Breastfeeding and white hat bias

American style cowboy hat

Rank the following in order of dangerousness:

  • Term infants exposed to A have a death rate of 5.6/1000.
  • Term infants exposed to B have a death rate of 0.5/1000.
  • Term infants exposed to C have an excess death rate of 0.

They’re already ranked in order of dangerousness, right?

What if I pointed out to you that in all cases the death rates are low so it doesn’t really matter? Would that change your assessment of dangerousness? Probably not.

What are we looking at?

  • A is planned homebirth with a licensed homebirth midwife.
  • B is vaginal birth after C-section.
  • C is infant formula.

If homebirth is more dangerous than VBAC and VBAC is more dangerous than formula feeding, why do advocates of natural parenting promote homebirth and VBAC as safe and formula feeding as dangerous?

Because they are biased.

According to Wikipedia:

Bias is an inclination of temperament or outlook to present or hold a partial perspective, often accompanied by a refusal to consider the possible merits of alternative points of view. People may be biased toward or against an individual, a race, a religion, a social class, a political party, or a species. Biased means one-sided, lacking a neutral viewpoint, not having an open mind.

Those who promote natural parenting are biased in favor of allowing nature to take its course and against technology. They lack a neutral viewpoint and don’t have an open mind. They are innumerate, lacking awareness of or interest in the real dangers of various natural and technological choices. Their bias leads them to label formula feeding as dangerous and homebirth as safe even though there has never been a single reported death associated with properly prepared formula, but dozens of babies who die each year from homebirth.

That’s personal bias on the part of natural parenting advocates, but breastfeeding science is also afflicted with many other kinds of bias.

The actual research on the benefits of breastfeeding is surprisingly weak, filled with conflicting studies and plagued by confounding variables. That is well known by anyone who reads and analyzes the breastfeeding literature. But breastfeeding science suffers from another form of bias that is less well known: white hat bias. Indeed breastfeeding research was identified as a paradigmatic example of white hat bias in the seminal commentary by Cope and Allison, White hat bias: examples of its presence in obesity research and a call for renewed commitment to faithfulness in research reporting.

What is white hat bias?

‘White hat bias’ (WHB) [is] bias leading to distortion of information in the service of what may be perceived to be righteous ends… WHB bias may be conjectured to be fuelled by feelings of righteous zeal, indignation toward certain aspects of industry, or other factors. Readers should beware of WHB and … should seek methods to minimize it.

Cope and Allison note that researchers have been so anxious to establish a connection between formula feeding and obesity that they have ignored or misrepresented what the scientific evidence actually shows.

Certain postulated causes have come to be demonized (… formula feeding of infants) and certain postulated palliatives seem to have been sanctified. Such demonization and sanctification may come at a cost…

Whether WHB is intentional or unintentional, stems from a bias toward anti-industry results, significant findings, feelings of righteous indignation, results that may justify public health
actions, or yet other factors is unclear. Future research should study approaches to minimize such distortions in the research record. We suggest that authors be more attentive to reporting primary results from prior studies rather than selectively including only part of the results, to avoiding PB, and to ensuring that their institutional press releases are commensurate with the studies described…

In other words, breastfeeding researchers are so sure that breastfeeding is beneficial, and are so angry at the infant formula industry that they exaggerate findings that place breastfeeding in a positive light and ignore findings that the benefits of breastfeeding in industrialized countries are actually trivial (approximately 8% of breastfed infants have one fewer cold or diarrheal illness in the first year).

White hat bias is bias in the service of what are perceived to be righteous ends, but it’s bias nonetheless and it’s wrong. When breastfeeding research is presented in biased fashion, we deprive women of the right to make informed decisions about infant feeding choices, and we substitute the beliefs of lactivists for the actual data.

Breastfeeding is great. I breastfed four children without too many difficulties and I (and they) enjoyed it. But it’s simply one of two excellent ways to nourish infants, and anyone who attempts to convince you otherwise is likely to be righteously but regrettably biased.

  • Allie P

    More jaw-dropping reporting from my “baby friendly hospital” experience: wandered into the breastfeeding class, which was in the private lounge of the private, ultra secure maternity ward. Lactation consultant teaching the class TWICE warned me when I was nursing the baby that although nursing was “allowed” in the class (???????????) I might want to rethink it because there were security cameras in the lounge.

    I have nursed in restaurants, museums, parks, planes, and I have never had anyone look even sideways at me while I did it. Yet in the BREASTFEEDING CLASS at the private maternity lounge of the baby friendly hospital with huge pro breastfeeding posters on EVERY WALL OF EVERY ROOM, I was warned about breastfeeding in front of security cameras. Hospital security cameras.

    • Young CC Prof

      That is really bizarre. I’m fairly sure hospital security cameras pick up things a whole lot more privacy-invading than a mostly-clothed woman breastfeeding.

    • DelphiniumFalcon

      If I were a person more secure with her body image, I probably would have turned to the camera and flashed it. There. Now we’re acquainted, mystery security personnel. I will now continue breastfeeding.

    • KeeperOfTheBooks

      …what the hell?? That’s just about the stupidest thing I’ve read on the Intertubes this week, and that’s saying something.
      IT’S A BREASTFEEDING CLASS, YOU TWIT. If breastfeeding’s an issue anywhere (and I’d argue it shouldn’t be), it sure as hell shouldn’t be there!

    • Mattie

      Precisely how are women supposed to learn breastfeeding techniques and fix latch problems or positioning if they can’t breastfeed? Stupidest thing I have heard in a while.

  • Gatita
  • Sarah

    On the subject of white hats, there was some research from the University of Swansea recently about whether parents of formula babies get more sleep than breastfed, and whether breastfed babies wake up more. They found there was no difference. Of course, the cohort they looked at was 6-12 month olds. Who are as a group, I think it’s safe to say, usually waking up less in the night than little babies (except teething). I’ve known a few EBF mums who were up constantly at first, but found it had toned right down after the first few months.

    Now if I were a researcher and I wanted to downplay the possibility that parents of formula fed babies might get more sleep, I’d definitely make sure I looked at the older ones. Because a lot of infants are sleeping through by six months anyway, and a good number of those who aren’t will only wake up once. As a parent who’s aware that (teething aside) the sleeplessness is normally worse with younger babies, the comparison I want is the 0-6 month group. Total coincidence that they chose to focus on the older ones though, I’m sure.

    http://www.swansea.ac.uk/humanandhealthsciences/news-and-events/latest-research/sleeplessnightsnewresearchfindsbabiesshouldwakeatnight.php

    • Joy

      I think it is also a swizz because they didn’t study babies over a year old. I know a lot of extended bfers who co-sleep who told me that their older kids (3-4) still feed every 2-3 hours during the night. When I mentioned by 8 week old was sleeping four hours in a row, three of my friends said that was more than their older kids slept.

