What if formula killed as many babies as homebirth?

Powdered milk with baby bottle of milk on green background

Whenever homebirth advocates get around to acknowledging the increased death rate at homebirth, they invariably characterize it as “tiny.” They typically say things like: The risk of neonatal death in the hospital is tiny, so even if they homebirth death rate is several multiples higher, several times tiny is still tiny.

To put that “tiny” death rate in perspective, it might be useful to do a thought experiment: what if formula killed as many babies as homebirth?

I’ve chosen to use formula as an example, because homebirth advocates are almost always lactivists as well, fanatically in favor of breastfeeding and remarkably intolerant of women who choose to bottle feed. Indeed, they have pushed governments of first world countries like the US to spend millions of dollars on public health campaigns to convince women to breastfeed when there are only soft benefits (fewer colds) and most of those soft benefits aren’t even proven.

Can you imagine the field day they would have if they could actually point to deaths directly attributable to formula?

Let’s suppose that formula feeding had an excess death rate over breastfeeding similar to Oregon’s excess death rate at homebirth. I’ve chosen Oregon’s data because they are the most comprehensive statistics currently available. In Oregon, hospital birth for low risk women has a neonatal death rate of 0.6/1000 (“tiny”) and a neonatal death rate at homebirth with a licensed midwife of 5.6/1000 (9X “tiny”) for an excess death rate of 5/1000.

There are 4 million babies born in the US each year. It’s not a stretch to assume that 3 million receive formula at some point during their first year. A death rate of 5/1000 translates to 15,000/3,000,000. Spread over a year, that rate would lead to the death of 41 babies who died unexpectedly each and every day simply because their mothers chose bottle feeding over breastfeeding.

Homebirth advocates/lactivists would go nuts. They would push for even greater government spending on breastfeeding promotion and support. They would decry women who found bottle feeding more convenient and in better keeping with working outside the home. They would undoubtedly taunt mothers for literally risking their babies’ lives for no better reason than the mothers’ “experience.”

It would not end there, though. The FDA would be investigating formula manufacturers, pulling products from the market and funding research to make safer formula. There would be extensive evaluation to determine if some formulas were safer than others. If it were found that the excess death rate was due to improper manufacture or testing of formula, fines would be levied and formula executives might even go to jail. Factories that had the highest death rates would almost certainly be closed. Parents would be suing those formula manufacturers and they would be winning large judgments. In short, a “tiny” excess death rate would trigger a massive reaction, because such a death rate would be viewed as appalling and utterly unacceptable.

So here’s my question to homebirth advocates:

What would you think of mothers who chose formula feeding over breastfeeding, knowing that 41 babies would unexpectedly die each and every day for no other reason than their mothers’ refusal to breastfeed?

More importantly:

Why shouldn’t women who choose hospital birth think the same thing about you?

820 Responses to “What if formula killed as many babies as homebirth?”

  1. Rozmin
    June 10, 2014 at 7:06 pm #

    Oh man. I think this is a great point, but at the same time I almost wish you hadn’t made it…..I am sure we will see many lactivists crowing “Dr. Amy admits that formula kills babies!” Reading comprehension amongst the natural parenting set is not always so good, in my experience.

  2. EM
    May 27, 2014 at 5:20 am #

    OT: Actress Thandie Newton, homebirth on her bathroom floor because she didn’t want to have her baby in hospital… HBadvocates are going to milk this story till the cows come home.

    • The Bofa, Being of the Sofa
      May 27, 2014 at 9:47 am #

      Birthing on the bathroom floor. How romantic.

      • Amy M
        May 27, 2014 at 10:04 am #

        And clean.

        • Young CC Prof
          May 27, 2014 at 11:37 am #

          Hey, it’s easier to clean up than a bedroom. But yeah, nasty.

      • EM
        May 27, 2014 at 11:43 am #

        What a way to come into the world! Wonder if it was unassisted…

    • Amy M
      May 27, 2014 at 10:05 am #

      Ha! She said “milk.”

  3. Guesteleh
    May 26, 2014 at 11:41 pm #

    The Fearless Formula Feeder wrote a recent post listing high quality studies and reports from the WHO and AHRQ concluding that the benefits of breastfeeding are modest at best. Here are the cites so you can check them out yourself:

    Evenhouse, Eirick and Reilly, Siobhan. Improved Estimates of the Benefits of Breastfeeding Using Sibling Comparisons to Reduce Selection Bias. Health Serv Res. Dec 2005; 40(6 Pt 1): 1781–1802

    Geoff Der, G David Batty and Ian J Deary. Effect of breast feeding on intelligence in children: Prospective study, sibling pairs analysis, and meta-analysis. BMJ 2006;333;945-; originally published online 4 Oct 2006

    Colen, Cynthia G. and Ramey, David M. Isbreast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons. Social Science & Medicine, Volume 109, May 2014, Pages 55–65

    Horta, BL and Victora, CG Long-term effects of breastfeeding: A systematic review. World Health Organization, 2013

    NIH Agency for Healthcare Research and Quality (AHRQ). Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. Evidence Reports/Technology Assessments, No. 153, April 2007

  4. OldTimeRN
    May 26, 2014 at 7:12 pm #

    I find it interesting that the US wants our Moms to be more in line with WHO but when Moms come to the US as refugees or newly American citizens they love that they have a choice to breast or bottle. Most pick either a combo of breast and bottle because the baby isn’t getting enough breast milk or bottle for the first few days then go on to nurse successfully after that. We hear “No Milk” all the time. But here we are in the US trying to get us to nurse like the rest if the world. And LC think they are the ones who need to be educated.

  5. Amy M
    May 26, 2014 at 7:20 am #

    I’ve lost track of this conversation over the weekend, and clearly it has devolved into another breast vs. formula debate, which probably surprises no one. I’m not sure if this has been said (forgive me if so), but in an attempt to bring it back to the original topic, I thought of another angle. Once one accounts for clean water and proper preparation, formula can’t really be compared to home birth because formula is regulated for safety and the home birth crowd fights tooth and nail against regulation. Of course that’s because they know damn well it isn’t safe.

    So I guess if formula were as unregulated as home birth, it might kill as many babies, but if home birth midwives and enthusiasts want a safety record rivaling formula in the developed world, they best get on that regulation thing. And no, recalls due to bug parts don’t really count, since that didn’t kill or injure anyone. If formula was ever recalled due to high levels of nightshade (I’m looking at you Hyland’s) that would be different.

    • Trixie
      May 26, 2014 at 7:52 am #

      Formula has been recalled due to cronobacter. It’s extremely, extremely rare, but if I were formula feeding a newborn, I’d buy RTF.

      • Amy M
        May 26, 2014 at 8:03 am #

        Ok, so that’s a fair one. Did it kill/injure as many babies as home birth?

        • Trixie
          May 26, 2014 at 1:13 pm #

          Oh, no, of course not. Because there’s a strict regulatory system in place. Still, the CDC warns that formula isn’t sterile, and RTF is the best way to go for newborns. http://www.cdc.gov/features/cronobacter/
          I in no way meant to imply that it was a danger on the same scale as homebirth. Just that there have been very rare cases of deadly formula contamination.

          • Jessica S.
            May 26, 2014 at 8:48 pm #

            I didn’t realize they recommended that – I’d be up for doing that, the convenience is an added bonus. According to that link, it sounds like they are recommending this for at least the first 2 months, I think?

          • Joy
            May 27, 2014 at 6:54 am #

            We used it for the first monthish because I couldn’t count at 3am, or 3pm for that matter.

          • Jessica S.
            May 27, 2014 at 9:36 pm #

            There were a few middle of the night feeds the first few weeks where I’d nodded off only to be startled awake by my son fussing – the bottle had slipped out of his mouth and I was basically feeding his neck. Ha! Good times.

        • Joy
          May 26, 2014 at 5:22 pm #

          I know of a recall in the US, but I thought there was debate about whether the baby died due to formula, or due to other contamination in the house.

          • Trixie
            May 26, 2014 at 10:10 pm #

            The CDC link below says there have been cases where the contamination was linked to the manufacturer.

          • May 27, 2014 at 1:03 am #

            And a great many harmful substances can be passed to the baby in breast milk, as well. It is a bit like flying in an airplane–flying is often perceived as being dangerous, but statistically it is far safer than driving or even taking a train. Contamination can, but very rarely happens, to formula. Ditto breastfeeding. There isn’t any risk-free method of doing anything, really.

          • Irène Delse
            May 27, 2014 at 2:27 am #

            Good point. And good comparison. Having in my family two persons who had to be exclusively formula fed (one because mom was taking medications, another because he was allergic to breast milk), I can certainly relate to the idea that sometimes, breastfeeding is the more harmful option.

          • Trixie
            May 27, 2014 at 7:20 am #

            I wasn’t trying to argue that it was dangerous to formula feed, just counter the assertion that formula had never been recalled for deadly contamination. It’s a miniscule risk, but one that can be eliminated with RTF. Similarly, although plane travel is very safe, I still restrain my children on the plane.

      • Mer
        May 26, 2014 at 7:39 pm #

        When my 5 mo was born we decided to supplement because A he was starving and my milk hadn’t come in yet and B he was nursing nearly nonstop when milk did come in and I needed a break. We used the RTF stuff because he was a newborn and we wanted to be super careful about what we fed him. Thanks to hanging out here I knew that was sterile and safe for a newborn (from a contaminant viewpoint). So glad we had that option and now we’re one of those success stories with my huge (21 lbs!) baby EBF since around 7 weeks.
        So props to all the commenters here who keep educating, explaining and fighting the woo! It really helped me!

        • OldTimeRN
          May 26, 2014 at 7:46 pm #

          As a nurse who works with babies I love hearing stories like this. It’s wonderful to know your baby went on to nurse exclusively after having formula the first few days/weeks. It’s nice to know your whole breast feeding plan wasn’t destroyed by the pushy nurses who just wanted to give your baby formula and wanted to ruin your plan.

          • May 27, 2014 at 1:00 am #

            I have always found the “if the baby so much as sees a bottle he’ll never successfully breast feed” mantra to be so much horsefeathers. The ambivalence of some mothers is something else — they are really hoping the fiction is true, so that they can convince themselves that exclusive breastfeeding was their only option: “No matter what I do, he won’t take a bottle” or “he wouldn’t return to the breast after a relief bottle [of expressed breast milk] because the nipple shape of the bottle was easier for him”.

            Babies are born with a sucking reflex; it is indiscriminate. If they are hungry enough, they’ll suck on anything in sight.

          • Mishimoo
            May 27, 2014 at 9:33 am #

            I seem to have the exceptions, they refused the bottles after a few test sucks until they were ready to wean (7 months/5.5months/9months) despite trying different combinations of bottle/nipple/formula. I wanted to be able to pump or supplement, but they weren’t amused. By and large though, most babies will drink from bottles given a chance.

          • The Computer Ate My Nym
            May 27, 2014 at 9:38 am #

            If it makes you feel any better, my small one was very unenthused about anything in a bottle. She’d take expressed breast milk in a bottle if she was really hungry, but mostly I ended up just coming home early to feed her. Fortunately, I was in a position to be able to do that.

          • Mer
            May 28, 2014 at 4:02 am #

            My middle child took a bottle for three months then refused it. I did eventually get him to take it again, but I can’t remember how. I do know that we tried several bottles and ended up with tommee tippee bottles working. But lord was he stubborn! I do remember that it was his aunt that got him to take the bottle, he would accept it from dad or me.

          • Busbus
            May 28, 2014 at 12:48 am #

            I tend to agree. I have heard from a few friends who had problems with their babies not taking bottles, and I don’t doubt that babies are different and some will develop a preference – but those were all women who had the option to come home and nurse, or women who’s children were older and already taking solids and who would just “hold out” on other food and drink until their mother came home. I have never heard of a baby dangerously not taking a bottle in a situation where that was the only choice – ie, with a mother who did not have the option to come home to nurse, or when the mother has to go on a trip or to the hospital, or is simply not there. Babies need food, and a hungry enough baby will take a bottle.

            Now, maybe you don’t want to put your baby through that if you have the means to avoid it, or maybe you’re fine with exclusive nursing. But that doesn’t mean that that’s the only choice you have – it’s just the choice you happen to make, given your circumstances.

          • Wren
            May 30, 2014 at 8:33 am #

            My second refused a bottle for 7 hours that I was away from her when she was 3 or 4 months old. I just accepted her not taking one as I was home generally anyway and it meant I didn’t have to pump or buy formula. She can be oddly fussy though. At almost 7 years old she still refuses to drink anything but water ever since she stopped breastfeeding at almost 3. Well after she was fine with water in a cup she refused breastmilk any way but directly from the tap.

          • Elizabeth Yirak
            May 28, 2014 at 1:20 pm #

            Giving my son 1/2-1 oz about 2 times a day after a nursing session is what kept us going as long as we did. I have IGT, so the fact that I was able to nurse with only 1-2 oz of supplementation a day for the first 2 1/2 months was pretty amazing. Without those few ounces a day, I would have given up way sooner.

          • The Bofa, Being of the Sofa
            May 29, 2014 at 9:23 am #

            Elizabeth Yirak – The part that bothers me is that you are considered to have failed because you didn’t “exclusively” breastfeed for a month or 6 months or whatever.

            I would hope that breastfeeding advocates would see your story is a great success! It’s wonderful.

          • Elizabeth Yirak
            May 29, 2014 at 9:48 am #

            OH no, it wasn’t. According to others, I didn’t do enough to continue. I belonged to an IGT support group that I ended up leaving because the women in it were horrified that I wasn’t trying an SNS or pumping every 2 hours when things started to slow down. I was so proud of myself for getting as far as we did without having the mental breakdown I did with my first child, but to all these other moms, I was a failure. It was so horrible.

          • The Bofa, Being of the Sofa
            May 30, 2014 at 9:20 am #

            And this is why folks like me have such a problem with “lactivists.” Instead of celebrating success, they still find ways to criticize.

            BTW, how wonderfully supportive of your “support group,” eh?

          • Mer
            May 28, 2014 at 3:53 am #

            Thank you! It was such a pain to get the dang formula too, kept getting counseling about formula and offered a supplementation system to tape to my breast, so rather than pushy nurses offering formula, I had nurses pushing breast feeding. I politely turned it all down, fed the baby a bottle and then alternated nursing him with a bottle for a day. He did so much better after getting some formula and his blood sugars came up and stabilized. Poor lil guy had a first blood sugar of 44 IIRC, his second one was in the 50s and then I insisted on formula and I don’t remember what it was after that but the pediatrician approved. I really do credit the commenters on this site for me knowing that the formula was beneficial to breastfeeding rather than destroying it entirely.

        • Jessica S.
          May 26, 2014 at 8:54 pm #

          Could you use any nipple on these RTF bottles? I can’t remember if we used any at home, or if it was just in the hospital – and we used their nipples there.

          • Bombshellrisa
            May 26, 2014 at 9:53 pm #

            the nipples and rings from the Gerber bottles (the basic ones at Target or Fred Meyer) worked just fine on the Similac RTF. Enfamil has RTF but you have to have a bottle to pour it into. Since Enfamil RTF is on sale at Fred Meyer and they keep sending us those coupons, this is what we have for when we go out.

          • Mer
            May 28, 2014 at 3:37 am #

            Rather ironically, the medela nipples fit perfectly. At my hospital they give us a medela hand pump in the new baby kit and it includes one bottle, plus we had a few left from our 3 yo, so we went and bought a few more since they worked with the stuff we already had and worked with the similac rtf formula. I’m pretty sure that any standard bottle nipple works. We’ve since switched to tomme tippee and that has a wide neck that wouldn’t work at all. Oh and I’m a huge fan of tommee tippee, the wide base on them encourages baby to latch onto the bottle so it’s easy to switch back and forth between breast and bottle (I know you plan on formula feeding, but for others that read this I wanted to share that)

    • fiftyfifty1
      May 26, 2014 at 8:56 am #

      Good point Amy M.
      Back before regulated commercial formulas, women who couldn’t breastfeed fed their babies all sorts of substitutes (raw milk, flour + water, oat gruel, broth etc. ) this unregulated “formula” did indeed cause a lot of deaths.

      Homebirth : Hospital birth as folk formulas: commercial formulas

      …but then you run up against the folk formula nutters who post all sorts of crazy homemade recipe formulas on the internet, urging women to avoid the “shit in a can”. Hopeless.

    • Renee
      May 26, 2014 at 12:19 pm #

      Great point!

  6. MLE
    May 26, 2014 at 12:45 am #

    Message to anyone who thinks breast feeding is universally easy and cheap: consider for one second that your experience might not be identical to every other woman’s, and shut up and listen.

    • Renee
      May 26, 2014 at 12:20 pm #

      BF may be easy for some (like me) but it is NEVER EVER cheap. Moms time counts, and the time she takes off work matters too. If you have never worked, and don’t value your time, well then I goes it cheap. These days most moms work, and taking time off can kill your earnings (ask me how I know, just ask me).

      • Anna T
        May 27, 2014 at 12:52 am #

        If the mom plans on staying home with her children, not only to breastfeed but to care for them in their early years, and she plans on doing this regardless of breastfeeding, then it’s NOT like she takes time off TO breastfeed.

        I breastfed my first not as long as I wished (15 months, which is great according to general statistics, but I hoped for more) – however, it’s not like I said, “hey, great, now she doesn’t need my breast so I can put her in daycare and get a job.” I continued to be home to take care of her because we believed that is best for our family.

        Today, I still stay home to homeschool my daughters (now 5 and 3 years old).

        So for me, and people like me, breastfeeding IS actually free. (Well, someone here mentioned the cost of extra food, but if you consider how much food is thrown away at the average household anyway, you’ll see that a lot more calories end up in the trash than converted to breast milk).

        • Trixie
          May 27, 2014 at 7:22 am #

          Yeah, I would’ve stayed home regardless, so BF was a cost savings for me. Although that didn’t particularly factor into my decision.

        • OBPI Mama
          May 27, 2014 at 7:33 am #

          I also don’t know anyone who stayed at home *just* to breastfeed. And I don’t know any mom who decided to go back to work last minute because her baby was formula fed. How my babies needed fed never factored into my decision to be a stay at home mother.

          • fiftyfifty1
            May 27, 2014 at 10:06 am #

            “I also don’t know anyone who stayed at home *just* to breastfeed.”

            I did. When my 2 were babies, studies like the PROBIT study weren’t available. I suspected that the improved outcomes associated with breastfeeding were likely just due to confounding but I couldn’t be sure, so I breastfed. If the PROBIT and discordant sib studies had been available then, I would have either formula fed right from the start or done very early weening and gone back to work full time at 6 weeks. With my first especially we could really have used the money and insurance benefits. I turned down a position I really wanted at the time, because it wouldn’t have worked with breastfeeding.

          • Anna T
            May 27, 2014 at 2:32 pm #

            Yes! I mean would my babies benefit less from my being with them if I, say, had a medical condition that prevented me from breastfeeding? Or if I were their adoptive, not biological mom? Of course not! Breastfeeding is important, but it was definitely not the only or even the major factor pulling me towards home.

            As for women who extend their maternity leave a little… who knows if they do it *because* of breastfeeding, or in order to be with their baby? Breastfeeding might be the practical reason given, but many women just ache to leave their babies behind and go back to work.

        • theadequatemother
          May 27, 2014 at 9:02 am #

          In Canada, where many (but not all) women have close to a year of EI for maternity and parental leave, women may chose their return to work date partly because of BF. EI is up to 60% of your earnings but tops out at a certain level and is based on a complex calculation I don’t understand. I have encountered mothers who would go back to work prior to a year but find they have a hard time getting the baby onto a bottle or find they can’t pump. And sometimes the plan for husband/ partner to take a few months of that parental leave is abandoned because the lactating parent is having difficulty weaning/ pumping.

          Of course, when EI is finished, the impetus to go back to work is greater regardless of difficulties. But at that time (1 yr) it’s “acceptable” to feed cow’s milk and number and duration of BF is generally lower.

          The delayed costs of a longer parental leave and parental leave that is largely taken by women include decreased accrual of room in the canada pension plan, a longer time to accrue seniority in jobs where you benefit from that (raises, promotions, etc), decreased ability to maintain and upgrade skills (also leading to promotions, raises etc. as those are often linked to skills upgrades in private industry), a decreased savings rate. Add in a woman’s longer life span and it all adds up to more female impoverished seniors.

          Now, I’m not saying that this is the fault of BF. But it is the fault of a society that thinks that women’s time is less valuable then men’s. Unfortunately the BF public health message perpetuates that.

          • Irène Delse
            May 27, 2014 at 9:52 am #

            What you say about Canada is true here in France too. Even though both parents have access to paid parental leave for the birth or adoption of a child, in practice it is more often mothers who do so, and the pro-BF messages unwittingly tend to reinforce the status quo. (At least, most of the time unwittingly. Because there are of course conservative voices to say that women should go back to home anyway.)

            In recent years, the government has tried to make parental leave more attractive for fathers by increasing the total length available for one child if both parents take at least some break from work. I don’t know if it will be effective in the long run.

          • MLE
            May 28, 2014 at 10:27 am #

            Yeah I think even of I had a year available, I wouldn’t take it because I would miss a lot in terms of opportunities to grow and advance that naturally come up during a year and aren’t planned career track type options.

        • Busbus
          May 28, 2014 at 10:08 am #

          Most people who want or need to return to work wouldn’t delay it “because of breastfeeding.” However, the constant rhetoric around breastfeeding sometimes makes it seem like you ought to – and women beat themselves up over it – even though the proven benefits of breastfeeding in developed countries are very small. Moreover, in the US, mothers have so little support in general (no paid maternity leave etc.), but they – not the state or policy makers, and certainly not fathers – are still the ones who are made to feel bad for doing what they need to do. Ideologically motivated lactivists are making this situation worse. Breastfeeding can be a wonderful experience and it’s great if it works for a family. But the attempt to inflate the supposed benefits of breastfeeding in order to convince others to do it is really anti-woman and very sad.

        • me
          May 28, 2014 at 12:55 pm #

          Exactly. When I made my decision to SAH, I actually planned to formula feed (it was all I knew). I was persuaded to give bfing a try (there is a TON of encouragement for mothers to at least attempt it), and, as it happened, it came fairly easily to me and my daughter and went very well, so by the time I took a look at the overall decision (to decide whether to continue on or not), it was a very easy decision. None of my kids ever got formula.

          But the choice to stay home with them was made long before the choice on how to feed them.

        • Guest
          May 29, 2014 at 9:06 am #

          I did, my sister did, my co-worker is. I know lots of people where the desire to breastfeed was a huge part of the calculation on how long to stay home after a baby is born. I also know lots of people who had hoped to bf, wanted to stay home longer, could not afford it, and ultimately their milk dried up. I waited 3 months with both my kids and I almost certainly would gave gone back sooner if we were formula feeding.

    • pj
      May 26, 2014 at 5:01 pm #

      Hear, hear!

