Why do people believe in vaccine conspiracies but not antibiotic conspiracies?

distraught looking conspiracy believer in suit with aluminum foil head isolated on white background

They utterly changed the nature of infectious disease. Communicable diseases that had previously wiped out wide swathes of the population could be controlled with simple injections. Deaths dropped dramatically.

They became ubiquitous and virtually mandatory. The companies that manufactured them became extraordinarily wealthy and developed into large multinational conglomerates.

It is easy for lay people to believe that antibiotics work, but it requires specialized knowledge to understand how vaccines work.

But there were side effects. Some recipients suffered serious medical consequences. Some even died. Yet despite these dire consequences, they have remained a cornerstone of medical practice.

What are they?

If you thought I was talking about vaccines you are mistaken. I am referring to antibiotics. I want to talk about a curious paradox. Antibiotics and vaccines are the two most powerful and effective weapons against infectious diseases. Yet antibiotics are accepted without demur and vaccines are the subject of a variety of conspiracy theories. Why should they be viewed so differently?

Both are highly effective. Both are delivered by injection (though they can be delivered in other ways). Both have serious side effects including death. Both are manufactured by large multinational corporations who profit from their sale. So why are vaccines the subject of hysterical pseudo-scientific conspiracy theories, while antibiotics are not merely accepted as necessary, but actively sought, sometimes even when they are not needed?

There are four critical differences and those differences shed light on the nature of pseudo-scientific conspiracy theories. The differences tell us why certain conspiracy theories flourish and others are rejected out of hand.

The first difference is the ease of explanation. The workings of antibiotics are, on their face, easy to understand. Antibiotics kill bacteria by poisoning them. Everyone understands what a poison is and how it can be effective. We routinely poison weeds in our lawns, and mice in our homes. Poisons figure prominently in crime shows and detective novels. When patients are told that antibiotics will cure them by poisoning the bacteria that are making them sick, patients have no trouble understanding or envisioning how the antibiotics will do the job.

In contrast, the explanation of how vaccines work is rather complex. It requires familiarity with the notion of the immune system in general and antibodies in particular, how antibodies function in the body, and how they are created. This is not information that can be acquired in the course of every day life. We have no direct experience with eliciting antibodies to fight disease. Antibodies are certainly not subjects for TV shows or novels. Understanding vaccination, therefore, requires specialized knowledge not easily obtained.

The second difference is the time scale. Antibiotics work quickly, in hours or days at the most. We are sick, we take antibiotics, we get well. It is easy to credit the role of antibiotics in curing illness because they are temporally connected. Cure reliably follows the administration of antibiotics. It is easy to believe that the antibiotics cause the cure.

In contrast, vaccines act over long periods of time. Pertussis vaccine is give in infancy. Years go by and those infants become young children who never develop pertussis. The connection between vaccination and wellness is not directly apparent.

Third, there is something fundamentally different between curing a disease and preventing it. Curing a disease allows for certainty on the part of the person being cured. Connecting the absence of a disease with a maneuver designed to prevent it is not apparent to most people. There are other possible explanations besides vaccination for why a child does not get pertussis. He or she may never have been exposed. Some children who are exposed do not get the disease, even if they haven’t been vaccinated.

Fourth, there is a difference in apparent effectiveness. The reality is that a given antibiotic will never be 100% effective, but there are almost always alternatives. If penicillin does not do the trick, another antibiotic may be more effective. Ultimately, though, the patient is cured by antibiotics, whether it is the initial antibiotic, a subsequent antibiotic or a combination of antibiotics.

No vaccination is 100% effective, either, but there is usually one and only one vaccine for a particular disease. If the vaccine fails, the person gets the disease and there is no other vaccine that can be administered to prevent it.

These differences can be readily summarized: it is easy for lay people to believe that antibiotics work, but it requires specialized knowledge to understand how vaccines work. That’s why it’s not a coincidence that vaccine conspiracies flourish among those who lack basic knowledge of science, immunology and statistics. They literally cannot understand the issues involved. And if they can’t understand it, there is lots of room to disbelieve it and to substitute conspiracy theories for the truth.

 

This piece first appeared in November 2010.

  • Daleth

    A British kid spent 5 days in the ICU with chicken pox, renewing calls to make the chickenpox vaccine available on the NHS:

    https://www.theguardian.com/society/2016/aug/01/worst-case-of-chickenpox-sparks-call-for-vaccination-rethink

  • Herbert West

    Pop Quiz…which product did the Supreme Court of the United States rule “Unavoidably Unsafe”?
    a) Car seats
    b) antibiotics
    c) firearms/guns
    d) vaccines
    e) chainsaws

    • Nick Sanders

      Better quiz: what does “unavoidably unsafe” mean?

      • Herbert West

        Use a dictionary if your vocabulary is that limited.

        • Nick Sanders

          Alright, I’ll give you a hint: it’s a legal term, and trying to define it based on everyday expectations will give you a false answer.

    • Daleth

      f) None of the above. I linked to the case below, but here it is again–on pp.9-10 the Supreme Court REJECTS the argument that vaccines are an “unavoidably unsafe product.”
      https://www.supremecourt.gov/opinions/10pdf/09-152.pdf

  • Diet dee

    I’m aware of the side effects, but no one is forced or penalized for not taking antibiotics. I have turned down antibiotics many times

    • MaineJen

      …hopefully not for anything serious?

      • Diet dee

        Mostly common infections, but some people want antibiotics for everything.

        • MaineJen

          They should not be prescribed for viral illnesses, that’s true. But antibiotics are very useful when used appropriately and taken as directed. Surely you agree that antibiotics are appropriate for treating strep? A UTI? A staph infection?

          • Diet dee

            I agree that antibiotics have appropriate use and I won’t hesitate to used them. But if I kept getting bacterial infections I would explore some alternatives to help my immune system.

          • Roadstergal

            “I would explore some alternatives to help my immune system.”

            Oh, the irony.

          • Diet dee

            Repeated use of antibiotics can cause other problems. Antibiotics destroy beneficial as well as harmful bacteria.

          • guest

            But you know what puts an end to repeated bacterial infections? Dying of infection.

          • Diet dee

            Do you know what causes antibiotic resistant bacteria? Over use of antibiotics.
            http://www.m.webmd.com/a-to-z-guides/news/20150417/superbugs-what-they-are

          • Monkey Professor for a Head

            Do you know what can help prevent certain bacterial infections, thus reducing the use of antibiotics? Vaccines!

