How about a MOTHER friendly breastfeeding initiative?

Woman Screaming at Anoher Female on White Background

If there’s a bigger oxymoron than the “Baby Friendly” Hospital Initiative, I’m not aware of it. There is nothing baby friendly about efforts to promote breastfeeding to the exclusion of a mother and baby’s actual needs. There is not, and there can never be, anything “baby friendly” about destroying the confidence of new mothers and making them feel guilty about a decision with trivial consequences.

It’s time (actually long past time) for a MOTHER friendly breastfeeding initiative.

What would a mother friendly breastfeeding initiative entail? It would start with some basic truths about breastfeeding and mothering:

1. While breastfeeding has real benefits, those benefits are so small as to be trivial in all cases except premature babies. Understanding and acknowledging this scientific reality is the first step to a safe, sane, respectful breastfeeding policy.

2. The obvious corollary to #1 is this: once a woman has been given accurate information about the benefits of breastfeeding, it DOES NOT MATTER what choice she makes, and therefore hospitals should NOT be devoting copious resources to it. Those resources would be much better spent teaching basic parenting to low income, young women or on programs to prevent prematurity.

3. Formula is an EXCELLENT source of nutrition for babies. There is absolutely positively nothing wrong with it, and no mother should be made to feel guilty for feeding to her child, regardless of the reason for choosing it.

4. Breasts are part of a woman’s body. NO ONE has the right to tell women how they must or should use their breasts. PERIOD.

5. I don’t know of a single endeavor where humiliation produces results. It’s time for lactivists and lactation consultants to acknowledge that and stop the hectoring treatment being offered in hospitals.

6. In my judgment, boosting fragile maternal confidence is an important task of anyone who cares for women and babies. Setting arbitrary standards, ignoring women’s own needs, pretending that every woman can breastfeed successfully are sure-fire ways to undermine self-confidence, not build it.

7. Stop treating new mothers like morons. EVERY women knows that “breast is best.” If a woman decides to formula feed, it does NOT mean that she doesn’t understand the benefits of breastfeeding.

8. Breastmilk does not have magical properties. Its ability to prevent vaccine preventable illnesses is small and easily outstripped by vaccination itself. It does not increase intelligence; it does not prevent obesity; and it does not confer health on its recipients.

9. No one has ever demonstrate ANY benefit to donor breastmilk for term babies.

10. The risks of potentially contaminated donor breastmilk from unregulated arrangements far outstrips any putative benefits.

Why is it critically important to make our breastfeeding initiatives MOTHER friendly?

We have made great strides in understanding the devastating impact of postpartum depression, yet we seem to ignore those insights when trying to promote breastfeeding. Adequate sleep, lots of help and feelings of competence can help prevent and treat postpartum depression. Why then do we pretend that breastfeeding is more important than these factors so critical for women’s mental health?

Contemporary efforts at breastfeeding promotion remind me of the efforts to encourage right handedness among the left handed in generations past. The humiliation and physical abuse associated with forcing right handedness were justified by claims that being right handed is “better” and “easier.” The humiliation and guilt inducing behavior of lactivists and their breastfeeding initiatives are justified by claims that breastfeeding is “better” and “easier.” Humiliation and physical abuse were believed to be “effective” in forcing right handedness when the reality was that it was effective only in inducing despair. Lactivists apparently believe that humiliation and guilt are effective in increasing breastfeeding rates when the reality is that they are effective only in getting women to lie about their intentions or to despair when they can’t realize those intentions.

There is NOTHING wrong with formula feeding, the benefits of breastfeeding are trivial and the harms to women and babies of venerating breastmilk as magical far outstrip any of those putative benefits. It’s time to get real about breastfeeding and to stop the nonsense of “baby friendly” hospital initiatives. Such initiatives are friendly to only one group: lactivists, who are building their own self-esteem by tearing other women down. If we actually care about mothers and babies, we would remove “baby friendly” programs and replace them with accurate scientific information, respect for women’s intelligence and efforts to support mothers regardless of feeding choice.

It’s time for safe, sane and respectful breastfeeding policies. It is time for MOTHER friendly breastfeeding initiatives.

  • Cindy Proctor Schlecht

    OMG just support what the mother wants to do!!

  • nikkilee

    This is a collection of talks from the Academy of Breastfeeding Medicine that you might enjoy. There are a wide range of speakers: clinicians, researchers, and an economist from the world bank. https://www.youtube.com/watch?v=Z3xvUuNPgQ0&list=PLNjm9nbuUu4tmGcBFICtlPGHA_GHjLTAN&index=1

    • Megan

      You’re still posting here?? There have been numerous breastfeeding posts since this one. Trying to comment without notice I guess…

      • nikkilee

        There are too many posts to comment on everything.

  • Stacy21629

    Stopping breastfeeding and going to exclusive formula feeding when my daughter was 4 months old and 7.5# was the most mother friendly thing I’ve done yet. I have no worries about her welfare and growth now because I know exactly how much she’s eating and she’s gained tremendously and passed multiple milestones. She sleeps better, and I sleep better. I don’t have to worry about making sure my clothes allow “easy access”, that I have a sling or a cover, or where I’m going (I’ve never been one to nurse while grocery shopping so I needed to plan where to feed my baby). I can actually *gasp* PROP THE BOTTLE UP and sweep the floor or start dinner, rather than having to drop everything every couple hours. Sure I still enjoy sitting with her…but honestly I read at the same time too!
    Miracle of miracles, she’s been just fine. No GI upset, no illnesses that everyone else in the house hasn’t had as well.
    Don’t get me wrong – I thoroughly enjoyed breastfeeding my teeny little baby…but this early return to freedom as compared to my other child is really wonderful too.

    • techqueen333

      It may have been a mother friendly decision, but it is not a baby friendly decision

      • PrimaryCareDoc

        Actually, the latest research now shows that it doesn’t make a damn bit of difference. Catch up.

        • techqueen333

          Clearly, you haven’t read the latest research.

          • PrimaryCareDoc

            I beg to differ. http://www.sciencedirect.com/science/article/pii/S0277953614000549

            I have read it. Have you?

          • techqueen333

            Self-reporting on duration of duration of BF and selection bias. These pose questions about reliability and validity. Second, like Horta study the focus of this study is on non-communicable diseases, behavior, and IQ. Again, like the Horta study, it ignores the benefits of BF re: mortality and morbidity due to infectious diseases. You can’t get around the fact that human milk contains immunoprotectuve, anti microbial, and anti-inflammatory agents and formula does not.
            One thing I did like about this article is the plea to change practices and policies around family leave, workschedules, and child care. In the US, we have some of the worst among developed countries.

          • Dr Kitty

            Stop posting on old posts.
            Once five people post after you and your comment leaves “recent comments” no-one can find it.

            Come and post on today’s topic so we can all find your posts.

            Unless you just want to have the last word and are hoping if we can’t see your nonsense we can’t respond to it…

          • techqueen333

            I respond to the comments on my phone via the links Disqus provides.

          • techqueen333
          • PrimaryCareDoc

            I give you a study, you give me a…blog post? Okay.

          • techqueen333

            I gave you my own initial response AND provided you with an analysis of the study by other scientists. Just because the analysis is posted on the Internet, doesn’t make it invalid. There are serious, legitimate concerns about the sibling study.

          • NoLongerCrunching

            Yes there are concerns, as there are concerns with EVERY study. Do you put as much an emphasis on the concerns when the results go the way you want? Breastfeeding is still great, and this study doesn’t take that away. It does however provide some reassurance to moms who didn’t breastfeed. Why are you threatened by that?

          • techqueen333

            It goes beyond concerns. It’s a flawed study. I am only threatened by the touting of flawed studies by those who want to say that the differences between human milk and formula are trivial. Women who choose to bottle feed or to supplement should understand that the two are not interchangeable. They should know what changes occur when formula is fed to a newborn. And please, don’t respond with more starvation and bilirubin stories. Those are rare and of course mothers have to seek alternatives.

          • NoLongerCrunching

            But the flaws are no greater than the flaws in many studies that show benefits to breastfeeding. Ii don’t agree with the idea that this is a gamechanger; it needs to be replicated and “breastfed” needs to be more accurately defined, but i am troubled by the knee-jerk dismissal of this study by the community of bf advocates. We have nothing to lose here.

          • techqueen333

            pS. I’ve given you studies and you’ve just ignored them.

          • Guesteleh

            Why are you commenting here and not on the most recent breastfeeding post? Any thoughts on the Ohio State study?

      • Stacy21629

        Please enlighten me – in what completely unseen way is my daughter suffering to an early grave, like she pretty much was before formula?

      • Happy Sheep

        How are you still on this article? Dr Amy has posted a new article about recent breastfeeding studies, and yet you insist on bleating the same BS here over and over again.

        • techqueen333

          No, she has not.

      • Cindy Proctor Schlecht

        Keeping you baby fed and safe is a “baby friendly” decision

  • Amy Tuteur, MD

    I’m not sure why anyone is arguing with techqueen333 and nikkilee. They are lacto-fundamentalists and like all fundamentalists they start from a premise the their “god” is the one true God and absolutely nothing you can say will cause them to question their faith.

    • NoLongerCrunching

      Because, like with fundamentalists, showing them that others are real human beings that may have some good points, may plant a seed that causes them to treat others with more understanding. Plus, it’s fun. (I don’t get out much.)

      • techqueen333

        Fundamentalist? You really slay me with the name calling. Oh, I love the false assumption about how I treat people. You don’t know me and have no idea what I do.

        • anion

          You’re right, we don’t know you, and you have refused to say what you do. All we have to go by are your comments here, which are rude, unpleasant, insensitive, and filled with idiocy.

          You don’t want us to think of you that way? Don’t behave that way, then. It’s very simple.

          (BTW, that’s not a “straw man,” either. Nor is it ad hominem.)

          I am done having a discussion with you, because you’re frankly boring. But I did want to clarify that running into a forum and acting like a jerk means people are going to think of you as a jerk, no matter how lovely and kind you may be to others in your personal life. We don’t know or see that. All we see is what you show us. That’s Human Relationships 101.

          • techqueen333

            I could care less what you think of me anion. You’ve given me absolutely no reason to care. Your post serves no purpose but to ridicule someone with whom you disagree. Furthermore, you have no evidence to support the assertion that my posts are filled with idiocy.

          • anion

            Q.E.D.

          • techqueen333

            QED from me to you.

          • LibrarianSarah

            Grow up

          • techqueen333

            Ooooooo. Now THAT hurt.

    • techqueen333

      That’s nothing but an ad hominem attack. It conveys nothing but your personal dislike for those who disagree with you.

      • AlisonCummins

        No, ad hominem is “if techqueen333 says it, it must be wrong because she’s a terrible person and so is her husband.” That’s very different.

        • techqueen333

          AlisonCummins, that’s exactly what she’s done with the use of lacto-fundamentalists and “like all fundamentalists.” For someone who is so quick to disparage what she seems to feel is confirmation bias or lack of evidence demonstrated by those who have reached different conclusions than she has she certainly loves her own echo chamber. Pot/kettle.

          • AlisonCummins

            No, she used a syllogism.
            > Fundamentalists cannot be swayed.
            > techqueen333 is a fundamentalist.
            > Therefore techqueen333 cannot be swayed.

            Amy Tuteur, MD did not say you were wrong because you are a fundamentalist (which would be an ad hominem) she said there was no point in arguing with you because you are a fundamentalist. It’s perfectly good logic, not a fallacy at all presuming the premises are sound.

            I’m not opining on the soundness of the premises, just saying that it’s not an ad hominem attack.

          • techqueen333

            She did say we were wrong. She implies such by stating we start from a false premise “one true god”and are impervious to reason.

          • AlisonCummins

            Impervious to reason, yes. Wrong, no.

            For instance, perhaps you believe that Earth’s atmosophere is 78% nitrogen because you accept the sacred text of Azota which reveals it to be so. You are a fundamentalist Azotan and nothing anyone can say could ever dissuade you from this central doctrine. There is therefore no point in arguing with you because your belief in the nitrogen content of air is not based on reason.

            You would, however, be correct!

            That is why an ad hominem attack is a fallacy. “Don’t listen to techqueen333 about the composition of the atmosphere, she’s a fundamentalist Azotan.” That’s a fallacy because no matter who you are, you could still be right and in this case you would be. The composition of the atmophere needs to be discussed on its own merits.

            Amy Tuteur, MD did not state that any particular assertion of yours was wrong because you are a fundamentalist. She just said that arguing with you would be unproductive. If it’s true that you are a fundamentalist and if it is true that fundamentalists are impervious to reason, then it follows that yes, arguing with you is unproductive. That’s not an ad hominem, that’s a syllogism.

            If she had said “There are no antibodies in milk because techqueen333 says there are and tecqueen333 is a fundamentalist,” that would have been an ad hominem and it would have been a fallacy. But she didn’t say that.

          • techqueen333

            Amy began with a false premise. That false premise implies an ad hominem, i.e. You are a fundamentalist and irrational (one true God) and you aren’t capable of processing MY alleged evidence. So arguing is futile. It does smack of syllogism, however, I used ad hominem to highlight the fact that she resorts to ridiculing me rather than addressing my arguments.

          • AlisonCummins

            “Ad hominem” isn’t latin for “calls me names.” It means attacking the person instead of the argument. She wasn’t attempting to refute an argument by calling you names, therefore it wasn’t an ad hominem.

            False premise is fine.

          • Medwife

            Really enjoyed this exchange and your valiant attempt at explaining those fallacies! Not Latin for “calls me names”. Ha!

          • techqueen333

            She’s called me a moron and an idiot, a activist, and a fundamentalist. I’d say that’s reason enough to assume she’s attacking me instead of my arguments.

          • NoLongerCrunching

            Fair point.

          • techqueen333

            It is a syllogism based on two false premises.
            It is ad hominem because she attacks me rather than my arguments.

          • AlisonCummins

            If you say, “You shouldn’t play with Alison Cummins because she’s a poopie pants and she stinks,” that is NOT an ad hominem. That’s a wise caution.

            If you say, “Ad hominems and syllogisms are the same thing because Alison Cummins is a poopie pants and she stinks,” that IS an ad hominem.

          • NoLongerCrunching

            I think calling someone a fundamentalist is somewhat ad hominem. But I’m curious, techqueen333, what if you were shown incontrovertible evidence that in the long run, breastfed and formula fed babies in the US had negligible health diffferences? Like maybe a few more ear infections and colds for FF babies. What would your reaction to that be?

            As a BF mom who has devoted the last 10 years to helping other moms bf, I would be sad because I think BF is really special and beautiful, and I would still help moms who wanted to and encourage my daughters to try it, but I would’t deny the science. Of course science is always learning new things, so that evidence might be overturned later, but I believe we have to act acording to what the evidence shows. Otherwise we are the very definition of fundamentalist.

  • Dr Kitty

    Tech queen, what is this “my husband the MD” thing about?
    My husband is a software developer.
    He knows as much about medicine as I do about coding…
    I know almost nothing about coding.

    My doctor friends have spouses who are barristers, engineers, teachers, bakers, podiatrists and artists.
    I’d only trust the spouses of doctors who are actually doctors themselves to dispense medical advice.

    If you are a qualified Lactation Consultant, use that. You don’t need your husband’s career to add credibility.

    • techqueen333

      I pointed out that my husband was an MD to illustrate that there were two scientists in the house reading the same research and coming to the same conclusions. I am not a certifie lactation consultant, but I worked with nursing mothers on a daily basis for nine years with OB supervision

      • KarenJJ

        Was this recent experience? Because some of your assertionis of what happens in a hospital seem a bit out of date. I admit to not being in the US so maybe it’s different there. Although judging from the stories I am hearing I suspect it is largely similar.

        • techqueen333

          My own experience is not recent. My daughter’s experience is very recent. My friends’ children have had babies within the last two years and they have all reported issues with formula pushing. Things are not as peachy between nurses and lactation consultants as you think.
          Over the years I’ve seen many a breastfeeding relationship sabotaged by the “well meaning.”

          • Durango

            Given your vocal antagonism, I would expect that everyone you know who experienced even minor issues with breastfeeding initiation will share them with you. I’ve never heard of “formula pushing” and all the new babies i know are breastfed. We see what we want to see, I guess.

            I am curious why you are so cagey about describing your former role in assisting new mothers breastfeeding?

          • Susan

            Me too! TechQueen what was your role and what years did you have the role? What exactly did you do? A vague reference to what backward region of the US you might be in ( at least breastfeeding wise) would be interesting as well…

          • techqueen333

            That’s really funny, because I am still sought out by friends and their children for help getting started with BF or with solving problems.
            I’m not telling you because it’s none of your business. I can’t see how that information adds anything to this “discussion.”

          • Durango

            Ah. You do realize, of course, that you were the one who brought it up? Just like telling us about your phd (in some random, unrelated subject), your MD husband, your carefully worded sharing of your “work with nursing mothers under OB supervision”–you seek to bolster your statements with (very) vague assertions of expertise. That hasn’t worked out so well for you or anyone (you’ve joined the ranks of the guy who told us his SAT score, and the multiple NCB-ers who have parents who are doctors and nurses). Again, in an online forum, your credentials don’t matter, your words do.

          • NoLongerCrunching

            Are you saying your friends’ children were happily breastfeeding and a HCP cam in and started pressuring them to give formula? Or was there a valid reason why some supplementation might have been recommended? Maybe you would prefer to use glucose water in that situation, but that is not evidence based care, according to the Academy of Breastfeeding Medicine.

          • lizzo

            I had a 9+ pound baby (plus a rather delightful C-section) and formula never came up. (I was kind of looking forward to the mountain of free samples I was promised by lactivists, but received none.)

            I feel too like maybe your anecdote is missing some key health information.

          • techqueen333

            My anecdote is missing zero key health information. There were consistent attempts to persuade mothers to give supplemental bottles.

          • ngozi

            But if the baby is healthy and feeding well, then why would they just suggest formula feeding? It doesn’t make sense?

          • Irène Delse

            Indeed. “They were happily breastfeeding”? But were they breastfeeding successfully? Were the babies really getting enough or was it a case of “we want to wait and give sugared water until supply is established”? Because in that case I’m not surprised if nurses weren’t appreciative. Oh, and since techqueen already answered serious questions with flippant jokes elsewhere in this thread, I’m not inclined to take what she says at face value. And *that* is not an ad hominem, btw, simply judging someone by their track record.

          • The Bofa on the Sofa

            Indeed indeed. There MUST have been some reason why the HCP recommended formula. If breastfeeding was going well, there would have been no reason to. The obvious answer is that it was not going very well, despite mom doing it happily.

          • techqueen333

            You are wrong. There you go making false assumptions again. Typically, formula is recommended during growth spurts when baby nurses more frequently. Mothers call to find out if this is normal. Now, we aren’t talking about situations where baby is losing weight, isn’t pooping or producing wet diapers. We are simply talking about frequency while supply builds to meet the new demand. Formula is digested more slowly than human milk and formula fed babies go longer between feeding. Suggesting formula cuts down on phone calls to the pediatricians office but it also is counterproductive in terms of increasing milk supply. Other examples include “helpful” HCP who insist mom should allow dad/mom2 to give relief bottle at night, etc. Concerns about the benefits of exclusive BF are dismissed. Concerns about the effect of giving relief bottles on supply are dismissed. Concerns about nipple confusion are dismissed.

          • The Computer Ate My Nym

            Typically, formula is recommended during growth spurts when baby nurses more frequently.

            Semi-anecdotally, my daughter’s pediatrician never suggested formula at any point. When I was rotating through pediatrics, no pediatrician said, “formula should be used during growth spurts” nor did the textbooks recommend any such thing. For that matter, my mother reports no particular pressure from my pediatrician to formula feed me as a baby. Up to date pushes breast feeding and, if anything, overstates the benefits. So where does this concept that formula is needed during growth spurts (assuming the baby is happy and well fed during them) even come from?

          • The Bofa on the Sofa

            o where does this concept that formula is needed during growth spurts (assuming the baby is happy and well fed during them) even come from?

            Oh, I would not be surprised if the topic came up…when mothers expressed concern. For example, they complained to the pediatrician that their baby just seems to want to nurse all the time, and they can’t deal with it any more. Naturally, the doctor says, let them have some formula to give yourself a break.

            But that’s not good enough for assholes like techqueen. Nope, moms are nothing but milk cows that have to have a baby attached all the time.

            How dare pediatricians offer moms solutions for relief?

          • The Computer Ate My Nym

            Certainly if the mother brought up concerns, but my reading of techqueen’s comment was that it implied that doctors spontaneously recommended formula for a healthy baby who was growing and feeding well and a mother who had no complaints about breast feeding. I guess the statement about helping the mother at night does imply a problem, i.e. not being able to sleep. I don’t see the problem with doing so: everyone will be happier if the mother has more sleep.

            BTW: Has anyone actually seen “nipple confusion” or is there any real evidence that it occurs? My small one much preferred the breast to a bottle (whether expressed milk, pedialyte, or formula) in any circumstance other than when she was starving for lack of milk production on day 2 of her life, but maybe we’re atypical.

          • The Bofa on the Sofa

            Certainly if the mother brought up concerns, but my reading of techqueen’s comment was that it implied that doctors spontaneously recommended formula for a healthy baby who was growing and feeding well and a mother who had no complaints about breast feeding.

            Yes, that is what she is implying, but I don’t believe it for a second. In fact, it was the statement about the “relief” bottle that tipped it off – I have known a lot of people to give that advice, to let dad give a bottle at night. but it always in response to mom being overwhelmed, or to prevent mom from getting overwhelmed.

            That similarly applies to a growth spurt. Having a baby that eats constantly is not easy for mom while she’s breastfeeding. Therefore, supplementing with a bottle can help.

            As for the “it hurts supply” claim, it’s idiocy. If a baby is on a growth spurt and nursing non-stop, giving a bottle so that you can get back to 8 feedings a day is not going to hurt anyone’s supply, for pete’s sake.

          • techqueen333

            You are incorrect on all counts. Further in almost every case, the mother was complaining about being told to give a “relief” bottle.

          • Young CC Prof

            Mine liked the bottle, but he was exceptionally tiny with an ineffective latch, and I have very wide flat nipples, so I imagine the issue was that he preferred eating something to eating nothing.

          • Irène Delse

            Anecdotally, what I’ve seen in my family was:
            A) Two children were combo-fed for practical reasons (mom working) and had no trouble going from breast to formula bottle until 6 or 8 months of life, after that it was formula with solids introduced progressively. Both never had a pacifier but sucked their thumb from birth until well into toddlerhood.
            B) Two babies exclusively formula fed due to health issues (of the mom for one, of the baby for the other). Both loved their bottles, had no pacifiers and sucked on their fingers instead.
            C) One baby who was near-exclusively breastfed for the first six months of life, with the occasional bottle of pumped milk or formula when mom had to be absent, with solids progressively introduced then in addition to breastmilk, and who continued to occasionally breastfeed as a treat until 2 1/2 years old. Interestingly, that one wasn’t keen on bottles, whether they contained breastmilk, formula, plain water or fruit juice, preferring a sippy cup for water or juice. But that baby also loved sucking on a pacifier when not eating! So here there was no confusion at all, the baby distinguished between the nipples on breast, bottle and pacifier, and expressed clear preferences for one “natural” as well as one “artificial”.

          • fiftyfifty1

            “BTW: Has anyone actually seen “nipple confusion” or is there any real evidence that it occurs?”

            No scientific support for this idea.

          • techqueen333

            In nine years of working with breastfeeding mothers on a daily basis, I saw many, many, cases of nipple confusion. This led to extreme frustration for mothers and babies. Of course, you can go ahead and dismiss this and everything else that doesn’t fit your schema.

          • NoLongerCrunching

            I believe from MY experience that what we used to think was nipple confusion is actually one of two things: 1. The baby had latching difficulties from the get-go, hence the need to introduce the bottle; the bottle did not cause the latch issue but its use was rather the result. 2. Flow preference either because mom has low supply, or a fast-flow bottle was used.

          • techqueen333

            Neither of those were evident in most of the cases I saw. It DOES take more work for baby to nurse from mom than from the bottle. Babies can develop a flow preference because the milk is always going to come out of a bottle faster, at least until the let down occurs. Some babies develop tongue thrust as a result of fast-flow bottle use and it causes a real problem for latch and efficient nursing.

          • The Computer Ate My Nym

            So if the mother prefers bottle feeding and the baby prefers bottle feeding, where’s the problem?

          • techqueen333

            Breast feeding is superior in terms of nutritional and immunological properties. The differences are not trivial. If mom prefers bottle feeding and chooses that, she should understand that she’s making a conscious choice to provide an inferior food. Information should not be withheld because every wants to be touchy feely. As far as what the baby prefers, since when do we alliow infants to make parenting decisions?

          • NoLongerCrunching

            You’d have to live under a rock not to know that breastfeeding is better. It even says so on the formula cans. But it is obvious through research and parents’ experience that formula is good enough for all practical purposes.

          • techqueen333

            Oh, but it IS obvious through research and frequently there are negative consequences to using formula. The research is simply ignored and HCP don’t push it because it’s inefficient and bad for business.

          • Stacy21629

            @techqueen…as a PhD married to an MD you understand the importance of research. Please provide us with the research demonstrating the existence of “nipple confusion”. We want to practice evidence-based medicine after all.
            But if you’re going to go on anecdata – both of my children were given their first bottle within the first 5 weeks of life. No nipple confusion at all.

          • ngozi

            I just want to say that my son’s pediatrician didn’t suggest formula even when my son wasn’t gaining enough weight according to what was deemed textbook normal. As long as he was gaining weight, he didn’t feel that it was a problem. He suggested I continue to breastfeed as long as I felt good about doing it. I just want to show that not every pediatrician is pushing formula for every little feeding issue.

          • techqueen333

            You are right. I oppose relief bottles. You are right, It isn’t good enough considering that often impacts milk supply and deprives babies of benefits of exclusive breastfeeding, none of which are “trivial.”
            I will ignore your name calling.

          • NoLongerCrunching

            Hence the need for a Mother Friendly Breastfeeding Policy. If a mother wants to give a relief bottle, because SHE FEELS SHE NEEDS RELIEF, who are you to oppose that?

          • techqueen333

            It’s about the baby. The mother is the grown up in the equation.

          • NoLongerCrunching

            So she should not get relief even once a day? Way to encourage PPD.

          • techqueen333

            Way to use hyperbole.

          • Elizabeth A

            Isolation and exhaustion are real factors in PPD, so denying mothers relief actually really does encourage the condition. Not hyperbole at all.

            But you seem to love throwing the term around, so knock yourself out.

          • Kelly

            I just decided to exclusively pump and give my daughter a bottle because I was on my to PPD with breastfeeding. (This also happened with my first daughter). Extreme lack of sleep and the stress of breastfeeding were a bad combination for me. I was able to get six hours of uninterrupted sleep as my Mom and husband both took a night feed for three days so that I could finally catch up. Even when breastfeeding, I had my Mom or husband give the baby a bottle to give me some sleep. It is the only reason I was not worse off than I already was. Women should not feel bad about giving the occasional bottle in the beginning in order to stave off depression.

          • Young CC Prof

            As I previously demonstrated, caregiver violence and accidental injury are the big threats to babies, not disease. Hence, a mother who sleeps enough to be patient and alert is vitally important.

          • Stacy21629

            Suck it up you weenie! Slap some lanolin on those bleeding boobs, get your lazy butt out of bed and take care of your screaming hungry child! Grow up!
            @@

          • NoLongerCrunching

            No no no. If her boobs are bleeding she’s “doing it wrong” because breastfeeding doesn’t hurt!!!!1! Get that child some craniosacral therapy and cut any frenulum in his mouth you can find, stat!

          • Mishimoo

            I had a surgeon ask me if that was the current fad diagnosis, because he’d had a few consults about lip ties recently. The mums insisted on having them snipped even though there was no reason to do so. He tried to explain the mechanics involved in suckling and that sometimes it’s just that the mother can’t produce enough milk, but they didn’t want to listen to his suggestion of mix-feeding or changing to formula instead of surgery.

          • NoLongerCrunching

            IMO tongue tie is way overdiagnosed, so when a real TT-related sucking difficulty occurs, doctors are going to roll their eyes rather than take us seriously. I feel terrible about those babies getting unnecessarily clipped. For truly severe TT, absolutely; but leave the rest alone ffs!

          • Mishimoo

            I agree! He did take my curiosity seriously though, and that prompted the interesting discussion.

          • techqueen333

            If her nipples are bleeding, she probably is doing it wrong.

          • NoLongerCrunching

            If you truly have experience in this field, you know very well that there are many causes for damaged nipples that have nothing to do with how the mother is breastfeeding (tongue-tied baby, flat nipples, dysfunctional suck, vasospasm etc etc). Not everybody wants to pursue fixing these things and waiting for their nipples to not feel like they’re being stabbed 8x/day for as long as it takes to improve.

          • techqueen333

            It comes from people who would rather recommend formula than answer phone calls from mothers.

          • NoLongerCrunching

            Can’t you see how insulting it is to assume those people are putting their own convenience above the health of their patients? Do you like it when HCPs malign lactation consultants? Why not be professional and assume positive intent? This isn’t the 1950s anymore.

          • techqueen333

            Actually, I got that line from my MD husband.

          • NoLongerCrunching

            So because he is an MD, that gives him the right to insult his colleages? I doubt he would appreciate being treated that way.

          • techqueen333

            I’ve heard pediatricians explain it that way and OBs. Doctors go to parties, picnics, and other events. Doctor families exchange babysitting. These things come up.

          • fiftyfifty1

            You do sometimes find the lactivist doctor-wife couple (somehow it is never a lactivist doctor-husband couple, you can draw your own conclusions about why). In any case, there are a few lactivist doctor-wife couples out there. They tend to be painfully self-rightous and often religion motivated with strict gender roles and firm ideas about what makes a “good woman”. In my experience, they tend to spend LESS time on the phone or in clinic listening to and helping their patients. A lot of “do what I say, I’m the doctor”.

          • techqueen333

            I’m borderline atheist. So much for that assumption. I have a PhD, taught college and now work as a researcher. My husband is the chief of surgery at a large hospital. Not exactly the Ephesians couple.

          • Elizabeth A

            You’ve mentioned the PhD a bunch of times. What’s your field? What did you teach? What do you research?

          • fiftyfifty1

            “It comes from people who would rather recommend formula than answer phone calls from mothers.”

            Please. I spend a lot of time on the phone and am glad to do it. And when I am concerned about a newborn’s feeding status, parents get my home phone number so they can reach me directly after hours if there is a problem. I also recommend formula when it is indicated: a baby inconsolable with hunger and/or an exhausted mom are both excellent indications.

          • techqueen333

            You are an n of one.
            Exhaustion passes once the growth spurt is over. Moms should understand what they are giving up so they can make informed decisions based on science instead of the emotion du jour.

          • fiftyfifty1

            Exhaustion is cumulative and has real health consequences. The mother as well as the baby are my patients. I’m not going to overlook the mother’s health because it is your personal opinion that she is making decisions on a whim. I thought that claiming that women can’t be trusted to make their own decisions because they are at the mercy of “emotion de jour” went out in the 1960s.

          • techqueen333

            Yet you are willing to withhold critical information from her because in your personal opinion a quick fix is better than a long term solution.
            In many situations, critical period is brief. Yet giving baby formula not only denies him/her the immunological and nutritional benefits of exclusive breastfeeding, it interferes with a system that is essentially supply and demand. Those supplemental bottles are often more of a problem than they are worth.

          • NoLongerCrunching

            Show me ONE study that shows health consequences to a little formula supplementation in a mostly breastfed baby. Adding formula may change the gut flora (which no one has shown to have any long term effect), but it does exactly squat to “deny him/her immunological and nutritional benefits” of the breastmilk he does get.

          • The Bofa on the Sofa

            Wait a minute. You claimed above that they were _pressured_ into giving formula. Now you say that it was just “formula was recommended during growth spurts”?

            Why were the mothers even talking to the doctors if they were happily breastfeeding? Was it because they had some concerns?

            Other examples include “helpful” HCP who insist mom should allow dad/mom2 to give relief bottle at night, etc

            …in response to mom complaining about being exhausted, of course.

            What a sleazeball you are. Seriously. You talk about dismissing concerns, but you have absolutely no concern about mothers in the least. You are absolutely as Dr Amy describes, a complete zealot.

          • techqueen333

            Multiple reasons. None of which have to do with health concerns.
            Sleazeball? The only thing you’ve done here is ridicule.

          • FormerPhysicist

            It *was* suggested to me to let my husband give the baby one bottle a day, starting around 6 weeks. I had no complaints about how breast-feeding was going.
            This was suggested along with “if you want your child to be willing to take a bottle at 3 or 4 months, it may be wise to introduce one fairly early.”

          • NoLongerCrunching

            Unless you were there, you don’t know whether it was pressure or just an option that was put out there.

          • techqueen333

            The mothers described it as pressure.

          • NoLongerCrunching

            I believe it. But I have seen enough situations to know that the HCPs themselves do not think they are pressuring, but rather trying to help the situation by presenting all options. What a patient hears is not always what was said.

          • techqueen333

            Yes, they were really getting enough milk.
            That comment about the joke while serious topics were discussed is crap. I do remember a Ka-Boom comment from the person with whom I was speaking at the time. You don’t get to dismiss me because you don’t like my attempt to lighten the situation.

          • Anj Fabian

            I find the giving sugar water instead of formula to be mostly a cost saving measure more than anything.

            The first two ingredients in formula are:
            water
            sugars.

            Formula IS sugar water, with additional nutrients.

          • techqueen333

            Yes, I am saying that my friends’ children were happily breastfeeding and HCP pushed formula.

          • Lizz

            What does pushing mean to you exactly? Is it a “here have a sample to take home just in case” or a ” their weight’s down a bit maybe a bottle would help” or are we talking about an honest to goodness and literal “you should be giving them formula right now”?
            To be honest I’ve seen to many people call having an ad up in the office or offering a sample just in case as pushing formula and neither really is.

      • Dr Kitty

        So, without any formal qualifications your husband or another Dr let you “work with” their patients?
        On a voluntary basis like a LLL leader?
        Was it a BF support group that met in a Dr’s office?
        Or were you paid?

        What made you give it up?

      • The Computer Ate My Nym

        So what is your PhD in? What was your thesis topic? Have you published in the field in the peer reviewed literature since?

        • techqueen333

          It doesn’t matter. I had two semesters of quant, one of qual, one of research design. I passed a qualifying exam and wrote a successful dissertation. I have been published in peer reviewed journals and am co author on several books.

          • The Computer Ate My Nym

            It does matter. If your PhD is in, say, ancient Greek literature or astrophysics, you are no more qualified than any other lay person to comment on medical issues.

  • I have a question for nikkilee and techqueen. Do either of you have any reaction to the situation with Jan Tritten and that poor dead baby? It is addressed in the two most recent posts. Have you even noticed things happening outside of lactivist land? Does it affect you at all?

    • Karen in SC

      Apparently not. They will keep their blinders on. What I find interesting is they have not really considered practicalities and the real world. It seems to be techqueen’s belief that low supply is rare and mothers that formula feed are lazy or have been misled. Not at all that for many families, FF is the BEST choice for so many reasons.

      And I say that as a mother who BF two babies for two years each. It’s not magic. It was just easier for me as I was able to be a stay at home parent.

      • techqueen333

        I worked with breastfeeding mothers for nine years in collaboration with my MD husband.
        Keep on deluding yourself that FF is best. It might be for practical reasons, but certainly not for health reasons. They are in no way equal.

        • Dr Kitty

          No…you’re right…
          If you have to return to your low wage job six weeks after the birth,your bosses won’t give you breaks to pump,and the choice is between FF and paying the bills or going on welfare, losing your home and having your kids go hungry.

          “Practical reasons” are in no way equal to a possible 3 point increase in IQ and a slightly reduced risk of allergies.

          • techqueen333

            In many states, employers are required to make accommodations for breastfeeding mothers. If you are working at a low wage job, I’m wondering how you are affording formula.
            There are more advantages to breastfeeding than what you list.

          • Dr Kitty

            And yet, somehow, most women in low paid jobs have done the maths for themselves and have made the choice to use formula.

            Which suggests that practically, it is the choice which works out best for them.

            BF is only free if you don’t count the extra calories and fluid for mum, or her time. If you have to take unpaid breaks to pump, it is going to cost a hell of a lot more than formula.

          • The Bofa on the Sofa

            And yet, somehow, most women in low paid jobs have done the maths for themselves and have made the choice to use formula.

            But see, this is the problem. YOU assume that women, even those in low paying jobs, have thought about the issue and made a careful decision. They are well aware of the breast is best message, but have made a decision based on their own circumstances.

            techqueen assumes that women are mindless morons and too stupid to actually consider it thoughtfully.

            Although she won’t admit it.

          • techqueen333

            I won’t admit it because it’s not true. I never said low income women were stupid morons. That is not what I think at all. What I do think is that you enjoy ridiculing people you don’t like, e.g. me.

          • techqueen333

            Your opinion. Most of the women I’ve met in low paid jobs (and that’s in the hundreds) FF because of cultural norms that communicated that BF was “nasty” or because they didn’t want to pump.

          • AlisonCummins

            How many reasons can you think of for an underpaid worker and mother not to be interested in dedicating hours a day to pumping?

          • Guestll

            Wow, classist, smug, and ignorant. Trifecta of lactivist drivel.

          • techqueen333

            Oh, please. Why don’t you actually say something instead of name calling. Nothing in your statement is even remotely true.

          • Young CC Prof

            Let me put it a bit more nicely. Have you ever asked an employer for a legally required accommodation that he didn’t want to provide? It’s a very ugly experience. Welcome to the back of the promotion line and the top of the shit list. And if your employer decides you are more trouble than you’re worth, even if you are inconvenient for a legally protected reason, he’ll look around until he finds a legal reason to fire you.

            Employment discrimination against women in general is a tiny fraction of what it was a generation or two ago. Discrimination against mothers, however, is still alive and well. And any attempt to judge the choices of other mothers, especially those in precarious economic situations, must take that into account.

          • techqueen333

            Young CC professor
            I am personally familiar with that situation. My daughter is a teacher in a large urban school system. In her state, employers are required to make accommodations for pumping, etc. Her principal did not want to do so. Fortunately, my daughter has the protection of the union, of being tenured, and having the support of parents. She has been able to pump at work without consequence. I can certainly appreciate what you are saying and know others aren’t so lucky. I feel compassion for those mothers. A focus of my activism (in addition to creating a culture that supports nursing) is actually focused on effecting change for mothers in the workplace, paid family leave, and affordable child care. Those are not exclusive.

          • Guestll

            Do you truly fail to understand how and why low income earners afford and avail themselves of formula? If so, that makes you ignorant, and that isn’t just name calling, it’s a statement of fact.

        • MLE

          Once again, WHO SAID FORMULA IS BEST? That’s right, no one. We are only stating that there are marginal advantages conferred by breast feeding but women who cannot or do not want to breast feed shouldn’t be wracked with guilt due to the exaggeration of formula’s perils from insensitive, callous, feeding martinets such as yourself.

          • perpetual lurker

            Dr. Kitty is absolutely right. Karen in SC did not say FF is best. She said when weighing circumstances, risks and benefits, for many families FF is best. Could it be that techqueen333 is using – duh duh duh – a straw man?

          • Karen in SC

            Thanks. I edited my original post to clarify my meaning.

          • techqueen333

            Did I say that Karen in SC said FF was best, perpetual lurker? No. Duh duh duh–a straw man?

          • techqueen333

            The advantages are not marginal. Women who cannot breastfeed, cannot. But, women who choose not to should be able to do so in the knowledge that they are denying their babies those advantages.
            No exaggeration of formula’s perils. They are well documented.
            Save me the ridicule…although I am impressed with your vocabulary…martinet…hmmm

        • MLE

          Not to mention that no one cares about your MD husband. It means exactly squat about your level of knowledge. Let your arguments stand or fall on their own.

          • LibrarianSarah

            You’d think that women have made enough strides in the past 60+ years that we wouldn’t have to glean on to our husbands accomplishments in order to try to give ourselves a heightened perceived status.

            Seriously no one gives a shit that your husbands an MD.

          • techqueen333

            Wow if that isn’t a red herring….
            My inclusion of his opinion has nothing to do with my leaning on his accomplishments. It’s another qualified voice.
            You don’t give a shit because he doesn’t agree with you.

          • Guestll

            No, we don’t give a shit because we don’t give a shit.

            He may be another voice, but it’s not him writing here.

            Your argument is either worthy of merit, or it isn’t.

          • techqueen333

            I don’t see what this personal attack contributes.

          • Guestll

            I’m not attacking you personally. I’m saying we don’t don’t give a shit that your husband’s an MD, because he isn’t the one posting, and your words either have value or they don’t, irrespective of your husband’s education.

            If I wanted to make this personal, I’d tell you that it’s because I listened to militant know-nothings like you that my daughter dropped from the 90th percentile into FTT, that I took Domperidone for 14 months in order to make enough milk to give my hungry child the bare minimum, that I tortured myself for not being good enough, because people like you and their bad science convinced me that formula would ruin her life. That would be making it personal.

          • techqueen333

            I’m truly sorry for your terrible experience. However, I didn’t do it to you and do not deserve to bear the brunt of your anger. Nor do I merit being included is your broad generalization called militant know nothings. Nor do I rely on bad science.

          • techqueen333

            You really enjoy saying shit, don’t you? Maybe you’d prefer to spend your time reading Rabelais or studying the mating habits of coprophagic beetles to posting here.

          • Susan

            TechQueen– I am also married to a highly educated professional. Not only would I not say ” he thinks so too” I resent it when people think I know X, Y , Z simply because I somehow through osmosis have his opinions or knowledge base. I don’t always share is opinions and though what we know overlaps a bit its far from the same knowledge base. I recommend you not say “my husband is a doctor and he thinks….” to bolster your position. If you want to talk about your experiences as the spouse of a doctor that’s valid, but using his opinion as a way to make your own seem more valid really accomplishes the opposite.

          • techqueen333

            I’m irritated by this false assumption. I am not saying that my husband is a doctor to bolster my opinion. I’m sharing his opinion along with mine.

          • LibrarianSarah

            I don’t give a shit because your husband’s degree (as well as your own) is a textbook red herring you massive hypocrite. It is completely irrelevant to the topic at hand. Arguments stand and fall on there own. And seeing that Young CC professor had to hold her hand and guide you thought the process of actually making an argument I think it is time for you to go back to school. Unfounded claims are not arguments. Copying and pasting abstracts is not an argument. Randomly posting logical fallacies is not an argument. Appeals to authority is not an argument.

            Go out and find what you feel is the best study that makes your point, link to it, and summarize what you think it says and why it supports your point. Then we can have a discussion on why we agree or disagree with you. If you can’t handle that gtfo and stop trying to have the last word.

          • techqueen333

            Nice vulgarity and name calling. In what ways does inability to control your anger and express yourself civilly moves this discussion forward?
            That wasn’t a red herring, dear. It was a direct response to a question put to me.
            Further, Young CC Professor guided me through NOTHING. I simply decided to take the time to respond to his/her question in a different way because she/he was civil and because I had more time that day.

          • techqueen333

            His voice is just as important as mine. Why should his vote be ignored just because he isn’t typing in the boxes?

          • KarenJJ

            Then he can post in here and argue with us. We can only go buy the words you write in here.

        • Karen in SC

          As my Chem Eng professor Dr. Grice told me many years ago:

          There’s the joke about the mathematician and engineer who find themselves in a room with a beautiful woman. She fluffs her hair and says, “Either one of you can have me–”

          She holds up her hand as they start to rush forward. “But to touch me, you have to go half the distance to me, then half the distance that’s left, then half the distance after that, and so on.”

          The mathematician throws his hands up and walks away because he knows he’ll never get there…but the engineer keeps going because he knows he’ll get close enough for practical purposes.

          You imply that formula is vastly inferior, even sub-human from the posts you’ve written. Probably most of the posters who replied have actually breastfed themselves (or their wives) but we don’t think that way. We believe formula is “close enough for practical purposes.”

          • techqueen333

            “Sub human?” I don’t think I said that.
            I do not agree that formula is close enough for practical purposes.

          • Karen in SC

            Well, I wrote that you “implied” it, not said it. And it’s my opinion that you are implying that formula is not fit for humans, ie sub-human.

        • Box of Salt

          techqueen333 “It might be for practical reasons”

          You HAVE to deal with the practical reasons.

          Exaggerating the “health reasons” beyond the truth cannot help families find solutions for the practical issues.

          • techqueen333

            No one is exaggerating the health reasons. I am all for trying to resolve the practical issues. I just prefer to resolve them without formula use, where possible.

        • LibrarianSarah

          “Keep on deluding yourself that FF is best”

          Now THAT techqueen333 is a strawman.

          • Young CC Prof

            Wish I could upvote this more than once. I’m a little tired of hearing every counterpoint inaccurately described as a straw man. Turning “breast milk is only slightly better” into “formula is better” is a prime example of a straw man. Completely changing someone’s argument in order to counter it more easily.

