The Village Effect: How Face-to-Face Contact Can Make Us Healthier and Happier (19 page)

The female effect in Rosenquist’s study was subtle, if not invisible, before statistical analysis. But during Prohibition women openly exploited their influence. In
Last Call
, Daniel Okrent’s lively history of Prohibition, we learn that female suffragettes such as Carry Nation, Susan B. Anthony, and Elizabeth Cady Stanton cut their political teeth in the temperance movement. Susan B. Anthony’s first public speech was on the dangers of alcohol, but “none quite hated it with Carry Nation’s vigor or attacked it with her rapturous glee,” writes Okrent, who describes Nation as “six feet tall, with the biceps of a stevedore, the face of a prison warden, and the persistence of a toothache.” Saloon owners and committed drinkers in the Midwest had to face Nation and her weapons of choice: a hatchet and her self-published newspaper,
The Smasher’s Mail
. By the turn
of the twentieth century, female activists had helped reduce the vast quantities of alcohol consumed daily by most Americans and were well on their way to making drinking illegal.

I had known that women had slowed the rivers of booze during the years of Prohibition (1920–33), but until I read Okrent’s book I hadn’t known that women played a key role in opening the beer taps again. A different group of women, this time more likely to sport pearls than hatchets, helped turn public opinion away from what they considered the unconstitutional meddling in the private lives of Americans. In 1930 the
Washington Post
reported the female anti-prohibitionists’ appearance at a Senate hearing on the front page: “Women whose names stand out prominently in the social register … outnumbered the men in the room four to one. These were grandmothers, matrons and debutantes, all pledged to a war on prohibition.” And after they had presented their case, “there was every evidence that the bill was dead.”
⁵⁶

It would not be the last time that two groups of passionately committed women knocked heads over what people should eat and drink. At around the time women were arguing about men’s boozing, the debate about what
babies
should drink was heating up. And it wasn’t just ideologically committed women who had strong opinions. Factions in science, politics, medicine, and business were at war about what infants should be fed—which was really a war about how they should be raised. The stakes were considered so high that, 150 years after the debate started, the shouting match has only become more shrill.

W
illiam was almost two months old when we first met. With two babies under the age of two, life was hectic for his parents, Bob and Diane (who, as I described in
Chapter 3
, first caught the pregnancy bug from Bob’s sister). Thankfully, Bob’s mother lived upstairs. She had been ready to sell her duplex in a gentrified part of Montreal’s Mile End neighborhood when Bob and Diane decided to buy in. Now the young family lived downstairs and the grandmother upstairs, much the way most of the area’s immigrant families had lived for more than a hundred years. Being under the same roof as her mother-in-law was more than an economic choice for Diane. “I’ve always thought that the way to stay close to your family is to stay physically near them. Some people would think that it’s insane. But I’ve always wanted to bring my people close to me. Elizabeth’s a wonderful mother-in-law. If she’s home, we usually eat together, though that wasn’t part of the plan at the beginning.”

I wasn’t the only dinner guest that night. Diane’s father, Dennis, was visiting from his home in the suburbs. Shortly after I walked into the aqua-tiled kitchen, he propped the cranky baby’s padded bottom on the kitchen table, his beefy hands encircling William’s torso. William’s downy head began to jiggle alarmingly as his grandfather started pumping him up and down on the edge of the table. “Bouncy, bouncy, baby! Bouncy, bouncy, baby!”

William immediately stopped crying and leveled his face with his grandfather’s. His slate-gray eyes were wide open now. He dropped his lower jaw with the rising pitch and volume of that last
ba-by!
then stuck out his small pink tongue and fixed his gaze on his grandfather’s eyes, shifting slightly from what he had been staring at a second earlier: the older man’s cavernous open mouth, his huge tongue and white teeth. This floor show was so absorbing that William forgot he had been demanding to be fed.

Soon enough, Diane scooped William off the teak table and sat down. She tucked him into the crook of her elbow, deftly positioning his head under the folds of her sweater. Frantic sucking sounds ensued, then slowed, the baby’s back rising and falling rhythmically. Suddenly it was quieter. Those of us who’d been talking loudly automatically adjusted our volume to the tenor of William’s nursing, just as five minutes earlier he’d adjusted his level of alertness to ours.

This is the mammalian pas de deux, honed over tens of millions of years of evolution. Breastfeeding is the infant’s slow food movement. It’s antithetical to a fast-paced lifestyle and it can interfere with a woman’s earnings—precisely because it’s a slow process that requires the mother to be with her baby six to ten times a day, and to be fairly immobile, too. There’s longstanding evidence that the physical contact and unhurried pace of breastfeeding releases a steady stream of oxytocin into both the mother’s and baby’s bloodstreams, the infusion dulling pain and promoting mutual trust. As a side benefit, the neuropeptide also enables mother and baby to sit still.
¹
Clearly, oxytocin greases the wheels of attachment in ways that can’t be mimicked by technology.

Yet even though it seems set up to promote social bonding, less than 40 percent of American mothers are still breastfeeding their infants by time they are William’s age (two months old). That number falls to 27 percent by the time babies are four months old, just when they’d be able to hold themselves upright enough while nursing to palm the breast with one hand and twiddle their mother’s
ear with the other. Though the World Health Organization recommends a diet of only breast milk until a baby is six months old, by that time a mere 14 percent of American mothers are still nursing their babies.
²
The other 86 percent are either working full-time or they find the demands of a nursing infant intrusive. As American journalist Hanna Rosin observed, “It was not the vacuum that was keeping me and my 21st-century sisters down, but another sucking sound.”
³

Does it really make any difference whether a baby is fed from the breast or from a bottle? As a child born the year the Russians launched Sputnik into space, when the zeitgeist was all about using science to race against time, I wasn’t breastfed and I can’t say I feel deprived. Still, in the coming pages I’ll present some of the latest evidence from developmental neuroscience that shows that face-to-face (if not skin-to-skin) contact tunes up the circuitry of the newly formed human brain, which until at least the age of eight is still a work in progress. This chapter is not so much about breastfeeding as it is about how a baby’s intimate bonds transform her neural networks. Human infants are hardwired to make lasting social connections. And not with just anyone.

