Pop Quiz! From perky to ptosis: what's to blame?

Which of the following affects the shape and overall appearance of your breasts?

A. Number of pregnancies

B. Age

C. Yo-yo dieting

D. Smoking

E. Breastfeeding

F. A through D, but not E

If you guessed F, ding ding ding, you are correct! This was studied recently, not by a bunch of lactivists, even, but by a group of cosmetic surgeons. Despite the myth that a nursing baby ravages one's bosom of its beauty, it turns out that the most significant changes occur as a result of pregnancy, period, regardless of the infant feeding choices made thereafter.

Age is also a major factor, of course, as gravity gets to all of us, losing and gaining large amounts of weight, which in turn loosens the skin and weakens the Cooper's ligaments which help give the breast its structure, and, possibly most surprising, smoking status is a significant factor as well. For the same reason that smoking causes wrinkles - the breakdown of elastin - smoking contributes to sagging of the breasts, clinically known as 'ptosis'. (Fitting term. Makes me think "ptooie!")

Alas, there is a very pervasive belief out there that breastfeeding, rather than pregnancy or any of the above, directly causes sagging, or otherwise 'ruins' one's breasts. This is especially disheartening when one looks at the perceptions of young women: a survey in the UK found that almost a third of them planned not to breastfeed because they believed it would "ruin the look of their breasts". I don't think it's a stretch to guess that the numbers in the US would be similar.

It's frustrating, to say the least, knowing that the same women who would deny both their babies and themselves breastfeeding due to this myth (especially considering that many of those same women maybe smokers). Add to this the possibility that smoking mothers might also believe that they would be better off formula feeding their babies due to nicotine being passed into their milk. While there is no denying it is far, far better to quit, if a baby IS to be in the household of a smoker, breastfeeding is absolutely still the better choice, as it helps to protect the baby from some of the damage that they would be exposed to regardless. (See Kellymom.com for more in this.)

But I digress. Back to aesthetics. I bring this up because of a debate that took place a few days ago. How exactly do we begin to break down what seems to be a deeply-ingrained belief in this harmful myth? Well, one breastfeeding advcacy site, Dispelling Breastfeeding Myths took the initiative and started a volunteer gallery of post-breastfeeding breasts, issuing a call over ye olde information superhighway for submissions from mothers. And some other breastfeeding advocates, like Just West of Crunchy, took issue with this approach.

Where do I stand? I'm going to go out on a limb and say that I see both sides.

Oooooh, courageous, I know. But truly - I understand that this is a serious problem that needs a really assertive approach to start changing public perceptions, and a provocative approach has a lot of appeal. But I also see that there may be some real problems with execution and interpretation, and it IS sadly true that a lot of the furor about nursing "in public" (used in quotes because really, it shouln't ever need the qualifier) is framed by the opposition as the exhibitionism of mothers who just love to use any excuse to, as the phrase goes, whip 'em out.

Once more with feeling: breastfeeding DOES NOT affect ptosis. Pregnancy does, as does number of pregnancies. Age does. Genetics may. A history of SMOKING does. History of large amounts of weight being gained and lost in general does (sometimes associated with pregnancy, but also on its own). But whether or not a woman chooses to USE her existing expanded breast volume to feed her baby does not change the shape of the overall breast. Now, the nipple, yes, it will become somewhat more drawn out. But sagging? It has been studied and dismissed.

So, as I stated in JWOC's comment thread, can we brainstorm? What are some other ways to get the word out that breastfeeding does NOT ruin the shape of your breasts, and moreover, that smoking is far more harmful? Can we come up with a different provocative way to get this message out?

P.S. If you need some more food for thought and visual illustration, check out this gallery of the ravages of smoking on one's appearance. The pictures of twins are particularly potent.

P.P.S. PhD in Parenting has a good post on this study as well.