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?

  • Rozmin

    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.

  • EM

    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

      Birthing on the bathroom floor. How romantic.

      • Amy M

        And clean.

        • Young CC Prof

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

      • EM

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

    • Amy M

      Ha! She said “milk.”

  • Guesteleh

    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

    • pj

      Thank you!

  • OldTimeRN

    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.

  • Amy M

    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

      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

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

        • Trixie

          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.

            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

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

          • Jessica S.

            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

          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

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

          • 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

            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

            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

        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

          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.

          • 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

            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

            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

            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

            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

            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

            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

            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

            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

            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

            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.

          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

            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

            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

      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

      Great point!

  • MLE

    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

      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

        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

          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

          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

            “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

            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

          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

            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

            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

          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

          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

          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

      Hear, hear!

  • Jessica S.

    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

  • yentavegan

    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.

      I love this and your honesty. 🙂

    • Bombshellrisa

      THIS. IS. AWESOME. Thank you.

    • NoLongerCrunching

      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.

  • Anna T

    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

      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.

        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

        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

          Wow, that’s a good idea!

        • Renee

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

        • Starling

          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

        “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

          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

            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

            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

            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

            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

            Right, agreed.

    • Renee

      Does the death count come close to HB?

      • Bombshellrisa

        Maybe if you leave out Colorado and Oregon

        • AmyP

          Nah, just leave out Portland.

  • Bombshellrisa

    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.

      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

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

      • NoLongerCrunching

        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

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

  • Sandy

    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

      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

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

    • Stacy48918

      “If you can’t hack”?

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

      • Jessica S.

        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

          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

            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

            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

        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.

      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

      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?

      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

      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

        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

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

        • theadequatemother

          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

            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

            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

            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

            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

            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

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

        • Irène Delse

          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

          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

          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

          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

          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.

          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?

            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

            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

      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

        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

      Who is knocking anyone who breastfeeds?

    • S

      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

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

    • LibrarianSarah

      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

        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

          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

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

          • Renee

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

          • Life Tip

            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

            I don’t even know what that means.

          • Irène Delse

            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

            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

            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

            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

            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.

            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

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

          • Mariana Baca

            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

            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

            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

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

        • Bombshellrisa

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

    • LM

      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.

        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

          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.

            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

      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

        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

          Depends how bitey the little buggers are.

    • lilin

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

    • NoLongerCrunching

      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

      TYPICAL LACTOFACIST!
      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?

      Signed,
      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

      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.

  • Sherri

    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

      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

      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.

        It says she’s from TX, I think.

        • Bombshellrisa

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

          • Jessica S.

            Disqus really likes to do that crazy stuff!

          • Joy

            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

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

          • Bombshellrisa

            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

      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.

        Well put. 🙂

    • Jessica S.

      *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

      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

      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

        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

      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……

      • OBPI Mama

        Completely life changing.

    • Beth S

      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.”

  • Fertile Myrtle

    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

      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

        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

          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

            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

            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

            Do YOU think it is atypical?

          • Fertile Myrtle

            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

            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

            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.

            No kidding!! Not worth the stress.

          • Joy

            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

            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.

            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

            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

            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

            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

            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

            Come on – not even one teensy tiny little study?

          • Fertile Myrtle

            I would start my search here.

            http://www.ncbi.nlm.nih.gov/m/pubmed/?term=breastfeeding+benefits

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

          • Stacy48918

            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

            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?

            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

            You bet I vaccinate.

          • S

            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

            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

            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

            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

            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

            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

            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

            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.

            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

            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?

            http://www2.aap.org/breastfeeding/PolicyOnBreastfeeding.html

            Benefits

            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?

            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

            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

            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

            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

            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

            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

            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

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

          • The Bofa, Being of the Sofa

            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

            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.

            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

            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.

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

          • Joy

            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

            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

            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

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

          • The Bofa, Being of the Sofa

            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.

            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

            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

            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

            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

            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

            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

            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

            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.

            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

            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

            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

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

          • The Bofa, Being of the Sofa

            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

            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

            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

            I understand what you are saying and completely agree.

          • The Bofa, Being of the Sofa

            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

            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

            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

            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

            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

            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

            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

            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

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

          • Bombshellrisa

            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.

            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

            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

            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

            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

            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?

            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

            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

            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

            Ha!

          • NoLongerCrunching

            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

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

          • KarenJJ

            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

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

          • Joy

            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

            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

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

          • The Bofa, Being of the Sofa

            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

            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

            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

            Sounds like a lipase issue.

          • The Bofa, Being of the Sofa

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

          • Trixie

            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

            Assuming that was even the problem…

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

          • Siri

            You’d obviously brominated it without meaning to.

          • S

            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

            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

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

            huh?

          • Jessica S.

            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

            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

            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.

            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.

            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

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

          • Renee

            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.

            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

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

          • Bombshellrisa

            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

            Under ACA, all insurance covers pumps.

          • Bombshellrisa

            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

            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

            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

            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

            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

            “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

            I cannot ever “like” this. Ouch.

          • Fertile Myrtle

            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

            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

            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

            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

            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

            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

            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

            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

            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

            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

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

          • Fertile Myrtle

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

          • Irène Delse

            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

            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

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

          • The Bofa, Being of the Sofa

            What negative comments are you referring to?

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

          • Bombshellrisa

            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

            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

            “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

            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

            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

            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

            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

            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.

            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.

            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?

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

          • Renee

            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

            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

            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

            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

            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

            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

            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

            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

            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

            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

            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

            Yes, they recommend breastfeeding.

            But where are those large benefits?

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

          • Fertile Myrtle

            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?

            http://pediatrics.aappublications.org/content/129/3/e827.full

            http://m.pediatrics.aappublications.org/content/129/3/e827/T2.expansion.html

          • Young CC Prof

            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

            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.

            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

            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

            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.

            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

            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

            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

            Who’s criticizing?

          • S

            Perhaps i misunderstood what you mean by being “fancy.” What did you mean?

          • Fertile Myrtle

            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

            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

            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

            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.

            Good point!

        • Trixie

          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.

            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

            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

            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

            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

            Nah, some company can just refuse to have it in their insurance plans due to religious reasons.

          • Jessica S.

            Well, exclusive breastfeeding *can* be considered a form of birth control, however imperfect. So, there’s that.

          • Lion

            Said a few of my friends with children eleven months apart…

          • Jessica S.

            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

            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.

            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

            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.

            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

            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

            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

            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.

            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

            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.

            Thanks, Siri! That’s a great idea. I’ve read a few posts there and found them riveting. 🙂

          • Trixie

            Yeah, because HBACs are very risky, as we know. Jeevan writes about some of the horrible VBAC cases he’s seen.

          • Bombshellrisa

            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

            I realize there are gaps that people can still fall though. I’m sorry you didn’t qualify.

          • Bombshellrisa

            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

          http://www.nwlc.org/resource/how-find-out-if-your-health-plan-covering-women%E2%80%99s-preventive-services-no-co-pay-required-he
          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

            Thank you!

          • Trixie

            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.

            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

            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.

            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

            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.

            I *am* in King County!! Do obstinate 3.5 year olds qualify? I have that in spades. 😉 What organization offers this?

          • Bombshellrisa

            It’s in Seattle parent! http://m.cooperhouse.org/fussybaby.php

          • Jessica S.

            Thanks so much! I’m going to keep this handy. 🙂

          • Bombshellrisa

            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.

            I did the same – I was SO impressed. They have an awesome mission.

          • Renee

            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

            “There is also a service . . .for fussy babies. ”

            Brilliant idea!

          • Renee

            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.

            Preach it!

        • 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

            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

            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

          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

            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

            I was lucky-
            Formula was low cost for us because of WIC. It really cut the cost down.

          • Young CC Prof

            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.

            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

            “Why does it have to be all or nothing?”

            It doesn’t.

          • Lion

            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

            I couldn’t do it modestly in a sports bra. Also, sports bras are so tight that it would have been painful

          • theadequatemother

            I can’t even picture how you’d do it in a sports bra!

          • Irène Delse

            If someone has very small breasts?

          • Bombshellrisa

            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.

            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

            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

            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

            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

            That answers my question. Thank you!

          • Jessica S.

            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

            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.

            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

            =)

          • Jessica S.

            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.

            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

            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.

        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

          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

            Part of me is grateful for those coupons they send in the mail, it’s made a huge difference buying formula

          • Jessica S.

            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

        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

          “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

            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

            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

            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

            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

            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.

            It’s Big Breastfeeding! They get you with all their claims! 😉

          • fiftyfifty1

            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

            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

            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

            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

            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.

            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

            “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

            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

            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.

            I’m dying at this comment, quite hilarious! (Sorry, I’m not laughing at your predicament – just your colorful way of telling it! :))

          • Kelly

            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

            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

          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

          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

            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

            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

          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

        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

          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

            My same thought.

          • Jessica S.

            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

        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

          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

            Milk storage bags aren’t a necessity for working and pumping moms though.

            So those working moms who use storage bags are wrong?

          • Trixie

            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

            Holy smokes I am envious of your supply!

          • Trixie

            It’s not all fun and games having an oversupply, trust me! But I’m glad I could help a few preemies.

          • MLE

            I’m sure, the grass is always greener!

          • The Bofa, Being of the Sofa

            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

            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

            Quite correct, that is exactly what I meant.

          • The Bofa, Being of the Sofa

            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

            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

            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

            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

            Or to use BPA containing plastic.

            But hey, it isn’t necessary…

          • MLE

            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

            Confused Myrtle with Lion as they seem to be making a lot of the same points.

          • Amy Tuteur, MD

            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

            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

            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

            Breast feeding doesn’t PREVENT colds. Oh heck, maybe I was doing it wrong.

          • Fertile Myrtle
          • Bombshellrisa

            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

            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

            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

            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

            “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

            “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.

            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

            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

            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.

            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?

            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.

            Yeah, it’s not just her opinion. These studies about benefits draw associations but associations don’t equate to causality.

          • Fertile Myrtle

            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

            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

            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

            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.

            “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

            Is your disqus acting up? I’m defending Lion, not Myrtle.

          • Lion

            I didn’t insist anything, I made one comment.

          • Lion

            Quite correct

          • Lion

            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

            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

            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

            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

            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

            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

            I think you’re fine there, Lion 🙂

          • Irène Delse

            I agree with araikwao. Please stick around, Lion, it’s good to have perspectives from different places and people with varied experience.

          • S

            Eh, that’s just Bofa. He won’t let anything go.

          • araikwao

            Um, you’re sounding unnecessarily snitchy today, Bofa.

          • the wingless one

            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

            “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.

            My sister in law ended up needing to buy a separate freezer, too. Another cost!

          • Lion

            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

            “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

            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

            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 for us. I have to buy toilet paper, and occasionally pay the plumber when the pipes have trouble, and then I need to pay the monthly sewage bill and the monthly water bill, so for me it isn’t free.” And then the original writer would reply “Don’t you realize that people stooled and urinated even before the invention of toilets and it was free then and it’s free for me where I live, and let me tell you how I just go outside to relieve myself, and the leaves we use to wipe that grow around here, and you should too”.

          • Lion

            And you need to realise that not everyone lives in the USA.
            Assumptions were made about what I meant, I have clarified numerous times that this was not what I meant, but you keep banging on about what you think I said.
            Not every mother in every situation needs milk storage bags. You can talk around in circles all you like – it doesn’t change that. Yes, some mothers do see them as a necessity.
            Lets have a look at needs and wants:
            needs – flush toilets, electricity, running water, food, shelter, clothing, medical care and so on. These are things peopole protest about and burn tyres about if they don’t have. These can be necessary for life or dignity or preventing disease.
            Lets have a look at wants: a flush toilet with differentiated flushing mechanism to save water depending on what needs to be flushed, dimmer switches on the lights, brand name clothing.
            If breastfeeding will cause such problems and costs for a mother in a developed country that she has to be expensive milk storage bags and extra freezers, why does she not just use formula to make up the balance of what she can’t store or pump? (the clue that I might not be a lactivist might be hidden there in plain sight by the fact that this is what I did) – by sharing that am I saying it is what every mother should do? No, I am not. I’m saying that when faced with that situation, it is what I did.
            I am quite happy with stainless steel cutlery and don’t need to use gold cutlery, but you know, just because you find the superior taste from the gold cutlery because the metal sheds fewer molecules doesn’t mean it is so for everyone. Just because you find that toilets with a dual flushing mechanism are a necessity in your house doesn’t mean they’re a necessity in my house. To tell anyone who claims otherwise that they’re being sanctimonious (which is the impression I am getting is what you are trying to say about me) is rather disingenious.
            Every point you make to rebutt what I say can be turned to rebutt what you say, it is a silly argument – it is just going around in circles.

          • fiftyfifty1

            “And you need to realise that not everyone lives in the USA.”

            This all started when TG shared with Fertile Myrtle that in her country (Israel) breastfeeding bags cost more than formula, and therefore for many women in Israel formula works out to be more economical for their families. That’s where you jumped right in and told her “Milk storage bags aren’t a necessity for working and pumping moms though” and told her that YOU had never used storage bags as if her point were not valid, as if she did know her own country, her own circumstances.