      • KarenJJ

        I was wondering if everyone who was having a very unsettled, wakeful baby that wasn’t getting enough milk has already switched to formula/supplementation with formula by six months?

        • Sarah

          Probably. Naturally, the study didn’t consider this.

          • KarenJJ

            Maybe they did and decided to collect the results they were more hopeful would give them results that fit in with what they wanted to see? Maybe they started collecting younger baby stats but decided to dump them.. Maybe I’m too cynical..

          • Sue

            Ha. Maybe too perceptive, Karen.

    • SporkParade

      There’s a slightly more fundamental problem: Parents who formula feed at night aren’t getting more sleep because their babies go longer without waking (though some people believe that is also true). They sleep better because they can take turns feeding the baby, so the mother only has to wake up half as often.

      • Sarah

        That too. Lactivists usually like to downplay this by pointing out that lots of women don’t have any help at night. Which is true of course, but hardly relevant to those of us who do have partners who’ll do their share and/or other people who are willing to look after the baby overnight.

        As for the issue of whether formula fed babies go longer without waking, there doesn’t seem to be much research on that for the little ones. I’d really like to know, but it strikes me as the sort of thing that maybe wouldn’t be the most popular choice for funding in case the results are inconvenient. If I had to guess, I’d think the difference would be greatest at first, but decrease with age, and be fairly minimal after a few months, once most of the breastfeeding dyads have got a good supply established and most babies aren’t up every two hours.

        • Cobalt

          There are confounders that tend to not get addressed, many being ideology driven behavioral choices that aren’t acknowledged or studied.

          For example, do we know if exclusively breastfeeding families are less likely to sleep train for personal reasons? Is sleep training helpful? Is cosleeping more common in one group, and what impact does it have on parent’s sleep?

          In the end, how much sleep anyone gets (assuming general good health and environment) depends on two major factors: the baby’s behavior and the parent’s behavior. It’s not just food and feeding patterns, but also beds and bedtime routines, inherent temperament and learned skill.

          • Daleth

            You could control for that by eliminating from the study families that cosleep or that use (a clearly defined form of) sleep training. I’m assuming you mean something like cry-it-out, but it would need to be defined.

          • Cobalt

            They could all be included, but the data on the variables needs to be included to get a more accurate picture. There are some babies that sleep long stretches early no matter what, and some that wake often no matter what, but the majority in the middle have a lot more factoring into their sleep than feeding method.

            And the assertion that even though breastfed babies wake to eat more, their cosleeping mothers get more sleep raises flags for me. First being: if you’re sleeping so soundly without interruption through feedings, how does that adjust your risk of sleeping so soundly through suffocating the baby in the bed next to you?

          • Inmara

            I think that increased sleep time means cosleeping mothers don’t have to step out of bed, go to another room to feed baby and then come back and fall asleep again (if we speak about cosleeping as being in the same room as baby). For bedsharing there is even less time to spend in addition to feeding, but yeah, suffocating risks are increased then.

          • Cobalt

            A baby that will hold his own cold bottle sleeping in an arms-reach crib requires only being handed his bottle. Opening one’s eyes is optional.

            I know that’s Not How It’s Done, but it worked just fine. Much better than my groggy in the dark attempts to feed the wrong end of him.

          • KeeperOfTheBooks

            I now have this mental picture of an exasperated, hungry baby seizing a proffered bottle waved drowsily in his general direction and chugging it, all while thinking, “Idiot mommy, I’ll do it myself!”
            *giggles*
            (To which, were it my kid, I’d hasten to reply “Works for me! Good night, kiddo!”)

          • Cobalt

            At the risk of losing whatever “mommy points” I have left, once I discovered the kid was satisfied with a chilled bottle handed over without fuss, I bowed out of night feedings completely as I am by far the heavier sleeping parent. That poor man handed over 2am bottles alone for another 6 months because he couldn’t bear to let the kid cry for five minutes. He was away for the weekend when the little one was about 11 months old, at which point the child immediately began sleeping through the night.

          • Amy M

            Yeah, more laying down time maybe, but I think this is more dependent on the mom: some people can fall back asleep easily, after being woken up, some can’t.

          • Busbus

            I nursed my older child while co-sleeping and started out a very smug new mom; I always thought “how great I don’t have to get up; no nap schedule to worry about; why isn’t everyone doing this?” But later on, when other children started waking up less or even (gasp!) sleeping through the night, and taking regular naps, and my daughter was still waking up every hour and completely refusing naps unless carried for hours, I wasn’t so sure any more… Also, as she got older and more wriggly, it got harder and harder for me to sleep next to her or go back to sleep after nursing. In the end, I didn’t dare to turn around in my own bed for fear of waking her and having another 30+ minute nursing session (through which I decidedly could not sleep anymore). Akh. I’m sure some people have better experiences with it than we did, but judging by other posts on AP boards, our experience isn’t unusual at all.

            Like many above posters, I am sure that my daughter’s sleep habits had a lot to do with our behavior around sleep and not with breastmilk itself. However, if you formula feed, you simply cannot have a baby suckle formula all night long; you’ll need to be more deliberate about feeding times and so certain habits can’t get ingrained in the first place.

        • KeeperOfTheBooks

          A lot would also depend, methinks, on cosleeping. Going by the local LLL’s page, cosleeping, nursing babies tend to keep eating at night long after they need to eat at night. In a recent thread, a lot of people were posting about their 18-24+-month-olds still nursing multiple times at night. Which hey, I wouldn’t care–if it works for you and doesn’t do any harm, I don’t really give a crap–except that the vast majority of the moms were unhappy about the fact that they were still having their sleep consistently disturbed by these older kids waking to nurse, yet were unwilling to sleep separately or night wean on the grounds that it would cause the kids some sort of harm to do so. Breastfeeding per se may or may not contribute to less sleep for mom, but behaviors common in some breastfeeding circles certainly do.

          • Daleth

            Maybe what we’ve got is the best of both worlds: we’re cosleeping (not when they were tiny, but from about 6-7 months when they got their first cold and couldn’t/wouldn’t sleep alone), and formula feeding. We feed them at 7:30PM or so and then again at… 7:30AM. Woohoo!

          • Megan

            We do the same thing and it’s been great. When we were still feeding during the night DD woke up more but since we’ve weaned from the bottle at night she is sleeping much longer stretches, 5-6 hours at a time usually. I’m hoping as teething gets better it will only lengthen!

