New US breastfeeding policy, adopted for the wrong reasons, will almost certainly save lives

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To my shock I find myself agreeing with something done by the Trump administration.

According to today’s New York Times:

A resolution to encourage breast-feeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly…

Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations.

American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

The lactivist community is outraged, but the new US policy — nakedly designed to benefit the formula industry — will almost certainly save the brain function and lives of newborns. Why? Three reasons:

Even had the purported benefits of breastfeeding appeared, they would not have justified the pressure on women; but those benefits never appeared.

1. Most claims of lactation professionals have been thoroughly DEBUNKED by scientific evidence.
2. There is NO EVIDENCE that breastfeeding is correlated with infant health outcomes.
3. There is a significant and growing body of evidence that the pressure to exclusively breastfeed HARMS babies. It doubles the risk of newborn hospital readmission and increases the risk of neonatal brain injury and death from dehydration, severe jaundice, hypoglycemia, and smothering in or falling from maternal hospital beds.

Sadly, it is lactation professionals themselves who are responsible for this dismal state of affairs. By grossly over promising on the benefits of breastfeeding, by utterly ignoring the substantial risks, and by disingenuously and irresponsibly extrapolating from the impact of contaminated water used to make formula in underdeveloped countries to demonizing formula instead of contaminated water.

Lactation professionals have given the Trump administration moral cover for what is undoubtedly a business decision.

According to the spokesman for the US Department of Health and Human Services:

The resolution as originally drafted placed unnecessary hurdles for mothers seeking to provide nutrition to their children,” an H.H.S. spokesman said in an email. “We recognize not all women are able to breast-feed for a variety of reasons. These women should have the choice and access to alternatives for the health of their babies, and not be stigmatized for the ways in which they are able to do so.”

That’s 100% correct because WHO breastfeeding resolutions since 1981 have been designed to benefit the lactation industry, not babies. The point of these resolutions has been to place unnecessary — and increasingly ugly — hurdles in front of women who wish to use formula: banning formula supplementation, locking up formula in hospitals, forcing women to sign formula “contracts,” banning formula advertising and banning the use of discount coupons to purchase formula.

These ugly hurdles violate mothers’ autonomy; women have the absolute right to decide whether or not they wish to use their breasts to feed their infants. Even had the purported benefits appeared, they would never have justified the inappropriate pressure on women. But those benefits never appeared:

There is no connection between country-wide breastfeeding rates and infant outcome. The countries with the lowest breastfeeding rates (like the UK which is the absolute lowest) have some of the best infant health outcomes and the countries with the worst rates of infant mortality and morbidity have the highest rates of breastfeeding.

To my knowledge — please correct me if you have other information — there is no evidence that increasing breastfeeding rates within a country has EVER had any impact in term babies or overall morbidity and mortality rates.

That’s hardly surprising since the campaign to promote breastfeeding is based on an empirical lie. In truth: Breast is NOT best for every mother and every baby since breastfeeding has a significant failure rate.

Up to 15% of first time mothers will be unable to produce enough breastmilk especially in the early days after birth. Breastfeeding — like fertility and pregnancy — is imperfect.

This was well known to our ancient foremothers. Contrary to the current pressure to breastfeed exclusively, indigenous people on nearly every continent practice prelacteal feeding and supplementation. The high rate of death from insufficient breastmilk led to the supplementation of breastfeeding with teas, water and honey. Sadly, those had their own drawbacks because of microbial contamination but the practice has been widespread for probably tens of thousands of years or more. The risk of death from insufficient breastmilk was greater than the risk of death from microbial contamination of supplements.

Lactation professionals have also promoted the empirical lie that formula is harmful. More than 40 years after the fact they continue to point to the moral horror perpetrated in Africa by Nestle. In order to increase profits, Nestle deliberately and knowingly encouraged African women who lacked access to clean water to replace breastmilk with powdered formula. Babies died needless, preventable deaths as a result. Lactational professionals use the moral debacle to demonize formula even though it was the water that was unsafe, not the formula. There is NO EVIDENCE that formula — properly prepared with clean water — is harmful in any way.

No matter. Try having a conversation with lactivists and you will immediately run into (the newly named by me) Tuteur’s Law of Breastfeeding Discussion. The well known Godwin’s Law asserts:

As an online discussion grows longer, the probability of a comparison involving Hitler approaches 1.

In other words, if any online discussion goes on long enough, someone will inevitably be compared to Hilter.

Tuteur’s Law of Breastfeeding Discussion asserts:

In any online (or print) lactivist discussion of formula, the probability of the invocation of Nestle’s abhorrent behavior approaches 1.

In other words, in any discussion of formula, those noting the inherent risks and limitations of breastfeeding will inevitably be compared to Nestle.

Just as the invocation of Hitler in Godwin’s law is designed to derail the discussion, the invocation of Nestle in Tuteur’s law is also designed to put an end to any discussion that might ultimately reveal the risks of exclusive breastfeeding.

In truth, Big Formula is no different from Big Pharma; both have behaved immorally in the past. But just as Big Pharma’s immoral behavior doesn’t invalidate the tremendous life saving powers of vaccines, statins, antihypertensives, anti-depressive and anti-psychotic medications, the immoral behavior of Big Formula doesn’t change the fact that formula has saved and continues to save the lives of more babies than breastfeeding ever could.

Once again the Trump administration is wrong, but this time they might save lives in spite of themselves. Even a broken clock is right twice a day.

  • Lisa Hayes

    I wish middle and upper-middle class women in the USA could try walking a day in the shoes of a working-class or working-welfare receiving mother. When/where/how are they to pump at a fast-food, warehouse or factory job? The Sanctimommies pressuring everyone who gives birth to breast feed need to get over themselves and realize how sweet they have it in life.

  • Trees

    Access to formula is something too many Americans take for granted. We shouldn’t be manipulating individuals’ food choices by coercion anyway.

  • Gail Jiles

    Love your column Amy, and I’m no Trump fan, but could it be that despite the goofy behavior and idiotic comments, Trump and his administration could actually be promoting individual choice for women about how to best feed their infants? I heartily agree with this philosophy and don’t see how we can make the sudden leap that our current administration is promoting/endorsing/in cahoots with the formula companies. Sometimes businesses stay solvent all by themselves. This could be because they produce something people want to buy? Thanks for all your interesting articles! Especially love the ones about attachment mothering and co-sleeping. My babies went straight into cribs from the hospital and I got soundly criticized by lots of people. I also got criticized for supplementing with formula. My first baby was a big boy and a hearty eater. I didn’t hesitate to do what I could to keep him fed. One friend’s baby became terribly dehydrated and jaundiced because his mother was terrified of nipple confusion! He wasn’t confused. He was HUNGRY!

  • This article ignores that hundreds of millions of mothers across the world have no such access to clean water, no access to properly sanitized bottles, no access to refrigerated storage. And these mothers who will be forced to mix their formula with unclean water in unsanitized containers and then leave the formula out in 100+ degree F heat are the same ones who can least afford to spare that extra money on formula, the ones who skip their own meals, or their other children’s meals, or dilute their baby’s formula because of the burden formula cost places on them.

    THEY are the ones for whom the formula/breastfeeding debate places by far the greatest burden. They are the ones who the vast majority of deaths come from. To suggest that the actions of the Trump administration “will almost certainly save lives” sounds ridiculous to me when I know the stories of these women.

    And some of the correlation claims in the article are weak in the extreme. Of course the most impoverished countries are forced to rely on breastfeeding more, and of course those deeply impoverished mothers have difficult outcomes for a host of reasons that have nothing to do with the breastfeeding/formula choice. Suggesting that that shows anything about the efficacy of breastfeeding is like suggesting that driving a car is healthier than walking, because people in countries with more cars live longer.

    • Who?

      The better solution would be to support the provision of clean water to every man, woman and child on the planet.

      Not much good breastfeeding if the water that keeps mother going will sicken or even kill her on a bad day. The breastfed baby will be right back to zero then, and likely to join the numbers of under-5s who die of waterborne illnesses every year.

      And who mixes formula and leaves it out? Mix as you go, small portions only if necessary. A whole lot easier than watching your baby starve to death.

      • The poor people who live in those areas can only with extreme difficulty ensure the provision of clean water to everyone. However, they can breastfeed.

        And claiming “not much good breastfeeding” just because there are risks to the mother doesn’t make any sense to me. It’s like saying that just because there’s one health risk, that additional health risks don’t matter.

        Who mixes formula and leaves it out? Just about everyone i know in my community – you don’t know exactly how much the baby is going to eat.

        • MaineJen

          “However, they can breastfeed.” But not every mother CAN breastfeed. And not every child will have a mother. Promoting breastfeeding so aggressively will do nothing to help children whose mothers cannot breastfeed or children without mothers. Aggressively addressing access to clean water will help everyone.

        • maidmarian555

          You do understand that if a breastfeeding mother is consuming pathogens in the dirty water she’s drinking that this can have a direct effect on the quality of her breastmilk? When I was breastfeeding, I *needed* extra calories. If I’d had repeated episodes of vomiting and diarrhoea, it would have tanked my supply. Dramatically. Breastfeeding is not ‘free’. It demands labour and energy from the mother supplying the milk. Which she won’t have if she’s not well hydrated and getting enough calories. Clean water is *essential* for effective breastfeeding.

        • maidmarian555

          And also, don’t assume that because a mother is poor and from a developing country that she doesn’t want to better her life. Maybe she does have an education. Maybe she does want a good job. Maybe she’s smart as fck and wants to keep furthering her career in a way that’ll get her out of her current hole. Maybe breastfeeding her children for years is not a good fit for her. The way we view these parents, particularly mothers, in wealthier countries is pretty fucked up tbh. They don’t all need to be saved by white people telling them what to do in order to better themselves.

        • Who?

          I didn’t say the people in difficult circumstances should ensure the provision of clean water, I said that supporting its provision to everyone on the planet would be a good thing.

          If mum gets so sick from repeated gut illnesses that she can’t breastfeed, or if whatever bug she has is transmitted by feeding, that’s a problem for the baby. And when the baby then gets the same water that made mum sick in the first place, it seems ridiculous to have fetishised early feeding and ignore everything after.