            It’s nice that you coach women on combining work with breastfeeding where you live. That does not mean that your advice translates across borders, or that unsolicited tips and critiques are always welcome.

          • Lion

            Actually, I was not saying that because I didn’t use them they weren’t necessary for any mother to ever use. I just shared that there were other ways to do this and what I did.
            Some mothers may of course find them a necessity, I never said that wasn’t the case. However, there are plenty of mothers who combine working and breastfeeding without them and without any undue hardship or lack of convenience in doing so – making the product not be a necessity for working and pumping. Some mothers might still find that they cannot navigate this situation without the pumping bags and I have not said that they should even try. All I did was share my experience, I did not belittle anyone elses needs or experiences. I’m not talking about Israel – I don’t know how long their maternity leave is, what protection they have for expressing time at work. In the UK mothers have maternity leave of a year, so hardly any mother needs to pump milk there so their situation is quite different. It is you and Bofa who are claiming that your experiences mean that every mother has the same experience. I have not claimed that at any point. We can keep arguing if you like, I’m enjoying it and have plenty of time sitting watching my children at rugby and ballet and horse riding to tap away at my iPad, you’ll just have to excuse the typing as I find the glass difficult to type on so make a lot of spelling errors. (No, I’m not saying that nobody should therefore ever use an iPad because I find mine difficult to type on)

          • Lion

            Trixie seems to have understood what I was saying:

            Trixie The Bofa, Being of the Sofa•3 days ago

            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.

          • fiftyfifty1

            I think you’ll find that Trixie is a generally nicer and more understanding person that either myself or Bofa.

          • The Bofa, Being of the Sofa

            For SOME women – not all women.

            But no one has suggested otherwise. No one has ever said, “All working women need milk bags.”

            However, YOU have made the claim that “milk bags aren’t necessary.”

            The problem is that it is wrong. There are many cases where milk bags ARE necessary. For everyone? Of course not, but clearly for some.

            So stop telling women who have had to use milk bags in their own circumstances that they didn’t have to.

          • Lion

            No, that is what you assumed I said. What I was saying was that they are not a necessity (they are not always necessary – it is possible to do without them without massive inconvenience). I am not telling women who needed to use them in their circumstances that they didn’t need to – you are trying to tell me that is what I said, when it isn’t. Going on like a stuck record doesn’t change what I was saying.

          • Lion

            Trixie seems to have understood what I was saying:

            Trixie The Bofa, Being of the Sofa•3 days ago

            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.
            But please, go on stating that what you think I said is what I said. Perhaps go back and re-read it and find the part where I said that no mother would ever need or want to use storage bags. As I don’t think that and never meant that, I doubt you’ll find it.

      • Starling

        That’s not necessarily the case for most of us, though–three 40 oz boxes of Walmart’s generic formula would run about $70 and be enough to feed a normal infant for a month. If you’ve got special nutritional needs and require more expensive formula, then you’re paying more–but the same is true if you have unusual breastfeeding needs or concerns.

        In comparison, my electric pump (non-hospital-grade, not covered by insurance) was $250 and my very cheap nursing bras were about $50. That right there is the equivalent of four months’ worth of formula.

      • the wingless one

        Not sure how expensive Neosure is relative to others since that is all we ever used (late term preemie) but I’m assuming since it is a name brand specialty formula that it’s probably not one of the cheaper ones out there. Two six-packs of the 13.1oz canisters lasted my son a month and then some at his peak milk intake prior to switching to whole milk. I just looked up our last shipment from Amazon back in February and it was $96.12 for the 12 cans. Not cheap and definitely a sticker shock when we first switched from breastfeeding but also not “hundreds a month.”

    • OldTimeRN

      Because for all the mantra of breast is beast some wonder, is it? Where is the real proof breast is better then formula? I nursed one if my children for a few months, then switched to formula. My other children had no breast milk. My child who received breast milk needed tube in his ears for frequent ear infections. My non breastfeeding children never had ear infections. So for me personally, which is really what it should come down to(a personal decision) breast wasn’t best for my kids.

    • Sullivan ThePoop

      No one has to try and claim the benefits are very small in developed country because they are. No one here hates breastfeeding so it is not the same at all as formula haters. What a lot of people here disagree with is lactivists who push women to breastfeed and not supplement at all even if their babies are failing to thrive and using data from developing countries to shame women in developed countries.

    • Renee

      Because the benefits ARE minimal! All the good studies have shown this- PROBIT and the recent sibling study. Once younremove the cofounders, those differences go away.

      BF is only cheap if you are already home all day. If you miss work for it, take time off, or need to pump at all, those cost savings disappear, and opportunity costs rise.

      • Jessica S.

        Exactly. In fact, I was reading over something the AAP put out recent and they have this to say about the studies:
        “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.”

        Of course, directly after this they launch into all the reasons these studies say BFing is better. It’s a bit frustrating.

    • MaineJen

      …Have you ever visited a “baby friendly hospital?” Because they are pretty off-putting as well.

  • Jocelyn

    OT: My friend just had a miscarriage this weekend. She was about four months along. 🙁

    • InvisibleDragon

      Poor thing! That’s so sad. I hope she’s doing okay. Physically, I mean.

  • Jessica S.

    Off Topic: Thought I’d follow up, the 3-hour glucose tolerance test I took yesterday was negative – yea!! So we just grow big babies, which we suspected anyhow. 🙂 The test was not at all bad, except I grew tired of waiting around. I didn’t really feel too sick or dizzy! Thanks everyone who shared their experiences, and also the great info and discussion on GD in general. I have gained a new respect for what it’s capable of doing to baby and mom, so I’m glad we tested to be safe.

    Even after all the blood draws and dumping sugar on an empty tummy, the thing that hurt most/longest (still hurts!) was the pertussis booster shot and residual soreness. Anything to protect the little one until she can get her own shots!

  • Susan

    Not sure exactly how this fits in to the discussion but a friend posted this link on Facebook. I thought the regulars ( or even not regulars ) might find it interesting and on topic.

    http://bfmed.wordpress.com/2014/04/09/should-the-aap-sleep-alone/

    • NoLongerCrunching

      http://m.bmjopen.bmj.com/content/3/5/e002299
      http://www.ncbi.nlm.nih.gov/m/pubmed/21669892/

      I’d love to hear people thoughts on the above two studies. One shows that breast-feeding and cosleeping increase the risk of SIDS, and the other one shows that it decreases it.

      Whatever the answer is, I do think parents need to consider whether lack of cosleeping is going to cause a mother to be dangerously overtired. Car accidents due to sleep deprivation that cause infant deaths would not be associated with sleep environment, but they can be.

  • Renee

    TINY is relative. It’s only small if you aren’t among the stats. The 8 or so babies lost each year in Oregon all have a mom, and a family. Every HB death leaves behind devastation. If it was a preventable one, it also leaves behind a massive load of self hatred and guilt.

  • Guest

    Has anyone mentioned the Chinese melamine-milk debacle?
    http://en.wikipedia.org/wiki/2008_Chinese_milk_scandal

    • OBPI Mama

      That really made my husband and I nervous. I told him that IF we had another baby, I would want to buy their year’s supply of formula while I was pregnant so if there was a recall, it wouldn’t harm him/her.

      • NoLongerCrunching

        My mom did exactly this for my nephew. Good thing he tolerated it ok!

  • Gene

    OT: interesting and sad article about a jailed woman who gave birth to a preemie alone.

    http://www.independentmail.com/news/2014/may/23/lawsuit-inmate-solitary-confinement-says-jail-igno/

    I noticed this sentence in the middle: “Just to let you know, I had to unwrap the cord from the baby’s neck, and as long as we don’t cut the cord, she’s gonna have some bit of oxygen to help her,” the lawsuit quotes Anderson as saying. ”

    Woo is just pervasive, isnt it?

    • Young CC Prof

      Arrest a pregnant woman for drug possession, leave her to deliver alone in a cell. Yup, drug prosecutions are doing a great job of protecting the unborn.

      • Jessica S.

        And drug addicts, for that matter.

    • Guestll

      This is so terribly sad. It would seem there were failures all around.

    • DaisyGrrl

      Reminds me of a story local to me: http://www.cbc.ca/news/canada/ottawa/inmate-s-rights-allegedly-violated-in-jailhouse-birth-1.1142465

      Woman in pretrial custody went into labour at 36 weeks. Transferred to segregation because her screams were disturbing the others. Staff only believed she was in labour when the baby’s FOOT was being delivered.

      Sad postscript: The baby died shortly after his first birthday from respiratory problems.

      • Guestll

        Ugh, I remember this (I’m in the GTA). Just horrible, that poor Mum and baby.

      • Young CC Prof

        I’m not excusing the staff in any way, but I have to ask. How often do pregnant women prisoners falsely claim to be in labor that the staff would act that way? Is it like a normal thing? Or are these particular staff just bad at their jobs?

        • DaisyGrrl

          This particular detention centre has had serious overcrowding problems for years (double and triple bunking are routine) so I imagine staff are overworked and spread too thin. That can lead to a culture of not caring. There was an internal investigation and, while the ministry didn’t release particulars, people were disciplined and dismissed.

          I suspect the normal protocol for pregnant inmates claiming to be in severe pain/labour is to transport to hospital for assessment by L&D. That someone was fired says quite a lot since these workers are unionized so would have had considerable protections if they were following accepted procedures.

  • Lion

    Necrotising enter colitis in premature babies and deaths from dehydration from diarrhea are attributable to formula where I live (the biggest killer of babies here is diarrhea from formula being mixed with water that hasn’t been boiled and in bottles and teats that aren’t clean) and failure to thrive from diluting formula too much to save money. Those aren’t just fewer colds. Is it different in developed countries?

    • Stacy21629

      Can you please provide us with numbers? The only way to make a valid comparison of risk is with numbers of deaths per 1000.

      I doubt that many people – even here – would disagree that in developing nations with poor sanitation babies benefit more from breastfeeding. And yet, it’s not the breastfeeding, per se. It’s that they aren’t exposed to poor sanitation. If the 100% breastfed infant plays in the drainage ditch, being breastfed doesn’t really matter.

      The water supply in developed countries like the US is very safe. But no one in the “formula kills babies” camp has yet to provide any statistical backup for their claims so who really knows?

      • Guestll

        It isn’t the “magic” of breastmilk per se that saves them but it is formula that kills them. It’s WASH but it’s also also dilution/underfeeding (a combination of reading comprehension and financial issues). The 100% breastfed infant who plays in a drainage ditch isn’t going to fare any better than the formula fed infant who does the same. But the formula fed infant is far more likely to be sick, small, and die before he can learn to play.

        • Stacy21629

          If I feed my child raw cookie dough and he gets Salmonella – is it the cookie’s fault? Should we discourage feeding children cookies?
          No, we discourage *improper* feeding of cookies (raw dough).
          The *formula* didn’t kill the baby. Improperly made formula did. If it was made and fed properly and sanitarily there would be no issue.

          • Guestll

            Semantics, but I know this is a sacred cow here, so…

          • Stacy21629

            No, it’s not just semantics. You said “it is the formula that kills them”. If I leave potato salad out on the picnic table all day and my entire family gets E. coli, it is not “the potato salad that kills them”. It’s the E. coli and improper sanitation.

            When you say “it is the formula that kills them” you are implying that something inherent to the formula itself is responsible when it’s not. You are inciting unnecessary fear of a product that saves baby’s lives – my own included.

            And wanting mothers to be provided with accurate information sans scare tactics is not a sacred cow. I breastfed my son for a year, was a regular LLL member, etc. However, I dried up early with my daughter, she was <8# at 4 months and needed formula. I have no particular preference one way or another. But women have a right to accurate information. Make your formula according to the package directions with clean water and it is safe. Deviate from the directions or use contaminated water and it is unsafe.

          • Guestll

            I’m not inciting fear, the relatively privileged women who argue back and forth on both sides of this issue manage to do that just fine on their own. It infuriates me that so much bandwidth is devoted to such a negligible issue, when a huge number of babies suffer the consequences of formula feeding elsewhere in the world.

            Formula is a sacred cow to some who post here. I’ve said it before and I’ll say it again, I don’t care how women in developed countries choose to feed their babies — formula, breast, combo, it makes little difference over the long haul. In developing countries, the same choices on a population level are a matter of life or death for babies. You’re being disingenuous if you don’t think there’s a lot of “and/but” mitigating/watering down that gets played out in the comments by women eager to defend the choice to formula feed.

          • Stacy21629

            “In developing countries, the same choices on a population level are a matter of life or death for babies.”
            And I’ve acknowledged that – at least twice.

            You’re being disingenuous if you can’t recognize that 1st world lactivists like the flouncing poster below don’t try to equate 3rd world deaths due to improper formula use to 1st world formula use in their attempts to discourage the choice to formula feed.

          • Guestll

            I’ve said more than once that I hate that the two get conflated. I see what she’s doing. But I’ve also seen the pro-formula folk (for lack of a better descriptor) doing the inverse as well to get their point across.