  7. Jessica S.
    May 25, 2014 at 11:16 pm #

    On the topic of feeding, I thought this Fearless Formula Feeder story was excellent. One of the best I’ve read there: http://www.fearlessformulafeeder.com/2014/05/fff-friday-my-breasts-belong-to-me-and-your-breasts-belong-to-you

  8. yentavegan
    May 25, 2014 at 10:20 pm #

    A year ago , this post would have ignited my ire and I would have been angry that a woman, a doctor no less, could have written something so hostile about lactation.
    However now after being a faithful reader of the Skeptical OB, I understand Dr. Amy Tuteur’s agenda.
    Our self worth is not twinned with our mammary glands nor with the functionality of our wombs.
    There are women lurking on the edges, preying on other women’s weakness and exploiting that weakness for their own profit or self aggrandizement.
    Why would an otherwise intelligent mother put so much emphasis on how stripped of modern amenities her child’s birth is?
    Why would an otherwise logical mother allow her infant to continuously lose weight, pass bloody stools and scream inconsolably from hunger pangs knowing that a safe alternative to breastmilk is readily available?
    Why? Because we have been manipulated.

    • Jessica S.
      May 25, 2014 at 11:08 pm #

      I love this and your honesty. 🙂

    • Bombshellrisa
      May 26, 2014 at 1:51 am #

      THIS. IS. AWESOME. Thank you.

    • NoLongerCrunching
      May 26, 2014 at 7:39 am #

      Yes. I think that disappointment and even grief are natural if you wanted to bf and couldn’t, but the self-blame and desperation to bf at all costs are a direct result of militant lactivism. So sad and so anti-woman.

  9. Anna T
    May 25, 2014 at 4:36 am #

    I commented earlier, and it seems it somehow didn’t pass through… bummer.

    I just wanted to note that a certain line of formula did, in fact, kill some babies, and permanently injured others.

    I am referring to the infamous Remedia case in Israel. Due to negligence, the vegetarian line of this formula almost completely lacked Vitamin B1. Babies who received this kind of formula as their exclusive source of nutrition suffered extensive neurological damage and some died. Some will live with the effects for the rest of their lives.

    You could say, of course, “they were not hurt by formula – they were hurt by *negligence*. The formula was defective.”

    Similarly, home birth advocates could say, “home birth does not kill babies – poorly managed, irresponsible home birth does.”

    I wouldn’t say that, personally. I *do* believe the safety of home birth could dramatically increase with extensive regulation of midwifery. I do believe the safety of home birth could increase if midwives refused to take on VBACs, breech, twins, and other high-risk cases.

    Still, even in low-risk women, situations may arise when an intervention is needed, and when that happens nothing can beat being IN the hospital, and having immediate access to the needed help.

    • Mariana Baca
      May 25, 2014 at 4:08 pm #

      But even the best managed, perfectly low risk homebirth still means you are very far from a hospital and has worse outcomes even for low risk women.

      Formula, prepared properly, does *not* have significant risks compared to breastfeeding in term infants. Even if you include rare instances of ridiculous formula, some women also produce breastmilk that causes failure to thrive or allergies. Kid would die without supplementation if EBF in this case, too. So there are some benefits to formula feeding over breastfeeding.

      On the flip side, there is no medical benefit to homebirth unless there is a negligent hospital.

      Formula cohorts are like hospital cohorts, they don’t only include women who chose to be there, but all the women who were high risk and didn’t have any other choices and *had* to be there.

      • Jessica S.
        May 25, 2014 at 5:10 pm #

        This is well put. Especially the emphasis that benefits on one side do not necessarily equate to risks from the other. Or, like you said, significant risk. Although, my personal story includes the very significant risk that I would’ve had a complete break down if I’d tried to breastfeed in addition to adapting to the huge change of becoming a mom. To me, it was not a difficult decision.

      • Anna T
        May 26, 2014 at 2:58 am #

        This is what I said, too: being OUT of the hospital still means more risk than being IN the hospital, even in perfect low-risk circumstances.

        Yes, properly prepared formula is safe, but the parents in the Remedia affair also thought they were giving their children proper nutrition (otherwise, obviously, they wouldn’t give it). It was a rare and tragic incident – something totally outlandish in developed countries – but we must remember it and keep a watchful eye on infant food. Neglect is unpardonable.

        If I were formula-feeding, I’d alternate between two brands, just in case something is missing or inadequate in one of them. This way, I’d have my child covered.

        • NoLongerCrunching
          May 26, 2014 at 7:40 am #

          Wow, that’s a good idea!

        • Renee
          May 26, 2014 at 12:23 pm #

          This is why we have so much regulation here. Its vitally important.

        • Starling
          May 26, 2014 at 12:34 pm #

          We actually do that, and I’m still breastfeeding, as well. (My supply is low.) It just doesn’t make sense to me to assume that there’s one formula that hits everything. And, extra bonus, you can also use up all your formula checks this way!

      • fiftyfifty1
        May 26, 2014 at 9:06 am #

        “On the flip side, there is no medical benefit to homebirth unless there is a negligent hospital.”

        There is arguably medical benefit to the mother if one of her goals is to avoid c-section. It comes at the price of increased risk to baby, but still. Depending on the woman’s priorities, avoidance of c-section may be considered a medical benefit.

        • Mariana Baca
          May 26, 2014 at 1:05 pm #

          That is not a medical benefit, but a personal choice benefit. Although they still shouldn’t be doing a c-section without consent.

          • Ellen Mary
            May 26, 2014 at 2:58 pm #

            It is 100% a medical benefit. Honestly this is so offensive to me, as a woman & a Cesarean mother. Do not pretend there is no medical sacrifice involved in having a baby surgically. No one would ever tell a man that an incision & surgery on his reproductive organs were of no medical consequence. Cesareans come at the price of possible infection, diminished future fertility & increased chance of hysterectomy. & increased risk of Previa & Accreta.

            YES my Cesarean was worth it, as my health would have been far more impaired by an adverse outcome at home. But it still has medical consequences in a great number of women.

          • Mariana Baca
            May 26, 2014 at 4:10 pm #

            Ok, you are missing the point of what I’m saying.

            Look, but why does giving birth at home prevent cesaereans? It is not because there are *medical* benefits to being at home that make cesareans less indicated. It is that you *can’t* have one there, so you need to transfer to a hospital in order to get one. It is easier to go AMA at home because there are no pesky doctors to listen to telling you when a c-section is indicated. The cesareans avoided were not avoided for medical reasons, but because of distance and no doctor urging a c-section when indicated.

          • Mariana Baca
            May 26, 2014 at 4:20 pm #

            Less TL;DR version:

            There aren’t less c-sections at home because of medical benefit, but because for a variety of factors, choosing to have a c-section after TOL at home is more difficult than in a hospital. Although avoiding a c-section may have a good medical basis, the only benefit being at home provides for this choice is to make the choice for a c-section more difficult and less obvious.

          • fiftyfifty1
            May 26, 2014 at 4:36 pm #

            The big way that homebirth reduces a woman’s chance of C-section is that homebirth, with its lack of effective fetal monitoring and its tolerance of protracted labors, shifts the risk from mother onto baby. Many babies who show even clear signs of fetal distress will be born before they are significantly damaged. Likewise, the majority of babies in prolonged labors will still be born vaginally and will not suffer from sepsis after all.

            This is not a risk trade-off I would make myself. But priorities and risk tolerance varies.

          • Mariana Baca
            May 26, 2014 at 4:39 pm #

            Right, agreed.

    • Renee
      May 26, 2014 at 12:22 pm #

      Does the death count come close to HB?

      • Bombshellrisa
        May 26, 2014 at 7:50 pm #

        Maybe if you leave out Colorado and Oregon

  10. Bombshellrisa
    May 24, 2014 at 11:09 pm #

    Remember the discussion yesterday about who answers the calls on the Similac breast feeding support line? They have certified lactation consultants provided by a 3rd party.

    • Jessica S.
      May 24, 2014 at 11:35 pm #

      Interesting! Now we know. 🙂 What an evil formula company. I’ll bet those consultants are really undercover saboteurs. We should call and test their advice.

      • MLE
        May 25, 2014 at 12:14 am #

        “Baby not latching? Try singing them a soothing formula jingle.”

      • NoLongerCrunching
        May 26, 2014 at 7:44 am #

        Actually I’d be curious to do it. What a disappointment to the formula haters it would be if those LCs turned out to br good. Come to think of it, that sounds like a fun job.

    • Renee
      May 26, 2014 at 12:26 pm #

      Uh-oh, they have actual help? No one will believe that, you just know they are the eeevvvvilllz.

  11. Sandy
    May 24, 2014 at 10:48 pm #

    The WHO recommends exclusive breastfeeding for at least 6 months and up to two years!! Why? Because breastmilk is best for your child. If you can’t hack breastfeeding your baby.. Fine. But don’t try to knock the women who are due to your shortfalls!!!

    • OldTimeRN
      May 24, 2014 at 10:51 pm #

      How do you know what is best for MY child? Or anyone else’s child? Breast feed all you want but don’t take away another mother’s right to feed her baby the way she determines what is best for HER baby.

    • Mishimoo
      May 24, 2014 at 11:21 pm #

      Oh dear, I am so sorry that I didn’t realise that my child making a choice was due to my ‘shortfalls’.

    • Stacy48918
      May 24, 2014 at 11:25 pm #

      “If you can’t hack”?

      Right, the old “formula feeding moms are lazy” argument. Nice.

      • Jessica S.
        May 24, 2014 at 11:34 pm #

        I’ll be the first to admit that my complete disinterest in wanting to breastfeed my son (or daughter-to-be-born-soon) was based on me, me, me. It was based on me not becoming a mental wreck from the suffocating anxiety I knew it would bring me. I wasn’t going to even open that door. So for my kids (and anyone within a 40ft radius), breast is worst. 🙂

        • NoLongerCrunching
          May 25, 2014 at 12:48 pm #

          Some women’s milk glands can’t hack breastfeeding in the same way my sister’s pancreas can’t hack making insulin. I mean how lazy are those glands anyway?

          • KarenJJ
            May 26, 2014 at 3:23 am #

            I have an over-acting immune system. I wonder if there is some moral high ground I can claim in regards to its over-achievement?

          • NoLongerCrunching
            May 26, 2014 at 7:36 am #

            Oh definitely! If someone complsins about their cold, raise your eyebrow and tell them that at least their white blood cells will be finally get some exercise, poor things.

      • Beth S
        May 27, 2014 at 3:52 am #

        Wow I wish I’d known I was lazy. Sure I FF, but I’m dealing with a kiddo who’s allergic to everything, not to mention keeping a house clean, fighting some sort of infection in my gut that’s making it impossible for me to eat a full meal, and taking care of my six year old who has decided all the sudden she wants to be a Momma’s Girl instead of the Daddy’s girl she’s been her whole life.
        I’m lucky, I admit this, because I could be in a situation a lot of women are in and not be able to stay home with my kiddos. I could be a single mother, with no father what so ever around. I could be my sister in law and living in a homeless shelter with my twins until something becomes available because none of us are in a position to help her. I’ve never thought of BFing moms as lazy I wish they wouldn’t think I am.

    • Jessica S.
      May 24, 2014 at 11:27 pm #

      Oh FFS, Sandy. No one is trying to “knock” the women who BF. And Sandy, you’ve proven quite well in your succinct tirade why women who feed formula to their kids might feel a teensy bit beat up and demoralized: because of their “shortfalls!!!” and all. So please, do us a favor and stop acting as the martyr. You and your ilk have made it painfully clear that you occupy the moral ground. You can’t occupy it and acted beat up on at the same time.

      Lastly, I would be very, very careful what you classify as “shortfalls!!!”. Surely you are not suggesting that women who turn themselves inside out to BF and who must turn to formula have fallen short? You’re a riot. Good luck with that.

    • Sue
      May 25, 2014 at 2:24 am #

      What is it again that “WHO” stands for? Wasn’t it WORLD HEALTH? Maybe that’s why they make recommendations relating to the health of impoverished communities, where lack of clean water and poverty really do make formula feeding potentially dangerous.

      IN the developed middle class blog-commenting cohort, though? Not so much. Ever read the studies that show how small and time-limited the difference is in our wealthy communities? And I don’t just mean monetarily wealthy – if you have reliable access to clean water and you are no so poor that you have to dilute the formula, you’re doing OK.

    • Who?
      May 25, 2014 at 4:30 am #

      So rude. Can’t ‘hack’ breastfeeding. Are you 12? And a bogan?

      Clearly you are a hospital birthing (obviously safer for the baby) and vaccinating parent? If not, how do you justify those decisions in terms of child welfare?

      Seriously, no one knocks mums who choose to breast feed. If only women would be a bit kinder to each other rather than using their children as weapons in a war of one-upmanship.

    • Sullivan ThePoop
      May 25, 2014 at 5:53 am #

      No one is knocking breastfeeding women. How did you even get that from what was said? Also, you have no idea why someone would choose not to breastfeed so it is very rude to assume it is because they couldn’t hack it. Your whole post makes me think you feel guilty about some shortfalls of your own.

      • Ellen Mary
        May 26, 2014 at 3:08 pm #

        Since I have spent the majority of the last 8 years BF, it does feel really bad when people say I was essentially wasting my time, not valuing my labor (or that my time must have been worth very little), just a Priveledge Princess who doesn’t understand work, etc.

        • FormerPhysicist
          May 26, 2014 at 3:32 pm #

          It does hurt when interpreted that way. I’m sorry. Except very few people are saying quite that, or meaning it that way.

        • theadequatemother
          May 26, 2014 at 3:33 pm #

          I don’t think people are saying it’s a waste of time. They are saying that your time IS valuable. If you chose to use it to BF great! If you chose to return to paid employment instead, great ! It’s just irritating when others pile on the pressure to BF by calling it “free” while ignoring the opportunity costs that go with it….they are the ones saying yourself is worth ” nothing”

          • Ellen Mary
            May 26, 2014 at 3:48 pm #

            I think saying a woman is too poor to BF or too valuable to BF is just another way of restricting women’s choices. I think we can all agree that ideally women should be able to elect to FF or BF regardless of their financial status.

          • Irène Delse
            May 26, 2014 at 4:03 pm #

            Good thing nobody here said things like “too poor” or “too valuable” to BF. In fact, theadequatemother just said the quite the contrary!

          • Life Tip
            May 26, 2014 at 4:08 pm #

            Saying that a woman is not allowed to breastfeed because she is poor would be restricting her choices (no one is saying that). Pointing out that many women are unable to breastfeed because of poverty is giving a reason why many mothers make the choice to use formula.

            Sure, ideally any mother could choose to FF or BF regardless of financial status. But in our current, non-utopian society, financial status does influence or restrict options.

          • LibrarianSarah
            May 28, 2014 at 11:05 am #

            We don’t live in ideal land. Circumstances restrict everyone’s choices and poverty is a big one of those. If a woman is the primary breadwinner of a family she cannot afford to take the time off to breastfeed her baby for 6 months to a year or whatnot. She has to worry about keeping a roof over her head and feeding both her and her children.

            Yes ideally poor women would have the ability to chose whether or not to breastfeed or bottle feed. But honestly that is the least of their worries. Ideally they wouldn’t have to live in an area full of gang violence and drug use. Ideally they will all have insurance for them and their children. Ideally they wouldn’t have to work 2 jobs to have just enough money to be flat broke.

            But here is the country I live in. I live in a country of wealth inequality where insurance is tied to employment and employers are rewarded for screwing over their bottom workers. I live in a country which is gutting social welfare in order to finance corporate welfare and the largest defense budget in the world. I live in a country where violent crime against middle to upper class white people makes international news and violent crime against poor people of color barely makes the local police blotter. Let’s face it I live in a country where it would be a cold day in hell before the “average” American taxpayer would tolerate a tiny portion of his/her tax dollars providing income for a woman to stay home with her kids.

            Pointing out the reality of the situation many, if not most, women in America face is not restricting their choices. There are a variety of things we could do to make things easier for the people at the bottom of the social totem pole but they require sacrifices from the people least likely to make them and those are the ones at the top. These are issues that most middle to upper class Americans don’t like to talk about because then they have to admit that this is not exactly the meritocracy that we market it as and there are no easy solutions.

          • Young CC Prof
            May 28, 2014 at 11:12 am #

            Exactly. Money matters so much MORE in the USA than in other first-world countries. Money means dramatically improved access to health care. It means living in a neighborhood with good public schools rather than horribly underfunded ones. It often means the difference between your child going to college and not going to college.

            If breastfeeding compromises your ability to provide those things, it’s probably NOT the best choice for your family. If your family’s finances are stable either way and breastfeeding means a smaller but still safe and adequate home, or not being able to buy as many toys or take as many vacations, then it’s a matter of personal choice.

          • Trixie
            May 27, 2014 at 7:25 am #

            Some people choose to be SAHM regardless of lactation, in which case, it really IS basically free to BF.

        • Irène Delse
          May 26, 2014 at 3:36 pm #

          Are you referring to comments which pointed out that it’s deceptive to claim (as some lactivist did) that breastfeeding is cheap, because time (and loss of revenue) isn’t taken into account? Talking about the market value of a woman’s time is not the same as pretending time spent breastfeeding is worthless, quite the contrary. In fact, it shows the need for compensated maternity leave.

        • Amy Tuteur, MD
          May 26, 2014 at 4:07 pm #

          You were using your time in a way that YOU valued. That doesn’t make what you did objectively the best use of every woman’s time.

        • Sullivan ThePoop
          May 26, 2014 at 6:25 pm #

          No one said any of those things. Again, I would deal with whatever your underlying issue is if it seems to you that people are attacking you when they are not.

        • OBPI Mama
          May 26, 2014 at 7:14 pm #

          That is how some of the comments are coming across to me as well and that would feel bad. I think both breast or formula feeding requires different sacrifices and we should be encouraging each other because both sets of sacrificing are not easy (either time or financial… for me it was financial since I stay at home AND had to, unexpectedly, buy formula). I admire my friends who choose to breastfeed and they sacrifice their time (many don’t have pumps)… one of the perks of bottlefeeding has been Aunties able to babysit earlier… got to take the perks as they come! As well as the more colds and illness con. haha. I don’t think that is how some commenters are meaning it maybe, so I’m giving the benefit of the doubt.

        • An Actual Attorney
          May 26, 2014 at 9:44 pm #

          The only people saying that your time wasn’t of value is those who proclaim BFing is free. Pointing out that it’s only free if your time didn’t have value isn’t saying that your time didn’t have value.

        • Jessica S.
          May 26, 2014 at 10:51 pm #

          It’s not a waste of your time if it was important to you, absolutely not. I didn’t BF and I’m the first to admit part of that was b/c it was too overwhelming for me to consider, and I knew this would not be good for my mental state.

          I have a lot of admiration for women who BF. And I wince at those words b/c they can seem so insincere but I’m being serious: breastfeeding is no joke, it takes sacrifice – no matter if it was easy or hard, if you love it or are ambivalent, whatever. I hope that doesn’t come across patronizing. I don’t think women who BF need validation or anything, I just honestly think it’s work and it’s a sacrifice. And I think that’s admirable. (Gosh, that word just sounds so fake! I need to find a different one.)

          I did say earlier in this thread that if a woman is breastfeeding, or feels pressure to or to continue, but has no desire whatsoever to do it for her own reasons, if she’s doing it out of shame, then it’s not worth it. That’s only for women who want to quit but don’t b/c of external pressure.

          One anecdote: a close friend of mine fed breast milk to all three of her kids, but she never enjoyed putting them to the breast. So she pumped for months on end. She did not like it and would probably say she hated it but did it b/c it was important to her. I don’t think her time was wasted, b/c she was guided internally. So there’s lots of different ways of doing it, I guess is what I’m saying.

          • Who?
            May 26, 2014 at 11:01 pm #

            Thankyou for sharing your friend’s story. I breastfed both mine, the first one was so hard, the second easier. They were both monster babies compared to my size, and were on solids fairly early. I was young-ish then and felt it was the ‘right’ thing to do, though didn’t really ever enjoy it-especially when number one would wet burp what looked like half a feed down his front!

            My point is that had I known how smart and kind and tall they would turn out I might have cut myself a bit of slack. New mums shouldn’t feel bad about being kind to themselves and honouring their feelings rather than doing what is ‘right’ according to others.

          • Young CC Prof
            May 26, 2014 at 11:33 pm #

            I’m going to paraphrase what I say about pain relief in labor: It is none of my business whether another woman breastfeeds or not, or what her reasons are. If it works for her, great. The only things that bother me are:

            1) Bad studies about the benefits of breastfeeding which confuse correlation and causation. (Or bad studies about the harms of epidurals)

            2) People who run around hyping those bad studies and shaming women who don’t breastfeed (Or who get epidurals.)

            Now, the analogy doesn’t hold 100%, all other things being equal, epidurals appear to actually improve outcomes, but it’s pretty close.

    • OBPI Mama
      May 25, 2014 at 7:12 am #

      I refuse to take personally the fact that my breasts have 2 milk glands and they are underdeveloped at that. I am refusing to feel bad about it anymore or feel like it is a shortfall. My body is a lemon and that is that. We are not all made “perfectly”.

      Personally, not being able to breastfeed (my son was getting lethargic by day 5) was very difficult for me to accept and it stole a lot of my joy with my 1st and 2nd babies until I accepted it for what it was with my 3rd and 4th. My mother nursed us all to 2 years old and I assumed I’d follow in her footsteps. After starving my son I tried: pumping after each nursing, taking Regalin, ingesting herbs/teas/tinctures, used the SNS device to get him formula but also stimulating the breasts at the same time, and then I encapsulated my placenta with my 2nd in hopes of that helping as well as doing the above again. Met with 4 lactation consultants… But you know, I couldn’t hack it.

      I would still have loved to breastfeed, but it wasn’t in the cards. I do think it takes a different amount of perserverence to breastfeed and I admire women who stick with it. Just as I admire women who know that breastfeeding is: A) either not in the cards due to meds/no ability/physical stuff or B) know themselves well enough to know that breastfeeding is not for them… and they go with it, happily and peacefully.
      It takes different guts to joyfully follow your path in feeding your baby/mothering.

      • Beth S
        May 27, 2014 at 3:45 am #

        As one of my favorite songs says “Life is a lemon and I want my money back!” Seriously I admire women who can breast feed. I have the same “mythical” defective boobs as you do. It runs in my family and I accepted early on that I was a formula feeder, which has not made life easier with the new baby as she seems to be allergic to everything and Ma needs sleep.

    • The Bofa, Being of the Sofa
      May 25, 2014 at 10:17 am #

      Who is knocking anyone who breastfeeds?

    • S
      May 25, 2014 at 5:07 pm #

      Interesting assumption. Dr. Amy breastfed all four of her children. I breastfed my first for two and a half years and intend to breastfeed my second. I also would like to know, specifically, how this post “knocks” breastfeeding mothers. Could you please elaborate.

      • The Bofa, Being of the Sofa
        May 25, 2014 at 5:20 pm #

        Yep. Refusing to demonize formula means that breastfeeding is evil. Or something like that.

    • LibrarianSarah
      May 25, 2014 at 5:50 pm #

      So just because Dr. Amy is not falling all over herself to give you the “best mother ever” medal for breastfeeding your kid she is a big jealous hater who is trying to “knock” you. Are you really so insecure about your choices that anything short of a parade sounds like an insult to you?

