qualities of Breastmilk; Selection of Wet Nurses; Slaves as Breeders and Feeders; Do You Have to Have a Baby to Breastfeed?; Surrogate Feeding; Breastmilk Pumps; Breastmilk Banks; Interspecies Nursing; Nursing the Aged; and The Healing Qualities of Breastmilk

2.1. Breastfeeding Beliefs and Practices

The authors show the strong influence that religion and customs have on birth and motherhood. For example, Jews who live in accordance with the Talmud (Torah) are supposed to breast-feed their children at least two years (p. 5). In many societies around the globe, it is the well-off and affluent families, in particular, who have a distaste for breast-feeding.

Collage of three photos about breastfeeding with text over it.© CC-by-sa 2.0, Collage Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland

Although we know that children who are breast-fed for a longer period have a better life expectancy, breast-feeding and the length of such change based on current trends. At times, breast-feeding has been seen as disgusting, unwomanly, or unhealthy (p. 5).

The preferences of the prosperous and upper-class (wealth) often influence the attitudes of an entire society.

For instance, many rich Chinese women were not able to breast-feed their children at all because they wore very tight dresses that completely flattened their breasts.

The breast has been transformed into a sexual object

In the United States, women, at least in certain states, have not been allowed to breast-feed in public.

For example, one woman who was nursing her child in her own parked car was warned by a police officer that she was in danger of breaking indecent exposure laws. The breast has been transformed into a sexual object.

In the early 1980s, the Food and Drug Administration (FDA) received the following message from the American Society of Plastic Surgeons (ASPS):

There is a substantial and enlarging body of medical information and opinion to the effect that these deformities [small breasts] are really a disease [that left uncorrected, results in a] total lack of well being (p. 7)

In other words, small breasts are a disease that needs to be cured.

This organization has had much success. In 1990 alone, a total of 130'000 women in the United States had operations to have their breasts enlarged. The FDA did not even begin to intervene in spite of the negative health consequences and reports of fatalities.

The authors discuss the issue of intercourse taboos during breast-feeding. There are indeed good reasons for restricting coital relations since children who are born too soon after their next older sibling have a significantly higher death rate in developing countries and are often later neglected.

The same thing happens when children aren’t breast-fed or are breast-fed for too short of a time. The book provides some related statistics and specific examples from various cultures.

Intercourse taboos

In several tribes in Africa, in particular, there is an intercourse taboo during the breast-feeding period. For example, in the Zulu tradition, it is believed that a man will become impotent if a drop of breast milk falls on his skin (p. 8).

Men have pressured their nursing wives for decades to accelerate the weaning process by switching over to formula, which is good for our dairy companies.

In addition, women on birth control pills that contain estrogen (oestrogen) produce a significantly lower amount of milk.

And in many cases, women who give birth (delivery) in hospitals are seen as “cleaned out” and the traditional intercourse taboos no longer apply (p. 10). This means that the time until the next child is born will most likely be shorter — with all of the disadvantages this brings.

The hormone "oxytoc..", which is produced for the birthing process and during breast-feeding, helps nursing mothers to feel calm and nurturing. However, it also reduces vaginal lubrication, which can make sex uncomfortable. Nature has actually provided a process that allows a child to better develop, without a second pregnancy occurring too soon. But we ignore this natural process (p. 10).

The diet restrictions for pregnant and nursing mothers vary widely in different regions and time periods. In certain areas in Tunisia, women don’t eat eggs, whereas in another region, the opposite is true and nursing women are encouraged to eat between six and eight eggs daily.

The authors discuss entirely absurd and harmful customs as well as beneficial practices.

Alcohol, cow milk and coconuts

We haven’t known for so long that when pregnant mothers drink alcohol, it can cause problems for the child — to a smaller extent, this can also happen when nursing mothers drink alcohol.

In Sierra Leone, pregnant women aren’t allowed to drink alcohol.

In Sri Lanka, nursing mothers are prohibited from drinking cow milk, and in other regions coconuts are off limits. Both of these foods can cause allergic reactions (p. 13).

In the next subsection, the authors deal with the special food cravings that pregnant women have. Many of these are still unexplained, but others are backed up by science.

In as early as about 400 CE, Plato wrote that he had seen pregnant women eating dirt. This craving for “dirt” can be explained by the fact that dirt contains vitamin B12 and other minerals that may be lacking in some women’s diets.

The practice of eating clay

The practice of eating clay is also well known and was popular among African American women.

Clay contains a high amount of iron and also chemical elements (trace elements) such as sodium (Na), manganese (Mn), arsenic (As), silver (Ag), molybdenum (Mo), and uranium (U).