          • guest

            Not the way you’re thinking. That’s a reason to cut down on antibiotic use in the *absence* of a bacterial infection. It’s not a reason to suffer through a confirmed bacterial infection with no treatment.

          • Diet dee

            I have no problem with anti biotics, being used to fight bacterial infections. Those in relatively good health should use these medications wisely. There is some concerns that they are used too much in agriculture to help livestock gain weight.,rather than to actually fight disease.

          • Roadstergal

            Yes, exactly! So it makes sense to prevent the need for the use of antibiotics in the first place. Let’s take one nasty bacterium, Corynebacterium diphtheria. This bacterium is sensitive to antibiotics. However, we both agree that’s suboptimal. So, what would be the easiest, most effective, safest, and most cost-effective way to prevent the deadly effects of Corynebacterium diphtheria?

          • MaineJen

            Obviously, it would be exploring alternative means of strengthening your immune system. I mean, what else could possibly be easier or more cost effective?

          • Monkey Professor for a Head

            If only there was a way to train your immune system to recognise pathogens and fight them more effectively.

    • guest

      No one is forced into vaccinating either.

      • Diet dee

        You can lose your job, get barred from school and get kicked out of a medical practice for not vaccinating so that pretty close.

        • Daleth

          If your job is providing care to sick and injured patients–that is, if you are a nurse, nurse’s aide, doctor, etc.–then yeah, obviously you can and should lose your job if you refuse to be vaccinate. And you probably can lose it if you insist on coming to work while sick with a bacterial infection that you refuse to treat with antibiotics.

          • Diet dee

            The effective ness of the flu vaccine is all over the places. At 60 % effectiveness (on a good match) doubt it even makes a difference. There are about 200 bugs that cause the flu and your vaccine will cover about 5 of them. virus have been discovered on the Ties of MD, so vaccinated worker could still infect patients

          • Nick Sanders

            You’re being self contradictory. If it’s 60% effective, then it makes a difference roughly 60% of the time.

          • Diet dee

            If the strain is matched if might 60% but there are about 200 other Flu bug out there and they mutate rabidly

          • Yes. That’s why the flu shot is different every year.

          • Nick Sanders

            And yet, cross-reactivity can still provide a measure of protection, even if the strain matching isn’t perfect.

          • Mike Stevens

            There are not 200 influenza viruses, Diet Dee.
            Where do you get your misinformation from?

          • demodocus

            Sounds like she’s confusing colds and flus

          • Jonathan Graham

            If the strain is matched if might 60%

            No, that’s not how VE is calculated. Not to mention that subtyping is done from a number of sentinel sites all over the world. For example:
            http://healthycanadians.gc.ca/publications/diseases-conditions-maladies-affections/fluwatch-2015-2016-25-28-surveillance-influenza/alt/2016-w28-fg2-eng.gif

            You can see that in Canada that influenza was A dominant and in particular A(H1) pdm09.

          • guest

            Rabidly? Look, no one ever said the flu shot protected against rabies. That’s a different shot, and we only give it if someone is bitten by an animal that can’t be proven to not have rabies.

          • Mike Stevens

            “There are about 200 bugs that cause the flu and your vaccine will cover about 5 of them”

            No, there are many viruses that cause infections similar to influenza (rhino, RSV, corona,etc), and then there are viruses that do cause influenza (AKA Influenza viruses… imagine that!)

            Of course flu vaccine cannot prevent illnesess that mimic influenza…D’oh.
            https://en.wikipedia.org/wiki/List_of_infectious_diseases_causing_flu-like_syndrome

          • Diet dee

            Thanks doc. So get your flu shot and get a flu like illnesses anyway, but ats least it won’t be the flu virus that you probably wouldn’t get exposed to anyway

          • Guest

            No, what people feel is NOT flu-like illness. Flu is high fevers, chills, body aches, and severe cough for 5-10 days. You can barely function let alone work. That’s what kills people. That’s what they’re trying to prevent. Feeling a little tired or achy or under the weather for a day or two is not remotely comparable.

          • Mike Stevens

            I get exposed to flu multiple times a year, thank you very much.
            Thanks to the vax, I don’t catch it tho.

          • AlisonCummins

            The flu virus is nasty and might kill you or someone you pass it on to.

            Flu-like illnesses might are much less likely to kill you.

          • Roadstergal

            “There are about 200 bugs that cause the flu”

            You’re not even trying to sound like someone who knows anything about biology, now.

            “your vaccine will cover about 5 of them”

            The flu vaccine, every year, is made to match the prediction using the best available evidence of what strains will be dominant that coming year.

            That does not mean the vaccine is unprotective against an un-matched strain. Cross-reactivity is a thing that exists. Also, if you make an anti-stem antibody, you’re protected from all of the strains – our group has seen anti-stem antibodies come up post-seasonal-flu vaccination. It’s rare, but it happens, and finding vaccines that elicit anti-stem memory more frequently is an active area of research.

            So every annual flu vaccine is a chance at global flu protection.

            Also, it’s not just about you – every carrier of the influenza virus has the potential to harm or kill old people, pregnant women and their fetuses, kids too young to be vaccinated, and other immunocompromised folk. But your posts make it clear that other people don’t matter to you.

          • Diet dee

            Any goods studies on cross-reactivity or is it a sales gimmick to sell vaccines no matter how ineffective they are? Does cross-reactivity reduce deaths or hospitalization?

          • Nick Sanders

            These are what I could find and at least attempt to understand:
            http://www.ncbi.nlm.nih.gov/pubmed/25759506
            http://www.ncbi.nlm.nih.gov/pubmed/26557805
            http://www.ncbi.nlm.nih.gov/pubmed/24354853

            There were a lot more, but they were so technical that I was completely out of my depth. Some of the medical people around here may be able to direct you better than I can.

          • Roadstergal

            Yes, here are some additional studies of it actually happening in actual patients:
            http://www.ncbi.nlm.nih.gov/pubmed/26934750
            http://www.ncbi.nlm.nih.gov/pubmed/21304946
            http://www.ncbi.nlm.nih.gov/pubmed/22245606

            The last one shows that seasonal influenza vaccination boosts pre-existing immunities to non-targeted strains, including anti-stem antibodies. It’s yet another good reason to get the seasonal flu vaccine – to not lose precious reactivities you’ve developed in the past.

