Two crappy new breastfeeding studies make irresponsible claims of benefits

breastfeeding prevents global warming

Why aren’t breastfeeding advocates satisfied with the real, albeit small, benefits of breastfeeding? Why do they repeatedly publish pathetically poorly done studies that make irresponsible claims about the benefits of breastfeeding?

I don’t know the answers, but I’m becoming ever more disgusted with their insupportable attempts and the willingness of scientific journals to publish the crappy papers that result. Not one, but two, new papers on the benefits of breastfeeding are making headlines this week and both suffer from flaws that would doom a middle school science fair project.

The first paper is Breastfeeding and early white matter development: A cross-sectional study by Deoni, et al. published in the journal NeuroImage. The purported “findings” have been published by sanctimommies everywhere under titles such as Breastfed Babies Are Smarter But That Doesn’t Mean Formula-Fed Babies Are Dumb. There’s just one teensy, weensy problem. The authors didn’t show anything of the kind. Indeed, as far as I can determine, they didn’t show anything at all.

To understand why the their study is fatally flawed, imagine for a moment that I did a study comparing two groups of children to determine if breastfeeding increases children’s height. Imagine further that I found the children from Group A, which contains a high proportion of exclusively breastfed infants, turn out to be several inches taller at age 5 than the children from Group B, who never received breastmilk. I’ve included a sophisticated graphical representation below.

letters stick figures

Would I be entitled to conclude that breastfeeding made the children in group A taller than the formula fed children in group B?

It might appear that way at first, but as students of statistics know, you must compare like with like. Are the mothers in group A the same as the mothers in group B? I’ve added more data to the sophisticated graphic representation.

mothers stick figures

Now we see that the mothers in group A are actually taller than the mothers in group B. We therefore CANNOT conclude that breastfeeding increased the height of the children. The more likely explanation is that the children in group A are taller than the children in group B because of genetic inheritance.

Deoni and al. committed that very mistake. They compared two group of children on a proxy measure of intelligence without ever comparing the intelligence of their mothers. The authors actually acknowledge:

While maternal IQ was not specifically measured, the combination of education and SES [socio-economic status] was believed to provide an adequate alternative.

But the education and socio-economic status of the mothers in group A was known to be higher than in group B. Hence any observed differences between breastfed and formula fed babies is most likely due to genetics and social advantages, NOT to breastfeeding.

That’s only the most egregious deficiency of the study. There are many more. The authors didn’t actually look at the intelligence of the children in the two groups; they looked at white matter development in the brain and implied that it is correlated with intelligence. There’s no proof that the two are correlated. Indeed there is no proof that white matter development is in any way related to intelligence let alone correlated with it.

So, in the end, the authors found nothing at all. The study is junk.

The second study, Cost Analysis of Maternal Disease Associated With Suboptimal Breastfeeding, is, amazingly, even more irresponsible than the first. Bartick et al. breathlessly conclude, with absolutely no basis in fact:

… [W]e estimate that current breastfeeding rates result in 4,981 excess cases of breast cancer, 53,847 cases of hypertension, and 13,946 cases of myocardial infarction compared with a cohort of 1.88 million U.S. women who optimally breastfed. Using a 3% discount rate, suboptimal breastfeeding incurs a total of $17.4 billion in cost to society resulting from premature death $733.7 million in direct costs, and $126.1 million indirect morbidity costs.

There is just one ginormous problem. There is NO EVIDENCE AT ALL that breastfeeding prevents maternal high blood pressure or maternal heart attacks. That means that out of nearly 73,000 purported lives saved, fully 93% are simply made up.

If there’s one thing we know about breastfeeding, it’s that women who breastfeed differ in important ways from women who don’t. Women who breastfeed tend to be wealthier, better educated, and thinner, among other things. There are studies that have investigated an association between breastfeeding and maternal cardiovascular health, and they’ve found that any observed differences disappear when the comparison groups are corrected for economic status, educational attainment and weight.

Bartick et al. acknowledge the tenuousness of their claim with this caveat:

If observed associations between breastfeeding duration and maternal health are causal …

There’s absolutely no reason to believe that breastfeeding affects maternal cardiac health and no mechanism has been proposed, let alone established. The idea that breastfeeding has a protective effect against the diseases of old age in affluent societies is absurd on its face. For most of human existence, women didn’t survive long enough to develop high blood pressure or have heart attacks.