            “Lion” above is from a developing country and asks a question about formula as it relates to infant deaths in his/her country (NEC and FTT) compared to a developed country. Did you answer it? Or did you jump to “show me the evidence”?

          • Irène Delse

            Lion’s question was about the difference made by formula use (and its dangers) in different countries. Several people did answer correctly that it’s not the formula per se that kills, but the intractable need for clean water and the relative price of formula compared to a family’s budget. You did mention the sanitation issue, but managed to muddle things by saying “it’s the formula that kills them”… As if it was poison. As someone (Mariana Baca IIRC) pointed out here, developing countries are not a solid block, there are also middle class people there who can afford to use formula safely, boiling bottles and filtering water as needed.

          • Guestll

            Thanks for proving my point.

          • Guestll

            And just because a percentage of people in less developed countries can use formula correctly doesn’t negate the amorality of formula companies marketing and lobbying in less developed countries. Which was actually the context of that discussion.

          • Irène Delse

            Oh, I see, you’re still on the Ellen Mary page? It was her who brought up formula marketing in the first place (completely missing the point of the original article btw). But not what Lion asked.

          • Guestll

            No, this has nothing to do with Ellen Mary. The comment you referenced by Mariana Baca was from a few days ago.

          • Irène Delse

            A day or three, it doesn’t make a difference, does it? But nitpick if you want.

          • Guestll

            ?

            Irene, you pointed out the following upthread: “As if it was poison. As someone (Mariana Baca IIRC) pointed out here, developing countries are not a solid block, there are also middle class people there who can afford to use formula safely, boiling bottles and filtering water as needed.”

            And then threw Ellen Mary’s comments on this thread into the mix.

            I’m not nitpicking, I’m pointing out that these were two separate and distinct conversations.

          • Irène Delse

            ‘GuestII’, I’ll be charitable: try going back to the beginning and read again what I wrote and what you wrote.

          • Guestll

            No thanks, Irene. Enjoy your night.

          • Irène Delse

            Great, a flounce. What a surprise.

          • Guestll

            I’m not flouncing, Irene. I’ve been posting here for 3 years. I just don’t care to engage with you on this issue any longer. It’s no big deal.

          • DiomedesV

            The word “amoral” was generous.

          • Guestll

            It’s truly what keeps me up at night. It makes me sick.

          • Irène Delse

            Canned answer that has nothing to do with what I said. You seem to care more about getting the upper hand than to actually help breastfeeding mothers. I wonder what point it proves!

          • Irène Delse

            Funny thing is, lactivists often bemoan the marketing of their products by formula manufacturers, but they don’t campaign for independently funded campaigns of information on infant feeding, or the availability of infant feeding consultants… Alternative messages are good as long as they only go one way.

          • DiomedesV

            “You’re being disingenuous if you can’t recognize that 1st world
            lactivists like the flouncing poster below don’t try to equate 3rd world
            deaths due to improper formula use to 1st world formula use in their
            attempts to discourage the choice to formula feed.”

            So what if they do? It’s a stupid argument that the vast majority of people can see through easily.

            Whatever difficulty FF moms encounter in certain sub-cultures in the US, it is nothing compared to the devastation wrought by marketing formula to women in countries where the water supply makes it next to impossible to FF safely.

          • Irène Delse

            You know that “whatever your difficulties here, someone in the world has it worse” nothing more than a ‘shut up!’ response, right? Because in effect, it means you can’t talk of any issue less important than gruesome, imminent death.

          • DiomedesV

            Irene– I am specifically referring to the whining–yes, whining–about misplaced arguments tying formula use in the developing world to problems in the developed world. It’s a stupid argument. We don’t all have to get our panties into a twist over every insult, no matter how absurd. Especially when it leads us into semantic arguments that effectively minimize the very real devastation wrought by formula feeding where water is not safe.

            I am not denying that FF moms can experience problems in *some* parts of the developed world. And it’s not right. Although where I live, FF is the norm and it was not a problem for me at all.

            Not every statement by BF advocates is worth getting upset about.

          • Jessica S.

            Sorry, still going to disagree b/c it’s not to much to expect advocates to contextualize their arguments. Not for my sake, but for the sake of reasoned argument. I mean, what else am I to assume, if someone is trying to argue I’m putting my kids at risk b/c of the increased likelihood of diarrheal illness due to formula feeding, but that they don’t understand that which they are arguing? So it does matter.

            I do, though, understand the argument you are presenting, but just b/c it doesn’t qualify as a big deal in your mind, doesn’t mean that’s the case across the board.

          • Jessica S.

            I have to agree with Stacy – it’s not really semantics, it’s more accurate to say incorrect methods of formula feeding kills them. The formula itself does not. It’s important b/c breastfeeding advocates are often hellbent on label formula as poison.

          • Trixie

            Almost — except it’s not just the sanitation of the formula, it’s the other immune factors in breastmilk as well.

        • Lion

          Thanks, that makes sense.

      • Lion

        I don’t have numbers. I just see the information our dept of health sends out in the media about causes of death and diarrhea is apparently the biggest cause of death in infants. Drowning increases as children get a little older. I see what you’re saying though, it makes sense. I also see I spelled entercollitis incorrectly.

      • Trixie

        It’s not *just* the clean water, though. If a baby happens to acquire diarrheal illness, and is formula fed, it is more likely to get severely ill, because breastmilk has other antibodies that are protective. It’s not just the lack of bacterial contamination, it’s the ability to help fight the illness. Preventing the infant from getting dehydrated is more important if no hospital is readily available.
        Again, the long-term solution here is better sanitation, vaccination, and clean water, so everyone can choose for herself. But breastfeeding exclusively can save many lives right now in many areas of the world.

        • Irène Delse

          Better nutrition, sanitation and vaccines would not only help with choice, it saves lives.
          The antibodies in breastmilk are better than nothing at least. Though I wonder if the WHO recommendations take into account that babies exclusively breastfed by mothers who don’t have enough milk (a serious problem if she suffers from malnutrition) will have a weakened immunity too.
          I’m thinking about programs like what was implemented in Brazil in the early 2000s: providing additional food to women who breastfed, and giving economic incentives to parents who brought their babies in for vaccination and check ups. They experienced a considerable decrease in infant mortality even in the poorest areas. I don’t have the link right now but it was very encouraging.

          • Young CC Prof

            There are a lot of programs that are working. Keep in mind, infant mortality in sub-saharan Africa today is substantially lower than it was in the USA a mere 100 years ago, and it’s fallen by half in a generation. There’s a lot more work to be done, but don’t lose sight of the fact that much of what’s already been done IS helping.

      • pj

        I keep wondering what happens if a baby dies because its mother is unable to breastfeed. Did this baby die because of breasteeding?! What then is the death count for breastfeeding? Formula has saved thousands of babies’ lives!

        • Sarky

          (I have formerly posted as sarahh.rosanne @ gmail.com and do not mean to switch names but my DISQUS account has somehow been inaccessible) I have wondered about the number of infants who do not have access to safe formula whose mothers cannot produce sufficient (or any) milk. I had such difficulty breastfeeding my children, particularly with supply. I cannot say for certain that given no other possibility for nourishment I wouldn’t have been able to exclusively breast feed at some point. My first baby lost over a pound (born 6 lbs 10 oz, so not very large to begin with either) while I listened to lactation consultants talk about the impossibility of not producing enough milk. My second was able to maintain his birth weight with very little supplementation but my supply never increased with or even met his needs and decreased spontaneously at 6 weeks.
          I was very indoctrinated with the breastfeeding religion at one time and I did not believe it was possible to be unable to exclusively breastfeed (for, like, three years, in public, with a floral wreath). Lactivists would have you believe that there are no women with these problems (or more obvious structural issues that prevent lactation) in developing countries but they surely exist and it is horrifying to contemplate. When I Couldn’t feed my daughter I remember thinking that if I could cut open my breast to reach some small amount of milk, like a human cactus, I would have done so. I can only imagine not having the ability to find an alternative.

    • Guestll

      To answer your question, yes, it is different in developed countries. Babies in developed countries aren’t dying in droves from formula feeding. Water, sanitation, education, resources, infrastructure, geography, gender issues, it’s all very different.

      • Lion

        Thanks. Despite being a middle class mother Ina developing country, it can be hard to wrap my head around the divisiveness about baby feeding. I have breastfed, but used some formula too.

        • Guestll

          You’re welcome.

          I have middle class colleagues in SSA who’ve dealt with the same feelings.

          • Lion

            It is funny, I see these negative comments about breastfeeding organizations here, yet where I live, they are a huge help for getting babies latched on, understanding normal feeding patterns and so on, that helps mothers who want to breastfed to do so. Much of what I see here that lactivists say is what I hear nursing staff in maternity wards say. I do volunteer work helping mothers to breastfed, jot often, but enough to see and hear a few things.

          • Stacy21629

            Unfortunately, being “wealthy” (by the world’s standard, simply middle class in the USA) provides women the luxury to complain about trivialities.

            I don’t doubt for a second that in a country or region where sanitation is poor and poverty is high that exclusive breastfeeding is better for infant mortality.

            In the US sanitation is good and poverty is low so the benefits gained by breastfeeding solely on those parameters are almost completely negated. Yet lactivists want to point to “formula kills babies” using 3rd world nation conditions. It’s completely hypocritical.

            I have NEVER sterilized/boiled any of my child’s bottles or nipples. I wash in hot soapy water and sometimes, in a rush, will just rinse out really well with hot water. I trust the water supply whether it’s the purified water I use at home or the sink water at the bowling alley. I have never had a single hesitation feeding my child formula.

          • Jessica S.

            “Unfortunately, being “wealthy” (by the world’s standard, simply middle class in the USA) provides women the luxury to complain about trivialities.”

            Yes, yes, a thousand times yes!

          • Jessica S.

            “Yet lactivists want to point to “formula kills babies” using 3rd world nation conditions. It’s completely hypocritical.”

            And if any of these same women are home birth proponents as well, think about the irony (?) of how they are choosing, in some cases and outcomes, “third world”, developing countries-like delivery conditions, where as ACTUAL “third world”, developing countries moms would think it was wonderful to have a safe birth in a hospital, as is the standard here.

          • Stacy21629

            I’ve read stories of women walking MILES in labor to get to a “clinic” to have their baby. Deplorable conditions by our American standards but wonderfully safer than having your baby in your hut. We are so very fortunate here.

          • Bombshellrisa

            Think about how many CPMs travel to 3rd world countries to go and catch babies so they have enough catches to get their certification.

          • Amy

            Poverty is actually not that low in the US, but even in the poorest neighborhoods water sanitation is good (places where fracking or mining occurs is a different story, of course), and WIC provides free formula.

          • Trixie

            Small quibble — there’s not much evidence for fracking contaminating wells in rural areas of my state. It has happened, but it is rare. What seems to be happening is that the wells were always full of methane, but no one bothered to test them until the gas companies came to town, or that old gas wells that were never properly sealed. Fracking is a good bit safer for the water supply than open pit mining.

          • Young CC Prof

            If clean water is hard to get, or water contamination is something that has a reasonable chance of happening, breast feeding significantly improves the baby’s chances of survival. If formula is a huge portion of the household budget, it’s not a good choice.

            However, if your water is totally trustworthy, as it is here, breast and formula fed babies are pretty much equally healthy. Here, formula is relatively inexpensive, it costs about a third of what each adult in the house spends on food, and the poor can get it free. Meanwhile, many working-class mothers literally cannot afford to stay home and breastfeed, and of course there are always a few mothers who just physically can’t manage to breastfeed.

            When a mother who does have reliable water and sanitation can’t breastfeed, either physically or financially, telling her that formula risks her baby’s life is unnecessarily cruel, especially since it is false. When a mother doesn’t have good water, she should of course be encouraged to breastfeed and assisted in any way possible.

    • Montserrat Blanco

      Just to give you a view from another developed country, I live in Spain, we are in the middle of a deep economic crisis with a lot of unemployment right now. Minimum wage is about 650 euros and we have a support system for people that lost their jobs.

      Only in very small rural areas the water sanitation might not be perfect. You usually get (all) your water from the city council supply and it is very well controlled. If despite that you still have doubts, bottled water is cheap and perfectly reliable. If you get your water from your own well then yes, it might not be that reliable, but as I said, then you can buy 1,5 litres water bottle for like 0,20-0,30 euros or 5 litres for 0,50-0,60 euros (virtually nothing here) and use that water for drinking and preparing formula and your well water for everything else. You can use normal water supply for cleaning bottles. There are sterilization systems cheap and reliable that you can buy almost everywhere. I live in a big city and have lived in different cities in Spain and different european countries. Every single time water from the tap, what you use for shower, cleaning dishes and clothes, was drinkable. sometimes not very tasty, I must admit, Barcelona water does not taste very well due to the minerals on it, for example, but it is clean and safe to drink.

      Formula is cheap and reliable as well. Lots of controls and good quality if you are really poor there are organizations that will help with the costs. One formula can is about 9-10 euros at my local supermarket (not a cheap supermarket, I must admit). I think one can would be for about a week-a week and a half, depending on the age of the baby. Breast is of course cheaper, but if you count the money that you have to spend in eating more… The difference is probably not that much. (50 euros a month is not that much anyway).