          I’m sorry you live among careless and sloppy people who leave food out to go bad-not all of us do.

        • momofone

          “However, they can breastfeed.”

          Unless they can’t.

    • Madtowngirl

      Doctors without Borders has repeatedly explained why aggressive breastfeeding promotion is hurting women in developing countries, too. Women in these countries also experience lactation failure. The clear solution is to focus on access to clean water, which wlthe WHO is conveniently ignoring.

      https://www.cnn.com/2018/07/11/opinions/breastfeeding-resolution-listen-to-women-lemmon-opinion/index.html

      • You’re somewhat misrepresenting their stance. If you read the links it says that they AGREE with the international consensus on breastfeeding, but exceptions should be made for extreme conflict zones like Mosul:

        “Although we agree with the international guidance described by Ververs and colleagues,2 and the statement that the requirements for the support of infant formula feeding go beyond the supply, we must re-emphasise the emergency nature of this intervention and the specific context prioritising the prevention of deaths due to malnutrition. Although the technical aspects of Ververs and colleagues’ Correspondence are not in contention, the displaced mothers from Mosul reported previous formula milk use,1 and its unavailability was the major challenge to adequate infant feeding.”

    • RudyTooty

      I can agree that if the world’s women had access to the same luxuries that we do in wealthy countries: clean water, safe communities, education, reproductive freedom, access to modern medicine, improved public health and reduced disease transmission, the outcomes would likely be similar. You’ve even said this – they suffer poor outcomes “that have nothing to do with the breastfeeding/formula choice.”

      How would breastfeeding be the magical balm that solves these problems? I’m not so sure that breastfeeding, or not breastfeeding is really the issue.

  • Mrs. PeterJoseph

    What is the “lactation industry”?

    • Chi

      As the name suggests, it’s the industry that benefits from the ceaseless pushing of ‘breast is best’ at all costs. It’s the lactation consultants hired by hospitals, private lactation consultants who charge you $200 for a consultation (and often this has to come out of pocket as some insurers won’t cover it).

      It’s the manufacturers of breast pumps and breastfeeding pillows, breastfeeding covers, nipple shields, ‘lactation’ cookies and supplements etc etc etc.

      Basically the lactation industry refers to anyone who profits from breast is best marketing.

    • demodocus

      Some women do not bother with anything Chi’s talking about, but -lots- of others, especially desperate women who don’t produce enough for their child, can spend crazy amounts of money on it.

    • The vast majority of the world’s mothers have no access to any such “lactation industry”, and it’s ridiculous to suggest that such a niche industry has such enormous influence that it has managed to force hundreds of nations across the world to stay in lockstep with them since 1981.

      Who are the lactation lobbyists? Where are their political donations?

      • Amy Tuteur, MD

        It’s a multi BILLION dollar industry! And it doesn’t have science on its side.

        • swbarnes2

          Do you have a citation for that? The last thing I looked up said it as about 1.2 billion, and formula was about 70 billion.

          • Amy Tuteur, MD

            https://www.marketwatch.com/press-release/breast-pumps-market-is-supposed-to-reach-us-30-billion-by-2022-2018-07-02

            That’s just breast pumps. It doesn’t include other accessories or lactation professionals’ salaries and fees.

          • Gæst

            And nursing bras and clothes!

          • Your own link says that North America dominates that market, yet they are the only ones who are OPPOSING the push for breastfeeding over formula. Because even in North America where the lactation market is largest, the formula market still outpaces it by 50 to 1.

            So where is the money coming from push the “lactation industry” in the vast majority of nations globally? You really want us to believe that American lactation consultants are sneakily convincing Ecuadorians, Russians, Kenyans, Indians, etc. to deny what you claim is the “right science” and argue against their own populations’ interests?

            This is just the second time I’ve ran into you on the web, and both times you were insistent on demonizing the people you disagree with based on the suggestion of ridiculous conspiracies that have no basis in fact.

  • PeggySue

    And this whole inane mess is making me irate over any supposed “analysis” of any issue that purports to be True, because it is Based on Data. My religious organization has published a Study of Things That Are Associated with Growth in the Local Congregation and all I can think of is, did you guys control for confounders? Do you know what confounders ARE? A little data can be such a terribly dangerous thing. We have all kinds of idiots going full on to make their worship services Lively (whatever that even MEANS) because that Will Grow the Congregation. One of the hugest correlates to congregation growth was location of a church in a non-white community. So, were these Lively Worship congregations that Make the Church Grow all the same ones that are in non-white communities? What effect are we actually looking at? A huge cultural difference in communities, or some sort of calisthenics? Maybe I am just nuts.

    • You’re definitely not nuts. You’re thinking like an actual data scientist. There is a reason that I spent multiple grad-level classes learning about study design, how to write polling questions, the importance of confounders, and thinking all this out before you ever started doing any data analysis. It isn’t easy, and using bad data or failing to account for confounders means you will get misleading results that lead you to entirely wrong conclusions.

      Never has the phrase “a little learning is a dangerous thing” been more accurate than when it comes to understanding data sets.

    • FallsAngel

      Yeah, my church has gone through the same thing.

  • PeggySue

    Well, so, earlier we had Eugene Gu, MD on twitter saying “all doctors know…” and going on with the whole breast is best thing. If I recall he is a surgical resident, no? Not even an OB/GYN. Geez.

  • Gæst

    I’m so frustrated with how this played out. We *should* oppose the WHO’s blanket endorsement of breast milk. But we should not be bullying other countries, and the fact that Trump is the one opposing it means a whole bunch of minds just locked themselves shut to hearing another side of the story. I am certain the Trump only opposes the measure because it hampers industry, definitely the wrong reasons. But I’m afraid this will damage all the headway we made pushing back against the BFHI and misinformation about breast feeding and formula.

    • fiftyfifty1

      “I am certain the Trump only opposes the measure because it hampers industry”
      I’m not so certain. I would bet culture wars are a part of it too. The obsession with exclusive breastfeeding is an “elite” thing and Trump knows he can use it as a wedge issue.

      • Gæst

        Maybe, but he seems more like the type of person who thinks breastfeeding is disgusting.

      • Allie

        I’m not so certain either. It’s such an oddly dichotomous issue: the left espouses breastfeeding as some sort of “back to nature” thing, and the right espouses it as some kind of “woman’s role” thing. All I know is that the end-game, in either event, is scarily Handmaiden’s Tale-esque (the book; I have not seen the miniseries).

        • fiftyfifty1

          Agreed. It is always so unsettling when opinions go so far Right and so far Left that they end up wrapping around and meeting up in agreement! In addition to your lactivism example, I also think of anti-porn, anti-trans, and anti-hormonal birth control as examples.

  • HailieJade

    “Lactation professionals have given the Trump administration moral cover for what is undoubtedly a business decision” – SO MUCH THIS!!

    Donald Trump won the election by appealing to people in society who felt unheard and forgotten by mainstream politicians and media. A pompous, washed up reality TV host in a bad wig managed to get people to vote for him who would normally never dream of voting for such a man, and he did it by pretending to care about their problems when it seemed like no-one else did. Of course he never really cared, he just wanted to be president.

    A similar thing is happening here- the decision is being framed as caring about women’s choices and listening to those who don’t feel listened to, instead of the business decision it clearly is.

    The breastfeeding industry brought this upon themselves. By not listening to women, they have created another group of people in society who don’t feel heard*. This plays right into the hands of the Trump administration who are now using it as a justification for their latest money-making scheme.

    But of course lactivists are too stupid to realize that.

    *Please note I am in no way trying to compare women who formula feed to Trump supporters! Merely pointing out the way in which the breastfeeding industry created the very problem Trump is now pretending to care about.

    • Jayann

      I agree with you except for one thing. I’ve come to almost loathe the breast is best patronizing groups that push their personal beliefs on other women, shaming women directly or indirectly who are often at their most vulnerable – but this move isn’t going to make me vote for Trump, ever. Nothing would actually. At its core, it’s a feminist issue as well as a privacy & choice issue and I think as long as articles like this are written & circulated to counter the lactivist’s misplaced rage – I wouldn’t worry about losing voters due to this. I think the groups he tapped into & manipulated had more in common than women who simply want others to mind their own business about this.

      • HailieJade

        I agree and I don’t believe he will win over any voters as a result of this either. They are two quite different issues, but the tactic employed by Trump is the same.

        My comment was merely to point out the irony in the fact that the aggressive lactivist movement has created this problem in society, and by doing so have basically handed Trump a convenient justification for this latest business venture which they detest so much on a silver platter. It’s like someone who is against cars going around and slashing the tyres of every bus in town, and then acting outraged when the local mayor announces his latest pledge to increase car manufacturing over the coming year.

    • Allie

      Is it a wig, or just a terrible comb-over/die job? Apologies, your comment was well thought out and thought provoking, but I just can’t get over the suggestion that any part of that atrocious hair is fake, and therefore intentionally that bad.

      • Zornorph

        Trump does not wear a wig – it’s just his ‘style’.

        • MaineJen

          “Style” *barely contained snigger*

      • Who?

        I’m waiting for it to stretch its legs and scuttle back to wherever it came from…

      • HailieJade

        I always thought it was a toupee? Could be wrong though! 😉

      • mabelcruet

        It’s a carefully constructed and arranged precision masterpiece. He started with a scalp reduction to reduce the size of the bald spot, then developed an elaborate 3D comb-over using lots of product to colour, thicken and hold it in place. Unfortunately, that means that the slightest breeze at the wrong angle lifts it up like a sheet of matted pubes.

        https://www.theguardian.com/fashion/shortcuts/2018/jan/05/has-the-secret-of-donald-trumps-hair-finally-been-revealed

  • The Kids Aren’t AltRight

    One thing that really disgusts me about a lot of breastfeeding propoganda is that it takes a ssociety-wide problem and tries to blame it on individual choices. The problem killing infants is lack of access to potable water, but breastfeeding propoganda allows us to blame their stupid and lazy mothers while ignoring our own privilege. I have also seen stories claiming that the infant mortality rates for African American women wouldn’t be so bad if only they could breastfeed like good white people, which erases huge issues with racism, lack of access to healthcare, possible genetic differences (on average) that would not have been accounted for in white-centric medical research, etc. This disgust is what led me away from birth woo and to this blog, coincidentally.