          • Daleth

            Yay! I’m sure it will! Every extra hour of sleep is SUCH a godsend.

          • Busbus

            Yes, seriously. After having spent several years on a well-known AP board, and eventually deciding to gently sleep train my second child due to the years of sleep trouble with my older one, I began to notice that sleep trouble is like the hidden dark secret of AP. Practically EVERYONE complains about it on AP boards, there are many posts detailing extreme exhaustion for months or even years and quite a few women who tearfully say they are absolutely at the end of their rope. (Of course no one ever recommends sleep training or even seperate beds.) On that particular board, it seemed like there were days where 80% of posts were about sleep issues.

            I’m so glad I stepped away from that and found a way that worked so much better for us and our son than what we did with our daughter (she woke 6-8 times a night to nurse until she was 2.5 and about 2-3 times a night even after weaning and in her own bed up to almost age 4; he’s been a champion sleeper since about 4 months and is until today, and after our first experience, I am SO relieved…).

          • KeeperOfTheBooks

            I can only imagine. I nursed (combo fed, really) to four months, and then went to FF only. DD was a pretty good sleeper once we sleep trained her, but there were some regressions, and I remember after just a week of once- or twice-a-night wakings at the 6-month sleep regression that I cried to my husband that I had no business driving a car because I was so tired, so terribly, bone-achingly tired. And exhausted/borderline hysterical as I was, I was definitely right: it wouldn’t have been safe for me to get behind the wheel.

          • Roadstergal

            That completely fits with my AP friend. I don’t think she’s had a solid night’s sleep since her now-toddler was born; she is exclusively responsible for feeding the kid, co-sleeps, EBF on demand, and I don’t think she usually gets more than two to three hours’ straight at a time. But sleep training, any kind, is child abuse, full stop. And the husband can’t take care of any of this, because AP.

            The reward, I think, the thing that keeps her doing this, is knowing that she is a Real Mom. I mean, not even a Better Mom than the ones who don’t, but much in the same way the EBF crowd won’t settle for Breast Is Best, Formula Is Fine, but have to ‘normalize’ Breast, the AP crowd makes AP into the only viable choice for a mom who ‘really loves’ her kids.

        • Allie P

          Re: “Women don’t get help.” Demonstrably false. I got up once last night to nurse my few-day-old. The second time, he got up and gave the kid an ounce of formula. Everyone was happy, fed, and reasonably well-rested for having a three day old in the house.

    • Marab

      All of the NICU nurses and the lactation consultants at my twins’ hospital were firmly convinced that formula feedings led to babies being able to sleep longer periods of time than breast milk feedings. This included the NICU nurse who was taking regular pumping breaks for her own infant. The NICU promoted breastfeeding heavily (like every U.S. NICU), though not insanely (formula was not under lock and key), and I know that the belief that formula takes longer to digest than breast milk is not necessarily supported by the science, but this quiet, “yes, but if you DESPERATELY NEED sleep, then…” caveat still amused (and reassured) me. (Note: I pumped sufficient breast milk to feed my preemies when they were in the hospital, and no one ever suggested they need formula to make the nurses’ lives easier — this was all about what happened once the babies went home.) I think I’ll go with the expert wisdom on this one…

      • Sarah

        Sleep is for wimps…

      • Kelly

        With both my kids, I always gave one bottle of formula a day and I always gave it at night hoping that it would make them sleep longer. I don’t think it did but it made me feel better.

        • Busbus

          With my combo fed baby, he got one bottle at night from my husband. Made for way better sleep…! 😀

      • StephanieA

        Those nurses never met my son, then. He was formula fed and woke up 5+ times per night until we did CIO at 6 months, then he would wake up 3x per night. If he did sleep longer, it wasn’t by much in comparison to the two weeks I breastfed him.

  • Carolina

    Timely. I was just kicked out of a militant facebook breastfeeding group for either (1) suggesting that doctors were not getting kickbacks from the formula industry or (2) telling a mother whose baby had lost additional weight at his two week check up that she needed to listen to her doctor and start supplementing ASAP (I made these comments within 5 minutes, so who knows which got me banned ). I’m surprised I lasted in the group as long as I did (a neighbor added me – I don’t really need help/support nursing my second baby). It just enrages me that vulnerable women are exposed to this crap under the guise of it being “best” or “normal” when there is so little evidence to back it up.

    • Daleth

      How appalling that they kicked you out for that. Talk about speaking truth to power!

  • Cobalt

    I’m going to try to express this articulately, please bear with me.

    Integrity demands consistency. To have personal integrity, one must be consistent in the guidelines used to evaluate the ethics involved in all behavioral choices.

    If shaming a woman for breastfeeding (publicly or otherwise) is wrong because it is her choice to feed her baby, then shaming a woman for formula feeding is wrong for the same reason.

    If negative public commentary directed at a woman for breastfeeding (in public or otherwise) is wrong because the public had no right to control a woman’s body or judge her for breastfeeding, then POSITIVE public commentary (like those thank you cards) is also wrong, and for the same reasons. As would be the same actions directed at those who use formula.

    If the public does not get to judge or discriminate (and amongst any safe feeding cchoice they shouldn’t) then the public doesn’t get to judge or discriminate.

    To demand that one public judgement be allowed (thank you cards) but another public judgement be outlawed (breastfeeding moms being asked to leave), just because one makes you happy and one makes you sad shows a severe dearth of personal integrity.

    But natural parenting has never been about integrity or consistency, has it?

    • Roadstergal

      “If shaming a woman for breastfeeding (publicly or otherwise) is wrong because it is her choice to feed her baby, then shaming a woman for formula feeding is wrong for the same reason.”

      Absolutely this, and that’s why there is such an industry of trumped-up ‘risks’ of formula feeding. You’re not harassing a woman for making a choice that you don’t agree with – you’re ‘informing’ her about the ‘terrible risks’ she’s running.

      • Cobalt

        Many do try to claim integrity that way, but unless they are lecturing nursing moms on the dangers of jaundice, anemia, unstudied medication interactions, how clean their bras are, how often growth evaluations are done, if their milk has been tested for contaminants, etc, then they’re still using different rules and creating a second class.

        • Daleth

          Seriously. I’ve seen, disturbingly often, posts in moms’ groups where someone says “I’m EBF and my 8-month-old is 5th percentile for height and weight, should I supplement?”–and people answer, “As long as he’s having 6-8 wet diapers a day, he’s getting enough!”

          More than once I’ve pointed out that 6-8 wet diapers only means he’s getting enough LIQUID to PEE… not that he’s getting enough CALORIES to GROW.

          • Cobalt

            I just can’t even. You have to feed the baby. It’s the second rule of producing surviving offspring. The first being access to air.