      It really starts before the child is born. Contraception is also virtually free. We have universal health coverage for nationals and legal foreigners. Under health system a birth control pill supply for a month is like 1-2 euros for a month supply, I usually bought them for like 10 euros without a prescription at my local pharmacy just to do not bother going to the doctor but even with that they are cheap. Intrauterine devices are placed for free at your local health centre. Just for the sake of convenience I got mine on a private practice and it was like 150 euros. It sounds a lot but it covered 5 years, so it was cheaper than the pill. Condoms at the supermarket vary according to the brand but you can get about 12 for 4 euros.

      We do have some necrotising enterocolitis in premature babies and that is why we have human milk banks at hospitals with a neonatal unit. Most of the babies do well despite that risk even if their mother is not able to breastfeed thanks to those banks. We do have a good survival rate among preemies here though it is obviously less than for at term babies. Death of a term healthy baby intrapartum is almost unheard of. One of my cousins was a preemie with IUGR 25 years ago and she is perfectly healthy right now. She did not have any problems apart from being small during her stay at the neonatal unit. She received some breastmilk at the beggining but was mostly bottlefed.

      Diarrhoea from not-so-clean water and diluting formula too much is unheard of in my social circle. Two of my little cousins (at term healthy babies) were bottlefed and they had no concerns about that whatsoever. There was always clean water available. Even in restaurants and so on it was not a problem at all. I remember once they brought the water to mix the formula too hot from the kitchen and we just poured some on a glass and refilled it with bottled water that we were drinking ourselves. Everybody regarded it as perfectly safe for the baby (we added the formula later, we did not dilute the formula). We did not have any concerns about loosing sight of the water because we were in Madrid, a place where the water from the tap is perfectly suitable for preparing formula, so they would have to go to great lenghts in order to get not-safe-to-drink water.

      So, in a word, yes. It is different in developed countries.

  • Jessica Lagor

    What if home birth killed as many babies as hospital birth? Of course none of this matters coming from someone posing as a dr.

    • Elizabeth A

      Dr. Tuteur’s identity and credentials are pretty easy to verify. So are the comparative rates of death at home births and hospital births. And yes, it absolutely does matter.

    • Young CC Prof

      Dr. Tuteur provides dozens of documented examples of babies who died at home birth who probably would have survived in the hospital. Please provide 3 documented examples from the last 10 years of babies who died of hospital birth.

      • The Bofa, Being of the Sofa

        …who would have survived at home.

        And let’s spot her that guy in Texas who botched the forceps delivery (although I don’t remember, did that baby die or was it just severely damaged?)

        I’ll even give her another helpful suggestion: find some examples of babies who died from hospital-borne MRSA. They would certainly qualify.

        • Young CC Prof

          Died a short time after. I’m not sure that should count, because as I understand it there was severe cephalo- pelvic disproportion and only a c-section could have saved the baby, but, since it was a total screwup by a hospital, I’ll grant it.

          • Amazed

            But C-sections are the mark of evil! They are never needed, unless homebirth advocates need to show that doctors screw up, too.

            I am truly interested to know just how a homebirth would have saved this baby. I mean, if they bring it out constantly, this mother must have been a perfect homebirth candidate. Midwife would have sectioned her right on the kitchen table.

            And, wingless, no. Homebirth advocates clearly don’t SEND their children to school. They need no stinking 4th grade. Jessica Lagor is just the latest example who has such great gaps in her education that she doesn’t understand she’s smart but ignorant and should be ashamed.

          • Renee

            No, because it would have died at home too.

        • The Computer Ate My Nym

          How do you feel about babies who died in car crashes on the way home from the hospital? It wouldn’t have happened if they’d been born at home, after all…

          • Box of Salt

            TCAMN: got any numbers on that?

          • Young CC Prof

            I’d guess, similar to the number who died from home birth because transportation became necessary and then didn’t go smoothly, like the car was broken or something.

          • Box of Salt

            ” like the car was broken or something.”
            I’m pretty sure we have one of those stories linked on this blog. I think it was from rural Ireland, but I am too lazy to search the archives here and confirm.

          • Young CC Prof

            I recall at least two such.

          • The Bofa, Being of the Sofa

            Tell you what – I’d accept that, too.

            All Jessica needs to do is to find two examples of where it happened and she can meet YCCP’s challenge (given my concession of the Texas doctor, even though others have debated whether it even applies).

            Come on, Jessica, we are making it easy for you, giving you situations that would count. You only need to find two to meet YCCP’s challenge.

            (seriously, the regulars here would be far more likely to meet the challenge than Jessica is)

    • The Bofa, Being of the Sofa

      What if juggling chainsaws killed as many people as home birth?

      • Renee

        We would ban the practice, jail those that allowed minors to participate, push the makers of chainsaws to build in a safety feature so they could no longer be juggled, then we would ban the sale of any chainsaw built prior to these features.

        Oh, you were kidding, LOL.

        • The Bofa, Being of the Sofa

          Not kidding, it was a rhetorical question.

          Radar: “We didn’t study those.”
          Henry: “What?”
          Radar: “Rhetoricals”
          Henry: “Stop messing around”

    • the wingless one

      Homebirth kills WAY more babies than hospital birth if you look at the rate at which kills babies vs the hospital rate. Isn’t this a concept generally taught in 4th grade in the US?

      • Renee

        Our trolls are getting dumber. The smart ones learn, and become commentors 🙂

    • MLE

      Thanks for the LOL.

    • Jessica S.

      Stats, please. Can you link to the studies that show babies die during labor and delivery more than and/or equal to home birth?

    • If it did, then homebirth would be as safe as hospital birth. But since homebirth kills nine times as many babies as hospital birth (per capita), then it’s a lot less safe. That’s what numbers mean.

    • Stacy21629

      That tinfoil hat must be really hot this time of year. “Posing as a dr.” Ha!
      And what, pray tell, are you “posing” as? – an “educated” home birther that hasn’t actually read any of the latest scientific data that shows that home birth is dramatically more dangerous than hospital birth? Or an ‘educated’ home birther that lumps preemies and those with congenital defects in with healthy babies in the hospital?
      Too funny.

    • Sullivan ThePoop

      If home birth killed the same amount of babies per capita as the hospital we wouldn’t be having this conversation.

  • Jenny_from_da_Bloc

    This is related to breastfeeding and kind of OT and funny, but one reason not to breastfeed lol: http://thestir.cafemom.com/baby/172730/why_breastfeeding_your_husband_isnt

  • Box of Salt

    “what if fhttp://www.webmd.com/parenting/news/20101215/drop-side-cribs-banned-safety-issuesormula killed as many babies as homebirth?”

    Drop-side cribs were actually banned in the US by killing fewer babies:
    “blamed for the deaths of at least 32 infants since 2001”

    http://www.webmd.com/parenting/news/20101215/drop-side-cribs-banned-safety-issues

    • Box of Salt

      Sorry about the cut and paste errors! Please read the link that landed in my quoted sentence as “formula” as in the original . . . .

    • Young CC Prof

      And, as far as I know, it wasn’t a problem of dropside cribs per se but of specific manufacturing defects in shoddily made dropside cribs.

  • ccccat

    I pointed out something similar to the folks at Grounded Parents (before I gave up on them). On a post on breastfeeding the author said that only RCTs would truly reveal risks of bottle feeding but that an RCT would be unethical. Yet on that same blog a different author was claiming that we don’t really know if home birth is dangerous until there are more RCTs! I wish more NCBers treated homebirth the way they treat bottle feeing.

    • ccccat

      Um, that’s feeding.

    • fiftyfifty1

      Although we do have a RCT for breastfeeding. It’s the Belarus PROBIT study. It was huge and well done. It showed that in Belarus, a country with safe water and commercial formula, that breastfeeding has only minimal benefits: a decrease in eczema and a small decrease in cases on diarrhea.

    • Stacy21629

      They tried to set up a home birth RCT in the Netherlands – you know, the Mecca of glorious home birth, where home birth is normal and everyone is comfortable with it – only one woman signed up. The study was canned. Shows how much women in the Netherlands trust home birth.

      • Box of Salt

        Stacy21629 “Shows how much women in the Netherlands trust home birth.”

        No, not really – it just shows that they value controlling their options (as much as that’s possible with birth). The homebirthers won’t risk getting randomized to a hospital, and vise versa.

        You’d have the same problem enrolling a randomized vax/unvaxed trial.

        • Young CC Prof

          How many trolls have we had here volunteering to be the control in a randomized controlled trial of vaccines? That vocabulary fail never stops being funny, except it’s sad.

          • Guestll

            +1

  • sleuther

    Interesting thought experiment Dr. Amy, thanks!

    I’m so done with even engaging the lactivists and boob-nazis. I guess once your kids are older (mine are 7 and 9) it becomes very clear that it really doesn’t matter what or how they ate when they were infants, as long as the baby was happy and thriving and the pediatrician was happy and parents were happy.

    It all seems very long-ago and far-away.

  • Young CC Prof

    To extend the thought experiment above, in 2010, there were almost exactly 4 million live births, and 24,572 infant deaths. Add an extra 15,000 home birth deaths, the total infant death rate would rise from 6.14 per 1000 to almost 1%.

    Assuming that all these home births occurred in full-term infants, the full-term death rate would rise from 2.3 per 1000 to 6.5 per 1000. The 2010 death rate among infants born at 34-36 weeks is 7.15 per 1000.

    So, being born at home, at full term to a low risk mother, is as dangerous as being born over a month early.

  • The Bofa, Being of the Sofa

    I was reminded of a post of yours (from a while back) the other day when I read about a massive recall by GM. Tens of millions of cars recalled because there were a couple hundred accidents that resulted from malfunction. Not deaths, but accidents (I don’t know if there have been any deaths attributed to it).

    Yet, 1 in a thousand deaths is considered “as safe as life gets”?

    • Sullivan ThePoop

      There were 13 deaths associated with that recall

      • The Bofa, Being of the Sofa

        So we are talking about 1 death for every million cars, or so. And because of that, the company wants to fix them all.

        Let’s hear ICAN talk about the unnecessary recalls. More than 99.99% of the cars being recalled will not have the problem.

      • Karen in SC

        13 deaths over a 10 year period IIRC. If so, that’s 1.3 per year. Contrast that with the preventable deaths documented by MANA for a five year period. Twice as many in half the time!!!!

        Yet, Melissa Cheney has yet to be called to testify in front of Congress. I plan on informing my congressman of this fact, please do the same in your state.

  • Ellen Mary

    Um, you know babies do die of Formula Feeding right? More correctly, they die of the water used to prepare the formula, mostly, and they die of lack of the resources to buy formula which leads to watering down, etc. But even in the US, some SIDS can be attributed to not Breastfeeding . . . Do we think anything bad about these mothers? No, they are victims of a predatory industry . . .

    • Sullivan ThePoop

      There is no good evidence that formula feeding leads to more SIDS deaths just like there is no good evidence that it leads to more accidents

      • Ellen Mary

        Then why does the AAP suggest Breastfeeding on their list of protective behaviors for SIDS? Serious question.

        I am not saying anything that is not mainstream, Gates Foundation type science.

        Telling me ‘fuck off’ is roughly equivalent to a HB advocate saying ‘FU, my HomeBirth rocked & saved me from a Unnecessarean!!!!’ That’s not how statistics work.

        • Young CC Prof

          How statistics work is that the association between formula feeding and SIDS is weak and heavily confounded by sleeping location and position and exposure to cigarette smoke.

          Gross exaggeration about the benefits of breastfeeding is not harmless, I personally know women who have put themselves through hell, in some cases actually harmed their babies through malnutrition or exposure to hazards in the milk, all out of unwarranted terror of “deadly” infant formula.

          • Ellen Mary

            But not non-existent. On the globe, it is not gross exaggeration of BF benefits that harms the most babies, it is gross exaggeration of formula’s benefits with marketing dollars behind it. Just like on the globe you could say that lack of obstetric care, not overmuch obstetric intervention harms the most mothers.

          • Sullivan ThePoop

            There is a stronger association between accidental injury and formula feeding. Do you think it is really formula increasing that risk? I have never heard any benefits of formula feeding in my entire life

          • Young CC Prof

            I grant you women with limited access to safe water. Now please provide evidence for an association between formula and SIDS, after controlling for sleep position, sleep location, and smoking in the home.

          • Irène Delse

            Could you please not constantly move the goalposts in this discussion? You didn’t specify at first that you were concerned about those areas of the globe where clean water is hard to come by.

          • Irène Delse

            “But not nonexistent.”

            That correlation is still considerably smaller than the risks of homebirth. That was the point of the original article.

          • Jessica S.

            Unless a formula company is stating that formula is BETTER than breast milk, they can’t be “grossly” exaggerating anything because the benefits of BF are not “grossly” superior to formula. Sorry to burst your bubble.

          • Renee

            Out of the USA that is true.