    • Allie

      “The problem killing infants is lack of access to potable water”

      That, right there, deserves a mic drop.

      • So what are ya’all doing about it?

        Until potable water is available for such mothers, breastmilk is clearly best for their babies.

        And even when water is available, issues of sanitation, adulteration, and cost are still going to weigh heavily towards breastmilk for them.

        • Sarah

          It’s interesting that, brand new to this website, you felt entitled to ask questions of others, without offering any information first about what you might be doing to assist.

          • I thought it was obvious that advocating and educating regarding breastfeeding was something to be doing about it.

            If the non-American version of the plan goes through, the goal would be to help ensure that vulnerable babies had less exposure to contaminated water, by breastfeeding. That’s the route being attempted. My question is, if you think another route is better and are happy with this route being blocked, then what are you doing towards the alternative?

            So far as what I’m doing, see my comment above.

          • Sarah

            That would’ve been a slightly better first post than your initial parachute and demand effort.

          • swbarnes2

            The underlying issue is the water. That’s where the focus of effort and money needs to be spent, not making women feel good about choosing to breastfeed. I’ve previously posted links showing that infant morality really change course in three countries with large increases in breastfeeding.

          • Amy Tuteur, MD

            So you think it’s okay to be wasting millions of dollar promoting breastfeeding around the world when those same millions could be used to provide clean water for those who need it most?

          • Can you explain what you mean by “those same millions”? You are either unfamiliar with how the relevant funding programs work or you are purposely being obtuse. If clean water systems become the priority that they should, there is certainly more than enough money available in this world to make it happen, but it’s a completely different sector and wouldn’t be sourced from the same programs at all.

            Breastfeeding advocates have never blocked a government water filtration system in order to fund breastfeeding advocacy.

          • Amy Tuteur, MD

            I mean that every dollar we waste promoting breastfeeding in industrialized countries or to women in developing countries who can’t produce enough milk or who are sick or injured is a dollar that we could be spending on clean water, antibiotics, vaccinations and other things that have a much greater ROI than breastfeeding.

          • Every dollar you waste on bottled water for the wealthy, expensive cups of coffee, and a million other things could also be providing those clean water systems. There are numerous things that wealthy people like yourself spend money on that don’t help public health at all.

            If you really care about clean water so much, you could start diverting some of THAT money.

            You well know that even if 100% of the funding for breastfeeding initiatives ended tomorrow, it wouldn’t add one cent of funding for clean water initiatives. That’s not how infrastructure works. It’s a false argument.

          • Amy Tuteur, MD

            Wrong! A variety of international aid, public health and United Nations organizations spend money to promote breastfeeding. They could use THAT money to provide clean water.

            You seem to be missing the fundamental point: Breastfeeding doesn’t save lives in real life no matter many mathematical theoretical models predict otherwise.

          • Your “fundamental point” seems to be something that the Lancelet, the American Pediatric Association, and nearly every nation on Earth disagree with you on.

            And as I have repeatedly reminded you, the issues faced by impoverished families who use formula is far broader than mere clean water.

            As far as the financing, you keep creating this false dilemma. There is no clean water infrastructure fund that is being raided to fund breastfeeding promotion instead. They are entirely different initiatives, you don’t just move money from one to another, and there is FAR more money available that could be used for clean water infrastructure if that is really the priority that you care to push. But that will never happen, of course, if the only time you care about clean water is when it’s time to insult pro-breastfeeding initiatives.

            I can list a ton of things that you and people who read your blog spend money on which are far more frivolous than promoting breastfeeding. I could make the argument that you could use THAT money to provide clean water if it is truly your priority.

            You keep creating this false dilemma as if there is a finite amount of available money in the world and someone has made some decision to promote breastfeeding instead of prof

          • Amy Tuteur, MD

            No fooling. Medical organizations can be wrong.

          • Daleth

            Jon, if you think promoting breastfeeding is the solution to contaminated water, you’re forgetting that 99% of humanity is more than six months old. What happens to those breastfed babies when they’re 10 months or two years or ten years old? They die from diseases or pollutants (lead etc.) that they got in the water.

            Even if you only care about babies, what about pregnant women? Is it okay for them to drink contaminated water?

            The solution is not breastfeeding. The solution is to build the infrastructure needed to ensure clean water. That’s where our millions should be going.

          • The Bofa on the Sofa

            The thing I don’t understand is, the places with the highest infant mortality and poor water supply already have very high breastfeeding rates.

            The places with the worst breastfeeding rates, where they have the most room for improvement, are 1st world countries where infant mortality is not related to nutrition/breastfeeding/formula.

          • That’s simply untrue – a significant % of the global population is in areas that have high infant mortality, poor water supply, and a large % of babies who being given formula.

            It is irrelevant whether the formula use rates are “only” 40% or 50% in those countries while they are 60% or 70% in the 1st-world countries. That’s still a huge number of babies who are exposed to an issue that 1st-world children aren’t exposed to at all.

          • Amy Tuteur, MD

            But it’s not the formula that’s the problem; it’s the water.

          • It’s not “just” the water.

            It’s the water.

            It’s the container sanitation.

            It’s the capacity for adulteration.

            And often most importantly, it’s the fact that formula is expensive and diverts precious household spending away that poor families could be using on nutrition for the mother, other children, medication, education, etc.

            Even if every community in the world got clean water tomorrow (which would be wonderful, and which the promotion of breastfeeding is not in any way preventing), there would still be that entire host of problems.

          • These two things are not at odds with each other. The idea that supporting breastfeeding pulls millions of dollars away from clean water provision is a simply ridiculous fiction. We should be working for both.

            But infants are certainly the most vulnerable, and a slow-based gradual exposure to the pathogens in the local water supply at 1 year of age or so is much safer than constant large-scale exposure from the first day.

          • Amy Tuteur, MD

            There’s only finite amount of money available for public health inititiative. We are wasting money promoting breastfeeding in industrialized countries where the benefits are trivial instead of supplying clean water in countries where the benefits could be massive.

          • Why is there only a finite amount of money available for public health initiative? Who made that up?

            You are playing with a complete false idea of how public health funding works. If all breastfeeding advocacy stopped tomorrow, not a single extra penny would be diverted to water infrastructure (which, as I’ve pointed out before, isn’t even in the same funding category).

            The idea that breastfeeding programs are draining money away from clean water provision is a pure fiction.

            I have an idea. The bottled water industry is $100 billion, more than a thousand times larger than lactation promotion. Coffee is another $100 billion. How can you live with yourself, watching your friends drink bottled water and coffees when millions are dying of lack of water?

            That should point out how silly your false dichotomy is.

          • fiftyfifty1

            “But infants are certainly the most vulnerable, and a slow-based gradual exposure to the pathogens in the local water supply at 1 year of age or so is so much safer than constant large-scale exposure from the first day.”

            Sure, newborns are the most vulnerable, but toddlers, children and adults are too. It is estimated that dirty water kills 1,000 children per day. That’s 365,000 per year, way more than the 25,000 that Gertler says are dying due to formula. Can you imagine gestating your baby 9 months, breastfeeding it 12 months, only to have it die at “1 year of age or so” after a “slow-based gradual exposure to the pathogens in the local water” that oops didn’t work out so well after all? Cold comfort that your baby didn’t die of contaminated formula! Clean water would save BOTH, but of course it involves more effort than browbeating mothers for being so ignorant.

          • The conclusion of the 2016 Lanceet metastudy analysis was 835,000 lives that could be saved by breastfeeding. That is not just related to dirty water, of course. Women in poverty face many other issues with regards to formula, including adulteration and dilution due to the inability to afford enough formula as well as other health opportunity cost lost due to its costs.

            We should certainly fight for clean water too. Neither I nor anyone else has suggested otherwise. What are you doing on that front?

          • Amy Tuteur, MD

            I’m not sure what you are having trouble understanding. The Lancet article is based on mathematical modeling using studies that have not been corrected for confounders and assuming causation where none has ever been proven. If breastfeeding really saved that many lives than increases in breastfeeding would have a measurable effect on infant mortality rates. Despite nearly 3 decades of aggressive promotion of breastfeeding and increases in breastfeeding rates in a variety of countries, no one has yet shown that breastfeeding saves any lives beyond extremely premature infants. If real world data collected over 3 decades does not support the mathematical model than the model must be wrong.

          • fiftyfifty1

            Back to the Lancet study that has been discredited? Please.

          • It wasn’t a “study”, it was a metaanalysis of many studies. And where did you see that it was legitimately discredited?

          • fiftyfifty1

            “And where did you see that it was legitimately discredited?”

            Do you deem the Gertler et al numbers to be illegitimate? If so, why? If you have problems with their methodology, let’s hear them here! Better yet, go to the page where Dr. Tuteur reports on their study and make your best case there! But please, don’t pretend you’ve never heard of it.

          • Gertler states that their numbers are solely for the effect of Nestle, only in certain countries, and that even for those countries they only comprise a “lower bound estimate.” Read the paper. They are not measuring the same thing as the Lancet metaanalysis, and it was disingenuous of Dr. Tuteur to claim that they did, especially since in other places she seems to claim that the Gertler numbers aren’t legitimate either.

            Also, as has been stated before, you don’t use a single study to claim to discredit dozens and hundreds of other studies, the whole point of the scientific process is to look to verify that result and take the weight of the evidence over time, not just the one that best fits your narrative.

          • fiftyfifty1

            Nestle’s data were studied because they were far and away the largest supplier of infant formula, in many countries the only supplier. And although they state that 66,000 is “lower bounds” for 40 years ago, Gertler elsewhere says that total current deaths attributed to formula in low and middle income countries is only ~25,000. So where are these missing 795,000 deaths?! Especially because Gertler found that OVERALL infant mortality was unaffected: “the intro of infant formula shows no statistically significant average impact on infant mortality for the population as a whole.” So although 25,000 infants die in places where water comes untreated out of ponds, puddles, streams, lakes etc., infants do NOT die (indeed mortality rate seems slightly improved although not to the point of statistical significance) if there is ANY improvement in water source at all, even just to the level of a primitive well. Once again, where are these missing dead babies? Nobody can seem to find them.