      • S
        May 25, 2014 at 5:52 pm #

        What i want to know is, if all the “right” choices happen to be the easiest ones for you and your family, do you still get the award? Or do you need to find another way to martyr yourself?

        (Obviously i really want my award.)

        • fiftyfifty1
          May 26, 2014 at 9:23 am #

          Hell yes you still get the award! It proves that you are “Right with Nature” (unless you are brown in which case it proves nothing because “our little brown sisters” are always Right with Nature because, bless your heart, how could they be anything but?!).

          Here is the hierarchy:
          White women who breastfeed easily
          White women who suffer mightily but prevail and breastfeed 100% anyway (their role is to provide proof that women who say they have problems and give up are actually nasty whiners who don’t love their babies, and thus they still get the award despite not being favored by Nature)
          Brown women who breastfeed 100% (these women rank much lower, but are still useful as Exhibit A in the Naturalistic Fallacy)
          That’s the entire hierarchy. Other mothers don’t even rank.

          • S
            May 26, 2014 at 9:27 am #

            Wait! What about yellow?? We are middle class so that make us white, right?

          • Renee
            May 26, 2014 at 12:42 pm #

            Depending who you ask, yellow is totally superior :-), or right below white.

          • Life Tip
            May 26, 2014 at 9:50 am #

            Real conversation on an NFP Facebook group I’m in:
            Woman posted a study that showed an increased rate of unplanned pregnancies in women wanting to space babies and using NFP while lactating.

            Woman #2: But this study is from Ethiopia! Shouldn’t those women have ecological breast feeding down by now?

            Um what?

          • The Bofa, Being of the Sofa
            May 26, 2014 at 9:56 am #

            I don’t even know what that means.

          • Irène Delse
            May 26, 2014 at 10:39 am #

            Apparently it’s tied up with NFP. As one Catholic blogger explains:
            “in a nutshell [it] means nursing your baby for nourishment as well as comfort without restriction”
            Cf. http://katewicker.com/2008/12/ecological-breastfeeding-book-review.html

            Basically, giving the breast to the baby every time she expresses a need for food, or soothing, or any kind of interaction, night and day, also taking naps with the baby so as to be always close by, etc. The proponents claims that not only does this method makes NFP more effective (unless “God has other plans” of course, which seems to be admitting a lack of effectiveness), but that it’s also more natural (with the usual anecdotes about African women doing it) and “healthier for mom and baby”.

            Confusingly, the proponents of ecological breastfeeding call it EBF, which I thought was already the abbreviation for exclusive breastfeeding.

          • Life Tip
            May 26, 2014 at 10:54 am #

            Effective or not. It’s next to impossible for anyone except for the most priveleged among us. And even if it was possible, it’s not desirable for many women.

          • Irène Delse
            May 26, 2014 at 11:22 am #

            My thoughts exactly. Things like work, or other children, seem not to exist in this vision. Or simply the wish for a little time by yourself, untethered from the baby for a change!

          • Renee
            May 26, 2014 at 12:38 pm #

            Ugh, ecological BF? Who even came up with that term?

            Do NOT do this type of BF! I did, and now I have an over 2 DD that has zero soothing skills and runs to nurse at every difficulty. It’s a very hard habit to break, because now in addition to weaning, she has to learn to self soothe at the same time. Please don’t suggest CIO, that has failed miserably, and only made it worse. Other suggestions are always gratefully accepted.

            In short- never do this once baby is past a few months old. Just don’t. It may go well, but if it turns out like mine did, there will be hell to pay. It makes me sad because I thought this was a good thing, with no downsides. No one mentions THIS stuff….

            What about being Ethiopian would make you BF like that? Huh?

          • Irène Delse
            May 26, 2014 at 12:55 pm #

            Well, there’s all sorts of assumptions in the so-called First World about what African women do. A lot of stereotypes, more often than not of the ‘noble savage’ kind. Nevermind that in Africa as in other places, women often work in or outside the home. They are often the ones who tend the fields and gardens, for instance.

          • Jessica S.
            May 26, 2014 at 10:35 pm #

            I won’t suggest CIO, but I will suggest a book, if you’re interested? I’ve had my nose in it lately b/c my 3.5 year old – who has always been a greater sleeper – is suddenly having issues, and at his age I don’t feel comfortable just letting him scream. I let him fuss plenty as a baby, I don’t know if you’d call it CIO, but I think I was just lucky. Now I’m stuck b/c I haven’t had to deal with sleep problems! Anyhow, enough of that – the book is Healthy Sleep Habits, Happy Child. I’ll warn you, it’s not very exciting and is quite dry, but he has lots of different routes you can take. It might be worth checking it out from the library first; you may not find that you need the entire thing. Otherwise, good luck! I feel your pain – it’s harder when they’re older, at least that’s what I think. 🙂

          • Lion
            May 26, 2014 at 1:24 pm #

            No, here in Africa we get our contraceptives from the pharmacy. 😉

          • Mariana Baca
            May 26, 2014 at 1:57 pm #

            It is not a real form of NFP, it is a made up thing by one NFP teaching couple (the Kippleys). It has no studies and reputable NFP orgs don’t recommend it. They recommend LAM according the the Bellagio consensus for anything NFP/Breastfeeding related.

          • Life Tip
            May 26, 2014 at 3:06 pm #

            Yep. Although I personally preferred using Marquette method while breastfeeding. Not that napping everyday with my newborn wouldn’t be lovely, just not realistic.

          • Joy
            May 26, 2014 at 5:21 pm #

            And certainly not those brown women who practice Las Dos, even though they actually have better long term bfing rates than white women. That one bottle a night makes it not count at all.

      • Renee
        May 26, 2014 at 12:34 pm #

        LOL, Dr AMy BF all 4 of hers. BUt that is always ignored.

        • Bombshellrisa
          May 26, 2014 at 2:39 pm #

          And Dr Amy always writes that she enjoyed breast feeding and endorses it!

    • LM
      May 25, 2014 at 6:45 pm #

      I didn’t breastfeed my youngest, not because I couldn’t “hack” it but because I had my breasts hacked off because of cancer.

      You may be Mother of the Year because you breastfed but you are an awful person!

      • Jessica S.
        May 25, 2014 at 9:21 pm #

        Technically, you did hack it…? :O (Sorry, probably in poor taste to make cancer jokes. :S) I’d upvote your comment 10 times if it let me!

        • LM
          May 26, 2014 at 7:58 pm #

          It is poor taste but doesn’t come close to the poor taste jokes in my house about my situation. Gotta keep your sense of humor!!! Thank you 🙂

          • Jessica S.
            May 26, 2014 at 10:25 pm #

            You do, absolutely! My mom had both a lumpectomy and then a mastectomy (two separate bouts of cancer) over 20 years ago. 10 years ago, for her 60th birthday, we went and got tatoos together. She had hers done on her “fake” breast. I don’t know if she thought it would hurt less, I don’t think that was the case! Ha! And my niece died at 19 from a rare sarcoma, bless her heart. Well, she actually beat the initial sarcoma, only to find out a year later that it had metastasized to her lungs. She had a spectacular attitude and humor about the whole situation. Cancer is a fucking bitch, excuse my language. 🙂

    • Joy
      May 25, 2014 at 8:10 pm #

      WHO states babies need to have supplementation of bm starting at 6 months. Not ebf for at least 6. http://whqlibdoc.who.int/paho/2003/a85622.pdf

      • Young CC Prof
        May 25, 2014 at 10:38 pm #

        Yup. 6 months is generally the point at which infants can no longer get optimal nutrition from breast milk alone. They need supplemental food of some kind, and it should include a good source of iron, since the generous newborn stores are depleted by then and breast milk supplies little.

        • kerlyssa
          May 26, 2014 at 4:42 pm #

          Depends how bitey the little buggers are.

    • lilin
      May 26, 2014 at 2:41 am #

      No brain, no heart, no reading skills and too much access to exclamation points. What a poster child for breastfeeding you are.

    • NoLongerCrunching
      May 26, 2014 at 7:47 am #

      I am an IBCLC who came here initially for the same reason as you, to bitch at Dr Amy. Stay and read for a while and prepare to have your mind stretched.

    • Renee
      May 26, 2014 at 12:33 pm #

      This comment shows exactly why lactivism is full of hateful, horrible, rude people that have no concern for other moms and their needs and choices.

      “Can’t hack breastfeeding…”- I would LOL if this wasn’t so hateful towards others, many who are already shamed plenty over this topic.

      Choosing not to do it, or having a work schedule that doesn’t allow it, or medical issues, or low supply, or pain, or a history of abuse- these are ACTUAL situations. “hack it” doesn’t even fit in this equation. If you take on a marathon, and cannot do it, maybe you could say “I couldn’t hack it!” but about BF? WOW, just, WOW. Could you be more of a rude hater?

      Mom still BFing an over 2yr old, that never, ever took a bottle one time. (and I still think you suck)

      (The WHO also pushes vaccination, I hope you follow all of their recommendations there too!)

    • wookie130
      May 26, 2014 at 9:41 pm #

      Ummm…hack THIS, Sandy.

      Because I guess I had IGT (insufficient glandular tissue, or tubular breasts), then I guess my breasts were actually my “shortfall.” I would never have produced enough milk for my daughter. Ever. So, don’t knock ME for having to feed my baby SOMETHING, lest she starve to death, in the name of the WHO’s recommendation.

      Honestly, though, my breasts and what is best for my child is none of your business. What I feed my child doesn’t define me as a mother, and you don’t get to parachute on in here, say something stupid, and then flounce off as if you’ve made some sort of a difference.

  12. Sherri
    May 24, 2014 at 7:32 pm #

    Wow. You are one angry spiteful woman. I have had 3 homebirths. All life changing and 3 happy healthy beautiful babies. I’m so glad to have had the opportunity to give birth at home. If it were my ideal world there would be a birthing center in every hospital so birth emergencies (yes, I agree, they happen and are not to be trivialized) could be managed quickly and safely, but where I’m from (middle of nowhere TX) that just isn’t the case and I chose to have my darlings in the comfort of my home over the hospital (where I’ve been before and hopefully never have to go back!!) I’m sorry to the mothers who have lost their children. That is a tragedy I cannot fathom.

    “More importantly:
    Why shouldn’t women who choose hospital birth think the same thing about you?”

    Ooof. What a witch hunt you’ve got going. Informing women about risks and complications of homebirth – great. Demonizing women for their personal choices? – I know where that leads. And it’s not pretty.

    • The Bofa, Being of the Sofa
      May 24, 2014 at 7:36 pm #

      I have had 3 homebirths. All life changing

      And I have two kids, both born by c-section. They were also “life changing” events, and I wasn’t even the one pregnant.

      What’s your point? Having kids is life changing, for sure. What does the “homebirth” have to do with it?

    • Bombshellrisa
      May 24, 2014 at 7:45 pm #

      Are you the same Sherri that is from the UK? The midwives you homebirth with in the UK are NOT the same as US homebirth midwives. A high school diploma was only recently added as a requirement for US homebirth midwives to be called a Certified Professional Midwife. As I understand it, UK homebirth had a strict criteria that must be met and the midwives are all nurses and emergency transfer plans are clear cut and integrated into the system. US homebirth CPMs don’t have hospital privileges and can’t even prescribe medication

      • Jessica S.
        May 24, 2014 at 8:02 pm #

        It says she’s from TX, I think.

        • Bombshellrisa
          May 24, 2014 at 8:33 pm #

          My disqus is acting up-attributed this remark to Sherri when it’s Joy that is from the UK

          • Jessica S.
            May 24, 2014 at 9:29 pm #

            Disqus really likes to do that crazy stuff!

          • Joy
            May 25, 2014 at 8:14 pm #

            I’m in the UK, I do not like US “midwives”, except for CNM. I hope i make that clear? TBH, I don’t like UK midwives much either. I mean, it was totally cool my 4 day old hadn’t a wet diaper in 12 hours. She just needed more skin to skin. Or, tasty formula.

          • Joy
            May 25, 2014 at 8:39 pm #

            Also, no hb for me. I’m going for a c-section if I have the next one.

          • Bombshellrisa
            May 25, 2014 at 11:18 pm #

            I was answering the wrong person-it attributed a comment someone else made to you. You sound reasonable. And like someone who understands the risks of homebirth! Sorry your experience with midwives wasn’t great, I had hope that well trained like the ones in the UK would treat their patients better.

    • Guestll
      May 24, 2014 at 7:49 pm #

      Your argument is somewhat reasonable, yet it hinges the fact that you prioritized your own needs ahead of those of your babies. You acknowledge that emergencies happen and are not to be trivialized, yet you chose to place your own wants ahead of what was safest for your babies. At least you’re honest about it.

    • Jessica S.
      May 24, 2014 at 8:18 pm #

      *sigh* Dr. Amy fully supports the right for a woman to make her own choices about childbirth. She doesn’t support the disinformation that surrounds home birth b/c women are not able to make informed choices when they aren’t being told the risks.

      Hospitals allow women a wide range of options regarding childbirth. Obviously there are going to be hospitals that are poorly run, or simply cannot offer all the amenities or options due to constraints. It seems to me the “limits” that people moan about are actually limits put there by their specific situation: you don’t want to accept that continuous fetal monitoring may be appropriate given certain circumstances currently happening in your body or your babies, but that’s not the hospital’s fault. There are many other examples to be made, but in sum: to reject hospitals because you believe they are arbitrarily limiting is really to reject the reality of a given situation.

    • Stacy48918
      May 24, 2014 at 8:25 pm #

      If a woman drove around with her 2 year old in the front seat of her car, unbuckled, and I denounced that action, am I “demonizing” her? Or speaking up for the safety and well being of a child that has no choice in the matter?

      You are 100% free to make an ill-informed personal choice that benefits YOU more than your baby. And I am 100% free to say that that is a bad choice.

    • lilin
      May 26, 2014 at 2:50 am #

      Again, homebirthers display their lousy reading skills.

      She’s not saying you can’t have home births. She’s saying that the home birth movement claims to have certain principles, but they don’t. They have two conflicting sets of principles. When it comes to breastfeeding, they claim any sacrifice on the part of the mother is worth it because babies are healthier and safer with breast milk. But when it comes to home birth, they throw ignore the safer option and say anything is worth it to have a home birth. In reality, although I’m sure they’d like babies to be safe and healthy, it’s not actually one of their principles. What they want is for mothers to birth at home and to breastfeed, regardless of anything else.

      • Renee
        May 26, 2014 at 12:53 pm #

        I don’t think all the HB advocates lack reading comprehension, I think they never actually read the whole post. IF they do, they only focus on the parts they don’t like.
        We are all guilty of this from time to time.

        To be fair, the last comment is directed at moms that HB, not as the movement, etc.

        But I think its an OK thing to ask, and is in no way a “witch hunt”*. It’s a COMMENT. No one is going into communities and ripping MWs out by their hair to burn them at the stake, or otherwise torment them (though this sounds great for Darby Partner,Laura Tanner, al the MWs from Greenhouse and Motherwise, and Faith Beltz)

        (*That phrase is a fav among the HB crowd, because of historical treatment of MWs (which I honesty doubt now, looking at what these ones say and write down for the future to read).

    • Renee
      May 26, 2014 at 12:47 pm #

      YOU GOT LUCKY. I am so glad you did, and am happy you enjoyed your experience. I noticed you said:
      “All life changing”
      Yes, HB can be VERY life changing.
      All the moms that had babies die preventable deaths/brain damaged babies due to HB agree with you, it sure was “life changing” for them……

    • Beth S
      May 27, 2014 at 3:56 am #

      She’s not demonizing you for your personal choice though. She’s demonizing an industry that hides or minimizes their statistics, that looks down on those of us who had to have things like medically required C-sections, and an industry that either wants to demonize or hide the mothers who haven’t had such positive outcomes.
      I had one homebirth, or at least what I considered a homebirth which was an ambulance birth in front of my house, and one C-section. Guess which one was healing and life changing for me? The one where I didn’t seize at the end of labor. The one where my husband and I were able to let go of the birth plan and say “I just want a healthy kid.”

  13. Fertile Myrtle
    May 24, 2014 at 6:19 pm #

    I totally understand the motivation behind trying to bring attention to how dangerous home birth & CPM’s/lay midwives are. I get that, I do. Why choose the option that increases risk to baby/mom when there is a safer alternative, always.
    What I don’t understand is targeting breastfeeding and trying to claim the benefits are menial? How are you any better than the formula haters? Could some please expand on this…. The majority of women end up formula feeding.
    I’ve enjoyed the interesting perspective on home birth but this whole “lactivist” situation is really off putting.

    • Fertile Myrtle
      May 24, 2014 at 6:55 pm #

      I should also say, I have friends/family who use formula and spend hundreds of dollars on formula a month. If you consider breastfeeding being free a “soft” benefit then it might be a little more realistic of you to realize not everyone has a doctors salary.

      • Bombshellrisa
        May 24, 2014 at 7:14 pm #

        There has been a lot of discussion about the true “cost” of breast feeding. It may seem at first that it’s without cost but that isn’t the case for many who choose to breast feed. Lost income, the cost of lactation consultants, pumps, lanolin cream, nursing bras, not to mention the extra food the mother needs to eat to produce that milk can really add up.

        • Fertile Myrtle
          May 24, 2014 at 7:19 pm #

          Thanks to “lactavists” we don’t have to lose income to breastfeed. Pumps are 100% covered by insurance, by law. Lanolin? Seriously? $5…. Will last 1 year. I’m sorry, not seeing it. You can be as “fancy” or “simple” about breastfeeding as you would like.

          • Joy
            May 24, 2014 at 7:34 pm #

            Well, bless your heart. I’ve spent almost 2,000 trying to get my baby to be ebf. It would have been cheaper to just go on formula. LC, tongue tie snipped twice, herbs, pillows, bras, a pump (I live in the UK, so not covered by insurance). Not to mention the emotional toll of realising your three week old was still losing weight. Glad it worked for you though.

          • Fertile Myrtle
            May 24, 2014 at 7:38 pm #

            I’m sorry you have had such a rough experience. According to Dr Amy, that was all for naught. Do you think your experience has been typical of women that breastfeed?

          • The Bofa, Being of the Sofa
            May 24, 2014 at 7:38 pm #

            Do YOU think it is atypical?

          • Fertile Myrtle
            May 24, 2014 at 7:50 pm #

            I don’t think it’s uncommon to have bumps in the breastfeeding relationship, but it’s not the typical situation to have tongue ties etc and spend $2000. If you have stats to back up how common it is I would happy to see them.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 8:58 pm #

            As I said, no, it’s probably not all that common to have that much invested, because most people give up long before going through that much shit.

            The more important question is, how common would it be if everyone were forced to have to rely on breastfeeding? It would be common enough that we would be looking for alternatives for those who are having problems like those.

          • Joy
            May 25, 2014 at 8:33 pm #

            Yeah, if I didn’t have a year off I would have given up the second the Health Visitor said, she’s still losing weight on day 12, just take the weekend and nurse really well and see if she gains weight over the weekend. I called a private LC and she said to put the baby on formula top ups. No way I was waiting a weekend to see if my baby would lose enough weight to be readmitted to hospital.

          • Jessica S.
            May 25, 2014 at 9:50 pm #

            No kidding!! Not worth the stress.

          • Joy
            May 26, 2014 at 7:36 am #

            I remembered why I kept up with both. Until she hit 6 weeks it took over an hour for her to drink 30 mls from a bottle. Now it could be because she was mostly full from bfing, but she still seemed hungry. She was just so slow I was worried she would decide to stop feeding and would need an NG tube or something.

          • Elaine
            May 24, 2014 at 9:02 pm #

            Okay, let me estimate my costs:
            $320 for 3 different breast pumps & their parts. (Electric pump, 2 hand pumps… i admit one of the hand pumps was not strictly necessary. I bought a double electric pump with my daughter, pre-ACA, which was necessary for me to return to work.)
            $400 for clothes (I’m a hard-to-find size)
            $40 for nursing pillow
            $40 for breast pads
            $250 to have my son’s tongue tie clipped (which might not have actually even been necessary, but I digress)
            $20-$40 or so for bags for frozen milk
            $45 for a bag to carry my pump in (this was frivolous too, but it was the purchase that made me feel good about BFing after my return to work)

            So that comes to around $1000. Oof. I’m not counting bottles, since we would have those either way.

            But most of those costs occurred on the front end. I was able to reuse all the stuff from the first baby when I had the second. And they aren’t continuing costs; right now, the cost to continue to breastfeed my son is maybe $10 every couple months for bags. I also used the ACA to get another pump at no additional cost to me, which I tucked in the drawer for when my current one gives up the ghost.

          • Jessica S.
            May 24, 2014 at 7:47 pm #

            It’s certainly not UNcommon. And no woman should ever try past the point of what it’s worth to HER, for HER child. The minute she ticks over to doing it b/c she feels guilty or shamed, all that is for naught.

          • Bombshellrisa
            May 24, 2014 at 7:50 pm #

            I do know Dr Amy endorses breast feeding because she loved it and did that with all four of her kids-but she also doesn’t assume that everyone can or even wants to breast feed.

          • Fertile Myrtle
            May 24, 2014 at 7:56 pm #

            And I would completely agree that not every can breastfeed or should want to. But claiming that there are only “soft” benefits flies in the face of many public health organizations and a huge body of research. It’s Really odd to me that Dr. Amy minimizes breastfeeding despite the research to save hurting feelings (?), but painstakingly uses statistics to jab home birthers. And no, formula isn’t going to hurt a baby, guilt isn’t necessary but that doesn’t mean it can give the benefits that breastfeeding does.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 8:01 pm #

            huge body of research.

            Bring it on.

            Come on, Myrtle, show us those great benefits.

            (HINT: You might want to look up “Pablo’s 1st Law of Internet Discussion” before jumping in, because you are facing it)

          • Fertile Myrtle
            May 24, 2014 at 8:30 pm #

            Would you like an exhaustive list of studies or? Personally, it’s enough that the WHO, AAP, AMA, CDC, ADA, DHHS etc all recommend breastfeeding as the best source of nutrition. What am I missing? Are they making those recommendations based on quackery and not legitimate studies? I’m sure they are using research.

          • Stacy48918
            May 24, 2014 at 8:33 pm #

            Come on – not even one teensy tiny little study?

          • Fertile Myrtle
            May 24, 2014 at 8:37 pm #

            I would start my search here.


            But WHO,CDC, AAP etc all list their study sources so those would be other studies I would cite.

          • Stacy48918
            May 24, 2014 at 8:39 pm #

            Yea…that’s not how you do a literature search.

            Nice third link though:
            “Cognitive and neurodevelopmental benefits of extended formula-feeding in infants.”

            You really don’t have a single specific study you could cite for us – right now – to back up any of your claims.

            I can cite you several home birth risk studies off the top of my head. Why can’t you do the same for a topic you’re passionate about?

          • Fertile Myrtle
            May 24, 2014 at 8:46 pm #

            It’s how you do a literature search on an iPhone. I keep getting badgered about finding studies, but NO ONE is answering my question. Are those organizations all full of it?????? Because I’m going to go ahead and trust the AMA, ADA, ACOG, AAP and all the qualified entities.