          • Joy

            That was the issue with my baby. As much I as hate KellyMom, the article says if your baby is growing then look at the diaper count. Not to ignore the growth part.

          • Elaine

            Well, it depends. If the baby has always been 5th percentile, then he’s probably fine. Somebody has to be the 5th percentile. If he’s dropping down the growth chart, something is probably wrong. That goes for either formula-fed or breast-fed babies.

            In reality I bet there’s a fairly small number of kids who make it to 6-8 months basically healthy and growing normally and only then start having problems getting enough nutrients (barring cases where some outside factor torpedos mom’s milk supply, like that she is sick or pregnant again or some such).

          • SporkParade

            I think that actually happens around 4-6 months based on the number of women I’ve known (including myself) who suddenly just don’t have enough milk after the 4 month mark. The baby just outgrows the supply. I will skip my usual rant on how the recommendation to EBF to 6 months sets women up to fail.

          • yentavegan

            Why do Lactation educators push for exclusive breastfeeding? What is so earth shattering wrong with combo feeding? So many mothers are happy nursing their infants and then introducing formula as the baby ages and can hold their own bottle. Mothers can choose to either continue to breastfeed and formula feed or wean completely because nursing a big mobile active baby is not the same as nursing a newborn who basically just sleeps eats and poops.

          • Ash

            @yentavegan:disqus , to me it’s an extension of creating a parental product.

            http://www.skepticalob.com/2015/02/biggest-problem-with-natural-parenting-it-treats-children-as-parental-products-not-people.html

            We are taught that if we do X Y Z completely according to plan, children will be financially successful and healthy. And if the plan is not followed, the parent has ruined their opportunity to create an extension of themselves (happy child showing that parents are happy…it goes round and round). By following these rules, such as exclusively breastfeeding for a certain period of time, you are providing insurance against falling out of the parents’ social class.

            …that’s my ‘deep thought’ take on it at least.

          • Monkey Professor for a Head

            I think there’s two possibilities. Firstly, they fear that if they accept combo feeding then they are giving approval to formula, and therefore that diminishes the hallowed place that breastmilk has in their minds. The second possibility is that if you “allow” women to combo feed then they might be tempted by it – basically if you don’t completely forbid formula then women will make the “wrong” decision.

          • SporkParade

            Because they are butt holes. I was pretty damn angry when I saw the AAP webinar on exclusive breastfeeding, and they not only totally ignored the mother’s preferences and mental health, but their top reason for avoiding formula was “stinkier baby poop.”

          • Sue

            Cos there are special “toxins” in formula that cancel out the unicorn sparkles, or something.

            Do lactivists think that formula somehow inactivates the good stuff in breast milk?

          • SporkParade

            Yes. Cf. the gut microbiome.

          • Angharad

            Yes, at least some do. They think formula is poison and it ruins the baby’s microbiome.

          • Kelly

            Just wait six months and that poop will stink like a grown man’s.

          • Roadstergal

            My lactivist friend chanted ‘nipple confusion’ like a mantra. Can’t combo feed, because nipple confusion. Despite the fact that her daughter took a pacifier, and still breastfed through 3 years old. They like to pretend that combo feeding doesn’t exist.

          • Monkey Professor for a Head

            The lactation consultant at our local hospital recommended against pacifiers because of the risk of nipple confusion, but was fine with letting the baby suck your finger while syringe feeding. I don’t see how that’s not more confusing.

          • Kelly

            My lactation consultant said that you need to start giving bottles at two weeks otherwise you might have hard time switching back and forth. She was pretty awesome.

          • KeeperOfTheBooks

            Which is quite interesting, and probably explains why Back In The Day, it was quite standard to start giving kiddo solid foods and regular milk at about four months. (Our pediatrician was still fine with solid food at four months if the kid was ready, and ours was. Cows’ milk, not so much. :p)

          • Kelly

            Nurse the baby and then give the baby a bottle. If they suck it down, they are still hungry and you need to supplement. If they don’t, they are just small. My daughter was small but since we put breast milk in bottles it was easier to tell how much she was getting and she followed the same percentile path.

          • Amy M

            Mine have always hovered between the 3-5th percentile. They are just tiny. But since they have been growing at a normal rate, their doctor is not concerned. (and they have small parents)

          • Sue

            SOME normal people have to be in the top and bottom parts of the normal distribution curve, after all.

            Elaine is right that maintaining a growth pattern matters, not just what part of the normal curve you are on.

          • KeeperOfTheBooks

            Quite. Recently saw that in the local LLL facebook page. They gave enough info that, assuming all information was correct, one could plug the numbers into a growth chart and see that the kid had dropped a minimum of 40-odd percentiles over six months.
            I was the only person there who seemed to think that was an issue.
            I really do need to unsubscribe from that group…

    • Kq

      THIS.

      It used to infuriate me when people praised me for nursing my son (publicly or otherwise). We were lucky – he had a good latch and I had a great supply, and I was a stay at home mom for the majority of our breastfeeding relationship. LUCKY. Nothing more. It was what worked for us, and I was absolutely uncomfortable and angry to get headpats and compliments about what a GOOD mother I was.

      Bullshit. I’m a good mother because I fed my child in a way that worked for us? What a pathetically low bar to set. And I bristled because I knew the very same people would condemn me if I made a different choice.

      Hypocrisy enrages me.

      • nomofear

        I am especially militant about gently correcting other mothers who praise me. The other breastfeeders I expect, but the formula feeders who express regret that they didn’t breastfeed make me so sad. I really dig into them that they shouldn’t feel bad, it’s just food, it comes easy to me in my current situation, there are no long term differences – and, for both, I’ll end with a joke that someone here made once – if it was THAT important, our doctors would be asking us as adults! But they don’t…and even past toddlerhood, a new pediatrician doesn’t ask. We’ve moved three times since my daughter was past that point, so I know!

    • JoannaDW

      I agree completely. If we allow public comment on anything, we must allow negative and positive reactions. If we want to demand that the public stay quiet, we can’t demand praise for our behaviors, and feel entitled to condemn the behavior of others.

    • guest

      I can’t upvote, but bravo/a!

  • Therese

    To have your numbers be consistent, wouldn’t you have to find the actual death rate of infants who are fed formula?

    • Daleth

      That would be like finding the “actual death rate of children who wear disposable diapers.” There is no such thing–in other words, the death rate is 0–because disposable diapers and formula, unlike home birth and VBAC, do not cause children to die.

      • Therese

        The death rate doesn’t become zero just because the formula doesn’t directly cause the death. I get the point that you and Dr. Amy are making, but right now it literally says that infants that are fed formula never die.