Because of its high pH, clay also has an antibacterial effect. Recent studies have indeed shown that clays rich in iron from several deposits have this effect.

Redaction comment

Sodium is one of the elements that is essential for all animal organisms.

Manganese is an essential element for all living things and a component of various enzymes.

Arsenic is a trace element in humans, but its biological significance for us has not yet been fully established.

Arsenic is also an essential element for many animals.

Silver is used as the color additive E 174 in the food industry, for example, for the shells of sweets such as pralines and in licorice.

Molybdenum is a trace element that is essential for almost all living organisms as it is a component of the active site of a number of enzymes such as nitrogenase, nitrate reductase, and sulfite oxidase.

In the Brothers Grimm fairy tale Rapunzel, the expecting mother looks pale and weak. The father to be steals rampion leaves (campanula rapunculus) from the neighbor’s garden.

Specific cravings during pregnancy are today seen as a sign of a deficiency in certain substances.

Today we know that rampion leaves and other green vegetables are rich in folic acid (vitamin B9 or folate).

Campanula rapunculus

Flowering of Rapunzel, Campanula rapunculus.© CC-by-sa 3.0, Fornax, Wikipedia

Wikipedia (English entry): Campanula rapunculus, common name rampion bellflower, rampion, or rover bellflower, is a species of bellflower (Campanula) in the family Campanulaceae.
Wikipedia (translation of German entry Rapunzel-Glockenblume): The roots are fleshy and can be prepared as tasty root vegetables like celery (Apium graveolens) or red beets. You can use raw root slices and leaves to make a salad. In the Middle Ages, people planted these in their garden. In the Alsace and in Switzerland, this type was grown between 1906 and 1929. As is done with lamb’s lettuce (Valerianella locusta), the rosette leaves are harvested in the winter.
In the book, the authors use the term “rampunion,” but the plant is actually called “rampion.”

The authors look briefly at the methods of the German physician Prochownik who restricted the caloric intake of pregnant women who had a small or contracted pelvis. His of goal was to reduce the weight of newborns so that mothers would have an easier birth. This was in some cases tragic for the children. Pelvic distortion can result from rickets, a disease caused by lack of sunlight and/or Vitamin D, calcium, or potassium. (p. 14).

Childbirth assistance and support provided to young mothers by relatives are also topics that are very much in contrast to today’s industrialized society.

Colostrum, the milk produced during the first few days, is increasingly being recognized as important for an infant’s health. It was long believed that this milk, which has a different color and flows somewhat thicker, was harmful for the child. This is why colostrum has been withheld in certain times and cultures. However, the practice leads to many early deaths and children who later have a weaker immune system.

Similar serious mistakes made in other cultures

The Indian system of Ayurvedic medicine (Ayurveda) also believed colostrum to be harmful: As far back as the second century BC, Indian Ayurvedic medicine recommended honey and clarified butter for the newborn's first four days, during which the birth mother's colostrum was expressed and discarded (p. 24).

This also happened in biblical times. The authors describe similar serious mistakes made in other cultures, for example, in Guatemala, Afghanistan, Sierra Leone, and Lesotho.

And Greek, Roman, and later French, English, and other European physicians recommended the same course of action up until the eighteenth century — without stopping to question the practice.

The British physician Dr. Ettmueller came into serious conflict with the medical establishment of the time when in 1699 he recommended that newborns should be breast-fed and receive colostrum from the beginning.

Another 50 years would have to pass until a similar call to action by the physician William Cadogan in 1748 would turn out to be more effective:

The mother’s first milk is purgative and cleanses the child of its long hoarded excrement; no child can be deprived of it without manifest injury (p. 24).

Redaction comment

Wikipedia cites William Cadogan (1711–1797) as the first physician who advocated the complete abolition of swaddling. He did so in an essay in 1748 titled "An Essay upon Nursing and the Management of Children, from their Birth to Three Years of Age".

Before this time, people were obliged to strictly follow this practice.

Early childhood mortality had previously been very high; Fildes showed in 1980 that just this one step reduced childhood mortality (infant mortality) by 16 %.

But mothers also take part in other practices, with the support of the industry, that are not in the best interest of the child. An example of this is the sugar water bottles that infants in the United States receive when they are still in the hospital. These make it easier to care for the babies as they are quieter – but it is to their detriment. It gets them used to taking a bottle instead of breast-feeding ...

In seldom cases, this can bridge the time until the breast milk comes in. But new babies usually don’t need any fluids besides breast milk, even in hot climates. And this breast milk should come from the baby’s own mother if possible, even if the milk doesn’t come in immediately.