        • Susan

          As I read it there is a correlation regarding SIDS that is strong but causation can’t be proved but there is some reason to suspect it. I don’t think it’s as clear though and while it’s very clear that most of these intrapartum deaths at homebirth would have likely been saved in the hospital it’s not so clear with a SIDS death what behavior would have prevented it. I think the point Dr. Amy makes is very valid, if that number of babies were dying and you could clearly point to formula as the culprit there would be an uproar, and lawsuits galore.
          I think the poster telling you to F*** O** was wrong. Your question is fair and obvious. But this isn’t the third world and there are good water supplies, and your comment “victims of a predatory industry” applies just as well to the homebirth world, where they are ignoring the mounting evidence that babies really are dying more often at homebirth. If you hadn’t put in the “victims of a predatory industry” the question would not have seemed like bait though… still I don’t like the nastiness no matter who it comes from.

          • Ellen Mary

            That was my point, that we needent blame/shame HomeBirth mothers unless we are talking about unassisted births.

          • Susan

            I agree regarding shaming. Shaming has no place in education. I actually, like many here, was a homebirth mom, I in no way believed I was risking my baby’s life.
            There is irony though re shaming as education. It’s worked in getting people to not smoke quit smoking. Framing it as an ucky behavior that low class people do has worked. And that thought extended to breastfeeding and formula to the extent that there was an ad comparing the “risk” of formula feeding to riding a mechanical bull while pregnant.

          • Bombshellrisa

            Ironic about the “low class” label- I remember my grandmother telling me that back when she was giving birth, home birth and breast feeding were considered “low class” things that only poor people who couldn’t afford hospitals did. Super ironic because that was Seattle then, now it’s woo central and it’s the upper middle class who are doing the home births and being lactivists. I love that there are all kinds of accommodations for nursing mothers in this city, but the shame and judgement for formula and bottle feeding is very real.

          • Susan

            I went to a breast feeding class for nurses once where the speaker suggested one way to promote breast feeding among Hispanic women is to point out it is what rich white women do. At the time, I felt only vaguely icky as I listened to that. Now it’s more disgust.

          • Renee

            We talk about HB because its dangerous. I am not seeing much shaming going on.

        • Sullivan ThePoop

          Well, I never told you to F off so I am not sure why you even brought that up and you have shown me no statistics. I am not sure why the APP would say that when the available evidence is of poor quality

        • Renee

          Because it never hurts to suggest something that is not detrimental, if you think there may be a important benefit. It doesn’t have to be proven. We know BF is a good thing, so why not suggest it in hopes that it is more than correlation re SIDS?

          AAP also suggests you BF until your kid is 2 IIRC. My kids dentist hates this with a passion. BF really messed her teeth up, and I guess he sees it a lot.

    • lawyer jane

      With all due respect, fuck off. My baby did not begin to thrive until we introduced formula. You don’t know what the hell you are talking about.

      • Young CC Prof

        Sometimes I wonder, if the sale of infant formula was strictly banned (with currently formula fed babies grandfathered in) how much would infant death go up? Right now the total is 6 per 1000, mostly preemies. Would it hit 2%? More?

        • Ellen Mary

          But you don’t wonder what would happen if they cut their marketing budget? And stopped marketing directly to NICU nurses, for example? Or their dubious marketing work overseas? Or sending out free cans directly to mother’s homes when they don’t sign up?

          • Amy

            Formula feeders are not mindless, vapid drones who do what we are told by marketing companies.

            My baby stopped making dirty diapers despite around the clock nursing. Switching to formula had nothing to do with advertisements. Quit blaming formula companies and have some respect for women who make their OWN decisions.

          • Ellen Mary

            Marketing is effective or they would not do it. People who do it have degrees in it. Advanced ones. Again, you may be an info warrior who never goes in for commercials but that is not how statistics works.

          • Amy

            What fucking statistics? No statistics matter to a mother whose baby is dropping weight like crazy, screaming for days and not making dirty diapers. How would any statistic on earth help that situation? Would my baby having a stroke satisfy you, internet stranger?

          • Ellen Mary

            I am happy to discuss statistics but this thread is not on topic & seems to be really emotional for the group. So I am going to bow out for the moment. If you want to take that as ‘she doesn’t haaaaaaave any statistics!!! :head on stake: Yk, party on.

            I have no interest in making anyone feel bad about their choice on here, my only point was that mothers who choose HB shouldn’t be the objects of your scorn.

          • Amy

            LOL Guess what, no one here feels bad because of you.

          • Stacy21629

            No kidding.

          • Bombshellrisa

            I thought the topic was formula feeding-not scorning HBing women. If so, we are on topic.

          • Jessica S.

            What are you talking about? It’s on topic as far as what you brought up? Sorry if you feel piled on, maybe that’s a sign you should reconsider what you’re arguing.

          • fiftyfifty1

            “I have no interest in making anyone feel bad about their choice on here”
            Don’t try to pretend that the reason people are calling you out on your ridiculous arguments is that they “feel bad” or feel “emotional” about their formula use. Neither one of my kids got any formula, they were 100% breastmilk fed, but I still think your arguments are crap.

          • Stacy21629

            “I am happy to discuss statistics but”
            Liar liar, pants on fire.

            Put up or shut up. You came in here with a bold claim about numbers of deaths and can’t provide any proof.

          • Stacy21629

            “I have no interest in making anyone feel bad about their choice on here,
            my only point was that mothers who choose HB shouldn’t be the objects
            of your scorn.”
            Huh. Well you haven’t tried to make that point AT ALL. So argument fail. You show up and start arguing that “formula kills babies too”. Show us some numbers so we can compare too. You can include improper formula use to be fair since home birth midwives kill babies through improper understanding of medicine. In the US – how many babies per 1000 died from formula feeding? We need that number to understand your “point” so we can compare it to home birth deaths.

          • thesouthway

            I have the utmost sympathy for women who were led to believe that they are doing what is best for their babies by choosing HB. They are victims of a truley vile marketing campaign. I have much better targets to scorn.

            I scorn the lay people masquerading as medical professionals who make their living off the claim that HB is as safe or safer than hospital birth. I hold the utmost contempt for these scam artists who line their pockets from the proceeds of unproven, useless, and/or dangerous NCB-related goods and services. Who attack OBs and claim they are lazy, money-hungry, and cruel while, at the same time, protecting lay MWs and other HB “professionals” who kill babies (and still pocket their HB fees).

            The only HB mothers who are objects of my scorn are those who are aware or become aware of the dangers of HB and wave them away for the sake of the “experience.” Who have a successful HB but refuse to admit that they took any risks or that their positive outcome was pure luck (and good genes). Even worse, are those “HB mamas” whose babies die or are severely injured but continue to promote HB because the experience is ALL that matters. Who claim that birth is something safe and to be trusted, that their bodies “worked perfectly,” even in the event of a placental abruption or a baby that gets stuck after being born feet first.

            “Birth professionals” and other HB crusaders deserve nothing but contempt. They are certainly far more dangerous than Enfamil or Simulac, despite all your accusations and pearl clutching.

          • Renee

            When did anyone say moms that choose Hb are scorned?
            Weird way of making a point.
            Its emotional because too many moms here have been harassed, and treated horribly by activists and they come here to be free of that.

          • Lion

            Can’t they just say no thanks if someone offers them breastfeeding help then?

          • Bombshellrisa

            Oh wait-I have a statistical analysis! I am 96.4% happier being able to delegate feeding to my husband/mother/sister in law/best friend. The slight dissatisfaction noted is due to the fact that I do enjoy nursing my baby and wish I actually made enough milk to do one feed a day. He does nurse a couple times a day for comfort since there is a little something in there for him. But on the whole, quite satisfied with his growth and comfort with the formula.

          • Bombshellrisa

            What commercials? I have been parked In front of a tv at all hours since my son was born and I have not once seen a commercial for formula. Not to mention that the formula I got in the mail had “breast is best!” Written on it AND the pamphlets that came with it (all about breast feeding).

          • The Bofa, Being of the Sofa

            But how much of their marketing is brand promotion? For example, if I use formula, and Infamil gives me free samples and Similac does not, I am more likely to start using Infamil. And if my child approves, I am not likely to switch.

            There, marketing was effective, but it had NOTHING to do with my choice of whether to breastfeed or not.

            Formula companies don’t just want you to buy formula, they want you to buy THEIR formula. It does Infamil no good if someone chooses formula but goes with Similac. In fact, that HURTS them.

          • Jessica S.

            Darn it, you beat me to it!

          • Young CC Prof

            I switched to formula because my son almost died. Because watching a team of nurses start a line in four-and-a-half pound infant with collapsed veins was the worst day of my life.

            The vast majority of formula-feeding mothers did so for at least one of these two reasons:

            1) Need to return to work very soon.

            2) Medical/Physical barriers, including quite a few women who try and fail.

            Demonizing formula isn’t addressing either of those problems. Like Bofa said, most formula marketing is aimed at seizing market share AWAY from other formula companies, not at going after women with a happy successful breastfeeding relationship and getting them to quit.

          • The Bofa, Being of the Sofa

            Like Bofa said, most formula marketing is aimed at seizing market share AWAY from other formula companies, not at going after women with a happy successful breastfeeding relationship and getting them to quit

            For pete’s sake, we even have formula companies including “breast is best” in their friggin commercials!

          • MaineJen

            Every sample of formula I got came with a booklet on breastfeeding.

          • Bombshellrisa

            The cans have 24 hour breast feeding support numbers on them. Like I am going to call at 3am while my newborn screams…

          • The Bofa, Being of the Sofa

            I wonder, has anyone ever called one of those numbers (the formula company’s hotline)? I wonder what they say?

          • Young CC Prof

            Man, now I’m tempted to try it when Baby Prof’s regularly scheduled evening cry starts tonight.

          • Bombshellrisa

            I had a regularly scheduled cry in the evenings too while baby tried to latch (had to offer the breast before the formula and then after I fed him I had to pump). I wonder if the people answering the support lines are used to crying mother with crying infant in the background?

          • Trixie

            Who’s picking up the phone on those helplines, though, and how much training do they have?

          • Renee

            So much bad info abounds.

          • Young CC Prof

            That was my takeaway from the discussion on “lactivists treat women like cows.” There is no good science on lactation, there are so many problems that no one really knows how to reliably address.

          • Trixie

            The breastfeeding advice in those booklets can be pretty sabotage-y. Like, only feed on each side for 10 minutes. If your baby is still hungry you may not be making enough. That kind of stuff. Although, to be fair, it’s been a few years since I read one.

          • Renee

            Me too, I hate this. They can do what they want, but I don’t have to like it.

          • Jessica S.

            And again, I suspect this has more effect on the brand chosen than course of feeding. Choosing to formula feeding over breastfeeding is not a significant drop in quality, as much as breastfeeding advocates like to tout. So while I don’t doubt that formula companies work to emphasize the benefits, or safety, of their products more than the potential pitfalls, they’re not marketing poison. And besides, breastfeeding advocates, and the companies that make money off promoting breastfeeding products and services, do the same thing: emphasize the benefits while denigrating the alternative. And downplaying the negatives of trying beyond all hope. It’s mainly the demonizing of formula that pisses me off the most, though.

          • Renee

            Yes, when moms pick which brand to buy, every time, I am sure marketing influences some of their choices. Even if it didn’t make a difference, it would not stop companies from trying to influence you! I get that. I am in Sales, so I get it. (I am also well aware of how much marketing FAILS to do what its supposed to.)

            When all formulas are basically the same, the choice has to be made somehow. Personally, I liked the price of the Babies R Us brand, but would have bought Enfamil because the packaging was cute if that wasn’t available. Good reason, I know, but so what?

            This is neither here nor there- I didn’t chose formula because of advertising. I didn’t choose BF because of what WIC told me. I chose each, for different kids, based on what worked with then, and with our lives, at the time.
            (and I LOVE BF, btw)

          • Bombshellrisa

            And respect for the women who listen to professionals whose job it is to make sure that the baby is thriving properly-like a pediatrician.

          • Amy

            Right. If I had listened to LLL’s advice to just keep breastfeeding I probably would have a baby with brain damage. No thanks! I’ll take an increased risk of obesity or allergies over that any day.

            I always wonder what lactivists make of the 3 million children worldwide who die of malnutrition every year, and the millions more who suffer from stunted growth. Let’s see some thoughts on those statistics, Mary Ellen.

          • fiftyfifty1

            “No thanks! I’ll take an increased risk of obesity or allergies over that any day.”
            But you don’t even need to make that tradeoff. The best breastfeeding study we have, the randomized controlled Belarus PROBIT study, actually found a *higher* rate of obesity and overweight in the breastfeeding intervention group. Now it is true that the breastfeeding group had lower rates of eczema as babies but that didn’t translate into ongoing problems or asthma.

          • Stacy21629

            “But you don’t even need to make that tradeoff.”
            Hubby and I are both bean poles and have no allergies at all. I’m not all that worried about the formula making my kid obese or allergic to the world.

          • The Bofa, Being of the Sofa

            What did the PROBIT study say about SIDS?