          • Who?
            May 24, 2014 at 8:49 pm #

            Great-just don’t make out that there is a moral or ethical element to it. I trust you also vaccinate your children on the advice of the AMA?

          • Fertile Myrtle
            May 24, 2014 at 8:53 pm #

            You bet I vaccinate.

          • S
            May 26, 2014 at 1:17 am #

            From what i can tell, the AMA and AAP pretty clearly recommend breastfeeding, so i don’t see why you’re taking issue with Fertile Myrtle’s statements to that effect, and not with the strong wording in those organizations’ position papers. They’re supposed to be the authorities, so how can we blame mothers for thinking there is one clearly superior choice?

          • S
            May 26, 2014 at 1:22 am #

            I’m not defending her position, by the way, but i’m saying it seems pretty reasonable to look to medical associations for medical recommendations. Or should we all have to do a literature search every time we have questions about something? I for one am not qualified to interpret medical studies on my own. That’s one reason i read this blog.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 9:05 am #

            but i’m saying it seems pretty reasonable to look to medical associations for medical recommendations.

            But whoever says otherwise?

            I don’t understand the point. We all know what the AAP and WHO say.

          • S
            May 26, 2014 at 9:23 am #

            All y’all who are saying “Show me the studies.” My point is the average mom should not have to go looking up studies. How about if these organizations quit misleading moms by overstating the benefits of breastfeeding? (Using phrases like “risks of not breastfeeding” etc. Falling back on WHO recommendations without putting them into context.)

            I see a bit of a double standard here. We excoriate commenters for showing up with their own bibliography salad on an issue like waterbirth or cosleeping while completely ignoring the mainstream medical opinion on those subjects. To me, the fact that Myrtle has offended people here (and that she happens to be wrong on this issue) isn’t a good excuse for being inconsistent.

            (Now, i do have a history of being a bit dense when it comes to calling out “double standard!” so am open to an explanation of why may i be wrong here. Although — and this comment is directed only to Bofa — i’m not interested in arguing for the sake of arguing.)

          • The Bofa, Being of the Sofa
            May 26, 2014 at 9:45 am #

            All y’all who are saying “Show me the studies.” My point is the average mom should not have to go looking up studies.

            The only reason we are saying, “Show me the studies” is because Fertile Myrtle claimed there was a “huge body of research” that showed great benefits.

            SHE was the one who brought it up, not us. However, when challenged on it, that is when she backpeddled to the AAP/WHO positions.

            And no one has ignored the mainstream position. The problem is, as I pointed out elsewhere, is that the AAP’s position is NOT what Myrtle is claiming it to be. “All else equal, breastfeeding is better” is absolutely true, but says nothing about how much better. Moreover, as I have noted many times, all else is never equal.

            Using formula because that is the best for your own situation does not go against any AAP recommendations in the least.

          • S
            May 26, 2014 at 9:56 am #

            I am reading it as, she assumed that if these big organizations are pushing for breastfeeding, then there _must_ be a huge body of research. Which is incorrect. But not an unreasonable assumption. That is my only point. Those position papers are worded as if there is one clear best choice. Maybe that is the nature of a position paper — they are, after all, expressing a position! But it is confusing to women who are trying to choose between two options, but aren’t given any sense of degree or perspective.

            Otherwise we’re pretty much in complete agreement on this topic.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 11:24 am #

            she assumed that if these big organizations are pushing for breastfeeding, then there _must_ be a huge body of research.

            Which is why, in my initial response, I cautioned her to be careful about being in a position where the people she is talking with know a lot more about the topic than she does.

            That didn’t stop her. She doubled down.

            But I have to disagree with your assessment. Taken in isolation, that is a generous interpretation of her position. However, taken in toto, you can see that, no, it’s not nearly that innocent.

            See her comment above. She claims she is different because she views breastfeeding in a positive fashion. How insulting! In fact, my initial response was to tell her to FO. Fortunately, my calmer head prevalied.

            At best, she’s a victim of Pablo’s First Law of Internet Discussion (seriously, does anyone think we aren’t completely aware of what the AAP says? So why presume to “educate” us by spouting AAP recommendations). However, I’m not buying it. Even after having it explained to her, she still, just today, insults everyone by accusing us of not viewing breastfeeding as a positive thing.

            Those position papers are worded as if there is one clear best choice.

            Not really, but that’s neither here nor there. She even admitted that she “understood completely” that it didn’t. So you are giving her the benefit of a doubt that she doesn’t have.

            You know, if she had just assumed that the AAP/WHO recommendations where based on soft information and nothing really substantial, she could have easily said, “Huh. I just assumed that they had really strong benefits they based that on. They seem to imply that, at least.” And you know what? Had she said that, everyone would have agreed with her! But instead she accuses us of being anti-breastfeeding because we don’t join in the chorus of insisting there are people who aren’t breastfeeding that should be, and don’t demonize formula enough.

          • Fertile Myrtle
            May 26, 2014 at 5:46 pm #

            I just found this. I literally did say I’m not expert and rely on the expertise of professionals. Which is mostly what you do when it’s not your job to find lists relevant research. The recommendations from the CDC and other health organizations state the same. You are presuming an awful lot. I was actually explaining my own thoughts, not attempting to educate anyone. And yes, of course I assume that the AMA, AAP etc have strong scientific evidence for their recommendations. I’m not trying to make recommendations, I don’t need to find all the various studies.
            I was not addressing every commenter on here and saying Everyone has a bad attitude regarding breastfeeding.
            And “S” above took the words right off my keyboard. I think it’s incredibly hypocritical that HBers get grilled for not following ACOG recommendations/statements but when it comes to breastfeeding the “grillers” suddenly say F the recommendations.

          • Jessica S.
            May 27, 2014 at 11:09 pm #

            I’m not saying F the recommendations. I’m saying the studies aren’t strong enough to prove causation, something they themselves admit. So S. is right in that the blame should fall on those organizations who over state the evidence leading people to believe that the recommendations are based on strong studies. Or that they apply equally in all countries.

          • Guesteleh
            May 26, 2014 at 1:36 am #

            I read the AAP policy summary page on breastfeeding and it’s quite interesting. Even though they encourage it, they don’t make huge claims for the health benefits. The policy paper itself makes bigger claims, but not the summary. I wonder why?



            For the baby Breastfeeding decreases the possibility that your
            baby will get a variety of infectious diseases, ear infections,
            diarrhea, etc.
            For the mother Breastfeeding mothers return to their pre-pregnancy
            weight faster and have a reduced risk of breast and ovarian cancer. They
            also experience less postpartum bleeding, as the hormones that help
            with breastfeeding also make the uterus contract.

          • Who?
            May 26, 2014 at 1:55 am #

            Don’t think I did. Not sure that the benefits in the first world are either ‘pretty clear’ or ‘strong’, for mum or baby.

            I do take issue with the concept that the choice is to trust AMA etc or to go wildly out on a limb and freestyle it with the formula. This is where the moral and ethical element comes in, which is unhelpful.

            Everything feels critically important when there is a new baby in the picture-well fed, warm and loved will do the trick most of the time, regardless of the fine detail of where those things come from.

          • Stacy48918
            May 24, 2014 at 9:02 pm #

            Well ACOG has a statement on home birth and, again, I am relatively well versed in the actual scientific literature behind it.

            I’m not saying they’re “full of it”. I’m saying, you showed up saying breastfeeding is awesome and that those of us that formula feed are risking our children’s health and yet you haven’t provided a single solitary example of either of those things.

          • Fertile Myrtle
            May 24, 2014 at 9:09 pm #

            Um, what? You go ahead and find the quote where I said formula is risking your child’s health. I did not say that. Breastfeeding is Associated with decreased risks of Diabetes, Obesity etc etc etc but that’s in NO way equivalent to formula feeding risking your child’s health.

          • Stacy48918
            May 24, 2014 at 9:17 pm #

            You said:
            “Breastfeeding isn’t a cause & effect type of thing my dear. People who exercise still drop dead of heart attacks sometimes. Does that mean we should forget about exercise? Doesn’t make a difference? No benefits? We are talking about “risks”. Personally, IF I can, I choose to reduce as many risks to my child’s health as possible.”

            What are those risks? My daughter is FF since she was 4 months old. In what ways did I risk her health by not continuing to breastfeed? You are clearly implying that while there may not be an A + B = C relationship between formula and disease that A still influences B significantly, often enough that formula feeding increases the risk of C. What is C?

          • Stacy48918
            May 24, 2014 at 9:24 pm #

            I have to go see a patient. Just fill in the blank.

            By switching to exclusive formula feeding, I increased my daughter’s risk of __________.

          • Bombshellrisa
            May 24, 2014 at 10:43 pm #

            Being fed a bottle by someone other then you
            Getting sufficient Vitamin D
            Being scowled at in public by Boob Nazis
            (Yeah, these risks look like ones you can live with)

          • Fertile Myrtle
            May 24, 2014 at 9:24 pm #

            To my knowledge, formula feeding doesn’t increase the risk of any particular disease. That’s not what I’m saying at all.

          • Fertile Myrtle
            May 24, 2014 at 9:25 pm #

            But that doesn’t equate to breastfeeding being without benefit.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 9:38 pm #

            But that doesn’t equate to breastfeeding being without benefit.

            But whoever claimed that?

            Remember, your criticism is that Dr Amy only addressed the “soft” benefits, and didn’t acknowledge the huge body of research on the (supposed) great benefits. Claiming that there are soft benefits, by definition, does not mean without benefit.

          • Young CC Prof
            May 24, 2014 at 10:20 pm #

            The long term benefits, well, they look exciting, but if you properly control for confounding variables like socioeconomic status, they tend to melt away.

            The one that doesn’t melt away is that during the first year and especially during the first 6 months, breastfed babies are slightly less likely to get GI and respiratory infections. After that, the benefit disappears even if breastfeeding continues, because they digest the antibodies instead of absorbing them.

            You know what the best benefit of breastfeeding is? When it works, it’s a special experience mother and child can share.

          • Jessica S.
            May 24, 2014 at 10:36 pm #

            My sister says that about her youngest. I think she BF all three, but she said she enjoyed it most with the last one b/c it was about the only alone time she had with her!!

            Re: the benefits for the first six months, I don’t even remember my son getting sick until he was older than six months. (He was exclusively FF.) Of course, in all fairness, he wasn’t around a lot of kids either, that would be prone to bring home everything under the sun from daycare and what not. And clearly my ONE story does not prove anything. 🙂

          • Bombshellrisa
            May 24, 2014 at 10:39 pm #

            Agreed-I only comfort nurse my little guy but I truly love that time with him. He can look up at me now and interact and it’s so CUTE

          • Jessica S.
            May 24, 2014 at 11:53 pm #

            That’s seriously the best moment – when you realize “hey! They notice me!” 🙂

          • Joy
            May 25, 2014 at 8:29 pm #

            My baby interacts by reaching up and sticking her fingers into my mouth or up my nose. Both are pretty painful, but it does make her laugh.

          • Fertile Myrtle
            May 24, 2014 at 10:43 pm #

            I didn’t realize when I chose to breastfeed that the bonding and special time with baby would be the best benefit, I came to the very same conclusion as you.

          • OBPI Mama
            May 26, 2014 at 7:07 am #

            I was particular about me being the one to mostly feed my babies, even though they were bottlefed. I liked that time… especially with the 3rd and 4th babies and it was like “our” time throughout the day together. Now, I DID encourage my husband to help out during the 8pm-midnight shift (after that I was game again… love and MISS those early morning feedings!). haha

          • Renee
            May 26, 2014 at 2:14 pm #

            That is the best benefit to me. We both enjoy it so much.

          • The Bofa, Being of the Sofa
            May 25, 2014 at 10:27 am #

            Meanwhile, bottle feeding allows others, such as Dad, to feed the baby, too, which can be special for him. So that’s even a tradeoff.

          • Jessica S.
            May 25, 2014 at 8:43 pm #

            I remember harping on my poor husband for propping up our son on a pillow and balancing the bottle against himself so he could play Minecraft. I’d lament “you’re supposed to be bonding! And staring into his eyes!” (Said the women who had her iPhone glued to her hand with every feeding. Ha! And in his defense, he didn’t do every single time.) Now, one of the boy’s favorite things to do is sit on daddy’s lap and play Minecraft. 🙂 And then he runs around the house pretending to be doing Minecraft things, very inventive like. I have no clue what he’s doing as I don’t play it. But anyhow, it’s just funny the things I thought we should be doing a certain way; now I’m like, as long as his life isn’t in imminent danger – or others around him – whatever! 🙂

          • The Bofa, Being of the Sofa
            May 26, 2014 at 9:03 am #

            I have talked in the past about how I don’t like the advice “trust your instincts, they are usually right.” Not that I think it is incorrect, but that it gets misinterpreted as “….and everyone else is wrong.” The basis for it is that there are lots and lots and lots of “correct” ways to do things, and since most people won’t be doing things that are obviously dangerous, then it’s all good.

          • Trixie
            May 26, 2014 at 6:56 am #

            I’m not sure that’s completely correct about antibodies being of no use after a year. One of the reasons WHO recommends BF til 2 is because of illness prevention.
            Anecdotally, each of my nursing toddlers has been unaffected by stomach viruses and other various illnesses that affected the rest of the household.

          • OBPI Mama
            May 26, 2014 at 7:05 am #

            Love that! Having multiple children sick at the same time is the pits (esp. if you are feeling it too). This is when I get envious I couldn’t breastfeed! haha.

          • Renee
            May 26, 2014 at 2:12 pm #

            I WISH that was try for everyone. My nursing toddler gets every single thing her brother (a year older) gets. Stomach bugs and all, even though they are few and far between (and I NEVER catch them, which is odd).

            The whole family got pneumonia this year (not me, I was vaxxed). BF 2 yr old was hospitalized, other kid and husband were not. I was very happy she was still BF though, because it was the only fluid she would take in, and allowed her to go home sooner.

            BF didn’t make her more able to fight a virus, but it did help fluid intake, and comfort. Worth it for US.

          • Young CC Prof
            May 26, 2014 at 2:17 pm #

            As I understand it, the main way nursing protects toddlers from illness is because they aren’t drinking impure water or unpasteurized animal milk. Again, a global concern, not a local concern for most of us.

          • Trixie
            May 26, 2014 at 2:30 pm #

            No, it’s protective against diarrheal illness because of the antibodies it contains, not just because it isn’t contaminated. No 1 or 2 year old’s only source of liquid is going to be breastmilk, but we know breastfeeding is still somewhat protective despite that. Obviously not a substitute for vaccination and public health measures and hospitals, but it still offers some benefit.

          • OBPI Mama
            May 26, 2014 at 7:03 am #

            The benefit of less GI and respiratory infections sounds pretty good when you have multiple children and one gets sick! My sister-in-love has a couple kids who always were sick their first 2 years. Her and her husband had to miss a lot of work and it was hard on them! Breastfeeding was not for her though and I had to respect that she knew it before she even had her girls! Loved her confidence and assurance she was doing what worked for her and wasn’t so emotional about it like I was. I was fortunate to only have 1 out of 4 formula fed babies that seemed to get sick a lot more (born right at the beginning of cold and flu season). It was rough on the family.
            To me, that benefit of breastfeeding is a pretty good one. I have to accept that maybe my baby would have got sick less had she been breastfeeding. Just how it is. There are always going to be pros and cons to our decisions and I’m learning it’s okay to understand the cons, accept them, and work at trying to lessen them. I did try probiotics in her formula

          • Jessica S.
            May 27, 2014 at 10:59 pm #

            Anecdote here: My SILs kids are frequently sick, and they were all EBF for at least 6 months. It seemed like it was more frequent once her oldest started preschool, which would make sense. My son, EFF, has not been sick quite as often, I don’t think, but I think that has more to do with him not having siblings (yet, at least not outside the womb*) and not being in preschool or daycare or what have you. But again, that’s just my story! 🙂

            *This reminds me of a funny story from this past March. The non-funny part is that he got a stomach bug and threw up a couple times, and then a week later I came down with the same thing. I think I was 20 wks along and it was miserable to say the least. The FUNNY part was when my son asked if Baby Sister “gags” in my tummy. (That’s his word for throwing up.) I laughed so hard and told him I sure hope not!!

          • Busbus
            May 28, 2014 at 12:34 am #

            As far as I understand it, even in those areas where benefits of breastfeeding show up consistently throughout studies – basically, GI and ear infections – the benefits are still very small. I seem to remember having read that you need 20 additional breastfed babies to avoid one ear infection. Chances are, you wouldn’t have noticed a difference at all, even if you had been breastfeeding. Other factors, such as exposure to siblings or daycare and personal constitution, simply have so much more effect.

          • pj
            May 24, 2014 at 9:41 pm #

            I’m pretty sure WHO recently released a document stating that there are basically no long-term (beyond 6 months) health benefits to breastfeeding.

          • Siri
            May 26, 2014 at 6:00 am #

            This is cringe-making, Myrtle. My toes are curling on your behalf.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 8:55 pm #

            YOU claimed there is a “huge body of research” that shows that the benefits of breastfeeding are not “soft.”

            I only figure that, since YOU claimed it, then you must know all about it.

            But now you admit that, you don’t actually know the research that you referred to, you are just trusting the recommendation of the WHO, AAP, etc?

            Come on, Myrtle. Show us a good study (not one suffering from massive confounders) that show “hard” benefits.

            For example, you might want to start with the PROBIT study in Belerus, which is very likely the best study of the effects of breastfeeding that has ever been done. Or the recent concordant sibling study that examined the question. What were those conclusions?

            I trust you are familiar with them, since you are so aware of the “huge body of research” that has been done, right?

          • Fertile Myrtle
            May 24, 2014 at 9:12 pm #

            I’m not a researcher, I’m not an expert on breastfeeding. I “foolishly” rely on the expertise and recommendations of the professionals whose job it is to know.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 9:28 pm #

            No, you went further than that. I rely on the expertise of professionals.

            But why do you think that their recommendations are not based on soft benefits?

            We all know what the professional organizations recommend. The question is a) why do they recommend that? and b) how significant is it if you don’t follow?

            For example, despite the AAP recommendations, ask your pediatrician about using formula. Will he or she run away screaming? Or will they say ok?

            I’ve done the experiment. Got no static from the doctor. None in the least.

            Here’s the thing that the doctors of the AAP understand and apparently you don’t: the guidelines are for “all else being equal.” As in, “all else equal, breastfeeding is better than formula.” And that is probably on the whole true. But what others also recognize is that all else is never equal, and therefore you have to take individual circumstances into account. In that case, the question is, is the difference large enough to make large sacrifices imperative? And the answer is, not in the least.

            So I have no problem relying on the expertise of the AAP. I really trust them. However, I also understand what the guidelines mean. The statement that “breast is best” does not mean that everyone has to breastfeed.

          • Fertile Myrtle
            May 24, 2014 at 9:29 pm #

            I understand what you are saying and completely agree.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 9:36 pm #

            So why are you complaining about Dr Amy only talking about the “soft” benefits?

            If you understand what I am saying, then you understand that there is nothing in the AAP’s recommendations that implies that there are big benefits to breastfeeding.

            Now, the WHO talks about the global situation, and, in that case, there are issues that apply to other countries that do not apply in the US, so we can’t rely on them to tell us about our situation.

          • Fertile Myrtle
            May 24, 2014 at 9:42 pm #

            She not talking about “soft” benefits! That’s why I’m complaining!!! In the above article she makes it sound like the “soft” benefits are trivial like preventing the cold and mostly unproven.

          • Bombshellrisa
            May 24, 2014 at 9:47 pm #

            But you do understand the majority of lactivists in this country are middle and upper middle class women. So the benefits may be only be soft for the babies born to them, yet they are ones who vilify formula and insist the benefits are these huge things when really they are only negligible

          • The Bofa, Being of the Sofa
            May 25, 2014 at 10:25 am #

            But it’s because the benefits are so soft that they are overwhelmed by other factors in pretty much all situations (in either direction).

            Yes, breastfeeding can be cheaper. Or it may not be. Depending on the circumstances. Sure, it is likely true that more often than not breastfeeding is cheaper, but since it is so dependent on individual circumstances, it doesn’t make sense to generalize it.

          • Stacy48918
            May 24, 2014 at 8:23 pm #

            Who cares if it’s “typical”? Do you support her in her individual situation? That’s what lactivists cannot do. They make broad generalizations like “breastfeeding is so much easier and cheaper” and cannot make allowances for women that struggle.

          • Fertile Myrtle
            May 24, 2014 at 8:33 pm #

            I respect and support a woman’s experience, of course. I’m not part of the tribe that’s pushing breastfeeding NO MATTER WHAT. If I were the woman above I probably would have formula fed, pronto. BUT it’s nonsensical to me to deny the benefits of breastfeeding. I DON’T think it has a bearing on the worth of a woman or what type of mother she is.

          • Stacy48918
            May 24, 2014 at 8:36 pm #

            Have you actually even listed any of these so called “benefits” for discussion, other than cost?

            My son was breastfed for a 1 year. My daughter is FF from 4 months. I’m sure she’ll be fat, have rampant allergies, be unintelligent and sick twice a month.

            What are the marvelous benefits that my daughter is missing?

          • Fertile Myrtle
            May 24, 2014 at 8:40 pm #

            Breastfeeding isn’t a cause & effect type of thing my dear. People who exercise still drop dead of heart attacks sometimes. Does that mean we should forget about exercise? Doesn’t make a difference? No benefits?
            We are talking about “risks”. Personally, IF I can, I choose to reduce as many risks to my child’s health as possible.

          • Stacy48918
            May 24, 2014 at 8:41 pm #

            So in what specific ways am I risking my daughter’s health?

          • Bombshellrisa
            May 24, 2014 at 10:05 pm #

            Breast milk infuses your child with morals and principals! The milk makes your child empathetic and compassionate and instills in them a sense of duty! Oh wait, that is actual parenting…..
            My son just had his four month appointment with his pediatrician and she could care less if it’s breast milk or formula that is making him grow. I did get the admonition early on that I was going to have to give him vitamin D supplementation if and when I was feeding him mostly breast milk, but now that he is mostly formula fed with a little breast milk mixed in she has said it’s suggested but not required. She didn’t tell me he is going to have allergies and more ear infections.

          • Jessica S.
            May 24, 2014 at 10:09 pm #

            What?? You’re telling me that breast milk doesn’t magically add Vit D out of the clear blue? That breast milk lacks something? Impossible! That would make it formula-like!

          • Rebecca
            May 25, 2014 at 10:54 am #

            Well, and here we come back around to the point of Dr. Amy’s post. The women who promote homebirth are overwhelmingly also lactivists who, like you, say they want to “reduce as many risks to [the] child’s heath as possible.” And yet they embrace homebirth.

          • Fertile Myrtle
            May 25, 2014 at 11:08 am #

            Sounds like stereotyping, and that’s something I prefer to steer clear of. I don’t know anyone who breastfeeds that has had a home birth or is remotely interested, and I know a lot of moms who breastfeed. I see the point she is trying to make but I think it’s super irreverent to start tying all breastfeeding to home birth.
            Some gentleman below even tried to “catch” me not vaccinating JUST because I breastfeed which is stereotyping. It’s close minded. It’s intolerant.