        • Therese

          I mean, I guess if Dr. Amy just wants to preach to the choir, it’s fine since we all know what she means, but any breastfeeding advocate is going to look at the claim that formula fed infants never die and just laugh.

          • Kq

            The issue isn’t that formula fed babies never die. The issue is that babies (in a first world country fed properly prepared formula) never die *because* they were fed formula.

          • Sue

            That’s what lactivists don’t get. Nobody dies from formula. If it is infected or diluted, as in impoverished countries, they may die of gastroenteritis, dehydration or malnutrition.

            But babies in wealthy communities don’t die from unclean water or extreme malnutrition. Rarely, some die from transmitted infections. There appears to be a small but real increase in the number of gastro and respiratory infections in formula fed babies in the first year of life. But there is also a major increase associated with exposure – babies exposed to older siblings, smoking in the household and group childcare get more infectious diseases. Rarely, one dies. But do we say that having older siblings kills babies, or that childcare kills babies?

          • Daleth

            Not unless they can also convince themselves that the numbers mean 99.5% of VBAC babies will live forever, too. Somehow I doubt they can convince themselves of that.

        • Cobalt

          Same rules are used for other stats, VBAC babies who were lost later for unrelated reasons aren’t included. The metrics are consistent but could use a more precise label. “Attributable to” or something similar.

          • Daleth

            Agreed, that language would be good. It would prevent hyper-literal automatons from misreading the article.

          • DelphiniumFalcon

            I don’t know, I’m a hyper literal automaton according to a few people I work with and I read it just fine. 😀

          • Cobalt

            Deliberately obtuse hyper liberal automaton, then.

        • Daleth

          Reading it that way reminds me of the joke about the computer scientist husband going grocery shopping. His wife says, “Pick up a loaf of bread, and if they have eggs, get a dozen.” He comes home with a dozen loaves of bread and no eggs because the store did indeed have eggs.

          In other words, that’s absurd. If you read the formula feeding rate that way, then you would also have to interpret the other death rates as meaning that 94.4% of home-birthed babies 99.5% of babies born by VBAC will never die.

          • Therese

            I assume it’s within a certain time frame, like up to one month following the birth. So if that was the case, you’d want to look at the death rate of formula fed infants up to one month of age. (Of course, I suspect breastfeeding advocates would disagree with that short of a time frame because they’d want to attribute many of the SIDS deaths to formula.)

          • Daleth

            It’s not about the time frame, it’s about the cause (whether the death was caused by the thing in question: the lack of medical resources in a home birth, the uterine rupture in a VBAC…).

        • Amy Tuteur, MD

          I changed it to the “excess death rate” of formula feeding to address that issue.

          • Mariana Baca

            Shouldn’t it also be the “Excess death rate of VBAC vs RCS” or “Excess death rate of HB vs Hospital birth,” though? Baby needs to come out somehow.

  • RMY

    Semi OT, the blogger I had been friends with before I realized she was crazy has refused to formula feed even when her son was diagnosed with ftt. Two years later she posts about how he was “a high needs infant” and hates doctors but hopes one can figure out why her son is the size of a one year old, has poor muscle tone and has delays.

    That’s a case of exclusive breastfeeding causing harm. She was worried he’d grow up to have Celiac’s if she formula fed him based on some PDF file she found online.

    • Chrisp

      A family friend of mine did the same thing. He was failure to thrive, not feeding well and she refused to supplement with formula. She would say “this baby is so fussy” and “he cries all the time.” I wanted to yell – “He’s STARVING.” As soon as he hit 6 months, and solid foods were provided, he got back on track and now is doing very well. But I often think – what the heck is wrong with you? I feel like my heart is being pulled out of my chest when my 7 month old daughter is not feeling well. It’s astonishing to me that she would just watch him suffer for 6 months and then blame him for his poor temperament. Poor baby.

      • Daleth

        Oh you guys, that’s so horrible. I feel so bad for those poor babies!

      • RMY

        Yeah, that’s why I defriended her. I couldn’t watch that. I only check up on her occasionally. I’m glad your friend’s kid was able to bounce back.

      • Lawyer Jane

        I didn’t even realize my LO was hungry until I saw how happy he was the first day the nanny had him and he got 16 oz in 8 hrs. After that he started gaining like gangbusters. The weird thing is that I had at least 10 ped and LC visits to address his weight gain and not one told me “just give him a bottle of formula a day.” I suppose I should have figured it out for myself but none of the professionals were saying anything.

        • Joy

          But that would be discouraging! Or whatever. I was told that it is better to do full health investigations, blood test and all, than to recommend formula, because it is so rarely a bfing problem.

        • Young CC Prof

          Even some pediatricians are now reluctant to recommend supplementation for low milk supply and other nursing problems, possibly too reluctant sometimes.

          • Cobalt

            The pediatrician might well be attacked by the mother for being an unsupportive Big Formula shill. The “exclusively breastfed” label matters! Although, if you ask them what benefit they get from all that suffering, other than the label, they can’t tell you or they make up some craziness about the microbiome.

            Offering formula to ease your or your baby’s suffering is getting to be the pediatric equivalent of offering an epidural to a woman in an agonizing labor. Except with formula it really can be life or death, and not for the person making the decision.

          • Liz Leyden

            I don’t know how WIC works in your state, but in mine a woman who breastfeeds exclusively gets food for 1 year. Supplemented babies gets formula, then solid food from 6 months until age 5, but Mom’s food is cut off at 6 months.

            Once we got back from Boston, insurance problems and the WIC sign-up process (which we couldn’t start when we were out-of-state) had us running low on formula. My daughter’s cardiologist was great about providing formula samples, but if your pediatrician doesn’t do that and you’re trying to breastfeed exclusively, you might be better off buying formula so you can get extra food.

          • Cobalt

            Where I am, the formula package has a higher cash value than the food package, and the food options are pretty limited for breastfeeding moms.

          • guest

            Yes, I saw a lactivist attack my pediatrician in our neighborhood group. She claimed he was terrible because “more than half” of his patients use formula. First of all, either she’s making her numbers up based on a handful of people she knows OR she somehow has access to his patient information and is being extremely unethical by reporting about it. But even aside from that, so what if 50% of his patients use formula? And why is that his fault? (He’s my ped., and he’s pro-breastfeeding and gives out cards to LCs at the first newborn visit. I used that card, and the LC in question is EXCELLENT (not the one complaining). She legendary among LCs, but also not crazy against formula. But nevertheless, this ped was publicly attacked.

          • Young CC Prof

            Exactly. I do not approve of rating hospitals or providers on breastfeeding rates. Have you ever heard someone say, “He must be a terrible doctor. So many of his patients smoke.”