          • fiftyfifty1

            IIRC did not address. Likely would be underpowered.

          • The Bofa, Being of the Sofa

            OK, so the effect on SIDS is so minor that it can’t be detected with randomly assigned samples of 50 000 mothers?

            That isn’t much of a correlation, then.

            Which makes sense, because SIDS really doesn’t have any obvious causes.

          • Young CC Prof

            To be fair, the overall risk of SIDS in the USA is 1 in 5,000. There could be a significant effect in relative terms which is still too small to find, except in full population data, where the confounders make it impossible to tease out.

          • fiftyfifty1

            “Which makes sense, because SIDS really doesn’t have any obvious causes.”

            Well smothering is a known cause. So 50,000 would probably be plenty if you were randomizing to face down in a crib full of fluffy crap vs. back-to-sleep recommendations.

          • Amy

            I don’t believe that formula is the cause of obesity….It’s just the mantra of lactivists and I need a mantra of my own since lactivists do not believe that any baby, at any time in history of the universe has been unable to breastfeed.

          • fiftyfifty1

            Well heck, now your mantra can be “obesity is higher in breastfed infants and previously breastfed children”.

          • Renee

            And the new study of siblings showed all the sacred cows were non existent. BF was not better.

            I am still BF my 2+ yr old. But it wasn’t because I thought formula was poison. Moms that only BF because they think FF is horrible must really hate BF. I like it, and didn’t need to be badgered to do it with DD.

          • Bombshellrisa

            I do-I wonder if there would be an increase of shaken baby syndrome from sleep deprived parents frustrated with their constantly screaming from hunger babies. I wonder if there would be much more ppd. I wonder what parents of late preterm babies (like me) would have done without that formula (my son couldn’t latch and then it wore him out to feed more than a few minutes).

          • The Bofa, Being of the Sofa

            Wow, you don’t think much of the ability of parents to make decisions, do you?

          • Jessica S.

            I suspect that marketing has more of an impact on which brand is preferred, not formula as a whole. I used, and will use, Costco’s formula and as far as I know, they don’t do any extra advertising to promote formula feeding. My point is, women are going to seek out formula outside of marketing. Besides, formula may not be “as good” as breast milk, but it’s a pretty darn good second, in all the areas that count like, not starving to death or less extreme, getting enough to eat to promote growth. Women who are motivated to breastfeed should receive the upmost support and attention. Those who choose not to should be left alone.

          • The Computer Ate My Nym

            Exactly. Every marketing campaign for formula I’ve ever seen is all about “if you can’t breast feed…”

          • Bombshellrisa

            Sounds like they are marketing to an appropriate audience then

          • Mac Sherbert

            Sometimes babies make the choice. I’m pretty sure my newborn had not been exposed to marketing, but she refused all but one brand of formula!

          • MaineJen

            Ah yes, the dreaded marketing. I remember being a victim of the dreaded marketing…I did receive a free can of formula through the mail at some point during my first pregnancy. Because I was planning to breastfeed, my thought process went something like this: “Cool! I guess I’ll put this in the back of the cupboard, just in case I need it some day.” I went on to breastfeed my son successfully, and I don’t think I cracked that can of formula open for months. No I did not “exclusively” breastfeed for more than a few months, because I (gasp!) work outside the home. Damn those evil formula companies.

          • Young CC Prof

            That’s what I did before my son was born. I was planning to breastfeed, but I did want one bottle and formula on hand if it was needed at some point. So when I got the free can in the mail, I said, “OK, one less thing to buy, I’ll keep this, just in case.”

          • VeritasLiberat

            I used my sample can after I got a kidney infection and had to take baby unfriendly antibiotics for two weeks.

          • The Bofa, Being of the Sofa

            We had a lot of friends give us their free samples, because they knew we were going to use them.

            We used formula to supplement, because my wife couldn’t pump enough to keep up with demand while she was working, so with that, combined with free samples, we didn’t end up buying any formula until about 8 – 9 months, and he quit nursing just after 9 mos anyway.

          • Trixie

            I will say that both times, the nurses were pretty pushy about me leaving with the formula sample bag. One told me I wasn’t permitted to leave without it. I had no supply issues and babies were transferring milk great. It sure seemed like they were trying to win a contest sponsored by their formula sales rep. I can’t think of any other explanation as to why they’d care.

          • Irène Delse

            Or because they had had experience of women who were optimistic about breastfeeding at first but didn’t manage it so well once alone? Especially moms who have to go back to work and found out that they couldn’t pump enough?
            Mind you, I’m not saying that your nurses were right to badger you, to the contrary! Only that not every instance of formula promotion is directly linked to the company’s bottom line.

          • Trixie

            Eh, I’m not convinced one small bag of formula would make a difference in that case, anyway.

          • An Actual Attorney

            It would get your through the night.

          • Trixie

            I know a lot of pharmaceutical reps. Perhaps it’s gotten better recently, but just like anything else, formula’s a product that’s got to have sales reps behind it. Just like anything pharmaceutical product, formula can be both lifesaving, and have some sketchy marketing practices behind it.

          • Renee

            Even if this is common (I don’t think it is), so what? Have you never been handed ads you didn’t want?Is throwing or giving it away too tough? I don’t agree with doing this, but I hardly find this so demonizing that BF moms quit and choose FF.

          • Stacy21629

            Let’s talk about the marketing budget of lactivists like you that make me read – every single day – a statement of “fact” that what I am doing is not the best for my child. Implying that I’m harming my baby. Every tin of formula says – in at least 3 places – “Breast milk is best for baby.” How about that marketing? Forget that nonsense. Breast milk was NOT best for my baby. She was withering away. Formula companies can stop giving out samples and marketing when they no longer have to put that nonsense line on their cans.

          • MSN

            When my IUGR daughter (she only weighed 2lbs 7 oz when she was born at 33 weeks) spent 5 weeks in the NICU, she was fed breast milk fortified with high-calorie formula, so that the mixture was 24 calories an ounce (as opposed to 20 calories an ounce for standard breast milk/formula). The Neonatologist ordered this because it was crucial that she have the energy to catch up and develop not only her muscular/skeletal system, but also her brain and organs. My friend, whose daughter had to have a series of heart surgeries after birth, was fed a fortified mixture of breast milk and formula at 27 calories an ounce, to help her keep developing and have the energy to recover from major surgeries.

            My point is, NICUs have a very real and crucial need for a number of materials, formula being one of them. Unless you are a Neonatologist, I doubt you are qualified to comment on the very real health needs of NICU babies.

            But then again, I guess my family and the NICU were all just victims of Big Formula’s “eev-ul” marketing campaigns.

          • Renee

            My 33 weeker was fed breast milk with added formula to up the calories as well. Once we went home she never touched a bottle again.
            SO WHAT

          • MSN

            Exactly! I absolutely agree with your point above, that pushing formula in an area without proper access to clean water or conditions to keep children healthy is cruel and evil. But in areas where proper conditions are met, formula has a number of crucial, beneficial applications–including preemies with special nutritional needs. Heck, my friend just managed to maintain her BFing because she supplemented a bit while establishing her milk supply. To demonize formula full-stop is incredibly narrow-minded.

          • Renee

            No, I don’t wonder. Moms are not stupid.
            In the USA, they choose which way to feed based on their life situations. I can see marketing influencing which brand they buy, but NOT whether they FF or BF. The choice to FF/BF has everything to do with their actual life. It’s not like all things are equal, and you choose from 3 options (Eff, EBF, combo)

            Besides, breast feeding has just as much marketing, and by more neutral sources, than formula does. Every government agency, most peds, and many moms, promote it relentlessly. There are tons of public campaigns. I see BF promotion at every WIC visit, at every ped visit, and all over “mom and kid” spaces, even billboards and buses. That isn’t even counting the social nastiness, er, pressure, that comes with activism (the harassing of moms with bottles is real and common).

            People don’t choose not to BF because they are ignorant or fooled by ads. Even with all the BF pushing, moms do not choose it for a large number of very valid reasons. Not wanting to is valid, BTW.

            (I agree the things they do overseas can be deplorable. Totally agree on this.)

          • Cold Steel

            Nurses can’t make treatment decisions such as a baby’s diet. Physician orders only.

      • Stacy21629

        Mine thrived for about 2 months. Funny how they start to wither away when the milk dries up. She weighed less at 4 months than she did at 2. But I guess we should have kept going to please Ellen Mary. Because formula is EVVIILLLL.

      • Bomb

        I attempted to BF all 3 of mine. First: failure to thrive. Second: BF literally 20 hours a day, good weight. Third: failure to thrive. Had milk tested, 10 cals an oz.

        If I’d known I would have just formula fed all 3. So not worth it.

    • JennG

      Which has no relation to this article, which is about certain groups’ willingness to live with a high rate of death in a first world country where competent care is available.

    • Amy

      Wow, how do you know when SIDS can be attributed to formula and when it’s attributed to something else? I thought the actual cause of SIDS was still a mystery. Breastfed babies have died from SIDS as well, so can you let us know what those parents did wrong, too?

      • Ellen Mary

        I don’t know which cases can be attributed, no one does, it has to do with the rate. Like this post does. Amazing how no one on here can use statistics unless it favors their cause. As soon as it gets personal it is Anecdata city.

        • Sullivan ThePoop

          How about you show some statistics and then you can talk about them

        • Stacy21629

          “Amazing how no one on here can use statistics unless it favors their cause.”
          So please use some statistics. Oh wait, you prefer to flounce. Sign of a solid argument.

        • The Bofa, Being of the Sofa

          What statistics are you talking about? The “Why does the AAP recommend breastfeeding to prevent SIDS?” statistic? Because that was your claim.

      • The Computer Ate My Nym

        The evidence on SIDS and breast feeding is mixed. Some authors even found an increased risk of SIDS with breast feeding. This consensus forum felt that there was enough evidence to recommend breast feeding if practical but concluded that confounding conditions could not be eliminated as the cause of the findings.

        In any case, the incidence of SIDS is about 0.5/1000 live births. If every last case of SIDS were caused by bottle feeding (obviously untrue since SIDS can and does occur in exclusively breast fed babies), bottle feeding would still be about 10x safer than home birth.

        • pj

          Looks like you replies while I was typing my response.

        • Young CC Prof

          When the “Back to Sleep” campaign rolled out in the USA, SIDS dropped by half in just a few years. So there’s a pretty strong link there.

          • The Computer Ate My Nym

            There are quite a lot of factors that seem to be related to SIDS, including sleep position (which seems to be a big one), smoking in either parent, sleeping on a soft surface, sleeping in the same bed as the parents or in a different room (safest seems to be same room, different bed), etc. But even if bottle feeding were the one and only risk, it would still be considerably safer to have the baby in a hospital and bottle feed it than to have it at home and breast feed it if it lived.

          • The Bofa, Being of the Sofa

            There are quite a lot of factors that seem to be related to SIDS, including sleep position (which seems to be a big one), smoking in either parent, sleeping on a soft surface, sleeping in the same bed as the parents or in a different room (safest seems to be same room, different bed), etc.

            …sleeping with pacifier….

            (one of my favorites, to make the “avoid nipple confusion” lactivists heads explode; would you trade nipple confusion for a 10fold reduction in the rate of SIDS?)

          • The Computer Ate My Nym

            Also vaccines. Vaccination probably lowers the risk of SIDS (though in some studies the relative risk crosses one…from the low side.)

          • Trixie

            Neither of my kids ever took one.

          • The Bofa, Being of the Sofa

            Mine either.

          • Irène Delse

            My lovely, breastfed-till-nearly-3yo niece loved her pacifier. It was what she used to take everywhere instead of a teddy. Her very crunchy mother was ambivalent for the whole time, but happy to have one thing guaranteed to make the baby happy.

          • pj

            Does a thumb also work?

          • Lion

            But if baby sucks a breast instead of a pacifier, surely it has the same effect, is it not the sucking or is it the silicon or latex nipple that is doing the trick?

          • Stacy21629

            Well considering I’d like to get some sleep on my own and it hurts my back to lean over the crib, naked from the waist up, and hang my breast into my child’s mouth while she is sleeping a pacifier is rather a lot easier.

            A baby cannot suck at the breast all night without being in bed with the mother which increases SIDS, suffocation, crushing, etc deaths.

          • Young CC Prof

            It’s the sucking all night during sleep, which isn’t entirely practical with a breast.

          • The Bofa, Being of the Sofa

            (guy perspective)

            🙂

            (/guy)

          • Mac Sherbert

            SIDS is an interesting subject. I concluded that all the things recommended to reduce SIDS works because when you do them the baby doesn’t sleep!!

            Anyway, my sleep deprived self came across this article right after my baby born. It’s not a huge study, but it’s interesting.

            http://www.foxnews.com/health/2013/11/12/brain-stem-abnormalities-linked-to-sids-study-shows/

          • Jessica S.

            Bahaha! So true!! Playing ‘reinsert the binky’ is a particularly fun game. 🙂

          • mishabear

            YES!!! That is my own personal hypothesis as well — baby won’t die “in their sleep” if they’re never really sleeping. Rock hard mattress, cool room with a fan, no blanket, on your back? Sounds like low level torture to me.