          • techqueen333

            I know what a straw man is, Young CC Prof. You are a cc prof (I’m assuming that stands for community college). I was a liberal arts college prof (16 years) and am now a researcher at a major university. I’d say there’s a good chance my vocabulary is at least as good as yours. In this case, I perceive that people responding to my posts here ARE consistently attempting to change my arguments in ways consistent with building straw men. Typically, they take one point, twist it and then build their argument. I read their response and say, “What? That’s not what I said!!!!”

        • Jocelyn

          “Keep on deluding yourself that FF is best. It might be for practical reasons, but certainly not for health reasons.”

          Techqueen333, due to medical conditions that I have, I am normally on a very limited diet. Recently we have discovered that my four-month old daughter has food allergies, and to continue breastfeeding I have had to cut almost everything out of my already very limited diet. Just in the past few weeks I have dropped almost six pounds (almost into the “underweight” category for my height) and it is very clear that I am not getting the nutrients that I need. For the time being, we have switched my daughter over to a formula that has entirely cleared up her allergies, including her thick, red, itchy, bleeding rash and her constipation.

          Tell me, which option was better for our health?

          • techqueen333

            For you to review your diet with a nutritionist. It is probable that you could have added things back in. You may not have eliminated the right thing.

            My daughter was allergic to cow’s milk, soy, and peanut in my diet. I lost a lot of weight by eliminating everything containing those things, but was able to work with a nutritionist to find substitutes.

            In this case, I was actually encouraged to continue nursing by the pediatrician. Her feeling was that even if they were able to find a formula she could tolerate, she might develop an allergy to that to. Then we would have been screwed. I (me personally) saw this happen many times during the nine years I worked with nursing moms. The mom would quit and then find out the baby couldn’t tolerate formula. Re-lactation is not easy…but had to be attempted in these cases.

            You might get lucky in your daughter’s case and you might not.

    • The Bofa on the Sofa

      They’ll just tell you to look it up

    • techqueen333

      I find the use of the word “lactivist” pejorative. It makes me not want to read your question.

      My first reaction to the Jan Tritten question here is that it’s a separate issue entirely. We were talking about breastfeeding. Do you assume that because you disagree with me on one issue that we will disagree on all issues related to birth and childcare?

      I’m not a fan of home births where they can be avoided (remote rural, emergency, etc). I say that even though (a) I am suspicious about the correlation between the huge jump in c-sections (which has remained high) and the malpractice crisis during the 70s and 80s, (b) though I disagree with certain hospital protocols and practices, (c) I’m aware of staph and other dangers in hospitals. I’m sure I will be flamed for each of those comments. My husband and I read the research, which shows some scary data re: mortality and other bad outcomes of home birth. We took into account concerns about regulation of midwifery (where is the accountability). We considered that despite fears about hospital germs, we knew the germs in our clean home (with pets) stood to be worse. We didn’t want the mess. I am also not convinced (not based on data, only my feelings and my knowledge of my children) that is was desirable or necessary for them to watch their mother give birth. We came to the conclusion that hospital births in birthing rooms would be safer, yet would address our desire for a certain type of setting.

      I am not intimately familiar with the specifics about the Tritten case. I only know two things: 1) she collaborated with other midwives on Facebook on a high risk the case and 2) her decision making ended in the unspeakable horror of a baby’s death. I think the birth should have occurred in the hospital where better monitoring and greater resources for dealing with emergencies are available. Any questions?

      Before you ask, I’ll anticipate your question about vaccinations. I am militantly pro vaccination. Again. I’ve read the research. Go ahead and flame me for it.

      • Flame? No way. Those are actually some pretty reasonable reactions. I’m surprised, given your posts here. Well, clearly you can indeed do some research. I don’t know what’s the deal with how incredibly off base your breastfeeding arguments are, but this an overall pretty reasonable response. Defensive, but that’s reasonable enough all things considered. Good for you, no sarcasm.

      • Young CC Prof

        Wow. You explained your reasoning, including your reasonable anxieties about hospital birth and why you chose it anyway. I am very impressed.

      • Susan

        Me too. Great explanation and reasonable!

    • nikkilee

      I have all I can do to deal with breastfeeding, already a hot topic. Going into another arena is too much for me.

      • Box of Salt

        nikkilee, “I have all I can do to deal with breastfeeding”

        Is this why you can’t acknowledge the gains already accomplished for breastfeeding?

        Honestly, you need to re-examine your goals, your attitudes, and your tactics.

        What exactly are you trying to accomplish? Mandatory breastfeeding for all women and babies, whether or not the mother is capable or desires to do so?

        If you goals are more nuanced, such as better support of breastfeeding for those who want to from both medical staff and the public, your arguments need to be more nuanced. You can’t continue recycling the same talking points from the previous century. Many of those are simply no longer accurate.

        You also need to step into the real world, and take a look at the real reasons women do not breastfeed, or stop breastfeeding earlier than you’d like. Why not focus your energy into lobbying the federal government for longer, paid maternity leaves which would allow breastfeeding women to continue past just a few weeks without fearing loss of income?

        The “breast is best” message is already here. What’s needed is better ways to implement it. None of them require exaggerating harms from formula nor inflicting guilt and punishment on women who use formula.

        • nikkilee

          I meant that I have a full plate educating people about breastfeeding so it becomes a cultural norm, so that women don’t have to hide when their infants need to eat outside the home, and so that families have all the information about feeding choices. As birth is another loaded political arena, I’ve chosen to pick my battles for my own comfort level; even though the consequences of labor and birth have an impact on breastfeeding.

          Industry does not give all the information about its product; industry actually derailed the HHS breastfeeding promotion campaign of 2003, because if the public knew all the information about the health risks of formula, they might not buy as much and industry needs profits.

          That ad campaign is discussed in detail in this article by the Washington Post; the article is well-referenced.

          http://www.washingtonpost.com/wp-dyn/content/article/2007/08/30/AR2007083002198.html

          • Captain Obvious

            You didn’t answer the question.

          • nikkilee

            What I am trying to accomplish is culture change.

          • Captain Obvious

            I think all women know breastfeeding is good. Weigh that to some people have difficulties, go back to work, husband wants to participate, etc etc , women decide what works for their situation. It doesn’t have to be the cultural norm.

          • Anj Fabian

            Women know that breastfeeding is good.
            Women know that formula feeding is good.

            It’s all good.

            The problem I have is when an activist or sanctimommy (It’s difficult to tell them apart, much like it’s difficult to tell a formula fed baby from a breastfed baby.) tell women that one of those choices is not good, or not good enough.

          • techqueen333

            But breastfeeding and formula feeding are not equal. It is intellectually dishonest to claim they are.

          • AlisonCummins

            Who said they were equal?

          • The Bofa on the Sofa

            Well, at least she’s backed off from the “quit saying formula is better” nonsense.

            It’s the same old problem we always see. “Formula is ok”

            “Stop saying formula is better than breast milk!!!!!!”

            It has to be the #1 strawman that comes up here, and techqueen fell right for it.

          • Dr Kitty

            Bollocks.
            The only people who need to support your choice to BF are you and your partner.

            Haters gonna hate. Ignore them.
            I BF my daughter until she was over a year. Locally les than 10% are breast feeding at 6months.My solution to the culture of FF being normal was not to GAF what anyone else thought about my choices.
            People might have given me funny looks, I couldn’t tell you, I wasn’t paying attention. Certainly no-one actually SAID anything to me, because most people aren’t assholes.

            If you are really, truly sure you are doing the right thing you don’t need other people to validate your choice, you just get on with it.

          • nikkilee

            Not everyone has the lovely GAF attitude you describe. When families are unsupportive, when employers and neighbors are negative, when hospital practices and healthcare staff derail breastfeeding out of ignorance, mothers lose confidence and/or have miserable experiences that lead to bailing out. Especially when it is a first breastfeeding experience; many women have never seen a breastfeeding relationship, and this also makes initiating that relationship difficult.

          • Young CC Prof

            “Many women have never seen a breastfeeding relationship, and this also makes initiating that relationship difficult.”

            In the USA in 2014? I can’t imagine that. I was breastfed. My younger brother was breastfed. I saw my cousins breastfed. Heck, I’ve seen women on the bus discreetly feeding their infants.

            This was a real problem in the 1970s, and possibly today in areas of the world. But I can’t begin to imagine that it’s a common problem now.

            Unsupportive employers? Absolutely. But neighbors? Relatives? I really doubt it happens much.

          • nikkilee

            It very much depends on the community where she lives. Not all states have laws protecting a baby’s right to eat wherever it is. Nowadays things like “Hooter Hiders” are sold, and women are still harassed for breastfeeding outside their home, even if they are wearing a blanket over their should. There was an incident in Victoria’s Secret recently, where a mother who had just purchased some bras asked to use a dressing room to nurse her baby and was asked to leave the store!

            http://www.today.com/moms/victorias-secret-store-bans-mom-breastfeeding-2D11968546

          • KarenJJ

            This stuff makes the news now. How often did that happen 40 years ago?

          • Irène Delse

            The telling point is that it’s uncommon enough to makes the news, and public opinion sides with the mother! Not exactly a cultural environment that discourages breastfeeding.

          • Dr Kitty

            My point is that it would be more effective to support these women by saying “ignore that nonsense! You keep doing what you feel is best and tell them to go to hell!” Rather than to try and “educate” everyone to be nice, or shaming women who decide that, actually BF isn’t best for them.

            No one “has” to use a nursing cover or feed in the car. It is YOUR response to the negativity that determines your actions, not the negativity itself. Indeed, sometimes there IS no negativity, and the woman pre-empts any possibility of it when, in fact, nobody would have given a damn if she had BF in that venue.

          • nikkilee

            Not all women have the psychological makeup, cultural background or learning style to do that.

          • Young CC Prof

            Guess what, if you have kids, people are going to disapprove of the way you raise them. If your two year old throws a tantrum in the store because you didn’t give him cookies, people are going to decide he lacks discipline. However he’s dressed, some people will think he’s too warm or too cold. Whatever you feed him, someone will think it’s unhealthy.

            You can’t please everybody, so what’s the big deal about a few people (and it is just a few) being unhappy with you breastfeeding?

          • Box of Salt

            nikikilee “What I am trying to accomplish is culture change”

            But that’s happened already. The culture changed. It’s not the 1970s – most people view breastfeeding as normal. Perhaps you are so focused on the pockets of resistance that you can’t see the forest for the trees. Have you failed to notice the Baby Friendly Hospital Initiative and New York City’s Latch On NYC?

            I’ll repeat what I posted before: get out into the real world, and find out why most women aren’t exclusively breastfeeding at 6 months. It’s not because you personally have not put enough effort into fearmongering about the evils of formula.

            The cultural pendulum has swung. Apparently, it hasn’t swung enough for *you.* But if you want to keep it swinging, you need to lay off pushing the extreme arguments, and find nuanced solutions to the more subtle problems.

          • nikkilee

            As someone who has worked in this arena for nearly 40 years, I must respectfully disagree with you. Yes, there are good changes coming. . .and still far to go.

            One challenge is that people sometimes take evidence about the risks of formula, and the benefits of breastfeeding to mothers, babies, families, and the environment as a personal attack.

            There has to be a big dose of kindness and respect introduced into this infant feeding discussion in our country. It is never about judgement, at least from me; it is about possibility and informed choice.

          • Young CC Prof

            When a mother has spent days or weeks doing everything possible to breastfeed her child, and ultimately has to admit it will never work, yes, lectures which exaggerate the benefits of breastfeeding and use words like “danger” to refer to formula feeding are attacks. There’s no kindness in humiliating a mother who is desperate to help her child.

            There are two ways in which I fundamentally disagree with you:

            1) After a thorough review of the literature, I believe there is no evidence for a link between infant breastfeeding and a significant difference health outcomes in adulthood. You believe otherwise.

            2) I believe that continuing to tell people that breast is best and formula is harmful is going to upset people without increasing the rate of breastfeeding. Most women already want to breastfeed.

            And as far as demonizing infant formula, remember that the perfect is the enemy of the good, and combination feeding is surely better that no breast milk at all. If combo feeders are alienated, will they give up on the breast entirely? Here’s another saying: You’ve got to meet people where they are if you want to help them get somewhere else. For many families, long exclusive BF just isn’t going to happen, and women who have smaller breastfeeding goals are still more likely to attain them if they have support.

          • nikkilee

            Evidence and belief are two different things. Did you review the thousands of studies and still feel confident refuting every single health organization’s recommendation in the world. Did you check out Table I in the Surgeon General’s Call to Action to support breastfeeding? Is there something behind all the governmental support for breastfeeding. Remember too that breastfeeding doesn’t make money for anyone, so there is no profit motive. Industry can not say that.

            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/

          • KarenJJ

            It makes money for lactation consultants.

            I do believe that there is something behind the government’s support for breastfeeding. What there is though is not compelling evidence for individual women to make a decision that they may feel will be detrimental to them in some way. People are going to weigh the risks and take into account their own circumstances.

          • nikkilee

            Few lactation consultants, unless they are working full time in a hospital, can make enough money to live. Whereas the infant formula industry made $3 billion in North America in 2010.

          • anion

            And I imagine the clerks at Babies R Us who sell tubs of formula aren’t getting rich, either. You can’t compare individual earnings to the profits of an entire industry. How much did all the lactation consultants and makers of supplements for breastfeeding moms and nursing bras and breast pads and nipple shields, etc. etc. combined earn in 2010?

          • nikkilee

            There is no comparison. Outside of hospitals, I don’t know a single lactation consultant in my region that is able to make a full-time living at this work. When one of us did, it was a major event in our community. Only hospital LCs get a regular salary. Being a lactation consultant in private practice is not a way to get rich!

          • Young CC Prof

            Check out how much nursing-product companies like Medela make before you conclude the motives of nursing advocates are untainted by corporate profit.

            And yes, I do feel comfortable in stating that the long term benefits for first-world infants are undetectable. The Surgeon General’s Call to Action is a tertiary source, and your link is essentially an exercise in pure mathematics which assumes a link between breastfeeding and heath outcomes, it doesn’t provide evidence.

            Have you read the actual original studies? Gone through the details and seen whether they were done well or poorly? Because so far I’m not seeing a lot of primary source material.

          • nikkilee

            What you are asking for is the condensation of all the evidence that I have been following for years. When I present summaries from leading health authorities, those are rejected. Go to a medical library and read all the studies yourself. Do you think that the Surgeon-General of the US is making this up, along with the AAP and the ABM? I offered a link to the governmental meta-analysis of the Maternal and Infant Benefits of Human Milk in Developed Countries, and that was rejected by folks on this list.

            All the medical documents I have submitted have enormous bibliographies. You are welcome to check all those studies. When the same findings emerge from lots and lots of studies, there is something to it.

          • Young CC Prof

            “All the medical documents I have submitted have enormous bibliographies.”

            That’s exactly the problem, ENORMOUS bibliographies. It would take hours for me to sort through all of the studies, many of which may be unavailable, and tell you the precise weaknesses of each one. Why don’t we pick ONE specific advantage and one or a few primary-source studies addressing it?

          • NoLongerCrunching

            May I suggest this HUGE meta-analysis focusing on developed countries?

            http://archive.ahrq.gov/clinic/tp/brfouttp.htm

          • nikkilee

            Because I don’t see the point of so much work. Your mind is made up. I suggest you create or join a journal club near you to discuss these things with other people. That’s a fun thing to do.

          • Young CC Prof

            OK, sure. But, even if you believe every single thing I say about breastfeeding is wrong, please do take one thing away from all this.

            Please remember what I’ve tried to explain about evidence. You seem like a great person, you’re very smart, but you seem to have some trouble with reading hardcore science. This is normal, almost everyone does who doesn’t have a relevant doctoral degree! It’s only because I respect you that I took the time to explain exactly where you were making mistakes.

            -Read the entire original study, not the abstract, not the rewrite in a magazine that was probably written by a reporter who didn’t understand it either.

            -Look for sample sizes, statistical significance, and p-values.

            -Publication dates matter. Something 20 years old isn’t a good source unless it’s still being actively cited and no significant work has been done since.

            -Confounding variables are a big problem. This one is a real challenge even for scientists.

            -Finally, what you’re doing is important, but don’t forget to enjoy the challenge.

          • nikkilee

            It is also important to look at the tables within studies, as there are often surprising findings that aren’t addressed in the body of the paper.

          • Expat

            Nickilee, a lot of people here have phds in various topics that make interpreting research easy. Many people here have looked at the research about breastfeeding and come to the same conclusion that Dr. Amy has made: there are significant benefits to preemies, but the benefits to term babies are small. IQ, obesity, diabetes, allergies, eczema. You will find studies that reach different conclusions on all of those topics, but a review of all of the studies, with an eye for confounders, shows a negligible benefit from breastfeeding compared to formula feeding for term babies. Negligible: so small as to be practically meaningless.
            I breastfed all 3 of my babies without problems, but i still found the hospital lactivist lectures obnoxious and annoying. A mom who can’t or doesn’t want to breastfeed shouldn’t have to be pestered like that.

          • anion

            So all these government agencies and health organizations recommend breastfeeding, but there’s “no support” for it?

          • Mishimoo

            Indeed! There is such little support for breastfeeding that over here, it’s required to be written on every single formula can/box of sachets in bright red letters that (paraphrased) “Breastmilk is best, consult your doctor before using this product.”

          • nikkilee

            Support depends on who she is and where she is and what resources she has. If a mother has private insurance, is aware that help is available, has that help within easy access in her community, and can afford it, then okay. The national goal is to make support (i.e. practical advice and encouragement) available to all women everywhere. Currently, that is not the case. Not all hospitals offer breastfeeding support or adequate support.

          • Box of Salt

            nikkilee,
            next time you edit your comment, could you please make a note of it as others do?

            The comment as it appears NOW, more than 5 hours I posted my reply directly below yours, is NOT the one to which I replied.

            You added two full paragraphs!

            I suppose I should be pleased that you are listening to my criticism, but rephrasing your argument after someone responds is dishonest.

            You could have replied to me instead of editing your earlier post.

          • nikkilee

            Thank you. I only just figured out how to reply directly when the background is completely black. I have to guess where the reply button is. I would rather reply somewhere than not at all.

          • anion

            The problem is that at some point, “wanting cultural change” means “wanting to make mothers do what I say whether they like it or not.”

            If a woman on the street is resistant to breastfeeding, it’s frankly lousy to insist that we as a culture should be pressuring her otherwise instead of assuming she has her reasons, and they are considered and legitimate.

            Frex, I had a friend who suffered severe, long-term sexual abuse. She’d worked with a therapist for years and was doing much better, but the thought of breastfeeding gave her traumatic flashbacks. More than once she was accosted in public by strangers who felt the need to lecture her on how she should be breastfeeding and how much better it was for the baby and how awful formula was. Those encounters left her in tears. You seem to be suggesting that the behavior of those busybodies was appropriate somehow, because we as a culture ought to be applying more pressure for women to breastfeed, and making mothers who do not feel even more abnormal. That’s a shameful and abhorrent idea. There is already plenty of cultural pressure to breastfeed.

            You can talk about wanting “ALL mothers to get the encouragement that they need,” until the hot air which fills you is expended, but what you mean is that you want ALL mothers to feed their babies in the way which you prefer, regardless of their feelings, and you want those who do not obey your dictates to feel alone and ashamed. and to be without support.

          • Young CC Prof

            “I meant that I have a full plate educating people about breastfeeding so
            it becomes a cultural norm, so that women don’t have to hide when their
            infants need to eat outside the home, and so that families have all the
            information about feeding choices.”

            I kind of think your job is done. Breastfeeding is a norm, the majority of new mothers at least try to breastfeed. Compare this to 40 years ago! Nursing in public is legal, and it’s socially acceptable almost every place where holding a baby is acceptable. (I wouldn’t nurse while driving, for example, but I wouldn’t hold my baby while driving either. I’d put him in the carseat.) Hospitals all have policies to support breastfeeding.

            The primary reasons that women don’t breastfeed NOW are physical difficulties of some kind or another, and the need to return to work quickly.

          • nikkilee

            Breastfeeding is not the norm.. . .yet. More babies get a sip of breastmilk in the hospital before going home, but exclusive breastfeeding rates at 6 months are only about 15%, when the Healthy People 2020 Goals seek 25%.

            The American Academy of Pediatrics is undermining breastfeeding on one hand, putting their logo on a formula discharge bag, while saying they support breastfeeding on the other hand.

            If a mother comes to the hospital and wants to bottle feed formula, 100% of moms get what they want. If a mother comes to the hospital and wants to breastfeeding, only 65% of moms (in my region), get what they want.

            We still have a long way to go when well-educated health care professionals insist that there are minimal benefits to breastfeeding!

          • Young CC Prof

            But how many women are still breastfeeding a few times a day at 6 months, even if breast milk is no longer the only food the infant has ever had? That might be a better measure of breastfeeding success.

            But the key question is WHY do women have trouble breastfeeding? When women want to breastfeed and fail, the solution is not to tell them over and over again why breastfeeding is good. This makes exhausted and emotionally vulnerable new mothers feel even worse and does nothing to increase breastfeeding.

            One piece of the solution is to make sure that women who have potentially solvable technical difficulties like bad latch have access to good, evidence-based advice. There’s so much breastfeeding advice out there, and it seems like half of it contradicts the other half. We need research on what really helps and guidelines to make sure that all LCs are practicing in an evidence-based manner.

            The other piece is paid maternity leave and other family friendly public polices, so that new parents are relieved of economic stress and can concentrate on being great parents rather than just getting by while they keep a roof over the family’s head.

          • nikkilee

            You nailed it!! Currently very few medical/nursing/nutrition programs teach students anything about breastfeeding. Support after hospital discharge is not available for every mother, and depends on many factors.

          • Young CC Prof

            Really? Because the lactation consultant who came to me in the hospital was utterly useless, but the evening shift nurse that day really helped us a lot.

            What I’d like is a study of different interventions and which result in more women attaining their own breastfeeding goals. That would really be awesome.

          • nikkilee

            Another professional embarrassment is when IBCLCs provide insensitive or unhelpful care. Breastfeeding help in hospitals is still very much about the luck of the draw, about who is working that shift.

          • techqueen333

            The last sentence of your post is obliterated. Please repost.

          • Young CC Prof

            The other piece is paid maternity leave and other family friendly public
            polices, so that new parents are relieved of economic stress and can
            concentrate on being great parents rather than just getting by while
            they keep a roof over the family’s head.

          • techqueen333

            I agree with this last paragraph completely. I believe there are good examples in countries like Australia. The USA where I am located claims to be family focused, but has few family-friendly policies. Paid maternity leave is either of short duration or non-existent (my daughter had to bank sick days for years before she and her husband could afford to have a baby).

          • KarenJJ

            Paid maternity leave helps (I’m Australian). Exclusive breastfeeding rates in Australia are not all that high because paediatricians advise introducing solids between 4-6 months. Most babies have already started solids by six months.

          • Box of Salt

            nikkilee,”exclusive breastfeeding rates at 6 months are only about 15%”

            When women have to return to work to support their families after only 6 or 12 weeks, most will not be exclusively breastfeeding at 6 months.

            If you want to increase exclusive breastfeeding for 6 months, your efforts are focused in the wrong place.

          • FormerPhysicist

            Exclusive breastfeeding rates at 6 months are crazy high, actually. What are the rates of breastfeeding (some, not necessarily exclusive) at 6 months?
            I bf my babies for years, but none of them were ‘exclusive’ at 6 months.

            Many infants are ready to start food earlier, and mothers are only guaranteed 12 unpaid weeks by FMLA (less after the birth if there are problems necessitating leave before the birth), and then only if the mothers are employed by a large company.

          • The Bofa on the Sofa

            Neither of our kids were exclusively breastfed at 6 mos. By then, my wife was back working part time.

            For my older, my wife couldn’t pump enough to keep up with feeding him EBM, so we did a mix of milk and formula.

            With my younger, he refused to take any breastmilk from a bottle. Not even 1 part in 10. We tried. So when he was in daycare, he was getting formula during the day 3 times a week, and then breastfed the rest.

            Now, what should have we done different? Should my wife not have gone back to work?

          • nikkilee

            You did the best in the situation you were in.

            It would be fabulous if maternity leave was paid and longer, as it is in many other countries.

            Another option is this: , although it is not possible for every work situation to permit the baby to come to work with mamma for a while.

          • The Bofa on the Sofa

            You did the best in the situation you were in.

            Why do you assume that everyone else is not doing similarly? They are all doing the best _for their own situation_?

            Actually, I provided our story to highlight an important point: it’s REAL easy to sit back and throw out vague potshots about how not enough women are breastfeeding. However, as soon as you get a real life example? Suddenly then, you back off and accept that, yeah, whether breastfeeding works or not depends on everyone’s personal situation.

            It’s just like the “too many c-section” nonsense. That’s really easy to say, but ask the question, who’s c-section should not have been done (without resorting to hindsight), and suddenly, that’s a lot harder.

            Why do you assume that women who choose not to breastfeed, or to supplement are not doing it because that is the best for their own situation?

            It would be fabulous if maternity leave was paid and longer

            Well, my wife has her own business, and therefore there is no one to give her “maternity leave,” unless you are going to propose that the government pay for it (and, if that is the case, the government is paying for EVERY post-partum woman). And she is out working with clients in different locations all the time, so “permit the baby to come to work with mama” is completely unwieldy.

            I absolutely support initiatives to support working mothers who are trying to breastfeed, but to think that is going to solve the problem in the lease is completely crazy.

          • resaurus

            It seems many aspects of women’s health care is stained with that kind of exceptionalism.

            “My C-section/abortion/formula feeding, etc. was necessary and justified in a way you could not possibly understand whereas *your* C-section/abortion/formula feeding, etc. was the result of…any number of individual vices, failings and shortcomings.”

            Seriously, we need to stop using women’s bodies as moral battlefields.

          • KarenJJ

            My work involves going into areas with high voltages. There is absolutely NO WAY I would take a baby in there. Substations and power stations are no places for babies.

          • techqueen333

            Breast pumps use voltage.

          • Young CC Prof

            That’s kind of a non sequitor. I’ve never heard of someone being electrocuted with a breast pump, and it doesn’t go on the baby in any case. She’s not concerned about some nebulous exposure, she’s concerned about accidental electrocution!

          • techqueen333

            I was being facetious. It is, after all, 3 a.m. here. Ironically, I am up with what is probably food poisoning.

          • Irène Delse

            In other terms, you’re throwing BS at random while pretending to have a conversation. Sorry for your food poisoning, but there’s got to be better ways to cope than spreading misery.

          • techqueen333

            I was not throwing BS at random. I was trying to lighten the conversation.

          • KarenJJ

            Yes they do. 12V. Not 330kV.

            *ka-BOOM*

          • The Bofa on the Sofa

            You know what?

            You just need to stop. You are so friggin ignorant about so much that you embarrass yourself.

            Best stay away from discussing topic that you know nothing about. The best answer would be, “Oh, I hadn’t thought about that. Sorry.”

            And then we can move on. But instead, you stick your ignorance out for everyone to see. It shows you a moron.

          • Guestll

            You…didn’t just say that.

          • Young CC Prof

            Yup. She did. And then tried to claim it was a joke. I don’t get it, so I suspect she didn’t get it either.

          • The Bofa on the Sofa

            Yeah. So even if it was really meant to be a joke, it went over very poorly, and my advice below stands: just stop.

          • techqueen333

            I have no motivation to take your advice. You haven’t impressed me as someone from whom I should take advice. You are at least as much of a bully as you accuse me of being.

          • techqueen333

            It was a joke. There was no trying to claim anything. Your suspicions are unfounded. I suspect you enjoy ridiculing someone with whom you disagree. Interesting, considering your insistence that those of us who support exclusive breastfeeding be tolerant of those with whom we disagree.

          • techqueen333

            Yes, I did. I was being facetious. I’m sorry that wasn’t obvious to you.

          • Guestll

            Well, considering the source and all…

          • techqueen333

            There’s nothing wrong with the source, Guest. I guess it’s just too tempting for you to take an opportunity to ridicule someone with whom you disagree.

          • Dr Kitty

            I worked in a paediatric ER when I returned to work.The place was full of babies, but I wouldn’t dream of taking my daughter there.

            I pumped when I could, but, funnily enough, a kid who’d been in a car accident or a suspected meningitis case took priority over my breast pump.

            I was working in the mist BF friendly, child friendly environment…but the job constraints meant that pumping was impossible some shifts.

          • nikkilee

            Yes, this is true for many healthcare workers. Physicians have high rates of breastfeeding initiation, and low rates of duration for that very reason, job constraints of scheduling and workload.

          • Box of Salt

            nikkilee, did you click on the “Babies at Work” link on that site you posted? Did you look at the lead photo?

          • nikkilee

            I went to the link and the home page looks like a bulletin board. Tell me what you mean.

          • Box of Salt

            nikkilee, click on the “Babies at Work” box on that bulletin board and tell me how the baby in the lead photo (top left) is likely to be fed.

            By the way, I will also point out that the bulletin board style home page does not exactly suggest an air of professionalism for those folks who are bringing their babies to work.

          • nikkilee

            I am curious about what you mean. Are you referring to the photographs of babies at work?

          • Poogles

            I believe Box of Salt is referring to the pictures that show the babies at work with Dad, rather than Mom – obviously those babies are going to be fed by bottle (whether those bottles contain formula or pumped milk).

          • nikkilee

            Thank you Poogles. My point is that bringing babies to work is a viable option in certain circumstances. Dad would be bottle feeding, yes. Although sometimes Mom can come to the workplace and breastfeed. Families are creative with exploring different ways to meet their goals. If mamma isn’t there, the baby will have to be bottle fed. What’s in the bottle will depend on the mother’s choice and circumstance. Some women use bottles of formula during the workday, and breastfeed whenever they are home with their babies. They can do this for years and it is their best option.

          • techqueen333

            That’s interesting Box of Salt. I know Carla Moquin of BaW and she is a major advocate for breastfeeding and of breastfeeding accommodations at work.

          • Playing Possum

            If only 65% of mothers ‘get what they want’, maybe there’s an unmodifiable reason why the other 35% don’t get it. Maybe there’s a trade off between underfed babies and diabolically stressed mothers. Maybe it’s not your place to make that decision for these mothers.

            All of the posters here will acknowledge the benefits of breast feeding. That isn’t under debate. Why won’t you acknowledge the benefits of formula feeding? The endless proselytizing from the ‘breast feeding at all costs’ has now led to formula feeding mothers feeling ashamed in public. Was that the goal? What does that achieve? It’s bad recruitment tactics for a start.

          • Irène Delse

            Or unrealistic goals? Because insisting on exclusive breastfeeding at all costs is counterproductive. It’s like the lactivists were looking for new battlegrounds after succeeding in making breastfeeding the norm after the 1970s!

          • nikkilee

            Babies have to be fed; if the mother is unwilling or unable to breastfeed and if there is no human milk available, then of course formula will be used.

            However, there are no health benefits to formula feeding for either mothers or babies. Industry knows that too. The challenge is that the public doesn’t know that as industry is keeping that information as hidden as possible.

            Industry has a history of hiding truth from the public. Think about the Ford Falcon and the Ford Pinto, both dangerous cars and it took industry years to admit it and take them off the market. Think about tobacco, and that it took 50 or 60 years before this cause of preventable death and illness was controlled.

            Most of the people who talk about the risks of formula are the breastfeeding helpers; not a good thing because it puts breastfeeding helpers in a poor light.

          • LibrarianSarah

            ” there are no health benefits to formula feeding for either mothers or babies”

            I’m sure not suffering from dehydration or death is a health benefit of formula for the baby. I’m also sure that being able to sleep at night because the baby isn’t crying all night in hunger is a health benefit for the mother. I am also sure that not falling into crippling poverty because mom can leave the baby with grandma and go to work is a heath benefit to both.

            And are you really comparing formula to tobacco and cars that explode? Really does your sanctimony know no bounds?

          • The Bofa on the Sofa

            This is the problem that we often encounter. It is always an issue of “what is the alternative”?

            As I noted below, for my wife to breastfeed, she could not have worked. Consequently, we would have to sell our house because we couldn’t afford the mortgage. You don’t think that such things have any health consequences? Especially long term?

            Losing our house would have a huge effect on our life, and that would absolutely have an effect on our children.

            As I say all the time, absolutely, all else being equal, breastfeeding is better than formula. But all things are never equal. What’s best for the child depends on everyone’s own circumstances.

            As I said above, it’s easy to throw out vague generalizations. But when it comes to specific cases? All of a sudden, it’s a lot harder to find gaps.

          • LibrarianSarah

            Exactly, I sometimes think that lactivists live in the “Leave it to Beaver” 1950esqe dreamland where poverty doesn’t exist, mothers don’t ever work or if they do they can quit as soon as baby arrives because hubby always make enough to support everyone, mothers always make adequate milk, is never on medication, never develops PPD or any other health problem that needs to be medicated, baby always latches perfectly, mommy never dies, adoption and foster care isn’t a thing and any other aspects that I have yet to think about off the top of my head.

            Only if all of those things are true could you honestly say that formula has no health benefits for mom and baby. I didn’t grow up in that universe so maybe I just don’t get it.

          • techqueen333

            Lactivist? What a tiresome cliché. No one is making any of the claims you outlined here. I can only conclude that your point was just to say something mean.
            No one ever said that in dire situations or where the mother isn’t there (adoption, death, surrogacy), formula shouldn’t be an option. No one said women shouldn’t work. Oh..and BTW, most stay at home1950s moms were bottle feeders. To be able to afford formula was seen as a sign of having made it.

          • Irène Delse

            You may add: babies are never allergic to human milk. One more instance of evolution by natural selection doing an imperfect job that leaves enough of a generation alive to perpetuate the species, but at the expense of the ones that die. Or would have died if clever people hadn’t developed adequate formula.

          • techqueen333

            Many people breastfeed and work. In many states the workplace is required to make accommodations for pumping, etc.

          • MLE

            This statement is so dismissive and ignorant, it’s staggering. I work from home for Pete’s sake, and it was incredibly time consuming and difficult to BF. There is no chance that it would have worked if I were going into the office every day. What a relief that my work environment saved the world from another dimwitted diarrhea sufferer!

          • The Bofa on the Sofa

            My wife pumped. It didn’t matter, as I explained.

          • techqueen333

            Librarian Sarah-Dehydration and starving are extreme conditions. No one is advocating for ignoring them. No one is advocating for denying a baby nutrition via formula once every effort to provide breastmilk, or in the case of a very short term situation, glucose solution, has been exhausted.

          • Box of Salt

            techqueen333 “No one is advocating for ignoring [dehydration and starving].”

            It’s a side effect of the extreme attitudes you are promoting.

            “No one is advocating for denying a baby nutrition via formula once every effort to provide breastmilk. . . .has been exhausted.”

            Exhausting every effort to provide breastmilk does in fact imply dehydration and starving.

          • techqueen333

            Rather than implying, you might just state what you mean.

          • Box of Salt

            techqueen333 “you might just state what you mean”

            This is what I mean: you have been posting from an extreme viewpoint, and your reply Librarian Sarah failed to back off that extreme.

          • techqueen333

            She asked a question. I answered it. I have experienced a similar situation. I described how I handled it and why. I’m sorry you see that as extreme.

          • Box of Salt

            techqueen333 “She asked a question. I answered it.”

            For the record, Librarian Sarah’s questions read:
            “And are you really comparing formula to tobacco and cars that explode? Really does your sanctimony know no bounds?”

            And you are right: by answering that you would exhaust all efforts at breastfeeding before using formula does in fact tell us that your sanctimony knows no bounds.

            My impression was you were going for a more moderate answer.

            Please re-read your own words, and try to think about why I find them extreme.

            And don’t forget that I’ve read your other comments on this thread.

          • techqueen333

            I think you find them extreme because they disagree with your point of view.

          • Young CC Prof

            But how long will exhausting those options take? A healthy newborn has about 3 days IF colostrum is flowing. Otherwise, or if the newborn has any health issues, hours.

            Plenty of women who wind up giving formula after nursing problems would have loved to keep trying, but just couldn’t let their baby suffer any longer, either because he WAS on the brink of dehydration or because he was constantly screaming with blood in his stool from food allergies she couldn’t identify after days on an elimination diet and working with multiple doctors.

          • LibrarianSarah

            You have to work on your reading comprehension. Nikkilee said that there was no health benefit to formula. I pointed out the most obvious health benefit, that it allows people to feed their children if they can’t make milk for whatever reason. In a world without formula, those babies would die.

          • techqueen333

            There’s nothing wrong with my reading comprehension. No one is suggesting babies be allowed to starve.

          • Stacy21629

            Except you just told me below that it would have been more baby to allow my daughter to starve.

          • techqueen333

            I most certainly never said you should let your baby starve.

          • nikkilee

            My only point is that industry does not tell the truth about its products, until so much harm has been generated that they are forced to do so. It doesn’t matter what the product is: pacemakers, cars, cigarettes, infant formula, or hip replacements.

          • The Bofa on the Sofa

            Industry does not tell the truth? You are just making this shit up.

            Jesus, when formula commercials are advertising “breast is best” it’s really hard to believe any nonsense about how they are not telling the truth.

          • Playing Possum

            Wow. You are comparing formula feeding to smoking? Are you suggesting that formula companies have evidence (beyond the giant, worldwide retrospective trial called the last 30 years of safe, appropriate formula) that formula is dangerous, yet are actively hiding it? Any credibility you once might have had just dissolves with that kind of ludicrous, untrue blather. You are the vocal, irrational minority that agitate for impossible goals, and then berate people for failing to achieve them. Babies need to be fed, full stop. What’s the point of ignoring a safe, available resource (formula), in favour of expensive, possibly infectious, (in the case of donor milk), possibly psychologically destructive or even unobtainable breast milk?

            Possum out. All I’m reading now is ‘teh conspiracies!! Big pHARMa!!11!!’

          • KarenJJ

            But when people raise reasons for not breastfeeding, people such as yourself judge these reasons as not good enough. It’s impossible to say anything in such a black and white argument such that you are presenting here. Many women have issues, such as sexual abuse, medication, work, personal reasons that they are not going to go into. Demonising formula the way you have been at it here weakens the message of breast is best because long term we can see that the results are marginal. It makes you appear untrustworthy. By all means support breastfeeding and breastfeeding mothers. You can do that without demonising formula to the extent that it has been here. It is a food source, it is not the same as a randomly exlpoding car or a known carcinogen. There is no reason to prefer an IV or sugar water over formula to help ease the hunger and distress of a healthy newborn.

          • techqueen333

            The results are not marginal. That is the statement that pisses me off so much. It’s simply not true for young babies.

            That latest WHO meta-analysis, the reference to which I can no longer find on this thread, focused on only four or five conditions. One of those Type II diabetes. Due to the limitations of the studies reviewed for the meta-analysis, this warrants further study. Another was obesity. I think there are differences in the components of breastmilk and formula that could influence obesity. This warrants additional longitudinal studies using reliable length of breastfeeding times. Still, I would think that dietary habits post weaning and genetic factors could override the benefit.

            For example, on the genetic factors: rs5082(C;C) is associated with increased Body Mass Index and food intake in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) Study. news Tufts University scientists said they discovered men and women carrying the CC genotype demonstrated higher body mass index scores and a higher incidence of obesity, but only if they consumed a diet high in saturated fat. Well, heck…

            I would also raise an eyebrow at the IQ studies. That is one area where I would definitely be looking out for the dreaded confounding factors. The one meta-analysis, I believe, mentioned the propensity of bf mothers to be more attuned to their babies or something like that..but that is something bottle feeders could learn to do better, if that is an issue.

            However, this meta-analysis does not review any studies of breast feeding and allergy, and of communicable disease. That’s where the gut environment issues come into play. There’s also the issue of otitis media. Actually, that meta-analysis accepts previous research that demonstrates the benefits re: these issues.

            I understand that there are issues of medication a mother can’t go without, inability to lactate, blah, blah blah. But for someone who can breastfeed who simply doesn’t want to…I’m sorry, but I’m not going to pat her on the back and tell her how glorious her choice is. I’m not going to go up and insult her, either.

            Your concern seems to be that mothers not be given false or exaggerated information. That is also my concern. I am frustrated that so many low income women are victims of cultural norms that tell them that breastfeeding is “nasty” or that ff is a sign of having “made it.” Aside from the health benefits for babies living in less than optimal conditions, the economic hit for ff is huge. In these situations, poor families struggle to buy expensive formula or the taxpayers foot the bill. The cultural paradigm needs to shift. Blog posts like Amy’s are detrimental to that cause.

          • Young CC Prof

            Thank you for a great post! THIS is how you argue on the Internet, and now we can have a great discussion!

            If you can’t read the whole post, click the “see more” button at the bottom.

            So yeah, we agree that the WHO meta-analysis found little evidence of a link between breastfeeding and certain chronic diseases. In fact, the authors concluded that the best studies found no link.

            Now, you’re right that the authors did not examine contagious diseases or allergies, and in fact the authors accept the contagious disease benefit flatly. For contagious diseases, yes, breastfeeding provides moderate risk reduction, but only up to age 1. After that, even if breastfeeding continues, it no longer supports the immune system, since the baby’s digestive system is now mature enough to digest the antibodies rather than absorbing them, and the baby is producing antibodies on his own.

            Allergies were not included in that meta-analysis at all as far as I can tell. The PROBIT study found no reduction in allergies among breastfed children. Still, we can discuss breastfeeding vs allergies if you want, it’s a legitimate question.

            As for the cost of formula, well, let me look it up. I see a 40-oz package of Target brand powder for $25. That’s almost 300 ounces prepared, which a 10-day supply, so $2.50 per day. A breastfeeding mother might easily consume an extra $2.50 in food every day! I’m not overwhelmed by the economic argument. (Yes, some infant formulas, especially the “convenient” single-serve ready to feed packages, are more expensive, but the cheapest option is pretty reasonable.)

          • fiftyfifty1

            The obesity issue is one that suffers greatly from confounding. In developed countries, rich people tend to be thinner than poor people. Poor people tend to formula feed.

            But when breast vs bottle was RANDOMIZED in the PROBIT study, it was found that overweight and obesity were more common in the BREASTFEEDING intervention group! This effect was apparent in infancy, and the most recent followup shows that it is still statistically significant at age 11. Over 20% more likely in the breastfeeding group at age 11.

          • NoLongerCrunching

            > I am frustrated that so many low income women are victims of cultural norms that tell them that breastfeeding is “nasty” or that ff is a sign of having “made it.” Aside from the health benefits for babies living in less than optimal conditions, the economic hit for ff is huge. In these situations, poor families struggle to buy expensive formula or the taxpayers foot the bill. The cultural paradigm needs to shift.

            I worked for WIC, and this is a gross misrepresentation of what is going on, at least in the community I worked in. These mothers are very well aware that breast is best (you’d have to live under a rock not to know that at this point), and very open to learning more about breastfeeding. However, breastfeeding exclusively for more than a few weeks is almost never a workable option, given the challenges facing these moms. Criticizing their use of formula is the worst way to support these moms.

          • ngozi

            “However, breastfeeding exclusively for more than a few weeks is almost never a workable option, given the challenges facing these moms.”

            Thank you, thank you, thank you. This is something that gets SO overlooked!!

            I’d just like to add that the WIC program also bends over backwards to help breastfeeding moms, even GIVING them an electric breast pump.

          • An Actual Attorney

            A lot of moms in higher SECs too. My mail carrier had a baby same time I did. She was back at work in 2 weeks because she didn’t have paid leave. Putting aside how physically demanding her job was for 2 weeks post birth, what was she supposed to do? Pump in the back of the truck?

            Or cops — bullet proof vests don’t come with boob room. OK, they should, but they don’t. So street cops have to choose between stopping BFing so their breasts will go back to what they were or BFing and not being able to work because they can’t wear a required uniform.

          • fiftyfifty1

            “However, there are no health benefits to formula feeding for either mothers or babies.”

            Really?

            Benefits to baby: reliable nutrition source, better source of Vitamin D and lower chance of rickets, better source of iron, much lower chance of dangerous levels of bilirubin, lower chance of re-hospitalization for dehydration with all that entails, protection against transference of communicable diseases such as HIV and CMV, can be given to those babies with metabolic abnormalities that preclude human milk.

            Benefits to mother: More sleep, decreased anxiety, avoidance of D-MER, no contraindication to any and all meds, reduced pain, improved dyspareunia, prevention of mastitis and breast abscesses

            And these are in addition to the economic benefits of returning to work–higher economic class is strongly associated with improved health outcomes.

            What is the healthiest for any individual baby and mother depends on that individual baby and mother. Health benefits that may be important in my case may not even be issues in yours. That’s okay! But to say that those health benefits don’t exist because they weren’t important to YOU, makes you seem selfish and out of touch.

          • KarenJJ

            I started looking at breastfeeding in a lot more detail when I was trying to decide on whether to take an important medication after the birth of my second child. If I didn’t take that medication I was at risk of damaging my hearing and eyesight. It was a risk I would take for a few months for important benefits for my child.
            It is critical that people are honest with the risks and benefits of breastfeeding because every woman is trying to weigh up her own set of risks and benefits that are important to her. For me, reading the risks and benefits meant that formula feeding was by far the optimal solution for my situation. If formula feeding really did lead to terribles outcomes, such as my baby randomly exploding due to a faulty fuel tank, I’d have done my best to try and breastfeed and not taken the medication.

