Potential consequences of invoking ‘natural’ in health promotion: Part 1 of 2

Ever since a Pediatrics article and an Evidence Based Birth publication showed up at her desk on the same day, Healthy Children Project’s Cindy Turner-Maffei, MA, ALC, IBCLC has been pondering the relationship between them, and the impact of lessons on how we communicate about biologic functions such as breastfeeding, and also about risk surrounding biology.

The Pediatrics Perspectives article reports on the unintended consequences of claiming breastfeeding is natural. The Evidence Based Birth article describes a rise of exclusively breastfed babies with life-threatening hemorrhagic disease due to avoidance of Vitamin K shots in Tennessee.

“The term natural has a lot of values packed into it,” Turner-Maffei begins. “Also, risk:benefit ratio is a difficult concept to convey in a practical sense.”

Similarly, the authors of the Pediatrics article entitled Unintended Consequences of Invoking the “Natural” in Breastfeeding Promotion write that “‘natural’… lacks a clear definition.”

Perhaps this is why, when I spoke with Turner-Maffei, our conversation took several directions. In part one of two posts, she’s contributed great insight on several abstract ideas that warrant ongoing investigation.

Turner-Maffei reiterates the Pediatrics publication authors’ concern about breastfeeding promotion that praises breastfeeding as the natural way to feed infants because the “messaging plays into a powerful perspective that ‘natural’ approaches to health are better.” The authors claim this promotion may actually be “ethically problematic… and… may ultimately challenge public health’s aims in other contexts, particularly childhood vaccination.”

Manifesting the authors’ concern, Rebecca Dekker’s, PhD, RN, APRN notes that when parents were asked why they had declined Vitamin K, their reasons included: concern about an increased risk for leukemia, a belief that the injection was unnecessary and “unnatural,” and a fear that their infant would be exposed to toxins in the shot.

Surely, our bodies and our planet can benefit from lifestyles with less harmful toxins; still, just because something is “natural” doesn’t make it intrinsically good for you.

“Rattlesnakes are natural, but you don’t want to step on one,” Turner-Maffei points out.  “I’d rather step on a plastic bottle than a rattlesnake any day.”

When it comes to maternal child health advocacy it’s sometimes easier to be a purist, touting a Breast is Best message.

“But it’s not that kind of world,” Turner-Maffei says.

She admits that she’s “done the purist thing,” once believing that moms who choose not to breastfeed weren’t doing what’s best for their children. She’s since changed her viewpoint.

“It’s too rigid, too unfair, not a justifiable position,” she explains. “Parents make infant feeding decisions based on their own unique situations; it’s no one’s right to judge them on the basis of infant feeding choice.”

Instead, we need to “look at our own mythology around lactation,” Turner-Maffei advises.

Not long ago, many in the lactation community fought back against Vitamin D recommendations for the exclusively breastfed infant, for instance.

“We tend to resist news that implies that breastmilk doesn’t have everything a baby needs,” she comments. “Most of the time [breastmilk] is great, but it can’t help with Vitamin K and most of the time, not Vitamin D.”

Interestingly, Dekker poses this question: “If all infants are born with low Vitamin K levels, is it really a deficiency or is this the natural design of human beings?” She includes three theories including a survival of the fittest scenario, the potential that an infant’s clotting system needs time to mature, and the potential that there is an unknown reason that leads to low Vitamin K transmission from mom to baby.

Dekker adds, “You could also make the argument that it doesn’t really matter why babies are born with low levels. The point is that they are born with low levels of Vitamin K, and that some babies will die from Vitamin K deficiency bleeding if they do not receive supplemental Vitamin K at the beginning of life. Most will not bleed. But some will, and some will experience brain injury or death. And these injuries and deaths are 100% preventable.”

Stay tuned next week for discussion on cognitive processes and flexibility. In the meantime we wonder, what other “natural” things can you think of that might not necessarily be healthy or beneficial?

Leave a Reply