David Crowe
July, 2011

Marian Tompson did not start a war. She did not end any. She did not make a billion on Wall Street, she did not lose it. She was not the star of a blockbuster movie, she was not famous just because she was famous. She was still one of the most important people of the twentieth century.

With fellow radicals Marian reduced the world’s GDP more effectively than any terrorist or communist organization or nefarious group of bankers. Yet they did it by bringing life to the world, not death.

Her autobiography, Passionate Journey: My Unexpected Life talks about a woman who was my some measures very ordinary. She loved being a mother and had seven children, not unusual for the 1950s and 1960s. She did distinguish herself by breastfeeding all her children, by having the births of her last four children at home and by not using physical punishment. This was unusual, but not extraordinary.

When she formed a breastfeeding support group with her neighbors she was being different, but she was probably not the first. When she agreed to be president of this small group it still seemed like nothing of note outside her community.

What was different was that this group, subversively called La Leche League (“The Milk” in Spanish, avoiding the use of the forbidden word “breast”), exploded as hundreds, and then thousands, and then millions of women hungered for more information about feeding their infants naturally despite the fact that most information publicly available on infant feediing at the time was controlled by infant formula manufacturers. These were the years where the only acceptable place in public for breastfeeding was a toilet and where the word itself was as unlikely to be heard in the media as the F-word. Marian was invited to be on television with Walter Cronkite but he refused to say “breastfeeding” on the air so the introduction was given to a subordinate who flubbed it, so the entire segment was erased from the show. And this was not in 1956 but 1990.

Poor infant feeding (i.e. formula feeding) was then, as now, an incredibly profitable enterprise. It was not just the cost of the formula and all the paraphenalia, but the litany of health problems experienced by formula babies that generated a huge amount of income for pediatricians and made their services seem critical to survival.

La Leche grew crazily and at some point Marian could have bowed out, but she never wavered, becoming the global spokesperson for the organization and seeding interest around the world despite having seven children at home. At home she was just "Mom" but in her role with La Leche league she was mixing with important doctors and even film stars and princesses if she could get them to agree to promote breastfeeding, which they did in increasing numbers. Somehow she balanced these seemingly incompatible roles.

Her husband Tom was equally as amazing, especially for that time, with his unwavering support of Marian despite all the time she was away from home as a member of the jet-set. That is, right up until 1981 when he was tragically killed in a car accident. Ironically, and obviously unrelated, this was the first year of AIDS, but the coincidence perhaps foreshadowed the next chapter of Marian's activism.

By 1996 Marian had been with La Leche League for 40 years and had helped build it into a powerful organization run for mothers by mothers avoiding financial corruption that came with any association with formula companies. The organization was initially diametrically opposed to the views of most doctors but, building on relationships with a few supportive doctors, gradually became accepted to the point where it was actually providing continuing education credits to doctors on the benefits of breastfeeding.

Now should have been the time for Marian to step back and rest on her laurels. She had led a group that had already revolutionized infant feeding in the United States and around the world. It appeared time to let a younger generation carry the torch.

But Marian was not done. She was worried by increasing calls for HIV-positive women to formula feed (and have C-sections and many other interventions) to prevent the transmission of a supposedly deadly infectious virus from mother to child. Major public health organizations like the CDC, WHO, UNICEF, UNAIDS led the charge to implement formula feeding programs in the third world while breastfeeding by HIV-positive mothers was effectively illegal in the first world. Few people in the breastfeeding community wanted to rock the boat. They had built comfortable relationships with many doctors now who were increasingly promoting breastfeeding, but almost all doctors believed fervently in the HIV=AIDS=Death dogma. La Leche had forgotten that in 1956 almost all doctors believed just as fervently in formula feeding.

Marian founded Another Look in the late 1990s which started to study this issue and produce position papers. While it was totally out of step with the majority view at the start, it eventually became clear to more people that formula feeding programs were leaving behind fields of white crosses and health recommendations started to turn back to exclusive breastfeeding which, even accepting the mainstream view that HIV causes AIDS and that breastmilk can carry infectious virus, is still superior when looking at the most important metric – infant mortality.

Just as with babies of HIV-negative mothers exclusive breastfeeding also reduces the incidence of many other health problems such as diarrhea and upper respiratory tract infection which are producers of much medical income in rich countries but often deadly in poor countries.

This is about the time that Christine Maggiore introduced me to Marian and we joined Another Look representing the radical side of a radical argument (several members accepted the HIV=AIDS dogma but not that breastfeeding was more dangerous than formula). I learned first hand of her calm persistence. When Marian asked me, in the sweetest way, if I would help out with something, somehow I knew it was an order and I had darned well better do it. I still do not understand how she had this mysterious power – but obviously it had been honed over decades of cajoling reluctant doctors and famous people to support her group.

One of those projects was a formal paper studying the meta-analysis claiming to have estimated the risk of HIV infection from breastfeeding based on pooling the data from every available study. Our analysis totally demolished the widely accepted risk of transmission of HIV by breastfeeding but we found Revisiting the Risk of HIV Infection from Breastfeeding impossible to get published in any medical or breastfeeding journal. This despite discovering smoking guns such as the study with the major risk of transmission being of a type that the very same paper said should be excluded, and another data source that relied mostly on unpublished and inaccessible data. While Marian did not write this paper it would never have been written without her gathering the group together and pushing us in the right direction.

Marian’s autobiography is a fascinating look at a complex woman who has always been out of step with her time. It is only later that people realize it was because she was several steps ahead of them.