            In any case, I do believe the WHO should be promoting breastfeeding in areas where drinking water comes untreated from surface sources like ponds, puddles, streams, lakes etc. But in ALL other situations, they have no business doing so, certainly not in high income countries. And simultaneous with promoting breastfeeding in these (limited) areas, the WHO should be working on risk reduction, because as Gertler points out, many women will still need to use formula. In those cases, water will need to be boiled, or purified first with chlorine tabs. I like his suggestion of including the chlorine tabs right in the formula package. Why not take the $ that the WHO spends on browbeating women to breastfeed in areas where there is safe water, and use it to educate women in the dirty water areas about how to use the chlorine tabs?

          • Again, they only looked at 46 countries, only at Nestle, and only at infant deaths.

            And they did not find that “overall” infant mortality was uneffected, they found that they couldn’t determine a statistically significant effect within the uncertainty of their models. For instance, infant mortality went up by 8 per 1,000 births between year 0 and year 5, but whether that was a statistically significant result or just an artifact was not possible to determine because of the uncertainty. In fact, the uncertainty was so great that the effect among households with no access to clean water may have been as high as 20+ per thousand births.

            And again, it was a single study. It can’t be used to immediately discredit every other study out there (especially when many of those studies looked at completely different things), that’s not how it works.

            Also, from the study:

            “Many of these deaths could have been avoided if more mothers had breastfed. There are a number of effective antenatal and postnatal behavioral change interventions that improve breastfeeding practices and thereby reduce infant formula use (35). Examples include education and counseling during the prenatal period as well as hospital and homebased support in the postpartum period (36, 37), and effects of which can be enhanced by including fathers (38). A very effective program is the Baby Friendly Hospital Initiative, which bans promotion of bottle feeding infants post-partum and supports breastfeeding immediately after birth and throughout the crucial first few days (38).”

            But people are ignoring that, and anything else that goes against what they wish to believe, and only cherry-picking the aspects of the results that confirm what they want confirmed.

            In respect to what you say about chlorine tabs, unfortunately there are some suggestions that chlorine tabs are a rather ineffective means of disinfecting household water supply. This is easy to believe because purely chemical means are usually sub-optimal for drinking water, and any methodology that requires continuous every-day action without natural enforcement is likely to result in poor compliance. Personally I use chlorine drops in emergency situations but i would not be comfortable employing them for everyday use, especially with infants.

            http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001497

          • Amy Tuteur, MD

            Have you ever heard of white hat bias? You are displaying it.

          • Daleth

            They are at odds with each other when “promoting breastfeeding” means making it harder to advertise, sell, or obtain formula. Which, when we’re talking about international resolutions or sweeping WHO recommendations, is usually what it means.

          • Can you tell me the country where formula is difficult to sell or obtain due to WHO policies? I’ve spent serious time in several of the countries in question and I have never found anywhere where formula was at all difficult to sell or obtain. Many countries are different so perhaps it is possible that formula is difficult to obtain somewhere due to how they have interpreted the WHO guidelines, but that’s certainly not how most countries interpret them and formula remains quite easy to access over the vast majority of the world for people who can afford it.

            I’m under the impression that the vast bulk of the effects in question revolve around advertizing/marketing, not barriers to the normal selling of the product by mothers who independently want it outside of industry pressure.

          • Daleth

            Have you been to a hospital that’s part of the “Baby Friendly Hospital Initiative” (BFHI)? Their idea of promoting breastfeeding is to make formula as logistically and emotionally hard to get as possible. They make women who just gave birth sign forms acknowledging the supposed risks of formula before they will provide it. Some won’t even provide it at all without a prescription from a doctor (!).

            https://www.romper.com/p/6-rules-about-hospitals-offering-formula-that-every-new-mom-should-know-9243876

            Or have you seen the World Health Org’s “Ten Steps to Successful Breastfeeding”? http://www.who.int/nutrition/bfhi/ten-steps/en/

            Step one is to comply with a 24-page resolution that prohibits advertising and promotion of formula, prohibits giving free samples of formula or formula accessories (scoops, bottles etc.) to mothers, pregnant women “or members of their families,” and–I could go on and on, or you can read all 24 ridiculous pages yourself: http://www.who.int/nutrition/publications/code_english.pdf

            And, of course, other steps of the WHO Steps to Successful Breastfeeding include, “Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated” (in other words, do not let mothers freely choose whether to BF, FF or combo feed their own babies) and “Counsel mothers on the use and risks of feeding bottles, teats and pacifiers” (in other words, tell new mothers about the risks of everything else, but not the risks of breastfeeding).

          • MaineJen

            Again, that does NOT help the children who cannot get breast milk because their mother is not producing it (because, for instance, they live in a war zone and their mother isn’t getting anything to eat), or because they do not have a mother (see above reason).

            Clean water > breastfeeding.

          • Clean water is never at odds with breastfeeding. They aren’t even in the same sector. There is no government slush fund where people have to decide whether they’ll spend that money on breastfeeding promotion or water purification infrastructure.

            And war zones? Really? For the small % of women raising babies in actual war zones, formula isn’t going to be very easy to access or afford, so either it’s going to be provided via emergency aid or it is not. And if the mother isn’t getting anything to eat, to use your own logic again, that has to be addressed no matter what the baby is eating. it is cheaper to provide proper nutrition to the mother than ship in formula for the baby, and it saves both of them – doesn’t do much good to save the baby’s life if the mother dies.

        • momofone

          1. The word, if it’s a word, is “y’all.”
          2. What are you doing about it?

          • You want to play grammar nazi with something you won’t even acknowledge as a word? What’s the point of that?

            Personally, I live in a very poor community and work to help everyone I know in it have healthier lives and healthier babies through education, literacy, and access for both women and children. I have worked to directly intervene in the lives of poor children, including one who was explicitly starving due to inability to drink her mother’s milk. I also work to educate others outside the community to advocate for changes which will help those in the community.

  • MaineJen

    This story on NPR confused me SO MUCH. Especially when they interviewed someone from the WHO, who argued that they are not trying to interfere with the marketing or distribution of baby formula (which she had to concede was good and necessary), but with the marketing and distribution of “other baby milk substitutes, which are not suitable for babies.” I couldn’t figure out what in the world she could be talking about. Is there any truth to this, or are the WHO people trying to spin it so they don’t look like they’re against baby formula?

    • swbarnes2

      It might mean discouraging companies who don’t meet Western standards, and discouraging mothers from making homemade formula out of goat milk and corn starch or whatever.

    • Baby milks are fortified milks marketed for babies over 6 months old, up to about 2 years I think. So I guess like a formula-lite for kids who are eating some solid foods? If that’s the case, then there isn’t really a reason to use them.

      • Allie

        Sure, sure. No reason except that they may be a nutritious and convenient substitute for babies whose moms are not breastfeeding, but who have not chosen to graduate to solid foods, which is not uncommon (snark directed at the WHO interviewee, not you, Ferminerd).
        I was breastfeeding, but between 6 months to about 11 months, my daughter had little interest in solid foods. Had I not been breastfeeding, you’re damn straight I would have continued with baby milk. Actually, once she turned 1, we started giving her whole milk with Ovaltine in it. If you think that’s wrong, feel free to call me at 1-800-EAT-SH… you know the rest (again, please note, snark is directed at WHO interviewee, not you, Ferminerd).

        • I know a lot of people who feed formula between 6 months and 1 year, along with solids. If the kiddo doesn’t like solid food much, they still get formula. I don’t know that you need a different set of baby milks that are marketed differently from formula, but then again, I am not a pediatric nutrionist or anything close to it!

      • maidmarian555

        Here in the U.K., it is only the Stage 1 milk that’s covered by the ‘no advertising, no promotions’ laws. So for me, I switched both kids to Stage 2 milk at 6 months bc it’s 2 for £18 in Asda instead of 1 for £11. It’s a dodge by the formula manufacturers (as far as I can work out it’s only a slightly different product with a bit more iron) to get around the advertising laws but from a parental perspective, I dgaf if I’m saving a few quid. They’re trying to ban them here so us FF parents get to pay full price for formula for a whole year instead of just 6 months. Because that will obviously make more parents breastfeed. Apparently.

        • Madtowngirl

          “If you have to pay more, you’ll just breastfeed instead!”

          What a condescending presumption they’re making.

          • maidmarian555

            That’s why the ‘we’re not targeting formula, we’re just going after baby milks’ position is so insidious. I understand that formula companies literally created baby milks to get around the rules but the reality is that a couple of quid a week does make a difference with regards to the food budgets of some families. And may make giving cows milk too early more attractive for them. These cretins don’t see it that way tho. They think it’ll dissuade the use of formula from the get go. I can’t see that happening, personally.

          • Madtowngirl

            I don’t think it will dissuade formula use either. If anything, as you said, it will encourage cow’s milk or less safe alternatives…

          • Amy Tuteur, MD

            Only someone privileged who has no idea what real poverty means could think that.

          • Madtowngirl

            Indeed! It’s a totally gross assumption and it will only encourage women to turn to cow’s milk or other, less safe alternatives.

  • Chi

    Yup Tuteur’s law. A friend of mine shared this article:

    http://thehill.com/policy/international/396025-us-turned-to-threats-to-fight-breast-feeding-resolution-report

    And in the comments under it, there is a Jack Newman worshipper who has just invoked the Nestle bullshit.

    *sigh* Also she’s going on about support and how SURE there SHOULD be formula education, just not to the detriment of breastfeeding.

    Ugh I just can’t even today.

  • Thank you for this informative piece. I’ll be sharing this over the coming days. By the way, this site is a bit hard to read and navigate on mobile. Would you maybe consider enabling a mobile-friendly version? If you’re using wordpress, it’s somewhat easy to do. You can use the WP Touch extension.
    Anyway, good job and I really appreciate there being a skeptical doctor writing about this.

  • fiftyfifty1

    “Even a broken clock is right twice a day.”