This isn’t the first time that Bartick has published her own wishful thinking as if it were science. In The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis published in 2010, Bartick used highly fanciful methods to  “estimate” that the US could save 900 infant lives and $13 billion if 90% of US women breastfed. The numbers are grossly misleading since not even a single US infant death (let alone 900 per year) has ever been attributed to not breastfeeding and since the purported savings are primarily the “lost wages” of the 900 dead infants.

Who is Dr. Bartick? She’s an internist and fervent campaigner to ban formula gift bags in hospitals, an idea that is punitive (particularly to women of color and those of lower socio-economic status) and has never been shown to have any impact on breastfeeding rates. Dr. Bartick appeared in the comments section of this blog and revealed herself to be a bit of a crank, bemoaning the way that babies are mistreated in the first hour after birth:

Instead, babies [are] routinely whisked off and traumatized during that hour with baths, shots, eye ointments.

Baths, shots and eye ointment are traumatic? I suppose if you believe that, without any evidence of any kind, it’s not hard to believe that breastfeeding prevents the diseases of old age in affluent societies.

Both papers are emblematic of current breastfeeding “research,” which substitutes wishful thinking for scientific evidence.

If you told me that breastfeeding reduces the chance of infants developing malaria, I would find that plausible, since malaria has posed a serious threat to babies for thousands of years and anything that protect against it would be highly beneficial. That’s why the fact that breastfeeding is somewhat protective against infant diarrhea is hardly surprising since diarrhea is a killer in primitive societies. But the claims that breastfeeding addresses the obsessions of contemporary privileged societies (such as the emphasis on infant “intelligence” and diseases of old age) are extraordinary claims. Why would breastfeeding prevent diseases that rarely occurred until the last century? How can we possibly believe that breastfeeding increases intelligence when we have lived through several generations of virtually exclusive bottle feeding with no apparent change in brain power, technical innovation or academic achievements?

Extraordinary claims require extraordinary evidence. Instead we are treated to poorly done studies making bizarre claims based on wishful thinking. What’s next? I’ve got it: breastfeeding prevents global warming!  That’s gonna really make a splash.

142 Responses to “Two crappy new breastfeeding studies make irresponsible claims of benefits”

  1. John Considine
    September 8, 2014 at 12:14 am #

    The thing is the maternal education and ses measurement used in this study only correlates roughly with maternal iq. I checked it out. Feel free to do so urself. This is plausible as we all know not all degrees are equal for example a physics graduate is a lot smarter on average than a psychology graduate yet they would both fall under the same education level (bachelor degree) in these measures of maternal education. Given that maternal iq is shown to be by far the most important confounder in these studies and that only a rough proxy for it was given (which deoni mistakes as an adequate substitute rather than mediocre proxy that it is) this study is not great. Maternal iq studies show largely reduced or nil effects.

    Another concern is that deoni uses the dha argument ignoring that all formulas used in the study would be dha fortified anyway as formula has been since about 2005. It may be true that breastmilk helps a little bit but this study is jargon loaded junk. Admire the research he’s doing but needs to be thought through more before making conclusions. The good thing about the study is the techniques developed and he should of focused on that.

  2. sdeoni
    September 25, 2013 at 10:54 am #

    Sorry, just reading this now and wanted to highlight two issues you make on your review of a paper from our group. As the Deoni in Deoni et. al., I might be able to provide some information that you either cared not to disclose, or didn’t find in our paper. You are correct in stating that we did not specifically measure IQ in the mothers, and instead relied on maternal SES and education (which have been shown to correlate with IQ). We also DID NOT find a significant difference in maternal IQ and education between the two groups as you state we did. We matched our infants on that criteria to remove this influence. Secondly, we did not measure IQ in the infants using established Wechsler tests because they are not available for children under 2.5 years. More than half of the children in our study were under this age limit. We did measure fine and gross motor control, expressive and receptive language, and visual reception, similar domains as tested on IQ tests using a standardized and accepted scale – the Mullen Scales of Early Learning. On this we DID in deed find improved scores in the breastfed children vs. those who were exclusively bottle fed. Since you quote our article, it seems odd that you missed these two points. However, we did not say that breastfeeding caused the differences shown, we found that they were correlated, which does not imply causation. There may be many faults with our study (as there are with any study), and if you care to discuss those, I am easily contacted. However, dismissing our results on the basis of the two points you chose is either disingenuous or poor reporting.