          • nikkilee

            The iron in formula is an overdose as it is in a form that babies can’t easily metabolize; this is identified as one reason formula fed babies are at greater risk of infectious disease as the iron that isn’t metabolized stays in the gut and feeds pathogens. Mothers who choose not to breastfeed have greater chances for breast cancer, cardiovascular disease, and metabolic syndrome. Breastfeeding mothers get more sleep and a better quality of sleep than mothers who practice either mixed feeding or exclusive formula feeding. Dr. Kathleen Kendall-Tackett has published extensively on that topic. Her website is http://www.uppitysciencechick.com

            Formula-fed children have twice the risk of SIDS. That is something I wish that everyone knew.

            A mother who chooses to feed formula, after knowing about both sides of the feeding choice, deserves practical advice and encouragement to support her choice without hassle or further discussion.

            When I worked as a lactation consultant in several hospitals, I would go to see the formula feeding mothers. They were initially suspicious about why I was seeing them. I offered them suggestions about how to get through the drying up phase with the most comfort. Once they became aware that I wanted their comfort, then they relaxed and we could have conversations. I would ask them, “How did you know to make the decision you did about feeding your baby?” Many women would say things like, “I just didn’t like the idea of breastfeeding” or “I wanted to bottle-feed.” I never pushed; I was truly curious. The really interesting thing was that about half the mothers I saw chose to use formula out of ignorance. They thought the medicine they were given for pain after their cesarean section would harm their baby. Or they were concerned about smoking cigarettes and breastfeeding. They were making their decisions based on their beliefs about what was best for their babies. Awesome. However, once they learned that all the medicines they were taking were compatible with breastfeeding, or, that there were ways to breastfeed and reduce infant smoke exposure, some chose to change their minds.

          • Karen in SC

            Why do you even visit formula feeding mothers? Don’t think for a minute that most of those mothers won’t feel the guilt you are heaping on them with that “honest” question. That same question from a friend =/= to that question from an LACTATION consultant for pete’s sake. Let the nurses help her with drying up the milk.

            There are plenty of resources for pregnant women. And isn’t nicotine in breastmilk?

          • nikkilee

            Still better for a baby to be breastfed, even if she smokes tobacco.

            I visited every mother because every mother deserves care. The visits were always well received, once mothers got over the initial shock that a lactation consultant would visit them. We had good conversations. I asked if I could visit with them. They granted permission for me to sit with them; once in a while a mother would refuse my visit. That was fine too.

          • Karen in SC

            I did a quick PubMed and Google Scholar search. I found one study that concluded breastfeeding cancelled out negative effect from low SEC for mothers in that group. There was not description of how they reached this conclusion.

            In a second study where the method was described and actual data taken (including amount of nicotine in breastmilk) the conclusion follows:
            CONCLUSIONS. An acute episode of smoking by lactating mothers altered
            infants’ sleep/wake patterning. Perhaps concerns that
            their milk would taste like cigarettes and their
            infants’ sleep patterning would be disrupted would motivate lactating
            mothers
            to abstain from smoking and to breastfeed longer (Pediatrics , Breastfeeding and Smoking: Short-term Effects on Infant Feeding and Sleep, 2007)

          • techqueen333

            For the record, I do not agree with Nikkilee on this. Studies show that babies receive nicotine and other toxins from their smoking mothers through BF. Unfortunately, this means BF would be contraindicated unless the mother quits smoking.

          • me

            Except they are going to receive nicotine and other toxins anyway. Even if you don’t smoke in the baby’s physical presence, smoke clings to your clothes, hair, and skin. The baby will be exposed regardless. Even the “mainstream” organizations do not say smoking is contraindicated for bfing, only discouraged – the same way it is discouraged for all parents.

          • nikkilee

            AAP Rethinks Its Opinion

            In 2001, The American Academy of Pediatrics (AAP) changed its official position on smoking and breastfeeding. The change was attributed to new research findings, as well as to an overall effort at the AAP to encourage an increase in US breastfeeding rates. Additionally, the committee stated, the removal of nicotine from the list of drugs of abuse not compatible with breastfeeding may afford physicians and their patients a greater opportunity to discuss cigarette smoking because: “Pregnancy and lactation are the ideal occasions for physicians to urge cessation of smoking.”

            The AAP report explained why doctors should discuss breastfeeding with mothers who do not wish to stop, or cannot stop smoking:

            It is recognized that there are women who are unable to stop smoking cigarettes. One study reported that, among women who continue to smoke throughout breastfeeding, the incidence of acute respiratory illness is decreased among their infants, compared with infants of smoking mothers who are bottle fed. It may be that breastfeeding and smoking is less detrimental to the child than bottle feeding and smoking. The Committee on Drugs awaits more data on this issue.

            Previously, nicotine was on the list of contraindicated drugs of abuse during breastfeeding due to documented decreases in milk production and infant weight gain, infant respiratory illness, and transfer of nicotine and other compounds to the babies from the milk of mothers who smoke. The 2001 report, however, stated that the committee found no evidence to document whether the amount of nicotine that passes to the infant through a mother’s milk is harmful, and it awaits further study on that issue.

            Batstra L, Neeleman J, Hadders-Algra M. Can breast feeding modify the adverse effects of smoking during pregnancy on the child’s cognitive development? J Epidemiol Community Health 2003 Jun;57(6):403-4.

            In this study, researchers examined school results of 570 nine-year-old children who were born in a Dutch hospital between 1975 and 1978 and whose mothers smoked during the pregnancy. Per the researchers, “Our results indicate that negative effects of maternal smoking on children’s cognitive performance were limited to those who had not been breast fed.” The children who had not been breastfed had decreased cognitive performance compared to the children who were breastfed. The researchers suggested that breastmilk promoted brain development and helped to counteract the adverse effects of cigarette smoking during pregnancy.

            Of course it is better not to smoke. And if she smokes, she should keep 2nd and 3rd hand smke away from the baby. However, her baby will still be better off getting her milk than not.

            **************************************************************
            This next study found that nursing babies of mothers who smoked tobacco had levels of cadmium in their bodies. Cadmium is in the same group as mercury and zinc; it is toxic.

            For some reason,the researchers Luck and Nau went on to test cadmium levels in two formulas that were not identified by name in the study. They discovered that the cadmium levels were, much higher in formula and formula fed babies than they were in the breastfed babies.

            Cadmium was used to make formula white.

            Toxicol Lett. 1987 Apr;36(2):147-52.

            Cadmium concentrations in milk and blood of smoking mothers.

            Radisch B, Luck W, Nau H.

            Abstract

            Cadmium concentrations were measured by flameless atomic absorption spectrometry in blood and mature milk of 15 nonsmoking and 56 smoking mothers during the nursing period. Both blood and milk concentrations increased with increasing cigarette consumption. The median blood and milk concentrations in nonsmokers were 0.54 and 0.07 microgram/l, respectively; these values rose to 1.54 and 0.16 micrograms/l in blood and milk of mothers smoking more than 20 cigarettes per day. Milk concentrations of cadmium were approximately 10% of corresponding blood concentrations. The cadmium exposure of infants nursed by nonsmoking as well as by smoking mothers was far below the exposure of formula-fed infants or the provisional acceptable weekly intake level set by the WHO.

          • Young CC Prof

            “The iron in formula is an overdose as it is in a form that babies can’t
            easily metabolize; this is identified as one reason formula fed babies
            are at greater risk of infectious disease as the iron that isn’t
            metabolized stays in the gut and feeds pathogens.”

            That is absolutely biologically impossible. Everything you swallow is either digested and absorbed through the gut, or passed through the gut and defecated. When a child or pet swallows an inedible object, it comes out. (And if it doesn’t, it can cause bowel obstruction, which is a medical emergency.)

            Have you ever taken iron supplements? What happened? That’s right, your stools turned dark and possibly harder. (Don’t believe me, try it yourself.) The same thing happens to babies when the formula contains more iron than they need. The extra iron just comes out the other end a few hours later. That’s partly why bottle-fed babies have darker stools.

            And uppitysciencechick is not a source of anything. Does this person have any qualifications? I can’t tell.

            You really seem to struggle with basic biology and with what constitutes a reliable source.

            And as far as which medicines are compatible with breastfeeding, did you talk to a pediatrician? Many medicines are, but there are some that are definitely not.

          • The Bofa on the Sofa

            You really seem to struggle with basic biology and with what constitutes a reliable source.

            DIdn’t Dr Amy discover that she advertises herself as a “holistic lactation consultant”? Sounds par for the course…

          • AlisonCummins

            Actually, it’s true. There is excess iron in the gut temporarily as it’s on its way out, and it can be a problem in some circumstances.

            When refeeding malnourished people for instance, iron is the last nutrient to be introduced. If ferritin has dropped because of protein deficiency, gut flora will have an advantage over the gut itself in scavenging the iron. This can be a problem. As the individual’s protein requirements and stores are built up their anemia will cause them to produce very high quantities of ferritin giving the individual a relative advantage over the flora in scavenging the iron and it becomes safe to reintroduce.

            A healthy term infant is at very low risk for this effect. If an infant is considered to be at risk, then they should be given a low-iron formula.

          • Young CC Prof

            Interesting. I don’t think that’s what Nikkilee was thinking of, though. I think she’s one of those folks who believes that colon cleansing is a thing.

          • Box of Salt

            Young CC Prof re Uppity Science Chick. From her “paper” though the Mother’s Sleep Survey button:
            The Uppity Science Chick’s qualifications are listed as Ph.D., IBCLC, RLC, FAPA, and her survey has two other PhDs as coauthors. Yes, it’s a survey: “[For a full description of the study participants, see (Kendall-Tackett, Cong, & Hale, 2010).] http://www.clinicallactation.org/article. php?id=5&journal_id=1
            Sample Recruitment
            The sample was recruited via announcements and flyers distributed to WIC Breastfeeding Coordinators, U.S. State Breastfeeding Coalition Coordinators, Lactation Consultants and La Leche League Leaders. The investigators described the study and asked for assistance in recruiting mothers. Flyers and cards were distributed electronically and via hard copy, with a Web link for the survey. This survey was open to all mothers with babies 0-12 months of age, regardless of feeding method.”

            Yes, it’s just a survey!

            I don’t have the time to look into it any further right now.

          • nikkilee

            http://www.medicalnewstoday.com/articles/237248.php

            Dr. Kendall-Tackett is editor of several professional journals, and an international expert on sexual abuse survivors and breastfeeding, on postpartum depression, and on the role of inflammation in disease.

            A whole new medical text, Iron and Infection, cites hundreds of recent studies showing that excess iron in the body enables infections to flourish (Bullen JJ, Griffiths E. Iron and Infection New York: John Wiley & Sons, 1987.;Weinberg ED. Iron and susceptibility to infectious disease. Science 1974;184:952.;Weinberg ED. Iron and susceptibility to infectious disease. Science 1975;188:1038.).

            A good example of this occurred in California in 1979. There was an outbreak of 60 cases of infant botulism. Researchers compared breast-fed babies (receiving no supplemental iron) with babies fed iron-supplemented infant formula.

            The breast-fed babies all had milder cases of the disease and none died. The formula-fed babies all had severe cases of the disease and ten died. (Emory T. Iron and Your Health: Facts and Fallacies Boca Raton, FL: CRC Press, 1991).

          • NoLongerCrunching

            I’d love to know what you made of that article on the risks of co-sleeping I posted before. Here is is again just in case: http://m.bmjopen.bmj.com/content/3/5/e002299

            And this one, about how formula supplementation can increase breastfeeding:
            http://m.pediatrics.aappublications.org/content/early/2013/05/08/peds.2012-2809.abstract

          • nikkilee

            I’ve already posted Dr. Alison Steube’s critique of the formula supplementation study. As for bed-sharing, that’s another whole can of worms that I don’t want to get into. I have all I can do to discuss breastfeeding in this forum.

          • Young CC Prof

            25-40 years ago is recent? OK. And for the first one, why link to the news article rather than the original journal article?

            I’m a little tired of the breastfeeding debate, and I’m just trying to teach you how to do science at this point.

          • nikkilee

            Thanks.

          • anion

            Thank you for addressing that; it sounded utterly nonsensical to me. I pictured my stomach full of iron that’s been there since my infancy. Like chewing gum, perhaps.

          • AlisonCummins
          • NoLongerCrunching

            >Formula-fed children have twice the risk of SIDS. That is something I wish that everyone knew.

            Yes. Mothers deserve to know this before making a decision. However, bed sharing also increases the risk of SIDS; do you agree mothers should be aware of this as well?

            http://m.bmjopen.bmj.com/content/3/5/e002299

          • Mishimoo

            Yes, feeding every hour on the hour for the first week, and then every two hours for the next 4 months definitely contributed to my quality and quantity of sleep.

          • KarenJJ

            “Babies have to be fed; if the mother is unwilling or unable to breastfeed and if there is no human milk available, then of course formula will be used.”
            There is an enormous grey area between women being “unwilling or unable”. That you refuse to see this means it is incredibly difficult to have a reasonable discussion with you.

          • NoLongerCrunching

            >If only 65% of mothers ‘get what they want’, maybe there’s an unmodifiable reason why the other 35% don’t get it. Maybe there’s a trade off between underfed babies and diabolically stressed mothers. Maybe it’s not your place to make that decision for these mothers.

            Exactly this. I work with breastfeeding moms too…and sometimes judicious use of formula *saves* the breastfeeding relationship. A baby who is not getting enough breastmilk for whatever reason is not going to be vigorous enough to stimulate a full milk supply. A little formula and pumping can help them to go on to exclusively breastfeed. Would you say that mom “didn’t get what she wanted”?

          • Susan

            Maybe you still have that fight where you live. Here no… A mom who comes with a plan to formula feed is exceedingly rare. If that is her plan we question her on her reasons to be sure she doesn’t believe a myth about breastfeeding. I know for certain some women simply say they are planning to breastfeed who have no interest but don’t want to appear to be “bad mother” to staff. It’s far harder for a mom to ask for formula here, let alone recieve it, than you think. I agree with you breastfeeding needs to be socially acceptable everywhere. If you live in some odd regional pocket then great BUT don’t accomplish the positive by shaming formula feeders. It’s been done and it’s cruel and in my mind the shaming is done by meanspirited bullies who want to wrap themselves in self righteousness. It’s ugly and not good for moms or babies.

          • Captain Obvious

            So there are health risks with formula. There are health risks with food in general. Should we breast feed forever?

          • Susan

            What region do you live in? Here it’s the norm… It’s the formula feeders who feel they can’t feed their babies in public without being scolded.

          • nikkilee

            No mother should be scolded in public for how she feeds her baby.

  • ABCD

    Baby-friendliness and the “breast is best” rhetoric are not about the welfare of babies (and certainly not about the welfare of mothers.) This rhetoric is about controlling the behavior of women, especially mothers. Just as the anti-choice rhetoric is not about the welfare of fetuses, but about controlling women.

    • techqueen333

      That’s BS.

    • If it was about babies, there wouldn’t be any of this “iv feeding a baby is better than formula” insanity.

      • KarenJJ

        If it was about mothers it wouldn’t be about using an IV to solve feeding issues either.

        • anon13

          It seems to me that the long term medical solution for people of any age who aren’t able to eat via their mouths due to strokes or birth defects is not an IV. These patients are fitted with opening in their abdomens and fed an age appropriate formula.

          • AlisonCummins

            If the gut works, use it. If they can’t swallow then they’re tube fed, usually through the nose, usually something like the cans of Boost or Ensure you can buy at the drugstore. (That is, age-appropriate formula.)

            If the gut is temporarily not working they get parenteral nutrition which is a completely hydrolyzed solution of sugars, amino acids, electrolytes and so on, into a peripheral vein. The drip is slow because the solution irritates the vein. This method can only supply a relatively small portion of nutritional requirements. Getting adequate calories into a preemie this way is really hard. Different things have been tried including alcohol which has 7 kcal/g vs only 4 kcal/g for sugar.

            There is also total parenteral nutrition which is through a catheter into a central vein so that the solution is mixed quickly with a large quantity of blood in the heart. In theory this can be kept up indefinitely.

            Parenteral nutrition has a high rate of complications and is avoided whenever possible. If the gut works? Use it!

            If the goal of the IV is to nourish the baby so that it can quickly eliminate bilirubin, and not just rehydration, we’re talking parenteral nutrition. This is as artificial and risky as feeding gets. There is no imaginable way it can be construed as preferable to formula.

          • The Bofa on the Sofa

            The suggestion that one should resort to IV nutrients just to avoid formula is completely mind-boggling.

          • ngozi

            You took the words right out of my mouth.

          • anion

            “Doctor, I’m not producing any milk for my baby.”

            “Don’t worry, that’s what IVs are for!”

            “But wouldn’t formula–”

            “No, you don’t want that, formula is just a man-made mix of stuff. What we’ll intravenously feed your baby is a totally different man-made mix of stuff. Awesome, right?”

          • Young CC Prof

            Except that most infant formulas have MILK as the first ingredient. IV nutrients don’t have any natural ingredients!

          • techqueen333

            Straw man.

          • nikkilee

            Milk from cows, a different protein from human milk. Or juice from soybeans, that is not milk because it doesn’t contain lactose.

          • AlisonCummins

            1) IV solutions have no natural ingredients. Please explain why you think such a drastic medical intervention is necessary to treat straightforward hunger.

            2) The proteins in cow and human milk are not a perfect match, but they are very similar with different proportions of whey:casein. In formula the proportions are those of human milk.

          • nikkilee

            Formula is static; human milk is dynamic, always changing in composition with infant’s age, time of day of feed, beginning and end of feed.

          • AlisonCummins

            You haven’t explained why you believe a major medical intervention is needed to treat hunger in a child who can eat.

            When I address your protein claim, you ignore it and change your claim to an irrelevant one about dynamism. Please address your protein claim either by agreeing that you were wrong about it or by explaining why I am wrong.

            Regarding your new claim that formula is static:
            1) so is donor milk;
            2) there is no evidence that time-of-day variation in milk composition makes any difference to a child, and absolutely no reason at all to imagine that it could make any difference in the timespan we are talking about —a week or so out of a human’s life;
            3) that à mother’s M

          • AlisonCummins

            3) that the composition of a woman’s milk is different after a year of lactation has no bearing at all when we are talking about the timespan of a single week.

            Stick to the topic. The topic is a newborn whose mother’s milk hasn’t come in yet and what to do about the fact that it is starving.

          • nikkilee

            Feed the baby. The mother has milk: hand express and feed it to the baby. Keep the baby skin to skin so mother’s body will provide metabolic stabilization. If no milk from mamma, use donor milk.

          • fiftyfifty1

            “Keep the baby skin to skin so mother’s body will provide metabolic stabilization.”

            Metabolic stabilization can be attained by skin-to-skin contact?! Amazing! I can’t believe that this whole time I did not know that dehydration, hypernatremia, hypoglycemia, hyperuricemia, hyperbilirubinemia and other metabolic instabilities could be prevented by skin to skin! Too bad nobody passed that bit of wisdom onto people who starved during famines. Strip down and cuddle people!

          • nikkilee

            I thought we were talking about babies. Skin to skin care was first discovered as a way for premature infants to survive in countries, specifically Colombia, where there were no ICUs. First studied in the 70s, it is an intervention that has been the subject of hundreds of research studies. Skin to skin in the OR after cesarean section keeps babies warm, with excellent blood sugars. Skin to skin is used in more and more intensive care units around the world, in rich and in poor countries. At the Brigham Women’s and Children’s Hospital, the chief of OB Anesthesia has a whole protocol for a Gentle Cesarean birth that includes a transparent drape and immediate skin to skin care (if baby is medically stable). More hospitals and intensive care units are using skin to skin care after birth, and in recovery room because it is enormously effective, doesn’t increase nursing workload, and reduces pain in mothers and babies. Nurses report that mothers require less pain medication in recovery room when their babies are skin to skin. Skin to skin care is the closest thing to a magic wand.

          • fiftyfifty1

            Yet another example of you getting caught making unsupported exagerrated claims and then trying to change the subject. You claimed that skin-to-skin “provide[s] metabolic stabilization” and suggested it as a treatment for medical problems due to inadequate intake in the neonate. But really it does nothing at all for metabolic problems, dehydration or starvation- It merely keeps the baby warm. If skin-to-skin is your idea of “magic wand”, there’s going to be a lot of babies in serious trouble.

          • nikkilee

            Skin to skin care does far more than keep the baby warm. Here’s a power point presentation from the March of Dimes that gives a lovely overview of the evidence and benefits:

            http://www.pqcnc.org/documents/milkncccdoc/modctm/PQCNCClosetoMeStaffEducation060611.pdf

          • Young CC Prof

            The nurses actually asked me to do skin-on-skin with my son, who was borderline premature and very small. Why? Because they were worried that he might not be able to maintain his body temperature. Since he was breathing well, skin-on-skin kept him warm. Otherwise, they would have had to separate us to put him in a warming bed in the special-care nursery, and they didn’t want to do that.

            I looked through that document. It was intended for NICU staff caring for very sick and fragile newborns, and many of the benefits were psychological benefits for the parents. Now, having had a child in the NICU briefly, I can say that the parent’s emotional state can be very fragile and I much appreciated everything the staff did to support parents, including facilitating holding. However, that’s not really an issue for term babies.

            The direct benefits to the babies were regulation of body temperature and some improvement in breathing and heartbeat. Healthy babies regulate their breathing and heartbeat just fine with or without kangaroo care.

            In a poor country where incubators are unavailable, kangaroo care can save the lives of preemies, at least those who are able to breathe without machines. In the first world, it provides a boost to preemies and helps mother and child bond. I can remotely believe that it might help regulate blood sugar in a brand-new baby who has low blood sugar only because his body hasn’t quite adjusted to the outside.

            It’s not going to fix or even ameliorate lack of food.

          • nikkilee

            You and your baby received good care. The benefits of skin to skin care are for term babies as well; good things for babies don’t have a “use by” date on them. Term babies can have some challenge to adjustment after birth due to birth interventions (operative delivery, labor medications, induction). In addition, there is not one single study that supports taking a healthy term baby away from its mother after birth.

            Here’s a bibliography of most of the articles about kangaroo care/birth skin to skin. It is compiled by Dr. Susan Ludington, who has been a technical expert on the subject for the World Health Organization.

            http://www.skintoskincontact.com/susan-ludington.aspx

            Names for the interention vary from study to study. Skin to skin at birth is recommended by the American Academy of Pediatrics and also by the Academy of Breastfeeding Medicine.

            http://www.bfmed.org/Media/Files/Protocols/hypoglycemia.pdf

            http://www.bfmed.org/Media/Files/Protocols/Protocol_5.pdf

          • Young CC Prof

            But does it make up for lack of feeding?

            Also, you say “benefits of skin to skin care are for term babies as well; good things for babies don’t have a “use by” date on them.” I would say that needs evidence. For example, preemies often need lung surfactants, a special moist room-temperature oxygen cannula, and even mechanical ventilation. They need a very special sterilized environment. Are these things appropriate for most term babies? No, of course not. That would be silly. Just like antibiotics are good for a baby with a serious infection, but will do no good and possibly some harm in a healthy baby.

            So, a study that shows something is beneficial to preemies cannot necessarily be generalized to healthy full term babies. I’m not saying skin-on-skin is bad, it’s certainly a nice way to bond. But you can’t assume that it produces measurable health benefits in a term baby just because it helps a preemie.

            By the way, don’t be upset. I’m not fighting with you, I’m debating. You are an interesting person to communicate with.

          • nikkilee

            Thank you Young CC Prof. I enjoy this good debate.

            Benefits of skin to skin for term newborns are not generalized; they are measured. One example is the work done by Bystrova et al. who found that babies who had gone skin to skin at birth had better state regulation at 1 year of age.

            There is more in the study than made the abstract. The study was all about term infants.

            http://www.ncbi.nlm.nih.gov/pubmed/12725547

          • Young CC Prof

            The full article is behind a paywall, and the abstract only said that newborns kept skin-on-skin right after birth warmed up better than those kept on nursery cots. It also says that the difference in foot temperature disappeared within a few days.

            Can you quote a few lines from the full paper that referred to effects at 1 year?

          • nikkilee

            ABSTRACT: Background: A tradition of separation of the mother and baby after birth still
            persists in many parts of the world, including some parts of Russia, and often is combined
            with swaddling of the baby. The aim of this study was to evaluate and compare possible longterm
            effects on mother-infant interaction of practices used in the delivery and maternity wards,
            including practices relating to mother-infant closeness versus separation.

            Methods: A total of 176 mother-infant pairs were randomized into four experimental groups: Group I infants were placed skin-to-skin with their mothers after birth, and had rooming-in while in the maternity ward. Group II infants were dressed and placed in their mothers’ arms after birth, and roomed in with their mothers in the maternity ward. Group III infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group IV infants were kept
            in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal
            numbers of infants were either swaddled or dressed in baby clothes. Episodes of early suckling in the delivery ward were noted. The mother-infant interaction was videotaped according to the Parent-Child Early Relational Assessment (PCERA) 1 year after birth.

            Results: The practice of
            skin-to-skin contact, early suckling, or both during the first 2 hours after birth when compared
            with separation between the mothers and their infants positively affected the PCERA variables
            maternal sensitivity, infant’s self-regulation, and dyadic mutuality and reciprocity at 1 year
            after birth. The negative effect of a 2-hour separation after birth was not compensated for by the practice of rooming-in. These findings support the presence of a period after birth (the
            early “sensitive period”) during which close contact between mother and infant may induce
            long-term positive effect on mother-infant interaction. In addition, swaddling of the infant was found to decrease the mother’ s responsiveness to the infant, her ability for positive affective involvement with the infant, and the mutuality and reciprocity in the dyad.

            Conclusions: Skin-to-skin contact, for 25 to 120 minutes after birth, early suckling, or both positively influenced mother-infant interaction 1 year later when compared with routines involving separation of mother and infant. (BIRTH 36:2 June 2009)

            Key words: delivery ward practices, skin-to-skin contact, early suckling, early separation,
            swaddling, mother-child interaction, sensitive period

          • Dr Kitty

            Wow…you can’t see ANY possible flaws with that study?

            Can you quote the P values?
            Since we’re talking about less than 50 dyads in each group it would be great to see them.

            I assume all the births were normal, spontaneous vaginal deliveries with no neonatal illnesses or maternal complications?
            That rates of maternal postnatal depression in each group were mentioned and controlled for?

            Otherwise the “study” is less than useless.

          • Young CC Prof

            I agree with Dr. Kitty. The total sample size is 176, and now we’ve got 4 subgroups and multiple measures? Definitely I’d need to see some p-values. Also, I’d want to know how many endpoints the study initially had, how great the differences were, and whether these mothers expected to get their babies immediately after birth or not.

          • nikkilee

            You can find the study. Remember this is only one of many. Check out the bibliography.

          • Young CC Prof

            I found it was behind a paywall. Think of my questions as examples of the questions that need to be asked any time anyone reads a study…

          • nikkilee

            There are plenty of valid and reliable study designs that are not randomized clinical trials.

          • Young CC Prof

            True, but what does that have to do with my critique? I said that the sample size was too small.

          • Elizabeth A

            Skin to skin care is associated with good blood sugar levels, but there is no mechanism by which it affects blood sugar. Correlation is not causation.

            A baby that is well enough to be held skin to skin, with a mother who is well enough to hold the baby, will often be fine and nursing will often be initiated without problems, but if nursing isn’t going well, skin to skin won’t magically increase the baby’s blood sugar.

            Also, those studies on kangaroo care in developing nations? Those studies showed that, in cases where NICUs were so direly underequipped that most babies in them died, skin-to-skin improved survival rates to levels that would cause a first-world NICU to be burned to the ground by angry mobs.

            (My daughter spent her first 32 days of life in the NICU at Beth Isreal, smack in between BWH and Children’s, and part of the same hospital system. They are really damn clear on the benefits and limitations of kangaroo care. They were happy to have me hold my daughter, but they didn’t expect it to have any effect on her assorted medical problems, and they certainly didn’t see it as a substitute for feeding her.)

          • AlisonCummins

            If skin-to-skin can treat dehydration, hypernatremia, hypoglycemia, hyperuricemia,
            hyperbilirubinemia and other metabolic instabilities in infants, why wouldn’t it be able to rehydrate an adult?

          • Nikki Lee

            I have no idea. Skin to skin can’t rehydrate a baby. Skin to skin keeps babies in parasympathetic mode, calm and content so their stress hormones are at the lowest levels.

          • NoLongerCrunching

            You wont find any argument here on the value of colostrum and skin-to-skin. Nevertheless, hyponatremic dehydration is common among breastfed newborns. (http://m.pediatrics.aappublications.org/content/116/3/e343.full). We can try all we want (and we do in my hospital, yet it happens despite best efforts). In those cases where breastfeeding frequently is not enough, formula supplementation is the standard of care, because it is quite clear that whatever risks there may be, the risk of failing to do this is worse.

          • Nikki Lee

            Hypernatremic dehydration, physiologic jaundice, and excessive weight loss are symptoms of insufficient breastfeeding. You never find any analysis of the breastfeeding in these articles; no evaluates breastfeeding frequency or baby’s ability to transfer milk. Dr. Lawrence Gartner talks about “lack of breastfeeding jaundice.” One’s bilirubin goes up during starvation. Not fair to blame breastfeeding until a complete evaluation is done of the whole picture.

          • AlisonCummins

            You’re trying to evaluate the whole picture while an infant is starving. What are you going to do for the infant while you try to figure out whether or not milk production can be improved?

          • Nikki Lee

            Feed the baby. Best is to prevent the situation in the first place; easy enough to do.

          • NoLongerCrunching

            Did you read the article? The authors state that 16% of breastfed infants born to primiparous women had weight loss exceeding 10% by day 3, despite education and support provided by a lactation consultant. You can quibble about whether that LC was an IBCLC or other details, but my point is that this is happening, despite the increasing breastfeeding education being done in most US hospitals.

            So we can do more of the same, with more babies being readmitted for dehydration, thus disrupting the mother-baby pair, or we can accept it and prevent it with careful use of formula supplementation. Donor milk is not usually available. We live in the real world, not in a magical world where breastfeeding always works out perfectly with no glitches and copious donor milk is available.

          • Nikki Lee

            The abstract doesn’t give any evaluation of breastfeeding. We aim for the best in our care. Most US hospitals are not on board with best practices to support breastfeeding; this is measured in the CDC’s mPINC biennial mPINC survey (maternity practices in infant nutrition and care.)

            http://www.cdc.gov/breastfeeding/pdf/mPINC/Maternity_Care_Practices.pdf

          • NoLongerCrunching

            Um…you do know you need to read the whole paper to have any clue about the findings, right?

          • AlisonCummins

            You propose skin-to-skin as superior to formula for starving babies whose mothers’ milk hasn’t come in yet or is coming in too slowly.

            That sounds awfully like you think skin-to-skin can rehydrate an infant.

          • AlisonCummins

            No, the mother does NOT have milk. We are talking about the example where HER MILK HAS NOT COME IN YET. The baby is hungry, dehydrating and starting to develop jaundice.

            Skin-to-skin does not feed the baby, rehydrate the baby or clear bilirubin.

          • Nikki Lee

            Mothers start making milk in pregnancy, as long as they have breasts. (I am thinking about breast cancer survivors who may become pregnant, and who may lack one or both breasts.) The term “milk coming in” is a misleading misnomer and refers to milk volume increase that occurs when hormones shift after complete delivery of the placenta. I would personally like to stamp out that phrase.

          • nikkilee

            Sometimes a baby’s blood sugar is so low that IV supplementation is used because it quickly raises blood sugar levels. This is especially important if the baby is symptomatic.

            Some parents will choose this option for a transient condition.

          • fiftyfifty1

            “Some parents will choose this option for a transient condition.”

            Yes, parents who have been misinformed by the likes of you.

            If the gut works, use it.

          • techqueen333

            No, parents who don’t want their baby’s gut environment compromised by cow’s milk or soy formula. The mother can pump in-between feeds and the iv, if actually needed, should be very short term. The formula shoved down my grandson’s throat was totally unnecessary. My daughter was able to pump and did so after the incident. However, she wasn’t even asked!!! The nurse just happily informed her she had given the baby formula. Awful.

          • AlisonCummins

            We aren’t talking about blood sugar, we’re talking about clearing bilirubin.

            I cannot imagine an MD going along with this option for a healthy infant who could suck.

          • The Bofa on the Sofa

            But this is total red-herring.

            For example, if that were the case, then we have to completely reassess your idiotic claim that donor milk should be used for non-preemies. In fact, it calls into the question of using donor milk for preemies, since, because lactation is so dynamic, then you have to insist that the only donors for preemies are those with preemies, because as their babies progress, their dynamic milk production will have progressed past the preemie stage.

            Similarly, if dynamic ability is so critical, then any donor milk that you advocate for newborns can only be given by newborns.

            Jeez, you think there is a short supply of donor milk now, imagine if we had to restrict donors to those with newborns?

            So here’s the problem: if the dynamic changes with breastmilk are truly critical, then you can’t accept milk from the mother of a 2 mo old for a newborn. Shit, you went on about time of day mattering even. If that really matters, are you screening donor milk for the time of day that it was expressed?

            Because you can’t claim that the dynamic properties of breastmilk are important while at the same time, dismissing it for donors with an excuse “but any breastmilk is good enough.”

            Is the dynamic makeup of breastmilk important? Or is it not? And if it’s not, why bring it up, if other than to change the topic?

          • nikkilee

            Some milk banks in the country do organize milk by the age of the donor’s baby, so there is a choice of premie or full term milk. Many milk banks will not accept milk from a donor whose baby is more than a year old. Human milk, even when cultured, pooled, pasteurized, and frozen is always best for babies. While some factors disappear (like the lipases) most are still present; and it is still species specific protein.

          • The Bofa on the Sofa

            Do you approve of giving a preemie donor milk from the mother of a non-preemie?

            Do you approve of giving a newborn donor milk from the mother of a 4 mo old?

            If yes, then your “dynamic milk supply” argument just got tossed out the window.

          • nikkilee

            Two things can be true at once. Human milk composition during breastfeeding is dynamic, changing during the feed, during the time of day, and during the duration of breastfeeding. And human milk, regardless of the age of the donor’s baby, is better for premature infants and newborns than formula because of the protein specificity, immune system boosters, and all its’ other components.

          • AlisonCummins

            If the dynamism of human milk composition is irrelevant to the discussion of what to do for a two-to-three day old baby whose mother’s milk has not come in yet, then just don’t bring it up.

          • AlisonCummins

            The question is not whether human milk is best, the question is what to do in the specific case when it is UNAVAILABLE.

          • AlisonCummins

            We’re still waiting for your reply to Bofa on the Sofa explaining the effects of formula on “the infants gut environment.”

          • nikkilee

            An exclusively breastfed baby’s gut is more acidic than the formula fed baby. Balmer and Bullen in Australia found that gut pH had not returned to physiologic levels by 6 weeks after a baby had ingested 1 ounce of formula every day in the hospital.

            Breastfed babies have guts that grow lactobacillus and bifidus bacteria that are not dominant in the formula-fed babies.

            “Moreover anaerobic bacteria detected by molecular biology have shown that the 2 types of feeding cause differences in gut flora composition never before suspected.” (“Postnatal Development of Intestinal Microflora as Influenced by Infant Nutrition” Lorenzo Morelli
            J. Nutr. September 2008 vol. 138 no. 9 1791S-1795SJ

            Altered gut pH is one reason that babies, especially premature infants develop Systemic Inflammatory Response Syndrome. Another reason to give nothing but human milk to premature infants. But why would the value of human milk for the gut stop once a baby has reached its due date?

            “Indeed, formula-feeding induces intestinal hypertrophy and accelerates maturation of hydrolysis capacities; it increases intestinal permeability and bacterial translocation.”

            Nutr Res Rev. 2010 Jun;23(1):23-36. Epub 2010 May 10.
            “Breast- v. formula-feeding: impacts on the digestive tract and immediate and long-term health effects.”

            Just a few of many, many such studies showing how feeding method changes the infant gut.

            Cesarean section also alters the infant gut microbiome, as the newborn becomes colonized with the flora of the operating room staff who handle the baby, instead of being colonized with its mother’s flora. Some researchers and physicians suspect this explains why babies born surgically (NOT all babies, and not yours. . .but in a large sample, most), have more allergies.

            This is a whole new area of exploding research and is why giving probiotics is recognized in pediatric journals as a treatment for colic.

          • KarenJJ

            Systemic Inflammatory Response Syndrome? What is this?

            I have a genetic auto-inflammatory syndrome and I have to say that although the chronic inflammation has done a fair bit of damage it sure beats starving. But I don’t see many kids suffering stresses from chronic inflammation and nor did my attempt at breastfeeding my first save her from the effects of chronic inflammation from inheriting the same syndrome.

            So how can you extrapolate from Systemic Inflammatory Response Syndrome and make it meaningful to the rest of the population? In what way does it affect healthy infants?

          • nikkilee

            “Systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body, frequently a response of the immune system to infection, but not necessarily so. It is related to sepsis, a condition in which individuals meet criteria for SIRS and have a known infection.

            It is the body’s response to an infectious or noninfectious insult. Although the definition of SIRS refers to it as an “inflammatory” response, it actually has pro- and anti-inflammatory components.”

            In infants, it can trigger necrotizing enterocolitis, a potentially fatal condition. Formula feeding exposure can have the consequence of colonization of pathogenic bacteria.

            “Figure 4-3 shows some of the measures that might be used to prevent NEC. The safest and most efficacious practices in the prevention of NEC include maternal breastfeeding, judicious advancement of enteral feedings, and careful infection control measures.”

            From the

            ‘Prematurity, Necrotizing Enterocolitis, and Systemic Inflammatory Response Syndrome’ chapter in:
            Gastroenterology and Nutrition: Neonatology Questions and Controversies
            by Josef Neu

            I have heard Dr. Paula Meier, from the NICU at Rush Hospital in Chicago talk about this at a conference. She said that SIRS can trigger NEC, diabetes and Crohn’s disease. I know about this only because I am called on to defend the role of human milk in the Intensive Care Nursery as part of my work.

          • KarenJJ

            So a good reason for premature babies to have access to breastmilk. Little reason to recommend feeding via IV for a healthy term infant that is starving and not getting enough breast milk.

          • Young CC Prof

            Um, yeah. We all know that breast milk reduces the risk of NEC in preemies. The original post states it and every person on this thread agrees.

            NEC doesn’t generally show up in term infants. Hence, we believe that the very limited and inadequate supply of donor milk should be for preemies first.

            And who are these people fighting you on human milk? Are you sure you aren’t tilting at windmills? I think most of the hospital staff want every baby to get breast milk if possible, though they might have slightly stricter definitions of possible.

          • nikkilee

            You are right, although not all hospital staff are on board yet. From what I have read on this blog, the people fighting human milk are here.

          • KarenJJ

            I will and have stood up for the right for women to breastfeed in my workplace.

            I will and have stood up for women that are being told falsehoods, exaggerations and moralising tales about breastfeeding. You are boxing at shadows here, tilting at windmills.

          • techqueen333

            Your statement that women are being told falsehoods and exaggerations is a false premise.
            Nice metaphors, BTW, but they don’t add much.

          • AlisonCummins

            I haven’t seen anyone fight human milk. I’ve seen people ask what you propose to do about a child who is starving whose mother’s milk has not yet come in. If the mother had milk we wouldn’t be having this conversation, but she doesn’t.

            Nobody is saying that donor milk is bad in this circumstance. They are saying it is unavailable because preemies need it more. “Bad” and “good but unavailable” are two very different concepts.

          • techqueen333

            Who said anything about kids starving? Talk about hyperbole. Wow..
            Why don’t you do a study?

          • KarenJJ

            I’m not a medical professional. My newborn baby took 6 weeks to get back to her birth weight. That isn’t hyperbole.

          • techqueen333

            That’s one case. I don’t know what kept you from lactating or if it was a case of sabotage. It’s not the norm (not to be able to produce an adequate supply).

          • Durango

            Why do your anecdotes count but others’ don’t?

          • techqueen333

            I don’t think my anecdotes count as research. I was damned earlier for not showing any personal knowledge.

          • The Bofa on the Sofa

            Where are your “studies” for your assertion above that “formula is the panacea for everything”?

          • Durango

            No one here counts their anecdotes as research either, but you blithely dismiss them all while thinking yours are important. You have been challenged because you keep making unsupported statements with a single anecdote-laden post and a few abstracts. Though you want us to believe you simply because you have a phd and you’re married to a doctor, you’re argument style has been exactly the same as a completely ignorant, unschooled person (who could easily go to any pro-breast feeding site, copy the abstracts found there and paste them here, then claim they support your argument). Your credentials don’t matter (and who counts their spouse’s credentials??), how/what you claim does.

          • techqueen333

            I’m not counting anecdotes as research. That’s the difference.
            I’m not sure why it took six weeks for KarenJJs baby to regain her birth weight. She didn’t say.

          • fiftyfifty1

            No, it’s not “the norm”, but it’s a common enough problem that it needs to be taken seriously. If you went to your doctor and he or she said “well your thyroid tests are really low, so that could explain all your symptoms, but having low thyroid is not “the norm” so I’ll dismiss these findings” how would you feel? Insufficient milk production has approximately the same prevalence as hypothyroidism: About 1% making almost none at all and 10% making some, but not enough for optimal health.

          • Young CC Prof

            And what bad LCs don’t understand is that the prevalence of primary insufficiency is generally HIGHER in the population of women who seek help with lactation. Now, I’m sure many clients have lots of milk and are just struggling with things like latch issues, but quite a few have genuine supply problems.

            Just like the population of people who are tested for thyroid issues due to symptoms are more likely to actually have thyroid issues than someone getting a blood test as part of a routine physical.

          • fiftyfifty1

            Exactly. It’s the concept of pre-test probability. Women who make plenty of milk don’t make appointments with the LC due to low milk. It’s the bottom 20% who do. Some of those can be helped by ensuring proper technique, frequent feeding, pumping and other measures. But a large percentage medically CAN NEVER, and WILL NEVER produce enough milk no matter what measures are used and MUST give formula.

            It’s as if an endocrinologist said “Hypothyroid is less that 1% of the population! How can half the people on my schedule today be here for low thyroid? They must all be hysterical hypochondriacs! Tell them to make sure to eat plenty of seafood and used iodinized salt and send them all home!”

          • Young CC Prof

            While in fact nearly half of the endocrinologist’s workload IS thyroid problems. The other nearly half is diabetes, with the occasional other very interesting case thrown in.

          • AlisonCummins

            Sabotage???

          • AlisonCummins

            Starving is exactly the example we are discussing. Baby was born two or three days ago. Milk still hasn’t come in. Baby is screaming with hunger, dehydrated, hypoglycemic and becoming jaundiced.

            Wnat are you going to do? Donor milk is not available to healthy term infants because it is reserved for preemies. Parenteral nutrition is far too risky.

          • techqueen333

            Where did you come up with this example? Most women’s milk takes two or three days to come in. Until then, babies get colostrum.

          • fiftyfifty1

            ” But why would the value of human milk for the gut stop once a baby has reached its due date?”

            By that logic, all of us, including adults, should insist on being 100% breastfed.

          • techqueen333

            No, it doesn’t. And, we are talking about newborns here. Read the literature.

          • fiftyfifty1

            I’ve read the literature and come to the same conclusion as Dr. Amy: Breastmilk has significant benefits for small preemies, but it has only marginal benefits for the term neonate.

            (Hey I *wish* breastmilk really was a magic wand like you seem to think. When my first was born, the only breastfeeding studies available at the time showed correlations with better outcomes.I knew they were all poor quality and observational, and suspected the good outcomes were due to confounding, but I decided on breastfeeding anyway, just in case. As luck would have it, my son had a very abnormal suck, which triggered a series of events that gave me crush-injury raynauds and a number of other problems. So I ended up pumping. To keep my supply up I had to do it for 30 minutes, every 3 hours round the clock. I did this for an entire year. It was torture. And then the randomized Belarus PROBIT study came out confirming that breastmilk has only minimal benefits in the term newborn. What a waste! I really regret sacrificing what I did to provide that milk. It was not worth it. Breastmilk is food, not magic. Formula is food, not liquid-devil.)

          • techqueen333

            Better go back to the literature. Obviously, you’ve cherry-picked just like Amy. Formula is food, but it’s inferior food for situations where breastfeeding isn’t possible. It should not be considered an equal choice. Kind of like when you feed your kids spaghetti-os instead of a nutritious, healthy meal.

          • fiftyfifty1

            No, it’s not cherry picking, it’s simply giving more weight to large, well designed, randomized, controlled studies rather than poorly designed, small observational studies subject to confounding. It’s the same reason that when my female patients ask for my opinion on post-menopausal hormone replacement, I base my opinion on the findings from the Women’s Health Initiative study rather than on all the hundreds of observational studies that came before that found that hormone replacement was associated with superior outcomes.

          • Playing Possum

            But doesn’t an unfed gut cause increased mucosal permeability and increased infectious complications? IIRC delayed feeding is suggested to be one of the inciting factors for NEC, and certainly early enteral feeding of appropriate composition is pushed in all at groups. The choice of colonising bacteria is of somewhat less importance than a serious illness.