          • Young CC Prof
            May 25, 2014 at 11:31 am #

            Most home-birth mothers are very into breastfeeding, however, the vast majority of breastfeeding mothers give birth in the hospital. Whoever said otherwise is making a logical fallacy.

          • Siri
            May 26, 2014 at 6:08 am #

            You use a lot of words that apply equally to yourself. The poster wasn’t trying to ‘catch’ you; he/she simply asked, ‘I trust you vaccinate..?’.

          • Who?
            May 26, 2014 at 6:25 am #

            Just trying to understand where you’re coming from is all. Interesting you stereotype me as male…not that I’m offended-they do rule the world, after all-just wondering what the cues were.

          • Renee
            May 26, 2014 at 2:04 pm #

            It is not intolerant. Intolerant is deleting your comments, or banning you.

            You are right that it is stereotyping, which is a common thing, everyone does it. You always see x and Y together, so you assume Z. It becomes a big problem when you cannot, will not, look at people as individuals.

            Often the people that come in here to say Breast is best! aren’t the ones that are like “breast is best, but formula is fine too, it depends on your family”. They are *stereotypical* lacto-fascists, who think formula is poison, moms that don’t bf are lazy, and anyone that says otherwise is ignorant. These types, more *often* than not, also HB, are into NCB and alt med, and are anti vaxx.
            Of course they all aren’t like this, but when you see this 150x, you will assume this is so on the 151 time, until you see otherwise.

            (not an excuse, just an explanation)

          • Certified Hamster Midwife
            May 24, 2014 at 9:36 pm #

            I was EBF to 12 months and I’m fat, stupid, have terrible allergies, and am constantly ill. I guess if I had been formula fed from the beginning, I’d be dead by now.

          • Stacy48918
            May 24, 2014 at 11:28 pm #


          • NoLongerCrunching
            May 25, 2014 at 2:15 pm #

            My sister and I were breastfed for 2 years, exclusive for 6 months. I’m pretty healthy, but she was (pre-gastric bypass) morbidly obese, had Type 1 diabetes, and constantly gets sick. Her son, thank god, is healthy as a horse despite being 100% formula fed.

          • Siri
            May 26, 2014 at 5:51 am #

            But you’re lovely, with a great sense of humour, and I’m sure you’re very pretty too 🙂

          • KarenJJ
            May 25, 2014 at 2:43 am #

            Well that’s great that you are not a part of the “breastfeed no matter what”, because some of us have encountered that and have found it counter-productive and harmful for both babies and mother’s mental health. I too tried very hard and spent hundreds of dollars trying to breastfeed my first (breastpumps, private lactation consultant mostly) and it wasn’t working.

            So sure, don’t deny there are benefits but also don’t over-sell something. Women can make a decision based on honest information and work out what is best for them and their families. Half the benefits I believed about breastfeeding were wayyyy oversold (IQ – nope, infections – in our case – nope, growth – nope, bonding – nope, mother’s mental health – nope). My second wasn’t breastfed and it really has made no difference.

          • Siri
            May 26, 2014 at 5:48 am #

            I really don’t think that’s a matter of course given your rude and dismissive response to Bombshellrisa above.

          • Joy
            May 25, 2014 at 8:25 pm #

            I don’t know if it was worth it. My baby is the slowest eater and it drives me nuts. On the other hand, I get a year’s leave in the UK and I like watching boxsets and sitting on my couch. If I were in the US and had less or no leave, I would have gone straight to formula, no regrets. The combo feeding has been really stressful, sometimes I am ok with it, others not. It probably would have been better for my mental state to not do it. I barely left the house in the first three months worried that we would miss a feed and she would spiral downwards. But if the (hypothetical) next kid has these problems…No way would I have the time to sit around as much. Do I think it was typical? Well, women don’t quit because it all works perfectly. So my problems might not be typical, but I think problems that aren’t compatible with people’s lives are.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 7:38 pm #

            My younger son wouldn’t touch breastmilk from a bottle. He would only take formula, and not even a drop of breastmilk in it.

            Free pumps aren’t worth anything in that situation. It was either my wife give up her job, or formula.

            Formula was a hell of a lot cheaper.

          • Fertile Myrtle
            May 24, 2014 at 7:46 pm #

            Okay, okay. You got me, it’s not cheaper in EVERY situation. But nonetheless in most it is.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 7:52 pm #

            And a large number of people breastfeed.

            However, there are a lot of people for whom breastfeeding is impractical for a variety of reasons, including the fact that it would absolutely be costly. And in those cases, the parents take that into account in deciding in whether to do it or not.

            So, after all your pontificating, all we are left with is, no, breastfeeding isn’t necessarily free (which was your original assertion), and it might not even be more cost effective.

          • Bombshellrisa
            May 24, 2014 at 7:57 pm #

            I just wanted to say Bofa it is awesome that you were able to help feed your baby. With my dd, I was breast feeding and very territorial of my baby and my husband wasn’t able to help me out as much as he has been able to with my son. Seeing my husband talk with baby and interact with him while he feeds the baby is heartwarming.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 8:04 pm #

            I was not able to feed my younger guy to much extent, because I wasn’t home much when my wife wasn’t, and because he wouldn’t touch a bottle that had any breastmilk in.

            Our younger guy, however, did blended mixes all the time, and I was home with him alone a couple days a week for months. It was great.

          • Trixie
            May 24, 2014 at 9:23 pm #

            Sounds like a lipase issue.

          • The Bofa, Being of the Sofa
            May 24, 2014 at 9:31 pm #

            Who cares? It’s not like we could change it.

          • Trixie
            May 24, 2014 at 9:43 pm #

            You can — not saying you should or shouldn’t have — scald the milk so that it doesn’t get the weird soapy taste from the lipase. Some babies mind it, and others don’t.

          • The Bofa, Being of the Sofa
            May 25, 2014 at 7:50 pm #

            Assuming that was even the problem…

            He quit nursing completely when my wife’s milk turned shamrock green (seriously).

          • Siri
            May 26, 2014 at 5:44 am #

            You’d obviously brominated it without meaning to.

          • S
            May 26, 2014 at 12:17 am #

            I am glad you are mentioning this for the lurkers, because i had never heard of this issue until i saw it mentioned on this site! By that time, i had already built up a nice frozen stash of stinky, useless milk — all down the drain.

            Oddly, i mentioned this to a lactation consultant the other day, and she seemed unaware of the issue. She had called me, unsolicited, to tell me that insurance would cover a breast pump, so since i had her on the phone, i asked if she could explain the heating process to me. She asked if i was leaving the milk out before storing it, and what was i storing it in? (I was putting it into the fridge to cool it down, then transferring to the freezer. Combination of “quilted” glass jars, plastic jars, and bags. All stinky.) Then she cautioned me against heating the milk, saying it would destroy the beneficial properties of the breast milk. (I said it has no beneficial properties if my kid won’t drink it. Because i have no tact.)

          • Lion
            May 25, 2014 at 12:24 pm #

            Actually flash heating deactivates the lipase and that usually solves the problem. The time it takes to do this is probably similar to kettle boiling time for making a bottle of formula.

          • fiftyfifty1
            May 25, 2014 at 5:43 pm #

            “kettle boiling time for making a bottle of formula.”


          • Jessica S.
            May 25, 2014 at 5:50 pm #

            I think we nuked our bottles for a handful of seconds, I can’t recall – why didn’t I write this stuff down – just to bring it to a room-ish temp. We pre-mixed out formula each day in a pitcher and kept that in the fridge. I might just make each bottle individually this time. Microwaving a bottle might be appalling to some people, but I can’t please everyone.

          • Bombshellrisa
            May 26, 2014 at 12:10 pm #

            Don’t make each bottle individually for the first few weeks-I still remember it was such a pain because you do it so often.
            Also, Similac has awesome ready to feed formula in 2 ounce and 8 ounce bottles, just attach a nipple and you are good to go. Sanity saving for when you are out and about or for when you leave baby with someone

          • Young CC Prof
            May 26, 2014 at 12:32 pm #

            We pre-measure our powder into little containers (it’s a pain, yes, but it’s half an hour once a week) then fill baby bottles with water to the correct line. When feeding time arrives, pour in powder, shake and serve. We’ve trained him to accept it room-temperature. Best of all, you can take the separate water and powder with you and don’t need to keep it chilled.

            The first few weeks we were doing either liquid formula, expressed breast milk, or a mix of the two and that was a much bigger nuisance, though prefilling the bottles in the evening helped get us through the night. And of course we weren’t going out very often.

          • Jessica S.
            May 27, 2014 at 10:46 pm #

            I used Dr. Browns bottles with my son, particularly the 4 oz for the first several weeks. As he got older, we just put all the little parts along with the bottles in the DW at night, but for the first few weeks, I washed all 8 of the little bottles by hand. Now, it’s important to note that I hate housework and housekeeping and all that comes with it. But there was something about washing those bottles, soaking and rinsing and setting them to dry, night after night, the same exact way, that was almost like meditation. Or maybe it’s that it was easy and reliable and didn’t scream and squawk and pee on me and thoroughly confound me in every way. It was literally the only little task and spot that had order and made sense. Once I got used to him and things got easier, the hand washing was a pain. 🙂 So it had it’s purpose for that period of time.

            There was something in your story about the pre-measuring that reminded me of that time period. Life goes by so quickly!

          • Jessica S.
            May 26, 2014 at 8:15 pm #

            Agree 100%! Once our first had established a routine, we used the Dr. Brown’s formula pitcher. I can’t recall, but I imagine that at some point down the line, I stopped warning his bottles and just gave them to him cold, like closer to his first birthday. But maybe not? I probably made note in the baby connect app I use. I’m definitely going to get some of those ready to use bottles!

          • Trixie
            May 26, 2014 at 6:49 am #

            She lives in South Africa and probably has to boil her water before mixing formula.

          • Renee
            May 26, 2014 at 1:53 pm #

            All DS bottles were either cold, straight outta the fridge, or room temp, straight off the nightstand
            (I would keep bottles with the right amount of water in them, and another little cup with remeasured formula. Add, shake, feed, no getting out of bed)

          • Jessica S.
            May 27, 2014 at 10:36 pm #

            Brilliant! I wasn’t about to get my son used to actual “warm” formula, b/c I wasn’t going to go to the hassle of continuing that for 12 more months. 🙂 I know, it’s so loving and caring of me. 😉

          • The Bofa, Being of the Sofa
            May 26, 2014 at 9:35 am #

            All our bottles were heated. It didn’t matter.

          • Bombshellrisa
            May 24, 2014 at 7:40 pm #

            Not all insurance covers pumps. I did bf my dd and I have had to give up the idea my son will be exclusively breast, he was late preterm and couldn’t latch until he was two months old and meanwhile I was paying $100 a month for the breast pump plus working with a lactation nurse (who absolutely was the most amazing lactation nurse ever)

          • Trixie
            May 24, 2014 at 9:22 pm #

            Under ACA, all insurance covers pumps.

          • Bombshellrisa
            May 24, 2014 at 9:37 pm #

            I wish I would have known that-they wouldn’t pay for the pump that was available at the store at my hospital (where I went for my lactation appointment). I was severely engorged and needed something right then so just put it on the credit card. Insurance insisted they wouldn’t pay for the hospital grade pump.

          • Trixie
            May 24, 2014 at 9:47 pm #

            There’s definitely been a lot of runaround from various insurance companies about what they say they’ll cover vs what the law requires. They’re hoping you’ll give up and do what you did — buy it yourself. You might want to look into whether you can report them for not covering a double electric pump for you. I think I read that you can, although I can’t remember where, now.

          • Jenny_from_da_Bloc
            May 25, 2014 at 5:38 pm #

            WIth my insurance I have to get a prescription for a double electric medela breast pump from my OB 45 days before my due date and order it from an in-network medical supply company. Definitely a pain in the butt and it took me about a month to figure this out because my insurance company didn’t have info online and the rep was didn’t know either. The HR lady at my husband’s company had to figure it out for us.

          • Bombshellrisa
            May 25, 2014 at 7:36 pm #

            That is the problem, the store at the hospital is not considered in network and it had to be approved beforehand (I read through the book this morning because I got curious).

          • Stacy48918
            May 24, 2014 at 8:21 pm #

            And those of us WITHOUT insurance???

            I paid for my pump – hundreds of dollars so I had a high quality double electric while I was at work so I could maintain my supply – out of pocket.

            I only got about 2 months use out of the thing before I dried up.

            I buy organic formula and my daughter drinks 32 ounces a day. At most I’m spending $200 a month. I guess that’s “hundreds” plural technically but not as much as you’re trying to make it out to be.

          • fiftyfifty1
            May 25, 2014 at 5:39 pm #

            “You can be as “fancy” or “simple” about breastfeeding as you would like.”

            You have the choice to be “fancy” or “simple” about breastfeeding only if things are going well for you and there are no complications.

            My second was an easy feeder–good latch from day 1. I had four (4!) months of paid (paid!) maternity leave with her. I had no mastitis, no cracked nipples, no engorgement, no problems. Why would I need a lactation consultant or a breastpump? Once I finally went back to work, I used the breastpump I already had. I “chose” to do it “simple” because I could.

            The story was very different with my first. Abnormal latch, suck and swallow led to a plethora of problems. I saw 3 different lactation consultants before I finally got the correct diagnosis (crush-injury induced raynauds). The last was out of network so didn’t come cheap, the first 2 were just normal $20 copays each. I had to rent a hospital grade pump for 3 months ($180 total) because my nipples could not tolerate the 2 other pumps I had bought for a total of over $300. Specially compounded APNO came in at $90. I also had to buy breast shields to protect my thrashed nipples and regular bras didn’t work. Due to the damage there needed to be a flap so that was $60 total. Then the prescription for the calcium channel blocker to try to fix the reynaud’s (it didn’t). Between all these, and then lost income at work (no paid maternity leave with my first) I spent many thousands of dollars. Trust me, I didn’t spend that money out of a desire to be “fancy”.

          • S
            May 25, 2014 at 5:50 pm #

            I cannot ever “like” this. Ouch.

          • Fertile Myrtle
            May 25, 2014 at 6:34 pm #

            Since you are replying to me I guess, I’m not talking about various medical abnormalities that impede breastfeeding. Those can obviously very consuming of time/energy/money etc.
            Recent changes in the law REQUIRE all insurance plans (except grandfathered plans) to 100% cover breast pumps, in a lot of cases, very quality pumps. I was provided a Medela PIS that had been awesome with FT use for the last 9 months. Employers (except tiny companies) are REQUIRED to provide time and place for women to pump. Lactation consultants run around birthing centers and are also required to be covered by insurance. I’ve never bought a nursing pads. 1 tube of lanolin lasts a year. You don’t need 18 nursing bras, a buy a few new bras every year anyways. You don’t need a whole new nursing wardrobe, or fancy pillows or etc etc etc. If I read down this thread and hadn’t ever breastfed I would think that it’s very complicated in deed. But it turns out that breastfeeding isn’t a new invention, it’s the basics. Of the 12 plus friends/family I know that are currently breastfeeding, none have had extensive problems. Mastitis is the only problem I heard mentioned.

          • Bombshellrisa
            May 25, 2014 at 7:33 pm #

            Employers may be required to provide time and space to pump, but for many, it’s a question of being able to take that time. Seriously, we are supposed to get two fifteen minute breaks and a 30 minute for a meal. But I have a job where those breaks are taken as I can get them. It’s the nature of what I do and that may mean some nights are so busy I don’t get a bathroom break. If things are quiet, taking a break would be ok but if it’s not quiet I can’t just go because I need to pump, it could mean endangering my patients.
            I think everyone here knows that breast feeding is not new and that if you can get by without needing anything to make it work, it can be enjoyable and work for you. But again, when you answer it’s all about you and what you didn’t need to buy, what you have observed in your friends. I never bought anything with my first child and made do because I had to and it was awful. I spent a lot of time nursing in public trying to make my one nursing bra and top work and trying to use a blanket as a cover (most of my first few weeks with my daughter were spent in the hospital with my mother and then after taking her to multiple doctors appointments every week. She had a stroke). No I didn’t NEED the fancy nursing bra or tops or a cover but I would have been so much happier if I had them. I didn’t have a nursing pillow or lanolin cream. I had nothing. Ultimately it worked because I was able to produce a good enough supply, the kid had a good latch and she did ok with just breast milk. But that is not the case with this baby and having a nice nursing bra and lanolin cream and a pillow really helped.

          • Fertile Myrtle
            May 25, 2014 at 11:47 pm #

            Yes, my perspective is shaped by my personal experience. But I’ve also repeatedly mentioned laws that affect the majority of us. It’s quite clear that your perspective that breastfeeding isn’t worth the benefits/ is expensive/ time consuming etc is shaped by your own personal experience. That you just went into great depth about. I don’t think my own family knows as much about my nursing experience as I now know about yours. So, thanks for your educational and well thought out contributions, but this is all anecdotal in my mind.

          • MLE
            May 26, 2014 at 12:18 am #

            That’s an extremely rude response. You want to talk about all these glorious laws yet you ignore what actual women are telling you about their actual lives and experiences. The law has absolutely nothing to do with the true cost of breast feeding on a woman’s career and the cost of the process itself.

          • Bombshellrisa
            May 26, 2014 at 1:45 am #

            Of course, i went into great detail, but I don’t imagine I am the only person who has a job where taking a break is dependent on workload. I never said that it’s not worth the effort or expense or the imagined benefits but nobody should be sacrificing unnecessarily if formula will fulfill the nutritional needs of the baby. If you can breast feed,awesome. If your friends also breast feed, awesome. Just stop making dense blanket statements that make the assumption that a couple laws and insurance plans are what makes breast feeding possible, or that nobody ever needs anything but nipples to breast feed.

          • Siri
            May 26, 2014 at 5:38 am #

            You are being very rude, especially in light of your little tantrum higher up the thread. I really think you need to take stock and examine your attitude before commenting further.

          • Fertile Myrtle
            May 26, 2014 at 8:42 am #

            The only “attitude” that I have that is different is that I view breastfeeding positively. There is a lot of snark and negative, bitter feelings about breastfeeding on this thread. I’m more than willing to listen to others experiences but I don’t see why my experience gets to be discounted, I’m assuming it’s because it’s positive. I’m done with this “conversation”. If I should happen in the future to use formula to feed my child I will not run around telling breastfeeding mothers a bunch of negative things about breastfeeding, I would be confident in my decision to formula feed and leave it at that. That’s the take away.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 8:54 am #

            The only “attitude” that I have that is different is that I view breastfeeding positively.

            Perhaps this your problem? You are arguing against a complete strawman.

            Actually, I think you owe everyone an apology for this insult.

          • Siri
            May 26, 2014 at 9:18 am #

            You utter, utter plonker. Fyi, I breastfed all my five children for varying lengths of time (four of them also had formula), and am a dedicated advocate of breastfeeding AND formula feeding in my professional life. The ‘negative and bitter feelings’ are all in your head, not on this page; the majority of commenters have breastfed, are breastfeeding or are planning to breastfeed. But I was expecting an insult and a big flounce, and you have made me look able to foretell the future.

          • Fertile Myrtle
            May 26, 2014 at 2:25 pm #

            You don’t have to look far to find the negative comments about breastfeeding. I have not made a single negative comment about formula, not one.

          • Amy Tuteur, MD
            May 26, 2014 at 2:48 pm #

            Pointing out that the benefits of breastfeeding are quite small is not a negative comment. It’s the truth.

          • Fertile Myrtle
            May 26, 2014 at 3:06 pm #

            Nonetheless they do exist, and it is recommended. Apparently, those suggestions are enough to create quite an upset.

          • Irène Delse
            May 26, 2014 at 3:57 pm #

            You seem to not grasp the fact that being realistic about the benefits of breastfeeding is NOT the same as saying they don’t exist. And what do you think is achieved by insisting on official recommendations? Did you assume that nobody here knew anything about that? No wonder you got reactions of annoyance.

          • Amy Tuteur, MD
            May 26, 2014 at 4:04 pm #

            The benefits are trivial and the “risks” are virtually non-existent. That’s why women who choose homebirth are hypocrites when they chastise other women for not breastfeeding. And that’s why breastfeeding does not entitle you to feel superior to women who bottlefeed.

          • Siri
            May 26, 2014 at 2:55 pm #

            Sorry, Myrtle, you can’t flounce and then resume the discussion! Have you no shame?

          • The Bofa, Being of the Sofa
            May 26, 2014 at 7:54 pm #

            What negative comments are you referring to?

            As Dr Amy says, saying that the benefits are small is NOT a negative comment.

          • Bombshellrisa
            May 26, 2014 at 12:07 pm #

            The reason you see breast feeding as positive is because it worked well for you. Anyone who has experienced otherwise had been discounted by you. You just refuse to admit that anyone might not be able to or want to breast feed because YOU had such a good experience.

          • Fertile Myrtle
            May 26, 2014 at 12:35 pm #

            That’s not true at all. I haven’t even mentioned what my actual breastfeeding relationship has been like at all. For all you know I could have had a baby with a tongue tie or poor supply. I haven’t mentioned it because I don’t think that my personal experience is actually average or super common at all. Even if I have an oversupply and a chubby baby, I still know that’s not common. Everyone has simply assumed.

          • S
            May 26, 2014 at 12:26 pm #

            “I don’t see why my experience gets to be discounted, I’m assuming it’s because it’s positive.” I don’t think people are discounting your experience. I think you have been overgeneralizing from your experience.

            Is your point simply that many women have an easy time breastfeeding? If so, i think part of the problem here is that this is such an obvious point that to most people, it goes without saying.

            “If I should happen in the future to use formula to feed my child I will not run around telling breastfeeding mothers a bunch of negative things about breastfeeding…” I don’t see this happening. At all. You seem to have a problem with the way breastfeeding difficulties are talked about in this conversation. Is that correct? But i don’t see women discouraging others from breastfeeding. To me, knowing that i might encounter X problem, and what my options are, is likely to result in less frustration than if i had never heard of X in the first place.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 1:05 pm #

            Is your point simply that many women have an easy time breastfeeding?
            If so, i think part of the problem here is that this is such an obvious
            point that to most people, it goes without saying.

            …and no one has ever said otherwise.

          • Fertile Myrtle
            May 26, 2014 at 2:24 pm #

            I’m not saying my experience represents the majority of breastfeeding mothers. I’m saying my experience is just as valid as “bombshellrisa” in terms of anecdotal evidence but just as invalid at representing breastfeeding. But I actually never detailed my experience. I don’t have any problem with women discussing their difficulties, it’s become a problem because I don’t think it’s fair to try to make those examples as the norm. Much the same way that my experience doesn’t need to be assumed the norm.
            As for formula feeding, that could be a reality for me in the next few weeks/months. . But as I said, I won’t be trying to make that out as right for everyone. I’m not going to start saying that breastfeeding benefits are trivial, that it’s a waste of time, too expensive or making snide comments about it “infusing children with morals and principles”. I don’t need to knock breastfeeding to make myself feel better about using formula.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 7:52 pm #

            I’m not saying my experience represents the majority of breastfeeding mothers.