    • Amy Tuteur, MD
      September 25, 2013 at 1:04 pm #

      Thank you for your comments, Dr. Deoni.

      The fact is, as you acknowledge, you never found any evidence that breastmilk causes increased intelligence, but you implied that it did, both in the paper and in the publicity for the paper, and I find that irresponsible.

      There is no evidence and there is no reason to believe that breastmilk has ANY impact on IQ. Therefore, an extraordinary claim that breastmilk raises IQ requires extraordinary evidence. Your study didn’t supply extraordinary evidence, therefore, in my view, it is extremely irresponsible to suggest that you did.

      Even more irresponsible, in my view, is that you let your bias show by insisting that the study means that we should be promoting breastfeeding even more heavily than we are already doing so.

      I am familiar with the pressure to hype research findings far beyond what they actually show, and I am familiar with the ways that press releases misrepresent research findings and journalists simply copy the press releases. Nonetheless, and perhaps this is touchingly naive on my part, I feel that researchers have a moral responsibility not to make policy recommendations based on preliminary research that has not been reproduced and has not in any way demonstrated causation.

      Unless, and until you and other breastfeeding researchers can reliably provide reproducible research, you ought not be implying more than what you findings show and you certainly ought not be claiming that anything should be said to mothers based on what is preliminary research about a minimal if any effect.

      I think you would have to acknowledge that you have yet to show anything about breastfeeding causing improved IQ, so why did you jump so far ahead to guilt inducing policy recommendations that aren’t supported by anything that you found?

      • sdeoni
        September 26, 2013 at 7:51 am #

        Hello, What we found, and what we reported, was that infants who were breastfed had improved expressive and receptive language, visual reception, and fine and gross motor. All sub-measures of IQ. Further, we found that greater breastfeeding also improved these measures, with a correlation of .6. Meaning 60% of the myelin volume change was explained by breastfeeding duration. In an attempt to minimise the influence of confounds, we matched our infants on a number of points, including (as you know from reading the paper), gender, age, maternal SES & education, some genetic measures, birth weight & height, number of siblings, type of birth (vaginal vs. c-section). Infants were excluded if the had a familial risk of psychiatric illness, in utero exposure to alcohol or smoking, were born premature, APGAR scores less than 8, medical history of neurological trauma, visit to the NICU.

        What we could not differentiate between was whether the change we observed was due to breastfeeding or breastmilk. Few parents choose to bottle-feed with breastmilk (we only had 2 parents who did so, and they were included in the breastfeeding group), so this will be a difficult question to answer.

        Beyond our own research, these is a large literature of breastfeeding and improved IQ, as a quick pubmed search will show. While some have methodological issues, they all point to a same conclusion. From the imaging literature, there is also a constant theme of breastfeeding being associated with increased white matter volume and IQ in older children and adolescents. Our work adds to this literature in examining infants and toddlers. Again, there is consistency in this literature across a wide age-range and using differing imaging methods. So, I think your statement that there is no evidence of breastmilk has any impact on IQ is disingenuous or lazy.

        Beyond IQ, there is also a growing body of evidence of supplementary benefits of breastmilk, including improved immune function.

        In terms of policy decisions, perhaps I have been misquoted, but my statement was that based on the growing body of literature on this topic, we should be doing more to *facilitate* breastfeeding. One of the primary reasons mums stop breastfeeding is the need to return to work, and most work places are not breastfeeding/pumping friendly. The effort, I believe, should be on workplace education or, even better, a more realistic maternal leave (such as in Canada and Europe). I specifically stated that we should not demonise mums who did not or could no breastfeed and that this research certainly is not the last line in how to raise a smart baby. All this said, I actually have no bias one way or the other, and do not recommend mothers breastfeed or not. My interest is simply in understanding normal brain development. This finding is important because it means in studies of suspected abnormal development, we need to include breastfeeding as an additional variable of interest. My advice to mothers has been, and will continue to be, to simply love your child.

        • Karen in SC
          September 26, 2013 at 8:29 am #

          You matched up the mothers, but did you match up fathers as well? Did you ask if either mother or father were “early talkers” or “early crawlers” etc?