        • Charybdis

          No, that is not “forcing” anyone to be vaccinated. It is requiring people to take responsibility for their actions/decisions. If you don’t vaccinate and don’t have a legitimate medical reason for not vaccinating, then there are consequences to that decision. Those consequences, like not being able to enroll your child in school or being asked to leave your doctor’s practice, are not ones that anti-vaxxers like. Just because they don’t like the consequences doesn’t make it a case of “forcing vaccination.”

        • Roadstergal

          You can get kicked out of a medical practice for not practicing sterile technique, too. People have Sincerely Held Beliefs that hand-washing is dangerous, so they should be respected.

          • Diet dee

            The effectiveness of flu vaccine are oversold.As is the danger of the flu.

          • Roadstergal

            Well, given the impressive understanding of science you’ve demonstrated elsewhere in this thread, what option do I have other than to take your unsubstantiated say-so to that effect?

          • corblimeybot

            WELP, there we go then! Totally convinced now to fly in the face of medical consensus. Thanks, internet crank!

          • Roadstergal

            “My aunt died of influenza, so they said. But it’s my belief they done the old woman in. Why should she die of influenza when she’d come through diphtheria right enough the year before…?”

          • Diet dee

            get your flu shots in fact take mine

          • Roadstergal

            I do take my flu shots. The problem is, someone’s baby might be too young to have had the shot yet, someone’s grandfather might be too old to mount an effective immune response, someone’s co-worker who seems perfectly healthy from the outside but has lupus and is on rituximab and MMF to control her symptoms and can’t get vaccinated – they’re not protected. I reduce the number of potential carriers they are exposed to when I get my flu shot – and you don’t.

            It’s doing something simple, safe, and easy to make your life better, and to improve and possibly save the lives of people around you.

            And yet you’re working so hard to make it seem otherwise.

          • Nick Sanders

            Well, if the danger is oversold, what do you say is the actual average annual rate of severe illness and death from flu and flu-related complications?

          • Diet dee

            I have 36000 die of the flu each year. Other sources say a few hundred.
            http://www.huffingtonpost.ca/lawrence-solomon/death-by-influenza_b_4661442.html

          • Nick Sanders

            So, you’ve got a blog, (badly) spinning something that even the CDC (that it tries to posit as some nefarious fearmonger) admits is a complicated and thorny calculation:
            http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm

            What I don’t hear is an answer to my question.

      • Herbert West

        BS. Children are being denied educations.

        • Daleth

          Children are being denied educations by their parents. If the parents think attending public school is less of a priority than avoiding a few shots, that is the parents’ decision. It’s a really bad decision, but the responsibility for it is on the parents.

          • Herbert West

            Supreme Court tells us these products are “Unavoidable Unsafe”, knowing a percentage of children will be harmed and killed by these products, and you have the nerve to talk about responsibility? Denying children access to an education is unconstitutional, and if CA gets a fair trial, 277 will be overturned.

          • Daleth

            A percentage of people will be killed by their own seatbelts, their own dogs, and for that matter by the process of their own immune system trying–unsuccessfully, in the case of this percentage–to deal with a vaccine-preventable disease.

            What’s your point? If “unavoidably unsafe” means some people will be hurt or killed by it, almost everything is unavoidably unsafe.

          • Roadstergal

            Life is unavoidably unsafe. It’s about weighing risks and rewards. On vaccines, the rewards for both individuals and our species as a whole is clearly on the rewards substantially outweighing the risks.

          • Daleth

            Oh, and here’s the Supreme Court addressing that issue. As you can see on pp.9-10, they actually rejected the petitioner’s argument that vaccines fit the definition of an “unavoidably unsafe product.”
            The case, Bruesewitz v. Wyeth, LLC, was from 2011.
            https://www.supremecourt.gov/opinions/10pdf/09-152.pdf

          • momofone

            “Children are being denied educations by their parents.”

            An upvote hardly seems adequate for this.

        • corblimeybot

          Anti-vaxxers are denying a relatively normal life to medically vulnerable children who can’t be exposed to archaic bullshit like measles or pertussis.

          • Herbert West

            Medically vulnerable children are denying a normal life to tens of thousands of vaccine damaged children as well as tens of thousand of healthy, non-vaccinated children. Sorry, the rights of medically vulnerable children do not trump the rights of other children.

          • Nick Sanders

            You picked a good name, what with bringing all those dead lies back from the grave.

          • Herbert West

            All what lies? Name one.

          • Nick Sanders

            vaccines are not anywhere near 100% effective

            Many have effectiveness ranges in the mid to upper 90’s. If that’s not near 100%, I’d like to discuss your definition of “near”.

            most older people have lost any temporary vaccine immunity they had from childhood

            Many last a lifetime, and for the ones that don’t, booster shots exist.

            Medically vulnerable children are denying a normal life to tens of thousands of vaccine damaged children

            This is utter crap.

            play Russian roulette with vaccine needles

            As is this.

            It is irresponsible to put medically vulnerable children into situations that may compromise them

            And while this is correct, you have the context reversed.

          • Heidi_storage

            Note, too, that “natural” immunity is not always for life, either. But sigh, why are we arguing with this person? It’s the same old dreary round of fallacies, falsities, and half-truths that every anti-vaxxer trots out. We’re not going to change this person’s mind; he isn’t going to change ours.

          • Nick Sanders

            Because if we just ignore his bullshit, passersby may think we have no answer to it and take him seriously.

          • guest

            It is so exhausting, though. Same old nonsense, same inability to understand science and the social compact.

          • MaineJen

            Those selfish cancer patients and organ transplant recipients…denying those poor vulnerable unvaccinated children a normal life. They should learn to better protect themselves. Amiright, Herbert? /sarc

          • corblimeybot

            That’s how you can tell that anti-vaxxers really are into eugenics.

          • Who?

            At last, a representative of Big Tinfoil. Welcome!

          • guest

            I’ll remember that next time someone tries to quarantine an Ebola patient.

        • MaineJen

          Nonsense. Parents are more than welcome to homeschool their unvaccinated little germ factories. There are many great homeschool/independent study programs available! So what’s the problem?

          • Nick Sanders

            They don’t like not having their irresponsibility coddled. How dare we inconvenience them just because they refuse to meet basic standards. Next they’ll be complaining about needing a license to drive.