    Actually, I would say that food policy is an area where the Republican party is predictably right much more frequently than the Democratic Party. We Democrats have an orthorexic love affair with organic food, anti-GMO, exclusive breastfeeding, locavore, and other bullshit food philosophies. It’s embarrassing. And it just plays into the culture wars. Working class families rightly get angry when they get criticized for what they eat and what they feed their families. When Michelle Obama made nutrition her First Lady project I was so disappointed. It was totally tone deaf and she should have known better. Fellow Democrats: stay out of people’s kitchens, stay out of school cafeterias, feed your own family what you choose and then STFU! We have waaaay bigger fish fry.

    • Madtowngirl

      Thank you for saying that. Part of the reason I have such a difficult time identifying with the Democratic Party is because of the pervasive woo, especially surrounding food. Politically, I’m a left leaner, but seriously I just grind my teeth when I see the “omg Monsanto is EBIL” stuff coming from the left. It’s kind of hypocritical as well, since the Democrats insist they are working in the best interests of the poor and working class, yet push for expensive food options.

      • fiftyfifty1

        Yes, it’s a huge turnoff to voters in agricultural areas. Like you said, it’s all “omg Monsanto is EBIL” and these farmers USE Monsanto products. What an insult! I went to my local Democratic Party caucus this past spring, and left wondering whether I was really a Democrat. I thought that given the current political reality, we would have a lot of important issues to address. But instead there were 4 separate written proposals to ban neonicotinoids, both in private yards and on farms, and not a single one of the clueless authors could even pronounce the word neonicotinoid. Literally I was the only person in the room of 30 who could pronounce it and knew what it was, and I was the only one who voted against the proposal to ban. And we Democrats wonder why we are losing the “F” in DFL?

      • LaMont

        Very liberal myself, I was chatting with friends of my future very conservative in-laws (my brother’s fiancee’s family) at the engagement party and when this guy was like “I work on GMOs” and I responded positively he was *thrown*.

      • To further nuance it, Monsanto is pretty evil. But they’re evil because of how they’ve done the soybeans and corn, not because GMO is inherently evil. They’re promoting the overuse of herbicides that are also pretty toxic to wildlife (and people), and their policies around seeds are horrific when introduced to subsistence farming communities.

        Round-Up is a lot less poisonous than other options, though, so it’s still … complicated.

      • mishabear

        Monsanto IS evil though. It isn’t the GMOs per se, but their business practices are literally corrupt. In Canada while trying to get BGH approved, they tried to bribe Health Canada officials into looking the other way when Health Canada asked to look at safety studies. In the prairies Monsanto goes after farmers for patent infringement when Monsanto seeds contaminate the farmers’ fields. (The plants are self-fertilizing and can be wind pollinated.)

        • Heidi

          Lol, no. Farmer Joe purposely planted his neighbor’s canola seeds, his neighbor who paid to grow them. When someone steals what you paid for, you have the right to turn them in.

    • Russell Jones

      “Fellow Democrats: stay out of people’s kitchens, stay out of school
      cafeterias, feed your own family what you choose and then STFU! We have waaaay bigger fish fry.”

      Truth. An exceptionally high percentage of anti-vaccine woomeisters are lefties as well. Single-issue woo played a disconcertingly significant role in electing a POTUS who proudly and publicly announced his belief that there are some “very fine people” among white supremacists and neo-Nazis.

      • FallsAngel

        And yet, the POTUS is anti-vaccine. He’s one of these “I’m not anti-vax but. . . ” types. Anti-vaxism spans the political spectrum.

        • Russell Jones

          You’re clearly right about anti-vaxxism spanning the political spectrum, but I doubt that Trump is really an anti-vaxxer. All his heath-related appointments (CDC, FDA, Surgeon General, Sec. of HHS, etc.) have been staunch pro-vaxxers. To the extent he thinks about such issues at all, I’m quite sure the thinking goes no deeper than “what’s good for the pharmaceutical industry is also good for me.”

          I think he put that dumbass nonsense about vaccines and autism on social media to troll anti-vaxxers. Can’t argue with the results. The internet is lousy with single-issue dipshits who call themselves “liberals” or “progressives” yet who voted for Trump based on vaccine tweets. It’s fun to rub their noses in their own idiocy, but the fact remains that they helped us get where we are today, and for that they deserve contempt.

          • FallsAngel

            Possibly. I’m pretty sure he had a flu shot because after that so-called “physical” he had this winter, the report was that he was UTD on immunizations. However, he did say he and Mel spread out Barron’s IZs.

    • MaineJen

      More tone deaf than our current “first lady” admonishing internet users to Be Best on the internet, while her husband is the biggest bully of them all?

      And…how is nutrition controversial? I never understood why people were so mad at Michelle Obama for growing a garden.

      • fiftyfifty1

        No, not more tone deaf than Melania, but perhaps more damaging. I doubt there exists anyone who is fine with Trump, but won’t vote for him because they don’t like Melania’s message. The same was not true for Obama.
        And how is nutrition controversial? Let me count the ways! Nutrition is an extremely fraught subject from birth onwards. The breast vs. formula culture wars are just the beginning. If you don’t believe Michelle Obama’s First Lady project could possibly be controversial go ahead and google “Michelle Obama school lunch.”

        • Jayann

          Anything she would have done would have been controversial, as well as her husband. They straight up invented controversies before he even got to the White House. I understand what you’re saying about telling others what is good/bad or legislating diets like with soda taxes, etc., but all she did was encourage vegetables and exercise – all evidence based. Those pushing organic food should and some are pushing for regulations to keep known toxic pesticides out of our food supply & addressing the issue of food deserts in areas where obesity and malnutrition are real issues. I drank soda and ate junk as a kid, but I was also active, had access to outdoors & had parents that provided nutritional meals and had access & means to them, a lot of families in the US don’t, and it is a real public health problem. Those marketing organic non-gmo snake oil is also a problem, but they are not the same thing.

          Also the die-hard anti-gmo, anti-vaxxers actually reside in both parties – blue crunchy moms and selective Libertarians on the red team.

          • fiftyfifty1

            “all she did was encourage vegetables and exercise”

            That is factually false. Her School Lunch initiative created a number of different new regulations which limited sodium, white flour products and restricted milk choices among other requirements. Her regulations were very controversial, both with lobbying groups and with average citizens. There was some fair evidence that the requirements only caused kids to throw away more food and drink less milk. My own kids hated the changes (and I’m pretty sure it wasn’t because of anti-Obama bias.) The initiative was unpopular to the extent that “Make School Lunches Great Again” became one of Trump’s campaign promises.

            “I drank soda and ate junk as a kid, but…”

            Yep, and Conservatives see this sort of statement as total condescending hypocrisy. It was fine for YOU to do, because reasons, good parents, blah blah blah…but Democrats feel they have the right to legislate away the same choices for others because…tell me why again exactly?

          • FallsAngel

            Michelle Obama was not and is not a legislator.

            School lunches are required to meet the Dietary Guidelines for Americans. “To receive federal reimbursements, school meal programs must offer “reimbursable” meals that meet strict federal nutrition standards. These standards, also referred to as “the meal pattern,” require schools to offer students the right balance of fruits, vegetables, low-fat or fat-free milk, whole grains and lean protein with every meal. . . The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) required the U.S.
            Department of Agriculture (USDA) to update these nutrition standards for
            the first time in 15 years. The new regulations, effective beginning in
            2012, require cafeterias to offer more fruit, vegetables and whole
            grains and limit sodium, calories and unhealthy fat in every school
            meal.”
            https://schoolnutrition . org/AboutSchoolMeals/SchoolNutritionStandards/

            How is that controversial?

            I work with a school advisory team and I do not recall any big controversy in my community. Yes, there is waste in school lunches. There always is.

            Trump is a jagoff and a racist. He did anything he could think of to stir up racist feelings about Obama, with the implication that voting for a Democrat, even a different Democrat was voting for more of the same.

          • fiftyfifty1

            Michelle Obama was not a legislator, but she made it her business to get the 2010 law passed to the point that is is called “her signature accomplishment.” If you disagree that passing the law was not due to her promotion, take it up with CNN, NPR, or any of the other major news sources who said it was.

            And you can insist all you want that it wasn’t controversial, that there is just NO WAY that nutrition could be controversial, and you will do nothing more than prove my point that liberals have a huge blind spot on this issue.

            And yes, Trump is a jagoff and racist. We 100% agree (and I’m not even from Pittsburg!) And yes he used the unpopularity of Michelle Obama’s school lunch regulations to his advantage. But the fact remains that her regulations were wildly unpopular in much of America years before he started his campaign.

          • FallsAngel

            Here is what NPR said: https://www . npr . org/sections/health-shots/2010/12/02/131761469/house-passes-bill-to-upgrade-school-lunches

            “The House of Representatives passed a bill Thursday that would upgrade the fare for federally subsidized school meals, clamp down on junk in school vending machines and make it easier for tens of thousands of poor kids to get free meals.

            The Senate unanimously passed the Healthy, Hunger-Free Kids Act months ago. Now, with the House vote, it’s on to President Obama for his signature. That’s pretty much a sure thing because the changes have been a top priority for the administration.

            First lady Michelle Obama said in a statement she was “thrilled” by the vote. She said the
            changes would “improve the quality of meals that children receive at school” and help to “combat childhood obesity.”

            Do you see anything in there about “her signature accomplishment? Neither do I. Now in fairness, NPR did say in another article that Michelle Obama “pressed” (ie, lobbied) Congress, but that is her right as a US citizen.
            https://www . npr . org/templates/story/story.php?storyId=129856526

            BTW, it’s PittsburgH.

          • MaineJen

            Yes, how DARE Michelle Obama care about what kids eat at school. If you don’t think that resentment was not primarily race-based, I have a bridge to sell you.
            And…is school-lunch-resentment really the hill conservatives want to die on?

          • fiftyfifty1

            Oh they are not dying on that hill at all. They are going to the polls and voting out the “red-tape liberals” and their “nanny state laws.” And they have convinced a lot of formerly Democrat-voting people to do the same.

          • EmbraceYourInnerCrone

            I do love the people who vote against Dems and then worry(my parents and some of my religious conservative friends were a prime example of this) that the following is or will be cut or abolished:

            Medicare, Medicaid, health clinics in rural/under-served areas for veterans, WIC, SNAP, prescription assistance, Medicare assistance programs. Child Health Assistance Program(CHIP), Farm Subsidies

            Everyone hates the Nanny state until it’s their personal ox that’s getting gored.