          There is so much variation in early child development. Some infants do things very early, then level out. Others are slower, but catch up. By two years, most are talking, walking, whatever. Generally by third grade, all children can read, tie their shoes, jump, etc. Why is it a race?

          • sdeoni
            October 6, 2013 at 8:05 am #

            Hi Karen, Ye, we did match up fathers. The reason I didn’t specifically indicate this is that the genetics of IQ follow the maternal line, not paternal. We also matched on maternal and paternal SES independently, not combined (because this would penalise single parent families).

            There is indeed considerable variation in early child development (hence the reason a number of early screening tools for abnormal behaviour) are not specific. That said, it does appear from our considerable longitudinal data that children ahead at the start tend to stay ahead (there are exceptions, but this is *generally* the rule).

          • Dr Kitty
            October 6, 2013 at 4:19 pm #

            But “ahead” meaning WHAT exactly, from a functional point of view?

            Unless it translates to a better quality of life as an adult, it is still of no relevance from a public health perspective.

            3 IQ points or talking a month earlier are no use in and of themselves unless they translate to happier, healthier, more successful adults.

            At which point confounding factors like personal life choices essentially make infant feeding method irrelevant.

            If Tom has an IQ of 128 instead of 124 because he was BF, but smokes cannabis daily from age 16 and drops out of high school I don’t really think it matters, do you?

          • Expat
            October 7, 2013 at 10:29 am #

            You are looking for small differences in averages over matched data sets. To match those data sets, you have carved out a subgroup which may still be confounded. This sounds a lot like a recipe for what not to do, statistically speaking. See: Apr 4 2009 on subgroup analysis. Also, matching maternal and paternal SEC independently of whether or not it was a single parent household and then combining the results sounds like a perfect way to screw up your data set. Were there more or fewer single parent households in the formula group? How were the SECs amongst the single parent groups? still matched? Separate out the single and two parent households and see what the data says about them independently. Not enough data for that? Try again.

          • Bob
            November 19, 2014 at 3:30 am #

            I cant find anything to suggest intelligence follows the maternal line alone…

        • Amy Tuteur, MD
          September 26, 2013 at 12:19 pm #

          As I said above, Dr. Deoni, extraordinary claims required extraordinary evidence and that evidence simply does not exist.

          We do not need to facilitate breastfeeding and we certainly don’t need to facilitate it by insisting that the breastfeeding research is anything other than preliminary, often non-reproducible, and generally conflicting.

          I understand that some people really, really, really want to prove that breastfeeding improves IQ but it hasn’t been done yet, and therefore, no one should be hyping their study as showing that breastfeeding promotes intelligence or that their study showed we should work harder to promote breastfeeding.

          The essence of science (in my judgment) is waiting for results to draw conclusions, not reaching conclusions (“breast is best”) and looking for weak data to support it.

          • sdeoni
            October 6, 2013 at 8:31 am #

            Hi Amy, I really, really, really don’t want to prove breastfeeding improves IQ (or, conversely that formula feeding worsens IQ). As I said, I want to determine the influences on brain development. In using your statistics example above (flawed because you blatantly lied about us finding an SES difference between our mums, but correct in that co-variates are crucial), imagine a case where we are examining children with ASD and children without. Imagine if by an unfortunate coincidence, all the ASD children were breastfed, and all those without breastfed were not. Based on our results already found, we would likely find a difference in myelin content between the two groups, but we couldn’t ascribe it to ASD, rather it could be ‘shine through’ from feeding practice. Hence, my motivation is to understand the genetic and environmental influences so that what we find in ASD, ADHD, dyslexia etc., is directly related to the disorder and not some other effect.

            We didn’t *want* to find anything. But we *did* find increased white matter myelin content in infants who were breastfed vs. those who were not. We also found improved language, motor and visual receptive scores in these children. These are the results that we reported.