          • Roadstergal

            Perhaps a closer parallel – they’ll complain about the requirement to carry liability insurance to drive. :p

        • guest

          No, children are being protected from diseases. There are private schools that can make their own rules about vaccinations, and there is always homeschooling. Take your whaaaaambulance somewhere else. Public health and safety comes before educational venue preferences.

        • demodocus

          online schooling is widely available in the US

  • Insider

    OT: Some satire that draws a parallel between natural childbirth advocacy and religious zealotry:

    (Warning: There’s some hate speech depicted on this page.)

    http://www.salon.com/2016/07/20/watch_westboro_baptist_church_trolled_by_triumph_the_insult_comic_dog_outside_rnc/

    Last week while the Westboro Baptist Church was demonstrating outside the Republican convention, a group of counter-demonstrators (some of them hired actors) arrived. In the photo in the article above, the Baptists stand in front of the barrier (with real signs) and the counter-demonstrators stand behind the barrier (with satirical signs). Here’s a closeup of the counter-demonstrators:

    http://blogfiles.wfmu.org/KF/2016/07/20/andy_westboro_500.jpg

    The satirical signs read:

    * God Hates People Born from C-Sections

    * Vaginally Born Is the Way

    * “C” You in Hell

    The counter-demonstration was organized by Andy Breckman (creater of the TV series “Monk”) and Robert Smigel (“Triumph the Insult Comic Dog”). A video of this event (and other events outside the Republican and Democratic conventions) will be part of a special to be broadcast on Hulu in early August.

    In case you missed it last year (before Facebook took the page down), a satirical group calling itself the Disciples of the New Dawn created a series of memes that likewise claimed that God condemns children born by C-section:

    (Another warning: It’s satire, but still disturbing.)

    http://www.dailymail.co.uk/femail/article-3021773/Controversial-religious-community-angers-thousands-women-anti-cesarean-campaign-shames-lazy-negligent-C-section-moms.html

    I wonder how accurately some of these satirical messages reflect the actual mindset of some natural childbirth advocates.

    • Roadstergal

      Wow, it’s really hard for me to tell the difference between satire and sincerity…

  • nomofear

    My mother just shared this on fb. Timely…2009? http://www.cbsnews.com/news/gardasil-researcher-speaks-out/

    • MI Dawn

      OMG….Sharyl Atkinsson. She’s a lousy reporter and so antivax it’s painful.

  • Rachele Willoughby

    OT: Has this been posted yet? Because it’s probably one of my favorite takedowns of lactivism *ever*.

    http://www.cracked.com/blog/5-groups-people-that-take-outrage-to-pointless-extremes/

    • Roadstergal

      You’re not kidding. That’s fantastic.

      “Breastfeeding your baby is wonderful, but it doesn’t make you an expert on all areas of child-rearing — in the same way that masturbating is fun, but doesn’t make you an expert on sexuality. All you’re doing is providing a bit of biological fluid and feeling better about yourself”

      “There are orc tribes sneaking up on hobbits with better ethics.”

      Oh, I could just quote it all.

    • Stephanie Rotherham

      Hee, I read that last night! I’m the one constantly saying to come here to learn more.

  • Cody

    All of the anti-vaxxers that I know also avoid antibiotics and basic stuff like Tylenol.

    • MaineJen

      Such BS. My 4 year old just spent 3 days in the hospital being treated for scarlet fever+staph scalded skin syndrome. IV antibiotics did the trick (finally). Why would anyone allow their child to suffer something like that, when there is modern medicine available to treat it? I can only imagine what our outcome would have been had I declined the antibiotics on her behalf, and I’m horrified at the thought.

      Our experiences over the past month have made me look at these anti-vaxxers and anti-medicine parents somewhat differently. If you can stand there and watch your child suffer a horrific illness, knowing that there is treatment available an easy distance away, and still do *nothing*…I just don’t know what to say.

      Dr. Amy has posted articles about parents who allowed their kids to suffer through pertussis, and even meningitis, untreated. What kind of person puts their ideology above their kids’ well being?

      • Burgundy
      • Mishimoo

        Oh no, poor kiddo and poor you! That would have been terrifying! So glad the IV antibiotics worked, I really hope they don’t have any lasting problems from scarlet fever.

      • MI Dawn

        Wow. Poor you and poor child. I can’t imagine dealing with that. Hope 4 year old is feeling better.

        • MaineJen

          She is completely better. 🙂 We finished a week of antibiotics at home, and the last of the rash has finally peeled off. Thankfully it was not MRSA.

      • guest

        My rule of thumb for administering medications to my children is asking myself if I would take medicine as an adult in the same situation. I know I am not willing to suffer when there is an easy treatment available and I feel the same way about my kids. Agree also that people that can watch their kid’s suffer through these illnesses untreated are people I can’t understand. How heartless do you have to be??

      • shay simmons

        I’m sorry your child (and your family) had to suffer through that — hope she is on the road to recovery.

    • Kathleen

      Yes! I was going to say – alot of the anti-vaxxers (or at least, questioning vaccines) are very into those “natural” remedies, a ‘natural’ diet (no dyes, sugars, especially fake, etc.), non-toxic *insert item here*, and don’t take (or rarely take) even OTC stuff like Tylenol or cold medicines.

  • Lurkerette

    Amy, you probably want to look into “loss aversion.” I think it explains most of this phenomenon – anti-vaxxers believe, pre-vax, that they have health/neurotypical kids/whatever, and that the vaccination will take that away. The baseline is (perceived to be) healthy, so the risks of the vaccines are perceived to be more threatening. But the risk of antibiotics, while greater, doesn’t threaten a perceived healthy baseline, so that risk is in some cases judged to be acceptable.

  • TheArtistFormerlyKnownAsYoya

    OT, I apologize. I’m curious where people here fall on the rice cereal in the bottle debate? I’m trying to work out whether the case against it is mostly lactivist demonization, or whether it’s actually useless, or potentially dangerous? Just ran across something claiming it’s “THE most dangerous thing you can do” and had alarm bells go off. I had to care for my niece for several weeks when she was 20 months old and she would wake up multiple times in the night due to hunger. I didn’t know about rice cereal in the bottle back then but now am wondering if it might have helped her.