            Due to reflux (one happy spitter and one miserable silent refluxer), I let my twins sleep on their stomachs from 2 months. Holy crap the difference that made. The silent refluxer used to sleep in 15 minutes stretches before that. (The only reason I didn’t shoot myself was because she was in the hospital for more than half of those two months.) The happy spitter spit up on her back once while awake. Supposedly babies “know” to turn their head…. Mine just looked panicked and started choking. With no family history of SIDS (and I was tummy sleeper as a baby because that was the recommendation then), stomach sleeping was the better choice given the gastro-intestinal issues.

          • mishabear

            http://en.wikipedia.org/wiki/File:Back_to_sleep_plot.png

            While there is a correlation, the SIDS rate was falling before the Back to Sleep campaign started….

          • Young CC Prof

            Hmm. What else changed in that time? Smoking rates dropped surprisingly little in the 90’s, but maybe there was less indoor smoking, especially by parents. HiB vaccine was introduced around there, but that should have produced a more abrupt drop.

            I’m done speculating. Something changed, maybe more than one something. Maybe it was partly reporting changes.

          • Box of Salt

            Nice graph. What’s the green line? I can’t trace the original through your wikipedia link.

            And, yes, the Back to Sleep campaign started in 1994:
            http://www.nichd.nih.gov/sts/Pages/default.aspx

            Maybe I’m reading too much into this, but every time I hear/read something like “rate was falling before” I wonder what agenda is behind it the attempt to discredit the data.

          • Young CC Prof

            Green line is percent of babies who (according to a parent survey I assume) are placed on their backs to sleep.

            And yeah, “rate was falling before” does make one think of antivaxxer crap. Unfortunately, I don’t think anyone knows what a nonfatal case of SIDS would even look like.

          • Box of Salt

            YCCP nonfatal Death?
            Umm . . . .a near miss could be when someone picks up the baby without noticing the danger.

          • Young CC Prof

            Precisely. We don’t know what a SIDS near-miss looks like.

            Or do we? There are babies who sleep on monitors. Of course, most of them have serious issues and aren’t really good examples.

          • Karen in SC

            There is a diagnosis of ‘interrupted SIDS’. IIRC those babies may not be able to be revived or are brought back with severe impairment.

            However, one case that I know of I believe the baby really had HIE as he stopped breathing at less than one day old in his mother’s arms. He’s essentially brain dead on a vent and g-tube at home now. I was told he was born at a birth center and they were at back at home when this happened.

          • mishabear

            Young CC Prof answered already about the green line.

            No agenda other than pointing out correlation doesn’t equal causation especially when rate was already falling. Admittedly there is some residual annoyance at the crazies on my old BBC birth board for whom to vaccinate or not was equally valid choices to be made but holy crap were they going to CPS report every mother who didn’t rear face their ginormous 18 month old or who pooped their pants when their kid started rolling over in their sleep — OMG they going to die in their sleep now.

      • pj

        This is actually something I would really like input on. I notice that breastfeeding’s protective effect against SIDS (or whatever it’s called now) is rarely mentioned here in discussions about breastfeeding vs formula. But that is one of the primary reasons that breastfeeding is promoted in New Zealand, where SIDS rates have historically been very high I always wonder if there ARE actually cases where breastfeeding might have saved some babies who died of SIDS. Can anyone explain this further to me?

        • Amy

          hmmmm….Isn’t mattress wrapping a huge deal in NZ? They claim that it’s eliminated SIDS almost all together.

          • pj

            No, I was never advised to wrap my mattress.

          • pj

            And I’ve never heard anyone claim it eliminated SIDS in New Zealand. I don’t know where you’ve heard that, but it’s false.

          • Amy
          • pj

            That site looks like a riot of false information.

          • Irène Delse

            And they are selling mattress-wrapping products, surprise surprise.

          • The Bofa, Being of the Sofa

            As I noted above, the entire website is based on the premise that SIDS is caused by antimony and/or phosphorous leeching from the mattress. However, the scientific literature that I found concludes that there is no evidence for antimony causing SIDS.

            Yep, despite the name “stopsids” it’s just a commericial advertisement.

          • Michelle

            Same here. That’s a falsehood by that company. Interesting back story to that one, at the same time that particular theory and mattress wrapping was being pushed* they were doing the New Zealand Cot Death study (started 1987) and this was one of the main ones that identified the actual risk factors for SIDS – sleeping positioning, lack of breastfeeding and smoking. Prone sleeping was the major one, and they’ve also found bed sharing and overheating is also a risk. After adopting that advice on sleep positioning (and the other risk factors) with the “back to sleep” campaign, rates of SIDS went from 4.19/1000 (1985) to 0.77/1000 (2008) with a sharp decrease from around 1990. The mattress wraps didn’t even go on the market until the mid-1990’s, and the rate per 1000 had already dropped below 2.

            *Loathe Sprott, his claims and the mattress wraps he was pushing were the reason they stopped Red Nose day for quite a few years where they raised money for research into cot death, they said it was confusing the public with conflicting claims.

          • Cold Steel

            This is a terrible profit-driven rumor that has been circulating the world for a while now. As others noted, it shills for the company’s product. Not a shred of science to back it up. And it detracts from the most common real cause of SIDS, which is suffocation. (Forensic pathologists can’t actually rule a death ‘suffocation’ unless they have concrete proof, which is vanishingly rare. It’s suspected to be the true cause in roughly 75% of cases, with the others being cardiac channelopathies.

        • Alannah

          SIDS is strongly connected to socio-economic status and so is formula feeding.
          If a family is of low SE status they are at much higher risk of having insufficient prenatal care, smoking or other substance abuse during pregnancy, premature birth, exposing the newborn to cigarette smoke, not having a proper sleep environment for the baby, not being aware of SIDS risk factors and prevention…. These factors are most likely responsible for the horrendous SIDS rates in indigenous populations all over the world.
          Low SE status women are also much less likely to breastfeed.
          So there definitely is a correllation between not breastfeeding and SIDS. But it is far from certain that there is causation. The SIDS rate will probably be brought down far more efficiently by universal prenatal care and assistance for parents to quit smoking.

    • MaineJen

      If there is a SIDS-formula feeding correlation (that is, if you could manage to get rid of confounding factors such as smoking in the home), I would tend to think a more important preventive factor would be that breastfed babies just wake up more often during the night, whereas formula fed babies are generally able to sleep longer stretches, and therefore are being checked on less while their exhausted parents sleep. Anyone know of any studies that addressed this? I would love to see the actual statistics in question…

      • And to that degree are breastfed babies more likely to die as a result of sleep-deprivation induced mental health disorders? Maybe breastfeeding isn’t as safe as some would like to believe it is.

        • guesting

          What!?

          • FormerPhysicist

            I think Mrs. W is referring to a link between post-partum psychosis and sleep deprivation in the mother.

          • Irène Delse

            That’s how I understood it too. I’ve known a mother who became overwhelmed by untreated post partum depression and started resenting everything in her baby, and getting violent every time the baby cried. It was scary. Thankfully her older children (teenagers at the time) noticed and were brave enough to tell her she needed help.

        • Trixie

          What?

      • ReinAB

        Yes, I saw an article on Pinterest of all places recommending breastfeeding only for premature twins. The article author had no references and stated this was the only safe way to prevent SIDS in premature twins. I tried to find some kind of info on this studies, anything ? because we are expecting MCDA twins this summer. But came up with nothing. Would love to know where the author got her info, and what she’s using to guilt twins moms into pumping and trying to get two premies to breastfeed. Recipe for one exhausted mother in my humble opinion.

        We plan to formula feed our girls. I’m trying not to feel guilty about that. Somehow when I read FFF blog, I still come away with the impression, breast is best, but if you can’t…. Whereas what if you just choose not to? I want support for that. I don’t want to.

        • Stacy21629

          Here’s your support – GO FOR IT! 🙂

          I breastfed my son for a year and now that my daughter has been exclusively formula fed for 5 months due to failure to thrive I have to say – I love it. People that say “formula feeding is so hard” don’t know what they’re talking about it. I don’t have to pay attention to what I’m wearing, where I’m going, who will be there. I can prop the bottle (*gasp!*) and fix dinner or take a shower. Daddy can feed, brother can feed. Lovely.

          If you don’t want to breastfeed, then don’t. You have my 100% support. Congratulations on your soon arrivals!

          • sleuther

            I think “formula feeding is so hard” is a red herring of the boob-nazis. There are nuisances associated with both BFing and FFing, to be sure, but boob-nazis tend to emphasize only the benefits of BFing and only the hardships of FFing. The reality for most of us is that we do what we have to do and then deal with whatever issues come up.

            I’ve heard tell: There are three sides to every story: One side, the other side, and the truth.

          • The Bofa, Being of the Sofa

            Formula feeding is hard? I thought that FF was taking the easy way out? Except, of course, that everyone can breastfeed, so that’s easy and natural, but if you opt out, it means you are lazy and not trying hard enough.

          • Stacy21629

            Has Dr. Amy ever done a post on the hypocrisies of various NCB mantras?
            Like homebirth is safe and natural but I “accept the risk”
            FF is hard, no it’s the easy way out.

            These people can’t make up their minds.

          • The Bofa, Being of the Sofa

            c-sections are terrible experiences, but are the easy way out.

          • Jenny_from_da_Bloc

            That made me laugh out loud!

          • Amy Tuteur, MD

            I’ve done a bunch of posts like that. Here’s one:

            http://www.skepticalob.com/2012/06/homebirth-advocates-and-hypocrisy.html

          • Ennis Demeter

            Hospitals are full of dangerous microbes, poo in the birthing tub is good for immunity.

          • Young CC Prof

            It’s hard if you’re talking to young girls or pregnant women, trying to scare them away from it. It’s easy if you’re talking to a mother who’s already made the choice, trying to shame her for it.

            Just like c-sections. They’re a horrible thing for doctors to do to a woman just because they’re afraid of liability, but women who consent to them are taking the easy way out.

          • Trixie

            My impression is that BF is generally much harder for the first 6 weeks or so.

          • MLE

            None of this would be an issue if babies didn’t need to eat all the damn time.

        • sleuther

          SUPPORT HERE!

          Your intentions don’t matter, logically. If formula is okay for moms who CAN’T breastfeed, then logically it is okay for any mom who wants to use it.

          I formula-fed both my kids. I don’t think the reason why is important, in 99.9% of discussions. What’s important is, they got fed, they thrived, they grew up.

          You’re going to have your hands full with twins. The last thing you need is a guilty conscience about feeding them. Don’t let the boob-nazis get into your head and don’t give them your power.

          Enjoy those babies! 🙂 And enjoy feeding them! 🙂

        • Irène Delse

          “The article author had no references and stated this was the only safe way to prevent SIDS in premature twins.”

          I’m not a doc, and can’t give medical advice really, but that’s two red flags right there. No reference is bad enough, but the overblown endorsement of exclusive breastfeeding is absurd. Of course there are other ways to reduce risks of SIDS, some of those already mentioned here: sleep position, no bedsharing, pacifiers…

        • Bombshellrisa

          SUPPORT!
          My friend had premature twin girls and the pressure to pump and breast feed was very stressful to her. She ended up formula feeding. Her now three year old twins show no difference (other than they were walking earlier and are much more verbal) then their exclusively breasted, naturally born playmate born one week later than them (40w exactly).

        • The Bofa, Being of the Sofa

          I understand to desire to breastfeed premature babies, but then again, twins present a challenge. It’s not like you can be hooked up to the milking machine all day.

        • Bombshellrisa

          Oh and as for the whole “formula feeding is hard!” argument, you know what is hard? Raising your children to have morals and principals. Raising your kids to have respect for their elders, to be compassionate and empathetic and to have a good work ethic. If breast feeding was shown to instill all this, then yes, breast would be superior. Otherwise, do what works well for you. You sound like a person who cares very much about the well being of your children already!

        • Jenny_from_da_Bloc

          You can buy cases of pre-made Similac bottles and all you have to do is shake and attach a nipple, toss when finished. It was the best decision I ever made and it saved my sanity. I nursed and pumped, but my son was a hog who was off the growth charts and he could never get enough. Don’t feel bad, my son had formula and was never sick, never had ear infections and was the biggest(by far) and healthy as all the breast fed babies I know.

          • The Bofa, Being of the Sofa

            Our younger guy would only drink the liquid Similac, and then only with a specific nipple (not the one that connects to the formula bottle). Believe me, we tried everything with him.

            Oh, and not a drop of breastmilk could be added.

        • Mac Sherbert

          I support you for just not wanting too! Happy mom, happy babies! I breastfeed my last baby, but if I were expecting twins I would not breastfeed! (ok. maybe if they were preemies I might pump at first, but that would be it.)

        • Renee

          Breast feeding makes no difference, once your babies are past NEC risk. There was a large, long term study recently that followed siblings that were parented the same, but one was FF the other BF. None of the things claimed by activists held up. It was covered on this blog, maybe you can search for it under sibling study?