            And don’t gastrointestinal flora shift to a household level after a period? So everyone has everyone else’s? So … eventually the baby will end up with the same or a similar clone?

          • nikkilee

            It doesn’t seem to work that way; the initial colonization seems to prime the gut. Risk factors for NEC include prematurity, blood transfusions, and formula feeding. A small dose, 1cc, is called a ‘trophic feed’ and will be given to a premature baby to help mature the gut. The way the research is heading seems to point that the choice of colonising bacteria leads to the subsequent illness. However, this area of study is developing and we will know more as time goes on.

          • Playing Possum

            Ok, so what’s worse? We are all in agreement that premature babies benefit from the most from human breast milk and rationing of this resource. So in a term, otherwise completely well neonate, what is the worse option? Increasing the short term risk of potentially catastrophic complications from starvation and using only IV, or feeding them formula and increasing the risk of long term allergic (and unpredictable, nebulous) consequences.

          • nikkilee

            Give them human milk; from companies like Prolacta and Medolac, from donor milk banks, and from informal sharing networks like Eats on Feets or HM4HB.

          • Young CC Prof

            Informal milk sharing isn’t safe, and how many times have we said the milk banks don’t have enough? Is this why you run into problems at work, because you want donor milk for every baby not being breastfed and other folks tell you that’s impossible? Guess what, it’s impossible.

          • nikkilee

            Informal sharing, when done responsibly, as described on the Eats on Feets website, is less risky than formula and the choice I would recommend, based on nearly 40 years of working in this area: teaching, practicing and researching. I would do it myself; I would suggest it to my daughters. One can pasteurize milk at home; one can visit the donor and see how she lives and how her baby is doing.

          • Elizabeth A

            I donated milk informally, because I’m ineligible for formal donation in the US (due to residence in the UK in the mid-nineties). I would NOT recommend it.

            No one ever asked a darn thing about my lifestyle or how my babies were doing. They certainly did not ask to visit me and check things out.

            The only questions I was ever asked were where, when, and what do you want for it. Recipients came to my house, at my convenience, took breastmilk, and left. Some of them drove for hours to do this. And they have to have been getting milk from multiple women like me, because I wasn’t producing THAT much. Clearly, it was very important to them, but it seems to me to be a huge effort, for very small benefits.

            When I stopped pumping for my own baby, I went to the grocery store and bought her formula. If I were to have another baby (now that I’ve had both mastectomies) I would go straight for formula. When my sister was having trouble breast feeding, I recommended formula. I would again.

          • Nikki Lee

            Interesting. As you say, it was important to them, who were making the choice and doing the work. Some sharing networks encourage buying locally and making a relationship between donor and receiver.

          • Elizabeth A

            All the networks encourage that, but that encouragement consists entirely of saying that it would be nice if you chose local, and great if you could be friends.

            Practical reality is that donors give to the first person who provides what they want. For me, a mom of two with intractable oversupply, I wanted my freezer back. I wasn’t charging, but I had a baby at home and one in the NICU. I didn’t have time to stand around making friends, and I wasn’t going to start anything that might make me feel guilty about cutting back my pumping schedule, or weaning so I could switch antidepressants.

            Edited to add: if you think donors aren’t also doing the work, that’s one of many reasons why there are so few donors.

          • Nikki Lee

            Donors are working; adding pumping to a busy day takes energy. Thanks for your wisdom.

          • KarenJJ

            I know that whatever benefit my eldest got from breastmilk, the added gut flora from the potting mix I caught her gnawing on probably undid it.

          • techqueen333

            We are talking about newborns, KarenJJ. Pay attention.

          • Durango

            Yes, but newborns grow up and gut flora evolves over time (and may I also add that the research in gut flora, while exciting and interesting, is still very preliminary, with few, if any, clinical recommendations). It is reasonable to point out that other things will influence a child’s gut.

          • Young CC Prof

            My brother at least once ate sand from our sandbox, that probably served as a cat-box for stray cats. I’m sure that had interesting effects on his developing biome and immune system.

          • fiftyfifty1

            “But doesn’t an unfed gut cause increased mucosal permeability and increased infectious complications? ”

            Indeed it does. This is why the adage of “If the gut works, use it”. Not just because you CAN use it, not just because it’s easier than an IV, not just because it doesn’t have the risks of an IV. You should use the gut, because it NEEDS to be used.

          • Young CC Prof

            Ever notice how often a baby poops in the middle of or immediately after a feeding? There’s a reason for that, and it isn’t “annoy Mommy.”

          • techqueen333

            Read the literature, Alison. I’m not going to do it for you. It’s there.

          • The Bofa on the Sofa

            Can you summarize it?

          • techqueen333

            anion, why don’t you learn about the differences in the guts of newborns who are exclusively breastfed and those who aren’t. It has nothing to do with formula being “man made.”

          • anion

            Techqueen, why don’t you NOT assume I don’t know anything about the whole “virgin gut” theory? I once believed it. I added probiotics to the occasional formula bottles my breastfed baby got. Either that worked just fine or the theory is nonsense, and given the scientific evidence I’m inclined the believe the latter. Either way, “preserving gut flora” is hardly an appropriate reason to feed an INFANT intravenously. FFS, what kind of sadist advocates putting tubes in the veins of babies like that instead of just giving them a bottle?

            And the “man-made” thing is a common anti-formula argument. Not everything is about you personally–especially things in comments which were not replies to you.

          • techqueen333

            What kind of sadist screws up an infant’s gut flora and ph when they don’t have to?

          • Amazed

            What kind of sadist brings her child to the point of needing an IV just to save the precious gut flora?

          • techqueen333

            Sadist? Hardly. Your name calling only serves to illustrate that you have no argument.

          • Amazed

            Make an argument? Why should I bother when you make my argument for me. Bofa’s for him, Young CC Prof’s for her and so on?

            Oh, and I don’t believe for a moment that you actually have a grandson. teenqueen333.

            Anyway, thanks for making our arguments for us.

          • Young CC Prof

            I agree with you on this. Definitely a teenager making things up. I’ve never seen an adult with such poor communication skills, and it’s definitely not a language barrier.

          • techqueen333

            Your persistent use of ridicule only exposes your lack of an argument. I’m well over fifty and have a PhD from a major research university. I have three grown children and one grandchild.

          • techqueen333

            I haven’t made any arguments for you Amazed. Again, your use of ridicule only exposes your lack of an argument.

          • Amy Tuteur, MD

            What kind of self righteous moron thinks that formula feeding is sadism?

          • techqueen333

            Ridicule and straw man argument. Woo aren’t you the tough guy. What kind of “MD” cherry picks research and gives patients false information?

          • perpetual lurker

            Oh FFS, it’s not a straw man. You JUST said, “What kind of sadist screws up an infant’s gut flora and ph when they don’t have to?” So you JUST effectively sad that choosing to formula feed makes a person a sadist. I know you love to throw around terms from your logic 101 course but you should really learn what they mean first.

          • techqueen333

            I was being sarcastic. It was a response to the person who called me a sadist for suggesting that an iv could be a better short term solution to an acute situation than FF. Sorry you didn’t understand that.
            Hahaha on the logic 101. You really think you are clever, but you are not. I’ve very clear on the meanings of those term.

          • perpetual lurker

            Lol, I see, so you respond to someone calling you a sadist by repeating that phrase and you are being sarcastic, but then Amy does the same and she is using a straw man? Yep, makes sense to me. I guess it took me a minute, you know, with the whole thinking I’m clever but not being clever thing.

            You really are something else on this thread. Keep it coming!

          • techqueen333

            Why don’t you check out the effects of even small amounts of formula on the infants gut environment. I would absolutely do everything I could to avoid having my infant receive formula. If the baby were six months old, or if the situation were dire, that would be a different story.

          • The Bofa on the Sofa

            Why don’t you tell us all about these “effects” on the “infants (sic) gut environment”?

            My children both had formula within the first 6 weeks. Please explain what is wrong with their “gut environment”?

          • Karen in SC

            Or my gut flora. Been working great for decades.

          • techqueen333

            Why don’t you actually read the literature instead of ridiculing things in ignorance?

          • DaisyGrrl

            Formula to a baby’s gut environment is like acid rain on the boreal forest. Only unicorn tears will save your children now!

            Or they could be okay. Yep, they’re fine.

          • techqueen333

            Ignorant comment Daisy.

          • The Bofa on the Sofa

            But more than you have actually said.

          • DaisyGrrl

            Which part? That Bofa’s children are fine? I have only his word on it and I’m inclined to take it.

            The part about equating formula to acid rain? From your posting, that’s my take away. I haven’t seen a serious discussion of the research from you and as a layperson I am not equipped to interpret the studies myself. Since others on the thread have parsed the numbers in various studies and explained what they mean in simple terms that I can understand, I am more inclined to believe them when they say that the current state of evidence shows marginal benefits for breastfeeding. So if all else is equal, bf. Otherwise, don’t beat yourself up about ff.

            Now, if you (being *such* an expert) would care to translate the research that uses all the big words and scary numbers into something that a person without scientific training can understand, I’d be very grateful. I’d then be able to evaluate your counter-argument and come to a decision on what I believe are the relative merits. Linking to study abstracts is meaningless to me.

            Back to my ignorant comment. Could it be the part about unicorn tears? You’re right. Bofa, I forgot to mention that there should be pixie dust mixed in with the unicorn tears in order to have the desired effect.

          • techqueen333

            There are quite a few studies that discuss this. You can find them in PubMed or even by using the Google Scholar database.

          • MLE

            Still referring people to PubMed and Google even after all these days? You have to a) cite the relevant paper, and b) note the SPECIFIC data from that paper which backs up your assertion. This was explained elsewhere on the thread in greater detail if you need it. Copying and pasting the author’s conclusions is not good enough.

          • techqueen333

            I’m not going to do your work for you. I don’t have the time. I’ve posted abstracts. Go read the study.

          • The Bofa on the Sofa

            I’m not going to do your work for you.

            Hey, YOU brought it up, pal. You made the claim, YOU do the work.

            Besides, I’m a neophyte and don’t have the expertise to understand the papers. Why don’t you just tell me. You shouldn’t even have to go to find the papers, since you are so confident that there are such huge problems that have been caused, you should be able to explain them to me.

            What is wrong with my kids’ guts because they had formula in the first 6 weeks?

          • techqueen333

            I don’t have the time to do your work for you. If I post citations or abstracts, I get flamed. You wouldn’t be asking me to do this if I said the research supported your actions.

          • Box of Salt

            techqueen333 “If I post citations or abstracts, I get flamed”
            yes, if you just post a citation.

            How about if you pick a study (not behind a paywall) to use as an example, chat it up with your in house sounding board, and come back and post a short summary of what that study is telling you.

            This is not doing work for others – it’s just showing your own work.

            Let us know *why* you think what you think. With sentences *and* links.

          • techqueen333

            I don’t have time to do that. I don’t see why you can’t read the studies for which I post citations or abstracts yourselves. I’m involved in several large program evaluations involving multiple universities and have a concert to prepare.

          • Young CC Prof

            Like Box of Salt says. Pick one study, then explain why it supports your point. You don’t need to write a research paper, a few sentences plus a link to the original source will do. This is how you argue well on the Internet.

          • The Computer Ate My Nym

            If I post citations or abstracts, I get flamed.

            No, you get challenged to support your interpretation of the study as well as the quality and generalizability of the study. And have frequently shown yourself unable to do so.

          • Elizabeth A

            TeHqueen, do you even know what iv nutrition looks like? What it takes to get it in place, what it does to the veins? Or what gut flora look like in a person not using their gut?

            There are worse things then changes in gut flora, and you seem totally oblivious to that. Formula is a solid means of keeping a situation from getting dire and iv supplementation and parenteral nutrition are options for dire situations.

            What you’re saying is that you would expose an infant to pain and risk of infection rather then alter that infant’s gut flora, even though we know that people come through just fine with all kinds of gut flora… and that treatments for infection are MORE harmful to gut flora. This is not logic for good medical decision making.

          • techqueen333

            Yes, I do know what it looks like.
            Do you know the difference between then and than?
            I would make sure that my child actually needed the intervention and it was not just another case of a doctor overdoing it due to fear of litigation. When my son was born, he was over nine lbs. They wanted to supplement to keep his blood sugar up. Reasonable. So, we used syringe (no needle) and sugar water. No formula. When my daughter had her large son, she had the same situation, but the nurse gave him formula without asking. We were all furious.

          • Elizabeth A

            This is the first time you’ve mentioned syringe feeding sugar water as an alternative to formula – I had been arguing against IVs for infants who can take food by mouth, and you had been insisting that said IVs were preferable to feeding babies who can eat readily available, age appropriate food.

            So, okay, you think sugar water by mouth is preferable to formula for babies with blood sugar concerns. Please explain why sugar water is a better choice then formula for syringe feeding. Why is sugar water better then a formula that contains fat and protein as well as sugars? Is sugar water equally appropriate in cases where there are concerns besides blood sugar (like jaundice)? For how long is it appropriate to administer sugar water if there is insufficient breastmilk available? Also, can you describe the effect of sugar water on an infant’s intestinal flora?

          • “Sugar water” [what percentage of sugar?] could have led to really severe hypoglycemia, btw. It provokes production of high levels of insulin, which means that once the sugar overload is dealt with, there is too much insulin in the blood, which causes a rapid and severe drop in blood sugar, in other words, perpetuating the problem.

            The correct response was to test the blood sugar at frequent intervals, and supplement with formula or expressed breast milk as needed.

          • techqueen333

            The “sugar water” was provided by the hospital and they determined the appropriate concentration. Again, you use hyperbole. Neither my son nor my grandson were “severely” hypoglycemic. In my case, the hospital readily offered the sugar water. In my son’s the nurse took it upon herself to give formula…it must be part of their protocol without asking the family. My daughter had clearly specified that her baby was NOT to receive any formula. After the incident, they only used expressed milk.

          • Then it was 5% glucose. That’s OK; I thought you were making it up yourself.

            A few feeds with that [and babies like it because it’s sweet] are OK, but it isn’t a substitute for proper food over a long time. 5% glucose solution is meant as a supplement, not primary nutrition.

          • techqueen333

            No one said anything about it being a long term solution. Obviously, in the unlikely case a woman can’t lactate or can’t lactate enough (not that she was sabotaged, or doesn’t want to), formula is the only option.

          • techqueen333

            I was talking about iv use as a solution to very short term problems as opposed to exposing newborns to cow’s milk or soy proteins and to disrupting the neonatal gut flora and pH.
            Syringe feeding a large baby for whom there are blood sugar concerns right after birth (a problem quickly resolved) avoids iv and formula. I do not know the effect of sugar water on gut pH and flora (don’t have time today to look for studies, either…find your own), but I do know it allows mothers to avoid exposing their newborns immature gut to cow’s milk or soy proteins.
            Obviously, I would not recommend feeding babies whose mothers could not lactate (a very small number in reality) or who were adopted, etc. a sugar water diet.

          • Elizabeth A

            I do not know the effect of sugar water on gut pH and flora

            So there’s a chance that sugar water impacts gut flora just as much, or even more, then formula. You don’t know, but you nonetheless prefer that unknown impact to the impact of formula, even though the change in gut flora caused by formula is inconsequential for most babies.

            Reflexive opposition. Awesome.

          • techqueen333

            Unlikely. Formula contains cow’s milk or soy, both of which are potential allergens given an immature newborn gut.
            The change in gut flora caused by formula is most definitely NOT inconsequential. Where the hell did you get that? Read the literature!
            Reflexive opposition? pot/kette, Elizabeth A.

          • Elizabeth A

            It is nigh impossible to tell the exclusively brest fed children from the children who received formula as newborns by the time those children are as little as a year old, so while the changes in gut flora may be drastic, they also appear to be without consequence. There are some special cases here, of fragile infants, or infants with specific health concerns, but in the vast majority of cases, inconsequential is accurate.

          • me

            When I had my second child four years ago, she was over 9 lbs. They encouraged me to bf frequently, and they checked her blood glucose a few times. Once they saw it was normal and remaining stable, they stopped checking. No one ever mentioned formula.

            Perhaps your grandson actually did have low blood sugar? If that were the case formula would be preferable to sugar water – formula has sugar as well as fat and protein. Sugar alone just causes a blood glucose spike and subsequent crash. Combined with protein and fat, sugar elevates the blood glucose level, and fat and protein help slow the metabolization keeping the blood sugar more stable hours later.

          • NoLongerCrunching

            >just another case of a doctor overdoing it due to fear of litigation

            I am so tired of this meme. It is insulting to the vast majority of doctors who make decisions they think are best for their patients’ health, not from fear of litigation.

          • AlisonCummins

            You are the one suggesting IV nutrition — not just sugar, but a parenteral nutrition solution containing protein — to help a hungry baby clear bilirubin when the mother’s milk has not yet come in.

            The doctor would NOT be recommending parenteral nutrition for a healthy tern infant. Litigation would happen if it were done, not if it weren’t done.

          • Melissa

            Especially because the changes to gut flora will happen at some point when the child is weened. Everything I have seen about the different gut bacteria in bf v. ff. make clear that the differences end when solid food is introduced. In other words, the benefits of breastfeeding do exist but do not have lifelong impacts. Which means that it is perfectly reasonable to decide that it’s better to introduce those evil gut bacteria a few months ahead of schedule if it prevents the child from being in pain from hunger or from needing an iv.

          • techqueen333

            Pushing formula is not good logic for medical decision making.
            Concerns about changes in gut flora and ph are not relevant to older babies. We are talking about newborns here.
            BTW, all of you who are so concerned about the pain of starting an IV….did you have your sons circumcised?

          • KarenJJ

            No.

          • Mishimoo

            I didn’t realise that my son’s genitals were any of your business. Please, do elaborate on exactly why I should discuss them with a stranger on the internet?

          • Durango

            For someone who regularly characterizes others’ comments as logical fallacies, you sure like to use them yourself.

          • fiftyfifty1

            Do you know what a line infection is?

          • techqueen333

            Yes

          • NoLongerCrunching

            There is NO evidence that the gut flora of a FF baby causes him any harm long-term.

          • techqueen333

            What evidence do YOU have to support that statement? Why would you want to risk harm in the short term?

          • NoLongerCrunching

            It’s impossible to prove a negative (e.g., prove there is no God). If you are asserting something causes harm, the burden of proof is on you.

            I would not choose to give formula, but many mothers do, and there is no reason to be needlessly alarmist about something that is theoretical. If they cannot be convinced on the proven merits of exclusive bf, then there’s really nothing you can do.

            Also, *if* changing the gut flora does end up having negative consequences, that will need to be compared with the risks of withholding supplementation in cases where there is a medical need.

          • fiftyfifty1

            “If the gut works, use it.”

            Yep, this is medicine 101. So important, for so many reasons, at every age.

      • rh1985

        IVs freaking hurt if given when dehydrated. Those poor babies.

        • techqueen333

          Stop with the dehydration hyperbole. Formula is pushed as a panacea for everything.

          • Durango

            Placing an iv in a newborn is a big deal. No one is going to do it just to “top up” a baby. If the baby is needing iv fluids or nutrition, it is extremely likely to be dehydrated. It’s not hyperbole. And trying to find a vein on a dehydrated adult is hard enough, I can’t even begin to imagine how much harder it would be on an infant.

          • techqueen333

            I understand about the difficulties of starting an iv in any dehydrated person and certainly in an infant. Babies are hooked up to ivs and given formula as a precaution…long before they are dehydrated. That was what happened to my grandson…who was not dehydrated (my daughter had great colostrum flow) and who was only slightly hypoglycemic. I have to wonder how many of these protocols were developed out of fear of litigation rather than actual necessity.

          • Elizabeth A

            But babies are NOT hooked up to IVs as a precaution. Babies are only placed on IVs when IVs are needed – IVs are tough to place in babies, and babies with IVs require closer monitoring and (usually) NICU admission.

            Yeah, babies are given formula on a precautionary basis fairly often, because if you can keep a baby from tanking, why wouldn’t you?

          • Anj Fabian

            Keep a baby out of the NICU? Of course!

            Give formula to a baby to keep it out of the NICU?
            Of course!

            I’m having problems wrapping my head around the POV that not feeding a baby something from column B is worse than the baby becoming so poorly that it needs to admitted to an intensive care unit.

          • techqueen333

            How did you go from zero to ten that fast Anj Fabian? Who is saying that one must do nothing until a baby is admitted to the NICU? Formula should not be the first option.

          • Anj Fabian

            Baby is losing weight, becoming dehydrated and jaundiced.

            Mother’s milk has not come in.
            Formula supplementation is suggested.
            Lactivist advises mother to refuse formula supplementation.
            Mother and baby are discharged with a bili light blanket.
            Mother’s supply is low. Mother still refuses to supplement on advice from lactivist who insists that putting baby to breast will cause supply to increase.
            Baby becomes lethargic, nurses poorly.
            When mother takes baby in to have the bilirubin levels checked, not only haven’t those numbers improved, baby’s weight has continued to fall and baby is now dehydrated.

            Doctor wants to admit baby to NICU for continued bili light treatment, IV fluids and monitoring.

          • techqueen333

            And this is an example of an extreme case. Nice slippery slope argument.

            Mother’s milk doesn’t come in for several days. DUH. In most cases, milk comes in fine if not interfered with through supplementation. In most cases putting the baby to the breast DOES cause the supply to increase. It is a supply and demand system.

          • Ainsley Nicholson

            What Anj described is almost exactly what happened to my daughter. However, by the time my milk came in (and oh boy did it!), she was already quite sick. She ended up back in the hospital for almost a week. Bilirubin can build up in be brain and cause a form of cerebral palsy. I believe my daughter’s odd movements when she is excited, and her inability to stay dry thru the night until she was almost 10 years old, are the result of a mild form of cerebral palsy due to her severe dehydration and jaundice shortly after birth. I wish I had listened to the doctors and given her a bottle or two of formula.

          • techqueen333

            An extreme case, not the norm at all. Do you have citations for any studies showing a direct relationship between bilirubin levels ( you don’t specify why she was sick or what her levels were) or dehydration and cerebral palsy? Or did a HCP attribute your daughter’s behaviors to any of these? Or, is this just your guess?

          • NoLongerCrunching

            Wat. What happened to Ainsley’s baby should NOT have happened. Period.

          • techqueen333

            Uh…sorry…Elizabeth A, but I was there. The baby was not in the NICU and the treatment was described as a precaution.

          • Dr Kitty

            How do you know he wasn’t dehydrated?
            What were his urea and creatinine and sodium levels?

            If he was hypoglycaemic despite “great” colostrum flow there was clearly a problem.

          • techqueen333

            I don’t remember what his levels were. He is now six months old. He was slightly hypoglycemic right after birth. We were told he was given the formula as a precaution. They had no right to do that without asking. My daughter had given clear instructions that she didn’t want her baby to receive formula.

          • Durango

            I do wonder if, given your extreme views on the evils of formula, you and your daughter will ascribe every health blip of your grandson to the bolus of formula he received. A cold? He wouldn’t have gotten one if he hadn’t had formula! Ear infection? The formula did it! Asthma? It was the formula!

          • The Computer Ate My Nym

            “Only slightly hypoclycemic”? Hypoglycemia can kill. Especially in newborns. Not something I’d want to risk my child or grandchild by playing around with.

          • The Bofa on the Sofa

            My first had trouble eating when mom’s milk let down, and ultimately his jaundice got so bad he had to spend a day under the bili light.

            During this, never once was formula suggested as an option, much less as a panacea.

            You are full of shit.

          • Box of Salt

            Stop with the “formula is pushed” hyperbole. It’s not. It wasn’t 10 years ago, and it isn’t now.

      • techqueen333

        Red herring. IV feeding to solve a short term problem (where one really exists, i.e. is not about the paranoia of a litigation fearful doctor or hospital policies that serve to sabotage nursing) and greater concentration on making breastfeeding work is better than formula.

  • The Computer Ate My Nym

    On rereading this post, it occurs to me that Dr. Tuteur’s points are:
    1. Breast feeding has some marginal benefits and significant benefits in premature infants. Women should be informed of the facts as they are, without either minimizing or exaggerating the effectiveness of breast feeding.
    2-8. Once informed of the facts, it is the patient’s right to decide what to do. She should not be pressured, shamed, or otherwise harassed for making the “wrong” decision.
    9-10. Donor milk is unregulated and potentially dangerous, except in the context of carefully tested donor milk used for preterm infants. Don’t buy bodily fluids over the internet.
    Obviously, I’m simplifying significantly. But the bottom line is, Dr. Tuteur is making a case for patient autonomy and science based policy. Why are so many people, most of whom are not regular commentors and don’t seem to read the site regularly, so outraged about this that they have to come here to specifically say that they don’t want Dr. Tuteur as their OB?

    • techqueen333

      1) She is making false assertions.
      2) It is the patient’s right to decide. However, they should have correct information
      3) Agreed on the point of carefully tested donor milk. Disagree on limiting its availability to preterm infants.
      She is not making a case for science based policy. She thinks she is, but her claims are false. It is very frustrating and potentially harmful.

      • Elizabeth A

        No one is limiting donor milk to preemies out of spite, they’re limiting it to preemies because there’s not enough of it. Do you have a plan for increasing the supply there? Because otherwise, availability is absolutely going to stay limited.

      • Happy Sheep

        You can disagree all you like, however there is a shortage of reliable breastmilk to feed the preemies. Ensuring the most vunerable and most benefitted population receives a limited resource first is just good sense.

      • The Computer Ate My Nym

        Which assertions that she’s making are false and what is your evidence? And how would you prioritize the distribution of safe donor breast milk if not giving it to premies first?

        • techqueen333

          For example…Her assertion that the benefits of breasfeeding are marginal and that formula is an EXCELLENT source of nutrition. It is an inferior substitute that should only be used in cases where breastfeeding is impossible (e.g. no milk, failure to thrive, allergy, adoption or death of the mother).

      • The Computer Ate My Nym

        Dr Tuteur claimed that breast feeding had marginal benefit for term infants that wanes over time. You posted three abstracts demonstrating…marginal benefit in term infants that wanes over time. If Dr. Tuteur is making false assertions, why do your references back her up?

        • techqueen333

          None of the references I posted back her up.

    • ngozi

      Since she is retired, she probably doesn’t care that they don’t want her as their OB.

      • The Computer Ate My Nym

        Which makes it all the more remarkable that people feel the need to come out and tell her that they don’t want her as their OB. They CAN’T have her as their OB. What’s the point of saying it?

        • The Bofa on the Sofa

          Oh they think it will make her feel bad.

          I’m reminded of the scene in A League of their Own where Jon Lovitz is talking to Geena Davis. I don’t remember what he said but she says,

          You know something? You’re not nice.

          His response? Sarcastic

          Ooo, that one hurt!

          The key? He doesn’t take it personally. Recall his comment

          Hey, no skin off my Ashtabula. You want to stay here plucking cows, that’s your business.

          So that’s what I think it is. They think they will hurt her. Naive they are, though.

  • An Actual Attorney

    This discussion brings to mind this quote:

    “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”
    ― Upton Sinclair

  • techqueen333

    Amy Tuteur, if you think your claims are valid, try writing a meta-analysis of breastfeeding research and get it published in a peer-reviewed scholarly journal. Good luck with that…

    • Melissa

      The claims are well backed up by the current analysis. All things being equal breastfeeding is better, but it is rare that things are equal and so the minimal benefits of breastfeeding have to be balanced against the real world needs of the family.

      So, if a woman is having to choose between being able to take medication that staves off depression and anxiety, or breastfeeding, the happy Mom is probably better for the kid than one that is in the grips of depression. This doesn’t even start to deal with issues of Mom’s who have to go back to work and those who have other children they need to care for, maybe by themselves. Every family situation is different. There’s nothing wrong with breastfeeding friendly policies in workplaces. And nobody here is arguing that breastfeeding should be outlawed in public or anything like that. Only that women not be made to feel guilty for using formula since the benefits, while real, are minimal and temporary. It is possible to make breastfeeding easier for women without demonizing those who don’t.

    • Young CC Prof

      Look. You’re so hung up on meta-analysis, try this one. Please do read every word and look up all the words you don’t know. Let me know if you don’t understand the graphs, I’ll show you a resource: http://apps.who.int/iris/bitstream/10665/79198/1/9789241505307_eng.pdf

      My favorite part is: [while discussing breastfeeding and blood pressure] “With respect to publication bias, we observed that small studies provided estimates that clearly overstated the benefits of breastfeeding. Among studies with sample sizes greater than 1000 subjects), the benefit of breastfeeding was modest.

      Control of confounding by socioeconomic and demographic factors led to smaller reported effects of breastfeeding. This is consistent with the study by Brion et al (21) comparing two cohorts with different socioeconomic confounding structures, which is discussed above. In addition, the only randomized trial on this issue did not find an association.”

      So, the larger the study and the better confounders are controlled, the less benefit is found. This is generally a sign that there’s no fire under the smoke at all.

      Also, from the conclusion of the report, pg 67:

      “Because the meta-analyses are almost exclusively based on observational studies (see Chapter 2), the possibility of self-selection and residual confounding must be considered. Even when multiple studies show similar results, these studies may largely be subject to the same biases. In particular, most studies are derived from high-income settings where breastfeeding is more common among highly-educated, better-off mothers who are more health conscious, and whose offspring may be less likely to suffer from the negative outcomes covered in the present review. The fact that estimates from high-quality studies, with tighter control of confounding, are less marked than those from all studies suggests that this may be the case.”

      Pay special attention to that last sentence. The better the study, the smaller the benefit.

      • nikkilee

        What about survival value? As mammals, we make milk after the placenta is delivered completely. If this system didn’t work, none of us would be here.

        • KarenJJ

          Well lets say that, for example, 80-90% of the time it did work..

        • Amy Tuteur, MD

          None of us would be here? You don’t seem to understand how evolution works. It is perfectly compatible with massive amounts of death.

        • The Bofa on the Sofa

          If this system didn’t work, none of us would be here.

          I am trying to maintain restraint here, but let me just say…

          How in the world did you ever come up with that? It’s not even close to being correct. It’s not consistent with anything we know about biology or evolution.

          Let me ask you a question: does our reproductive system work? You’d have to say yes, right, because if it didn’t work, “none of us would be here”, right?

          But that doesn’t mean it’s perfect. Our reproductive system currently has a failure rate of AT LEAST 15% or so, and that is only viewing it in terms of the miscarriage rate. It does not refer to fertilized eggs that don’t even implant.

          So there is an easy and obvious example of how “if it didn’t work, we wouldn’t be here” is absolutely incorrect. As Dr Amy notes, evolution and survival is about being good enough.

        • Young CC Prof

          Um, no. It only has to work most of the time. If women produce an average of 2 children who survive to adulthood, the species continues. If they produce, say, 3, the species increases pretty quickly. (10 people become 40 in one century!)

          So tell me, do you really want to have 8 kids and watch 5 of them die from one cause or another, like my great-great grandmother did?

          Babies absolutely have starved because their mothers didn’t produce milk. But in prior centuries, wet nurses and animal milk saved many of them, and now with nutritionally correct disease-free formula, we can save them all.

          • The Bofa on the Sofa

            I heard an OB claim once that, historically, the “natural” way for our species was that the female would have about 8 children over her lifetime and 5 of them would reach adulthood (to reproduce).

            Who knows what the cause of those 3 deaths would be? Disease, for sure, but how much of that is due to malnutrition due to inability to sufficiently breastfeed?

            Regardless, 3/8 dying is an awful lot of waste, but here we are, surviving with no problem.

            “If it didn’t work, none of us would be here.” What a joke.

          • KarenJJ

            And even then, 80-90% of women would have had around 8 children.

            The rest of the women?

            This type of all or nothing thinking in regards to women’s health is just crazy. I had issues with conception, giving birth and breastfeeding. I can’t extrapolate that to ALL other women – not everyone will have my issues.

            And same to those women that have had straightforward conception, pregnancies, childbirth and no issues breastfeeding – it does not mean that their experience is universal or that others are doing things “wrong”.

        • Amazed

          Look, usually I overlook such statements but since you claimed you’ve made a career in this area, I cannot help but ask the following: WHO WAS THE BLIND IDIOT WHO CLEARED YOU TO WORK THIS?

        • An Actual Attorney

          Apart from the utter stupidity on evolution *headdesk*, you contradict your own self, above:

          “Mothers start making milk in the middle of pregnancy, around the time that they feel their babies move. Your milk volume took a while to increase. This is normal.”

          • nikkilee

            How is that a contradiction? Mothers start making milk in the middle of pregnancy; after the placenta is delivered completely, the volume of milk they make goes up.

          • Young CC Prof

            Actually, they start making colostrum in the second trimester. True milk appears a few days after birth. The composition and quantity are very different. But of course I’m sure you knew that.

          • nikkilee

            Colostrum is milk. It is defined as the first milk made. It is sufficient for newborns until the milk volume increases. Most of the barriers to newborns getting enough milk at breast has to do with hospital practices and policies that exist because “we’ve always done it that way.” The challenge for hospital systems now is to implement best practice so the mothers that choose to breastfeed can leave the hospital doing so.

          • Karen in SC

            hmmmm my son was mighty hungry for the five days it took for my milk to come in. I spooned him water, as I was into the woo. Nothing would have been wrong with some formula.

          • KarenJJ

            Based on what you’ve been writing here, I hope people like yourself are kept well away from changing any hospital policy.

          • anion

            Which hospital practices and policies are those? The ones that force rooming-in no matter what, or the ones that force new mothers to listen to lectures about how if they give their babies formula they might as well spend that college fund on furniture because their babies will grow up stupid?

          • YOU KNOW, those policies THIS POST IS SPECIFICALLY ABOUT.

            ETA: not shouting at anion, of course.

          • anion

            🙂

          • Box of Salt

            nikkilee: “Most of the barriers to newborns getting enough milk at breast has to do with hospital practices and policies”

            In my opinion, your opinion is a decade out of date. In my area, back when I gave birth, hospitals practices and policies absolutely supported breastfeeding. I am not alone on this, both among my real-life peers (with children the same age as mine) and the women who post regularly here. And my first born is going on ten this year.

            It is so frustrating to read complaints like yours over and over again because they have no relation to the reality most women currently (and have for the past decade!) experience.

          • EmbraceYourInnerCrone

            Possibly it is even more out of date than that, my daughter is going to be 20 this year. When I gave birth to her the nuns(Catholic hospital) and the lactation consultant(yes they had one from the La Leche League who worked with all the new moms) were VERY much encouraging of breast feeding, The hospital also had default rooming in for all health babies although they did still have a newborn nursery and I could and did bring my baby to the nursery when I needed to sleep. They highly encouraged us to only use the nursery at night if at all. So when I hear that hospitals are supposedly “forcing” formula on people and that you have no choices in a hospital setting my usually reaction is “What the what?!” Did the hospital give me free formula samples, yes if I wanted them, which I did. I had decided while pregnant that I did NOT want to breatfeed. My daughter is a normal , healthy young adult who just made dean’s list again. Somehow she survived my working mother, formula feeding, vaxxing, disposable diapering, jarred baby food at 4 or 5 months, ways. Also public school, daycare, and after school care. You love them and do the best you can with what you have.

          • techqueen333

            My daughter just gave birth to a health full term baby in a hospital located in a major US city. The nurses tried to push “relief bottles” even though he was not jaundiced, not losing more than a few ounces. She was very upset. There were issues between the nurses and the lactation consultants.

          • Stacy21629

            And studies show that women with low milk supply early in the nursing relationship that supplement with formula actually end up nursing LONGER because baby is stronger and can nurse better and more efficiently. Rather than getting a weak starving baby to nurse inefficiently and not establish milk supply.

          • Mishimoo

            Maybe it’s just me, but I’d rather feed my baby than allow it to starve.

          • Young CC Prof

            OK, there’s no way anyone who uses logic as badly as you do and has a mind as rigid as yours is old enough to be a grandmother. People who have raised children to adulthood are far more practical and flexible than you. You’re 19 years old at most, and making things up. Good night.

          • ngozi

            The only time I experienced any barriers at the hospital was when my children were born very ill. I think the oxygen, antibotics, and billirubin treatment they received far outstripped being at the breast. And I love breastfeeding, by the way.

          • Young CC Prof

            And even with very sick babies, if they are strong enough to potentially suckle, capable of eating with their mouths and can be briefly removed from their bed and held, the staff will let you try breastfeeding!

          • ngozi

            Not only let you try it, will completely encourage it.

          • Young CC Prof

            Hospital I was at kept privacy screens and breastfeeding pillows in the NICU just for nursing mothers. And had an LC on staff who was quite familiar with the special feeding problems of premature and sick babies.

      • The Bofa on the Sofa

        BTW, thanks to Young CC Prof for providing this reference, and the clear analysis of it. Yep, the old “vanishing effect with the quality of study” problem.

        • techqueen333

          Not

          • The Bofa on the Sofa

            What do you mean? Do you dispute the conclusion of the meta analysis (that you so wanted) that the effect diminished with increasing quality of the study?

            You just deny reality?

      • techqueen333

        I have read this study and will comment on it tomorrow when I have the time. In the meantime, here are some comments from others on the obesity piece. It mentions the earlier WHO study by the author of the one you posted, but also some others mentioned on this blog: http://bfmed.wordpress.com/2013/03/15/the-breastfeeding-and-obesity-controversy/
        My initial comments are that this is a study of long term benefits of breastfeeding on five non-communicable diseases: overweight and obesity, blood pressure, total cholesterol, Type 2 diabetes, and performance on IQ tests. It is not a study of short term benefits of breastfeeding for infants, which it acknowledges as being well established, “particularly the reduction of morbidity and mortality due to infectious diseases in childhood.” It states that “a pooled analysis of studies carried out in middle/low income countries showed that breastfeeding substantially lowers the risk of death from infectious diseases in the first two years of life.” This is interesting because even in high income countries, like the US, the people who are most apt to CHOOSE (not be forced into it by failure to thrive or other dire issues) to bottlefeed are the uneducated and low income, whose babies are most apt to be exposed to risk.

        • Young CC Prof

          Do you understand WHY breastfeeding reduces infant mortality in poor countries?

          1) Unsafe water. For many families, mother’s milk is the only liquid they have that won’t cause dysentery.

          2) No medical care. The simplest things like IV fluids, and antibiotics can be hard to come by.

          In the USA, municipal water is safe to mix with powdered infant formula. And even the poorest mothers can take their babies to an ER to get treatment for diarrhea or pneumonia. These are hazards of place, not of class.

          Do you know how many full-term infants in the USA die of contagious digestive diseases? Just for you, I looked it up. 20. That’s right, 20. We don’t know how many of those WERE breastfed, or, if those babies were formula-fed, how many would have been saved by breastfeeding.

          Just to put that in perspective, 233 full-term infants were murdered in 2010, and 63 died in car accidents.

          So what’s the higher priority, to save babies HERE? Making sure they are breastfed? Or relieving stress on their parents so they aren’t murdered by a caregiver and don’t die when the driver falls asleep at the wheel?

          • anion

            I have/had a great-aunt who died at two weeks old because of, according to her death certificate, “gastroenteritis.” She was exclusively breastfed. She was even a homebirth! So yeah, to say “If you breastfeed, your baby is sure to live” is, sadly, just not accurate.

          • The Computer Ate My Nym

            My great-uncle died of pyloric stenosis. Despite a home birth and breast feeding. My second cousins once removed didn’t die because my great-aunt brought them to the hospital when they started having projectile vomiting and they were treated surgically. They probably got formula somewhere in there, though.

          • Trixie

            My husband had pyloric stenosis at 3 weeks also. He was breastfed. In the hospital, in those days, they gave formula after the surgery so they could measure his intake, and his mother’s milk dried up from the stress and the lack of breastfeeding in the hospital. Today, I’m sure, they make an effort to get the mom to pump or do weighted feeds to support breastfeeding after the surgery if at all possible.

          • techqueen333

            And you know with absolute certainty that the diagnosis was correct and that she was exclusively breastfed. You must have been there or read the file, correct?

          • Stacy21629

            Here’s something I know “with absolute certainty”. I KNOW I breastfed my first child to 1 year without issue. I KNOW that my second EBF child weighed 8.5# at 6 weeks and 7.4# at 4 MONTHS and had wrinkly skin because she had metabolized all her fat and was starving. I KNOW that she gained a pound a week after we started her on formula, was noticably stronger, slept better and passed multiple milestones rapidly. My breast milk was categorically INFERIOR to formula when it came to feeding my 2nd child and she was starving to death while I tried to EBF. If I had lived 100 years ago and was without access to a wetnurse she would have continued a slow, weak decline to a grave.

            Thank GOD for formula.

          • anion

            This was a member of my FAMILY, you fucking asshole.

          • techqueen333

            Oh, and you were there when your great aunt was a baby? Thanks for the vulgarity and name calling.

          • techqueen333

            I wonder how the bottle feeders in WVA were feeling after the contamination of their water supply.

            Even with safe water, formula is inferior.

            Yes, I know why breastfeeding reduces infant mortality in poor countries. You left out the fact that mothers pass on protective antibodies to their babies during breastfeeding for a variety of infectious diseases, that can’t be treated with antibiotics.

            I don’t know where you got your numbers. You don’t mention infectious diseases like flu.

          • Stacy21629

            RE: WV…well since we live in the US in 2014, they just went and bought water. JUST LIKE EVERYONE ELSE THERE.

          • techqueen333

            My sister lives in WVA. It was hard for stores to keep up with the demand for water. People were buying soda and juice and other fluids in order to stay hydrated.

          • Young CC Prof

            Numbers are from the CDC wonder database. Look it up and do your own searches. Do exclude preemies. (Then include preemies, at which point you will understand why taking donor milk out of the mouths of preemies to give it to healthy babies is monstrous.)

            Then find me evidence that BF babies have lower morbidity and mortality from flu after controlling for number and ages of siblings, day care, and caregiver vaccination status.

          • theNormalDistribution

            What the everloving fuck? Breastmilk does not protect babies from the flu.

          • techqueen333

            Nice language.

            Babies who are breastfed get the benefit of the antibodies made by mom’s immune system and to help both mom and baby fight each illness to which both are exposed. When babies are born, their immune systems are very immature and they have less ability to fight illness-causing germs. Bottlefeeders feed their children dead food, i.e. no antibodies.

          • KarenJJ

            Babies inherit immunity from their mothers. If the mother is not immune to something baby is not immune. The problem with the flu is that it changes so frequently that the immune system doesn’t recognise it. This inherited immunity wanes when the baby is around 6 months old.

            The passive immunity from breastmilk is very limited and only certain immunoglobins pass through.

            Once babies get older, their gut starts digesting these immunoglobins the same as any other protein (eg steak) and any immunity benefit from breastmilk is largely gone.

            The passive immunity babies get from breastmilk is so vastly overstated by breastfeeding advocates. It is there to some level but the effects diminish as the baby gets older, it does not protect from something that the mother is not immune to already (eg flu unless the mother had a flu shot while pregnant) and it is most certainly not to be relied upon as a form of vaccination.

          • techqueen333

            This was a study of women given an antenatal influenza immunization. It’s not talking about passive immunity. There’s no overstatement. Further, others have studied the same thing during the last year or so and have found the same thing.

          • AlisonCummins

            If the mother develops immunity to that spedific flu before the third trimester, the baby will be born with her antibodies. They will clear in about six months.

            Antibodies in breastmilk protect the gut. They do not pass into the bloodstream and do not protect the respiratory system.

            So no, breastmilk does not protect babies from the flu.

          • techqueen333

            Clearly, you didn’t read the study or the others like it out there. They refute what you just said.

          • techqueen333

            Well, that’s pretty vulgar, tND.

            Actually, there are some very interesting preliminary studies supporting the assertion that antenatal immunization of mothers with influenza vaccine increases serum antibodies and results of influenza rates in mothers and their babies. One such study is:

            Schlaudecker, E.P., Steinhoff, M.C., Omer, S.B., McNeal, M.M., Roy, E., Arifeen, S.E., Dodd, C.N., Raqib, R., Breiman, R.F., Zaman, K. (2013). IgA and Neutralizing Antibodies to Influenza A Virus in Human Milk: A Randomized Trial of Antenatal Influenza Immunization. PLoS ONE 8(8): e70867. doi: 10.1371/journal.pone.0070867
            This study is peer reviewed and open access.

            The study used a randomized trial to look at the phenomenon under study at intervals up to one year between comparison groups (influenza-vaccinated mothers (p = 0.0042) and pneumococcal-vaccinated mothers).

            Study participants: “Briefly, mothers were recruited for the Mother’sGift study [19] at three clinics in Dhaka, Bangladesh, during the third trimester of pregnancy. After obtaining written informed consent, we randomly assigned 340 pregnant women aged 18–36 to receive either influenza or 23vPPS vaccine during the third trimester of pregnancy. Mothers reported breastfeeding frequency, along with frequency of other infant foods and episodes of infant respiratory illness with fever, every week for the first 6 months of life.”