          • MaineJen

            Medicare is on the chopping block next. I DO wonder how that will play in the areas suffering from Economic Anxiety.

          • MaineJen

            Okay, let me ask this: would these nutritional guidelines have been controversial if Melania Trump (or any Republican first lady) had promoted them? Or would she be celebrated for trying to do the best for the nation’s children?

            If Michelle Obama had made her cause anti-internet-bullying, would there be an outcry about the “nanny state” trying to tell us what we can and can’t say?

          • The Bofa on the Sofa

            If Michelle Obama had made her cause anti-internet-bullying, would there be an outcry about the “nanny state” trying to tell us what we can and can’t say?

            At least she would have some credibility in doing it. As opposed to Melania Trump, who is nothing but a laughingstock on such matters (“You want to end cyberbullying? Start with your husband…..”)

            Then again, IIRC it was Michelle Obama’s office that initially put out a pamphlet on cyberbullying, and, as part of her anti-cyberbullying campaign, Melania Trump just sent it out again (without crediting the original author). But then again, we know that Melania Trump is a big fan of things that Michelle Obama said and likes to repeat it.

          • MaineJen

            It’s almost like….she “really doesn’t care”

          • fiftyfifty1

            Would these nutritional guidelines have been controversial if Melania Trump had promoted them?

            I believe yes. Policies that limit food choices tend to be very unpopular with consumers of the foods that have been limited. For proof we can look to how harshly Jamie Oliver was derided when he did a pilot program with “healthier” school lunches. Jamie Oliver is a good test case because he is neither Repub or Dem, being from England. Another proof, that is absolutely non-political, is when Coca-Cola took away Coke and replaced it with “New Coke.” Coca-Cola explained that their studies proved that the new formula tasted better, and that even if you didn’t agree at first, you would change your mind with time. People lost their shit! Who was Coca-Cola to tell them they couldn’t have what they wanted!!!

            And if Michelle Obama had made her cause anti-bullying?

            Also no problem. Dems are mad at Melania only because they think it’s hypocrisy because her husband is such a bully. The same case is not true with Michelle Obama.

          • MaineJen

            Oh, I think she would have received pushback no matter what she did. Conservatives/repubs criticized her wardrobe, her demeanor, her MOTHER, basically her very existence.

            Considering the current occupant of the white house (I refuse to call him the president) and their conspicuous LACK of criticism of him, I think we can easily surmise what their real complaint was.

          • fiftyfifty1

            Ok then, I guess we are stuck. The conversation now goes like this:
            Anybody: Any criticism, no matter how mild, of the Obamas, even if it comes from a Democrat (like me).
            You: You are criticizing only because you are looking to do so. Your criticisms are based only in prejudice.
            Conversation closed.

          • fiftyfifty1

            “Yes, there is waste in school lunches. There always is.”

            So more is better?

            “I work with a school advisory team, and I do not recall any big controversy.”

            In my home district there wasn’t much controversy either. But in the district where I work there was. Can you guess which district went heavily for Clinton, and which went Trump?

          • FallsAngel

            As I said, there always is food waste in the food programs. Do you have any documentation that it has increased under the new plan?

            So the opposition to the lunch program is political, not food preference. Got it!

          • Toni35

            There is a crap load of controversy behind the USDA guidelines, period.
            For example, recent, well designed studies show that whole diary products are likely better than low/reduced fat dairy products for weight management, but the USDA still recommends the low/reduced fat products (and one of the changes initiated by Mrs Obama’s lunch initiative was to take away 2% milk and 1% chocolate milk, and replace it with 1% milk or fat free chocolate milk). And let’s not get started on all the controversy regarding animal products, grains, sugar, and cholesterol…. Yeesh.

            I don’t think the government ought to be giving out nutrition advice in the first place. Too much of the science is still up in the air.

          • FallsAngel

            I think the science is pretty clear about some issues, and “the government” is paying for the lunches. And it’s ludicrous to think that Michelle Obama had that much influence that should could convince a majority of both houses of congress to agree with her.

          • Toni35

            Some issues, maybe, but nutrition science is still relying heavily on observational studies (rife with those pesky confounding factors), and the politics are huge (meat and dairy industry lobbyists, grain and sugar lobbyists, subsidies, decades of dietary dogma from various food industry funded organizations that can take decades to undo, etc).

            Yes, the government pays for these lunches (in part), but children are a captive audience. They are forced to go to school under penalty of law, and while, yes, better off parents can afford to pack lunches, many kids rely on the school lunch program. So they are stuck with whatever the government decides they should be served. Since school funding is riding on compliance (meaning choice has been taken from the districts), and the kids obviously have no choice, if the federal government is going to meddle with what is served to school children, they need to get it right. And right now, they can’t. They don’t know what is “right” (just why are they still serving fat free milk? The cost is the same).

            But my point was more about the level of controversy in nutrition. Michelle Obama followed USDA guidelines, yes. Part of the problem is that not everyone agrees with those guidelines. And they aren’t always terribly “evidence based”. So, yeah…. Controversy. That was all I was getting at. You asked how following the guidelines could be considered controvertial. Just offering an explanation.

          • Jayann

            It’s not hypocrisy at all. It’s understanding that I had access to things and I don’t take that for granted -like having safe areas to play outside and walk in my neighborhood as in exercise and having parents that had the time and resources to make me eat veggies and restrict empty calories. So, I support all children having that as much as possible – the healthy foods they need and the fun things all kids want.

            Providing healthy meals & changing school guidelines to match current nutritional knowledge is not restricting anyone from eating or drinking other kinds of food. For the families that struggle to provide balanced nutrition when kids are not in school – it was an opportunity for those kids to have what better off families do. For families that can afford more – then they weren’t being forced to eat those meals – they could bring their own lunches and eat whatever they wanted before and after school.

            I didn’t like a lot of foods when I was a child – but I didn’t have a choice. Kids shouldn’t be dictating to their parents or the school about what their options are. When I was lucky enough to buy school lunch instead of brown-bagging it – I was thrilled bc it was like pizza and chocolate milk. That’s a treat, not something kids be provided as a regular meal choice in school.

            I do agree that some probably well-intentioned legislators go too far in trying to force what they think is better on others – this program was not one of them.

            As a parent with a child about to go to school and no idea what to give him since PB is not allowed anywhere anymore- I would feel far less apprehensive about what she’s eating under Michelle’s initiative than under Trump’s. So, what I want for others is exactly what I want for my own family. If that answers your question.

          • Jayann

            Also – why is it that Republicans are against evidence-based solutions for the prevention of costly public health issues such as diabetes that could save money? An ounce of prevention is worth a pound of cure, right? Is it that there’s more money in the cure for republican lawmakers than taxpayers. Makes sense for them, not for taxpayers though.

          • fiftyfifty1

            “why is it that Republicans are against evidence-based solutions for the prevention of costly public health issues such as diabetes that could save money?”

            For lots of reasons:
            1. Because your assertion that it is evidence based is made up. Link me to the study that shows that Michelle Obama’s school lunch initiative prevented a single case of diabetes. Heck, link me to even a study that showed that the average weight of children went down in schools where it was implemented. Truth is, for all the good theory behind it, we have zilch in terms of evidence on this one, and the Republicans know it. You said it yourself indirectly; Back in the day, school lunches were pizza and chocolate milk…and yet obesity rates were low. Now there is more and more red tape about school lunches, but obesity continues to be a problem. So Republicans look at this and they are not persuaded that what we need is more red tape.

            2. Republicans have a very different mentality on public health. Their philosophy is more like “Sure, tell me about the studies, but then I’ll make up my own mind for myself and my kids. I am the parent for my kids, I don’t need a nanny state.” If they say their kids can eat something, they don’t want to hear that you have decided it is so unhealthy that you won’t allow it “for their own good.” They see it as a matter of liberty. You don’t have to agree with it, but we Democrats force the issue at our own peril. Perhaps Michelle Obama’s nutrition initiatives “shouldn’t” have been controversial, but the fact is that they were. They stirred up a LOT of anger and class resentment. Once again, is this really the hill we want to die on?

          • Jayann

            I didn’t follow that specific health initiative that closely. I know that depending on what is being looked at – results may not be known for some time-and something like overall health rates would be difficult to measure due to all the different factors that would need to be accounted for.
            The evidence I was referring to was about how losing weight, exercising regularly, maintaining a healthy weight, and a balanced diet based on whole grains, vegetables, healthy fats and lean protein that either eliminates or reduces intake of white starchy foods, sugar, too much of certain fats and not enough fiber has been proven to prevent diabetes, reverse pre-diabetes type II, heart disease, and a whole other range of preventable health problems. Genetics and other factors obviously play a role in that, but the average person is healthier the more of that they do.
            The other evidence is the obesity problem we have, most alarming in children and the evidence that in poorer populations – the obese also suffer from malnutrition – meaning they are getting empty calories. They aren’t starving, but are depriving their bodies of nutrients & will have costly health issues in the future. We know there are food deserts – places in the country where the only food available nearby is 7-11 snack-food and no grocery stores to buy produce and other nutritional food. There is also evidence that hunger makes it hard to focus and learn. The program was geared to help those whose families were struggling to feed their children. So for all Republicans do & talk about not providing any help to poor families, are they also the recipients complaining that they don’t like the choice of food? If we as a country are going to provide healthcare and assistance to the elderly & disabled and the poor when they need it – preventing diseases cost a lot less than treating them – so from a practical, fiscal perspective – it also makes sense.

            There are so many areas of compromise between a “nanny” state and not doing anything about public health issues. I think those who understand that in a large, complex civilized society it is important to balance individual freedoms with efficient, useful regulations such as making sure our food is handled properly, that the drugs we buy are safe, etc. It is not a simple all or nothing issue. Democrats sometimes go too far, but Republicans don’t do enough. Dems are also are really really bad at framing what’s positive about some of their legislation and proposals and they just let Republicans take the narrative and run so far from any actual truth – it’s going to be hard to come back from that.