The authors then turn to the topic of premature and small infants (p. 25). In particular, they criticize the fact that pediatricians only look at weight gain and, if they are not satisfied with this, they recommend supplementing with formula rather than examining the mother’s health and eating habits and suggesting changes as necessary. Ironically, this was recommended by Soranus von Ephesos eighteen centuries ago.

Demand feeding

At the beginning of the twentieth century, the physician Truby King from New Zealand popularized the harmful practice of nursing babies every four hours and encouraged mothers to stop the practice of demand feeding.

In addition, nurses analyzed the fat content of the milk and prescribed supplementary feeding.

Again this was done instead of giving the mothers nutrition advice and finding out more about their environment. These were also standard practices in England (pp. 28 and 128).

The authors give an overview of other changes and differences related to breast-feeding and carrying infants that are found in diverse cultures. They regret that infants no longer sleep in a family bed as was traditional. Disruptions caused by breast-feeding are much smaller when the baby is in the parent’s bed because the baby receives milk as soon as it needs it and doesn’t have to be moved.

Studies suggest that mothers and their babies have a mysterious connection that is caused by prolactin (PRL) and seem to dream in unison and both know when milk is needed. The sleeping cycles of the mother and child are similar so that they can both get the periods of deep sleep (hypnogram and polysomnography, PSG), which are needed for overall health (p. 31).

Our inner clock and the symbiosis between mother and child

Our inner clock ensures that we maintain a stable 24-hour rhythm, for example, of sleep and wakefulness and is also responsible for many endocrine processes such as the production of cortisol and melatonin.

The functions of our central nervous system show clear, endogenously controlled daily rhythms, which are called circadian clocks (circadian rhythms).

See also circadian rhythm sleep disorder, Neurologie der Bindung (Neurology behind the connection between mother and child, German only), and cosleeping.

I find that sleep training is the wrong method as it isn’t natural, even if nobody has published studies on this topic ...

The central circadian clock is found in the suprachiasmatic nucleus (SCN) of the ventromedial hypothalamus. Nerve cells in the SCN rhythmically express clock genes.

Molecular circadian rhythms are also found in peripheral organs such as the liver, pancreas, kidneys, adrenal glands, heart, and lungs. The hypothalamus controls these peripheral clocks.

Today we know that if you eat at night during the inactive phase, the central circadian clock in the suprachiasmatic nucleus (SCN) uncouples from the other internal clocks.

A chronic disorder of the circadian rhythms can cause a higher rate of heart and circulation disorders, obesity, type-2 diabetes, and cancer.

The clock gene was first researched in the Drosophila melanogaster.

Redaction comment

On the symbiosis between mother and child from Wikipedia (German version): Margaret Mahler sets the beginning of the symbiotic phase at around two months, during the oral phase. At this time, the child is physically and mentally dependent on the mother.
"It cannot yet distinguish between inside and outside, between itself and objects, or between itself and its mother. It experiences the mother as part of its own self, and has an inseparable symbiotic unity with her."

"The mother must be able to recognize the child’s needs in order to ensure that it is satisfied and healthy since the child has not yet developed conscious thinking. If the mother is available to the child during the symbiotic phase, the child can develop basic feelings of security and trust. The relationship between mother and child serves as the foundation for later relationships."

See also Erikson’s stages of psychosocial development from the psychoanalyst Erik H. Erikson (1902–1994).

The authors write that it is fortunate that swaddling is no longer widely practiced, and they describe reasons why it was introduced in many cultures. However, the authors write, Swaddling is not good for children. In addition to hampering normal muscle development and coordination, swaddling can lead to a variety of medical problems involving the lungs, arteries, and veins (p. 35).

Children must receive breast milk and be free to move

The renowned anthropologist Ruth Fulton Benedict (1887–1948) commented that women have expressed their fundamental values in their swaddling techniques.

As examples, Benedict describes swaddling practices in Russia and Rumania.

In the 1740s, the physician William Cadogan at Foundling Hospital in London warned that children must receive breast milk and be free to move.

A Turkish study showed that swaddling causes an increased rate of pneumonia.

Nevertheless, swaddling is still practiced today in some areas of Eastern Europe, in Asia, and in the Middle East in countries such as Mongolia, Afghanistan, Turkey, and Greece.

How long should infants be breast-fed? This is a question that is asked time and time again and that the U.S. Surgeon General Dr. Antonia Novello answered as follows in 1990:

The American Academy of Pediatrics says that babies should be breastfed until age one. … It’s the lucky baby I feel who continues to nurse until he’s two (p. 35).