            Smoking is a much larger health concern than infant feeding method, and, unlike breastfeeding, everyone is physically capable of not smoking. And yet we recognize that the reasons people smoke, or don’t, are complicated, personal and not entirely under the control of any one medical professional.

          • Busbus

            Isn’t that to be expected? I don’t have the numbers on hand, but that seems totally normal. I always thought that by four months, the vast majority of babies get at least some formula in the US.

          • Ash
          • Busbus

            Right. The CDC graphs show that 60% of babies get at least some formula before 3 months. And at 6 months of age, there are approximately 50% formula fed babies, 30% combo fed babies and 20% exclusively breastfed babies. So?

          • Busbus

            Which, incidentally, also shows how ridiculous it is to leave combo feeding out of the picture. At 6 months, more women combo feed than exclusively breastfeed (which is not surprising at all). To me, these statistics are very reassuring – exclusive breastfeeding is only possible for 1 in 5 mothers, so if you can’t or don’t want to, you are simply normal (ha!). It also shows how crazy this whole move to shame formula feeding mothers (80% of mothers at 6 months!) really is.

          • Ash

            Yes, you are correct, I was just providing the links to the numbers per the CDC in case anyone is curious.

          • Busbus

            Sorry, Ash, my “So?” was not directed at you! Just at people who would say these numbers are bad or indicate a problem to be fixed. Thanks for posting the link!

        • anotheramy

          Yep!! My LO was a terrible, TERRIBLE sleeper, waking up to eat every 2 hours for the first six months and needed frequent weight checks because he was on the low end of normal. No one suggested I should supplement b/c he was “still growing”, but I wish I would’ve recognized the poor sleep as hunger and supplemented!

        • nomofear

          No, when you’re a new mom, the combo of hormones and sleep deprivation excuses those lapses! And, if he was your first, you wouldn’t have anything to compare to.

    • Cobalt

      Well if he gets Celiac’s, he will have trouble digesting some foods. If you just starve him, there won’t be any food to have trouble digesting! Sounds totally legit. Like using pregnancy for birth control, or unpredictable infection for immunity, or callused bloody stumps for shoes.

      • RMY

        Death prevents a lot of health issues, but I don’t recommend it for children. Celiac’s isn’t the end of the world at all, especially not these days when there’s so many gluten-free food options.

        • DelphiniumFalcon

          If my sister who has celiacs can kick ass doing Brazilian Jujitsu and win grappling tournaments I’m pretty sure if formula caused celiacs (which it doesn’t) her kid would be just fine.

          My sister happened to be the one who was formula fed because Mom was taking a med that recommended not breastfeeding. As I’ve mentioned before, despite having celiacs she is stronger, faster, has a more robust immune system, and less mental illness issues than I do.

          Hell she might have been better off! Mom has issues with her immune system and I was the breastfed kid and my immune system is whacked out too! Does that supposed benefit of antibody transfer in breast milk have the potential to backfire? Lol

          • Monkey Professor for a Head

            I’ll throw in some anecdotal just for the hell of it. Me and my 4 siblings were all exclusively breastfed. 4 out of 5 of us (including me) have coeliacs (as does my mum). Breastfeeding didn’t cause it but it sure as hell didn’t protect us either.

          • DelphiniumFalcon

            Goodness it’s almost like there’s a genetic factor at work and if enough things stack up you manifest the disease!

            On a more positive note, I’m glad you got diagnosed. I know too many friends and family that ended up nearly bedridden from it or at death’s door. So anyone who gets diagnosed while it’s a “that sucks” it’s also a “Yay! No slow and painful death from malnutrition or vitamin deficiencies!”

          • Monkey Professor for a Head

            I’m glad I got diagnosed too. It was lucky that I did – none of my family including myself have much in the way of GI effects, so if my GP hadn’t tested my sister when she was run down and exhausted then none of us would have been diagnosed. I only get fatigue after eating gluten, so I’m lucky that my family history allowed me to make the connection and I could get on a gluten free diet prior to pregnancy.

    • wookie130

      This is neglectful. When I struggled to breastfeed before I was diagnosed with IGT, even the crunchiest of lactation consultants who was assisting me told me that no matter what, I still had to “feed the baby.” She didn’t say that it had to be breastmilk…and it took me no more than an hour of listening to my hungry daughter scream before I took the cue, and busted out the bottle. Can you imagine being a helpless baby, dependent on your mother to meet your every physical and emotional need, and she fails to satisfy the bare-ass minimum, which is food? It’s really DHS/CPS material, seriously.

      • RMY

        Cps was involved. I am not sure how that played out. I think she found someone to donate milk to be able to keep her child.

      • StephanieA

        I struggled with breastfeeding in the hospital and was told by the LC and nurses to just keep doing it, your baby is getting colostrum, he doesn’t need very much right now, etc. His second night he literally did not sleep, would feed and come off the breast crying, wanting to feed again 1/2 hour later, repeat for 12 hours. Finally at 5 am it clicked- I am this baby’s mother and my child will not starve. I requested formula (after a lecture from two nurses) and my son drank it like a milkshake and slept for 4 hours after that. I felt awful that he was hungry for even that short amount of time- how can any parent ignore their child’s hunger cues for months on end? It makes me sick to my stomach.

        • Angharad

          I wonder about this idea that newborns don’t need more than a tiny bit of colostrum and a teaspoon or two will hold them over for hours. My daughter certainly could have more formula than that and it didn’t seem to make her sick.

          • Daleth

            I think their theory is “evolution would not have made babies who need more milk than their moms can produce, therefore, newborns must only need colostrum and only in tiny amounts.”

            What they are forgetting is that humans didn’t start living in nuclear families–in other words, small groups in which there was only one lactating female–until like 100-200 years ago. Before that, we lived in extended families, tribes and other larger groups (e.g. a large wealthy family plus its servants–which would include some wet nurses or some maids who could pitch in as wet nurses when needed). I have little doubt that in more “natural” living conditions like that, while mom recovered from childbirth, she AND whoever else was lactating would feed the baby when it cried. And THAT is what evolution had to work with, until very recently.

          • StephanieA

            I agree. I can’t find much information about shared breastfeeding, but I’m guessing that other mothers fed the baby until mom’s milk came in. I doubt a newborn would’ve been left screaming for a day or two (even though LCs will tell you not to feed alternatives because the baby won’t be stimulating milk production).

          • Young CC Prof

            That’s because they don’t teach the correct newborn supplementation technique. I was happy to supplement my newborn, but no one told me how!