    ETA: also if anyone knows if there’s any truth that introducing solid foods too early causes allergies? This seems to be cited often as a reason not to do cereal in the bottle.

    • swbarnes2

      Since about 2008, the AAAAI has said that introducing potential allergens between 4-6 months decreases the odds of allergies.

      https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/Preventing-Allergies-15.pdf

      The Science of Mom just did another post on introducing solids early. Compliance with the proposed introduction strategy was low, but it didn’t seem to harm the kids who stuck to it, and it seems to have reduced the numbers of kids with some allergies.

      https://scienceofmom.com/2016/07/18/the-eat-study-more-food-for-thought-on-earlier-introduction-of-solids-to-prevent-food-allergy/

      Another site that looks pretty science-based (and at the bottom, another link to another Science of Mom article)

      http://breastfeedingwithoutbs.blogspot.com/2013/11/bullshitometer-rice-cereal-edition.html

      (A 20 month old should be more than capable of eating enough during the day to not eat at night. Most babies can do that at 6 months. Night weaning is called for, not rice cereal)

      • demodocus

        what i was going to say until i was distracted by a small child

      • I am a great advocate of solid foods being given by spoon, and liquids either by breast, bottle, or cup. Thickening formula with rice cereal or cornstarch is a great way to fatten babies up with empty calories.

        • swbarnes2

          I figured that my kid will have the rest of her life to enjoy empty carbs, so why start early? Especially with a food that she’s not going to eat once she’s out of infancy.

          We started mine a bit after 6 months (I didn’t have all my links at my fingertips back then), my mother and aunt were astonished at how easily she took to it. I think they were used to frustration of trying it earlier.

          • guest

            Unless the issue is GERD or something, I see no reason to add cereal to bottles BUT I hate the “rice is empty calories” thing. Cooked white rice has protein, fiber, iron, folate, niacin, selenium, phosphorus, and some other stuff I’m not going to transcribe. Other foods may have more, but rice isn’t “empty.” Second, baby rice cereal is fortified on top of that, so that it contains more iron (it was in fact an important food for my daughter when she was anemic, because she was an infant and wasn’t big on beef or kale), vitamin C, B vitamins, vitamin E, etc. It is calories AND nutrition. Absolutely, other foods are more nutrient-dense, but remember that our bodies only need so many of these nutrients. Eating 200% or 1,000% of the RDA a daily vitamin or mineral doesn’t make you healthier. The extra just gets excreted – most nutrients your body can’t store it and can’t use it after a certain point, so out it goes. It’s possible to get all the nutrients you need in too few calories, basically. As long as you get enough nutrients, it doesn’t matter if some of the calories are less nutrient dense – you need enough of both calories and nutrients.

            This doesn’t mean anyone *has* to give their baby rice cereal, since all of that stuff is available in other foods you can choose instead. But please let’s stop saying rice is an “empty” food for babies. It isn’t.

          • Monkey Professor for a Head

            Whenever my son is cutting a tooth, he tends to go right off solid food – it’s made weaning pretty difficult. There’s been days where all I can get him to take is breastmilk and rice cakes. I feel bad about it, but I’ve been trying to reassure myself that at least he’s getting practice chewing and they are iron fortified so he’s getting some nutrition out of it.

            (He’s doing loads better with his eating in the last few weeks. We’ve just been giving him the same food that we’ve been eating, which is mainly Indian food, and he’s been really enjoying it. Although we do need to keep a cup of milk on hand in case it gets a bit too spicy – he yells until we give him a drink, and then he goes right back to eating. Must be his dad’s genetics coming through.)

          • guest

            Our bodies are made to survive temporary scarcity. Your son is 100% fine if he just wants rice cakes for a few days while he’s teething.

          • Nick Sanders

            he yells until we give him a drink, and then he goes right back to eating. Must be his dad’s genetics coming through.)

            Sounds like a guy thing alright. If something is tasty enough, I’ll choke it down with tears welling in my eyes and my face turning red, guzzling huge gulps of whatever beverage I have…

            And I hate spicy food.

      • Fleur

        So, the mums on breastfeeding forums who boast that their 14 month old babies won’t eat any solids, because babies are mini-geniuses who know that anything but breastmilk is going to give them allergies, are probably talking BS?

        (I’m currently confused as hell over when to introduce solids. The health visitor keeps saying “around six months”, but what kind of time period does “around” cover? My baby books all state either that introducing solids before six months is dangerous, or that waiting until after six months is damaging – so does it have to be on the dot of midnight on her six month birthday?!)

        • Heidi

          I tried a few times before six months. If the baby isn’t ready, the baby won’t take solids. Coincidentally, it was pretty close to six months before my baby started to take anything from the spoon and actually enjoy it. I think maybe about 5 months and three weeks, he really started to some purees and cereal.

          • Fleur

            Thank you. I’ll try soon and see how she reacts! She’s been showing an interest for a while but the health visitor kept closing the subject down, so I wasn’t sure if it was a problem to try before six months or not.

        • Megan

          I’ve just started trying with my 4.5 month old. Don’t think she’s quite ready yet as she seems to still have a pretty good tongue thrust reflex. I give her a few spoonfuls and a bit gets swallowed. Mostly she’s just experiencing some new tastes but not really getting much in the way of calories. I think my older daughter finally took to solids somewhere around 5.5 months. Both my kids were born a few weeks early (barely term) though too.
          I usually tell parents to try between 4-6 months and that good signs of readiness include lack of/decreasing tongue thrust reflex, ability to have good upper trunk and head/neck control while sitting for meals (on a lap or in a highchair) and mostly, enjoyment of solids. If baby doesn’t want it, I usually just say try again in another week or two.

          • Fleur

            Thank you – that’s really helpful. My daughter’s just under five months and she’s fascinated by solids to the point where I can’t eat in front of her anymore, plus her trunk/head/neck control is good. I’m not sure her tongue is quite there, but I’ll probably try her with something shortly and see how she reacts!

          • Megan

            Sounds like she’s ready or very close to ready! If you don’t have luck this week, you may find you do if try again in as little as another week. Good luck!

          • Fleur

            Thank you!

          • Kelly

            You can always try a very small amount. I started at four months with the older two but they sucked at eating until they were five months. For my third, I didn’t want to deal with all of that so I just started her at five months and we bypassed all the tongue thrust issues. I also thicken up their food with rice cereal because it is like trying to feed soup to a baby. If it was thicker, it didn’t dribble out of their mouth as badly. You may just have to try out different things until she gets it or is physically ready to do it. Honestly, there is no hard and fast way to do it and I have done many different things with my children.