            Even if that is the case, the key word here is, “breastfeeding mothers.”

            Mothers who have lots of issues don’t end up breastfeeding. Once again, you dismiss them.

            Then again, I want to know, is my wife considered a “breastfeeding mother” or not? She nursed the kids until they quit around 9 – 10 mos, although we a) introduced solids soon after 4 mos, on the advice and consent of our pediatrician, and b) we supplemented with formula.

            According to the Exclusive Breast Feeding rules, our kids were not EBF even 3 mos. But they actually did breastfeed until they were 9 mos or older.

            She liked breastfeeding, and it worked pretty well but making it work with working was harder. So do you just not count her in the “breastfeeding” club so that you can ignore her experience? Or do you count her among those for whom breastfeeding wasn’t perfect?

            I don’t need to knock breastfeeding to make myself feel better about using formula.

            Who’s knocking breastfeeding again? Not overstating the benefits of breastfeeding is not “knocking it.” It’s being honest about it.

          • Renee
            May 26, 2014 at 1:48 pm #

            I LOVE BF. LOVE it, love it, love it, for me. If I have another baby and cannot BF, I will be very sad.
            I think many people here have positive experiences. I think many even think its better. BUt I see no issue in discussing the issues.

          • the wingless one
            May 27, 2014 at 3:08 am #

            FWIW I LOVED breastfeeding my son. But it wasn’t easy, sacrifices were made and a lot of your comment did take the tone that because you or the people you know have had a certain experience that it doesn’t matter if others have experienced it differently. I promise you are not the only mother here who loved breastfeeding. Dr. Amy probably included among those since she BF-ed some (or is it all?) her kids.

          • Jessica S.
            May 27, 2014 at 10:27 pm #

            There are a lot of bitter feelings about BFing and why shouldn’t there be? Women who FF are demonized, plain and simple. They have to explain themselves and their decision not to BF. There is absolutely NO equivalent campaign to support and educate parents who want to FF. And the idea that there should be is likely to be scoffed at as ridiculous and unethical.

            I’m not saying this is what you think of people who formula feed. And I can see that you have been piled on, and yes unnecessarily nitpicked to a degree.

            No one is trying to discount your experience. But in your first few posts you relied heavily on the fact that the people you know didn’t need A, B or C. That feels very much like your saying people who DO need it are actually under the wrong impression. So that makes other people feel that you’re discounting THEIR experience.

            My biggest problem is your beef with Dr. Amy asserting that breastfeeding only provides “soft” benefits (in context of a developed nation like the US). But she’s not wrong. The studies that supposedly associate lower rates of leukemia with BF are not proving causality. But pamphlets and posters promoting BF don’t make that distinction. They say: BFing lowers the risk of leukemia. And that’s going to make someone who chose to FF look bad, feel bad or both. Plain and simple.

            So I think yes, this is obviously a touchy subject but rightfully so: there are fewer arenas that people can express skeptical views about BF than those that are skeptical of FF. I think you’re justified in feeling a little picked on, but your martyr-style exit is over the top.

          • Jessica S.
            May 27, 2014 at 10:12 pm #

            Good lord, this is rude! She was pointing out that you had used personal experiences and you criticize her for doing the same. I read her response three times and can’t find cause for the tone you’ve used.

          • Who?
            May 27, 2014 at 10:30 pm #

            How is B’s story anecdotal and your story not?

          • Renee
            May 26, 2014 at 1:46 pm #

            LOL on employers having to do anything. Many states have no protections for workers. None. You can get fired over anything, or nothing at all. They don’t have to tell you WHY, they can just say “GTFO”. This may be uncommon with higher skill workers, but, lower wage workers often have to watch everything they do. lots of people are there to take their jobs. Taking extra time to pump? Not if you wanna keep your job.
            That is the reality for many women. It sucks, I would like to see it change.

          • Young CC Prof
            May 26, 2014 at 1:54 pm #

            Thank you. There may indeed be laws protecting mothers from getting fired because they take leave, or because they take pumping breaks, but even if you do have some contract protection, if they want to get rid of you, they will FIND a legal reason to fire you. Or just make your life as difficult as possible.

          • An Actual Attorney
            May 26, 2014 at 9:39 pm #

            As I often say, if everyone followed the law, then I’d be out of a job. I’m not worried about my job security.

            And seriously, even if an employer says – GTFO I’m firing you for taking too long to pump, what’s a woman to do? Sue? Is there a cause of action in the ACA? Even if there is one, it can take ten years for a lawsuit to come to conclusion. What’s going to pay the bills in the meantime?

          • Bombshellrisa
            May 26, 2014 at 2:35 pm #

            Exactly! Laws are laws, they aren’t reality for so many women. Instead of going on campaigns to lock up formula in hospitals, the lactovists should be crusading for making paid maternity leave a reality for lower wage workers. Or making employers accountable if they aren’t complying with the laws. I could get behind that.

          • The Bofa, Being of the Sofa
            May 25, 2014 at 8:02 pm #

            You have done a lot of backpeddling. “Oh, I’m no talking about that. Or that. Or those women.”

            You’ve basically run into a position where, everyone can breastfeed, and there are great benefits, and it’s really cheap. Except in those cases when it isn’t. You aren’t talking about that.

          • Fertile Myrtle
            May 25, 2014 at 11:18 pm #

            Um, no. Just no. My position has never been that everyone CAN/SHOULD/MUST breastfeed. This is why I almost never comment on here. Because if I say I breastfeed then many regular commenters jump on your back, ASSUME you think a certain way and stereotype you. So so typical.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 8:51 am #

            So what the hell IS your point? I haven’t figured it out?

            You came here to say “breastfeed”? That’s all? Really?

            Of course not. You whined about only talking about the soft benefits, and mentioned something about a huge body of research that you didn’t know anything about since you weren’t a researcher, but the AAP says breastfeed and that’s good enough for you. In the end, you’ve said nothing.

            That’s not about assumptions. I have throughout this discussion only responded to things you have said. And every time you get called out with examples that run counter to your claims, you dismiss them.

            All we have is what you say. If you don’t think we have characterized you correctly, then perhaps reconsider what you have said in this thread. Reread your comments and see what we have responded to. Then ask yourself, was that really what I meant to say, and how could I have expressed my views more clearly.

          • Fertile Myrtle
            May 26, 2014 at 12:41 pm #

            I guess you could always refer to my initial question. Since the rest of my comments are mostly replies, so if they are “off target” from my initial post then it’s because other point were brought up.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 1:04 pm #

            Here is your initial question:

            What I don’t understand is targeting breastfeeding and trying to claim the benefits are menial?

            We’ve addressed this very clearly. The benefits ARE menial.

            The reason we target it is because there are those in the world who far overstate the extent of the benefits.

            Like you.

          • Fertile Myrtle
            May 26, 2014 at 1:08 pm #

            Did I overstate them? I said the AMA, ACOG, AAP, CDC, WHO all recommend breastfeeding. But apparently they are all quacks without sound evidence. Mmkay. I think I’m done here.

          • Renee
            May 26, 2014 at 1:43 pm #

            Of course they aren’t quacks!
            At this point, its shown that there are either small, but real benefits, or no benefit at all (brand new data!). It makes perfect sense to assume BF has benefits, and suggest it, especially when they are talking to ALL parents, including those with preemies.

            I think its awesome that the ACA (evil Obamacare) covers this stuff! It will cut the cost of BF a LOT for those that need to pump. Add in real, paid, maternity leave, and maybe there would be more BF.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 7:46 pm #

            Yes, they recommend breastfeeding.

            But where are those large benefits?

            HINT: they aren’t required for the AAP etc recommendations.

          • Fertile Myrtle
            May 26, 2014 at 9:25 pm #

            Are you saying that the AAP is claiming large benefits or I am? I didn’t say large benefits. But looking at this AAP statement and this table of risks is pretty convincing. Why do you think that these risks are overstated? I’m not arguing, I’m truly interested to hear what your take is. How about SIDS? No reduction in risk?



          • Young CC Prof
            May 26, 2014 at 10:01 pm #

            For the first few benefits, the evidence is clear and the mechanism of action logical. Breastfeeding reduces infections during infancy, and partially protects against NEC in premature infants. This is why I pumped for a month, because I wanted some antibodies in my son during his most vulnerable weeks.

            For SIDS and leukemia, the only studies that decently controlled for confounders were not large enough to prove anything.

            For the other benefits like allergy and obesity, the better controlled the study is, the smaller the benefit, and the best studies find no benefit at all.

          • The Bofa, Being of the Sofa
            May 27, 2014 at 9:34 am #

            Are you saying that the AAP is claiming large benefits or I am? I didn’t say large benefits.

            You were the one who said this

            But claiming that there are only “soft” benefits flies in the face of many public health organizations and a huge body of research.

            You also told me to refer to your initial question, which I quoted above:

            What I don’t understand is targeting breastfeeding and trying to claim the benefits are menial?

            If you don’t think there are large benefits, then why do you think “trying to claim the benefits are menial” is “targeting breastfeeding”?

            Those are YOUR words. Not those of the AAP or WHO. Therefore, yes, I am saying that YOU are claiming there are large benefits.

            And where again does the AAP claim LARGE benefits? We’ve already agreed (I thought) that their recommendations do not require that the benefits be large (you said you understood completely when I explained it).

          • Jessica S.
            May 27, 2014 at 10:04 pm #

            I’d just like to second Young CC Prof’s reply b/c it’s spot on. The AAP is dubiously pushing a few of those benefits, whether intended or not. I suspect it’s unintended, b/c it supports their viewpoint.

          • S
            May 26, 2014 at 12:35 pm #

            I do honestly see that happening, and i think it is happening because just saying you breastfeed, or that many women breastfeed without issue, doesn’t really add to the conversation. Because no one ever claimed that _most_ women who breastfeed will encounter problems. So people try to figure out where you are going with your comments, and it leads to all kinds of assumptions of intent. That is just my guess though.

          • Renee
            May 26, 2014 at 1:38 pm #

            I think its semantics. Often on blogs, if you aren’t specific on every itty bitty point, you will get a million comments about something you never meant.
            Its not really a BF thing, people here just really like to debate 😉

          • Jessica S.
            May 25, 2014 at 9:33 pm #

            I read the AAP’s FAQ on the recent changes in the ACA re: pumps and consultants and I didn’t like how many times the words “grandfathered plans” were used in terms of exemption from those mandates. It really gets to me, b/c if it’s important enough to include in the act, it should be important enough to offer as a service outside of insurance. Never mind that not everyone can afford insurance, even if they’re mandated to have it. I hope I’m wrong and there aren’t that many finding themselves being denied.

          • MLE
            May 26, 2014 at 12:32 am #

            You really make some huge assumptions here. You have zero empathy and it’s probably pointless to argue with you if you absolutely refuse to imagine that perhaps there is a broader array of experiences out there besides yours and those of your 12 pals.

          • S
            May 25, 2014 at 5:45 pm #

            I bought almost nothing to breastfeed my son. I had two hand-me-down bras and a pump. Didn’t even use a pillow. I used to tuck him under one arm and go pour myself a bowl of cereal with the other.

            You know what that makes me? Singularly unqualified to criticize any mother who has breastfeeding issues or needs any kind of special equipment.

          • Fertile Myrtle
            May 25, 2014 at 6:22 pm #

            Who’s criticizing?

          • S
            May 25, 2014 at 7:56 pm #

            Perhaps i misunderstood what you mean by being “fancy.” What did you mean?

          • Fertile Myrtle
            May 25, 2014 at 11:14 pm #

            I meant you can get complicated with it and buy a dozen gadgets for breastfeeding or keep it simple. I’m certainly not trying to criticize doing either, just saying most of the time there is a choice.

          • S
            May 26, 2014 at 12:30 am #

            Okay. It looked to me like you meant _unnecessarily_ complicated.

            My sample size is pretty small, but the large-breasted nursing moms i know tend to rely much more on things like sturdy bras, pillows for positioning, etc. I can choose not to buy expensive nursing bras for my little boobs without factoring in back pain, or having my bra snap open in the middle of meeting with a client. It’s true that some of us have the choice to be simple or fancy, but for others, the “simple” choice really sucks.

            I also get that it can be hard to communicate a point in a short comment without managing to alienate someone.

          • Renee
            May 26, 2014 at 1:33 pm #

            For SOME you need nothing (like me), for others, not so much. In many cases it’s more about opportunity costs.
            Same for FF. With WIC, it can be low cost, if you don’t go nuts on bottles.
            Babies cost MONEY, even if you keep it as basic as possible. And Kids, cost even more (IME).

          • Busbus
            May 26, 2014 at 11:57 pm #

            Who can pump at work? Sure, if you have an office or white collar job, you might be able to swing it. If you’re a waitress, work at McDonald’s or have any other of the myriad of not-so-cushy jobs, not so much. Then it’s either formula or stay home (aka, no income.)

          • Jessica S.
            May 27, 2014 at 9:58 pm #

            Good point!

        • Trixie
          May 24, 2014 at 9:21 pm #

          Lactation consultants and pumps are covered under ACA now. As far as the extra food, how much does 300 extra calories a day cost? Not a whole lot, and you can get extra WIC if you’re breastfeeding to cover those calories. As far as nursing clothing, people have to buy clothing in various sizes due to changes in pregnancy anyway. The main cost is really lost income.

          • Jessica S.
            May 24, 2014 at 9:36 pm #

            I hope that coverage reaches all women b/c that is really cool. So often, even when it’s a gov mandate, there are little exemptions that leave people out, or create loop holes to exclude. I hope that’s not the case with the ACA!

          • Certified Hamster Midwife
            May 24, 2014 at 9:37 pm #

            The question ends up being what pumps are “covered.” Hospital-grade electric pumps, or plastic hand pumps? One of those is a lot more useful than the other.

          • Fertile Myrtle
            May 24, 2014 at 9:39 pm #

            That probably depends on the insurance company but the ACA makes providing pumps an “upfront” benefit meaning no deductible has to be met. My insurance 100% for a double electric pump.

          • Jenny_from_da_Bloc
            May 25, 2014 at 3:58 pm #

            LMy insurance company will pay for a c-section, hospital grade breast pump and 4-5 days in the hospital here in a few months but wouldn’t cover an iud or any birth control a few months ago. Guess I showed them lol!

          • The Bofa, Being of the Sofa
            May 24, 2014 at 9:40 pm #

            Nah, some company can just refuse to have it in their insurance plans due to religious reasons.

          • Jessica S.
            May 24, 2014 at 11:45 pm #

            Well, exclusive breastfeeding *can* be considered a form of birth control, however imperfect. So, there’s that.

          • Lion
            May 25, 2014 at 12:21 pm #

            Said a few of my friends with children eleven months apart…

          • Jessica S.
            May 25, 2014 at 4:59 pm #

            Ha! You know what’s troubling about that, is that WHO uses that as one of their points in their breastfeeding initiative, as a benefit to the mother: “Exclusive breastfeeding is associated with a natural (though not fail-safe) method of birth control (98% protection in the first six months after birth).”

            98%? Can that be right? Is that number based on the assumption of completely adherence? I guess the WHO is focusing on a different subset of women, women who will likely not have any other alternative and therefore will stick to EBF.

            But still – is it the case that nearly all women are capable of holding off their period as long as they BF correctly and exclusively? I don’t know enough about BFing to assess their statistic.

          • fiftyfifty1
            May 25, 2014 at 5:21 pm #

            The lactational amenorrhea is 98% effective only if a woman breastfeeds her baby at least every 4 hours while awake and a max of 6 hours at night AND doesn’t get her period AND the baby is less than 6 months old.

            Some women get their periods back despite frequent feeds and this method won’t work for them and they shouldn’t rely on it. The problem is that you can unknowingly ovulate before you have gotten back your first menses.

            And if you sometimes go a little over 4 hours between feeds, all bets are off.

            Therefore works better in women who want to space out babies a little but it’s not trustworthy if you really don’t want to conceive.

          • Jessica S.
            May 25, 2014 at 5:44 pm #

            That’s what I figured, that the percentage was “true” but not perfect in practice. I’m still surprised that the WHO uses it so freely, but they know what they are doing more than I do. 🙂

          • fiftyfifty1
            May 25, 2014 at 7:40 pm #

            The problem with the WHO is that they are the WORLD health organization. They are great in that they look beyond the developed world and focus on the developing world which needs all of these things (safe birthing practices, safe infant feeding, inexpensive family planning) so badly. But what is good advice for the developing world is often a poor fit for individuals in the developed world. Keeping C-section rates low is super important for the developing world, just read the blog “The Learner” and you will see an OB go to great lengths to prevent C-sections to the point that he will choose to cut up a dead obstructed fetus and remove it vaginally rather than do a CS. But we have other safe options here and family size tends to be low. Likewise with breastmilk; important where water is dirty but unimportant where it is clean. Lactational amenorrhea? Free, acceptable by all major religions and largely woman controlled. It makes sense for the WHO to promote it because it is a lot better than the alternative which is often nothing at all.

          • Jessica S.
            May 25, 2014 at 9:15 pm #

            Yeah, I was thinking about the birth control situation in other countries, specifically in developing countries. That lactational amenorrhea is the best option for the WHO to reasonably promote, one that will cover a multitude of restrictions, religious, cultural, etc. I figured that was the case.

          • Medwife
            May 25, 2014 at 9:24 pm #

            It’s the one and only reason my Catholic grandmother breastfed her NINE children. Maybe she would have had 13-14 otherwise, who knows?

          • yentavegan
            May 25, 2014 at 10:29 pm #

            We are being culturally ignorant when we keep spouting the line about dirty drinking water. women from communities lacking treated/clean water are raised learning how to boil the water before cooking with it. Lactation failure occurs for them too, for the same reasons it occurs here,

          • Trixie
            May 26, 2014 at 6:46 am #

            Except, lack of modern sanitation in the community still increases the risk of diarrheal illness, and a breastfed baby has a better chance of fighting diarrheal illness than a formula fed one, even if the formula is clean.

          • Jessica S.
            May 25, 2014 at 11:12 pm #

            Out of pure curiosity, is it crucial to keep the c-section rate down in developing countries b/c of hospital conditions? Or is it the risks during recovery? More susceptible to infections and more? You mentioned the size of families, is that the main concern – risks in subsequent pregnancies?

            Sorry for all the questions. My curiosity is insatiable. 🙂

          • Siri
            May 26, 2014 at 5:28 am #

            I really recommend you read all the obstetrical posts on Dr Jeevan Kuruvilla’s blog The Learner; all your questions will be answered and more! The value placed on women and girls plays a huge part, as do poverty, ignorance, lack of safe facilities, lack of transport, lack of antenatal care, etc etc etc.

          • Jessica S.
            May 26, 2014 at 8:18 pm #

            Thanks, Siri! That’s a great idea. I’ve read a few posts there and found them riveting. 🙂

          • Trixie
            May 26, 2014 at 6:44 am #

            Yeah, because HBACs are very risky, as we know. Jeevan writes about some of the horrible VBAC cases he’s seen.

          • Bombshellrisa
            May 24, 2014 at 9:41 pm #

            If you qualify for WIC-I was Medicaid spend down for my first pregnancy and we didn’t qualify. Our budget for two people for food for a week was $50. It doesn’t sound like a lot of extra money but we were counting every penny.

          • Trixie
            May 24, 2014 at 9:49 pm #

            I realize there are gaps that people can still fall though. I’m sorry you didn’t qualify.

          • Bombshellrisa
            May 24, 2014 at 10:09 pm #

            I was pretty lucky with the clothing part, my friend gave me all her maternity clothes which I didn’t have to use much and maternity tops can be great for nursing too.

        • Trixie
          May 24, 2014 at 9:54 pm #

          I found this script. I know someone with Aetna and they covered the institutional equivalent of a Hygeia Enjoye without the battery pack, but she had to order it through a specific online vendor.

          • Bombshellrisa
            May 24, 2014 at 10:08 pm #

            Thank you!

          • Trixie
            May 24, 2014 at 10:11 pm #

            I had to go through a similar runaround to get Healthamerica to cover my Mirena when the ACA first rolled out. They kept saying no, and I kept saying, “but, ACA!” and then eventually they conceded that I was right. But they clearly had a script that was hoping I’d just give up and pay for it myself.

          • Jessica S.
            May 24, 2014 at 11:44 pm #

            How infuriating! Not to pontificate, but it would be so much better if we could just get these services straight from government agencies like WIC or something. ALL women, regardless of income: the consultants, the pumps, the whatever. I was just reading an FAQ on the AAP breastfeeding site about what’s covered under the ACA and they discussed how any plans that were “grandfathered” in were exempt from some of these requirements. The good thing is, it sounded like the were able to reduce the amount of plans that qualify to be grandfathered, which will increase the amount of people who will have access to these benefits and more.

            But it all got me thinking: obviously this is something the government is willing to provide. Wouldn’t it be nice if it weren’t administered through insurance companies that will often give you the runaround – intentional or no? Maybe I’m just a dreamer…

          • Bombshellrisa
            May 24, 2014 at 11:59 pm #

            I wish everyone could have access to the lactation nurses I had. They were so realistic about what it would take to have my son get to the point where he could be exclusively breast fed, and were honest about how hard it would be on me to offer the breast/feed him/pump every three hours around the clock. I appreciated their advice! There is also a service that is provided to Medicaid qualified families (and for a fee to those who don’t qualify) for fussy babies. They do home visits to help manage fussy babies. What if THAT was available to everyone for free, not just Medicaid eligible families? Less shaken baby syndrome? Less PPD?

          • Jessica S.
            May 25, 2014 at 5:04 pm #

            That would be incredible. And seriously, for ALL families, not just those that couldn’t afford such services. To say, “this is the value we place on parent/child/family unit.”

          • Bombshellrisa
            May 25, 2014 at 6:06 pm #

            If you are in King County it IS available for a fee and calling them for help is always free but I totally agree. This is what to put the emphasis on to really support families

          • Jessica S.
            May 25, 2014 at 9:17 pm #

            I *am* in King County!! Do obstinate 3.5 year olds qualify? I have that in spades. 😉 What organization offers this?

          • Bombshellrisa
            May 25, 2014 at 11:21 pm #

            It’s in Seattle parent! http://m.cooperhouse.org/fussybaby.php

          • Jessica S.
            May 25, 2014 at 11:40 pm #

            Thanks so much! I’m going to keep this handy. 🙂

          • Bombshellrisa
            May 26, 2014 at 10:12 pm #

            I just read up on the people on staff and I think it’s worth looking into even if your child isn’t an infant. The staff is experienced with older children too!

          • Jessica S.
            May 27, 2014 at 9:13 pm #

            I did the same – I was SO impressed. They have an awesome mission.

          • Renee
            May 26, 2014 at 1:27 pm #

            We don’t support families here in ‘Murica. Politoco’s use it as a mantra, while killing any plans for maternity/paternity leave, any social programs, and help with your kids? HAHAHAHAHA

          • fiftyfifty1
            May 25, 2014 at 5:09 pm #

            “There is also a service . . .for fussy babies. ”

            Brilliant idea!

          • Renee
            May 26, 2014 at 1:26 pm #

            LOL, this is ‘Murica! We only let the government provide services if a private company will benefit. We hate “socialism”, and government services, so much we won’t allow the government to just give us those things. Even when its much easier and cheaper for all to do so. (uh oh, I used the word “give”…..)

