Book Review: Breasts, by Florence Williams

I received Florence Williams’ book, Breasts, for Mother's Day last year. It’s a fascinating book, whether or not you are someone (like me) who works with women and their breasts on a regular basis. Breasts turn out to be an incredibly complex topic which she explores from a variety of angles. I cannot do this incredible book justice in a blog post, but hope to share with you some of the information I found most interesting and surprising.

In the first part of the book, Williams describes conversations she had with several anthropologists who study breasts. Other primates develop breasts only while they are actively producing milk for their young. These anthropologists seek to discover why human females develop them at puberty and keep them for a lifetime.

Some researchers use eye tracking technology to study where men look first when they look at women, and which body parts receive the most attention. They believe that our species developed breasts so that women would appear healthy, fertile and attractive to men.

Other anthropologists think that women developed breasts because they were an evolutionary advantage to women. These anthropologists argue that breasts don’t make sense as a sexual object because they are at their largest when women are pregnant and lactating - precisely the times women are infertile. In addition, women with small breasts are usually just as fertile as women with larger ones, and are normally able to produce just as much, if not more milk. These anthropologists suspect that breast development may have more to do with fat storage. As our ancestors became less furry, this extra fat may have helped keep them warmer. Extra fat is also advantageous during pregnancy and lactation since the developing baby’s brain needs large quantities of it, both in utero and during breastfeeding. Breasts were the obvious place in the body to store the extra fat our ancestors needed because estrogen, fat and breasts go together well. Fat secretes estrogen, and breast tissue is extremely sensitive to estrogen. What better place to store fat than in the body part most sensitive to the hormones it produces?

Another argument for theories that breasts evolved for women’s survival and not for aesthetics is that not all cultures view breasts as sexual. An argument made by one anthropologist Williams interviews is that humans and cultures can make anything sexy. They discuss the example of bound feet and the anthropologist says that it’s really just a set of cultural symbolizations that makes us see one body part as more sexy than another, and that any body part can be symbolized in that way.

No theory of breast evolution has yet to be proved, and Williams argues that maybe breasts didn’t evolve for men, but that men evolved for breasts. Our ancestors with larger breasts and more fat may have been more successful at childbearing, childrearing and breastfeeding, and it “makes perfect sense that we would grow up to appreciate and enjoy breasts [...] Perhaps, all along, the breasts were calling the shots.” (p. 35)

Another topic Williams explores in depth is breast implants. She delves into their history, and meets Timmie Jean Lindsey who received the first experimental breast implants in 1962. Williams goes to a plastic surgeon specializing in breast implants for a consultation and has her breasts analyzed to learn about the process of getting implants and what kind of augmentation the surgeon would suggest for a woman like her. She explores the benefits and risks of past and current implant technologies, including all the ways breast implants can leak, break down, morph into unusual shapes, and contain carcinogenic chemicals.

A theme throughout the book is how sensitive breasts are to the environment, particularly pollution. Many chemicals in the environment mimic estrogen and other hormones. Many of these toxins are absorbed by fat in the body and settle in breast tissue. Once there, they accumulate and are very difficult to get out of the body.

Williams and her daughter decided to learn more about the toxicity in their bodies and had themselves tested for a number of chemicals. Then they did a detox avoiding dairy, plastic, shampoo, cars and many other sources of toxins we all encounter in our daily lives, in an attempt to bring their levels down. They were able to bring down some, but not all of the levels of chemicals in their bodies. It was a testament to how pervasive these toxins are in our daily lives.

Most of the toxins that accumulate in the breasts are excreted into breast milk. When she was breastfeeding, Williams had her own breast milk tested and found it to contain high levels of many chemicals including flame retardants that are common in furniture. She reports that, “lactating mothers off-load about 2 to 3 percent of their total PBDE body burden per month to their offspring, or about 30 percent if they nurse for a year...Mothers who breast-feed for a year also siphon off to their infants 90 percent of their body burden of perfluorinated compounds, known as PFCs.” (p. 210)

I was shocked to read that this off-loading of toxins has an observable effect in marine mammals. The first-born of bottlenose dolphins are considerably less healthy and have higher morbidity rates than their younger siblings, presumably at least in part because their mothers are effectively dumping over 90 percent of their accumulated toxins into their offspring.

Breast cancer and breastfeeding are themes throughout the book and Williams points out some surprising information. Pregnancy and breastfeeding are well known to help prevent breast cancer. However, it turns out this protection is only for women who have their first pregnancy before age thirty. “In fact, mothers who give birth after thirty have a slightly higher risk of breast cancer than women who never have children.” (p. 153)

The book has much more detail surrounding these shocking statements and on the whole I came away from the book still convinced that breastmilk is the normal and most healthy infant food available and that breastfeeding is overall healthier for mothers than not breastfeeding. As a lactation consultant who promotes and supports breastfeeding, whether women have their first pregnancies before or after thirty, I think the evidence is still strong that breastmilk and breastfeeding is healthier for babies, particularly premies, than any alternative. Even if breastfeeding doesn’t reduce the breast cancer risk for women who have their first child after thirty, the cardiovascular and metabolic advantages to mothers of breastfeeding are still extremely significant and Williams touches on them in the book. And of course the bonding experience of breastfeeding for both mothers and babies is unparalleled.

I certainly wonder now if some of my firstborn’s health issues have anything to do with the toxic load I unknowingly uploaded into her during two and a half years of breastfeeding, but I still suspect that the benefits outweighed the risks. And of course I’ll be on the look-out to see if the next detox fad will involve induced lactation!

If you want to know more about a fascinating topic that affects us all, I encourage you to check out Florence Williams’ amazing book.