        • swbarnes2

          I think your baby books are out of date. For instance, here’s the Mayo Clinic, it says 4-6 months

          http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/healthy-baby/art-20046200

          • Fleur

            Thank you – that link is really helpful. So much better than the NHS leaflet that the health visitor gave me, which was so vague that I nearly threw it at the wall!

          • Dr Kitty

            When we were kids it was 3-4months.
            Then the WHO said 6months, and the NHS feels they have to go with that.
            But the latest good quality research says that introducing solids after 6months raises the risks of allergies.
            So we’re now at “at least 16 weeks, provided your baby can sit upright in a high chair and take food from a spoon without choking and before 26 weeks at the latest”.

            FWIW I started my daughter on solids at 5 months just so we could get it done before I went back to work. My son got baby rice and mashed potatoes the day he turned 4 months because he was a hungry hungry hippo and clearly needed it.

            I started introducing finger foods about 9months- I do not have the tolerance of mess and waste required for BLW.

            At 11 months my son will eat any jar or pouch of baby food you give him and is more than happy to eat raisins, toast, chips, bread sticks, digestive biscuits, ice cream, yogurt, oatmeal and most fruits.

            Neither of mine will eat eggs in any form.
            I have tried.

          • MI Dawn

            Yeah, my eldest wouldn’t touch eggs. Nor mashed potatoes. French Fries, fine. But she apparently hated the texture of mashed potatoes from the start.

            I think I started my kids on solids around 4-5 months. They got finger foods early on. At age 1, my eldest was feeding herself pretty well (though she did decide that spaghetti was more fun as a shampoo…)

        • AlisonCummins

          When it’s so hard to pin down the ideal time, that means the risks and benefits are hard to pin down. Which means don’t sweat it.

          Back in the eighties I recall that the thinking about identifying the ideal window worked like this:
          > Healthy children can usually be introduced to non-milk foods between 3 weeks and 18 months without obvious ill effects.
          > Ideally the child should be old enough to learn to swallow interesting things without dlluting them to milk-like consistency (over 3 to 4 months) and
          > not too old to learn to like chewing (usually less than 10 months).
          > Six months is an age where babies can probably use more iron and vitamin C in their diets, so that’s probably a good time to introduce variety.

          At that time, concern about allergies was theoretical because there wasn’t enough good science. There was a general principle of introducing new foods not more frequently than every three or four days so that you could easily identify any food intolerance, but that was it.

          The science is more detailed now and can give better support to particular choices, but if you end up making different choices within the general window

      • TheArtistFormerlyKnownAsYoya

        Well isn’t that interesting…the direct opposite of what is claimed by those against rice cereal. All I’ve been able to find is “solid foods too early cause allergies”, with no specifics. Not even that rice cereal will increase the chance of rice allergy/sensitivity, but just very vague claims that it will “cause allergies”. One site did link to this study, which seems to actually be saying the opposite of what the site thinks it says:

        http://www.ncbi.nlm.nih.gov/pubmed/19969611

        I mean, the conclusion is “Late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens.” I suspect someone looked at this study, saw that babies were being given solid foods under one year of age, and drew their own conclusion that this was “too early” and must be the cause of the allergies.

    • Allie

      I avoid rice-based foods due to arsenic levels. Other than that, the current recommendation in my area is to introduce solids and allergens at 6 months. However, that is a guide and some babies want to eat much sooner, others later. I tried a few wheat-based cereals, but my daughter was never interested, and also never slept better after she began solids, which some apparently do – or perhaps allegedly is a better word : )

      • Sarah

        Wouldn’t worry too much about the arsenic levels, they’re vanishingly low.

    • Sarah

      I had always read that rice cereal in a bottle was a choking risk. If you’re going to give it, seems to make more sense to use a bowl and spoon.

      • TheArtistFormerlyKnownAsYoya

        I’m coming across this too, but not sure how much truth there is to it. One problem seems to be when parents make the hole in the nipple larger to accomodate the cereal. Apparently this is a no no, and there are special nipples you can buy for rice cereal. Another problem seems to be unmixed lumps of cereal. But couldn’t this be true of unmixed lumps of formula too?

        • demodocus

          definately. it can be a pain when the formula’s clumpy.

      • Charybdis

        How thick are you making the cereal? I would occasionally add a little rice cereal to a bottle, especially when DS was 4-ish months old, as a way to start introducing solids and allergens. I only used something like a tablespoon in a 6-8 oz bottle, so the consistency/viscosity of the formula wasn’t noticeably different than normal. A variable flow nipple helped as well.

        I wasn’t trying to make DS suck something like a thick milkshake through a tiny nipple hole. But it was a wonderful way to start introducing solids/allergens and we worked up from there.

        • Sarah

          I’ve never made it in a bottle. Used it briefly with one of mine, from a bowl, I think it was quite runny. But thicker than formula.

          • Charybdis

            I think I need to explain a bit. When DS was 4-ish months old, we started to introduce a little rice cereal into his diet as he was indicating that something a little more substantial than just formula, but he still had trouble eating from a spoon. We would add something like a tablespoon of rice cereal to a 6-8 oz bottle and that resulted in a liquid that was marginally thicker than formula. He could still drink it from his bottle without a problem. The amount of cereal never increased; we weren’t stepping him up to drinking Cream of Wheat out of a bottle. As he got a little older and was able to deal with the spoon feeding, we stopped with the cereal in the formula because he was eating the cereal mixed with fruit, yogurt, juice or milk, along with purees. He was partial to a chicken and pear combo, along with sweet potatoes, squash, carrots and peas together, and any fruit other than peaches and prunes.

    • MI Dawn

      Yeah, a 20 month old shouldn’t be waking up multiple times due to hunger unless mom/dad let her get away with it. Or, they are just feeding her instead of addressing why she’s waking up, because it’s easier. So baby gets used to mommy and daddy giving her social time at night.

      Also, on the point of rice cereal in the bottle….I tried that ONCE. Since the nipple hole has to be made much larger, it turned out to be a huge mess. Never again.