          People need to quit playing nice, and placating the lactofacists. The fact is that formula is just fine, and is not at all inferior. We need to quit with the Breast is best BS, because that comes with a LOT of IF’s, which makes it meaningless.

          Go into a primary school and see if you can divide the class up between who is BF and who was not. Until you can do that< i just don't see a big issue.

          • The Bofa, Being of the Sofa

            “All else equal” breast is best.

            However, all else is never equal.

          • Karen in SC

            Bofa’s Law!

          • The Bofa, Being of the Sofa

            I can see it being something attributable to me, but I don’t know if it’s good enough for Bofa’s Law.

            I’d like Bofa’s Law to be more about professions. Something of like, “If your defense of a profession consists of “they aren’t all bad, there are some good ones” then that is a sign of a serious problem.”

        • Amy M

          Just an anecdote, but I have MCDA boys—they were formula fed, they are now 5. They are very bright boys and are doing very well. I have no guilt, I didn’t have enough milk for both of them and I had to go back to work when they were 3mos old, so they got formula. Oh well. 🙂 They were 36wkers. Good luck, I hope your girls get to 36wk at least!

        • Jessica S.

          I didn’t want to either, so I didn’t. (I didn’t have twins – I’d have been DOUBLY sure about FF if I had!)

      • Jenny_from_da_Bloc

        I can’t find any articles on formula feeding being linked to SIDS and I’m pretty great at research.

        • Captain Obvious

          Found this, I don’t know how reliable it is.

          http://www.stopsidsnow.com/CritiqueOfTraditionalAdvice.html

          Breastfeeding does not reduce the risk of crib death, as a comparison of international breastfeeding and crib death statistics demonstrates:

          • The Bofa, Being of the Sofa

            Do you buy the premise of that website, that SIDS is caused by phosphorous and antimony out-gassing?

            I found this paper:

            Arch Dis Child. 2000 Mar;82(3):244-7.

            Concentrations of antimony in infants dying from SIDS and infants dying from other causes.

            the conclusion:

            “There is no evidence to support a causal role for antimony in SIDS.”

            That website looks to be nothing but a marketing page for a “wrapped mattress” company.

        • Young CC Prof

          I found a meta-analysis and a recommendation paper from AAP, but it sort of made my head spin. It said something like:

          We think it cuts the risk in half. But we maybe didn’t control for confounders. But we tried, but maybe we didn’t completely succeed. If it is, we think the mechanism is fewer colds, and possibly because breast-fed babies don’t sleep as deeply.

          • Jenny_from_da_Bloc

            That is a lot of maybe’s to be certain enough to link formula feeding to SIDS and it actually being the cause. What I meant above was an actual positive link to SIDS, which I don’t think any theory has an actual positive link to the cause of SIDS. I get ahead of myself sometimes.

          • Young CC Prof

            We don’t know exactly what happens with SIDS. If we did, we could be more sure which associations were true causes.

          • Jenny_from_da_Bloc

            My point exactly.

    • Stacy21629

      Way to miss the point.

      But entertaining your premise – Yes, certainly children die of *IMPROPER* formula feeding, though I’d wager that in the US even that number is low. Since you’re decrying deaths from improper formula feeding – please enlighten us and back up your claim with statistics on infant deaths in the US due to improper formula feeding so we can compare it’s relative risk to home birth.

      Children die from improper Salmonella cookie dough consumption too – do you decry feeding children cookies? Children die in improperly installed carseats – do you decry putting children in carseat? Children die from malnutrition – do you decry feeding children?

      We aren’t talking about *IMPROPER* formula feeding. We’re talking about formula feeding in general.

      And the very nature of SIDS is that it CAN’T be attributed to anything else. Yes, breastfeeding seems to lower the relative risk but breastfed babies can and do still die of SIDS. Also (someone please correct me if I’m wrong) the SIDS risk at it’s height (before introducing back to sleep and other measures) was still lower than the risk of dying at homebirth. So I could smoke, formula feed, put the baby on the couch in the other room and still be safer than homebirth. Seeing that my child sleeps on a firm mattress, in my room, with a fan and no one smokes, I’m not all that concerns about her formula killing her via SIDS.

      My daughter weighed less than 8 pounds at 4 months of age due to an unexplained loss of supply (I nursed my son for a year). Should I have continued nursing her? Formula saved her life.

      • Therese

        1.5 out of 1000 at its height, .5 now. So it possibly used to be as dangerous as homebirth, depending on what stats you look at, but homebirth back then may have been more dangerous as well, right? Less that the hospital could do for emergency transfers, perhaps?

        • Stacy21629

          Thanks for giving me a number.
          So currently 0.5/1000. The baby of a low risk mom (like myself) with a CNM in a hospital has roughly a 0.38/1000 risk of neonatal death (per my CDC Wonder manipulating). But that 0.5/1000 includes low risk SIDS babies (breastfed, paci, back sleep, room share, no smoking, etc) and high risk SIDS babies. So practicing some of those activities, conceivably, lowers the risk to less than 0.5/1000. Certainly on par at least with her risk of death at birth – in a hospital – and still orders of magnitude less than at home birth.

    • Trixie

      The babies who die of formula feeding in the US are mostly preemies who get NEC. Safe, screened, pasteurized donor breast milk is lifesaving. There also isn’t enough of it to go around, and unregulated online milk sharing instead of donation to milk banks is partly to blame.
      There have been a few cases of the caused by cronobacter contamination in formula powder, but this can be solved by giving RTF bottles to newborns.

      • Renee

        They don’t die from the FORMULA. They die because they got NEC, and they got NEC because they were preemies. You cannot blame formula for this.

        BF can, and does, lower the incidence of NEC overall, but still does not stop all cases of NEC. This is because not all moms make breast milk that prevents NEC, only some have the right antibodies (or whatever does the trick biologically).

        • Trixie

          “not all moms make breastmilk that prevents NEC” — do you have a source for that? Because I’m pretty sure I would have heard about that at some point during the milk donation process. They generally match one baby to one donor, if possible, so if some donors have milk that doesn’t prevent NEC, it would be surprising that they still took milk from those donors.
          Formula feeding raises the risk of NEC compared to human milk feeding. Obviously that doesn’t mean that all FF preemies will develop NEC. And that doesn’t mean that preemie mothers who couldn’t pump enough milk for whatever reason are to blame, just that more donor milk is needed.
          And none of this is relevant to a discussion of full-term babies receiving formula, which is perfectly safe.

          • Young CC Prof

            I’ve never heard that only some breast milk prevents NEC. I’ve heard that breast milk is only partially effective in preventing it, but I’ve never heard about research into a particular component present in some breast milk but not others. Plenty of protective measures are only partially effective.

        • Therese

          Wouldn’t the antibodies be destroyed in the pasteurization process anyway?

          • Young CC Prof

            Actually, this question came up here a few months ago. Apparently flash-pasteurization CAN destroy pathogens while still leaving some of the antibodies alive.

          • Trixie

            Nope, they’re slightly reduced, but remain, using the special pasteurization process that milk banks employ. I believe it also has something to do with the type of good bacteria breast milk encourages in the gut.

    • Jenny_from_da_Bloc

      yeah that is from uneducated, dead beat parents who are neglecting their children and not properly feeding their babies, not the formulas fault. If they were left to breast feed than they wouldn’t feed the kid at all.

    • Captain Obvious

      How many babies die from “improper” breastfeeding? Breastfeeding if mom has HIV? Exclusive breastfeeding with barely any milk coming out where babies don’t thrive? Women who are supposed to be breastfeeding but are out at the bars with their boyfriend? Agree with commenters below. You missed the point.

    • Renee

      If you want to add deaths due to bad water and dire poverty, which are happening out of the USA, I guess we ought to add all the deaths (maternal and babies) due to OOH birth in those undeveloped nations too?

      Water quality is a separate issue. It is not the actual formula. Had you mentioned the time there was a recall, that would have been correct.

    • Cold Steel

      Ellen, you are right that multiple studies have shown that breastfed infants have lower rates of SIDS. BUT the thing is, breastfeeding families are usually radically different– more white, more well-educated, more likely to be in 2 parent homes, wealthier– than are all mothers at large, and especially than the groups in which SIDS is most heavily concentrated. Most people think it’s the huge confluence of other factors that really matters in re: SIDS death rates, and breastfeeding is just a status marker, not causative.

      This is a developed world-centric discussion, and while the deaths of babies in poor countries who died of diarrheal disease from dirty water are certainly tragic, it’s not relevant to countries where piped water is absolutely universal and where formula is provided gratis to the very poor who might otherwise be tempted to ‘stretch’ it.

      • Ellen Mary

        First, municipal water is NOT universal in the United States, absolutely not, a good percentage of US Citizens are on well water. Also if you follow water politics, of late, it is becoming an antiquated notion that all women in the US have constant access to clean water. They just don’t, we learned that this year in WV, this weekend in Portland, etc.

        • Box of Salt

          Ellen Mary “a good percentage of US Citizens are on well water.”

          How many?

          “antiquated notion that all women in the US have constant access to clean water”

          Can you boil it?

  • Susan

    Wow. Amazing. Applause for that thought experiment.

  • Mel

    I reserve my scorn for the unqualified birth junkies who accept money in exchange for risking mothers’ and babies’ lifes and health to feed their own egos.

  • atmtx

    This is awesome! I really don’t understand this mindset that waives the risks of homebirth, cosleeping, even breastfeeding (when it’s damaging to the mother or child), while they scream about the dangers of improper car seat use and the remote chance of harm via circumcision. Oh and put a choking hazard necklace on their child because they think it helps with teething (it doesn’t).

    I really appreciate this blog for its daily breath of sane, fresh air. It hasn’t exactly made me many mom friends and I’m not open about the fact that I read it, but I have used the information herein to make better, more informed choices for myself, and to gently influence friends. I know your no b.s. stance helped me convince a mom to properly feed her baby and keep him out of the hospital. So thank you so very much, even though that mom will likely never know that she was by proxy influenced by the “meen” “Dr” Amy!

  • NoLongerCrunching

    I seriously think you deserve some kind of Woodward and Bernstein award for investigative journalism.

  • Alannah

    Clever play on the fundamental hypocrisy underlying the `natural` movement.

    In some areas no risk is too small or too hypothetical to be irrelevant: Formula, vitamin K and vaccines are demonized.

    In others no risk is too great or too obvious. Homebirth and bedsharing are considered safe and even superior to alternatives despite massive evidence to the contrary.

    Keeping up this level of doublethink takes a lot of effort. On planet NBC, the AAP is an authoritative source when it comes to breastfeeding, but that same AAPs recommendations on homebirth, bedsharing and immunisation are brushed aside. Same for the WHO: cited as gospel about infant feeding and cesarean rates, ignored and `debunked` when it comes to vaccination.

    It`s hard being deep in the woo.

    • The Bofa, Being of the Sofa

      In some areas no risk is too small or too hypothetical to be irrelevant: Formula, vitamin K and vaccines are demonized.

      In others no risk is too great or too obvious. Homebirth and bedsharing are considered safe and even superior to alternatives despite massive evidence to the contrary.

      It’s due to it being uncommon.

      I have pointed out before that the problem with drunk driving is not the risk it involves, but the prevalence. The actual death rate for drunk driving is something like 1 death for every 4 million miles driven drunk. What does that mean for someone who needs to drive 8 miles home? Not much.

      However, considering that, by DOT estimates, there are 10s of billions of miles driven drunk in the US each year, that very low rate adds up to thousands of deaths.

      If drunk driving were as common as homebirth, it wouldn’t be a problem. As I’ve pointed out before, consider the recent MANA report, which covered 27000 homebirths. If these were drunk driving instances, and assuming those averaged 8 miles per drive, the negative outcomes would have been 8 DUIs, 4 accidents, and no deaths.

      And that is before we throw out the results that occurred because the drunk drivers were driving without their headlights on or had BACs above 0.2 (so we restrict it only to the LOW RISK drunk drivers)

      Given that, we could all conclude that drunk driving was perfectly safe, right?

    • Trixie

      The WHO’s breastfeeding advice makes tons of sense in areas without access to clean water and the ability to clean bottles safely. Breastfeeding really does help prevent death from diarrheal illness.

      • Amy

        I think it also applies to places where they feed babies tea and biscuits (what I think amounts to cookies, in the USA?)

      • Irène Delse

        I doubt anyone dispute this. But the point here is the NCB community picking and choosing from the WHO publication. The rotavirus vaccine also reduces the risk of death from diarrhea, to which even children who were breastfed can be exposed once they are weaned. But try finding support for vaccines among the all-natural crowd.

        • Young CC Prof

          Heck, even babies who are still exclusively breastfed can get rotavirus, by direct contact with infected children or adults. The IgA in the breastmilk helps, as it does against all GI infections, but it’s not anywhere near as effective as a specific vaccine.

          • Irène Delse

            Good point. And even in the so-called first world, in the best living conditions, it’s a disease that can send babies to the hospital for rehydration.

          • Young CC Prof

            So yeah, if you’re going to pick and choose WHO recommendations, you’d better come armed for bear, or maybe armed like the Credible Hulk.