          • Jessica S.
            May 27, 2014 at 9:56 pm #

            Preach it!

        • May 25, 2014 at 1:08 am #

          When in nursing school, our instructor told us that “when pregnant, a woman eats for one and a half; when nursing, she eats for two”. The quality of the milk stays pretty consistent whether the mother is eating well or not — it only deteriorates if she is extremely malnourished, but if she isn’t eating properly, her body will supply the nutrients at her cost [that’s where the old adage “a tooth per child” comes from — women lost calcium from bones and teeth because it went into the milk]. We were also told, by the dietitics instructor, that breast feeding was therefore “the most expensive way to feed an infant”. Add to that possible loss of income if the mother cannot work, and breast milk can be very expensive indeed.

          • Trixie
            May 25, 2014 at 3:53 pm #

            Except, you don’t actually double your caloric intake to breastfeed a single baby. Or you shouldn’t. Assuming my normal caloric intake would be about 2,000 calories, that’d mean I’d have to eat 4,000 calories. I am sure I ate extra while breastfeeding, but I also burned off all of the 50 lbs I gained while pregnant. I didn’t eat 2,000 calories extra.

          • me
            May 28, 2014 at 1:33 pm #

            Is a daily multivitamin for adults more expensive than formula?

            IDK about where you are, but here in the US getting enough calories isn’t exactly an issue (a great deal of pregnant women are overweight/obese to begin with – bfing and the ability to burn a few hundred extra calories a day while doing it could theoretically help with that, lowering their healthcare costs later down the line, but I digress). And nutrition can be obtained for about 3 bucks for a 100 day supply (generic multivitamin at Chinamart).

            Loss of income/earning potential is definitely the more sound argument…

        • Anna T
          May 25, 2014 at 6:48 am #

          Somehow everyone here seems to take this as an absolute choice: breast or bottle. Why does it have to be all or nothing? What if it’s breast AND bottle? I breastfed exclusively, but that’s because I wanted and was able to stay home with my babies. Many women who go back to work breastfeed part-time, only when they are home with the baby (say, morning, afternoon and evening). This means the baby still gets the immunological benefits of breast-milk, and the family doesn’t have to buy as much formula.

          Also, if your baby only eats formula, it means you go through a pretty fixed amount of the stuff (until the baby begins to eat solids, anyway).

          If you breastfeed, it doesn’t necessarily mean you need all the breast-related accessories.

          I never paid to see a lactation consultant (there was one at the hospital), never bought a pump, nursing bras (you can nurse very comfortably in a simple, cheap sports bra), breast pads, creams, or anything of the sort. As for the extra food, I honestly believe the costs were negligible and nowhere compared to buying formula. We are a family that cooks and eats plenty of healthy food anyway, so it wasn’t like we needed to buy anything special.

          • OBPI Mama
            May 25, 2014 at 7:21 am #

            I also think formula is way more expensive… it puts a strain on our family when we have a new baby to afford a year’s worth of it. But better an alive baby than a starved one! Most of my friends breastfeed and rarely use pumps/breast pads/nursing bras, if at all.

          • Renee
            May 26, 2014 at 1:21 pm #

            I was lucky-
            Formula was low cost for us because of WIC. It really cut the cost down.

          • Young CC Prof
            May 25, 2014 at 10:54 am #

            I actually wanted to do something like that, exclusive until I went back to work, combination feeding after. Then, of course, my baby was born with mild health problems and bf just didn’t work out at all. So I pumped for a month, then quit.

            And some ladies can nurse in a cheap sports bra. Others of us grew 4! sizes, two before I even realized I was pregnant and wound up not only beyond sports-bra territory but beyond the size range of most brands of nursing or maternity bras. I had to special-order.

          • Jessica S.
            May 25, 2014 at 5:40 pm #

            My bras are always spendy, pregnant or not, but you can’t get the same support without shelling out some cash. I end up with less bras but it makes a huge difference. I miss my favorite bras. I can’t wait until I can fit into them again!!

          • sdsures
            May 25, 2014 at 10:54 am #

            “Why does it have to be all or nothing?”

            It doesn’t.

          • Lion
            May 25, 2014 at 12:17 pm #

            I agree, it doesn’t have to be all or nothing. I couldn’t always pump enough at work, who would use formula if I had a shortfall. I have also had a breast reduction, so I used an sns and it sometimes had my pumped milk and sometimes formula.

          • VeritasLiberat
            May 25, 2014 at 12:33 pm #

            I couldn’t do it modestly in a sports bra. Also, sports bras are so tight that it would have been painful

          • theadequatemother
            May 26, 2014 at 3:36 pm #

            I can’t even picture how you’d do it in a sports bra!

          • Irène Delse
            May 26, 2014 at 4:04 pm #

            If someone has very small breasts?

          • Bombshellrisa
            May 25, 2014 at 1:46 pm #

            I don’t see it as absolute one way or the other, as I said before I bf my daughter without any incident and things only got complicated when I had my son at 35 weeks. I saw lactation consultants on an out patient basis and ended up needing a hospital grade pump which I paid for out of pocket to rent. I also had to feed him formula because he couldn’t latch and it was deemed “medically necessary”. I am able to nurse him a little now that he is four months, but the majority of his nutrition comes from formula. The problem I have with comments like “it doesn’t cost anything to breast feed”, “you can just use a pillow off your bed”,” lanolin cream doesn’t cost much”, “sports bras worked just fine for me” is that the point isn’t what works well for someone else. It’s what works best for ME and that is what matters. It was a rude awakening after having no problems breast feeding one baby to have to get supplies the morning after we came home from the hospital with the next baby. When I was nursing my daughter I was incredibly hungry all the time, one extra sandwich was not going to cut it and I had a budget of $50 per week for food. I am not bashing breast feeding but wish the only thing people said when you choose to formula feed is “whatever works best for you” and leave it at that.

          • Jessica S.
            May 25, 2014 at 5:38 pm #

            It’s kind of how I feel about maternity clothes, b/c I abhor spending money on clothes with such a limited purpose. But my husband – the super gem that he is – repeatedly points out that if it makes me feel better about life and myself, it’s worth every penny. So yes, you could get by without properly fitted maternity clothes. Or you could make it work with whatever’s on hand or cheapest for nursing. But in the end, if it helps you feel better about the situation – like, a true impact, one that makes the monetary output worth it (if you have it at all) – then it’s important.

            This is how I ended up spending $20 on one (ONE!) pair of maternity panties (they are oh so sexy – NOT!) that fit perfect. It was totally worth it, I just need to buy a few more. And so laundry more often. Oh what a difference it makes, having underwear stay put!! 🙂

          • S
            May 25, 2014 at 11:47 pm #

            Ooh! Maybe you can enlighten me on the mystery of the maternity panties! How are they different from regular panties? Do they ride lower? Stretchier?

            Seriously, a friend gave me a bag of her old ones, and i’m totally confused by them because they seem like regular panties. (So, for those of you who are grossed out right now — i never did wear them.) But it might just be the way underwear sits on my body.

          • Bombshellrisa
            May 26, 2014 at 1:22 am #

            Some maternity tops and dresses make really good nursing clothes. I was lucky enough to get a ton of clothes from my friend and couldn’t believe how well it worked to use them for nursing outfits

          • Trixie
            May 26, 2014 at 6:41 am #

            The top has a wider opening. I carried really, really low and there was no such thing as just putting underwear bellow my belly.

          • S
            May 26, 2014 at 8:48 am #

            That answers my question. Thank you!

          • Jessica S.
            May 26, 2014 at 8:31 pm #

            The pairs I bought are actually over-the-belly, or at least over the belly button. 🙂 And even provide a bit of support, although it’s probably more like smoothing than actual support. So like I said, not attractive necessarily, but for women like me who carry low (lower this time than the first, which I assume is normal? And I had a little bit more of belly “pooch” this time, thanks to the first preg. 😉 I bought them off Amazon:

            I’m hoping these boy short style will be nice with dresses, when I’m 9 mos huge come July: https://www.amazon.com/dp/B003E1U89U/ref=cm_sw_r_udp_awd_VS9Gtb168WN0DGQ0

            The other pair are just regular brief cut, but I can’t paste the link into this comment b/c Disqus hates me. I’ll do a separate comment with the link, hang on.

          • S
            May 27, 2014 at 10:28 am #

            Ooh, if those actually are supportive then they look NICE right about now (having an ouchy day). The ones i have look like regular low-cut panties, probably extra wide like Trixie explained. I carry low too but tiny — geometry-defying pelvis or something, with average-sized babies — so have gotten away with regular undies. Finally i look obviously pregnant enough that all of a sudden people are asking when i’m due. Less than four weeks now, so i’ll manage with what i’ve got. =)

          • Jessica S.
            May 27, 2014 at 9:10 pm #

            Definitely, if you’ve only got 4 weeks to go then I’d save the $$. I, on the other hand, am far from tiny and still have 7 and a half weeks left. I can’t fathom how big I’ll be at term. I didn’t feel this big with my son, but he was 10lbs 10oz. Here’s a picture I took earlier today, I feel huge!

          • S
            May 28, 2014 at 12:49 am #


          • Jessica S.
            May 26, 2014 at 8:32 pm #

            Here’s the other link: https://www.amazon.com/dp/B0051UKZHW/ref=cm_sw_r_udp_awd_5V9Gtb04B39QC6NP

            I’m happy with them!

          • Jessica S.
            May 25, 2014 at 5:31 pm #

            Yeah, the all or nothing mentality is counterproductive. I suspect it’s a necessary reflex, to defend ones ideology. But it lends itself only to discourse, not reasoned discussion, I guess.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 1:00 pm #

            Somehow everyone here seems to take this as an absolute choice: breast or bottle. Why does it have to be all or nothing?

            While is doesn’t have to be all or nothing (and it very rarely is), I will mention that we are not the ones fixated on “exclusively breast fed for 6 months” and stuff like that. That type of descriptor is what makes it “all or nothing.” As many people have described, if a baby gets 2 oz of formula in the hospital for whatever reason, but exclusively breastfeeds after that, it does not count as “EBF for 6 months.”

            So I agree, the all or nothing attitude is silly. So tell the lactovists to quit promoting it.

      • Jessica S.
        May 24, 2014 at 7:40 pm #

        Breastfeeding isn’t free, the costs are less overt. Some families could qualify for formula from WIC. I don’t doubt that there’s a gap between those that qualify and those that can afford to buy on their own, leaving some out of luck. That’s the case with many services, I suspect. But I digress. I can’t recall exactly how much formula my son went through, but let’s say he went through one can a week. We bought from Costco, their in-house brand, and it’s about $17 a can. (Obviously not everyone has access to Costco or they may have a baby with an expensive taste.) So we didn’t pay “hundreds of dollars” a month on formula, by any stretch of the imagination. Even the super expensive brands would be a notch over one hundred. Unless babies go through more than one standard can a week – I can’t remember!

        • Young CC Prof
          May 24, 2014 at 10:01 pm #

          One standard can (24 oz) costs lasts my baby 6 days, and he drinks almost a quart a day, which experts say is the maximum a baby should consume. So one can every 5-6 days for bigger babies, less for newborns. I stock up when it goes on sale, it works out to $2-$3 per day.

          Now, when he was a newborn, he was on a special and more expensive preemie formula per neonatologist’s orders, but at 2 months old we were able to switch him to the regular stuff.

          • Bombshellrisa
            May 24, 2014 at 10:06 pm #

            Part of me is grateful for those coupons they send in the mail, it’s made a huge difference buying formula

          • Jessica S.
            May 24, 2014 at 11:17 pm #

            I’m going to have to get back into the rhythm of this, less than two months to go. It’s amazing how much I’ve forgotten over the last 3.5 years!!

      • LibrarianSarah
        May 24, 2014 at 8:14 pm #

        I recently went to the eye doctor and after the appointment I handed over exactly $0 to the office. Now was that appointment free? Obviously not. I paid for that appointment with my insurance premiums. The same kind of logic is true for breast feeding you pay for that through lost wages and increased grocery bills.

        Let’s say that a woman is the primary bredwinner in the home but needs to take extra time off because she wants to breastfeed her baby. That might cost the family thousands of dollars a month in lost wages or tens or hundreds of thousands of dollars in lost income oportunities (promotions, raises etc.) depending on the type of work said mother is in. That can be a lot more expensive then the cost of handing a bottle of formula to grandma.

        As my parents say “there is no such thing as a free lunch” or “there is no free only free for me.”

        • Stacy48918
          May 24, 2014 at 8:25 pm #

          “The same kind of logic is true for breast feeding you pay for that through lost wages and increased grocery bills.”
          And bras and nursing shirts and bra pads and nursing tanks and a pump and a nursing pillow and and and…

          Breastfeeding has a lot more to it.

          • Lion
            May 25, 2014 at 12:10 pm #

            Those are all non essentials though. You can still breastfeed without any of that. Two pillows off your bed, a foot stool and your usual shirts and bras work fine. Not all mothers leak and so don’t all need nursing pads, and some use washable cloth ones. I used disposable ones and only leaked in the first few weeks but have breastfed each child for minimum three years.

          • FormerPhysicist
            May 25, 2014 at 3:22 pm #

            lol. No. My usual shirts and bras did NOT work fine, and two pillows off my bed did nothing to help prop the baby and keep her secure.
            I’m glad that worked for you, honestly.

          • KarenJJ
            May 25, 2014 at 11:41 pm #

            Great when it works for you, other women try and find it doesn’t work for them. Instead of second-guessing everyone’s choices how about a bit more acknowledgement that not all women get to make the easy choices.

            It’s a bit like women saying how setup for a baby isn’t all that expensive and you don’t need a fancy pram/cot etc and then you find out that they were able to borrow a cot from their sister and their parents chipped in some funds for a pram. It’s choices of the privileged and they don’t always apply to the rest of us.

          • Renee
            May 26, 2014 at 1:09 pm #

            I needed *nothing* to BF, but I didn’t know that! I thought all manner of things were required. Other moms told me this, as well as all over blogs, the web. I knew this baby would BF so I got the stuff in advance, like I figured I should.

            I bought a few nursing tanks and shirts, a pump, bottles and accessories for the pump, lanolin and NUK cream, a pumping bra (never used out of NICU), nursing pads, bags to collect milk, a boppy (and I got another nursing pillow as a gift), a sling and wrap for ease.

            NONE of this was needed- FOR ME. But I still bought it all.

            The tanks/shirts were useful a few times, but normal clothes were even easier to use. I never used the rest of that stuff, at all. The boppy is a couch pillow for my kids stuffed animals, the pump and all the stuff to go with it were never used, and resold at a huge loss, or donated. The sling and wrap were too irritating, so I switched to an Ergo, but BF in that was a no-go.

          • Bombshellrisa
            May 26, 2014 at 6:56 pm #

            It’s really trial and error with so much of it. I found that Old Navy maternity tanks have this strange fabric shelf in them that you can tuck your flanges into and you don’t need a pumping bra (even better, they were hand me down tank
            Tops from a friend!) and also work great to nurse in. I used the nursing pillow for two weeks BUT it helped so much for those two weeks I am glad I got it. I still had my second hand Bjorn from dd and used it, ds is less thrilled with it and we have switched to an Ergo. Could one of us just carry him? You bet, but it’s easier to get stuff done with two free hands. None of this stuff was absolutely necessary but it helped me.

          • Jessica S.
            May 26, 2014 at 11:37 pm #

            It’s Big Breastfeeding! They get you with all their claims! 😉

          • fiftyfifty1
            May 28, 2014 at 11:05 am #

            And my experience was the exact opposite! I bought nothing ahead of time because I was told none of it was really needed. It resulted in my husband making a number of urgent drives across town in the middle of the night to the 24 hour pharmacy to buy these “unneaded” supplies.

          • Lion
            May 26, 2014 at 1:40 pm #

            Yes, not everything is necessary, but for some people it is. I had also bought many things I thought were needed but that I never used. I gave them to friends who had more use for it.j

          • MB
            May 26, 2014 at 5:03 pm #

            I am pregnant with my first child. I have not breastfeed before obviously. My usual bras put me in REAL PAIN from week 6, so I had to buy new ones. Those are good for breastfeeding as well so I am planning to use them for a long time, but they were necessary to walk around without PAIN and they were not exactly free.

            There are a lot of things that are not necessary but really convenient.

          • An Actual Attorney
            May 26, 2014 at 9:49 pm #

            Toilet paper is pretty easy to make, though labor intensive. And almost free since you just take used paper and add water.

            Funny thing, Costco sells plenty of tp. Convenience and the value of a person’s time is real.

          • MLE
            May 25, 2014 at 3:41 pm #

            Yeah a resounding no on that one from me. The only reason I could BF is because I work from home, because I couldn’t pump enough in advance to leave for any amount of time (for 9months!!). I had to have something sturdy so that I could nurse hands free and type at the same time. My normal small bras would have exploded had I tried to lash them on, and I wasn’t about to stretch out my only “presentable in public” clothing for breast feeding, so nursing tanks and nursing bras were a requirement.

          • Jessica S.
            May 25, 2014 at 5:27 pm #

            Now you are stripping us of all our luxuries!!! I’m totally kidding. But it does, perhaps, illuminate the marketing side of breastfeeding – sure, a lot of that stuff is really convenient, but is it necessary? That depends on each woman’s degree of comfort, and of course her financial state.

            I can get sucked into marketing claims pretty easy, but as my child has gotten older, and I have gone through a half dozen “wonder” products, I finally started to realize that there is rarely a one-size fits all solution.
            Except footie jammies with zippers. I don’t understand why most footies have snaps! Have these people never tried to change a squirmy, screaming newborn in the middle of the night before? 😉

          • the wingless one
            May 26, 2014 at 1:46 pm #

            “Not all mothers leak” – OKAY but SOME DO! Like me! And I only breastfed for just under 10 months and weaned over 6 months ago and I STILL leak sometimes! Thanks for discounting my experience though. Btw I used the washable cloth pads, I needed a lot of them (because see above, I am one of those mothers that don’t count who leaks like a faucet and sometimes needed more than one pad) and they weren’t free nor did they wash themselves.

          • Jocelyn
            May 27, 2014 at 10:56 am #

            It can be different with different kids, too. My first, I leaked a LOT. My second, not at all. I didn’t even use the breast pads I bought.

          • Kelly
            May 26, 2014 at 10:03 pm #

            I wish. Unless I was going to walk around singing “Do your boobs hang low can you swing them to and fro” I was not ever going to fit into my regular bras. Bras with underwire give me mastitis and during my pregnancy I went up four sizes. I can only get my bras at an expensive specialty shop and had to buy all new shirts to fit my new chest. I refuse to look like I should be in the old annuals of National Geographic and thus I do spend the money to be able to leave the house.

          • Jessica S.
            May 26, 2014 at 11:35 pm #

            I’m dying at this comment, quite hilarious! (Sorry, I’m not laughing at your predicament – just your colorful way of telling it! :))

          • Kelly
            May 27, 2014 at 8:58 pm #

            Ha ha thanks. I use humor to help me deal and I am glad it made someone laugh. I made my husband promise to get me a chest reduction when we are done having kids before we even got married.

          • Kelly
            August 19, 2014 at 1:56 pm #

            Oh, I totally use humor to deal with the crappy things in life. I always joke I am going to also be able to tuck them into my pants when I am much older.

        • Bombshellrisa
          May 24, 2014 at 8:30 pm #

          Also if the women is the one who carries the health insurance. My husband is self employed and while he makes more than I do, I carry the insurance. Me not working just so I could breast feed would mean us having to pay out of pocket for insurance and the cost is very high even now with the ACA. Not worth the “benefits” of breast feeding.

        • Lion
          May 25, 2014 at 12:06 pm #

          Why increased grocery bills? It just needs an extra sand which a day. Personally, I was eating too much anyway so needed no extra food.

          • LibrarianSarah
            May 25, 2014 at 5:27 pm #

            An extra sandwhich a day will still increase your grocery bills. And just because you were eating too much and didn’t need to spend more on grocery bills doesn’t mean that the general principle is untrue. There is no such thing as a free lunch. If you are not making money you are spending it.

          • Kelly
            May 26, 2014 at 9:59 pm #

            I am one of those people who lose a ton of weight while nursing. I can eat all day and never feel full. We spent a lot on groceries because I would feel very sick without the extra food. I recognize that this is my experience and even for some an envious experience but I also recognize that not everyone reacts the same way. I am sure we spent more on food for me than we would have with formula. For us, nursing is all about saving money but I am not sure if we did.

        • Guest
          May 26, 2014 at 8:49 am #

          You’re exactly right. I’m in that position at the moment, where, as the primary income earner in our family, my time is extremely valuable which makes it a sacrifice to take maternity leave. This almost prompted me to resume work a few weeks after bub is due (soon) but then we decided that the sacrifice is worth it and time with bub is more important. Always more time to work later 🙂 but I do realise I am privileged to be in a position where a) I am a High income earner and b) I am able to make these decisions.

      • Certified Hamster Midwife
        May 24, 2014 at 9:32 pm #

        Breastfeeding is free only if a mother’s time is considered worthless. Not every woman has the privilege of (or even any interest in) staying home with an infant.

        Even time spent pumping at work is time taken away from eating lunch, or running errands for the benefit of the family.

        • OBPI Mama
          May 26, 2014 at 7:23 pm #

          ouch. that seems harsh. I think breastfeeding is great if that is what works for mom and baby and family and would consider the fact that it is free a perk. That doesn’t make the mom’s time less valuable. No time spent with your children is worthless. I guess I don’t quite get what you are saying…

          • Fertile Myrtle
            May 26, 2014 at 9:29 pm #

            My same thought.

          • Jessica S.
            May 26, 2014 at 11:33 pm #

            I think she’s actually saying that time spent breastfeeding IS valuable, by the very nature that a woman’s time is always valuable. I think she was responding to the (intended or no) implication that free = easy, or not of value. What I’m hearing her say is that it’s a sacrifice that’s valuable and should be valued. I could be totally wrong, but that’s how I read it. And what I believe is true, too. Even if you never spend a dime (I’m using that loosely), BFing has costs that are valuable. Whatever motivates you to do it, it involves sacrifice. Boy, that’s really the theme of motherhood, though, isn’t it? 🙂

      • TG
        May 25, 2014 at 2:45 am #

        somehow in israel, which is still lactivist country except that formula isn’t taboo, milk storage bags cost more per feed than formula. i pumped because the pump was a present, and because i could get away without using bags. and because i was legally entitled to the time at work. then it offset the cost of formula a bit.

        • Lion
          May 25, 2014 at 12:05 pm #

          Milk storage bags aren’t a necessity for working and pumping moms though. Using milk from today for tomorrow requires a fridge or cooler pack and two or three bottles or cups. For longer term freezer storage, ice cube trays and lids and sand which bags are fine. I work and breastfeeding till my kids self wean and have never needed storage bags. I hand expressed a lot but did have a double electric pump. I pumped till a year with baby one and sixteen months with baby two. It doesn’t have to be costly. We are given two breeks plus lunch time for pumping here though. No space is required to be provided though, so many mothers sit in an open area in a bathroom and use a manual pump. I am in South Africa.