            They found that:
            “Influenza-specific serum IgA levels and neutralization antibodies were higher in the mothers who received influenza vaccine, with the highest levels at delivery . The influenza-specific IgA levels were statistically similar by 12 months postpartum”

            “The higher levels of specific IgA and of adjusted specific IgA in influenza vaccinees through 6 months suggest active specific antibody production throughout lactation. This is further supported by the significantly decreased number of respiratory illness with fever episodes observed in infants of influenza-vaccinated mothers.”

            They concluded:

            “Greater exclusivity of breast feeding in the first 6 months of life significantly decreased the estimated number of respiratory illness with fever episodes in infants of influenza-vaccinated mothers (p = 0.0042) but not in infants of pneumococcal-vaccinated mothers (p = 0.4154).”

            The researchers plan follow up studies:

            “We are undertaking studies to determine the cellular and immunologic mechanisms of breast milk-mediated protection after antepartum immunization. These findings need replication, including with other vaccines like diphtheria, tetanus, and pertussis vaccine, but suggest that pregnant mothers should be aware of the infant benefits of influenza immunization pre- and post-partum. Few U.S. mothers breastfeed as long as 6 months [29], but the possibility of long-term protection of the infant from influenza should be considered in discussions with breastfeeding mothers”

            If you are interested in the specifics of their study design, data collection methods, study limitations, and analysis of data, the study is open access and you are free to view it. As I said, this is a preliminary study. I saw several like it in PUBMED.

          • Irène Delse

            Tone trolling. Using preliminary data as if it was definitive proof… Yawn.

          • Anj Fabian

            The antibodies are passed in utero. This is something that is well known.

            IOW, It’s not the breast milk passing the antibodies, it’s the placenta.

          • techqueen333

            The antibodies are passed in utero while the mother is pregnant. They are passed through breast milk after. Read the study. There are others just like it.
            Oh and your comment about preliminary studies was lame. Do you always dismiss the conclusions of preliminary studies when they don’t align with your agenda or do you try and find follow up studies that refute the claims of the preliminary studies.

          • Young CC Prof

            Nope, that’s a commonly repeated myth. Disease-specific antibodies (IgG) pass ONLY before birth. The antibodies in breast milk are different (IgA) and mostly protect the digestive tract.

          • techqueen333

            Read the study, Young CC Prof. It begs to differ with you. The specific antibodies are in the milk up until I believe six months. They are not there in the breastmilk produced by those who were given the other immunization. And, the babies whose mothers were given the antenatal flu immunization had fewer cases of flu.

          • AlisonCummins

            Most preliminary studies don’t pan out. When they do, the effect is usually smaller than suggested by the preliminary study.

            It’s not about waiting for sure and certain proof, it’s that no matter what it is, if it’s a preliminary study it’s not good enough for clinical decision making.

            Remember vitamin A and C to prevent cancer? Should be a no-brainer, right? But when proper studies were done, it turns out that vitamin C actually increases the rate of cancer in smokers. Lots of people were disappointed with this result, but them’s the breaks.

          • techqueen333

            There have been multiple studies of this phenomenon and they have all panned out the same way.

          • nikkilee

            Bartick and Reinhold (Pediatrics April 5, 2010 DOT: 10.1542/peds.2009-1616)
            calculated that 911 babies a year die in the US because they are not breastfed. They die of NEC, of diabetes type 1, of SIDS, of leukemia, of asthma and lower respiratory infection.

          • Anj Fabian

            “calculated”?

            So it’s speculation?

  • ashley l.

    And this is where I can finally, finally be reassured that you are utterly insane. I ave no need to ever EVER visit your blog again. Good job!

    • moto_librarian

      Just be sure to stick the flounce.

      • LibrarianSarah

        Why is that those who make a big deal about “leaving and never coming back” rarely leave and never come back?

    • LibrarianSarah

      Don’t let the door hit you on the way out.

      • Ashley L.

        And interestingly, I was starting to pay attention to the facts that Dr. Amy was giving before seeing this post pop up in the sidebar highlights…not a very brilliant way to educate people. I will be amazed if Dr. Amy every makes any headway on what she says she so firmly believes using these approaches. She has just invalidated every thought I had that she might know what she is talking about. I shudder for your children! All of your children!

        • LibrarianSarah

          Would it make you feel better to know that I am infertile? Next time stick the flounce.

        • ngozi

          You said you were going to leave about 15 hours ago and yet you are still here…
          What did you want us to do? Burst into tears?

        • “Oh, golly gosh, I was LEARNING and then I realized that I was learning and THAT HAD TO STOP!” – Person who didn’t get enough attention from her first drive – by flounce

          • MLE

            Best flounce analysis ever.

        • MaineJen

          It only took you 14 hours to decide to come back. I’d say Dr. Amy is doing just fine.

        • moto_librarian

          What did I say this morning? Please, go away and stay away if you have nothing constructive to add.

        • Certified Hamster Midwife
        • MLE

          One of my favorite aspects of the blog is the comments reel. Bringing back memories and creating new ones simultaneously.

        • Happy Sheep

          So because you don’t like ONE post, you can now ignore all of the facts that you were listening to? Really? Is that how you go about learning in the real world?

  • Erin Miller

    So glad you were not my OB. Also, you are an OB not a pediatrician. I’m sure you wouldn’t try to supersede the agreed standards set by oncologists. It’s no less complicated of an issue. I don’t go to my OB for advice about my babies after they are born for a reason. Breast milk might not be magic but it is pretty darn awesome.http://www.dukehealth.org/health_library/news/newly-discovered-breast-milk-antibodies-help-neutralize-hiv

    • Amy Tuteur, MD

      No it’s not awesome. It’s just another thing produced by the human body. Evolution does not create awesomeness. It’s all about survival of the fittest, not survival of everyone.

    • The Computer Ate My Nym

      Interesting finding, but I would note some cautions: HIV is transmitted from mother to child in breast feeding in 1 case in 10. That’s a huge risk compared to, say, intercourse, where the risk is, IIRC, more like 1 in 1000. So the protection is, shall we say, partial.
      In a poor country where many people may live without access to clean water, etc, it may be worth the risk to breast feed to reduce the risk of GI infections versus feeding the baby formula made with unclean water. That’s a calculated risk and a reasonable one. Especially if the mother is on HAART therapy which reduces the risk further.
      However, in a rich country where access to clean water and equipment to sterilize bottles is well assured, the risk of infection by HIV via BF becomes unacceptably high and feeding the baby formula makes more sense. As the article you linked to points out. If work on the antibody they found changes that balance some day, then it’ll be a different story. But for now, HIV is one of the situations where a clear recommendation against BF can be given.

    • The Computer Ate My Nym

      I’m sure you wouldn’t try to supersede the agreed standards set by oncologists.

      Also, why would oncologists (cancer specialists) be setting the standard of care for breast versus bottle feeding? Is this a slip of the fingers?

      • The Bofa on the Sofa

        As I like to point out, every single guideline that is published, comes with the unspoken caveat, “All things equal…”

        However, never is it true that all things are equal.

  • techqueen333

    Despite her impressive credentials, Dr. Amy has CLEARLY not read any of the empirical research on this subject. The benefits of breastfeeding are not trivial. Further, I find it ironic that she rants about the alleged humiliation to which formula moms are subjected, when practically everything in hospital environments serves to discourage and sometimes humiliate nursing mothers. I have to wonder what happened in her life that made her so ANGRY.

    • Amy Tuteur, MD

      What made me angry? People like you lying about the benefits of breastfeeding.

      • techqueen333

        I’m not lying about the benefits of breastfeeding. Read much peer-reviewed empirical research Amy?

        • Amy Tuteur, MD

          Just about all of it. Most of it does not correct for confounding factors, so it is worthless.

          • techqueen333

            Your opinion. A misrepresentation of fact.

          • Young CC Prof

            Please provide one actual study (not a recommendation or literature review, a study) which finds long-term benefits to breast-feeding. Then we can have a pleasant discussion about the strengths and weaknesses of this study.

          • LibrarianSarah

            Put up or shut up.

          • Mel

            Oh, heavens. Why don’t you link ONE of these studies from Pubmed? Then, in the words of Young CC Prof, we can actually discuss a study.

            Or do you prefer posting random logical fallacies?

            My favorite in the natural fallacy. A great example of that is the idea that since mammals breast-feed the best solution in all situations is breast-feeding. OFC, I was a mostly formula fed premature infant. Perhaps that’s permanently destroyed my logic abilities…

        • theNormalDistribution

          You clearly haven’t.

    • PrimaryCareDoc

      Seriously? What hospital have you given birth in lately that has humiliated nursing mothers?

      • The Bofa on the Sofa

        Don’t you know? Many hospitals these days STILL have formula IN PLAIN VIEW!!!! Not even hidden away in the cupboard!

        • Karen in SC

          No, it was hatting! without the mother smelling her baby, no milk will come in, didn’t you know that?

      • techqueen333

        You have to be kidding, right? Mothers are constantly guilt tripped into allowing formula supplements to be given in the nursery.

        • Amy Tuteur, MD

          Guilt tripped? You’re claiming that nurses have so much extra time on their hands that they make a sport out of feeing formula to babies who don’t need it?

          • techqueen333

            Straw man. No one said anything about extra time or making a sport. I only said that they do it. I could easily produce hundreds of mothers from various generations who would attest to that. Crying baby in nursery? Formula. Formula is an quick fix, but one that alters the infants gut flora in negative ways, and can have other negative consequences. Nurses often contradict what the hospital lactation consultants tell nursing mothers. They readily admit what they are saying is based on efficiency or just their own opinion. Doctors also sabotage breastfeeding relationships. Again. It’s about efficiency. One pediatrician told me it’s far easier to prescribe antibiotics for formula babies’ ear infections than for them to take phone calls from mothers struggling nursing babies going through growth spurts (and feeding around the clock). I’ve known many doctors over the years, including my husband. Even OBs and pediatricians know little about nursing. They vaguely know it’s better and they know the anatomy. Most of their information and their attitudes are formed by what they, their wives, mothers or other family members did. They don’t inform themselves about it because they realize that a woman who doesn’t want to breastfeed or is having a lot of difficulty isn’t going to no matter what the advantages are. They’ll rationalize it away and if pushed, go to another doctor. It’s bad for business.

          • MaineJen

            You would rather that babies NOT get antibiotics for ear infections?…

          • techqueen333

            Enormous straw man MaineJen. Of course I want doctors to treat ear infections. The point was that particular pediatrician and I have heard many similar anecdotes, would rather have dealt with the consequences of formula feeding, e.g. increased numbers of ear infections, than take phone calls from moms who needed lactation support. Efficiency.

          • MaineJen

            That was partially tongue in cheek. 🙂 But my anecdata, FWIW: I breastfed both of my kids and I was one of the lucky ones who had an easy time and really enjoyed it. My son, who lost interest in BFing at 9 months when he started walking (!!), has never, ever had an ear infection in his young life, and rarely ever gets sick. My daughter, who breastfed until she was 2 and only recently weaned (and that, reluctantly) has had multiple ear infections and was -this- close to needing tubes, and seems to get sick more often. (My mother tells me I breastfed for about as long as my daughter did, and I was another one who suffered repeated ear infections throughout childhood.) I think it just depends on the kid. Is there any actual evidence that BFing reduces ear infections on a population level that isn’t tainted by confounding factors (i.e. socioeconomic status)?

          • Karen in SC

            my BF son has so many infections he lost his middle ear and is deaf on the right side!! And our pediatrician was affiliated with a nurse line based at our children’s hospital that was answered 24/7. This was 20 years ago!

            NCB myths, I dislike them.

          • PrimaryCareDoc

            Seriously! My BF son had so many ear infections that he ended up hospitalized at age 15 months. He finally got tubes and his adenoids out. Oh, he’s also the one with asthma, eczema and an anaphylactic food allergy.

            My FF son- totally healthy. Never sick.

          • Amy Tuteur, MD

            The plural of anecdote is anecdotes, not data. You have yet to present any data of any kind. Perhaps that’s because you don’t have any.

          • The Bofa on the Sofa

            But she really doesn’t even have an anecdote, just vague accusations.

            I provided an anecdote

          • techqueen333

            Nice cliché. The data is in PUBMED.

          • Amy Tuteur, MD

            In other words, you don’t have a clue!

          • theNormalDistribution

            Do you have issues with reading comprehension? Several people have pointed out to you that the data does not support the claims that you think it does. Either be specific about what you think the benefits are and why, or shut up. You are clogging the tubes with your anecdata and mistaken accusations of logical fallacies.

          • The Computer Ate My Nym

            Saying “the data is in Pubmed” is like saying “the data is in google.” Pubmed is a search engine, not a source. What article or articles are you referencing and in what ways do they support your position?

          • theNormalDistribution

            Source for all NCB claims: have you tried looking on internet? All the data is there.

          • LibrarianSarah

            Well then you could go find that data and post it here along with what it says and why it supports your conclusions. You are the one making the claims and you are the one who is supposed to find the evidence to back it up. Stop being lazy and make an argument.

          • techqueen333

            Here is an example:
            Tarrant, Marie a; Kwok, Man-Ki b; Lam, Tai-Hing b; Leung, Gabriel M. b; Schooling, C. Mary b
            InstitutionFrom the (a)School of Nursing, The University of Hong Kong, Hong Kong SAR, China; and (b)Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong SAR, China.
            TitleBreast-feeding and Childhood Hospitalizations for Infections.[Article]
            SourceEpidemiology. 21(6):847-854, November 2010.
            AbstractBackground: Infectious disease is a leading cause of morbidity and hospitalization for infants and children. During infancy, breast-feeding protects against infectious diseases, particularly respiratory infections, gastrointestinal infections, and otitis media. Little is known about the longer-term impact of breast-feeding on infectious disease in children.

            Methods: We investigated the relationship between infant feeding and childhood hospitalizations from respiratory and gastrointestinal infections in a population-based birth cohort of 8327 children born in 1997 and followed for 8 years. The main outcomes were public hospital admissions for respiratory infections, gastrointestinal infections, and all infectious diseases. Cox regression was used to assess time to first hospitalization.

            Results: Breast-feeding only (no formula-feeding) for 3 or more months was associated with a lower risk of hospital admission in the first 6 months of life for respiratory infections (hazard ratio = 0.64 [95% confidence interval = 0.42-0.97]), gastrointestinal infections (0.51 [0.25-1.05]), and any infection (0.61 [0.44-0.85]), adjusted for sex, type of hospital at birth, and household income. Partial breast-feeding (both breast-feeding and formula-feeding) in the first 3 months also reduced hospitalizations from infections but with smaller effect sizes. Beyond 6 months of age, there was no association between breast-feeding status at 3 months and hospitalization for infectious disease.

            Conclusions: Giving breast milk and no formula for at least 3 months substantially reduced hospital admissions for many infectious diseases in the first 6 months of life, when children are most vulnerable.

          • The Computer Ate My Nym

            Again, good. This one even provides clinical outcomes. Two questions:
            1. The population studied in this study was Chinese women in China. Are the results transferable to other populations, specifically to patients in the US?
            2. They note GI infections had a relative risk of 0.51, CI 0.25-1.05. What does that say about the risk of GI infection in the breast fed population?
            Bonus question: Do these data say anything about health later in life?

          • Amy Tuteur, MD

            Not good enough. If you want to claim that a paper supports your point of view, you must READ it, analyze it, quote the relevant portion from the article NOT the abstract, and then we will have something to talk about. Until then you are just an activist who parachuted in to helpfully demonstrate that you have no idea what you are talking about.

          • techqueen333

            You asked for data. You got it. I’ve read the articles and analyzed them. That’s why I chose them. Now it’s up to you to do the same. Otherwise, you are just another nasty activist with an anti-breastfeeding agenda.

          • LibrarianSarah

            From where we are sitting it looks more like you read the abstracts and copy and pasted them into the comment section. That is not analysis. We are not going to just take your word for it that you read and analyzed the papers just because you said so. What does it say in your own words and how does it relate to the point you are trying to make.

          • techqueen333

            No, I read the studies. That’s why I chose them. I provided the abstract so you could get an overview. You can go to the library and read them, too. I was asked for data. I provided it. I’m not here to write a meta-analysis for you.

          • Amy Tuteur, MD

            Nope, not good enough.

            Did you say you have a PhD? In what? Did they accept cut and paste abstracts in place of actual analysis?

          • LibrarianSarah

            From where we are sitting it looks like you just read the abstracts and chose them based on that. You are the one who is making a claim and it is you who has to provide evidence and analysis to back that claim up. I wouldn’t let my 18 year old undergraduate students get away with just posting a couple abstracts and saying “there read these it’s proves I’m right.” That is simple lazy thinking that we try to whip out of undergrads before they graduate. Not very becoming of a PH’D. Make a claim, make an argument and use sources to back up that augment. Don’t make a bunch of unsupported claims and toss a half assed bib salad at me and pretend you made a damn argument. You are the one making claims. You came here to convince us of something. If you don’t want to do the damn work the door is located on the red X on the upper right hand side of the page.

          • techqueen333

            Here is another:

            Breastfeeding and wheeze prevalence in pre-schoolers and pre-adolescents: the Genesis and Healthy Growth studies.

            Guibas GV, Xepapadaki P, Moschonis G, Douladiris N, Filippou A, Tsirigoti L, Manios Y, Papadopoulos NG.

            Author information

            Abstract

            BACKGROUND:

            To date, extensive research has been undertaken on a potential link of breastfeeding (BF) to wheezing illnesses. Nevertheless, an association remains to be established, partly due to age-dependent discrepancies and different definitions of exposures/outcomes across studies. We thus investigated the relation of diverse infantile feeding patterns with wheeze/asthma prevalence in two cohorts of children of different ages (preschool and preadolescent).

            METHODS:

            Wheeze ever/in the last 12 months (current) and doctor-diagnosed asthma were retrospectively reported by parents of the participants of two cross-sectional studies: the Genesis study (1871 children aged 1-5) and the Healthy Growth study (1884 children aged 9-13). Information on feeding practices (exclusive breastfeeding vs. mixed vs. formula feeding) and their duration (2 vs. 4 vs. 6 months) was recorded. Perinatal and anthorpometric data were also collected.

            RESULTS:

            In pre-schoolers, regimes that did not entail exclusive BF were positively correlated to current/ever wheeze, both before and after adjustment for confounders. No differences between the associations of regimes with 2, 4 or 6 months of exclusive BF with current/ever wheeze were shown. Furthermore, there was no consistent correlation of feeding practices with physician-diagnosed asthma. In pre-adolescents, no association of infantile feeding patterns with the wheeze/asthma outcomes was observed.

            CONCLUSIONS:

            Exclusive BF is associated with reduced prevalence of current/ever wheeze in pre-schoolers; however, this appears to wane in older children. The association of a period of exclusive BF as low as 2 months with pre-school wheeze prevalence, appeared to be comparable with that of 6 months of exclusivity.

            © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

          • The Computer Ate My Nym

            Let’s look at the actual data behind this one. The authors compared rate of wheezing in children who had been breast fed exclusively for up to 6 months with children who had been breast fed for lesser amounts of time or had been fed mixed breast/formula or had been fed exclusively formula, using two sources of data for children aged 1-5 and 9-13. I’m abstracting data from tables 5 and 6 of the paper.

            Table 5 looked at wheezing in children ages 1-5. They used exclusive breast feeding to age 6 months as the control. Wheezing rate was slightly elevated in a few combinations compared to exclusive BF x 6 months. However, the rate for exclusive formula feeding for 6 months was no different from EBF, including incidence of current wheezing or doctor diagnosed asthma. If there were a causal correlation, one would expect a stronger effect with less BF and more FF. It is not observed.

            For children age 9-13, even less effect is observed. There is basically no difference in any group from EBF to exclusive FF in the adjusted odds ratios.

            IMHO, the authors vastly overstated their conclusions, arguably misrepresented their data and the study does not support a role for breast feeding in the prevention of wheezing or asthma.

          • techqueen333

            Um…that’s why they didn’t make claims for older babies/children in their conclusions. The study does support a role for exclusive breastfeeding for younger children and is a springboard for additional research.

          • The Computer Ate My Nym

            Nope. You didn’t read or possibly didn’t understand the article. A couple of combinations of breast feeding and formula feeding did show a trend towards increased risk of wheezing (but not, in all cases but one, an increased risk of an actual diagnosis of asthma), but, critically, exclusive formula feeding was NOT associated with increased risk of current wheezing or diagnosis of asthma and the risk of wheezing at any time had a CI that included one. If FF increases the risk of wheezing so much that even a little formula in with mostly breast feeding (i.e. EBFx2 months then mixed) can cause wheezing, why isn’t a huge effect seen in exclusive FF? Biologically it makes very little sense and strongly suggests hidden confounders. Especially when you consider that the effect essentially disappears when discussing physician diagnosed asthma.

          • techqueen333

            I most certainly DID read and DID understand the article.

            “In regard to the duration of breastfeeding practices, we show that the combinations of mixed feed/single formula use in the absence of at least 2 months of early exclusive breastfeeding, are linked with an increased prevalence of ever/current wheeze in preschoolers” (p.776).
            “In keeping with our findings, other investigators have shown exclusive BF for 4 months or more to improve bronchial function and/or lower the risk for later asthma” (p. 776).
            Key strengths of our study are its population-based design, the investigations in two discrete cohorts of children of different ages, and the adjustment for several confounders.”

          • theNormalDistribution

            Way to demonstrate that you didn’t read or understand the study AND you didn’t read or didn’t understand the comment you were replying to.

          • techqueen333

            To whom are you speaking theNormalDistribution?

          • theNormalDistribution

            You, genius.

          • perpetual lurker

            With all due respect, techqueen333, do you see the difference with how you’re approaching this debate vs The Computer Ate My Nym? TCAMN is providing an a critical analysis of the information the author’s present. You are just quoting the authors, thus taking their conclusions at face value without evaluating the study’s strengths and weaknesses for yourself. It may seem like nitpicking, but it’s an important distinction. What do YOU think of this study?

          • techqueen333

            With all due respect perpetual lurker, What I see as the difference is that TCAMN posted an incorrect analysis. I responded. I posted abstracts for studies I had read, analyzed, and believed to be valid so the reader could have some idea about research design, sample size, methods, and conclusions. In the case of the wheezing study, one of the issues raised by Amy (confounders) was addressed. I used this as part of my selection criteria. I do not have the time to post a meta-analysis of breastfeeding studies. Read the studies and critique them for yourself. If you don’t agree, say why. I note that neither has TCAMN or Amy the OB/GYN has posted a meta-analysis even though Amy makes broad, inaccurate claims about the “trivial” benefits of breastfeeding.

          • The Computer Ate My Nym

            What I see as the difference is that TCAMN posted an incorrect analysis.

            Fair enough. In what way was my analysis incorrect? Please refer to the data, not the authors’ conclusions when discussing where you think I went wrong in analyzing the paper.

            My basic conclusions are
            1. While there were statistically significant differences in the rate of wheezing in some groups compared to exclusive breast feeding for 6 months, the differences were very small (RR0.01, making the chance of error high.
            2. In addition, the lack of clear trend towards better results with more breast feeding and poorer results with formula feeding makes it hard to attribute the differences observed to differences in feeding method. If formula feeding increases the risk of wheezing, why does exclusive FF not differ statistically from exclusive BF?
            3. Numerous possible confounders from recall bias to exposure to second hand smoke were not clearly accounted for.
            4. Therefore, my conclusion is that the authors at best overstated their case. This paper does not demonstrate a clear increase in risk of wheezing with FF and definitely does not demonstrate an increased risk of asthma. There is no reason, based on these results alone, to encourage either feeding method.

          • techqueen333

            Glad TCAMN has so much time. I have a full-time plus job and no time to write detailed analyses. I selected the studies I posted because I had read them and found them sound. It’s up to you now to read them and decide for yourselves.

          • techqueen333

            As you read the article, not that they controlled for “confounding” factors.

          • Dr Kitty

            They didn’t consider that different physicians may have different threshholds for diagnosing asthma.

            EBF kids may be less likely to be in full time childcare and therefore less likely to contract a respiratory virus (viruses being a major cause of wheeze in pre-schoolers).

            The lower socio economic groups with colder, damper, overcrowded housing, more exposure to mould spores and tobacco smoke also have lower breast feeding rates…was that controlled for?

          • techqueen333

            Another:

            Breast-feeding vs Formula-feeding for Infants Born Small-for-Gestational-Age: Divergent Effects on Fat Mass and on Circulating IGF-I and High-Molecular-Weight Adiponectin in Late Infancy

            Francis de Zegher, Giorgia Sebastiani, Marta Diaz, María Dolores Gómez-Roig, Abel López-Bermejo and Lourdes Ibáñez

            DOI: http://dx.doi.org/10.1210/jc.2012-3480

            Received: September 28, 2012

            Accepted: December 10, 2012

            Published Online: January 30, 2013

            Abstract

            Context:

            Fetal growth restraint, if followed by rapid weight gain, confers risk for adult disease including diabetes. How breast-feeding may lower such risk is poorly understood.

            Objective, Study Participants, Intervention, Outcomes:

            In infants born small-for-gestational-age (SGA), we studied the effects of nutrition in early infancy (breast-feeding vs formula-feeding; BRF vs FOF) on weight partitioning and endocrine markers in late infancy. Body composition (by absorptiometry), fasting glycemia, insulin, IGF-I, and high-molecular-weight (HMW) adiponectin were assessed at 4 and 12 months in BRF controls born appropriate-for-GA (N = 31) and in SGA infants receiving BRF (N = 48) or FOF (N = 51), the latter being randomized to receive a standard formula (FOF1) or a protein-rich formula (FOF2).

            Setting:

            The study was conducted in a University Hospital.

            Results:

            SGA-BRF infants maintained a low fat mass and normal levels of IGF-I and HMW adiponectin. In contrast, SGA-FOF infants normalized their body composition by gaining more fat; this normalization was accompanied by a marked fall in HMW adiponectinemia and, in FOF2 infants, by elevated IGF-I levels. In late infancy, SGA-BRF infants were most sensitive to insulin, even more sensitive than appropriate-for-GA–BRF controls.

            Conclusions:

            Because the health perspectives are better for SGA-BRF than for SGA-FOF infants, the present results suggest that FOF for SGA infants should aim at maintaining normal IGF-I and HMW-adiponectin levels rather than at normalizing body composition. Nutriceutical research for SGA infants may thus have to be redirected.

            Affiliations

            Department of Reproduction, Development, and Regeneration (F.d.Z.), University of Leuven, 3000 Leuven, Belgium; Hospital Sant Joan de Déu (G.S., M.D., M.D.G.-R., L.I.), University of Barcelona, 08950 Esplugues, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (G.S., M.D.), Instituto de Salud Carlos III, Madrid, Spain; and Department of Pediatrics (A.L.-B.), Dr Josep Trueta Hospital, 17007 Girona, and Girona Institute for Biomedical Research, 17007 Girona, Spain

          • The Computer Ate My Nym

            Excellent. You’ve finally started providing actual references instead of just saying “it’s in Pubmed”. Now, what do you think that this study demonstrates?

          • techqueen333

            Chapter:Breast feeding and the intestinal microflora of the infant–implications for protection against infectious diseasesAuthor:Wold, A EBook:Short and long term effects of breast feeding on child healthISBN:0-306-46405-5, 978-0-306-46405-8Date:2000Page:77 – 93
            Place:BostonPublisher:Kluwer Academic / Plenum Publishers
            DOI:10.1007/0-306-46830

            Breast feeding and the intestinal microflora of the infant–implications for protection against infectious diseases.

            Wold AE, Adlerberth I.

            Author information

            Abstract

            Human breast milk contains an array of factors with anti-infectious potential, such as immunoglobulins (especially secretory IgA), oligosaccharides and glycoproteins with anti-adhesive capacity, and cytokines. Breast-feeding is associated with protection from the following infections or infection-related conditions: gastroenteritis, upper and lower respiratory tract infection, acute otitis media, urinary tract infection, neonatal septicaemia and necrotizing enterocolitis. Some of the protective effects may derive from an altered mucosal colonization pattern in the breast-fed infant. In other instances breast-fed infants develop less symptoms to the same microbe which causes disease in the bottle-fed infant. An example of an altered colonization pattern is that breast-fed infants have less P-fimbriated, but more type 1-fimbriated E. coli. This may protect against urinary tract infection in the breast-fed infant since P. fimbriae are the major virulence factor for urinary tract infection. An example of changed consequences of the same microbial colonization is that secretory IgA in the breast-milk protects very efficiently from translocation of intestinal bacteria across the gut mucosa by coating intestinal bacteria and blocking their interaction with the epithelium. This mechanism may protect the infant from septicaemia of gut origin and, possibly, necrotizing enterocolitis. Breast-milk is also highly anti-inflammatogenic and contains hormone like factors which counteract diarrhea. Thus, breast-fed infants may be colonized by recognized diarrheal pathogens and still remain healthy. Due to a less virulent intestinal microflora and decreased translocation breast-fed infants will obtain less stimuli for the gut immune system, resulting, in e.g., lower salivary IgA antibody titres.

            PMID:11065062[PubMed – indexed for MEDLINE]

          • techqueen333
          • nikkilee

            http://uslca.org/wp-content/uploads/2014/02/Heart-Health-Press-Release-2.17.14.pdf

            There is a lot in breastfeeding for mothers’ health. Several articles cited in this press release.

          • The Computer Ate My Nym

            Recently, an article was published that demonstrated an increased risk of triple negative breast cancer (the least treatable form of BC) in Mexican women who breast fed. Be careful about generalizing about “mother’s health”.

          • techqueen333

            This is a secondary source, but a comprehensive one with citations to peer reviewed research. http://www.co.missoula.mt.us/healthservices/EatSmart/pdfs/Infant%20Formula,%20Not%20Even%20A%20Drop.pdf

          • techqueen333
          • The Bofa on the Sofa

            Crying baby in nursery? Formula.

            We have had two babies in the last 6 years. In neither case was their any suggestion of using formula if they cried in the nursery.

            Nurses often contradict what the hospital lactation consultants tell nursing mothers.

            Often? We had a lot of nurses, and they all brought their own ideas toward breastfeeding, but no one contradicted anything.

          • PrimaryCareDoc

            “they realize that a woman who doesn’t want to breastfeed or is having a lot of difficulty isn’t going to no matter what the advantages are. They’ll rationalize it away and if pushed, go to another doctor.”

            So are you saying doctors should push and guilt a mother into breastfeeding? That’s what it sounds like.

          • nikkilee

            One of the Healthy People 2020 goals for the US is to reduce the number of breastfed babies that are given formula in the hospital. Currently the national figure is 25% of breastfed babies given formula in the hospital. No formula-fed baby is ever given human milk. Why should the mothers choosing to breastfeed get derailed? Breastfed babies are given formula out of ignorance, to deal with jaundice and hypoglycemia and “excess weight loss.” Folks don’t consider that a mother who has been given lots of IV fluid in labor will birth a baby that will have a diuresis in the first 24 hours of life. (
            Noel-Weiss, J., Woodend, A. K., Peterson, W., Gibb, W., & Groll, D. L. (2011). An observational study of associations among maternal fluids during parturition, neonatal output, and breastfed newborn weight loss. International Breastfeeding Journal, 6(9).
            Her’s is only one of at least 3 studies to discuss this inflation of infant weight. In the meantime, if a baby needs to be supplemented, its mother has enough milk that can be given via hand expression/syringe or spoon feeding if the baby won’t breastfeed.

          • Mel

            Can you pick a single idea? Yes, some breast-fed babies in hospitals are given formula. You don’t tell at whose request that happens.

            Yes, that study supports that babies lose weight on the first day. That’s not new information.

          • moto_librarian

            I get really tired of you lactivists and your insistence that everyone can breastfeed and that those of that don’t have been derailed because we are stupid. I waited and waited for my milk to come in. Used a hospital-grade pump to help. Put my baby to the breast frequently. Guess what? It never did. I never had engorgement, never felt let-down, nada. This happened with both children. I spent weeks feeling like a failure the first time. Then I learned about IGT. While I tried nursing my second as well, when a week had passed with no supply, I gave it up without guilt. People like you spewing unsupported, sanctimonious bullshit are the problem, not hospitals and nurses.

          • nikkilee

            I am sorry for your loss. You did try hard. Sometimes things don’t work out; thank goodness for alternatives.

          • Amazed

            Loss? That says it all. To your ilk, the non-happening breastfeeding is a loss, although no one was hurt. To those whose babies ended up hospitalized because mothers were brainwashed into nursing at all costs, even when their babies starved… what do you say to them? Tough luck, maybe. It cannot compare to the loss of breastfeeding.

          • nikkilee

            She tried to breastfeed, twice. It didn’t work for her because of insufficient glandular. She had to feed her baby. When you go for something, twice, and it doesn’t work out, what is that called?

          • Trixie

            It’s called not working out. “Loss” implies death.

          • Amazed

            Her children are developing nice. You claim that she, and they, were bereft of something. She doesn’t agree. When you dare pity someone for their misery when they clearly aren’t miserable and there were no ill effects of what happened, what is that called?

            I call it insolence.

          • moto_librarian

            My children are doing just fine, thank you very much. I will add that both of them had cow’s milk protein and soy allergies as infants, so even had I had ample supply, I may not have continued to breastfeed because dealing with those dietary limitations would be a huge pain in my ass. I know you will think that is selfish, but I don’t care. I no longer feel the need to be a total martyr for my children.

            And again, I am not bereft due to not breastfeeding. Do you truly believe that bottle feeding isn’t just as amazing an experience? I cherish those memories of feeding my babies, holding them close and peering into their little eyes. If you can’t recognize that, I feel sorry for you.

            You sound like the LC I had to deal with after my first child was born. I should note that he was in the NICU due to TTTN (after SROM at 38 + 3 and a totally unmedicated vaginal birth) and I was dealing with recovery from a cervical laceration and a massive pph. This “professional” was a real bitch. She repeatedly grabbed my breasts roughly without asking, shamed me for using a nipple shield (I have flat nipples), and recommended fenugreek which is contraindicated for someone who has asthma (like me). I was too unwell to advocate for myself, and I let her get away with this behavior. I’ll bet that you are a real treat to deal with too.

          • anion

            Agree! And you know who else cherished that time with the baby and the bottle? My husband. You know, the baby’s FATHER, who was able to handle some of the feedings himself with my first, and still remembers it mistily. Funny how some people act like those pesky men don’t matter, huh?

          • Durango

            I tried to fit into my pre-baby jeans at least twice and failed. Are you sorry for my loss, too? I just bought bigger jeans, and moved on.

          • anion

            Well, I tried twice to have a son, and instead had two daughters. Are you implying that my daughters are a “loss?” Or that they are clearly inferior in some way that requires your sympathy?

          • moto_librarian

            Loss? Are you fucking kidding me? I didn’t lose my children, I simply fed them from a bottle rather than my breasts. The only reason that I felt like I had failed was because of the message from people like you that breast feeding is a requirement to be a good parent. Your evidence is shaky at best, and frankly, non-existent in most cases. Don’t mourn for me. Reserve your pity for the women who lose children due to the idiotic precepts of the natural childbirth and lactic it’s communities.

          • nikkilee

            Every single health organization in the world recommends breastfeeding. Why do physician groups and public health agencies do that? Why do governmental health agencies recommend breastfeeding and human milk for infants? Why do the infant formula companies write breast is best on the cans of their products?

          • KarenJJ

            Because on the whole it is a straightforward recommendation and because there are small benefits. How is your comment at all relevant to moto_librarian’s personal experience of not being able to breastfeed? None of those government recommendations are meant to be at the expense of infant nutrition. She wasn’t going to starve her baby to potentially prevent an ear infection and 1-2 bouts of gastro.

          • nikkilee

            Benefits are huge.

            Individual situations vary.

            Where is the evidence that formula is good for babies? Where are the well-done research, i.e. non-industry funded, studies that say it makes no difference how babies are fed? I am waiting.

            My comments are based on a career spent in this arena, and I am genuinely curious about the deep anger that is evoked about this topic. A baby is better off lovingly formula fed than being breastfed out of obligation or pressure. That doesn’t change the science and the odds of better health.

          • Amazed

            Huge, how huge? Would you care to share citations? Not from the lactivist organizations you seem to be working for if you please.

          • nikkilee

            This is a list of the 1,613 citations from the National Library of Medicine’s database. Help yourself.

          • Amy Tuteur, MD

            Nikkilee, in the world of science, discussions involve the relevant quotes from the relevant papers, careful analysis of claims, and a synthesis of the scientific literature as a whole, not merely the papers you like.

            I know that you think by cutting and pasting citations you are demonstrating your “knowledge,” but the reality is that you are demonstrating your ignorance. It’s pretty clear that you haven’t read the papers you cite and that you lack the appropriate skills to analyze them even if you did. You are not helping your cause here; you are hurting it.

          • techqueen333

            Where’s your meta-analysis, Amy? Please include your selection criteria when you publish it.

          • AlisonCummins

            You’re the one asserting that there’s a significant difference for healthy term babies. It’s up to you to disprove the null hypothesis.

          • Young CC Prof

            Why should she write a meta-analysis just because you asked her to? Why should any of us?

            We asked for evidence, you posted entire abstracts from a dozen different studies with no explanation or reflection.

            Pick one study. Cite it, and explain in your own words what breastfeeding benefits it provides evidence for and how the authors controlled for confounding variables. Then I will discuss the study with you. I don’t have time to sort through an epic linkspam.

          • nikkilee
          • nikkilee

            In this recent study from the American Journal of Epidemiology, looking at 3,563 children, the researchers concluded: “.. that breastfeeding explains 17% and 9% of the observed gaps in reading and math scores, respectively, between African Americans and Caucasians, an effect larger than most recent educational policy interventions.”

            Ann Epidemiol. 2013 Oct;23(10):646-51. doi: 10.1016/j.annepidem.2013.06.091. Epub 2013 Jul 21.

            Does breastfeeding contribute to the racial gap in reading and math test scores?

          • nikkilee

            There are feelings about going for something, and not achieving the goal. This is true for women who want a vaginal birth, and end up with a cesarean section. This is also true about women that want to breastfed, and don’t. Many times there are societal barriers, and family pressures, and a lack of recognition, support and value that get in a woman’s way. Sometimes there are physical issues, in mother or in baby. There is never any judgement about mothering. I wonder where the support and help is for the mothers that choose to bottle-feed formula; when they go home with newborns, and have questions about mothering and infant feeding, where are their support groups and help? There is so much governmental support now to boost breastfeeding rates, for a variety of evidential reasons, that the mothers who choose not to breastfeed don’t seem to be part of the discussion.

          • Amazed

            And encouraging those feelings of “loss” is helpful… how?

          • moto_librarian

            The entire way that you have framed this discussion is judgmental, period. Bottle feeding mothers do talk to our doctors about feeding issues, just as breastfeeding women do. You are right about one thing though. Breastfeeding is seen as such a moral imperative that anyone who doesn’t do it often feels the need to justify why they don’t. And you know what? That is ridiculous. My breasts, my choice. I don’t need to give anyone a reason why, but when lactivists are constantly hounding women about how they feed their children, it creates an atmosphere of anxiety and shame. There is nothing feminist about this.

          • Young CC Prof

            OK, this thread has gotten nasty. I’m going to take a step back and explain my point of view from the beginning.

            Someone else cited the Belarus PROBIT study. It’s a particularly reliable study because it was prospective and randomized. In Belarus at the beginning of the study, breastfeeding rates were pretty low, and many mothers were simply choosing not to breastfeed.

            Some new mothers were taught that breastfeeding is healthy for babies and encouraged to breastfeed. They were also educated on how.

            Obviously, the “intervention” group had a much higher rate of breastfeeding. The children were followed for several years to see if there was a difference in health status.

            Overall, the difference was very small and disappeared by school age. The breastfed babies did indeed have fewer bouts of stomach illness before age 1. No difference on a number of factors. Oddly enough, the breastfed babies had MORE food allergies.

            Now, let me explain the flaws in most studies performed in the USA that find a dramatic difference. Read carefully.

            In the USA, most people believe that breast is best. Regardless of the facts, most people believe it, most medical professionals say it, even the formula companies say it (because they’ll get negative publicity if they don’t). Thus, “good parents” do their best to breastfeed, just like they spend time on careful baby-proofing and on developing their children’s physical and mental skills.

            Who are “good parents”? There’s more to it than love. They are people who have more support, more resources, more knowledge. In general, they’re older, better educated, healthier, and wealthier. They’re more likely to be married.

            A teenage single mother who is herself the child of a teen single mother may love her baby just as much or more than a yuppie couple, but she just doesn’t have as many resources.

            And, at least in the USA, these mothers with limited resources are less likely to breastfeed. Sometimes it’s because they have to return to work just a month or so after giving birth. Low-end jobs have little or no paid leave, and she just CAN’T take unpaid leave without winding up out on the street.

            But these parents of limited resources are also less able to support and advocate for their children’s education. They’re less likely to have good health insurance. More likely to live in an unhealthy home or neighborhood (lead paint anyone?) Less able to provide nutritious food, including fresh veggies, as children get older. And a parent who can’t breastfeed for medical reasons, well, some of those medical reasons may be hereditary.

            THIS is why the true benefits of breastfeeding are so hard to measure. Because when everyone believes it’s best, the people who make the effort to do it are the same people doing everything else they’re “supposed to” do. THIS is what we mean by “confounders.”

            So, the biggest confounders are: Mother’s age, educational status, marital status, health status, and household income.

            Any breastfeeding study that fails to control for those is useless. And the studies that DO properly control for all these things find that breastfed babies have slightly fewer (one less on average) stomach illnesses during infancy, but that there is no difference later on.

          • MaineJen

            There is a fine line between ‘recommending’ something and ‘Forcing it upon people.’ There are women who simply can’t, or don’t WANT to, breastfeed. After all the education is done, the respectful (and *truly* empowering) thing to do would be to stand back and let the mom make her own decision, based on what is best for her and her family. Not to lock up the formula and passive-aggressively scold women who are unable or choose not to breastfeed.

          • nikkilee

            You are absolutely right.

          • Amazed

            A very nice acknowledgment that “it all depends on mom’s peace of mind”, “it’s up to the individual woman” and “no two women are alike!” You don’t view your epic failure to breastfeed as some great loss but nikkilee does, so, moto, it’s clearly a loss! Who are you to say it wasn’t?

            That’s why I am very skeptical of this fashion to speak outright untruths because “that’s my feeling of the situation!”. It isn’t an objective view and especially when it’s someone else’s feeling of another one’s situation, it can be downright pressure against them to feel in a certain way.

            I’ve already given an example of how false “the feeling of a situation” might be. I still don’t feel that the 17 year old neighbour who pressed my screaming 9 year old body down and tried to force himself in was trying to molest me. Any idea what he might have been trying to do? I mean, the fact that I still didn’t know what sex was and molestation was not even a word in my mind could not have anything to do with it, right?

          • moto_librarian

            Not that I am “liking” what happened to you – it was beyond horrible – but your comment is spot on.

          • Amazed

            I always keep this memory in mind when dealing with feelings – both mine and other people’s. It serves to remind me that gut feeling is not always the best judge of what happened and that sometimes feelings should not be validated. I mean, when I grew up, I realized what I had narrowly avoided. And I still can’t “feel” it. Just how logical is that and what does it make him?

          • Pillabi

            But then again, how can you compare child abuse with “failed” breastfeeding?! It’s not a matter of subjective feelings… The difference between these two experiences is utterly and totally objective!!!

          • Amazed

            No problem. I’m curious what you thought my point was, though. I didn’t see your original post.

            I write here when I’m taking a break from work, I am not a native speaker and, regretfully, I seldom do spellchecking, so rometimes the results surprise even me!

          • Pillabi

            I’m non native too – but your written English is superb!! 🙂

          • nikkilee

            For some reason, I am unable to reply directly to your description of the dreadful forced latch foisted upon you by a hospital LC. The back ground is black. So I am replying to you up here, with a white functional background.

            The practice of forced latch, of taking breast in one hand and the baby’s head in the other, and forcing them together, undermines breastfeeding hugely and is responsible for many of the cases of breastfeeding misery I see in my private practice. No one eats like that. Babies learn to see the breast and scream, and refuse to attach. Mothers hate having their breasts handled, even when they’ve given permission, as much as one can in a hospital. As the baby’s tongue has to reach out and cup the breast from below, there is no amount of forcing that will make a baby attach in a way that won’t hurt mom. I hate hearing these stories. They are a professional embarrassment as well. As I teach healthcare professionals about breastfeeding management, I always include information about never doing that. There are so many gentle and patient ways to help a mother and baby connect after birth; half of all babies don’t latch in the first day after birth. Let’s relax, and stop forcing things.

          • anion

            Nurses like you–judgmental and totally agenda-focused–made my first hospital experience hell, btw, and sent me into PPD. Thanks for that.

          • techqueen333

            The evidence supporting the superiority of breastfeed info over bottle feeding is there.

          • GuestB

            Then why don’t you show us?

          • moto_librarian

            Because she can’t. We have already discussed the PROBIT study and it’s modest conclusions. It is the best one that they have.