          • Jayann

            I was unclear. I didn’t eat cafeteria food enough to recall what they served daily. I do remember that there was a lot of processed food in general back then, but I wasn’t suggesting that the problem is new. It pretty much started as a trend when I was in grade school, which is why we have obese adults and now a lot of obese children. I was pointing out the fact that I had more to balance those things out. Things have changed that aren’t going to reverse- more parents working out of want and need plus all the technology usage – means the issue will only get worse if not addressed. Below are a few basic stats to consider with the takeaway that the public awareness and various initiatives introduced have made an impact, but we have to not only maintain those public policies but possibly increase them in order to reverse these trends. There are policies that work like investing in public green spaces and many others that don’t violate individual liberties.

            One last thing to note – and I think this is important. Of the myriad of reasons why Republicans should care or voters should be convinced to recognize this as truly a public concern is the Military and other essential public safety professionals such as our police force, EMTs, firefighters, etc. I can find you a link if you haven’t heard of this or you can research it- but obesity was recently found to be a national security issue due to the amount of the population that would be medically disqualified for service due to their weight & health.

            “Nationally, childhood obesity rates (ages 2 to 19) have remained
            stable for the past decade — at around 17 percent [National Health and
            Nutrition Examination Survey (NHANES), 2011-2014 data].26”

            “Since 1980, childhood obesity rates (ages 2 to 19) have tripled —
            with the rates of obese 6- to 11-year-olds more than doubling (from 7.0
            percent to 17.5 percent) and rates of obese teens (ages 12 to 19)
            quadrupling from 5 percent to 20.5 percent.27,28 [NHANES, 2011-2014 data]”

          • fiftyfifty1

            How does your reply in any way address my points 1 or 2? They don’t.

          • fiftyfifty1

            And I can assure you that Conservatives do not agree with you, and are not interested in your “helping” of their families with what they see as nothing more than red tape and nanny state rules. And my point is, as Democrats, is this a hill we want to die on?

          • MaineJen

            To me, it just looks like conservatives were looking for a reason to be displeased with Michelle Obama.

          • fiftyfifty1

            That’s always what I hear when anyone criticizes either of the Obamas: They were looking for a reason to be displeased. And maybe some were. But I am not convinced this is the case for voters in general. We have to remember that there were lots and lots of rural places that went for Obama but later went for Trump. I have some rural friends and acquaintances who voted this way, and they are able to articulate something like this, “I voted for Obama the first time with a lot of hope. I voted for him again the second time even though I had lost a lot of my hope in him. But by the end I was fed up with his bullshit policies and I voted for Trump.” (conversation had over a Blatz beer and some Cheetos). Is this really somebody who was predisposed to hate anything Michelle Obama did?

          • MaineJen

            which “bullshit policies” specifically

          • fiftyfifty1

            Depends on the person. For those that could no longer buy low cost catastrophe insurance, it was Obamacare (others were fine with Obamacare.) Others it was bailing out banks and automakers, others it was cultural issue as exemplified by school lunch red tape. For others it was just a sense of “He promised a lot of good stuff but it was all empty promises, he doesn’t care about us.”

          • The Bofa on the Sofa

            Remember when Michrlle Obama got criticized because ahe was advocating changing the meals for the army.

            The nutrition plan she was pushing was the one being used by tje Navy Seals. She wanted the Army to do it, too. But this was unreasonable. Because she waa an Obama.

        • MaineJen

          Oh, I remember the controversy. But I’m still SMDH at it.

        • Allie

          Ugh! Michelle was no where near as bad as Jamie Oliver. Love the dude! Sure, use your passion to show people how to make inexpensive, simple meals, but don’t make it into a class war/shaming thing. The reality is that people gotta do the best they can. Let’s work with that. I remember a big to-do over some healthy labeling thing that chose to label processed cheese slices as healthy. The organic, macrobiotic, privileged crowd cried foul, and everyone else said “calm down, they’re damn cheese slices.” There needs to be a selection of foods, within a reasonable price range, that kids will actually eat, and I’m sorry, but cheese slices totally fill that bill.

          • fiftyfifty1

            Yes, Jamie Oliver was the worst. He got run out of town due to it, and rightly so.

    • Look at the state of family farms in the USA, look at the state of crop sustainability, look at the total volume of fertilizer, pesticide, herbicide, etc. that gets dumped on our crops every year, look at how many things those cows you eat get shot up with and the total environmental cost of their waste, look at how deeply the government is subsidizing industrial farming, and really keep trying to say Republicans are anywhere close to right on farm policy with a straight face.

      Current farm policy is almost entirely designed to maximize profit for the wealthiest and minimize how much labor they need to get there. Which is ridiculous, because if there’s anything the world has in excess, it’s profit for the wealthy, and if there’s anything the world has in surplus, it’s people who would like to work.

      What we actually have too little of and have to learn to use more efficiently is land. What we actually have too much of and need to learn to reduce is fertilizer/herbicide/pesticide. And what we actually have to maximize is the ability of SMALL farmers to farm sustainably and the plant, animal, and human health outcomes. Republican farm policy doesn’t do any of those things well.

  • BeatriceC

    I don’t have the spoons for this today. I posted one rebuttal on one person’s timeline, and only because that person is generally very level headed and open to new information, and her friends are generally level headed as well. I’m kinda stalking this comment section and Dr. Amy’s FB page hoping for all the links to various studies I lost when my computer decided to go wonky will be reposted, and then I might feel better wading in.

    • Chi

      I shared her article about how countries with the highest breastfeeding rates also have the highest infant mortality rates:

      http://www.skepticalob.com/2016/01/if-breastfeeding-saves-lives-why-do-countries-with-the-highest-infant-mortality-rates-have-the-highest-breastfeeding-rates.html

      Because if breast milk is a magical panacea then surely the countries that exclusively breastfeed have lower infant mortality right? Oh wait…

      *rolls eyes*

      • BeatriceC

        I also use the argument that if breastfeeding did all these wonderful things, then the rates of childhood illnesses should be going down since breastfeeding rates started increasing after a nadir in the early 70’s. That, however, is not only not happening, but the rates of childhood health conditions such as obesity, asthma, and allergies are actually rising steadily in a trend that continues to the current day.

      • PeggySue

        When I am not so mad I can’t see straight I say that, if breast milk fulfilled its promises, then anyone ought to be able to go into a preschool class and, with trivial ease, identify the kids who had been breastfed. They would be thinner, brighter, calmer, have fewer absences, and be allergy free. Right? Then I challenge people to try it.

        • Who?

          Exactly, I do the same. People get very sniffy at the suggestion. Hell, they can’t even reliably pick a breastfed baby in a line up!

        • The Kids Aren’t AltRight

          My woo-obsessed SIL claims she can smell the difference between breastfed and formula fed kids…

  • Madtowngirl

    As the day goes on, more and more of my friends are sharing this damned article on social media, usually coupled with some rude comment about formula being bad for babies. I finally just had a fit of rage and blew up on my personal feed. I am sick of people, especially men and women who don’t even have children, harping on about how “BREAST IS BEEEEEEEEEEEEST” and that “we need more education! Less formula marketing! omg if you didn’t breastfeed you just didn’t have support!”

    Fuck this. I had support. I’m well educated. I still, to this day, have not seen any marketing beyond Facebook for infant formula. I’m not a victim of marketing. I’m not an idiot. Breast was not best for me and my baby. Stop moralizing food.

    • Heidi

      The person who shared this on my Facebook is a middle-aged childless man who I’ve witnessed do cocaine in bathrooms and makes a living DJing at dive bars. Nothing wrong with that, but what the fuck does he know about breastfeeding? And I guess I find it rich of him to have strong feelings about health or the formula industry considering his own lifestyle? I mean surely he realizes there are some moral issues surrounding the manufacturing and trafficking of illicit drugs?

      • HailieJade

        I know a guy who up until recently fit that exact same description. Now his wife has successfully converted him to the all natural hippie woo life and both share anti-vax, NCB, EBF, anti-GMO earth-mama rubbish on their walls constantly. I think a lot of people who lead that kind of hard-partying lifestyle feel like they have something to prove, like they have to make up for all the poor health decisions they made in the past by going to the complete opposite extreme.

        Personally, I am far more offended by a man who thinks he has any say whatsoever in what a woman does with her breasts than what he chooses to snort off a nightclub toilet on weekends. The irony is he probably thinks he’s being a feminist.

    • fiftyfifty1

      “Stop moralizing food.”
      This.

  • JTatter

    While we have the “fed is best” movement in the U.S., since when th is
    breastfeeding antifeminist, if that’s what mom wants to do? Back in the 80s, I was going against the grain when I breastfed (I also supplemented with formula). Many moms choose bedding in and attachment parenting on their own as there’s more pressure towards the opposite, for the most part. It really just isn’t that accepted in the U.S. and will earn a parent the side eye even by people of their generation.

    • Madtowngirl

      I’m sorry, I am not understanding what you are saying. Breastfeeding, attachment parenting, and co-sleeping (I assume that is what you mean by “bedding in”) are completely acceptable and even the choices of the majority in my area of the US. Maybe it’s not in yours, but it certainly is not “unacceptable” in the entirety of the U.S.

      • JTatter

        I’m in the DC area and maybe I should have said “considered unusual” not “unacceptable”. I just meant that many people in my area, especially the non religious conservatives think it’s “hippie dippie” stuff. I believe it really depends on what each family is comfortable with. We co slept with my youngest son because he was just more content (big surprise ;-)) and it was so much easier for the first couple months.

    • LaMont

      *Forcing* breastfeeding, and telling women they’re shit for not being “natural mothers” is what is anti-feminist. Telling women that formula is basically as toxic as cigarettes, or chemotherapy, and requires a dire informed-consent, is what is anti-feminist. Telling women to stay out of the workplace and spend literally 24/7 attached to their baby is anti-feminist.

      • JTatter

        Yes! Absolutely!

    • Sarah

      Could you clarify your reason for asking about why breastfeeding if the mother wishes it is antifeminist? I assume you must have got it from somewhere, not here or the Fed Is Best movement obviously, but somewhere.

      • JTatter

        I was responding to another poster, Clarissa.