Customs are very dependent on cultural attitudes. The authors agree with this statement and give reasons why infants should be exclusively breast-fed until they are six months old. At that point, food should be gradually introduced.

A healthy mother with enough milk can also exclusively breast-feed for longer, but after nine months exclusive breast-feeding should be questioned. Continued breast-feeding (along with food) after six months is still always the best method.

Breast-feeding practices

How just very different breast-feeding practices are can be seen in the fact that as late as the 1820s English women in East Lincolnshire apparently let their children drink breast milk until they were seven or eight years old. In the Solomon Islands, breast-feeding was continued until children were 15.

But in 1991, a mother in Syracuse, New York, was found guilty of neglect for breast-feeding her child for more than two years. Her child was even taken from her and placed with a foster care family for a short time.

Muslim religious laws dictate that mothers with twins should give the son breast milk and the daughter bottle milk.

This can lead to appalling inequality as UNICEF shows with an example from Children’s Hospital Islamabad in Pakistan. The doctor had advised a mother to do so, which led to her daughter suffering from malnutrition (marasmus) and dying. The authors have included a photo on page 37 that the mother gave to UNICEF to use as a warning in their publications.

2.2. Wet Nursing, Surrogate Feeding, and Healing Qualities of Breastmilk

Wet nursing (wet nurse) came into being to save children when their mother had died or wasn’t able to give milk. Later, wealthy families turned this into the standard practice. For example, the pharaohs in Egypt had wet nurses raise their children.

Today, people in the West don’t quite know what to think about surrogate mothers and have mixed feelings on the subject. The reasons for wet nursing were and are to provide an infant with breast milk who would otherwise not receive any and to try to decrease the number of deaths caused by a lack of breast milk.

The topic of wet nurses and practices in many cultures and time periods

Most Egyptians, Babylonians, and Hebrews breast-fed their children for about three years, but richer Greeks and Romans used slaves as wet nurses.

The authors discuss the topic of wet nurses in detail and give an overview of practices in many cultures and time periods.

The authors also include the story of the wet nurse Judith Waterford, who in 1831 at the age of 81 proudly showed that she could still produce milk that was of the same quality as milk produced by younger women. When Waterford was 75, she regretted that she now only had enough milk for one child and could no longer take on two children.

Most people believe that only a woman who has just given birth to a child can breast-feed.

However, any woman can stimulate milk production by using a breast pump daily for two to three months.

Read also more about induced lactation or relaction and erotic lactation. Sometimes, no milk is visible in this period of breast pumping, but as soon as the infant latches on, the milk comes in (p. 52).

Collage with paintings: "Louis XIV. And the Lady Longuet de La Giraudière", 1640, Charles Beaubrun.© CC-by-sa 2.0, Collage Catalina Sparleanu, PhD, Foundation Diet and Health Switzerland

In the section titled “Surrogate feeding,” the authors provide examples of cross nursing. In this case, one woman nurses the child during the time when the other woman is at work or vice versa. Surrogate feeding is simply the practice of wet nursing, which generally involves the grandmothers. In the West, we can hardly imagine this occurring, but there are indeed passages in the bible where Naomi (also Noemi) serves as the wet nurse for her daughter-in-law Ruth’s child.

Surrogate feeding and breast milk bank programs

This method is still common today in certain parts of Africa. The authors include a quote from Margaret Mead from 1933 to show that even she had difficulty accepting such practices.

In newspapers and in the Charleston Medical Journal and Review, an article appeared in 1874 telling of how a 60-year-old woman had, as part of play, offered her breast to a child for three weeks and then was amazed to see that after this time milk appeared and even in greater quantities than in the case of the child’s own mother.

The authors describe how milk can be expressed by hand or with a variety of different types of breast pumps. They also provide information about breast milk banks, which have been and are still often found in children’s hospitals. This milk can be cooled, but shouldn’t be heated. Sweden and Denmark are examples of countries that have active breast milk bank programs. The banks accept milk that women produce within the first three or four months of lactation and pay a good price for this.

Eastern European countries have had an even stronger tradition. For example, 200'000 liters of breast milk were collected in the eastern part of Germany in 1989. In contrast, there are or were eight breast milk banks in the United States and one in Canada. But this milk is pasteurized in order to make sure there is no risk of contracting HIV or hepatitis.

Redaction comment

A list of current milk banks in North America shows three for Canada, 19 for the United States, and seven that are currently in planning. See hmbana.org/locations.

When Finland began to pasteurize the milk in its banks, they found that the infection rates in infants increased and were ultimately higher than what they had been with nonpasteurized milk. Canada closed down all of its milk banks, and this turned out to be worse for the children than introducing pasteurization (p. 57).

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