          • KarenJJ

            Just to point out how offensive this attitude is, do you feel sorry for parents that are disabled in anyway? Do you say “I’m sorry for your loss” to a parent that is deaf, blind, physically impaired etc? I do not hear well without hearing aids. Are you sorry that I didn’t hear my child’s first word without the use of an intervention such as a hearing aid?
            Because it is incredibly offensive to me if I was to be told that. People’s bodies are different and have different strengths and limitations. Thankfully women and babies are resilient and can use technology to work around these types of issues.
            Would it be better to hear without hearing aids? Undoubtedly, but that is not my reality and I dare you to feel sorry for me because of it.

          • nikkilee

            No. Thank goodness for hearing aids. However, if someone tries and doesn’t meet their goal, whether it be for an Olympic gold medal or a vaginal birth, or breastfeeding, it is good they tried and their attempt needs to be honored.

          • AlisonCummins

            If I try something because I think I will like it, and it turns out not to be for me, I don’t need your condolences. Other things will be for me.

          • An Actual Attorney

            nikkilee, I assume you are a native American English speaker, based on the way you write. You must know that “I’m sorry for your loss” is what one says after a death. It’s on every cop or medical show. Saying that about not breast feeding implies that you think it is on the same level as the death of a child. Words have contextual meaning, nit just literal meaning.

            Another example, back to the cop show, if I said someone is a “working girl,” you know I mean she is a prostitute, not a teenager with a job at Burger King.

            If you aren’t a native speaker, maybe you misunderstood. But I don’t see anyway that you could have, truly, not meant the message the words convey.

          • Pillabi

            For what it’s worth, I’m not a native speaker, and I still perceived this “sorry for your loss” incredibly inappropriate in this context!

          • KarenJJ

            So do I get a gold star for trying to hear without interventions? Do I get a special “hearing consultant” to try and get my hearing to work like other people’s? My attempts to hear without hearing aids are laughable (I have some hilarious stories at my expense).

            Someone with IGT can’t change their reality. Baby needs food, mum has to try and work with what she’s got to feed her baby. What we have is technology and as a result, thriving and happy babies that grow into thriving and happy children.

            I was the same. My first baby didn’t get back to her birth weight until she was 6 weeks (we started formula supplementation from 3 weeks due to her alarming weight loss). Our stories are all so similar and the response from lactivists like yourself has been so predictable: but it’s really rare, you must have been doing it wrong/getting poor information, I feel so sorry for you.

            Just STOP. Let women and babies get on with it without guilt and judgement and shame and feeling sorry for them. Be honest about the evidence. You think that ‘really rare’ means it never happens to a woman in your care and that they must not be trying hard enough. Listen to what we are saying. We are not such a pitiful bunch as you seem to think. Nor are our children. It is possible to support breastfeeding without wallowing in our supposed misfortunes and without this sort of feeding/good mother hierachy.

          • techqueen333

            One case does not a study make. I’m sorry for your struggles. The percentage of women who actually cannot breastfeed is actually quite small. No one said women who are incapable of lactation were stupid.

          • moto_librarian

            So prove to me how many women cannot breast feed? What are your criteria? How much suffering is adequate for you?

          • LibrarianSarah

            Maybe hospitals give formula instead of human milk because they don’t actually have gallons of donor milk lying around so they have to ration it out to where it will do the most good? Nahh they just hate women, babies and breastfeeding because they are big mean meanies who are mean. That has to be it.

          • Certified Hamster Midwife

            “No formula-fed baby is ever given human milk.”

            And why not? I think carefully screened lactivists should volunteer their time to wet-nurse strangers’ formula-fed babies in the hospital.

          • The Computer Ate My Nym

            Breastfed babies are given formula out of ignorance, to deal with jaundice and hypoglycemia and “excess weight loss.”

            Jaundice, hypoglycemia, and excess weight loss can kill.

          • Young CC Prof

            By the time I realized my son was very sick, he was too sleepy to breastfeed. He hadn’t been latching and sucking well before, but at that point he was falling asleep after just a couple minutes at the breast. Even the blood test barely woke him at all. It’s possible that aggressive formula-feeding alone could have brought him back, but the IV and ultraviolet made it happen much faster. Breastfeeding alone never would have saved him, not from the best breasts in the world.

            The only thing that keeps me from totally feeling guilty about not recognizing the problem sooner is that neither my mother nor the pediatrician really saw it either. The ped did NOT say he was dehydrated or suffering from excessive weight loss, just said he needed a blood test for the jaundice. Luckily, we got the test done and the results back in just a couple hours, and he was being treated actively less than an hour afterwards.

            And, you know, hypoglycemia in a GD newborn? That’s no problem, right? Seizure or two, who cares?

          • nikkilee

            There are plenty of evidence-based ways to deal with those things in a hospital without using formula.

          • KarenJJ

            You keep telling us things without showing us.

            What evidence-based ways of dealing with these issues in hospital without using formula? Are we expected to take a stranger on the internet’s word for it?

          • Amy Tuteur, MD

            And formula is an excellent way to deal with those things. It’s the mother’s choice.

            I’m sorry that for your own fragile self-esteem you really need to feel like you did something super-duper special when you breastfed your kids, but you didn’t. Your desperation is rather sad.

          • Young CC Prof

            Please tell us what they are, and point out the evidence. (Yes, IV feeding is a option, but formula is much easier on the baby.)

          • nikkilee

            Keeping babies skin to skin is one of the most powerful strategies to keeping babies’ blood sugars in the right range, for keeping their temperatures in the right range, and for keeping them calm. Creating an environment for unrestricted, infant self-attachment is also help. Hand expressing newborn milk and feeding it to the baby every hour or two is also effective. Babies can also be supplemented with small amounts of donor milk. All of these are strongly supported by evidence.

          • Young CC Prof

            Hand-expressing works if there is in fact any milk.

            And donor milk? Awesome. Tell me how many hospitals have any donor milk at all, much less how many have enough to waste on full-term babies.

            None. There isn’t enough donor milk in the entire country even for all the preemies in need, and preemies are first priority.

            So. You have a 72-hour baby whose weight is dropping fast. Attempts at pumping or hand-expressing by the mother produced very little. Mother is determined to keep trying to breastfeed, but doesn’t want baby to starve. And you live in the real world where there is no donor milk. What now?

            All you have to do is say it. That there are circumstances in which breastfeeding doesn’t work.

          • nikkilee

            Yes there are circumstances where breastfeeding doesn’t work. My personal belief is that I would move heaven and earth before I would ever give a child I loved commercial infant formula. There are nasty things in it that don’t have to be on the label. There is little regulation of infant formula by industry. Formula is a great experiment. Right now, there is a TRIGR trial going on now, as industry is trying to figure out a way to make a formula that won’t make babies diabetic. Industry is also experimenting with lower calorie formulae because one of the reasons formula feeding leads to obesity is that it is too high in calories. Meanwhile, human milk has stood the test of time. What industry is trying to do is make human milk in a can. This is an unsustainable process that taxes the environment. Human milk leaves few carbon footprints.

          • Young CC Prof

            That’s nice, you’d move heaven and earth. I’m glad you love your child. You still haven’t told me what the magic solution to lack of milk is.

          • nikkilee

            Milk from other mothers. One can pasteurize milk at home.

          • Elizabeth A

            Which other mothers, nikkilee? Who’s giving new moms the (unscreened) milk that they can pasteurize at home (after it’s had plenty of chances to grow bacteria in transit)?

            My infant feeding experiences are all over the map. I fed my first child an ounce of milk in hospital, and then exclusively breast fed him for nearly eight months – we eventually weaned when he was 20 months old. My second was a NICU baby who needed caloric supplementation starting out. I stopped pumping breast milk when she was 9 months old, because the crying jags were getting to me, and she weaned completely at 13 months. As it so happens, I’ve donated milk informally (I had considerable oversupply, but don’t meet the criteria for donation of bodily fluids in the US because of residence in the UK in the mid ’90s). I had a lot of milk for a donor, but not a lot of milk compared to the level of demand out there. The 2-3 women I was able to help drove (sometimes very long distances) to my house to pick up milk when I had it, at my convenience. It could not have been the sole source of nutrition for any of their babies, and it was available only on my schedule, not on theirs.

            In order to get my milk to a newborn, someone at the hospital would have to hunt around the internet, make some calls, and arrange a hand off (I work during most days, and often don’t have the car when I’m home). That’s hours of delay to get an infant a food no better, really, then formula – no one has demonstrated any benefit to donor milk (as compared to formula) for full-term infants.

          • nikkilee

            Women refrigerate milk and freeze it; they manage to get the milk, transport it safely, and bring it to their babies. What keeps this safer is that informal sharing is all around donation of milk; no money changes hands. As soon as money enters the equation, so does corruption. (Except for milk banks and Prolacta)

          • Durango

            “little regulation of the infant formula industry” lol. Care to show how you came by that nugget?

          • Karen in SC

            What do you think about the studies that have been done showing pollutants in breastmilk?

          • nikkilee

            Human milk is cheap and easy to get for analysis; doing biopsies on people to get tissue samples is costly, painful, and complicated. A baby’s bioburden of pollutants comes from gestation; human milk is polluted because mothers bodies are polluted, as we all are living on this planet. Cord blood studies show this.

          • What?

            I… Don’t… Even…

            What?

          • Elizabeth A

            You would move heaven and earth before you would give a child you loved commercial formula? Well, nikkilee, here’s what I learned in the NICU: Moving heaven won’t feed your baby. Moving earth won’t feed your baby. You can go out and turn over every rock in creation. You can cry to every God and saint you can think of, and at the end of the day, the baby is still hungry. If you skip to formula without investing time and energy in futility, you can prevent all kinds of problems.

            HUMANS LEAVE CARBON FOOTPRINTS. Breast milk does not assemble itself out of nothing. There are two basic ways to feed a baby: Make formula, or feed a mother. Five hundred calories of food for me actually requires more energy and industrial inputs then a similar quantity of formula (shipped dehydrated, and shelf-stable at room temp).

          • This comment so perfectly demonstrates how over the top the lactivist movement is that I made my husband read it. He was speechless. That never happens.

          • nikkilee

            This link is to the Global Strategic Business Report about the infant food and formula industry. Scroll down to the Regulatory Issues and Developments section. Note the chapter “Known contaminants in infant formula” and the one about perchlorate and E. sakazakii.

            http://www.strategyr.com/Baby_Foods_and_Infant_Formula_Market_Report.asp>

          • Box of Salt

            What link? I got “The page cannot be found”

          • nikkilee

            http://www.prweb.com/releases/baby_foods_market/infant_formula_market/prweb4123354.htm

            The link to the Table of Contents of the Global Report is in the body of the text.

          • Box of Salt

            nikkilee,
            You do realize you linked to a marketing report, right? One that’s being offered for sale? Your section on Regulatory Issues and Developments lista for $495. The perchlorate and E. sakazakii section is only $100. Did you actually pay for it and read it?

            If not, why bring it up? You have no idea what it actually says, do you? (I admit: neither do I.)

            Do you have any sources people can actually read?

          • Box of Salt

            ^Do’h. lists with an s.

          • nikkilee

            Yes, I did buy some of the report, including the section on contaminants. It goes into the details of the topics listed in the table of contents. I found the table of contents shocking. It is one reason I would never use infant formula for any baby that I loved.

          • Box of Salt

            nikkilee,
            claiming the table of contents is shocking does not mean anything without those missing details.

            Please find some sources for your horrified reaction that are not behind a triple-figure paywall.

          • nikkilee

            You can do a search for any contaminant in infant formula. Here’s one example:

            http://livinganointed.com/protect-our-babies/msg-in-infant-formula.pdf

          • Box of Salt

            Your link is about MSG. Although here is plenty fo fear-mongering about it, MSG is just the sodium salt of a common amino acid.

          • Box of Salt

            nikkilee,
            And I’ll point out that your link is part of the fear mongering, written by the founders of “a nonprofit organization dedicated to accurate labeling of MSG and the removal of MSG.”

            This is not a scientific source.

          • Box of Salt

            nikkilee, “the one about perchlorate”

            By the way, I found this scientific paper (available for free through PubMed, but the actual journal has a paywall) on analyzing perchlorate excreted in urine by infants (PubMed ID 21449579 in case the link doesn’t work), where the authors compare different feeding methods – breastfed vs cow milk formula vs soy formula:
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084336/

            This particular finding seemed interesting:
            “Breast-fed infants had significantly higher urinary perchlorate levels than infants who consumed cow milk-based formula (p=0.004) and soy formula (p<0.001) consistent with the findings of others (12, 13, 27, 28)."

            Here's a link to the journal (Valentín-Blasini et al, Environ. Sci. Technol., 2011, 45 (9), pp 4127–4132), where you can view the abstract without paying. There's even a helpful bar graph:
            http://pubs.acs.org/doi/abs/10.1021/es103160j

          • Box of Salt

            nikkilee “There is little regulation of infant formula by industry.”

            What does this document include? Oh, it’s the FDA Regulations for infant formula.
            http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/InfantFormula/ucm136118.htm

            I’ve also linked Article 412 (link from the above page, specific to infant formula) here: http://www.gpo.gov/fdsys/pkg/USCODE-2010-title21/pdf/USCODE-2010-title21-chap9-subchapIV-sec350a.pdf

            People with the attitude you’ve expressed here on this site are a menace.

          • nikkilee

            This is from the link that you just cited:

            Does FDA approve infant formulas before they can be marketed?
            No, FDA does not approve infant formulas before they can be marketed. However, all formulas marketed in the United States must meet federal nutrient requirements and infant formula manufacturers must notify the FDA prior to marketing a new formula. If an infant formula manufacturer does not provide the elements and assurances required in the notification for a new or reformulated infant formula, the formula is defined as adulterated under section 412(a)(1) of the FFDCA and FDA has the authority to take compliance action if the new infant formula is marketed.

          • nikkilee

            Every year, there are brands of formula that are recalled for manufacturing errors. That doesn’t happen with human milk. Here’s a Similac recall from 2013:

            http://www.parenting.com/article/similac-recalled-due-to-beetle-contamination

          • Box of Salt

            OK, some formula was recalled last year. What else gets recalled? Lot of other food products. Here’s the FDA for the last 60 days (2014): http://www.fda.gov/safety/recalls/

            In the past week, we’ve got chocolates (twice), hummus, ice cream, potato chips, mismarked syringes, and two medications.

            You know what I don’t see going back to the end of December? Any more infant formulas listed.

          • KarenJJ

            Do you propose that we test mother’s milk for pollutants and infectious agents, similar to formula, and then mandate breastfeeding or not based upon these test results?

          • nikkilee

            No.

          • Box of Salt

            The important part of your quote is this:

            “all formulas marketed in the United States must meet federal nutrient requirements and infant formula manufacturers must notify the FDA prior to marketing a new formula”

            Formula is not a drug, requiring documentation of safety and efficacy. It’s a food, for crying out loud!

            But it that does not mean it is not regulated.

          • Durango

            So you don’t actually know anything useful. Skin-to-skin to maintain blood sugars?
            As for hand expressing, if Mom’s milk hasn’t come in, hand expressing is going to be a frustrating, painful and fruitless experience. The more you post, the more we learn how little you know.

          • Young CC Prof

            Yeah, skin-to-skin works for temperature regulation, and it can increase feeding in babies aren’t eating well from a bottle, but it’s not going to raise blood sugar in a newborn who’s hardly eaten and has no reserves left.

            It must be really weird to live in a world where breast milk is magic, formula is dangerous, and there’s a giant conspiracy of obstetricians, pediatricians, formula companies, baby nurses, hospital administrators and grandparents out to deny babies their precious milk. I wonder what it’s like in there.

          • moto_librarian

            Donor milk should be reserved for preemies, period. They are the one group of babies in the developed world who really and truly benefit from breast milk because it helps to prevent NEC.

          • Trixie

            As a milk bank donor, I’m sort of insulted that you think my milk should go to your hypothetical healthy full term baby instead of the micropreemie whose life it could actually save. How selfish of you.

          • Amy Tuteur, MD

            Oh, dear Nikki is a “holistic lactation consultant.”

            http://www.breastfeedingalwaysbest.com/about-me/

            How unfortunate that she’s in a position to spread her nonsense to innocent women.

          • techqueen333

            IV doesn’t disrupt gut flora and ph.

          • Elizabeth A

            IV carries risk of infection and requires ongoing hospitalization for the baby. The IV hurts to place, and each placement carries a greater risk that you’ll blow a vein. IV feeding is a drastic solution, viable only for a few days. If Mom’s milk doesn’t come in, you’re headed for formula anyway, and the IV is not conducive to breast feeding or skin to skin cuddling – it requires a lot of care in handling.

          • KarenJJ

            Plus I still feel traumatised when nurses were trying to get a blood draw from my dehydrated toddler. She screamed and had to be pinned down. Trying to get an IV into a dehydrated newborn would just be awful.

            If techqueen333 thinks hat IV feeding a dehydrated newborn is better then giving them actual food then I don’t think there’s much I can say to that. She’s the sort of true believer that I just cannot converse with or have a reasonable discussion with. How awful if she were able to influence hospital policy much. I hope she keeps away from new mothers and babies too.

          • Young CC Prof

            “Trying to get an IV into a dehydrated newborn would just be awful.”

            Yes. It is.

            It took five tries, each on a different part of the body, and eventually the NICU nurses had to get their best vein sticker, who presumably is the best vein sticker in the entire hospital. For days afterward, every time I saw the bruises I’d shiver.

          • Elizabeth A

            I am so sorry! We had a prolonged NICU experience (not for feeding issues) and the various needle sticks DD needed were just awful. I wanted to throw a party every time a line came out for good.

          • moto_librarian

            Our eldest was in NICU for 2 days of observation for TTTN. He was being given IV antibiotics as a precaution, and ripped his line out twice. It was awful.

          • AlisonCummins

            You’ve got to be kidding me.

            Basic rule of feeding: if the gut works, use it. That overrides anything else.

          • Box of Salt

            “techqueen333: “IV doesn’t disrupt gut flora and ph”
            Why would you put an IV into a newborn who can suck from a nipple? What possible justification could you have for that?

          • moto_librarian

            Really? You would rather cause a baby the pain of an I.V. than give a bit of formula? Tell me, are you opposed to Hep B at birth? I ask because that seems to go hand in hand with NCB and lactivism, yet you are fine with advocating for an unnecessary medical procedure like an I.V. When formula is readily available. You are a sadist.

          • Guestll

            Are you for real?

          • anion

            No. S/he is trolling us. I’ve stopped feeding it.

          • fiftyfifty1

            “Breastfed babies are given formula out of ignorance, to deal with jaundice and hypoglycemia and “excess weight loss.””

            Supplementing with formula when a baby has lost 10% or more of birthweight is associated with INCREASED long-term breastfeeding rates as shown in the 2013 study by Flaherman et al in the journal Pediatrics. We should be encouraging this practice not demonizing it!

          • nikkilee

            There are other things that can be done than giving formula. The 2013 study in Pediatrics was thoroughly dissected in academic circles, for the shoddy research. Within 1 week, Similac had launched its’ “formula designed for supplementation”. Interesting coincidence.

          • fiftyfifty1

            Are you claiming Flaherman has ties to Similac?

          • Young CC Prof

            Please direct us to or summarize one of the critiques.

            (And how does a company launch a product complete with packaging in one week?)

          • nikkilee

            OB/GYN Alison Steube discusses the article.

          • nikkilee
          • techqueen333

            Straw man.

          • anion

            You are really unpleasant, aren’t you?

            Insisting something is true doesn’t make it true. That applies also to insisting you provided evidence when you’ve done no such thing, at all, not even a little bit, not even remotely. You’ve not even given a single example.

            BTW, that is not a straw man. Your knowledge of logic-based arguments is extremely faulty.

          • MaineJen

            I’ve noticed that; I’ve heard a lot of ‘straw man’ ‘logical fallacy’ and the like. “You keep on using that word…I do not think it means what you think it means.”

          • techqueen333

            Then you think wrong.

          • theNormalDistribution

            Nope.

          • MaineJen

            …Your childish need to have the last word is quite illuminating.

          • techqueen333

            No. I’m not.
            That’s my point, exactly. I have provided a number of examples. You, on the other hand, have provided none. Nor has Amy provided a meta-analysis.
            A straw man is a misrepresentation of what I said with a different proposition to try to make it easier to attack. Logic 101.

        • PrimaryCareDoc

          No, I’m not kidding. I’ve given birth twice in the past 6 years and there was no pressure to formula feed. Quite the opposite. And I hear the same from my many, many patients.

          And what nursery? The vast majority of hospitals don’t even have a well-baby nursery. They have rooming in with mom.

          • The Bofa on the Sofa

            Well, our hospital had a nursery. But not only were we not “guilted” into formula formula feeding, the topic never came up!

            When (before? I don’t remember) the baby was born, the nurses asked how we planned to feed him. We said breastfeeding. OK, they went to all extents to help us.

            With our first, it meant calling the room ahead of time to warn my wife they were coming, and I would lay warm towels on her chest to help with milk let down. Then afterward, she would pump, and we would feed him expressed milk from a syringe.

            The question of formula never came up.

          • techqueen333

            Lucky you.

          • The Bofa on the Sofa

            You’ve not provided any reason to think we were “lucky”. I’ve been around parenting forums for almost 6 years now, and examples I have heard that illustrate your claims are very, very few, while ones like mine (or more extreme) are common.

          • techqueen333

            I don’t know where you are located, but nurseries do still exist. Even with rooming in, there is to supplement. There always has been.

          • Susan

            Hospitals these days don’t have well baby nurseries where all the babies are lined up on display. There are NICU’s for babies who need them and nurseries where you can bring a baby for observation. There really aren’t new hospitals with rooms big enough to even fit all the babies who are routinely with their moms. And formula just isn’t given without consulting the pediatrician and having an actual reason. Really, you are just wrong.

          • PrimaryCareDoc

            Says who? You?

          • rh1985

            And thank goodness for the sane hospitals that still provide nurseries. IMO it is medically negligent not to have one since some moms that had very difficult births or csections and are on heavy pain meds may not be able to physically care for the baby immediately after birth and may really need the rest for their recovery.

          • THIS. I will never forget being kept awake for almost 3 days straight, until I was literally hallucinating*. No well baby nursery, no nurses who would even walk him around, even when I cried and begged.

            *Rember Clippy? The annoying “helper” for Office a million years ago? You could change Clippy to different characters. One was a claymation professor that looked like Einstein. I hallucinated him floating around my room. There was also a small silver blimp. Weird.

          • anion

            That is almost exactly what happened to me, right down to the sobbing and begging while the nurses flat-out refused to help. Did the nurses make you feel like a horrible mother for even asking, too?

          • Sucks, don’t it? I don’t remember if they guilt ed me or not. I do remember the first night nurse – not only did she refuse to help, she gave me a sponge bath (after much pleading, after a full day of labor, a cs) and left me lying naked and uncovered. I cried and asked to be covered and she said, “nobody’s going to come in” and ignored me. I did report THAT to my day nurse, who was very angry and helped a lot – but in the day I had family for the baby. Too busy and noisy to sleep.

            They also often left my son with me, wedged between me and a pillow against the bedrrail, as I nodded out and tried to nurse. Any idea how dangerous that is? I’m still angry – not at the hospital but at the three shitty nurses and one shitty anesthesiologist.

          • Irène Delse

            That does sound dangerous. They didn’t even put the baby in a bassinet by your bed? That way, at least, mom can hope to catch a nap, knowing the baby is safely held.

          • He did have a bassinette. He hated it and screamed in it mostly.

          • Young CC Prof

            And of course, for the first 24 hours or so post-op, you can’t get out of bed yourself, much less safely lift a baby with you.

          • rh1985

            So sorry you had to deal with that. I have a scheduled CS tomorrow and thankfully there is a nursery. At least there was two months ago hopefully they didn’t ninja close it. I would lose my mind I have gotten two hours of sleep per day the past week of so as my medication had to be stopped at least a week before birth to prevent newborn withdrawal and without it I don’t sleep all night and can get a brief daytime nap if lucky…

          • Young CC Prof

            Good luck with the CS! (Waiting for Baby Prof to digest well enough that I can put him down.)

          • Mishimoo

            Hope everything goes well! 🙂

          • anion

            Best of luck to you, I can’t wait to hear about your beautiful baby!

            FWIW, the nurses at the hospital where my second was born were AMAZING. Kind, supportive, happy to watch my baby (there wasn’t a nursery but they kept her at the nurse’s station for me), caring…it was an awesome experience all the way through. I’m sure the same will happen for you.

          • KarenJJ

            My hospital had a well-baby nursery, although they encouraged rooming in. You could still leave the baby at nursery for a shower/nap etc.

            I still ended up in tears because they refused formula for my unsettled baby.

        • The Computer Ate My Nym

          How long has it been since you’ve been in a maternity ward? When I gave birth about 10 years ago breast feeding was strongly encouraged and formula supplementation was discouraged even in the presence of a newborn who was starting to get dehydrated–a problem that was solved, incidentally, by one bottle of formula for her, several bottles of water for me, and a bit of time. We went on to have nearly 2 years of successful breast feeding, so don’t bother pulling out the “personal disappointment” theory of why I’m calling you on this nonsense.

          • techqueen333

            Not a bit of nonsense. Your personal anecdote does not a study make. I provide many counter examples.

          • The Computer Ate My Nym

            I provide many counter examples.

            Actually, you haven’t. You haven’t even supplied anecdote. Just an unsupported statement. And while I will admit that anecdote is the weakest form of evidence, it beats unsupported statements.

          • techqueen333

            I most certainly did.

          • AlisonCummins

            You said, “You have to be kidding, right? Mothers are constantly guilt tripped into
            allowing formula supplements to be given in the nursery.”

            Nobody posting here has had this experience. You have NOT said what your assertion is based on and you have NOT given any examples of this happening.

          • The Computer Ate My Nym

            Where have you provided counter examples? I don’t see any on this thread, but disqus being what it is, perhaps they’ve moved to some place not obvious. Could you repost or link?

        • MaineJen

          You mean the old, “Your baby seems to be getting a bit dehydrated, has lost 15% of his birth weight, cries constantly and your milk does not seem to have come in after 3 days” guilt trip? Yeah, those evil nurses.

          • Young CC Prof

            At my hospital, they released my son without freaking TELLING me he was down 12%, and he was low-birth-weight to start with. This resulted in him in the regional NICU for jaundice and dehydration the day after being released. I’m still a little pissed about the whole thing.

          • techqueen333

            No, that is not the example and it is not the norm.

          • theNormalDistribution

            Oh really? Did you read that on internet?

          • techqueen333

            Nope

          • MaineJen

            Well, maybe it didn’t happen to you and it didn’t happen to me, but not everyone is ‘lucky’ enough to be able to breastfeed. Plenty of babies back in the day used to DIE or need wet nurses because their moms couldn’t make enough milk. It may not be common, but it does happen.

          • anion

            What you’re suggesting isn’t the norm, either.

          • theNormalDistribution

            What is she even suggesting? A guilt trip needs a reason to feel guilty and if “your baby is starving” isn’t the most obvious and most prevalent reason to encourage formula feeding, I’d like to know what is.

          • anion

            I get the sense she’s suggesting that nurses holding bottles of formula lurk outside every new mother’s room, waiting to pounce, and if the mothers refuse the nurse pull out big scarlet letter Bs to sew on the mothers’ clothing. Then the nurses gather to point and scold and throw rotten fruit at those mothers who bravely resist the incredible pressure placed on them to formula-feed. Which is probably so strong because, as everyone knows, maternity nurses get huge financial kickbacks from the formula companies for every baby they can hook on the bottle. All they have to do is tell Big Formula they got another woman to try it, and the check is in the mail.

          • ngozi

            I am laughing my head off at this.

        • Susan

          Well, I have been a OB RN for 25 years. It’s been a LONG time since there was any routine here that babies go to the nursery at all. Do you have recent experience? At least three times last week I explained to a mom why formula wasn’t best for her breastfed baby, as do all my other colleagues. Really, if there is a guilt trip happening these days it’s shaming moms who for whatever reason might choose to formula feed. Is this real life recent experience or just something you read somewhere?

    • Anj Fabian

      Citations welcomed, if you have any.

      • theNormalDistribution

        She doesn’t.

        • KarenJJ

          OK so she does, but she doesn’t know how to use them to make an argument as to why she is citing them and why she feels that they prove her point.

    • anion

      The “childcare educator” who worked at both hospitals where my daughters were born reduced many formula mothers to tears during her “new baby” class, because of her insistence that they were causing their babies irreparable harm. I’ve never been in or heard of a hospital where “breast is best” isn’t shoved down the throats of new mothers and where lactation consultants aren’t on-staff to help.

      I’d like to know of what hospitals you’re speaking, and where they are, and how long ago it happened.

      • nikkilee

        Crappy care is unfortunately, part of the medical system. OBs contribute to the rise in the cesarean section rate, and for the increase in the number of preterm infants, the result of medical intervention (i.e. induction). Lactation professionals are not exempt. Kindness and courtesy gets lost in a technologically driven system.

        • anion

          Nonsense. Crappy care is not part of the medical system, and OBs don’t do c-sections for fun.

          • An Actual Attorney

            To be sort of fair, OBs set the CS rate — BECAUSE NON-PROFESSIONALS LIKE NIKKILEE CAN’T DO CRAP FOR A BABY WHO IS DYING IN UTERO.

          • anion

            Oh, absolutely. We’re in total agreement, I just condensed the explanation to “they don’t do c-sections for fun.”

          • An Actual Attorney

            Sorry – the shouting wasn’t at you. I just can’t bang my head on my desk at the stupidity any more.

          • nikkilee
          • Just needed to double upvote this.

          • nikkilee

            OBs due cesarean sections because that’s what they have been trained to do. They do them because they don’t want to wait for the natural process of labor to take its own time. A woman who has her labor induced has a 50% chance of having a cesarean section. They do them because they are afraid of being sued, and are liable for 21 years after the baby is born. However, if you explore the topic in any depth, the topic of the unnecessary cesarean section will emerge. ACOG published this recently, on the topic of elective induction of labor:

            Dang, the link won’t work. You’ll have to cut and paste.

          • Amy Tuteur, MD

            Really? How would you know? Did you go to medical school? Have you done OB training?

          • Do you ever say anything that ISN’T an easily debunked talking point from your sanctimommy handbook?

          • KarenJJ

            So you’ve read some articles that reinforce your personal beliefs and are lecturing people here on the current experiences of hospitals and breastfeeding and maternity care. People that have given birth in hospitals in the last few years/months/days/weeks. People that work at the coal-face of maternity care. Do you suspect that your personal beliefs might be a bit outdated? That you are coming across as a know-it-all blowhard?

            I went through similar with a family member that had poor maternity care in the 70s and also had unnecessary c-sections (and I read her books by Grantley Dick Read and another one called “Silent Knife”). It all caused me a LOT of anxiety during my first pregnancy. I considered a homebirth (briefly – my husband was much too anxious about that idea).

            But then I went through “the system” and it was FINE. I had options, I had respect. My obgyn I thought was a bit of an ass, but he was competent in spite of his slightly offputting bedside manner. My relative was surprised at the level of information I was given and the options I had. I still had the c-section due to fail to progress but it was my decision and I am very happy with that.

            My relative made a complaint about her obgyn back in the 70s (for doing something unethical) and felt that her complaint had in a small way helped women who gave birth in today’s health care system.

          • Karen in SC

            Being afraid of being sued is not a trivial thing. Do you bet your career every day with the care you give? Are you even required to carry malpractice insurance? What if you give advice that leads to malnourishment or illness in a newborn? Even if there was only a 1/100 chance of a problem?

            The latest ACOG bulletins states the opposite, that inductions don’t increase the chance of c-sections. I’ll wait until someone more knowledgeable explains the data, but it makes sense. Inductions help labor get started when the risk of doing nothing is higher than the risk of induction. What is so hard to understand?

          • ngozi

            The OB who did my c-section did it because my baby was dying inside of me. We knew this because of a failed NST test. Believe me, I hated the thought of a c-section as much as anyone. This decision had nothing to do lawsuits, impatience, or just wanting to be mean, my child was actually DYING. You think that is why some of these other OBs are doing c-sections too?

          • MaineJen

            I would like to see the data that say HALF the women who are induced have a c section. And those studies are talking about “Elective” inductions, right? Not inductions for medical reasons, for prolonged rupture of membranes, etc?

          • techqueen333

            No, they don’t do them for fun. However, during the late 1970s and into the 80s, there was a huge leap in malpractice insurance rates…to the point where it was nearly impossible to find a practicing OB in my state. The c-section rate soared. Deeply suspect.

          • Elizabeth A

            Have you compared the rates of instrumental delivery in those decades with the rates now?

          • ngozi

            There are also higher rates of women starting their pregnancies at unhealthy weights which causes more complications. More complications make c-sections necessary. My last pregnancy ended in a c-section mainly because of my gestational diabetes. I probably would not have had GD if I had started my pregnancy at a healthy weight. I know I am about to be crude, but should I blame my fat ass on my doctor?

          • The Bofa on the Sofa

            You realize why malpractice insurance rates went up, right? Because there were suddenly a lot of bad malpractice suits that OBs were losing. The OBs, according to juries of our peers, were doing things that were too risky when they were better, safer alternatives.

            So to counter that, OBs changed their practice to avoid malpractice suits. You know the best way to avoid malpractice suits? Avoid doing bad things.

            So let’s connect the dots: OBs stopped doing bad things as a way to prevent being sued.

            How is that a problem? That is EXACTLY what lawsuits are supposed to do – stop people from doing harmful things.

            There’s an old adage: no one ever got sued for a good outcome.

            Our society is the one that determined that doctors were being too risky, and should use less risky methods. Doctors listened.

            The system worked.

        • The Computer Ate My Nym

          OBs contribute to the rise in the cesarean section rate
          …and so to the lower rate of intrapartum fetal demise, neonatal mortality, and hypoxic encephalopathy. Evil OBs.

    • ngozi

      Please tell us what they do in hospitals to humiliate nursings mothers. You might want to answer carefully, because I have been a nursing mother in a hospital SIX times.

      • Karma Kidney Stone

        I’m a breastfeeding mother and felt humiliated when I had my last baby. The hospital was “baby friendly.” My baby was born at 36 weeks, induced because of a high risk pregnancy. One of the conditions I have, antiE sensitization, can cause jaundice. 2 of my previous babies needed phototherapy, and we were unsure of my titer status because the residents were idiots and kept forgetting to run the panel, even though I asked repeatedly. At 30 hours of life, the baby started getting yellow and was developing jaundice. My milk was not in yet, and typical for preemies he wasn’t nursing well, either. They sent in lactation who yelled at me because my baby was sleeping in the isolette, and then refused to help me because I would not sit topless in front of her. I discussed the situation with my husband (oh, did I mention he is a pediatric specialist?) and we decided to start supplementing with formula to try to keep the jaundice at bay. I asked the nurse for formula. She told me that it had to be ordered by the Pediatricians, who then came in (interns) and tried to shame me for using formula for jaundice. After several hours, I finally got the formula. The whole thing was very humiliating. My son narrowly missed being readmitted for phototherapy by one tenth of a point.And we went on to have a perfectly fine breastfeeding relationship until he became a toddler.

        • MaineJen

          Ugh. I’m starting to think “baby friendly” means “Run for the hills!”

        • Young CC Prof

          I’m sorry they were so nasty about you doing what was reasonable and best for your child. It’s not at ALL unusual for borderline preemies to need supplementation during the first few days, for so many reasons!

  • Deborah

    Wow! You are one angry woman…..I’m sorry that yoy have this anger or sorrow inside of you, but it is more painful (and damaging)that you put this out to the world

    • Karen in SC

      Wow, you are one woman with reading comprehension problems!

      There is no anger in this conclusion: “It’s time for safe, sane and respectful breastfeeding policies. It is time for MOTHER friendly breastfeeding initiatives.”

      • techqueen333

        I can assure you, Karen, that I have no reading comprehension problems. Dr. Amy’s rant is full of anger. Further, it’s full of assertions that don’t stand up against empirical research. Check out PUBMED.

        • moto_librarian

          Look up “confounding factors” and then get back to us, techqueen. The breastfeeding research is littered with so many of them that any conclusions drawn from them are pretty much worthless.

          • techqueen333

            Moto_librarian. I have a PhD. I know what confounding factors are. BF researchers have been addressing that criticism of previous research along with other criticisms.

          • theNormalDistribution

            You are just all flash and no substance, aren’t you?

          • Young CC Prof

            Yup, they have been addressing confounders. And lo and behold, the better they are addressed, the less benefit is found!

          • techqueen333

            That is a flat out lie.

          • theNormalDistribution

            Prove it.

          • moto_librarian

            What is your PhD in? Unless it is something directly related to this type of research, I am not impressed. Missy Cheney has a PhD too. In anthropology. That’s not working out too well, now is it?

    • LibrarianSarah

      Yes feel free to ignore Dr. Amy because she feels emotions.

  • Jfd

    Boy I am glad you are not my MD. I would not be able to trust a word out of your mouth

    • Amy Tuteur, MD

      What makes you think I would want you as a patient?

      • Susan

        LOL I have mentioned before here that I have seen docs practically dance when patients fired them off the case whilst the doctor who has been chosen by said patient looks on with envy.

      • techqueen333

        I’d say, that if you wouldn’t take her, she dodged a bullet. Despite your impressive credentials, you clearly haven’t spent much time perusing the empirical research in PUBMED. My MD husband and I (PhD) have been reading the research on breastfeeding for 35 years. The benefits of breastfeeding are most certainly not trivial. Further, its the nursing mothers who face the bulk of the unfriendly policies and attitudes.
        I don’t know if you’re just someone with body issues whose grossed out having an infant suckle at your breast or if you were unsuccessful at nursing. I’m sorry if someone hurt your feelings about it. However, I’d suggest getting some help for your anger and to stop lying to your patients.

        • Amy Tuteur, MD

          Talking about how impressed your are with yourself and your credentials is not going to convince anyone of anything. If you want anyone to pay attention to what you say, you need to demonstrate that you have read the bulk of the breastfeeding literature and understand it. So far you’ve merely demonstrated that you’ve read what you like and ignored the rest.

          • techqueen333

            Genetic fallacy, Amy.
            There’s no mechanism for publishing a literature review here. It’s available in PUBMED for you to read.

          • Young CC Prof

            How is that a genetic fallacy? You stated that breastfeeding has major benefits and that nursing mothers are persecuted. You were asked for examples of persecution, or for specific benefits and evidence, and again you merely stated that evidence exists.

            If you provide specifics, we can have a rational debate. You might even change some minds! But if people disagree with you the first time, saying it again louder isn’t going to help.

          • The Computer Ate My Nym

            There’s no mechanism for publishing a literature review here.

            Um…Review article on specific proposed benefit of breast cancer. There. Definitive evidence that there is a mechanism for publishing or at least posting a literature review here.

            Now, once again, I’m going to propose that you pick a benefit of breast feeding you find particularly compelling along with some data as to why you find it compelling so that we can evaluate a specific claim instead of some nebulous discussion of breast feeding being “better”.

          • The Computer Ate My Nym

            Um…breast feeding. Not breast cancer. Though I would point out that the SEER data shows a decreased risk of death in the next 5 years for women who have stage I breast cancer discovered. Does that prove that breast cancer is good for you? Well, no. It is probably a result of the confounding fact that women who have regular screening mammograms probably also have their other medical issues cared for. Notice any possible parallels to the current discussion?

        • The Computer Ate My Nym

          My MD husband and I (PhD) have been reading the research on
          breastfeeding for 35 years. The benefits of breastfeeding are most
          certainly not trivial.

          Ok, so why not go into some detail? Pick a benefit of breast feeding that you find particularly compelling and well documented and present the evidence for it. Then we can discuss the evidence, how well founded it is, whether there are confounders that might change the results (in either direction), and whether the benefit is seen in all populations versus a specific limited population.

        • Guesteleh

          She breastfed four children. But way to go in trying to shame another woman for how she chooses to use her body and feed her children.

          • techqueen333

            Hard to believe.
            I don’t go around shaming other women…but I do mentally judge women who WON’T breastfeed (I didn’t say who couldn’t. I said who wouldn’t). Very selfish. Formula should be a last resort, especially for newborns. Formula and breastfeeding are not interchangeable. Not even the formula companies would dare be so intellectually dishonest as to say that.

          • Poogles

            “but I do mentally judge women who WON’T breastfeed (I didn’t say who couldn’t. I said who wouldn’t). Very selfish.”
            I guess I’m just going to be selfish like that then, since I want to feed my (someday-in-the-future) baby perfectly healthy, nutritious food in a way that won’t cause me a ton of stress and discomfort.

          • theNormalDistribution

            Agreed!

          • moto_librarian

            So you are a misogynist. Thanks for clearing that up.

          • theNormalDistribution

            I don’t go around shaming other women…but I do mentally judge women who WON’T avoid feeding their children processed foods (I didn’t say who couldn’t. I said who wouldn’t). Very selfish. Processed foods should be a last resort, especially for growing children. Processed foods and whole foods are not interchangeable. Not even the processed food distributors would dare be so intellectually dishonest as to say that.

            Your silent judgement of non-breastfeeding mothers is about as valid as judging women who feed their children hot dogs.

          • MLE

            I am mentally judging you right now. Three guesses what I am thinking about someone who looks down on women who choose not to formula feed while having no critical analysis skills beyond crtl+c ctrl+v.

          • Susan

            Shaming? sure you do… what was the “too grossed out to suckle speech” if not shaming?

        • Susan

          yeah, well, Dr. Amy actually breastfed her four children and doesn’t regret it, but she doesn’t go around bragging about it as her life’s greatest achievement. Hey but I will brag… I breastfed my three babies all well into their toddler years… there are mothers who breastfeed who don’t get as ugly as you did about women who make a choice different from the one we did. Grossed out having infant suckle???? Really??!!!! And you are counseling Dr. Amy about her anger issues…?

      • Guest

        Those you reject are lucky given your irrational hostility toward breastfeeding and your rejection of the empirical research that confirms its benefits. Do you always reject research when you don’t like the outcome?

        • Amy Tuteur, MD

          Thus far you haven’t presented any research at all. Why not try presenting some instead of insisting that we take your word for what the research shows?

          • techqueen333

            I presented a number of studies. Where is your meta-analysis?

    • theNormalDistribution

      Yeah, totally! It’s not like a remotely intelligent person could independently verify everything she says.

  • Pragmatic IBCLC

    Now since my mother was taught to pasteurize milk and the MDs at the time of my birth thought women were completely capable of engaging in that process, I have to ask Angry Amy who is really doing the patronizing here? Have women lost IQ points since the late 1950s and early 1960s?

    It is easy to pasteurize milk and sterilize it. It can be done in the home. Human milk is no different from cow’s milk in that regard. There have been numerous studies on powdered formula – where it states clearly on the can in teeny weeny fine print “not a sterile product”. Women are not that stupid. They actually can learn to sterilize milk from ANY species. And for that matter – if one wanted to process human milk in the same way as cow’s milk it could be readily available in the grocery store

    • Karen in SC

      Yeah, there was a sci fi story I read years ago, called The Barn, I think. Human females with huge breasts were led to milking machines. Somehow, their intelligence had been removed, they were as docile as cows. I forget if the milk was destined for a grocery store….

      • techqueen333

        Probably written by a bottlefeeder.

    • Young CC Prof

      Can women sterilize things in a kitchen? Of course. Anyone over the age of about 7 can sterilize things in a kitchen. Would I trust a stranger to do it correctly every time and never get lazy, or cross-contaminate after the fact? If my baby’s health absolutely depended on it? Hell no.

    • Trixie

      Which is why we have HMBANA milk banks, to provide safe, screened, pasteurized donor milk to the babies who actually benefit from it the most — preemies and otherwise medically fragile infants. As an IBCLC, I’m sure you know that such donor milk is in short supply — which is why it drives me nuts to see unregulated internet milk sharing going to babies who would by and large be totally fine on formula. And I’m sure you know that contamination with pathogens isn’t the only kind of contamination you need to worry about with human milk donation.

      Milk donation to a milk bank is as worthy a cause as blood donation. It saves lives. Internet milk sharing is just stupid. And it syphons potential donors away from the neediest babies.

      I say all of this as a former milk bank donor, who was carefully screened, blood tested, and carefully followed the exact instructions given to me by my milk bank, which I’m sure most casual internet milk donors don’t even know exist.

      • Young CC Prof

        I totally agree. The very limited supply of donor milk should be reserved first for preemies and second for other at-risk newborns. It shouldn’t be essentially wasted on perfectly healthy babies.

        • techqueen333

          It should be available to any infant under six months of age.

          • Young CC Prof

            Great idea! How are you going to make enough? Because there ISN’T enough even for all the hospitalized preemies out there. And they get first dibs.

            Or are you denying that breastmilk can prevent NEC? It’s the one lifesaving benefit to breastmilk in first-world conditions, and you’re saying it doesn’t matter?

    • Trixie

      And also, as an LC, you should know that for at risk babies for whom non-sterile formula powder is a concern, RTF formula is recommended to prevent the very small risk of cronobacter. So stop scaring people with the “not a sterile product” stuff and maybe actually help educate them on safe formula preparation if they need it.

  • nikkilee

    Are you serious? Wow. The global epidemic of obesity and diabetes has nothing to do with how newborns are fed? Human milk doesn’t prevent NEC in premature infants? The earth is flat, and is only 6,000 years old? Wow.