            If a breastfed newborn appears to need supplementation for any reason, including but not limited to excessive weight loss, continue to attempt breastfeeding at least 8 times per day, and also offer formula with every nursing session, enough to keep the baby healthy until milk comes in. If baby and mother must be separated or baby will not or cannot suckle effectively, use a pump.

          • Daleth

            Anyone who tells you “don’t feed your baby” is an idiot who should not be listened to. There is no excuse for not feeding your baby.

          • Young CC Prof

            I think that babies are supposed to get small meals for the first few feedings while their stomachs get used to the idea of eating, but within a couple of days, they happily down 2-ounce bottles.

    • Young CC Prof

      And that is the real harm in the formula demonization: That parents are willing to risk a baby’s health rather than supplement. Very few people would take it that far, but even among the mainstream crunchies, there is I think too much reluctance to add formula and too little recognition of the risks of insufficient intake.

      • Roadstergal

        I wonder about some of the negative stats from formula feeding. If we have women willing to let their kids lose substantial amounts of weight at a critical time for development before they ‘give in’ and supplement, that’s going to shift the accountability for long-term effects caused by starvation onto formula feeding…

        As someone (was it you?) mentioned some time back, ‘intent to treat’ is the only halfway decent way to approach it. It’s like emergency C-sections caused by too much devotion to the idea of a vaginal birth being blamed for the bad outcomes of the distress that preceded it.

      • KarenJJ

        It’s almost like it’s anorexia for your kids… Not quite sure what I’m trying to say there, but such an irrational fear of a basic food source doesn’t seem healthy. Most people that have been told that their baby is suffering will do what they can to help them thrive.

        • Mishimoo

          Orthorexia-by-proxy, perhaps? Since it is based on the idea that breastmilk is healthier/more pure.

          • RMY

            That’s what I was going to say. It is orthorexia by proxy. Celiac’s is caused by the HLA-DQ2 and DQ8 genes, not by formula. But reality doesn’t factor into the decision making of some people.

        • Tiffany Aching

          I think that many women who desperately cling to ebf even when their child obviously doesn’t thrive project some kind of eating disorder on them. I would be very interested to know how many of them suffered from eating disorders. Being that obsessed with food, making it a source of great anxiety and catergorizing it with notion of purity / poison, denying doctor’ s concerns about weight and health definitely make me think of anorexia.

        • Sue

          Great point, Karen. It is certainly a pathological attitude to food.

    • KarenJJ

      Wow that’s awful. Poor little mite. No wonder so many of these women need external validation. because they’re not getting it from witnessing a happy, content, thriving baby..

    • anotheramy

      How sad. Given his poor muscle tone and delays, it’s hard to blame the ftt completely on the ebf, though. It might be because of a genetic or metabolic condition or cerebral palsy. I work with developmentally delayed infants and toddlers. I’ve seen many kids diagnosed with ftt, and they were all formula fed, IIRC. But common sense would say if baby is ftt, switch to or supplement with formula and see how baby does. It drives me nuts when lactavists or moms paint doctors as evil boogeymen who are out to sabotage their nursing relationship.

      • RMY

        I’d agree, but he was born in the 50th percentile, went down to the 5th, the mom complained about her supply and tried every herb under the sun because her supply was low, had tongue ties dealt with, etc. She felt it was her supply at the time and chronicled the whole thing (which she deleted later). He got listless and weak so his Dr called CPS on her as she refused to formula feed, then she got donated breastmilk and he perked back up. I really am certain he was starving. He didn’t gain weight for months after he was born. There’s no way to say that the muscle tone/etc are 100% caused by the refusal to supplement, but I really think she didn’t do him any favors.

        • Elaine

          That is awful. I don’t know how a parent can watch their child be miserable and still insist nothing is wrong and be unwilling to listen to their doctors. I mean, I get that it’s hard to admit that what you’re doing has been the wrong course, but as a parent you have to put your ego aside and do what’s best for your child. That poor little guy.

    • Mel

      That made me shudder. My twin had Ftt due to severe gerd after premature birth. My parents followed the doctor’s advice and fed her medical grade predigested formulas. She weighed 12 lbs at 1 year, but had caught up to me by 20 months. Can’t imagine doing the same level of malnutrition to a child for the sake of breastfeeding.

  • Amy M

    Those lactivists try so hard to make sure that the only thing any woman ever sees is the “benefits of breastfeeding” and the “risks of formula.” I think the worst thing about that is the whitewashing of the risks of breastfeeding. They seem to think that many women are just looking for an excuse to not breastfeed, so the slightest negative thing about it will sway them to formula. But they are disingenuous because the only negative they acknowledge is that nursing in public is not ok with all women. They’ll also sort of admit that breastfeeding is more work because only “lazy moms choose formula wo/even trying breastfeeding.”

    But many of the reasons women choose formula have to do with the woman’s circumstances. Then, formula feeders get accused of choosing formula because “they don’t want sagging breasts” or “they are ashamed to nurse in public” or “they were brainwashed by formula ads.” The time commitment, issues with pumping while working outside the home, and possible physical pain, low supply, loss of sleep, and DMER are not mentioned ahead of time because they are not considered risks. If they even exist (many lactivists think anyone complaining of any of those things is lying), they are mere bumps in the road, that real mothers would push past, in service to her baby.

    I am guessing that more women wouldn’t even try breastfeeding if they were given complete information that included possible downsides. And the lactivists know that, and can’t tolerate it, so suppression and censorship it is.

    • wookie130

      I had to chuckle at “the risks of formula”…yeah, I see that a lot on mommy forums and blogs. There really aren’t any, if handled safely, stored properly, and as long as clean fresh water are being used. These people equate formula with letting your child climb up onto the roof of your house. But, I guess that’s “free-range parenting”, which is safe, and fine. Anything is better than the dreaded FORMULA.

      • DelphiniumFalcon

        So if they’re screaming about the risks of formula, which the “true” risks are mostly issues with preperation, why aren’t they screaming about the risks of all food? Almost all food has risks when preparation is done wrong.

        • Roadstergal

          The intersection of the Venn diagram of formula demonizers and raw milk advocates is marked ‘above average hypocrisy.’

          • Young CC Prof

            Risks of formula feeding: May transmit serious diseases if you choose to go old school with raw animal milk instead of actual formula.

          • DelphiniumFalcon

            I didn’t live on a dairy farm but Tillamook was only about forth five minutes south of where I lived and they had all the videos, the models, and so forth. We also visited one of the dairy farms and even after cleaning the udders I still though to myself “Ew. I’m glad for pasteurization.” Then when I was older I found out about pus and blood that could be in it! Then I nearly started screaming. So much ew.