      • TheArtistFormerlyKnownAsYoya

        That’s definitely what happened. They always put her to sleep with a bottle and as a result, she couldn’t sleep without one. No matter what we fed her before bed she woke up at least once crying for a new bottle. It was a bigger problem than we could fix in the few weeks we had her though. She was hungry but I’m sure it was also for comfort. She has sleeping problems to this day (she’s almost 6 now) that seem to go back to when she was a baby. I’m expecting my first now and trying to work out what I can do to help him sleep, because it’s been an absolute nightmare for her.

        • demodocus

          Depends a lot on the kid, too. Mine are naturally really good sleepers. The big one didn’t get cereal until he was 4 months old and starting spoonfeeding. The little one has had only formula so far. Some days she wakes at 3 and has a couple ounces, other times she doesn’t wake until later, even as late as 630.

          I think the biggest thing would be to makes sure your child has other bedtime rituals. Lullabyes (Dad) or stories (Mom) are must haves for my son. He’s getting stubborn now, so we have to chase him back into his room a few times (or several depending on the day) before he sleeps.

          • guest

            Agree on having other bedtime rituals. We started playing a music box for the kid’s at a few months old and did it every night. Also had a ritual of quiet cuddle time before bed, then tuck in and wind up the music box. These rituals are nice because they travel well and helped our kids settle in when staying over in new places.

          • The Bofa on the Sofa

            PSA: Don’t forget reading as part of your bedtime ritual. It’s a great thing to do during cuddle time.

            Do it every night.

        • She’s going to incur large dental bills if she keeps going to sleep with a bottle. The bacteria that causes caries in teeth LOVE a steady dribble of milk in the mouth all night.

          • TheArtistFormerlyKnownAsYoya

            Yes, this was 4 years ago, and her teeth were ruined. Her parents no longer have custody of her as they’re both totally incompetent.

          • MI Dawn

            Oy. That’s horrible. Poor child. Bottle mouth is awful.

    • Heidi

      From what I’ve read, there is some super minuscule chance the baby could inhale it and it could lead to pneumonia. I don’t know if there’s ever been a verified case of that happening. I think the biggest concern is it’s fortifying the milk with calories the baby doesn’t need. At that age, fullness is more about volume than caloric density.

      • TheArtistFormerlyKnownAsYoya

        This makes sense to me (about the calories). A lot of people seem to say it’s just ineffective.

        • Heidi

          I think there was a study that showed it didn’t help babies sleep through the night. However, people thought it worked because at the time people generally start adding rice to the bottle, many babies naturally start sleeping through the night.

          • guest

            That makes sense. I was at my breaking point with sleep deprivation at 4 months, but was afraid to sleep train. I got the OK to start solids, and right after that they started sleeping for five hours stretches. I always wondered if the solids helped them, but it could also be coincidence.

    • Megan

      I generally tell parents that cereals are for spoons unless there is a special circumstance (like what another poster said below). For instance, my daughter had pretty severe GERD that was causing weight loss because she was vomiting up so much of her food. We tried thickening her bottles for a bit to see if it would help (it didn’t). For babies without problems like this, I would avoid introducing cereals until baby can actually eat them from a spoon. IMHO, a 20-month old waking several times a night has a sleep association problem, not a hunger problem, though I’ve seen babies who get into this habit who then downregulate their calorie intake during the day to compensate for the habit.

    • AlisonCummins

      She was waking up multiple times in the night because she was a toddler, and that’s what toddlers do. The problem was that she didn’t know how to fall back asleep without her bottle.

      For some babies, sleeping and eating are completely separate. They are hungry, they fuss, they get fed, they’re happy, they interact and check things out, they’re sleepy, they fuss, they get put to bed, they fall asleep. Very ordered, very simple.

      Other babies fall asleep during a meal. Because for months they fall asleep every time they eat, teaching them to fall asleep without eating can be tricky. My brother was one of those. (In addition to a familial tendency towards the post-prandial nap, he was premature. He came home at 4 lbs and for the first while eating took a disproportional amount of energy.) When he started sleeping alone at around ten months he would wake up, cry for a bottle, get one and fall back to sleep. He ended up with nasty bottle-mouth by the time he was four. (In the meantime also very, very wet diapers in the morning and bad diaper rash.)

      Yes, ideally he would have been taught to fall [back] asleep without a bottle long before then, but he gained weight well, was sunny and cheerful, wasn’t sick, and as an adult his secondary teeth are beautiful.

      You *are* going to deviate from the official recommendations at some point. You are both going to be fine.

  • 3boyz

    I do know some woo people who prefer naturopaths over real doctors because “doctors just see your kid for 30 seconds and push you out the door with a rx for antibiotics”. They particularly love to cite the increasing evidence, which happens to be true, that antibiotics need to be used very judiciously and can in fact be quite harmful (both individually and on a communal scale) when used unnecessarily too often. The thing is, doctors know this and have known it for some time! Yes, when I was a kid, we were still in the era of antibiotics for every ailment, even the probably viral ones. Since having kids myself, I haven’t met a single pediatrician who gives antibiotics without a positive test for bacterial illness or otherwise very strong evidence of such. When my oldest was catching strep every six weeks for several months, the pediatrician recommended we consult an ENT about removing his tonsils because he felt the risks of such regular antibiotic use far outweighed the risks of surgery (and yes, he did end up having his tonsils removed, and hasn’t had strep in 8 months). So yeah, all these antibiotic-peddling peds don’t actually exist anymore, because believe it or not, most peds do try to keep up with the times and practice TRUE evidence based medicine.

    • CharlotteB

      The last 2 times I took my son to the doctor for mild illnesses (eye discharge, fever for 3+days) they gave me paper Perscriptions that I could fill *if* needed. Obviously, they also told me what to watch for–but even with a mild ear infection, the Ped didn’t think antibiotics were necessary right away. He told me all the stats (which I don’t remember) about how many clear on their own vs. with antibiotics.

      Point being, my kid’s doctors have been cautious with antibiotics, which I think is good. They aren’t handing me an rx and shooing me out the door–they’ve told me what to look for, etc.

    • guest

      Yes, my daughter was sent to the ER at age 18 months for a catheter to find out conclusively whether she had a UTI before she got antibiotics. The fast tests all came back negative and we were sent home, but nearly a week later some test that takes longer came back positive and she got a prescription. The ER visit is a lot of trauma for a kid that age, but my pediatrician was not going to give antibiotics unless they were really necessary.