    • Young CC Prof

      This post acknowledges the unique benefits of breast milk in preemies, but correctly states that the benefits in full-term babies are very small indeed.

      And no, formula doesn’t cause diabetes and obesity. Sedentary lifestyles and ample food do that, along with agricultural policies that subsidize corn syrup but not vegetables.

      • nikkilee
        • Young CC Prof

          That’s a CDC recommendation site. Please provide the actual sources.

          • nikkilee

            The CDC makes recommendations based on meta analysis. You can do a search yourself on google or on PubMed for anything and find enough evidence.

            Here’s the meta-analysis done by a government agency:

            Bottom line: the human race wouldn’t have survived if breastfeeding didn’t work. None of us would be here. Most women make milk; who can afford to throw food away? What baby needs modified extract of genetically modified soil fungus, alien protein (from cow or soy), silicon, MSG, and a host of other chemicals in its food? Infant formula is only food and does nothing for immune system development.

          • Young CC Prof

            I think your link didn’t work.

          • nikkilee
          • Amy Tuteur, MD

            Pro-tip: READ your citations before you cite them.

            The authors of the ARHQ report acknowledge right at the outstart of their report, in the abstract:

            “Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings…”

            The authors could not have made it plainer. No one should use their study or the data in their study to claim that breastfeeding causes the improved outcomes they discuss in the report.

          • nikkilee

            Let’s flip this discussion. Where is there any well-done study, or any recommendation by any health organization (ACOG, AAP or the WHO as examples) that says babies not breastfed have even the same outcomes as breastfed babies.

            Or that not breastfeeding is good for mothers?

          • nikkilee
          • nikkilee

            Babies not breastfed have an increased risk of SIDS

            http://www.ncbi.nlm.nih.gov/pubmed/21669892

          • Dr Kitty

            Babies whose parents don’t have college educations have an increased risk of SIDS too.

            Not everyone can go to college.
            Not everyone wants to go to college.
            We accept that people are able to make the decision that is best for themselves about college, even if the risk of SIDS is increased for their children.

            Same should go for breast feeding.

          • nikkilee

            Never saw published anything about going or not going to college as a risk factor for SIDS.

            According to current evidence,these are the risk factors for SIDS. Many are modifiable.

            Most deaths due to SIDS occur between 2 and 4 months of age, and incidence increases during cold weather. African-American infants are twice as likely and Native American infants are about three times more likely to die of SIDS than caucasian infants. More boys than girls fall victim to SIDS.

            Other potential risk factors include:

            smoking, drinking, or drug use during pregnancy
            poor prenatal care
            prematurity or low birth weight
            mothers younger than 20
            tobacco smoke exposure following birth
            overheating from excessive sleepwear and bedding
            stomach sleeping
            lack of breastfeeding

          • moto_librarian

            And don’t forget co-sleeping…

          • Dr Kitty

            I am alluding to the higher risk of SIDS in areas of deprivation.
            In the second study, particularly, maternal level of education was used as an indicator of social class.
            So yes, data exists that having a college level education is protective for SIDS

            http://www.bmj.com/content/344/bmj.e1552
            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449471/

          • nikkilee

            Thanks. Very interesting. Complex topic.

          • Karen in SC

            Pretty much anyone who is in their 50s, 40s and 30s.

          • nikkilee

            Research looks at populations and large samples. Can’t use a research finding to say anything specific about one individual.

            Like a seat belt. Are you guaranteed to survive a car crash if you wear one?

            No.

            So why wear one?

            Because your chances of survival go up so much that it is worth it.

            Breastfeeding is nature’s seatbelt. Gives a baby and mom the best chance for a healthy life; not a guarantee.

          • Amy Tuteur, MD

            Nature doesn’t have seatbelts. Evolution is not about perfection; it’s about survival of the fittest. That means that plenty of offspring, in many cases the MAJORITY of offspring will die. “Nature” doesn’t care. The population will grow as long as more than two children per mating pair survive. All the others can die and it’s just “fine” by Nature.

          • nikkilee

            Breastfeeding is supported by evolution; the fittest children survive. This means the breastfed children have a better chance. Why argue about our mammalian template?

          • theNormalDistribution

            Oh, sweetie. That’s not how evolution works.

          • Karen in SC

            Maybe way back when, in the middle ages. Now we have all sorts of help to survive, including formula, insulin, glasses, antibiotics, etc. BF children had a better chance vs goat milk or watered down bread, perhaps. But NOT NOW.

          • Karen in SC

            Now you are refuting your own argument!

            Yes, BFing is best for six months to a year on a population basis. Dr. Amy doesn’t dispute that. It’s only that the benefits are small, formula is a good substitute, so each family should decide on an INDIVIDUAL basis.

            As Bofa says, “__________ might be best if all things are equal. All things are never equal.”

            Just as no laws should prevent BFing in public, no hospital should be so biased as to discourage a mother who has decided to formula feed. It’s her INDIVIDUAL business.

          • techqueen333

            The benefits are NOT small.
            Yes, it’s her individual business to feel her infant an inferior and dead food. I don’t see that as anything to celebrate.

          • Jocelyn

            You know what other “dead” foods I enjoy? Fruits…vegetables…grains…meat…

          • Young CC Prof

            Personally, I prefer my meat dead and sterile, don’t you?

          • techqueen333

            False analogy.

          • Young CC Prof

            Humor. Try it.

          • techqueen333

            Do you feed them to your infants? False analogy.

          • techqueen333

            Another straw man. No one said formula feeding led to cognitive impairment.

          • Young CC Prof

            OK, fine. Breastfeeding doesn’t make much difference when it comes to intellectual accomplishment. What ARE the biggest benefits? You seem to think that physical health is one?

          • Young CC Prof

            Actually, formula-fed newborns are substantially less likely to suffer from jaundice during the newborn period, which can become quite dangerous if not treated promptly. So there’s one example of a formula advantage.

          • techqueen333

            What percentage of newborns suffer critical levels of jaundice???

          • anon13

            What percentage of newborns suffer critical levels of diarrhea?

          • nikkilee

            The research is strong in saying that if a baby breastfeeds 8 or 9 times every day for the first 3 days of life, physiologic jaundice can be prevented. This frequency is recommended by both the AAP and the Academy of Breastfeeding Medicine.

          • Young CC Prof

            Baby breast-fed every 2 hours around the clock. At age 4 days, his jaundice levels were twice the acceptable maximum.

            You were not there in the NICU when I watched a team of nurses stick my baby five times trying to start an IV because his veins were collapsed from dehydration. Go ahead, judge me for giving my baby formula. (And when my milk did flow in reasonable quantity, after he was able to leave the hospital, I had to pump and bottle feed, because he simply couldn’t latch.)

            If the mother isn’t making milk, there’s no milk. If the baby isn’t latching correctly and sucking hard enough, there’s no milk. And believe it or not, formula actually clears jaundice faster than breast milk, ounce for ounce.

          • Jocelyn

            My milk didn’t come in for the first three days of my baby’s life. Feeding around the clock didn’t help her. There was nothing for her to eat.

          • nikkilee

            Mothers start making milk in the middle of pregnancy, around the time that they feel their babies move. Your milk volume took a while to increase. This is normal.

          • Durango

            So do you think that a mom should just starve her baby for the three days until the milk comes in?

          • nikkilee

            Nope. There are other options besides using formula.

          • Durango

            Based on your other answers, you do seem to advocate for the baby starving. Either a mom should use donor milk (of which there is very little, and preemies need it more), she should hand-express (how that helps if she is not making milk is a puzzle), or you seem to claim that newborns don’t need very much so there. Techqueen seems to think IVs are preferable to formula, as well.

            And you think Dr. Amy’s original post was extreme? Her post basically said breastfeeding is a little better, but formula is fine. Here you are undertaking all sorts of mental gymnastics, special pleading, misunderstanding of basic science, demonizing formula feeding, elevating breastfeeding & breastmilk to magic–and you think Dr. Amy has the problem?

          • fiftyfifty1

            “Your milk volume took a while to increase. This is normal.”

            Yes it is. But it is also “normal” and common for that volume to be so low in the early postpartum days that it is unhelpful in preventing substantial jaundice. In addition there are substances in breastmilk itself that inhibit the process of conjugation and removal of bili from the bloodstream.

            Why must lactivists pretend that breastfeeding is perfect? Refusing to acknowledge real downsides to breastfeeding backfires. When a lactivist claims “put your baby to the breast 8 times per day in the first 3 days and you will prevent jaundice” and a mother does that and her baby gets severe jaundice anyway, it is a huge confidence blow. This betrayal of trust is compounded when (as so often happens) the lactivist then refuses to believe the mother when the mother tells her she has been breastfeeding that frequently! How much better it would be just to freely acknowledge breastfeeding’s downsides. A matter of fact “Oh that sometimes happens with breastfeeding, it’s not your fault, let’s supplement with formula for a few days” would go so far toward restoring trust between women and breastfeeding advocates and would improve long term rates of breastfeeding.

          • Young CC Prof

            You know, I ran into to 2 hospital LCs. The NICU one was actually like that. She basically said, “There’s milk in your breasts now, I can see it. You want to get some milk into your baby, let’s see if we can make that happen. The pumping room is over here, let me show you how to set it up. Nope, not quite like that… There.”

            A few minutes later, “OK, 10 ml. That’s better than nothing! Now you can try nursing directly, then we’ll give him the pumped milk, then we’ll top him off with formula.”

            The other one… Yeah, pretty useless. Lady, I know how to hand-express my colostrum. Stop rubbing my breasts and help me figure out how to get the baby to latch, or take your perfume which is setting off my asthma and GO AWAY.

          • Jocelyn

            Yes, but it didn’t prevent jaundice, did it?

          • nikkilee

            What kind of jaundice did this baby have? There are several kinds. Physiologic jaundice can be virtually prevented if babies breastfeed 8 or 9 times every day for the first 3 days of life. ABO incompatibility is a different story. So is true breastmilk jaundice doesn’t show up until the baby is a few weeks old (baby can keep on breastfeeding). Jaundice as a symptom of serious illness is another thing altogether.

          • Young CC Prof

            This is an interesting discussion of jaundice and other severe feeding issues in newborns. Mostly focused on late preterm babies, but as you see, they also affect nontrivial numbers of term babies:

            http://www2.aap.org/sections/perinatal/PDF/SchanlerLatePreterm09.pdf

            The idea is to AVOID the infant winding up with critical jaundice and dehydration. That’s a great way to ruin breastfeeding, since the baby then requires aggressive bottle-feeding and hospital readmission, which means separation from the mother. Giving an ounce of formula a few times a day can prevent all that and set up mother and baby for months of happy breastfeeding.

          • nikkilee

            Late preterm infants are premature infants and often don’t have the endurance or neuromuscular coordination to breastfeed well. Mostly all they want to do is sleep. Sometimes parents believe that if the baby is discharged, then things are fine and they expect the baby to act like a term baby. This is a set-up for trouble. Their mothers need a different education that includes pumping regularly, breastfeeding on a schedule, and supplementing (best with mamma’s own milk) until the baby matures, along with regular follow-up, encouragement and practical advice. Many hospitals will discharge 35 to 37 weekers without giving mothers these special instructions; then these little ones are readmitted, in trouble. Sometimes breastfeeding gets blamed for this, when the real issue is lack of education and support for the mothers who are going home with premature infants. The OBs that will encourage mothers to induce labor for convenience also play a role in this as inducing labor is a sure way to guarantee a premature infant. That’s why induction is a serious intervention, to be done only when benefits outweigh the risks. The March of Dimes started their “Give my my 39” campaign as a way to educate mothers to stay pregnant for at least 39 weeks to reduce inductions of convenience.

          • Young CC Prof

            OK, you didn’t read it.
            35% of term infants have clinical jaundice.
            7% have substantial feeding problems.
            And almost all inductions before 39 weeks are done for medical reasons.

            Drop the ideology and work in the real world. Practical attitude = More breastfeeding moms.

          • nikkilee

            That’s not what ACOG is saying.

          • fiftyfifty1

            “The research is strong in saying that if a baby breastfeeds 8 or 9 times every day for the first 3 days of life, physiologic jaundice can be prevented.”

            Frequent breastfeeding can reduce the chances slightly but it no guarantee of prevention. The risk of substantial jaundice is still many times higher in breastfeeding infants than in formula fed ones.

          • techqueen333

            You are cherry picking Amy.

          • Amy Tuteur, MD

            LOLOL!!

          • Young CC Prof

            What Dr. Amy said. If I had a few hours, I’d dig through the dozens of references and discuss the weaknesses of each one, but alas, I need to start the laundry before the baby wakes up.

          • anh

            There was no golden age of breast feeding. You seem to think that prior to the invention of formula human history was full of breasts filled with ample milk, fat happy babies who latched perfectly, and all that was ruined by evil formula pushers. wrong. History is full of weeping mothers and babies dead from failure to thrive.
            Sure, we survived as a species, but I’m personally not ok with babies dying in huge numbers.

          • Young CC Prof

            And mothers always used substitutes and supplements, many of which were animal milk. Formula is simply the only one that isn’t nutritionally inadequate and/or a potential source of disease. In Victorian times, many infants were “brought up by hand,” that is, fed animal milk in a glass bottle with a nipple made of India-rubber or an actual nipple from a cow.

          • techqueen333

            Gross

          • Young CC Prof

            I know. Isn’t it so wonderful that I can feed my baby a safe, sterile nutritionally balanced liquid in BPA-free plastic bottles washed with safe clean water?

          • techqueen333

            No. It’s still an inferior food.

          • Karen in SC

            Or death. Which would you choose for your child?

      • Pragmatic IBCLC

        Young CC Prof – you need to actually read the research in its entirety, not comments by opinion based celebrities who thrive on creating faux causes. The World Health Organization, the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the Academy of Breastfeeding Medicine have had hundreds of scientists review the literature and the risks of formula are real for infants and mothers alike. Among the conditions that are common and important that confirmation biased commentators employ is to cite multicausal conditions such as diabetes and obesity. As someone who had more epidemiology courses than I can count, there are ways of teasing out the various contributions, but it is beyond the comprehension of those who employ confirmation bias, cherry picking poorly designed studies to shore up their beliefs. Where the evidence is abundantly clear is on diarrhea (which yes does exist in developed countries) and ear infections.

        And if you actually do take a decent epidemiology course (there are some that are really not good) you will learn that there is more than just whether a trial is randomized to determine whether evidence for causality is plausible and probable.

        • Karen in SC

          Please explain how these studies eliminated confounding factors like parents’ weight and educational level and family history of diabetes.

          • techqueen333

            Read the studies and you will see how they did it.

          • techqueen333

            e.g. see wheezing study posted earlier.

        • Young CC Prof

          I have read the research. Long before I ever heard of Dr. Amy Tuteur or most of the skeptical community.

          Yes, the evidence is clear on diarrhea and other minor infections before age 1. In the 3rd world, this is a matter of life and death, here, not so much. Properly controlled studies find no long-term difference among babies growing up in areas with sanitation and clean water.

          • techqueen333

            You are absolutely incorrect. Way to cherry pick the studies you read.

          • theNormalDistribution

            Never in my life have I heard someone in an academic setting just flat out tell someone “you’re wrong”. ACTUAL academics are quick to tell you you’re wrong, give you all the reasons WHY you’re wrong, and tell you where you can find the evidence that those reasons are true.

            You keep bragging about how you have a PhD, how you read al the studies, how you understand them so well, and yet you can’t be assed to back up any of your assertions with an actual argument, tossing bib salad around like a monkey. Nothing you have said has demonstrated an actual understanding of the of the studies that exist and what their limitations are, and anyone who has attempted to explain those limitations to you, you reply with a vacuous ‘the authors address that’. Not how they addressed it. Not why what they did was sufficient. Just, ‘go read. The information is on internet’. I can’t understand how so many people have had the patience to put up your stupidity for so long. It is clear that you are not interested in genuine discussion or truth.

            And OMFG. Nothing Young CC Prof said in her post could be considered cherry picking. Do you even know what those words mean? (Hint: don’t just say ‘yes’. You tell me how you figure what she said was cherry picking. My prediction: you won’t. Because it wasn’t cherry picking and you know it. Or you don’t understand what it is. Either way, your attempt to intellectually bully others with their logical fallacies is only succeeding in making you look like an idiot.

        • fiftyfifty1

          “As someone who had more epidemiology courses than I can count”

          hmm…I have a hard time trusting the statistics ability of someone who admits she has trouble counting.

        • fiftyfifty1

          The Belarus PROBIT study. Best study we have. Huge, well designed, randomized. DID find that breastfeeding reduced eczema and diarrhea. Did NOT find it reduced asthma, ear infections or obesity. Obesity was actually *higher* in the breastfed group, a statistically significant effect which has persisted to age 11 (the most recent analysis).

  • Pat in SNJ

    The Mother Friendly Hospital Initiative has been going on for several years. It is designed to lower the ridiculous C-section rate in the US and give mothers quality care during childbirth and quality care as they being their most important job – being a mother.

  • Ann Hodgman

    Samantha. Evidence, please. Literally everything you’ve said here has been your opinion. Anyway, what’s it to you? Why so angry? Do you feel threatened?

    I can contribute anecdotal evidence about my own experience. I’m a 57-year-old who couldn’t nurse my kids because I’d had a breast reduction. In their first two years of life, both children had demonstrably fewer illnesses than their breast-fed peers–and they both ended up graduating from Harvard. When you’re a couple of decades older, I hope you’ll realize that there are all kinds of ways to raise healthy children, that all parents are trying to do their best, and that raging at people never convinces them you’re right.

    • techqueen333

      You are cherry picking Ann. I am in your age group. I offer a few cherry picked anecdotes for you in return. I breastfed all three of my children into toddlerhood. Formula never touched their lips. All of the moms in my parenting group breastfed. Our babies had very few illnesses. My nephew was formula fed and had to have tubes in his ears. My best friend’s sister was a bottle feeder and two of her sons had to have tubes in their ears. Her children constantly had snot running out of their noses. These are just a few examples. Overall, I observed a huge difference between the breastfed babies (probably fifty or more) and and equal number of formula fed babies in my sphere.
      I was breastfed for about three weeks. Then I was fed carnation milk with dextramaltose (sp?) in it. I had eczema, constant colds/sinus infections, and wheezing.
      My grandson was exclusively breastfed. He has had no issues. His cousin is formula fed and has severe intestinal issues. My best friend’s daughter couldn’t bf due to a thyroid issue. Her son has severe asthma.
      I cringe when I see a brand new baby slucking down formula.

      • Jocelyn

        Anecdotes =/= data

      • AlisonCummins

        Just out of curiosity, did the bottle-fed babies get more babysitting?

      • Young CC Prof

        That’s so nice for you. My brother and I never had a drop of formula. The eczema started when we were just a few weeks old. I had constant colds, brother constant ear infections. I now have asthma, food allergies, extremely severe skin allergies to the point that I can’t even wear sunscreen, and seasonal allergies.

        My mostly-bottle-fed son? My mother can’t get over how clear and healthy his skin is. No one in our family gets healthy rash-free skin!

        Again I challenge you. Pick ONE study, perhaps two. Explain in your own words what benefits it strongly demonstrates and which confounders were controlled for. Please use words like “dose-response relationship.”

        I really want to debate you. But it’s like playing tennis with someone who keeps picking up the ball and throwing it over the fence, I just don’t know where to begin!

        • techqueen333

          I have no intention of spending my time explaining studies to you. I have posted several examples. I even gave you abstracts instead of just citations. If you are interested, you can read them for yourself. The researchers who did the wheezing study clearly articulate what confounders were controlled for.

          The evidence overwhelmingly supports breastfeeding. If you or Amy disagree, then write a meta-analysis confirms your assertions and get it published in a peer-reviewed scholarly journal.

          Your attempt at ridicule via the tennis ball analogy falls flat. You don’t know where to begin because the science isn’t on your side.

          • Young CC Prof

            “I have no intention of spending my time explaining studies to you.”

            OK. You don’t understand them. Fine. Pick your favorite two (no more) and I’ll explain them.

          • techqueen333

            Nice try. I guarantee I understand them at least as well as you. The fact that I don’t have the time and don’t choose to do your work for you doesn’t mean I lack analytical skills.

          • KarenJJ

            Young CC Prof and techqueen333 are people I don’t know in real life. I only have what I read about you both on the internet.

            Young CC Prof has gone in to the data of a study and given an opinion based on the data in a study as well as summarised another study’s key findings in her own words.

            techqueen333 has stated her opinion and then copy and pasted links to studies and also copy and pasted parts of the studies that support her opinion.

            techqueen333, can you not see how doing the sort of work that Young CC Prof did is not helping your argument. She has already shown greater understanding of the papers then you have.

            Saying “I understand it as well as you do” is meaningless if you don’t show it to the other readers here.

  • Samantha Anderson

    Since when is breastfeeding a choice? I’m sorry that so many of you are gathered here to OOOH and AHHH and pat each other on the back for your illogical choices, but just because you find a group of people who agree with you doesn’t make you correct.
    Formula is not, has never been, and may never be as good as human milk. It is not acceptable, it is not a “choice”, it is not “good nutrition” for a baby. It is an emergency fallback that should only be used when other routes have been exhausted.
    Women can and SHOULD be judged by these first choices they make for their children. It is telltale when a woman can’t even provide the most basic function for her child because she’s just “so fragile” that she can’t manage to put her nipple in the baby’s mouth?
    Has no one noticed the irony of everyone here harping on how horrible natural childbirth is, then turning around and recounting their own non-NCB experiences and how horrible they were that they just “couldn’t” breastfeed from being so exhausted and, traumatized, and broken? Interesting.

    It all comes down to this: No one wants to hear that, 100 years ago, your kid would have died because you couldn’t nourish it. So from that (using formula when it’s absolutely necessary), we turn breastfeeding into a “CHOICE” now, and then we sit around and coddle each other and “support” each other for making sub-standard decisions for our children. It’s embarrassing.

    • rh1985

      It’s been a choice since modern technology gave us a choice.

      • Samantha Anderson

        I also have a choice to smoke crack, but it’s not the best decision for me.

        • Monica

          Crack is not the same as formula. Crack is illegal formula is very legal and a perfectly viable option at sustaining life in infants. The point is why do you care what another woman chooses to feed her baby? What affect does it have on you? Is formula not better than starving a baby? Is it not better than giving a baby soda or juice or cow milk before she’s a year old? Of course it’s a woman’s choice how to feed her baby. Not everyone lives the same life as you where she’s able to breastfeed on demand or even pump every two hours. FYI, this is coming from a woman who chose to formula feed a child, chose to give breastfeeding a try and was only successful at it for a few days, chose to breastfeed to the point that it could have killed her child because he wasn’t thriving on my milk, and then breastfed for 14 months and did not give one lick of formula to one child. Those were my choices and the choice of my husband and what was best for us and our family at that point in time of our lives. And the exclusively formula fed child is doing no better or worse in life than the exclusively breastfed child. I dare anyone to come into my home, look at all 4 of my children, and tell me without knowing anything about us which one had how much breastmilk in their life. You couldn’t do it.

      • Samantha Anderson

        NO WAIT, I’m sorry, I have that decision to make and NO ONE – NO ONE – should judge me for it!!!!!!!!!
        Is that right?

    • antigone23

      Hey, how about you go fuck yourself? My kids are fine. Why don’t you spend your time worrying about children who are actually in peril? Donate to some children’s charities. Become a foster parent for abused/neglected children. Stay the fuck out of my business.

    • techqueen333

      Brava!

  • Teleute

    If I could have traded in the time I spent pumping at work (three 25-minute sessions in 12 hour day) to sit feeding my baby three bottles of formula, you bet your ass I would have. The truth of the matter is that lactivism has nothing to do with babies; it’s entirely about their (sancti)mommies.

  • MichelleJo

    Love.this.post. I’ve copied and pasted onto a word document for the benefit of any exhausted guilt ridden breast feeding mother.

  • Bethany Barry

    I breast fed my daughter for 15 months, which I flashed like a platinum hectoring pass when rooming in with my son (at a “baby friendly hospital”). I basically said to the nurse “Look, I breastfed one kid until she was old enough to tell me she was sick of looking at my boobs. Kindly take this one for 3 hours so I can get some sleep.” I brought my own pacifier and formula with me, and gave not two figs what anyone had to say. After all, I did all the no-no things the first time and still managed to breast feed because I wanted to and was not physically unable to. Ta da. Sadly first time moms and their partners often have no such protection or foreknowledge.

    I think it’s time to start volunteering my services as a post-natal pal, a sort of bizarro-duola. I will hang out in your room and say things like “Gidget has been awake for the last 36 hours, and hasn’t had a full night’s sleep in 3 weeks. For the sake of her health and well being, you will take this baby to the nursery for the next 3-6 hours, at which point her mother will be here to hold the baby. Thank you.” Or “You may notice that little Svengarten has been nursing continuously for the last 2 hours and is still crying from hunger. He is to be given a snack so that Gidget can enjoy some bonding time with a happy baby, or maybe go shower.”

    PS, for the moms posting about giving birth in hospitals that had eliminated the nursery…how did you shower?!?!?!!?!?!?! Because I really needed a shower.

    • Happy Sheep

      At my hospital, the bathrooms were pretty big, you were expected to wheel the bassinet in there with you to shower, or use the toilet. We were told repeatedly to NEVER let the baby out of our sight.
      Pushing a bassinet, while lugging an IV pole to go to the bathroom 10 hours after birth is not fun, let me tell you.

      • Young CC Prof

        Gotta guard those babies carefully, 10 feet away isn’t good enough. Because, you know, a newborn getting kidnapped out of a hospital has happened a whole one time in the last generation, and that was BEFORE they started locking maternity wards more carefully than psych wards.

  • MelodyCason

    Yes! Great post!

  • ajwatter

    I’ll be giving birth at a “baby friendly hospital” (the only hospital in my small town) in six weeks or less. This week I attended the hospital’s childbirth and breastfeeding classes. They’ve gotten rid of the nursery, but you aren’t necessarily given a private room. The pressure of not being able to sleep because of one’s own baby is one thing, but is it really baby friendly to expect a new mother to lose even more sleep because of a roommate’s baby too? Furthermore, these classes heavily promoted not asking for pain relief unless the pain was “really bad” and even touted the hospital’s arbitrary and antiquated 4-5cm policy. The breastfeeding class was 2 hours 30 minutes and about an hour and a half of the information was lactivist propaganda with considerable time spent on all the diseases breastfeeding prevents. I’m really pissed off I had to sit through all this. I want my dang medicalized birth and not to have to sit for long periods in uncomfortable chairs (with hemorrhoids no less) and listen to “educators” pass along propaganda under the guise of “evidence based research.”

  • The Computer Ate My Nym

    Tangentially related: You know that blanket statement that breast feeding reduces the risk of breast cancer, especially high risk cancers? It may not be universally true. May I say fuck generalizing from a single population to all populations?

    • MichelleJo

      I had a woman telling me that she doesn’t need to go for breast exams because she nursed eight babies and the risk of breast cancer diminishes significantly with each baby nursed. And she was serious.

      • Young CC Prof

        Statistical significance, yes. Practical significance at a population level, yes. Practical significance at an individual level? NO!

        Grrr. Need to teach statistics to more people!!!!!

  • Jessica Atchison

    Heh, I was reading a (much anticipated) sequel to a romance novel I had read over the weekend and the heroine of the story gets preggers. And then I started bleeding from my eyes as the author then digressed into a preachy bit about how vaccines cause autism and breastfeeding is best and skin touching and cosleeping etc… Thing is, this was just published on Tuesday, so it’s not like it was published before the study proving the link between Autism and vaccines was discredited. So whyyyyyyyyyyy?????

    • Anj Fabian

      Whoa, what?

      The romance genre is usually “Take me away!” to some other place and time. Author inserts usually ruin that experience.

      http://tvtropes.org/pmwiki/pmwiki.php/Main/BlackHoleSue

      • Jessica Atchison

        Right? I’m reading this because I love the trope of the Alpha Male and the kickass broad who loves him. Not to read BF anti vaxxer propaganda!

  • theadequatemother

    It’s like there has been a SOB baby boom! Congratulations everyone.

    We had our second son on the weekend. It was precipitous and “natural” although not really by choice so much as circumstance. I’m feeling great. My husband is shell shocked by what he witnessed. I’m keeping an eye on him because he’s pretty anxious about it.

    Our hospital is not BFHI as far as I know although they are paying lip service to it. I wasn’t lectured, and as a multip I wasn’t given much advice or support either which was perfect because I didn’t need it.

    I took my own formula with me in the hospital bag. On discharge with an intermediately high risk bili, I cut off all the concerned instructions for a recheck in two days with a “that’s okay, we’ll just supplement until my milk comes in” which caused the RN to breathe a sigh of relief. Are they not allowed to suggest it? I didn’t ask. I just wanted to get home.

    • LynnetteHafkenIBCLC

      Congratulations!!!!

    • Jocelyn

      Congrats! 😀

    • Jessica Atchison

      Congratulations!

    • Josephine

      Congratulations! There has indeed been a baby boom. So happy for all of our new parents here.

    • Bethany Barry

      Congratulations on your new addition!

    • Isramommy

      Congratulations!

    • Happy Sheep

      Congrats!

    • Dr Kitty

      Congrats!

  • Antigonos CNM

    The truism that “one size fits all” seems to have become standard practice all over and of course, it isn’t true at all. Each baby and each mother have individual needs and care has to be tailored to each to be effective. When my granddaughter was born I saw this very clearly [and she gave birth in a hospital where, 30 years previously, and pregnant with her, I had worked!]

    This maternity unit had been built before rooming-in became trendy. All the rooms are for 3 women and barely big enough to accommodate three beds and three bedside tables, let alone armchairs suitable for mothers to sit in to nurse their infants and/or the babies’ cots themselves. Yet, it has now become normal practice for babies to come from the nursery after morning rounds and remain with the mothers until 11 p.m. The crowding is uncomfortable, and unsanitary. But rooming-in, no matter how tired the mother, is A Good Thing. It really helps the other two women in the room, also, if one baby persistently screams.

    Breast-feeding advice was constantly given — and given — and given. A good deal of it was contradictory [the nursing school instructor, with her students in tow advised engorged mothers to put COLD compresses on their breasts] In point of fact [I was there and saw it], NO real advice was given on how to deal with engorgement. When my daughter, who was post C/S and still didn’t walk easily, asked a floor nurse to get her a bottle from the nursery, she was ignored. “You should nurse more” even though her milk had not yet come in. I went down the hall to the nursery and, after argument, got a bottle of water which did not pacify my granddaughter for more than 10 minutes. No one ever looked at my daughter’s nipples, which are inverted, or gave her any advice [I brought her nipple shields, which helped a little; the unit “reserved” its electric breast pump “for mothers whose babies are in NICU”]. It is assumed, apparently, in the Breastfeeding Universe, that all nipples are exactly the right size and shape, and babies know instinctively how to latch on [they know how to suck, which is not the same thing].

    In the end, the staff were very happy to discharge my daughter a day early and have her return to have her staples out, as the entire unit was swamped with a flood of delivered women. I got my engorged daughter and my dehydrated granddaughter home, got daughter into a warm bath and helped reduce the engorgement, gave granddaughter a bottle, and arranged for a breast pump [ultimately daughter chose to feed pumped breast milk by bottle as all attempts to feed directly from the breast didn’t succeed]

    Very friendly, indeed. Very stupid and inconsiderate, IMO.

    • realityycheque

      Your daughter is extremely fortunate to have a sane, assertive mother on her side! I’m sorry to hear she was treated like that, it’s inexcusable.

    • Sarah

      Interesting, which hospital was this at?

      I gave birth at har hatzofim recently and while I did get challenged by 1 doctor for not wanting to bf, the nurses were amazing and actually gently reminded me that if I’ve definitely decided not to bf, then it would be worth taking dostinex to avoid unnecessary pain later down the line (milk hadn’t come in yet due to c-section).

    • TG

      lol a lot of this happened to me. this describes SZMC to a T- am i right? if i didn’t explicitly tell them not to wake me for the midnight feed, they ran after me with the bassinet. when i was done and wanted to return the baby, they said “why are you bringing him back?” oh yes- i was probably the only primip in the ward and they’re used to it being everyone’s sixth kid, so i got no guidance whatsoever until the lactation consultants (probably that same instructor, students in tow) discovered me and said i’d never have enough milk (PS- i do, and i was lucky that the baby latched immediately).
      and that #$%#$@% loudspeaker! i couldn’t keep up with their schedule- i was always late somewhere. not a very relaxing two days. but L&D there was amazing and i’d go back.

      • Antigonos CNM

        No, it was Hadassah Mt. Scopus. There’s not a lot of difference between Jerusalem hospitals in policies on the maternity ward, especially now that Misgav Ladach closed — and a lot of ML’s flexibility was due to it being a very small hospital. Large institutions nearly always have to be quite doctrinaire or chaos results.

    • Anka

      That sounds awful! My entire maternal side is Israeli, and I had been romanticizing Israeli hospitals after catching a few glimpses of one while visiting relatives, but now I see I have to stop. Your daughter is lucky to have you!

      • Antigonos CNM

        The medical care is excellent; the nursing care varies because the patient/staff ratio generally is not as good as in the US and the nurses are rushed off their feet, but the physical plant in just about every instance is way below what US hospitals regard as optimal. For example, when I had my hip replaced a year ago, the orthopedic ward at Mt. Scopus still had hand-cranked beds and the airconditioning was minimal. Most hospitals do not have the option of private rooms. And Hadassah’s food was awful, so don’t romanticize Israeli hospitals!

  • KarenJJ

    I had the pick of two hospitals and chose the one that had a nursery during the night if I wanted to use it. I was very glad I did. With my first I started shaking and vomitting at 4am after birth and with my second I had a flare or my immune system issue (fever, shaking, nausea, exhaustion – like coming down with the flu) and couldn’t get out of bed. Was glad to have the babies in the nursery with someone watching over them for me.

  • KarenJJ

    OT: I just spotted this advertised in a local parenting paper. I always thought that some sort of mythbuster session needed to happen with parenting myths. Haven’t read it myself but I might see if my local library is interested in getting a copy.

    http://uwap.uwa.edu.au/books-and-authors/book/will-mozart-make-my-baby-smart/

  • Elisabeth Graham

    I’ve fostered about 60 newborns, usually with some difficulties related to the birth mom’s addictions, or to some very traumatic birth circumstances. I’ve breastfed a couple I acquired in the regular way so I’ve seen both sides. My conclusions: formula feeding makes more dishwashing; newborns feed best in the breast feeding position; I would have to be tied down to make me co-sleep – but a cradle beside my bed works for me. The most difficult feeding experience was with a baby on the verge of starvation who had to be given a drop or two of food every 10 minutes. Next would be the baby who was at risk of kidnapping – so was sent to me from the hospital weighing 4lbs 2oz. My whole point is that babies need to be fed – it doesn’t matter what approach is used.

  • Lisa

    Due to a rare birth defect, I was born without a bunch of muscles in my arms and legs. Various people wanted to send me off to Easter Seals, but (with my parents unwavering support) I worked extremely hard and graduated at the very top of my classes at both my Ivy League college and my Ivy League graduate school. I know what it is to overcome challenges and sacrifice for what’s important.

    But, no matter how hard I try or how much I want to, I cannot — and will never be able to — lift my arms above my waist to hold a baby, carry a baby, bathe a baby, or rock baby, much less hold a baby to my breast and help him latch. When my first child was born, I desperately wanted to breastfeed him, but my birth defect made it completely untenable. I grieved for weeks that my disability meant I had to miss out — yet again — on something I really wanted to do.

    Even as I was trying to come to terms with my disappointment, lactivists tortured me for months with crazy schemes and ways that I might be able to breastfeed “if I really wanted to.” (Craziest idea: Put the baby in his car seat on the bed, and then bend over him so my breast would dangled into his mouth. Like anyone could stand that way for more than 3 minutes without hurting their back!) Worse, it was painfully obvious that everyone (including our pediatrician) thought I was a bad mother for not “overcoming my disability to breastfeed.” Over and over, I was told that “loving mothers breastfeed.” I was already crying myself to sleep each night, terrified that I was a failure as a mother because I couldn’t take care of my baby myself and terrified that my baby would form some mystical bond with our nanny, not with me. By essentially confirming that because my disability kept me from breastfeeding, I really was a bad mommy who would never develop a bond with my baby, the lactivists in my area made an already upsetting situation that much more traumatic. There are some people I will never forgive.

    (Btw, I got over it, and went one to have two more children. I never really found pleasure in the baby phase — that hurt never fully went away — but my little boys thrived on formula, and now ADORE their mommy. All those tears over nothing!)

    • Susan

      Wow what a story. I hope the baby friendly people DO read some of these comments because I don’t believe that anyone but true crazies want to create a climate where someone would have your experience. I am so glad you overcame it.

    • Kumquatwriter

      I am so sorry you went through that!

    • auntbea

      WTF. I wonder how much of their willingness to be total douches was because they see people with physical vulnerabilities as easy targets. Do you think you were treated worse BECAUSE of your disability?

      • Lisa

        Sort of, but not the way you might think. Everyone’s accustomed to me exceeding their expectations (which is sort of an oxymoron, right?) and everyone likes to pretend my disability isn’t really a big deal at all. So, I think it frightens people when they are confronted with how limiting my disability really, truly can be. Reflexively, they want to be reassured that it’s just another problem that can be overcome if I really want to and just try hard enough. (Does that make sense?)

    • Anka

      That is awful! I thought my experience with lactivists was bad (and it was), but I just want to find your lactivists, and, I don’t know, take them to court or something and prohibit them from ever doing harmful things to other people’s relationship with their babies again, on pain of some kind of punishment!

  • Aussiedoc

    OT but not really – our baby boy Owen is here. Birth went well (apparently while pushing I was screaming at the OB are you sure? I’m supposed to have an emergency Caesar! Doctors don’t have vsginal births. Lol.

    Aftercare was horrendous. No help whatsoever with breastfeeding. Not offered a chance to bathe my baby. Baby with tongue tie who doesn’t feed well – no help. Begged for some sleep and formula – given lecture,

    Seems baby friendly means no one friendly.

    Now getting help from very sensible lactation consultant and mother. Planning long complaint letter and finally enjoying my baby.

    Proves even GP obstetricians are not immune from this….

    • araikwao

      Congratulations!! (I have some bad aftercare stories too, sadly, from my corner of Australia.) Hope the sensible LC is helpful and your recovery is fast.

    • Young CC Prof

      Hello Owen!!!!

      Glad you had a relatively uneventful birth. Sorry the hospital was so useless afterwards. (Really, hospital, you want to be baby friendly, so you stop providing formula, but you can’t get LCs in? If you want to change your clothing styles, you have to buy new things, not just toss out all your old ones.)

      • KarenJJ

        Or you convince people that it’s all fine and normal to have invisible clothes, and if they feel differently to you then it must be their fault.

    • Susan

      Congratulations on your baby and I hope your letter helps other moms in the future!

    • Josephine

      Congratulations on the new baby! I’m so sorry for the unpleasantness you experienced. That must have been horribly frustrating.

    • Jocelyn

      Congratulations!!!

  • Stacey

    Any hospital that gets rid of well baby nurseries, in favor of mandatory rooming in, is doing moms a HUGE disservice, as well as putting babies at risk. Even if each baby had its own nurse, just their presence can ensure mom does not get the sleep she needs directly after birth.

    I have experienced this. My baby was given to me only a few hours after I had been up 48 hours, labored 36 and then had an CS. I was suppose to do ALL his care, from 7 pm – 7 am (at least they still had a day nursery). This meant getting out of bed to feed, soothe and diaper him, at a time I was unable to move at all and heavily medicated. I was actually totally unable to move, or get up at all for nearly 3 days.

    I admit that I was unable to care for him at all. I had to let him cry until the nurse felt bad and took him on rounds with her, which was nice, but was in no way a good solution. I am also pretty embarrassed to say that I was actually relieved to find out he went to the NICU- I finally got the rest I needed. And I still managed to pump every 2 hours, and every 4-5 at night.

    I cannot think of any other surgery or major medical event where you are not only handed a totally helpless baby directly thereafter, but are also expected to care for them with little to no help. Then you are told this is BEST FOR BABY! HAHAHAHA

    • Susan

      We have a tiny nursery and the babies are routinely out with their moms. We may keep a baby in the bassinette at the desk with us but I would never take a baby into another patient’s room with me. To me that’s what “rounds” means, is that what the nurse meant? I get this, a mom with twins and breastfeeding issues could be … every three hours start of feed to next, try to breastfeed Baby A… try to breastfeed baby B…. pump….feed babies pumped milk… perhaps supplement with formula… clean up paraphernalia… the whole thing is going to take more than an hour. That…. is not much sleep, and no guarantee the babies won’t be fussy. Would be bad enough with one baby never mind two! ( Baby Friendly hospital… )

      • Ainsley Nicholson

        My experience with newborn twins…Hour 1: Baby A try to breastfeed, feed from pumped milk, cuddle & diaper; Hour 2: Baby B try to breastfeed, feed from pumped milk, cuddle & diaper; Hour 3: walk 1/4 mile back to room, pump, cleanup, eat (if food is there), sleep 15 min, walk 1/4 mile back to special care unit…start over again. This was after an uncomplicated vaginal delivery, and I already knew how to breastfeed. I was so glad when I was released from the hospital and got a break from having to do all that walking. I can’t imagine how someone with a c-section wound and new to breastfeeding could do it. I actually don’t understand how I managed to.

        • Susan

          Amazing what new moms will do for their babies!

        • Young CC Prof

          Clearly, evidence that your vagina has superpowers. (And, you know, the rest of you.)

        • Amy M

          I only attempted nursing my twins in the hospital, and I tried tandem nursing every time because I saw if I tried to do one at a time, all I’d be doing was feeding babies, round the clock. I wanted them on the same schedule. Of course, this meant I needed at least one nurse to help me because I don’t have six hands and they were my first children and I had no idea what I was doing. Thank god they had a nursery at this hospital and made liberal use of it. They even offered to do a finger-feed for me so I could get more sleep…I took them up on it.

          • Ainsley Nicholson

            Oh yes, I switched to tandem nursing as soon as both babies had the nursing thing figured out.

          • Amy M

            Yeah, I switched to exclusive pumping as soon as I walked in the door of my house and noticed I didn’t have any nurses hanging around to help with that dang SNS thing. Then after a few weeks I switched to exclusive formula feeding because that whole pumping thing wasn’t working…boy was that a relief! I got some sleep! Not enough, but more than uselessly pumping for 45minutes every 3hrs. 🙂

    • rh1985

      The hospital I will deliver at wants to become “Baby Friendly”, but doesn’t want to get rid of the nursery (patient demand maybe?) – I bet they fail at getting approval which is fine by me!

      • Karen in SC

        I think if you read the original information on baby friendly status, it is neutral on nurseries. So these hospitals are going above and beyond, or trying to save a buck. You decide.

        • rh1985

          when I read it it pretty much said they think a certain % should room in but the nursery doesn’t have to go. Honestly I think most of the things they promote should be available choices, the problem is pressuring moms who don’t want to room in or EBF or have skin to skin immediately, etc…

    • antigone23

      A-fucking-men. Getting rid of nurseries is a fucking travesty. It should be illegal as it is a health risk to leave newborns with patients who are unable to care for them. Postpartum mothers are PATIENTS. They are in the hospital FOR A REASON. Sure if they had an uncomplicated birth or a family member staying with them and want the baby in their room, let them. But don’t force everyone to do it. To be honest, I think this getting rid of nurseries stuff has more to do with saving $$$$ than anything else. If they really want to encourage breastfeeding, than they should at have lactation consultants available to assist with feedings 24/7. But oh no that is expensive.

      My OB delivers at two hospitals. He openly discourages one that is working on baby-friendly status because when his wife delivered there, they gave her a hard time about sending baby to the nursery. They still have one, but you have to fight to actually use it. He wants his patients to be able to heal and rest for a few days before being up all night with babies. I am happy I had this information because I LOVED my non baby friendly hospital. I got the rest I needed and no one demanded to know why I was formula feeding or attempted to re-educate me. I was treated with dignity and respect.

      • palmafm

        We are lucky in this side of the world (SA) that they baby friendly initiative hasn’t caught on yet. The hospital that I delivered in required a 2 night (minimum) stay after an uncomplicated vaginal delivery. Night one – baby stays in nursery and the baby nurse brings baby to be fed. Night two – baby stays in moms room (but I was assured even on this night that if I needed to I should bring him to the nursery so that I could get enough rest).

      • Anka

        The hospital where I delivered is aspiring to “baby-friendly” status, and their attitude is basically “leave the baby with the exhausted parents [who in my case had no help and no relatives or other visitors to relieve us] and when there are nursing problems [my milk hadn’t come in and there was just about no colostrum to speak of], maintain a laissez-faire, sink-or-swim situation because it is Good For Them.” So our first full night with our son, he was shrieking and crying from hunger, I was trying to recover from third-degree tears with inadequate painkillers and lugging an IV tree around like a bloodstained zombie [they later admitted that I didn’t really need the IV, but because of it, I couldn’t shower], and both of us were shell-shocked and sleep-deprived and trying to get this shrieking baby to stop crying, and eventually my husband managed to convince a nurse to come in, and she was all,”did you try NURSING? You should try harder.” She sighed and rolled her eyes and swaddled him, which kept him quiet for about ten minutes, and walked out. I have never done something like this in real life and never would, but these days as I’m emerging from my PPD, I have fantasies about finding those nurses and beating the crap out of them.