    • AnotherOor

      I don’t think anybody is saying breastfeeding is antifeminist? Moralizing it and trying to pressure women into it with junk science is antifeminist.

      • JTatter

        Absolutely!

    • EmbraceYourInnerCrone

      Not sure what you mean by it just isn’t that accepted? What isn’t accepted? Breastfeeding seems pretty accepted ( at the same time that giving parents parental leave seems to Not be accepted in the U.S. )

      Co-sleeping seems somewhat accepted, although personally I think it’s a somewhat dangerous practice if a baby, especially a newborn is sharing a bed with adults and not just in the same room.

      Attachment parenting is somewhat accepted but rightly(again, my opinion) not appreciated by many parents as it basically says you need to be physically connected to the baby 24/7.

  • lawyer jane

    My guess is that breastfeeding promotion has a role in very limited circumstances abroad — for example, making sure mothers in a disaster setting preserve their supplied if there isn’t a ready source of formula & water. But the WHO policy exhibits no such nuance; but quashing it would not lead to better aid in disasters anyway. Trump Admin did this just to throw their weight around and show their disdain for international institutions. I do also think it’s possible/likely they are being advised by food industry lobbyists, given their similiar aggressive action on obesity issues.

    At the end of the day, I think we can all agree that Trump does not GAS about children’s health, particularly not in other nations.

  • Gene

    Ugh. I can’t stand Trump. And I think their reasons for their stance has nothing to do with healthcare and everything to do with money. But toppling the alter of the almighty boob will save lives.

    And I’m getting trounced in reddit comments: but boobies! And breastfeeding is free! And natcheral!

    • Madtowngirl

      I pointed this out to someone earlier today too and i got the same “but Nature intended!!!!!” garbage.

      • Manly Seadragon

        Nature intended me to die as a small baby, with a small birth defect that was easily fixed with surgery. Nature intended me to be infertile, but I got pregnant thanks to simple medication. Nature intended me and my baby to die in childbirth, but luckily I live in a country with fantastic free public hospitals. Nature intended me and my baby to have a really shitty first week with dehydration and jandice but I supplemented while my milk came in.
        Nature is fantastic but imperfect, and does not give a s$&t about the individual.

      • Casual Verbosity

        The attribution of intentionality to an anthropomorphised “Nature” is usually a good marker that what’s about to follow is not worth listening to. Unfortunately even very intelligent people can easily fall into the trap of substituting nature for god.

    • Sheven

      Death is also natural. As for breastfeeding being free, tell them to type “breastfeeding” into the search field on amazon. Everything from pumps to cookie bites. Also, there’s the true phrase: “Breastfeeding is only free if you think a mother’s time is worth nothing.”

      • JTatter

        Yes, some uber gullible people will buy that crap on Amazon but seriously?! Breastfeeding saves people with any sense lots of money. Maybe I should be glad that Amazon wasn’t a thing in the 80s and 90s cuz the only pos that I ever bought was a pump. Of course, I was also smart enough to know that I needed to supplement with formula. Maybe since my siblings and I were bottle fed, even as a not very savy 19 year old, I still knew that fed is best. Is it possible that the problem really is that since many in my generation didn’t breastfeed that the younger generation doesn’t have mom’s that can guide them without the false guilt and so all they think they have for guidance is these “experts”? Maybe breastfeeding, in and of itself is still perfectly fine and feminist, depending on the motive, eh? Free the nipple!

        • Madtowngirl

          Again, I have no idea where in the US you are, but this stuff is not “crap on Amazon.” Lactation cookies, pumps, covers, and all other types of breastfeeding products are big business in my area. Natural parenting in general is big business here. We have a local cloth diapering business that literally sells out of product in minutes and has a huge worldwide following. It’s not just “gullible people,” it’s very much a culture of nature worship, and it’s very financially lucrative.

          • JTatter

            Wow! While it’s great that so many things are available for those that really want them, it’s a shame that some people feel pressured to buy them. The young moms, that I know, were more interested in making their own lactation cookies since they do tend to be expensive. We’ve got the “free the nipple” movement so I think breastfeeding covers are usually given as a gift. I don’t think I’ve ever seen one being used in person though I did give one, that I got for reviewing it, as a gift. But pumps, yes, they’ve been the thing for every nursing mom to have forever(?). They have a new, very inexpensive (-10) one piece silicone one now that I bet works really well. Although I know there’s a cloth diaper movement, Idk of any local organization benefiting from it. When my daughter thought she wanted to, we just price shopped for the old fashioned cloth diapers that they used when I was a baby. Those make great burbing and cleaning cloths so no big loss there. Now those diaper wraps! You really gotta price shop for those suckers! Oi! In other words, I’m not arguing w/anything you’re saying, just giving info.

        • Casual Verbosity

          It’s not necessarily the case that breastfeeding will save lots of money for people with sense. Women with low supply or other breastfeeding problems are routinely told that until they have tried the usual laundry list of: tongue tie revision, sessions with a lactation consultant, power pumping, natural supplements, and off-label prescription medication then they can’t say that they’ve given breastfeeding a proper go. Depending on where you live, those things can easily out-cost the price of formula. And that’s before you consider lost income for those without paid maternity leave or paid pumping breaks. At a certain point too the sunk-cost mentality sets in, which prevents women from opting out of the rest of the laundry list without a lot of emotional turmoil.
          If it were the case that women who struggle with breastfeeding were routinely told: “Our knowledge about breastfeeding is woefully inadequate, so you can try these non-evidence-based approaches if you really want to, but it’s also absolutely and unequivocally acceptable to go straight to formula”, then one could argue that breastfeeding saves money for people with sense. But as long as women are receiving the message, explicitly or otherwise, that they have to check-off everything on the laundry list before they can be deemed to have “tried hard enough”, then it doesn’t matter how much sense you have, because this isn’t a rational issue; it’s an emotional issue.

          • Sarah

            It’s also worth pointing out that such costs, if needed to pursue breastfeeding, will be front loaded. It may well cost more overall to formula feed in a particular instance, but those costs will be much more evenly spread over a longer period. It’s no good a low income person being able to spend half as much on breastfeeding as on formula, if all the breastfeeding costs are going to be incurred in the first few weeks. One might well have access to £500 over a year but not to £100 upfront.

          • Casual Verbosity

            That’s an excellent point!

          • JTatter

            Wow! Yeah, I see your point. I wonder if my daughter “knew better”, when she didn’t have enough milk because I nursed yet didn’t own 200million contraptions. Plus, she saw me supplementing with formula with her younger siblings. I guess LLL was a lot kinder and gentler in my day. Back then, they even admitted that some moms just weren’t comfortable with nursing and that was ok. Sad that they’re reputation has changed.

          • Casual Verbosity

            It sounds like your daughter had good modelling to base her behaviour on. Some people are also lucky in that they’re either not exposed to these ridiculous expectations or they’re more resilient to them.

        • MaineJen

          How are you supposed to maintain breastfeeding without a pump, if you have to go back to work? Inquiring minds want to know. I had a breast pump and it certainly wasn’t free; I don’t consider myself uber gullible.

          • JTatter

            Oh sorry. I meant they will buy ALL the breastfeeding accessories that they see. Although, I found pumping by hand easier for me but that was back when the electric machines were pretty much exclusively in hospitals, at least as far as I knew.

          • FallsAngel

            Re: breast pumps-These days most health care plans must cover the purchase of a breast pump.

            “Health insurance plans must provide breastfeeding
            support, counseling, and equipment for the duration of breastfeeding. These services may be provided before and after birth. . . This applies to Marketplace plans and all other health insurance plans, except for grandfathered plans.”
            https://www . healthcare . gov/coverage/breast-feeding-benefits/

            I know that was not the case back in the 80s when I had my kids.

      • FallsAngel

        No one has to buy that crap. I breast fed with a few nursing bras as my only breast-feeding specific equipment, and as I had to wear a bra anyway, so what? Someone has to feed the baby a bottle, too!

        • Casual Verbosity

          See my comment below starting with: “It’s not necessarily the case that breastfeeding will save lots of money for people with sense” for a more comprehensive response, but the quick and dirty version is this:

          Until formula is presented as an unequivocally acceptable option, women will feel pressured into buying those things because until they have tried everything, they are not deemed to have tried breastfeeding properly.

          And in response to your claim that someone has to feed the baby a bottle too, of course that’s true. However, unlike feeding directly from the breasts, that someone doesn’t always have to be the mother. Thus, the load of feeding a baby can be shared between partners, family and friends, and childcare employees.

          • FallsAngel

            A breast fed baby can always be fed a supplemental bottle. A family member is doing that right now.

          • Casual Verbosity

            I’m not quite sure what point you’re trying to communicate… No one here would argue otherwise. In fact, we all champion supplementation when necessary to maintain the baby’s physical and mother’s mental health.

          • FallsAngel

            I’m not sure why you were arguing the point that “someone has to feed the baby”.

          • Casual Verbosity

            I wouldn’t have mentioned it, except that in your original comment you seemed to use it as a rebuttal against the argument that breastfeeding is only free if a woman’s time is worth nothing. Yes, no matter the feeding method, someone does have to feed the baby. However, if you use a bottle, you have much greater scope to share the burden of feeding. This can free up the mother to do other things like attend to her own needs or even work to earn an income – something the vast majority can’t do if they personally have to feed the baby every 2-3 hours. Hence, breastfeeding is only free if a woman is not sacrificing part or all of her income in order to do it.

    • Amy Tuteur, MD

      I hope someone will post my piece on Reddit. That would really generate a lot of comments!

      • -MARK-

        I linked you to Friendly Atheist. You might be getting some angry comments from their.

        • Heh, I’ve just been arguing there as well.

          • -MARK-

            I see

            I blocked several people and decided not to post their anymore based n the stupidity I got.

    • Maria

      I saw this first on reddit (on this thread: https://www.reddit.com/r/politics/comments/8x1ji4/us_opposition_to_breastfeeding_resolution_stuns/) and at the time there was only one person pointing out that there are good reasons for the US to oppose this. It’s frustrating, so I was glad to see this post!

    • MaineJen

      I believe 100% that no real thinking went into this decision, on the part of the Trump people. They saw that it was a subject involving women, and that most liberals were for it, therefore they were against it.