          • The Bofa, Being of the Sofa
            May 25, 2014 at 5:08 pm #

            Milk storage bags aren’t a necessity for working and pumping moms though.

            So those working moms who use storage bags are wrong?

          • Trixie
            May 25, 2014 at 9:24 pm #

            I don’t think she was saying that at all, just explaining her system.
            I bought storage bags to store my milk for donation at my own expense. The milk bank provided little 4 oz screw-top containers, but I was pumping 7-10 oz at a sitting, and the bags took up much less room in the freezer, and held more. I asked the milk bank not to send them, but it was policy or something, so I just donated them to the preschool for various projects.

          • MLE
            May 26, 2014 at 12:37 am #

            Holy smokes I am envious of your supply!

          • Trixie
            May 26, 2014 at 6:34 am #

            It’s not all fun and games having an oversupply, trust me! But I’m glad I could help a few preemies.

          • MLE
            May 26, 2014 at 3:30 pm #

            I’m sure, the grass is always greener!

          • The Bofa, Being of the Sofa
            May 26, 2014 at 8:37 am #

            No, she insisted that milk storage bags aren’t a necessity for working and pumping moms. OTOH, lots of working and pumping moms are using storage bags.

            The implication is that they are using something that is unnecessary. I want her to own that accusation.

          • Trixie
            May 26, 2014 at 1:16 pm #

            I think you’re being a little touchy. Lion’s right, they aren’t a necessity. That doesn’t mean they aren’t useful and nice to have, and she didn’t state otherwise.

          • Lion
            May 26, 2014 at 1:32 pm #

            Quite correct, that is exactly what I meant.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 1:38 pm #

            Or very helpful.

            If we run down to what is necessary, you can throw out pretty much everything. That doesn’t mean that they won’t be using them, and that they shouldn’t be using them.

            It’s a silly standard to use. Breastfeeding women use storage bags. I don’t give a shit if anyone else thinks they absolutely HAVE TO do it, they absolutely do. The reason they do is because they find it beneficial to their own circumstances. To dismiss that on the grounds that “they don’t have to” is pretty insulting.

          • Trixie
            May 26, 2014 at 1:48 pm #

            She’s from a country where most of the things we think are necessary, are just simply not within the realm of most people’s ability to obtain. And she’s stated that she’s high-income enough to afford many things most cannot. Still, I think this is a failure of communication due to cultural differences, and not an attempt on Lion’s part to lecture other women.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 1:54 pm #

            Let me give you my experience:
            with our first, my wife started pumping and storing from the beginning. She was trying to build up our supply so that when she went to work, that we would have breastmilk to feed our son.

            Now, the problem was that she didn’t pump enough for a full feeding. Therefore, pumping a day or two before she had to go and storing it in the fridge was not an option. As it was, I had to use a mixture of milk and formula, just to make our supply last.

            Was it necessary? No, of course not. I could have used up all the breast milk in the first two weeks, and then given one bottle of milk a day and the rest formula. But we wanted to spread it out.

            The only way we could do that was to store as much as we could all the time. And that took storage bags in the freezer.

            So while storage bags weren’t “necessary,”, what were the alternatives? Give him straight formula? My wife not working?

            Or perhaps storage bags WERE necessary for us to feed him the way we wanted to?

          • Trixie
            May 26, 2014 at 1:59 pm #

            Her only point was, you can use another receptacle for storing or freezing milk that isn’t a dedicated milk storage bag, although it may be less convenient or take up more space or create more work to use alternate receptacles.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 4:58 pm #

            Or to use BPA containing plastic.

            But hey, it isn’t necessary…

          • MLE
            May 26, 2014 at 3:29 pm #

            Myrtle has been making assumptions up and down this thread, from you don’t need a nursing pillow to you don’t need storage bags. It’s incredibly patronizing and rude. Without a nursing pillow I wouldn’t have been able to nurse and work, so guess which one I would have given up? And yet she claims it’s not necessary without bothering for one minute to put herself in someone else’s place. And yes, I’m feeling a little touchy about someone telling me what is and isn’t necessary and dismissing other experiences. It’s taking me back to the incredible stress and pressure of breast feeding that I somehow powered through with the help of a stupid pillow, something she has decreed is unnecessary.

          • MLE
            May 26, 2014 at 3:32 pm #

            Confused Myrtle with Lion as they seem to be making a lot of the same points.

          • Amy Tuteur, MD
            May 26, 2014 at 4:10 pm #

            Myrtle is just desperate for someone to acknowledge that she is a better mother than women who have made different choices. She simply cannot tolerate the idea that her personal preferences are not an objective standard to which all women should aspire.

          • Bombshellrisa
            May 26, 2014 at 5:43 pm #

            Didn’t you say you had tons of pipe cleaners and other crafting supplies left over from projects with your kids? Maybe you can make her a “Mother of the Year” award. And then make a Scarlett F for my son and all the other poor formula fed babies so everyone will know who the formula fed kids are when he gets to kindergarten.

          • Fertile Myrtle
            May 26, 2014 at 6:11 pm #

            You, on the other hand, have decided for all women that the small benefits of breastfeeding are trivial across the board. Maybe preventing your child from catching the cold and having to stay home from work to care for that child isn’t trivial to all women.
            You have no idea what my personal preferences are and no one else on this thread does either. Some of my preferences for my child would be a down right bad idea for other mothers I’m sure. I certainly don’t hold them as better than anyone else’s. That assertion is comical. I’m sure you are a very talented and professional OBGYN but you currently make a very poor psychologist.

          • Bombshellrisa
            May 26, 2014 at 6:46 pm #

            Breast feeding doesn’t PREVENT colds. Oh heck, maybe I was doing it wrong.

          • Fertile Myrtle
            May 26, 2014 at 6:53 pm #

            But what do those imbeciles at the AAP know?

          • Bombshellrisa
            May 26, 2014 at 6:59 pm #

            They didn’t say it prevents infants from getting the common cold they said “are less likely to become ill if they are breastfed or fed their mothers’ milk in a bottle.”

          • OldTimeRN
            May 26, 2014 at 7:34 pm #

            I have a friend who is breastfeeding her 3rd kid. Nursed the other 2 for over 2 years and I’m sure her present 1year old will be I different. Let me tell you her kids are always sick. Her baby constantly has either a cough or a fever. So where is there breast feeding benefit?

          • Fertile Myrtle
            May 26, 2014 at 7:57 pm #

            So, something has to be true in EVERY situation to be a possible benefit eh? It would seem like from what I’ve read is that it reduces the chances, that’s no guarantee. But to me, a reduction in those chances are important. My almost 10 month old has never had any type of illness/cold. Maybe it’s the breast milk, maybe it’s that she isn’t exposed at daycare, or maybe it’s just dumb luck.

          • OldTimeRN
            May 26, 2014 at 8:07 pm #

            You would think it would more the a “possible benefit” or a “may prevent”. In order for something to be true one would think there would be facts to back up what is being claimed.

            When the kids all stand in line for kindergarten graduation or seniors all line up to get their diplomas can you tell the former breast feeders from the bottlers? I’m pretty sure you couldn’t so where is that benefit again?

          • fiftyfifty1
            May 26, 2014 at 8:48 pm #

            “So, something has to be true in EVERY situation to be a possible benefit eh?”

            No not at all! Even a 5-10% reduction in chance of an illness may be important when you multiply it across a large population. But the bottom line is whether this reduction is real vs. just an illusion due to confounding. For instance asthma and obesity are lower in breastfed babies and intelligence is higher. But when you remove the confounder of higher socioeconomic status (by randomizing or discordant sib studies) these benefits go away completely.

          • fiftyfifty1
            May 26, 2014 at 9:05 pm #

            “But to me, a reduction in those chances are important. My almost 10 month old has never had any type of illness/cold. ”

            Sounds great! Dr. Amy says right at the top of this piece that although unproven there might be soft benefits to breastfeeding such as fewer colds. Am I reading you right when I say that It sounds like the chance of reducing colds is important to you and that breastfeeding is perhaps something you wanted to do anyway? Your choice of breastfeeding sounds like a great choice for you then.

            Women should absolutely be told about the potential soft benefits of breastfeeding. Then they can make up their own minds. What should NOT happen (and I think we can all agree on this) are exaggerations about breastfeeding. For instance no one should say breastfeeding reduces obesity or asthma or diabetes or cancer, or increases IQ or emotional stability, because research that controls for confounding does not back up any of these long-lasting hard outcomes.

          • Jessica S.
            May 26, 2014 at 11:20 pm #

            My son was the same, and he was FF – he didn’t start getting regular colds until his older cousin, who we see quite often, began preschool. This doesn’t prove anything, of course, but it’s been my observation that it’s more likely linked to exposure. Or let’s say that the frequency and likelihood are more linked to exposure. But again, just my observation.

          • fiftyfifty1
            May 26, 2014 at 8:40 pm #

            Yes, I share your frustration. You would like to think that the AAP would do a better job than that! I understand that research needs to be simplified and edited when it is presented to a lay audience, but one important factor that should NEVER be cut out is the idea that finding a correlation does not mean there is a causation. Like their assertion about the obesity, for example. Yes breastfed babies are less likely to be obese. But that’s because breastfeeding rates are highest in health-conscious wealthy women. But when the Belarus PROBIT study randomized breastfeeding, they found the breastfeeding group had an *increase* in obesity that seems to be persisting well into childhood.

          • An Actual Attorney
            May 26, 2014 at 9:56 pm #

            Um, that doesn’t say that BFing prevents colds. I

            “If you develop a cold while breastfeeding, for example, you are likely to pass the cold germs on to your baby—but the antibodies your body produces to fight that cold also will be passed on through your milk. These antibodies will help your infant conquer the cold germs quickly and effectively and possibly avoid developing the cold altogether.”

            A few colds might be prevented, but it clearly says that your kid is likely to get the cold.

          • Jessica S.
            May 26, 2014 at 11:15 pm #

            The AAP also states: “Major methodologic issues have been raised as to the quality of some of these studies, especially as to the size of the study populations, quality of the data set, inadequate adjustment for confounders, absence of distinguishing between “any” or “exclusive” breastfeeding, and lack of a defined causal relationship between breastfeeding and the specific outcome. In addition, there are inherent practical and ethical issues that have precluded prospective randomized interventional trials of different feeding regimens. As such, the majority of published reports are observational cohort studies and systematic reviews/meta-analyses.”

          • Who?
            May 26, 2014 at 10:33 pm #

            Dr T hasn’t decided anything ‘for all women’. She’s reviewed the material and expressed an opinion.

            This site provides disinterested factual information about topics of importance around pregnancy, childbirth and feeding. The presentation is passionate-Dr T is impatient with promoters of activities that are objectively dangerous when they choose to hide or fudge the evidence about what they promote; she is also not afraid to point out hypocrisy when she sees it. She lets her feelings show and good on her-some of what she reveals is deeply disturbing.

            Some bloggers seem to be medicos, nurses or other medical professionals or scientists; others are interested bystanders; still others are interested in facts on the internet not nonsense.

          • Jessica S.
            May 26, 2014 at 11:13 pm #

            Yeah, it’s not just her opinion. These studies about benefits draw associations but associations don’t equate to causality.

          • Fertile Myrtle
            May 26, 2014 at 5:00 pm #

            You are making so so many assumptions. Somehow I’ve offended you because I said that there multiple ways to go about breastfeeding and the costs can be quite different high/low. I didn’t say there was a hierarchy associated with the costs. Someone said they grandparent breastfed 9 children, I bet they weren’t spending $2000 each time on Pumps/Boppys & LC’s. My ONLY point regarding this was that you shouldn’t generalize that breastfeeding costs are high for everyone. However, formula does have a direct cost, always. For my mother, breastfeeding was practically free. For me, well not so much.

          • Amy Tuteur, MD
            May 26, 2014 at 5:48 pm #

            No, you offended people because you implied that OTHER women’s needs weren’t needs that you had and therefore aren’t valid needs.

          • Fertile Myrtle
            May 26, 2014 at 5:55 pm #

            NO, I said there are choices with breastfeeding cost. I did not say that I think any of them are more or less valid, not my judgement( or anybody else’s) to make. Dr Amy, I have paid for bottles , micro steam cleaning bags, pump membranes, storage bags etc. ALL I’m saying is that that might not be necessary for everyone, we all make our own decisions
            This is just getting to be silly honestly.

          • S
            May 26, 2014 at 6:14 pm #

            I think this is a great explanation of why Myrtle got piled on. I agree that she managed to invalidate a lot of people’s experiences — and that deserves to be called out even if it was accidental.

            But, regarding your comment below, why the assumption of intent? I’m very uncomfortable with all the mind reading flying around in this thread.

          • Jessica S.
            May 26, 2014 at 11:09 pm #

            “Someone said they grandparent breastfed 9 children, I bet they weren’t spending $2000 each time on Pumps/Boppys & LC’s.”

            If anything, it certainly speaks for the power of advertising breastfeeding accessories!

          • Trixie
            May 26, 2014 at 10:16 pm #

            Is your disqus acting up? I’m defending Lion, not Myrtle.

          • Lion
            May 27, 2014 at 4:50 am #

            I didn’t insist anything, I made one comment.

          • Lion
            May 26, 2014 at 1:31 pm #

            Quite correct

          • Lion
            May 26, 2014 at 1:30 pm #

            No. The comment was on how expensive storage bags are, I replied that they aren’t a necessity. You can pump at work without them. I then mentioned other cheaper options

          • The Bofa, Being of the Sofa
            May 26, 2014 at 1:36 pm #

            And I still want to know, if they aren’t really necessary, then why do so many working women use them? OK, they aren’t “necessary” but they are “very, very helpful”?

            Kind of like running water. It isn’t necessary. It just is very helpful to have them.

            I get tired of dismissing people’s actions because someone, somewhere asserts they “aren’t necessary.” Damn it, let’s ask those women who use them how necessary they think they are.

          • Trixie
            May 26, 2014 at 1:41 pm #

            Seriously, you’re overreaching here. Remember, she’s from another country where the bags are probably way more expensive than here, and quite a few things are different. She came here to ask questions and learn, she hasn’t been the least bit sanctimonious. Don’t drive her away — I love it when we get perspectives from around the world, and we certainly don’t have many African commenters.

          • Lion
            May 26, 2014 at 1:47 pm #

            Maybe they like them? I didn’t dismiss anyone’s actions, you assumed that. They don’t add a huge amount of convenience’ but that depends on the person, not like running water does. You really are trying to start an argument. I made an observation which clearly pushed your buttons. Personally I don’t find driving a Mercedes a necessity, my Toyota is just fine.

          • The Bofa, Being of the Sofa
            May 26, 2014 at 1:58 pm #

            You think they are a luxury, then?

            See my description below. We had three options
            1) Feed our son maybe one feeding of breastmilk and then two bottles of formula (because my wife couldn’t pump enough to provide a full day’s worth)
            2) Have my wife stay home, or
            3) Pump as much as possible ahead of time and store it for when we would need it.

            These were our options.

            Your Toyota isn’t necessary. You could walk everywhere. Oh sure, it would suck royally and be a total pain in the ass in your life, but hey, you don’t NEED a car at all.

          • Lion
            May 27, 2014 at 4:47 am #

            Ah, so you are offended by my suggesting that storage bags wren’t the only way to store frozen milk because of your own personal situation. I breastfed and used formula. I don’t have some agenda to drive. I have been reading this blog for a long time and only recently got the confidence to start asking questions, as I would see so many people being jumped on like this for asking something that they didn’t understand or expressing a different point of view. Perhaps you should not assume that every question anyone asks is to denigrate other people’s choices, but that perhaps they don’t have the knowledge and information you do, or live elsewhere where things are different. I find this blog really interesting and have enjoyed learning and reading the comments where discussion takes place, even comments from you, which are usually not so nasty. I’m not a health care worker, I don’t live in the USA, when I ask a question or make a statement, it is not with some hidden agenda. You have completely misinterpreted what I said. You might have needed storage bags in your wife’s situationbut they are not a necessitsy for every mother. Just because that was the choice that your wife made does not mean it is the choice that every mother makes – her needs might be different. You can keep on arguing if you like, but I’m no longer going to respond on this particular thread. I’ve said all I have to say on the matter and arguing is not resolving anything. I will carry on learning what I can on this blog, I enjoy the factual content, and I’ll carry on commenting where I have something to ask or to say. If that offends you, I’m sorry you feel offended, but I’m not going to be beaten down by you.

          • araikwao
            May 27, 2014 at 8:11 am #

            I think you’re fine there, Lion 🙂

          • Irène Delse
            May 27, 2014 at 8:33 am #

            I agree with araikwao. Please stick around, Lion, it’s good to have perspectives from different places and people with varied experience.

          • S
            May 27, 2014 at 10:24 am #

            Eh, that’s just Bofa. He won’t let anything go.

          • araikwao
            May 27, 2014 at 5:47 am #

            Um, you’re sounding unnecessarily snitchy today, Bofa.

          • the wingless one
            May 26, 2014 at 1:39 pm #

            I bought milk storage bags that were BPA free since the milk had to be heated in the bag. It was the reason I didn’t want to use the regular plastic sandwich bags even though we always have plenty around. As someone who had a freezer full of the storage bags, I would have had to buy an entire extra freezer or two to hold the equivalent in ice cube trays, not to mention how much I would have had to spend on ice cube trays (and the annoyance of having to sterilize them). Glad your system worked for you and storage bags weren’t a necessity but it would have been a HUGE pain in the ass for me any other way.

          • fiftyfifty1
            May 26, 2014 at 6:37 pm #

            “Milk storage bags aren’t a necessity for working and pumping moms though. Using milk from today for tomorrow . . .”

            Actually it really depends on the person! Many women experience a big decrease in milk production once they go back to work. They are not able to pump enough milk today for the amount their baby needs tomorrow. So many/most women who plan to go back to work stockpile ahead of time. This stockpile obviously must be frozen. This brings up the question of what to store the milk in. Many daycares have a policy of only accepting milk in the container from which it will be fed. You could choose baby bottles, but obviously that would be very expensive. So your other choice is plastic bags that can be attached to a nipple (Playtex I believe is the main brand). So that is the reason women often use breastmilk bags. See, it’s not out of a desire to be “fancy” as Fertile Myrtle suggests, or even out of convenience. It may actually be the cheapest option that the daycare will allow.

            Now I myself lucked out and found a nice in-home daycare where they let me bring in a week’s worth of frozen milk at a time. That was nice because I hated to thaw the milk the night before because my baby was hard to estimate due to his severe spitting up/vomiting. If I thawed too much I would have to toss it, or if I didn’t thaw enough my baby would go hungry. Instead they just thawed it there as needed. I stored my stockpile in re-used glass jars. Lactation consultants say you are not supposed to use glass because the antibodies are sequestered by glass which has polar molecules unlike plastic. But who the hell knows if that is true, so I did it anyway. But in any case, those jars were really space consuming (unlike the bags) so I did need to buy a separate freezer. But I lucked out and found one at a garage sale. But my story is the exception to the rule–most women who stockpile end up needing to use bags.

          • Jessica S.
            May 26, 2014 at 11:03 pm #

            My sister in law ended up needing to buy a separate freezer, too. Another cost!

          • Lion
            May 27, 2014 at 4:36 am #

            That is what I was trying to say. It does depend on the person. Some like to use them and some don’t. They’re not essential, you can do it without. Some prefer to use them some don’t. The little bits I needed to freeze went into ice cube trays with lids so they were stackable, then the frozen blocks went into sandwich bags with a date on them. I never had more than two or three bags like that. Many of my friends did use the special bags, many didn’t. Most of the people I know expressed on one day, took the milk home in a cooler and it was fed to baby the next day. That is what I did mostly. Different mothers needs are different. I’m quite horrified by the way what I said about bags not being a necessity was attacked by Bofa on the Sofa, as if I was saying no woman ever needs them. All I said was that they weren’t essential and shared another option. You shared other options here too. I hope you don’t get attacked for it too.

          • fiftyfifty1
            May 27, 2014 at 8:28 pm #

            “That is what I was trying to say. It does depend on the person. Some like to use them and some don’t. They’re not essential, you can do it without.”

            No, you really don’t get it. It’s that they ARE essential for some women. Just because they weren’t essential for YOU, doesn’t mean other women’s situations are the same as yours. I myself could never have kept up with my babies’ needs just pumping day to day like you did. I was able to avoid the bags ONLY because the in-home daycare I used was lax with rules. If I hadn’t been lucky with my mother having a friend who did unlicensed daycare, and if I hadn’t been lucky with finding an affordable freezer at a garage sale, I too would have been basically forced to use the freezer bags. I agree with Bofa, not you.

          • Lion
            May 28, 2014 at 4:05 am #

            For SOME women – not all women. Just because they were essential for YOU doens’t mean that all other women’s situations are the same as yours.
            We’re just talking in circles here.
            I’m in a developing country. We can only get those bags from baby shops and they are extremely expensive. As a working and breastfeeding mother who volunteers helping mothers in low socio economic circumstances to breastfeed (because of risks of malnutrition from diluting formula to stretch it and of death from diarrhea because of lack of clean water and no facilities to sterilise with) when mothers see adverts for these bags and think that not having them means they will have to formula feed when they know they can’t afford to, I do explain to them that there are other ways to store their milk. These mothers might not have a freezer at home or even a fridge, but the day care usually has one or their place of work has one.
            Perhaps in a country where everyone can afford such items, they might be seen as a necessity for every working mother who breastfeeds (personally, for my shortfall I used formula) or at least add enough convenience.
            I don’t think that it is fair and reasonable to assume that no working mother can pump and breastfeed without specialised storage bags though. When I had my first child these weren’t even avaiable in our country. When I had my second, they were, but when I saw the price, I thought that money was far better spent on paying for a good nanny for my children while I’m at work.
            I’ve been trying to say that different people have different needs and make different choices based on what their needs are.
            Where I live, formula is very expensive, even taking costs of what some consider to be necessities into account for breastfeeding doesn’t make the costs comparable. We get 4 months of maternity leave here, and our right to express milk at work is protected, so many mothers who are breastfeeding while on maternity leave can continue to do so while at work – most use a manual pump or hand express, some can afford electric single pumps and a lucky few can afford double electric pumps (i had one and because of my breast reduction I found it a necessity, but I would never tell someone else that they can’t work and breastfeed without one – or without storage bags).
            Perhaps for mothers in the USA it is impossible to work and breastfeed without storage bags, but where I’m from, they’re not a necessity in every situation.

          • fiftyfifty1
            May 28, 2014 at 8:18 am #

            This thread started with the tired old claim that Breastfeeding is Free. When women write in to tell their own stories of how breastfeeding wasn’t free for them and then list the costs, lactivists jump in and accuse them of doing it too fancy and implying that the costs they incurred reflect ignorance or being spoiled, and then explain the simple way of doing it that the ignorant mother should have used.

            Everyone is aware that breastfeeding bags are not used by most of the world. But you don’t seem to understand that not everyone lives in South Africa.

            It’s as if I wrote that sewer systems were free. Someone might reply “Well, it’s not free fo