      • MichelleJo

        Yeah like someone telling you “I hope you’re getting your strength back.” Like where from? A screaming, never let you sleep baby? People who have gone through a childbirth like procedure, and there are few that take so long, are so painful, and leave you so ragged, get nursed, looked after and pampered. But not a woman after birth. She gets nothing and has to give everything. Mad world.

  • Kara

    Thanks for this post! I was brainwashed into thinking that breastfeeding was THE ONLY way I could feed my baby. I didnt have great supply, my baby starved and was always underweight. Any time I suggested perhaps supplementing with formula, I was told it would hinder my supply even more and to pump instead. I got depressed and my baby was still hungry. Finally, 9 months into it I bought a container of formula and it solved all my problems. Most importantly my daughter wasn’t hungry anymore. Why the hell didnt someone just tell me I needed to do that? Because theyre protecting the breastfeeding initiative? Isn’t feeding a baby’s hunger much more important? Because of it I have a bad taste in my mouth about breastfeeding. Not a good experience.

    • araikwao

      Nine months??? Tell the LCs et al to try going hungry for nine months!!

      • Young CC Prof

        I had to be on a liquid diet for two weeks after surgery. By the beginning of the second week, it felt like it had been going on forever and would never end. Food was the first thing I thought of when I woke up, and the hunger was the last thing I knew before I finally fell asleep at night. I can’t imagine a child going through that. (In fact, UNICEF had the good luck to hit me up for money around day 10 of this ordeal, and I gave them a LOT.)

      • Kara

        I know right?! The LCs told me I wasnt trying hard enough and the baby nurses were telling me I wasn’t feeding her enough, when obviously I was trying as hard as I could! Like Dr Amy said, the effects of maternal depression are clearly documented, give a new first time mom a break for pete’s sake!

  • Jocelyn

    OT: I had a baby this weekend! Our beautiful new little daughter was born at 2 in the morning on Saturday. This labor was so different from my first (the first: super long, extremely painful contractions from the get-go; this one: very short, not very painful contractions) that I almost didn’t realize I was in labor until it was too late. We barely made it to the hospital! I had her 15 minutes after we got there. No time for pain relief, not even time for them to strap the monitors on me. They had to run find the on-call doctor when they realized she was crowning. So there went my plan for a second epidural labor, haha! Now having had one with an epidural and one without, I can tell you that I DEFINITELY prefer the pain relief. I didn’t need it for the contractions this time, they weren’t that bad, but MAN pushing her out hurt like nothing else in my whole life.

    Side details: I actually tested GBS positive during my pregnancy and since we didn’t make it in time to the hospital in time for the antibiotics, I was really worried about that. But they kept an eye on her while we were in the hospital and we took her in to the pediatricians the day after we came home, and they said that she’s looking just fine and we don’t really need to worry at this point.

    And relevant to this post: The hospital I delivered in was “baby friendly.” That meant that there was no nursery for my daughter to stay in at night, so I got less than an hour of sleep the night after she was born, after having had less than two hours of sleep the night before. I was a miserable, miserable zombie during that night and sorely missing the hospital I delivered at with my first. All my baby wanted to do all night was eat, and I would have loved to give her just an ounce of formula because my colostrum clearly wasn’t satisfying her, but I didn’t want to ask the nurse for any formula because I didn’t want to get lectured. I got lectured just for asking for a pacifier. The nurse told me they “didn’t like giving babies any pacifiers in the first couple weeks.” Yeah, well, my first had a pacifier right from the beginning and she was just fine. Secondly, this: http://goo.gl/dgRB0J. Thirdly, it’s my decision anyway. But, it was 3 in the morning and I was a zombie and I just mumbled things like “Mhm, mhm,” until she gave me the pacifier.

    Anyway, sorry for the novel! We’re excited our new baby girl is here!

    • Young CC Prof

      Like for the arrival of your healthy daughter, not like for nurses being unhelpful.

    • Cellist

      Mazel tov!!!

    • Dr Kitty

      Congratulations!
      Enjoy the baby, and don’t sweat the small stuff.

    • Kara

      I was at a baby friendly hospital too and was so exhausted I was hallucinating. I would have killed for them to take the baby away for one night to get rest so I could have healed.

      • C T

        How is that “baby friendly” to leave a baby in the care of an exhausted, hallucinating post-partum mother instead of an alert, non-anemic nurse? I still shudder at the state I was in with my second child when the nurses brought her to me; I’m very fortunate I didn’t fall asleep on her.
        I’m putting on my next birth plan that I want to get some SLEEP and to please keep my baby with the nurses so that I can. I’m quite confident by now (I’ve had four babies already) that baby and I will have no problems breastfeeding or bonding just because I got some sleep with a couple of doors between me and baby. Wonder how that’ll go over….

        • Young CC Prof

          See, that’s another thing that’s weird about NCB folks. They place so much importance on bonding the first day. We’re not ducks, for heaven’s sake, and the parent-child bond is something that grows over months and years. Shockingly, some parents actually DON’T fall in love at first sight, and still develop great relationships with their children. Some fathers don’t see their babies for days after birth, or even longer, and still develop strong relationships.

          • C T

            Hehe. I still remember when they showed me my first baby…all purple and white and a bit like a screeching alien. I asked, rather in shock, “Is that my baby? Is that my baby?” and they took her away for a few hours while they took care of my tears and cleaned her up. When they next brought me to her, all cute and clean, I cried tears of joy to be with her and did the same thing every time we were reunited after she had a stay in the nursery. I loved having her in the baby nursery. 🙂 That was in the Philippines.
            I had #4 in Colorado, and the nurse here said, “If she can’t be off oxygen and in your room in six hours, she’s going to the NICU!” Luckily, she bent the rule and let me sleep a little, bringing me baby closer to the eight-hour mark.

          • C T

            (Just noticed I used the word “tears” twice. The first time, I was meant “tairs”, the second time “teers”. 🙂 )

          • PJ

            I feel sorry for them because they seem to have rather fragile bonds with their children. At least, they seem to require precise circumstances to initiate them and seem to be easily damaged by trivial things. I would have loved my children just as much no matter what happened at their births.

        • Susan

          Would go over fine where I work! ( and it’s baby friendly )

          • rh1985

            I think it has to do with how hospitals interpret the guidelines. I read through the entire “Baby Friendly” criteria on the BFHI website, and it doesn’t mandate rooming, just a certain % of healthy babies will room in – I guess hospitals are afraid if they bend on it, too many moms will choose the nursery and they fall below the special percentage (or they are just looking for an excuse to cut costs, ugh…)

          • Susan

            I just did all the baby friendly education stuff that is required and the vast majority of it I actually agree with. What did I learn the most from in it? How to formula feed! That’s part of it and I even though I have been a labor nurse for 25 years I have rarely had to formula feed a baby and I know zilch about bottles, cleaning and teaching that stuff for discharged moms. The education includes that stuff. There were definitely things I didn’t like, such as stating some fuzzy data as facts, but mostly it wasn’t as over the top as I expected. Now, some of the nurses who had had trouble breastfeeding themselves found it upsetting, and for that reason I think the BF people need to change the language to language that is not shaming. Because if you are shaming a level headed, open minded RN who is trying to do the best by her patients ( my friend) , than something is wrong with it. But overall, yes, I agree that if sane people are working with this stuff it doesn’t have to be bad. And yes, I too worry that it could appeal to hospitals because they don’t have to staff as much without well baby nurseries, but frankly, I have never worked in a hospital where there was mandatory nursery time and mostly I have worked with the mother/baby model and really, most moms love it. The idea though is not to go so crazy with it that an exhausted mother CAN’T send her baby to the nursery or a mom who just doesn’t want to breastfeed feels judged.

          • rh1985

            Yep, I don’t care it because I’m a single mom by choice, I’ll be going home to mostly care for my baby alone (sure, family plans to help some, but I will be the only parent) so I’d rather have some rest/recovery/alone time at night while in the hospital before going home to do that. I imagine I might be more interested in rooming in if I had a spouse/partner with me at the hospital.

          • Antigonos CNM

            One thing lactivists don’t tell women is that, if they become too tired, THAT will impact on milk supply, no matter how much breast stimulation is given via nursing. Zero plus zero still equals zero.

        • mom4474

          I absolutely know how you feel! It was bad enough with my first, but I was completely alone every night with my second and third (husband had to be home to take care of the other ones). I was so sleep deprived, and the baby slept with me most of the time in the bed because it was so hard to get up and down after the c-section. Thank God, everything was fine, but when I think back about how exhausted I was, and how the baby spent so much time in bed with me, I just cringe. I remember one particularly exhausting night with my second baby. The nurse came in around 5:00 in the morning and was talking to me for a good 10-15 minutes. When she walked out, I realized I had absolutely no recollection of the conversation I just had. I was so exhausted that I was basically asleep while talking to her! I called my husband in tears and begged him to get back to the hospital as soon as possible. I’m done having babies, but I really believe they need to bring the baby nurseries back. Leaving newborns with exhausted mothers for hours on end is a recipe for disaster.

          • BeatlesFan

            I wonder what will happen when disaster DOES strike, and an overtired and/or physically limited mother drops her newborn, of falls asleep on it and suffocates it? Will hospitals change their “absolutely no nursery for healthy babies” rule, or just quietly settle the lawsuits?

          • FormerPhysicist

            Seriously. Let’s tell mom’s not to co-sleep, but let’s take an exhausted, possibly ill mom, and leave her with the baby. My last slept on a boppy on me as I slept on the hospital bed with post-partum pre-E and an c/s incision that wasn’t healing right. What part of this was safe?

        • Antigonos CNM

          Oddly enough, a considerable amount of the pressure to become “baby friendly” comes from the mothers themselves, who feel that allowing staff to help them indicates in some way that they aren’t good enough mothers. For a dozen years I worked at a “revolutionary” hospital where babies roomed-in on a 24 hour basis and even though I found mothers swaying in exhaustion or even fainting by 1 a.m., they would become very angry if I suggested they let the nursery take care of their infants until 5 a.m. and let them get some sleep. It always amazed me.

    • Mishimoo

      Congratulations on the new arrival!

    • Susan

      Congrats to you!

  • Jessica

    I’ve shared this lots of times before. Of the first twenty-four hours following my son’s birth the memory that bothers me the most is the nurse telling me that she didn’t want me to be discharged because my son wasn’t feeding very well. When I told her that my mom was available to help me with breastfeeding, that I had a hospital grade pump at home, and that we’d use formula if we needed to, her response was, “Well, we don’t like to do that.” I thought my husband was going to lose it, and I had to remind him after she left the room to talk to the pediatrician that how we fed our baby was OUR call.

    Her attitude completely turned me off to the hospital and its drive to become “baby friendly.” I’d been in the hospital for nearly 48 hours that point (as I was induced), I was exhausted, my husband was exhausted, my husband wanted to get back to his older son, the hospital LC was almost never available to see us and certainly wasn’t going to be there overnight, and the nurses were doing a terrible job caring for me anyway. UGH. In the end, my son got formula for all of two days before my milk was fully in (and when it was in, it was IN), I ended up BFing exclusively until he started solids at six months, and I’m still nursing him twice a day and he’s almost 17 months old. I didn’t need guilt or strong-am tactics to successfully BF, and the whole experience left me pretty unhappy.

  • OttawaAlison

    In Canada the BFHI standards include discussing the benefits of breastfeeding and the risks of formula feeding and call it “Informed Decision making”… It’s pretty awful.

    • Young CC Prof

      Ah, risk-benefit analysis! I’ll tell you all the risks of doing A and the benefits of doing B, and then you can make an informed decision!

      Can they even try to appear impartial?

    • rh1985

      What happens if the mother refuses to listen and insists they leave the room and leave her alone? I REFUSE to listen to a BF lecture after I have my baby. I’m already planning to have a family member there to try and prevent people like that from coming in the room.

      • Susan

        Try this, I have researched the pros and cons of breastfeeding and I am making an informed choice to formula feed.

    • Anka

      The literature on breastfeeding at my hospital, considered one of the best in Canada, says that one of the risks of formula feeding is death. DEATH. Whoever wrote this piece-of-shite brochure needs to be…reeducated.

  • AllieFoyle

    Finally, a bit of sanity amid all the breastfeeding hype. Breastfeeding can be great, but not so much that it justifies adding stress or anguish to new parenthood–which is already a huge adjustment and life stress. If hospitals want to promote infant health and well-being they might consider doing things that support the mother and new family so that they go home well cared for, well rested, and with access to good, accurate information that doesn’t leave her feeling shame or guilt for doing what is best for her or her family.

  • For me, the big problem was that all the “remedies” to breastfeeding problems drastically depleted my already limited coping resources. I fed formula through a little tube while nursing, which flummoxed the baby’s latch and caused my nipples to bleed. I was told to pump between feedings to boost supply, which eliminated any chance to “sleep when the baby sleeps” or enjoy any self-care. I had been going for daily walks and having friends over, but that just didn’t work anymore with all the pumping and washing of pump bits. Suddenly my only adult contact was online, where other moms accused me of lying about how hard I was trying to breastfeed; if I were that committed, it would be working. So I was isolated, sleep deprived, in pain, hormonal, spending all of my time on one activity I couldn’t succeed at, and spending no time on anything rewarding. Then I started taking Reglan.

    All of this made me WAY less able to stand up against the pressure and condemnation around infant feeding. Now I can just hold up my middle finger and move on, but at the time it destroyed me to be a “second-rate” mother. I never thought about hurting myself at any other time in my life. But in those first couple months, I felt completely trapped by failure.

    • PJ

      The things that actually helped me deal with the pain, and ultimately continue breastfeeding, were things that lactivists discourage: nipple shields and replacing feeds with expressed milk in a bottle (plus a steroid ointment that my doctor prescribed that really seemed to help the damage on my nipples). Lactivists seem to be so invested in the idea that breastfeeding is perfect that they can’t fathom that their are problems beyond a poor latch. Come on now; is it really plausible that an intelligent, well-resourced woman who really wants to breastfeed could be completely unable to figure out how to latch her baby on properly TWICE?

      I would really like to know how much evidence there is that either nipple shields or replacing some feeds with a bottle are detrimental to breastfeeding. My baby had absolutely no trouble switching from bottle to breast. (Nor did my developmentally delayed nephew, for that matter.) With my first baby, though, I followed the advice about not bottle feeding in the early months–with the result that he completely refused to take a bottle later on. It is GREAT having a baby who will also take a bottle!

      I would also be interested to know if size makes a difference in terms of nipple pain in the first weeks. Both my babies were smaller; I wonder if having a small mouth makes it impossible for them to get the nipple far down enough in their mouth to stop it being chafed?

      • Young CC Prof

        The only cases I’ve heard of where bottles interfered with breastfeeding is when the baby was exclusively or near-exclusively bottle fed for the first few weeks. At that point, they sometimes decide they like rapid-flow bottles and don’t want to work at sucking.

        Occasional bottles, even starting from Day 1, can make life easier and make sure baby doesn’t reject bottles later. I’ve heard you should introduce the bottle by 2-4 weeks and continue at least once a week, to ensure that bottles remain an acceptable food source and feeding by other people is an option.

        My brother did the complete bottle rejection routine, and much as she enjoyed nursing, I’m not sure Mom particularly liked being absolutely tied to him for a year. (Matter of fact, she was ranting about that just the other day.)

        • Trixie

          Except, especially the early days, you’ve got to pump to replace the bottle feed anyway, and pumping tends not to be as effective at draining the breast for some people. So you’re either tethered to the baby or the pump; for me, it was easier to just nurse. A baby doesn’t *have*to know how to take a bottle, as a developmental milestone or something. Of course it’s a fine choice and often a necessity, but it’s also a fine choice to never introduce a bottle at all.

          • Jessica

            But if most women knew that (a) introducing bottles early and regularly will not interfere with BFing and (b) doing so can give them options for returning to work, enjoying a social life, seeking medical treatment, or any number of issues that may crop up before baby is one, then they might choose differently, right?

          • Trixie

            I don’t think introducing bottles is a big secret? I mean, I knew all of those things, but still chose not to bother. By 6 months they can take cups, anyway.

          • Jessica

            There’s a big difference between introducing a bottle in the first week or two of life versus waiting until six weeks or so, which was the recommendation from every LC I saw.

          • Trixie

            Most of the advice I’ve read says around 4 weeks. If you’ve only got 6 weeks of maternity leave, between 3-4 weeks gives you time to get the hang of it.

          • Young CC Prof

            Oh, definitely. You don’t have to introduce bottles. But many mothers plan to eventually, especially if they need to return to work, and they may not realize that some exclusively breast fed babies will reject bottles. My mother was unpleasantly surprised when she went out for the day and came back to a ravenous screaming baby, rather than a fed napping baby.

            The bottle is a tool, and it’s good to know how to use it.

          • PJ

            “pumping tends not to be as effective at draining the breast for some people.”

            Is there evidence for this?

          • Trixie

            Yeah, it’s really tough for many people to get a let down for the pump, who have no trouble letting down for the baby. To some extent, it’s a learned skill, and pump quality is a factor. I’ve seen a lot of instances where, for example, the baby is gaining fabulously, but the mother can pump maybe 1 oz in 20 minutes. Off the top of my head, I don’t have studies to back that up. But it can mess with your head if your newborn is nursing all day long and you try to pump to “see what you are making,” and you don’t pump much at all.

            Personally, I had such an oversupply that I pumped for donation. At my peak I was putting out 10-12 oz in a single session. But I’m not the norm.

          • Amy M

            I attempted to exclusively pump and it didn’t work at all. I got very little out, had constantly plugged ducts and ended up with mastitis at one point. I wasn’t real upset when I stopped, and my boys were formula fed, but I had gone into it thinking pumping would be easier than it was.

          • I would have killed for 1 oz. in 20 minutes. Even at my peak, after 2 weeks of Reglan and 10-12 pumpings a day, I never got that much. Even after switching to EP after nearly a month of nursing on demand. My baby’s demand for formula didn’t go up, though, so she wasn’t getting any less from the pump.

      • Trixie

        The older nipple shields were much thicker and did impact supply by reducing milk transfer. The new ones, if they’re sized right, are often helpful.

        I do think size disparity between mom’s nipples and baby’s mouth makes a big difference. The second time around, I found that by reclining and having her belly down on top of me, and latch herself, caused her to open a lot wider and deeper, greatly reducing pain for me.

        • Suzi Screendoor

          Well that’s interesting to hear about the nipple shields. My baby friendly hospital only had one in the building and it was too small. Cramming my huge nipple into that tiny thing for 24 hours helped the baby latch but made my pain much worse.

          • Trixie

            Yeah, and it goes back to women who WANT to breastfeed and are trying to breastfeed getting horrible information/support. A wrongly sized nipple shield is worse than no shield, same with pump flanges being the wrong size (too small, can lead to plugged ducts and mastitis, too large can affect output). Hospitals tend to throw nipple shields at problems without getting more into what might be wrong. But if the shield is the answer, the person handing it out needs to know how to size them. Also I think a lot of hospitals miss screening for anatomical issues in the mouth that can affect milk transfer and the ability to latch effectively (tongue tie, lip tie, etc.).

      • Well, for me the pain was small potatoes next to the jaundiced, lethargic baby falling asleep at an empty breast. The pain was just one more thing making the days seem inescapably miserable. But if powering through the pain had worked, I would have put up with a lot of it to sidestep the self-hate of being unable to do something “critically important, that all mothers can do if they try hard enough.”

      • KarenJJ

        I was feeling guilty about using a shield and the nurses were discouraging it and kept telling me to try feeding without it. One of my friends vistted me in the hospital with her 6mo and said “nipple shields? I’ve been using them for 6 months. He won’t latch without them. The nurses don’t like it but it’s been working.” Suddenly I wasn’t feeling so bad about using shields and just got on with it without feeling so guilty.

      • yentavegan

        A wonderful sane Lactation Consultant once lectured that “nipple confusion’ is only a problem when a mother is told that bottles interfere with a baby’s ability to latch. Mothers have been switching back and forth between bottles and breasts for generations. The overwhelming majority of babies can do both, but they fuss and fight and modern mothers cringe at the thought of making their babies unhappy, even for their own good..

    • Anka

      You sound like me. I am so sorry. ((Internet hugs if OK/desired.))

  • yentavegan

    I loved my breastfeeding experience. I loved the deeply human, fleshy way nursing made me feel. Breastfeeding for me, bordered on orgasmic. Not earth moving, but toe curling. However in order to get to the sweet spot I endured bleeding, scabbed blistered nipples. But my children gained weight, slept peacefully for the most part and frankly I had no marketable skills , nor did my family need any income I might have generated. Mothers of today do not have it as easy as moms did 30 years ago. No one really expected me to work after I got married.

    • Susan

      That’s the thing, breastfeeding really can be a great experience for mom and baby, and it should be “normal” to see mothers breastfeeding, but we don’t have to demonize or shame formula feeding to achieve that. I think it’s true too that moms today who would like choose to stay home may face more of an expectation that they should be working. It’s so hard isn’t it? It’s not so easy always too to begin working again after a lapse in employment. I’m not sure I would advise my daughter anymore to completely stop working, unless maybe she were in a profession where you can take a hiatus and get back in. Overall, I am so glad I got to be a stay at home mom to my toddlers, or as with the youngest, work very part time, which turned out to be a very smart choice. It gets lost when people read this blog that most of us regulars breastfed their children, even “extended” breastfeeding, but we don’t type “natural birth X3, baby wearing, breastfeeding” ( type in crunchy creds after the name) BARF…..

      • Young CC Prof

        I’ve been able to arrange a half a year leave from my job, then I’m planning to go back there full-time. I will probably be less “driven” for a while, but that’s OK, I don’t need another promotion any time soon!

        My grandmother doesn’t really approve. My mother, on the other hand, took three years off after my brother’s birth, then worked part-time for quite a while. She worked below what she was worth for years, sometimes for people she despised, and finally, rebuilt her career practically from the ground floor. I don’t think she regrets her choices, but she definitely understands mine.

  • NICU RN

    I will be really interested in following this – there is some talk about hospitals’ reimbursement being tied to % of breastmilk feeds and donor milk even being used with term babies in LDRP. We will be required to chart a medical reason that babies are getting formula – could be as simple as “maternal request.”

    • Ob in OZ

      I would hope that the national organization for pediatrics would put out a statement that this is about maternal choice based on medical evidence (similar to maternal request c-s). As an individual I would be offended at the idea that a hospital should promote poor medical advice (donor milk) over sound options and individual autonomy.

    • Young CC Prof

      Your hospitals have that much tested and sterilized donor milk that they can afford to give it to healthy babies? Somehow I don’t believe that, as most hospitals don’t have enough safety-tested donor milk even for their preemies.

      • NICU RN

        The donor milk thing is a long way off (I think) but it was absolutely mentioned by my NNP friend who is on the feeding committee. I think it seemed pretty ridiculous but it was mentioned as the “wave of the future.”

        • rh1985

          I think it’s weird – it’s just me, but I personally would not allow my baby to receive donor milk unless she had a medical reason for needing breast milk which I could not provide (prematurity or another medical condition). Otherwise it just squicks me out for some reason. I guess it’s a mental block I have. I could overcome it for a medical reason but not any other reason.

  • Trixie

    On the other hand, I’ve received some truly terrible, and fairly aggressive, breastfeeding advice from postpartum nurses. Like one who decided to test my daughter’s suck reflex with her finger (I hope she used a glove!) and then come into my room and inform me that because she spat it out, I should consider supplementing with formula. Now, I knew my baby was peeing and clearing meconium like a champ, and frequently nursing, and loudly gulping. All of which the nurse thought was less important than my baby pushing out her finger. Then there was the IBCLC who told me I HAD to take the formula gift bag home, after I said I didn’t need it.

    So yeah, shaming about women is wrong. People can feed their babies how they want. But there’s also a lot of terrible, terrible breastfeeding advice being given to mothers who WANT to breastfeed.

    • Guesteleh

      I got terrible advice and I paid for it because it was a private lactation consultant. My son had a feeding disorder and she never identified it even though in retrospect it was obvious he had a bad latch and weak suck. It makes me wonder what kind of training and qualifications are being required for LCs. I don’t have a lot of faith in the standards of the profession.

  • Susan

    Idea for a future blog title “listening to only what we want to hear” mother’s survey. These people do really have the loaded language thing down, not coincidentally reading about cults.

  • Young CC Prof

    The talk of bonding made me think of something:

    The first time I bottle-fed a baby, I was eight or nine years old, and the baby was just a few weeks. Looking in her eyes, THAT’s when I knew I wanted to be a mother someday. (The baby graduated from Barnard a year or two ago, and she’s an intern in some kind of startup now.)

    So yes, you can most definitely bond with a baby by bottle-feeding! When they’re several months old, they can learn to hold the bottle for themselves, but newborns really need to be held when feeding no matter how you do it.

    • Elle

      That’s a sweet story! I think it’s horrible when mothers are made to feel that breastfeeding is necessary for bonding. Bonding comes from meeting a child’s needs and loving them… it is not a checklist.

      • Burgundy

        I roll my eyes every time I hear the breastfeeding bonding BS. My 16 months old refused breastfeed and only accepted bottles; yet, she prefers me over anyone else (including my husband). Meanwhile, my 75% breastfeed up to age nine-month older daughter is a “daddy’s little girl”.

    • PJ

      I started replacing some of my baby’s feeds with expressed milk in a bottle as a way to help with the pain. My husband LOVES feeding her! How about promoting bottle feeding as a way for fathers to bond with their children? (Not that something as trivial as feeding is going to affect a dad’s bond with his children, of course–it is lovely, though.)

    • Poogles

      I did most of the child care for my younger brothers when they were infants (I was 8-11 years old), and bottle feeding them was one of my favorite things – the gazing into each other’s eyes, the milky smiles around the nipple, the baby falling asleep in your arms – it’s just all so sweet.

  • Clarissa Darling

    I have commented before about the experience of other women I have known who have run up against the “breast is best” shame message. Now that I’ve had my own experience I am more convinced than ever that the way this message is being presented can be harmful to women. I mentioned in a previous comment that in the hospital I was given a new baby care handbook which listed all of the “benefits” of breastfeeding- preventing obesity, cancer, diabetes, asthma, better bonding etc…. Then the book went on to give about 15 pages of breastfeeding information including, ironically, what to do if you don’t feel supported in your choice. To round out the message there were multiple depictions of angelic looking babies and calm contented mothers a la Madonna and Child. Formula moms got a trite “formula is an adequate source of infant nutrition, ask your doctor for more information”. Talk about feeling like a second class mother! I had been reading SOB and FFF and other websites with balanced information on infant feeding and felt I had made a good choice. However, when I got that information from the hospital, I was feeling a combination of anxiety mixed with post partum hormones and I started to feel awful. I asked the nurse If I could talk to someone about the anxiety. She sent a social worker who rolled her eyes, not at me but, at the hospital handout. She said “I’ve seen so many women dealing with guilt surrounding breastfeeding and I’m proud of you for choosing to feed in the way that works best for you, I couldn’t breastfeed and my kids turned out just fine”. If a social worker at a hospital is commenting that it’s so common for new mothers to feel guilt and anxiety over feeding choice or inability to breastfeed, isn’t it time to do something about it? This wasn’t even in a “baby friendly” hospital, in fact the doctors and nurses really didn’t pressure me much!

    When I got the supplemental information about formula feeding (a 2 page hand out) I was still felt feeling lost. It was mostly about sterilizing water and such, which my pediatrician had said wasn’t necessary. When I got home I signed up to receive more information on formula feeding from Similac. Yeah that’s right, the big bad corporations were more willing to help me than my hospital and at this point I didn’t care whether or not it was for monetary gain!

    I contrasted all the information I received on feeding with the information presented in the baby care handbook about circumcision (not looking to start that controversy). It basically gave the pros and cons of the procedure, and gave very straight forward care instructions for a circumcised vs uncircumcised penis. There was no moralizing, there was no over statement of either the risks or the benefits as far as I could tell, no emotional language or artwork to tug at your heartstrings. I don’t understand why feeding information can’t be similarly presented without all the shame and moralizing. It is, in part, a medical decision too is it not? Sorry for the long post. Now more than ever, I feel really strongly that the public health message surrounding BF has gone way over the top. Especially with all the awareness around PPD and PPA doesn’t it make sense to pull back and consider what is best for baby AND mom? Breastfeeding is sometimes best. Formula feeding is sometimes best. Women are smart. They deserve balanced, scientific information rather than a marketing campaign from either side. And they especially deserve to feel supported with either choice.

    Tl:dr: Thanks a lot over zealous lactivits. In your quest to do what is “best” for babies, you’re making a lot of new moms feel like crap. A new mom left feeling anxious and guilty is not “best” for anyone. The End.

    • Ob in OZ

      This is as well stated as the original blog. The vocal minorities have taken over, and it’s almost impossible to fight back. Hope you do.

  • Susan

    You probably know this but the NCB whackaloons have their own definition of mother friendly which is just as bizarrely “what we like is friendly and what YOU might need is … “so sad, the fault of big Pharma, those OB surgeons, Western medicine” yada yada yada

    http://www.motherfriendly.org/MFCI/

    • Zornorph

      I read that. The one thing I really don’t understand is the dislike of electronic fetal monitoring. When my baby was spending this last hours in the womb, nothing gave me more comfort than to see/hear his heartbeat and whatnot. The knowledge that if something started going wrong, they would be able to address it right away was wonderful. Who wouldn’t want that? Why wouldn’t you want it?

      • Young CC Prof

        There was a study that found EFM increased c-sections without improving outcomes, but it was under-powered, that is, the sample size was too small to detect a change in the rate of intrapartum death. Later, larger studies contradicted it. Since then, it’s been pretty well established that EFM reduces intrapartum death and brain damage from hypoxia. Unfortunately, the original study got way too much press.

        • araikwao

          Has that made its way to the Cochrane Collaboration? I read something ?last year that was still bashing EFM (and “interventions” as a whole, and this from an eeebil doctor!), based on the Cochrane review, IIRC..

    • Young CC Prof

      I especially like the part about “Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.” How about, “Educates staff in drug and non-drug methods of pain relief, and provides analgesics on request unless medically contraindicated.” I don’t believe that every laboring woman needs to have an epidural or lots of drugs, but the safest pain relief options ought to be available and provided promptly and without judgement if desired.

      • theadequatemother

        unrelenting severe pain not relieved non-pharmacologically IS a complication

  • auntbea

    Wow. For some reason, #4 never occurred to me, even though it is patently obvious. Where DOES anyone get off trying to tell me what to do with a potentially sexually-charged part of my body?

    • realityycheque

      This really bothers me, as I think that sufferers of sexual abuse are often overlooked in these discussions. What woman wants to be confronted with a pushy MW or LC and probed for “adequate” excuses (we all know that for hardcore activists, there are none) as to why she didn’t BF when the answer is, “I’m a victim of sexual abuse and find it triggering”?

      A lot of women are going to (understandably) withhold that very personal information and instead fall back on something like, “I have supply issues”, or simply, “We’ve chosen to use formula,” which we all know won’t fly with these folks and won’t free the mother from harassment and shaming.

      I wish that I could say that honesty about sexual assault and triggers was enough for people to lay off women about the breastfeeding vs formula feeding issue, however I still cringe to recall a woman in a forum being told, “Well, if you were able to get pregnant in the first place, your history of sexual assault can’t be THAT big an issue”.

      A woman should be able to say, “I have chosen not to breastfeed” and that be the end of it. Period.

      • auntbea

        “Well, if you were able to get pregnant in the first place, your history of sexual assault can’t be THAT big an issue”.

        Ew.

  • Thank-you! I am a breast feeding mother – but I combo fed with my daughter in her late infancy and wish I had been a little more diligent in bottle feeding my son, as I literally have felt booby trapped countless times by his insistence on breastfeeding. I desperately want to wean the little guy (he’s 14 months) — I’m so ready to have my body back.
    I cannot stress how disturbing it is to me, to tell grown women what they should or should not do with their bodies. There is something about that, that strikes me as being incredibly wrong and I don’t care if it is breastfeeding or giving birth. Provide women with the evidence and information, discuss their choices with them, let them decide what to do, and respect that choice.

    • Jocelyn

      “Booby trapped.” Ahaha. 🙂

  • Amy M

    Anything around sleep gets me the most, because that was the hardest thing for me: I did not deal with sleep deprivation well, and it led to PPD.

    There are people who seem to get joy out of the fact that new mothers don’t get enough sleep, with statements along the lines of “Well what did you expect!” (because mothers don’t deserve sleep) and “Just sleep when the babies sleep!” (because you have nothing else that needs to be done, even if you could just drop off to sleep whenever, and that’s assuming your baby DOES sleep) and “My baby slept through the night at 2 minutes of age!” (shut up.)

    Then the lactivists swoop in. “You get more sleep if you breastfeed because…1)you have the baby sleep right next to you and you don’t even get out of bed!

    2)You don’t even wake up once breastfeeding is established, the baby feeds itself!”

    But some of the most common laments I have heard from breastfeeders, including several close friends are: the baby wakes up every 2hrs to eat even at 12mos old and the baby is in our bed to facilitate nursing and kicks and thrashes around and wakes us up all night long. Either way, they aren’t getting enough sleep.

    They try to warn you away from formula on the grounds of “not enough sleep” because you will “have to be making up bottles” at 3 am. Because clearly if you are dumb enough to be formula feeding, you are too dumb to make up bottles ahead of time so they are already ready at 3am, and too dumb to have set up a shift schedule with your partner (if you have one) so you can get some sleep.

    I know not ALL breastfed babies eat every 2hrs for the whole first year. I know not all breastfeeding mothers cosleep, or if they do, they don’t all find themselves constantly woken by a restless child. Certainly not all formula fed babies sleep through the night at an early age. Mine didn’t go all the way through wo/getting up at all until 6mos old. I am generalizing for sure.

    But it seems to me that a lot of the possible issues with breastfeeding—issues that seem to be quite common, a MAJOR one being sleep deprivation—are glossed over in an effort to pretend they don’t exist so more women will breastfeed because if they knew they might be up every 2hrs for 6mos to a year, they’d say eff that noise, get me some formula. Sleep deprivation is brushed off as no big deal in America, which I think is awful and sad because not only can it lead to depression, it is also really bad for our health in general and we need to take it more seriously. Here’s one place where many women might be able to do something about it: get some formula so someone else can feed the baby so they can sleep and instead, we have swathes of people telling them to take a giant step back and be the only available food source for baby, too bad for you mom, you don’t get to sleep.

    • anion

      Totally agree. The forced rooming-in policy (so “mother-friendly”) at the hospital where my first was born led to serious sleep deprivation and PPD for me, as well. I begged the nurses to help me and take the baby for even an hour so I could get some sleep, and not only did they refuse, they acted like I was a horrible person for even asking.

      • Kumquatwriter

        Seconded. I was literally hallucinating from sleep deprivation when we left the hospital.

      • Young CC Prof

        Went on the hospital tour this weekend. I was SO happy to see that they have a nursery, and that their standard policy is to take the baby at 11pm each night. (They also mandate flu and pertussis vaccines for all staff and have 24-hour anesthesia availability. Those two were my absolute minimum requirements.)

      • AllieFoyle

        Same here. My husband had to leave to be home with our older child, and knowing that I was already seriously behind on sleep (severe anxiety about the birth, plus the usual discomforts –> very little sleep in the preceding weeks), asked the nurses if they would take the baby to the nursery for a bit so I could sleep. They were agreeable about it to him, but as soon as he left they came into my room and told me that actually they wouldn’t. I was beyond exhausted, the birth had been everything I feared and specifically asked to avoid, and I was left alone all night holding an inconsolable newborn in a tiny single bed, terrified I’d fall asleep and drop him on the floor. Nursing was the only thing that kept him quiet. I sobbed to myself all night and ended up with blood blisters by morning. No idea what was “baby friendly” or health promoting about that experience.

        • Dr Kitty

          I really hope you complained in the most strong language possible.

        • KarenJJ

          “They were agreeable about it to him, but as soon as he left they came into my room and told me that actually they wouldn’t.”

          WTF? That is beyond reprehensible.

    • Rochester mama

      I hate “sleep when the baby sleeps” I can not nap for the life of me. When I get over tired and go to bed late I take forever to fall asleep. The only nap I could ever take was when my baby was little and waking up at six am to be fed then going right back to sleep till 10.

      • Josephine

        Preach. I am an absolutely horrible napper and if woken up too early from a nap I’m like a bear being disturbed in hibernation – disoriented and pissed. So that just doesn’t work for me.

      • Julia

        And even if you could nap every times the baby sleeps – I found that repeated short segments of sleep just didn’t do it. I was a complete zombie when my son was a newborn even though I probably slept 7-8 hrs total each day – but never more than 1 or 2 hrs at a time. I started feeling human again after we sleep-trained and I got at least one 4+ hour segment of uninterrupted sleep.

      • Amy M

        Yeah, it never worked for me either. I was lucky too..my boys ate and slept at the same time, and they were generally good sleepers. Of course they ate every 2-3hrs for the first 3mos, like newborns do. The next 2mos they only woke once in the night to eat, which wasn’t terrible, but the month between 5mos and 6mos…I will never forget. It was the worst month of parenthood so far (they will be 5yrs in January). They started waking up for no reason every 2-3hrs again, and started leapfrogging each other. They didn’t want to eat, they would just wake up and be fussy. This went on for 4wks straight and just when I felt about ready to die, they started sleeping all the way through the night for good. I know they were babies and it wasn’t personal, but it was awful, and made me thankful I had twins, because if they were one baby, I would not have had another for fear of going through that again.

        • araikwao

          Blech. My son has been doing that for 3 months, but mostly more frequently. Not even to feed, anymore. Just pats or cuddles. Sleep training attempts have helped to get me a 3-4 hour stretch, but that is under near-constant attack due to him being some sort of human Petri dish (so much for all those magical antibodies from BF!) His first birthday is creeping closer, and I am losing hope that it will actually improve around that time, as it did for my daughter. SIgh.

      • antigone23

        Much less the whole older child thing. I too went back to sleep after the first feed of the morning with my first. With my second, whoops my first is now awake and needs cared for. Most people have more than one child so this advice is really not applicable at all for the second, third, etc.

    • Jessica

      Part of the problem is the insistence that sleep training at any age is dangerous and abusive. It’s one thing to be dealing with a newborn who truly has a need to eat every couple of hours, but at four months? six months? A year? There is a point at which a baby really does not need to be fed during the middle of the night, and yet the lactivists and anti-CIO people will hotly deny that fact. It’s ridiculous.

      • Young CC Prof

        Excellent point. Yes, newborns need to be fed every two hours round the clock, but when they hit that two or three month mark, it’s time to start encouraging larger, less frequent meals, more play in the daytime and more quiet time at night. It’s not “abusive” unless you’re an idiot about how you do it.

        • Trixie

          But when you’re breastfeeding, you can’t simply encourage larger, less frequent meals. Anatomically speaking, different women have different milk storage capacities, and there are people who need to nurse more frequently to maintain an adequate supply. So yeah, there are women out there who can nurse 4 times a day, their baby gets like 7-8 oz at a time, and that’s it. Then there are women whose babies only get like 2-3 oz at a time, so they need to nurse more frequently to get to 24-30 oz by the end of the day. Generally, the more frequently you drain a breast, the more milk it will produce.

          So there are women for whom sleep training, or encouraging babies to only nurse every 3-4 hours during the day, absolutely will kill their supply or result in the baby not getting enough to eat. You can’t take a bottle feeding model and expect it to have a 1-to-1 correspondence to breastfeeding.

          My first nursed a good 8-10 times a day until a year. On top of a huge amount of solids after 6 months. He slept a good 12 hours at night, though. I just got lucky with that. But to this day he burns through an incredible amount of food without putting on weight.

        • Jessica

          While this is true for many, it’s still up to individual mothers to decide whether the potential of frequent night feedings through the first year is worth it to them. Guilt tripping women into sacrificing sleep for a whole year due to the overstated benefits of breastfeeding is grossly unfair and offensive.

          I was happy to nurse my son at night through his first birthday. Fortunately after month two or so he only woke once at night, around two A.M., and only about 50% of nights, so I generally wasn’t *that* sleep deprived. The exception was a two week growth spurt when he was seven months old, during which time I nearly lost my freaking mind, as he was nursing every two hours from 6PM through 8AM. It affected my work and my marriage, and I was on the verge of weaning or sleep training when he went back to sleeping a solid 12 hours at night most nights of the week. I can’t imagine living like that for a whole YEAR.

          • KarenJJ

            For my two kids, they woke for a feed around 3am until they were 11 months old. I would wake up (or my husband would), get a bottle and feed them. It took all of 5 minutes and I was still on maternity leave. I was getting pressure from the child nurses to put a stop to the feed, but I didn’t find this particularly exhausting and felt even less up to dealing with them crying and waking the whole house at 3am.

            They’d dropped it of their own accord at 11 months and would sleep through for 12 hours at night. It was bliss when they slept through and I can well understand this routine not working for others, but waiting it out is an option that worked for us.

    • Josephine

      There was a woman in a due date group on a forum I frequented who was on baby #8 or something, and she was extremely busy with church commitments, other kids’ extracurriculars, etc. Which is all well and good, of course, her choice. However, she co-slept with her baby and breastfed, waking up all night long for months and months. She constantly complained about being exhausted (um, duh).

      Every time someone mentioned perhaps ceasing the cosleeping/breastfeeding all night combo she got extremely defensive. Finally one day she posted that she’d fallen asleep at the wheel from sheer exhaustion and been in a car accident. At this point everyone’s babies were probably 10 or 11 months old and many commenters told her to either stop with the cosleeping and bfing all night or to shut the hell up, much to everyone’s relief.

      The whole myth where the cosleeping and breastfeeding combo is soooo very easy is complete BS.

      • Trixie

        I think it IS easy, for some women.

        I can’t cosleep. I can’t nurse while asleep. But I fully believe there are those for whom it actually works.

        • Josephine

          Oh I have no doubt that it works well for some people, even a lot of people! The problem is when you get people like this mom who repeatedly state that “this is what works for my family/baby/me” when that’s so clearly NOT the case, because our society has made breastfeeding a moral virtue. And don’t get me started on the NCB types’ obsession with cosleeping.

  • Zornorph

    Even in my circumstance, I got pressure from some well-meaning people to get donor milk (at great expense) or perhaps just let my LO breastfeed from my surrogate for the first week to get the magical colostrum.

    • Young CC Prof

      Because, you know, encouraging her milk to come in and then taking the baby right when it really gets going wouldn’t be unpleasant for her at all.

      • Zornorph

        I know! Apart from the fact that I wanted to be the one to feed him, it didn’t seem at all fair to her to ask that of her. I think she would have agreed if I had asked, but I’m fairly sure she was glad I didn’t.
        But to hardcore lactavists, nothing matters more than getting them that ‘liquid gold’. Not my feelings, not the feelings of my surrogate, only that he ingest the sacred substance.

    • Elle

      That seems to be a common trope of lactivism too… the idea that donor milk is somehow easily available…. as in, “Oh, just get donor milk.” It’s not that simple or easy!

    • Elizabeth A

      What is *with* the recommendations for donor milk? I’m a former breastmilk donating mom, and when I needed to stop pumping breast milk for my own daughter (giant crying jags at the pump, awful), I went to the grocery store and bought formula. It’s what I’d tell my sister or my friend to do.

      I was giving my milk away for free, but finding a donor I felt good with and running that kind of errand (sure, I’ll drive an hour at your convenience!) was just not on.

      • Zornorph

        In my case, I would have had to fly it in.

  • The Bofa on the Sofa

    5. I don’t know of a single endeavor where humiliation produces results. It’s time for lactivists and lactation consultants to acknowledge that and stop the hectoring treatment being offered in hospitals.

    One thing I learned from the old nun in catholic school was that shame and humiliation is not an effective for teaching good penmanship.

    And that it doesn’t work for much else, either.

  • Rochester mama

    I hate how inability to breast feed is treated like it doesn’t exist in breastfeeding classes. My class was honest about how hard it can be but the mantra was that any obstacle could be over come if you wanted it enough. I wish hospitals just had infant feeding classes that taught about both breastfeeding and proper formula feeding. I intended to breastfeeding but ended up with a sleepy jaundice baby losing weight and not putting out diapers and was told to supplement, but was given no guidance and how to formula feed a 4 day old baby. Thankfully I found the fearless formula feeder website after bringing myself to tears with all the anti formula websites that come up. Mayo Clinic does have good info on their website but you have to know how to find it, it didnt come up in the online searches.

  • Young CC Prof

    Thank you! Fact #1 especially, the breast-is-best message has been push so far ahead of the science that an amazing number of people simply don’t believe that the real benefits are so small. (Except for preemies, of course.)

  • FormerPhysicist

    Applause!