      • demodocus

        My boy got weirdly round sores on his hip when he had the cast on. The nurse practitioner prescribed antibiotics because she thought it looked like staph. A while later when I told the doc about it, he made a face that suggested he wasn’t so sure it had been a good idea.

  • guest

    An interesting comparison, because you can be “injured” by antibiotics too – people have allergies, and there are other potential side effects, including deafness.

    • Dr Kitty

      Three separate classes of antibiotics have tried to kill me (two by anapylaxis, one by Stevens Johnson Syndrome).
      I still take antibiotics if I need them, I’m just very careful about which ones (luckily I can take take Cefalosporins, even though I’m properly Penicillin allergic, otherwise my options would be very, very limited).

      • guest

        And if we were talking vaccines, you’d have every excuse to skip them with such serious reactions. Too bad there’s no herd immunity for antibiotics.

  • Kerlyssa

    Yeah, people don’t think they’re going to catch what the vaccine prevents. Their various woo practices will protect them. Antibiotics are for illnesses they are currently experiencing. If vaccines could be administered mid illness it’d be a different story.

    • demodocus

      or better yet, for an injury that got infected.

  • Amy M

    I agree with all of what Dr. Amy said, but there is also the subgroup of anti-vaxxers that DO avoid antibiotics. From what I can glean, they do cite “resistant bacteria” but they don’t really understand that concept either, because they think it means the specific bacteria on/in their own bodies, or possibly, just their own bodies, will develop resistance and then that prescribed antibiotic would never work for them again. Also, a number of anti-vaxxers are just anti-doctor/anti-science and think drugs are designed by the pharma companies in cahoots with the government to keep people sick, or that cayenne water with lemon juice will cure anything, no need for “unnatural” drugs. I’m pretty sure that Kate T. woman does her best to avoid antibiotics, and so did that Canadian couple that killed their kid.

    • Amy Tuteur, MD

      There are certainly people who refuse to use antibiotics, but few people claim that antibiotics themselves are a part of a massive government/industry conspiracy. That’s the difference that I was trying to highlight.

      • Amy M

        Oh I see. Sorry, I saw it as: people who are anti-vaxxers are, by definition, anti-science/medicine. SOME are, but yeah, there’s no big push against abx specifically. *embarrassed grin* Didn’t mean to miss the point.

        • Amy Tuteur, MD

          It’s my fault that it wasn’t clear!

  • Mel

    Honestly, I think the difference between the two is based solely on avoiding short-term personal discomfort.

    When you need antibiotics, you generally feel sick. Sometimes very sick. A bacterial infection may kill you if left untreated, but most people will fight it off eventually. Taking an antibiotic, then, is a way to decrease personal discomfort.

    Avoiding vaccines is all about parental comfort. Getting your kids the needed vaccines sucks in the short-term. The kid cries, feels bad for a day or two and needs some extra TLC. If the kid is older, this can be a long, drawn-out process (says the person who pretty much needed to be physically restrained for shots until her teenage years….). Sure, sure, parents will discuss how worried they are about “immune overload” or “autism” or whatever the newest buzz word is…but the truth is that it’s all about avoiding the short-term discomfort of your kid getting shots.

    It’s most obvious when you contrast it with the long-term discomforts. Yeah, most healthy adults will eventually fight off bacterial infections – but at what cost for morbidity or mortality? True, skipping the flu shot at 35 probably won’t kill you – but how much time can you take off of work when you get the flu? Yeah, trucking your school-aged kids in for vaccines sucks – but does it suck more than the 6-weeks where chicken pox invaded our house when I was 5 and my twin got a raging staph infection? How about the two month quarantine my dad’s family was under due to measles? (Seriously. Eight kids. Some kids took longer to catch it than others…)

  • Roadstergal

    The tricky part is that it’s fairly easy for bacteria to evolve and share antibiotic resistance – which we’re seeing – but vaccine resistance is a whole ‘nuther ball game. You could make the case that influenza is engaging in that when it swaps around Hs and Ns, but that evolved as part of its ongoing arms race with immune systems. it’s not like bacteria passing resistance genes around (very specific genes to address the very specific MOAs, unlike the broad, polycloncal immune response) like a used copy of Fifty Shades at the beach.

    I mention that because Bill Maher reveals his fundamental misunderstanding of vaccines and antibiotics when he brings up overuse of antibiotics to support his opposition to vaccines.

    • MaineJen

      1. “Like a used copy of Fifty Shades at the beach” SO stealing this.
      2. Bill Maher should stick to criticizing politics/politicians and stay away from medical topics. He is deep in the woo and it shows.

      • Roadstergal

        I really think he’s so compromised in his thinking that he needs to step aside and let someone else do the political jokes. I mean, he’s an HIV/AIDS denialist, FFS.

  • mabelcruet

    I think its also down to the fact that when someone needs antibiotics, they are generally sick and have symptoms of illness. The antibiotic stops them feeling so ill, so it obviously works, whereas a vaccine is given to a seemingly healthy person, and to a vaccine conspiracy theorist-why give a chemical to someone who isn’t sick? What is the purpose? There isn’t an obvious illness or sickness, therefore there is no purpose. The concept of disease prevention seems beyond them. It’s similar to being prescribed medication for certain conditions-hypertension for example. Systemic hypertension doesn’t generally make you feel unwell (until you stroke out or your kidneys fail of course)-many antihypertensives have side-effects and it can be difficult to accept for some people that you need to take medication which might make you feel bad even if you feel OK without it. There is no obvious reason for taking this that they can see-the concept of primary and secondary disease prevention is difficult to get across to some folk.

    • Roadstergal

      I’ve mentioned this in the past, but I was at a talk at a conference a few years ago where they were discussing predictors of noncompliance. I don’t remember all of them, but the two that stood out to me were 1: improvement of symptoms (feeling better) and 2: male gender. I see both of those a lot… :p

      • demodocus

        i wonder where the average trans male falls in compliance

        • mabelcruet

          Trans men and women both take hormones-isn’t there evidence that if someone is already on long term medication they are more likely to take other prescribed medication and be more compliant with treatment compared to someone who isn’t on any other medication? And they will have had a lot of contact with medical and surgical professionals, so would they be more accepting of conventional pharma? I don’t know, I bet someone somewhere has done the research!

      • MaineJen

        Also 3: Adolescence. Sad but true…