            I guess what I’m trying to say is please irradiate, pasteurize, wash, and disinfect my food and I’m so happy to live in a country and time where that can happen. I don’t like the sound of cholera or typhoid.

          • Liz Leyden

            As a child, I had a baby-sitter who lived on a dairy farm. My home health client lives on a dairy farm. I’ve seen dairy cows up close and personal for years. I’m extremely grateful for pasteurization.

        • nomofear

          Right? I’m to the point where I almost exclusively buy pre-cooked meat. Unless I have a very specific need for raw meat, it doesn’t enter my house. When it does, it’s like defcon 5 with hand, utensil, and counter-washing. I even wash watermelons before I cut them. Friends were laughing at me, and then I happened to see that the sticker on the watermelon actually tells you to do so. I felt vindicated!

      • Kelly

        And honestly you don’t even have to worry if you mess it up a bit. I did not follow all the rules and my children are fine. They make it sound like you will spend hours and tons of money feeding with formula.

    • Rita Rippetoe

      I thought breastfeeding was the ‘lazy’ way 🙂 ; no bottles to wash, no running to the store for formula in the middle of the night, no toting insulated bag with formula, etc. Guess it is a matter of perspective.

      • Megan

        Breastfeeding for me was much harder. I had really low supply and DD had a tongue tie which we didn’t discover until she was hospitalized for jaundice. Then I was put on a ridiculous pumping schedule so I not only had all the crappy things about breastfeeding with none of the perks but I also had bottles to wash and warm up in the middle of the night and eventually formula supplements. It was the worst of both worlds. My life got infinitely easier when I switched to all formula. Wish I had done it sooner.

        Even if it had gone smoothly I would’ve had to pump when I went back to work so there still would’ve been bottles to wash, etc. Unless you are a SAHM and/or never ever leave your baby, bottle washing, etc is par for the course with breastfeeding also. I guess that’s why the argument about not having to deal with bottles bugs me because a lot of women who breastfeed still do.

      • Cobalt

        It’s all relative to the individual circumstance. Tradeoffs have different costs for different people.

        • KarenJJ

          That can’t be right? How will I know if I’m a good mother or not if I don’t conform to a checklist of arbitrary ideals set by society?

      • Monkey Professor for a Head

        Its the same logic that declares c sections to be both major abdominal surgery which will be hell to recover from and the easy way out.

      • The Bofa on the Sofa

        It’s simple, Rita.

        Breastfeeding is easy and convenient, and women who choose to do it are making a heroic effort of self-sacrifice.

        Formula feeding is a hassle and complicated, and those who choose to do it are lazy and taking the easy way out.

      • StephanieA

        Bottle feeding for me meant sleep, an opportunity for my husband to bond with our son (something he still talks about), an improvement with my PPD, and the freedom to feel comfortable feeding my baby in public (I’m not conservative by any means, but for some reason I could breastfeed in front of family, let alone at the mall).

        We put the bottles in the dishwasher and bought formula when we bought the rest of our groceries. It wasn’t a big deal to us, we would’ve needed bottles anyways when I went back to work if I had chosen to pump (thank god I didn’t).

      • Amy M

        We never ran to the store in the middle of the night, we always had plenty of formula in the house, AND made up all the night feedings before going to bed. Bottle washing wasn’t a big deal, and the diaper bag (which every new mother totes, even if there is no formula in it) had an insulated compartment. Not that it was necessary, because they make these awesome plastic containers that carry measured servings of formula powder, and then you can just toss in a few bottles of water, and dump in the powder when you need it.

      • Sarah

        Nah, it’s a matter of making sure you always have formula in, which you can achieve by buying it when you go to the supermarket. If you run out in the middle of the night, you’re doing it wrong. Also, premade is a thing.

        That said, if you find washing bottles more effortful than doing all the night feeds, I won’t be the one to argue with you. Perfectly valid to prefer one to the other.

        • Gatita

          Plus now you have all of the online delivery services. You can schedule repeat shipments ahead of time so you don’t even have to think about buying it.

          I wish I’d used premade on our outings. It really was a giant PITA to tote around powdered formula and bottled water (we mixed it onsite to avoid spoilage).

    • indigosky

      Just found out that my new ob/gyn was one of those lactivists yesterday. He’s the only doctor around that does Nexplanon and while getting my vitals I had to see that biased sign about the “risks” that formula feeding does to mom and baby. Yes, just what every expectant mother needs to see – a list of scarmongering lies. And with my arm sore from the insertion, it’s making me even more ragey.

    • Sarah

      That is certainly the reason I didn’t even try with my second. Having a good idea of the potential benefits and downsides, I knew that having to be the one to do all the night feeds simply wasn’t worth it.

    • seasiren

      I chose formula because I was going back to work. When I got home, I wanted to be with my daughter, not a breast pump. I got called on it by my first OB and I dumped her judgmental self and found a different OB whose four kids were all formula fed and he felt the same way as Dr. Amy regarding supposed benefits. I had to interview eight peds to find one who wasn’t going to flip their lid over me using formula. It was ridiculous. I got so much patronizing that it was the hormones leading me to bad choices, I should have let those supposed hormones take over and punched a few people.

      • Amy M

        Wow, that’s crazy! I also chose formula, and one reason was because I was going back to work. Lucky for me, none of my doctors or the pediatrician ever had a problem with that, at least not to my face.

      • Sue

        What an irony that the lactivists think it is the medical profession pushing formula as company shills!

        In my experience, it’s much harder to be dogmatic about things when you have lived through the experience yourself.

      • Daleth

        Holy crap, that’s just obnoxious! Do you live in an especially crunchy part of the country? I had no problem where I am. Found a ped who has no issues with how you feed, as long as you’re feeding them enough and they’re growing, and who won’t let antivax families be patients.

  • Roadstergal

    Is that B: number for VBAC at a VBAC-approved hospital?

    • Montserrat Blanco

      Yes. The rate for homebirth VBAC is outrageous, and higher than the homebirth rate showed here.

      • Roadstergal

        Oh, yeah, even a layperson like myself cold tell that wasn’t the HBAC death rate – but I was wondering if that was the rate for VBAC-approved hospitals as per the current US guidelines, or all hospital VBACs? I’m terribly ignorant, I don’t know if other countries have more lax VBAC hospital standards, or if US hospitals can be insured to offer them without meeting those guidelines.

        • Anonymous

          The VBAC number is probably as low as it is due to recording in hospitals. If you tried to figure the ones in “birth centers” or homebirth VBAC it’d most likely be much higher.

          • Roadstergal

            Gotcha. I actually just noticed, now that I’m not on my phone, that she has a link to the study, and that rate is for Scottish hospital VBA1Cs with a singleton term pregnancy.