THE MOUTHS OF BABES

The capacity to comfort a hungry infant with your breast is a singular pleasure. Some women describe it as orgasmic. Perhaps that’s one reason why the fervor of breastfeeding advocates rivals that of Carrie Nation, the prohibition activist we met in the previous chapter. When an article in the
British Medical Journal
suggested that an exclusively breastfed baby over four months of age is more prone to allergies and anemia than a baby who drinks breast milk but eats other foods too, a British breastfeeding advocacy group labeled the article “backward” and accused the researchers of being shills for the baby-food industry.
⁴
Passions run high when it comes to breastfeeding: you either endorse the practice absolutely or you’re a sellout. And along with such ideological rifts, there’s a class divide.
When Hanna Rosin mentioned that she was considering switching her one-month-old from the breast to formula, she was shunned by the other educated upper-crust mothers in her Brooklyn playground. “Circles were redrawn such that I ended up in the class of mom who, in a pinch, might feed her baby mashed-up Chicken McNuggets,” she wrote.
⁵

Social class notwithstanding, in the United States, where there is no guarantee of paid maternity leave and new mothers get a token four weeks off with their babies (only Lesotho, Liberia, Swaziland, and Papua New Guinea are as stingy), working women of all stripes find themselves switching to the bottle before their little one can hold up his head and smile: at about five weeks of age. In Canada, where parents get an average of nine months of maternity leave, more mothers breastfeed than in the U.S., but half of them have given it up by the time their babies are three months old. Meanwhile, breastfeeding rates among British mothers—who get twenty weeks of paid leave—are even lower than Americans’. The downward trend in the industrialized nations is unmistakable.
⁶
By the time babies are a few months old, two-thirds to three-quarters of mothers in Western democracies are either pumping out their breast milk and dating the baggies with a Sharpie before tossing them in the freezer, or they’re mixing up formula.

This wholesale switch to formula gives public health authorities the heebie-jeebies. Scholars have linked breastfeeding to reduced rates of diarrhea, meningitis, urinary tract infections, sudden infant death syndrome, necrotizing enterocolitis, ear infections, and respiratory tract infections. If all that weren’t incentive enough, several good studies show that exclusive breastfeeding during the baby’s first six months is associated with boosted intelligence, fewer behavior problems in childhood, and eventually, upward social mobility.
⁷

Still, there’s a basic confusion about terms. Governments and women’s groups are “purblind, unwilling to eye whether it’s his mother, or her milk that matters more to a baby,” the Harvard
historian Jill Lepore noted in a 2009
New Yorker
article.
⁸
As far as the Centers for Disease Control in Atlanta is concerned, it’s not about bonding but about the chemical composition of the milk. “It doesn’t matter if it is coming straight from the breast or being pumped into a bottle,” the CDC’s Karen Hunter wrote me in an email. “If the baby is getting breast milk, they are getting breastfed.” Oxytocin and intimacy don’t enter into the equation. If Sarah Palin can tout her family values by telling
People
magazine that she often had to “put down the BlackBerries and pick up the breast pump,” the inference is clear. Once you give birth, a baby’s routine feeding and maintenance is no big deal. An electric pump and a bottle can do the job just as well as the mother can.

Well, not quite. Breastfeeding the old-fashioned way does seem to make most babies healthier and smarter, regardless of social class. One landmark study of Belarusian mothers and babies—the largest randomized trial of breastfeeding mothers ever conducted—assigned more than seventeen thousand mothers and babies from thirty-one maternity clinics to either a breastfeeding promotion group or a control group (one that offered postnatal care but no breastfeeding education or advice). The twenty-strong team of international researchers who conducted this study found that the increased rate of early breastfeeding in the experimental group led to fewer digestive and skin ailments in the babies in the short term, and also to a boosted verbal IQ score in the long term, when these children were tested six years later.
⁹

Presumably every parent wants clever children, and an average increase of 7.5 IQ points is nothing to sneeze at. So impressed were they with the data showing enhanced health and intelligence in breastfed babies that officials at the World Health Organization based its international breastfeeding strategy on a meta-analysis of these studies. This leads us to an uncomfortable question. If the majority of women in the West are giving up the practice before their infants can hold up their heads, what are they missing?

I asked this question of Michael Kramer, the McGill-based pediatric epidemiologist who is the Belarusian study’s lead author. I also wanted to know what he thought was making the breastfed babies smarter. “I like to think it’s the social contact,” he said while chatting with me in the waning light of a late December afternoon. A wiry man in his early sixties, Kramer had dropped by my office on his way home from a Friday afternoon squash game. He looked scrubbed and relaxed—not at all like the driven young scientist I remembered from thirty years earlier. We had been members of the same hospital-based research group then, he as an epidemiologist, I as a newly minted child psychologist.

“It could even be something as simple as the fact that breastfeeding takes longer,” he said. “And the mothers are talking to their babies and stimulating them, smiling at them, singing to them all that time. When you’re breastfeeding, you spend more time talking to the baby face-to-face, and we did find greater increases in verbal IQ compared to nonverbal IQ.”