            Now, I’m going to take some issue with how you’ve reported this, because you have blatantly misled or lied in your original post. Your large graphic is fun, and educational, but utterly wrong when you definitely say that we found an SES and educational difference in our mums. As you know, all papers go through a rigorous peer review process. Unlike your book, which can be published without expert review or fact checking, and can include statements appearing as fact with no reference or external backing. Certainly, some papers make it to publication that include errors, but these must be described and detailed within the paper. You are throwing around statements implying breastfeeding research is preliminary, often non-reproducible and generally conflicting. Would you care to back any of those claims up? A quick review through the published literature doesn’t show that at all. One could hardly call the randomised study of 14000 infants at McGill (Kramer et al. Arch. Gen Psychiatry, 2008; 65:578) to be preliminary or non-reproducibile. And a nice summary by the same author (Early Hum Dev. 2010; 86:729) also shows convergence in findings in prior studies.

          • Amy Tuteur, MD
            October 6, 2013 at 12:29 pm #

            Dr. Deoni, you keep eliding the central point. It was you and your colleagues who claimed the breastfeeding provides neurodevelopmental advantages and that your research shows that breastfeeding should be promoted. You know as well as I do that you showed no causation of any kind, and without causation, you should not be making public health recommendations.

            As for peer review, I have explained many times on this blog that peer review means that a paper is worthy of being included in the scientific conversation. It does not mean that the authors claims are true, or even that their findings are true.

            There is a large amount of evidence that shows that women who choose to breastfeed differ in important ways from those who don’t, suggesting that any findings are more likely to be due to confounding than to anything else.

            If breastfeeding causes an increase in IQ or neurodevelopmental advantages, you should be able to fulfill most of Hill’s criteria. How many of those criteria does your research or any research on the supposed neurodevelopmental advantages of breastfeeding actually fulfill?

    • Lizzie Dee
      October 6, 2013 at 6:41 pm #

      Just out of idle curiosity, why didn’t you do IQ tests on the mothers? And are you going to do follow-ups on the children so that more reliable IQ tests can be done when they are old enough?

    • John Considine
      September 8, 2014 at 1:28 pm #

      The thing is the maternal education and ses measurement used in this study only correlates roughly with maternal iq. I checked it out. Feel free to do so urself. This is plausible as we all know not all degrees are equal for example a physics graduate is a lot smarter on average than a psychology graduate yet they would both fall under the same education level (bachelor degree) in these measures of maternal education. Given that maternal iq is shown to be by far the most important confounder in these studies and that only a rough proxy for it was given (which deoni mistakes as an adequate substitute rather than mediocre proxy that it is) this study is not great. Maternal iq studies show largely reduced or nil effects.

      Another concern is that deoni uses the dha argument ignoring that all formulas used in the study would be dha fortified anyway as formula has been since about 2005. It may be true that breastmilk helps a little bit but this study is jargon loaded and hyperbolic and doesn’t demonstrate that. Admire the research he’s doing but needs to be thought through more before making conclusions. The good thing about the study is the techniques developed and he should of focused on that…..

  3. grateful
    August 19, 2013 at 3:00 pm #

    Thank you for writing this article. I was unable to breastfeed because I had past breast surgery. I read the study on white brain matter yesterday and was deeply traumatized by it. I knew all of the previous breast feeding studies were flawed, mainly on the socioeconomic factors that you pointed out, but when I saw how they said that social factors were taking into consideration the study wounded me. I sat next to my sleeping three month old, that I endlessly try to stimulate so that he reaches his full potential, thinking that I harmed his development with my inadequacies. Thank you again for taking the time to cut through both of these studies and reveal the truth behind them. Compared to modern advanced formula breast feeding benefits are minimal not life changing. The child’s genetics, environment and nuturing are the determining factors for intelligence, emotional stability and motor skills.

    • yentavegan
      August 19, 2013 at 4:57 pm #

      The love and attentiveness and stability you provide for your child along with proper nutrition is all that matters. Breastfeeding does not guarantee the best reading scores in 1st grade or the best SAT/ACT scores for college. You have not deprived your baby of anything qualitative or quantitative because you did not feed her with breastmilk.
      You will see as she grows and makes friends you will not know which one of her nose-picking bed-wetting little playmates were breastfed. It really does not matter.

  4. Els
    July 19, 2013 at 7:10 am #

    Well, breast feeding means you don’t need to sterilise or use plastics, which DO contribute to global warming when they are produced. Also it saves water when rinsing. Or it saves electricity if using a microwave steriliser.

    Also, women of lower socio-economic status do not benefit from being given free formula, as using formula is expensive, and they would save money by buying themselves some quality vitamin pills and omega 3 supplements, which would improve the quality of their milk and their own health, rather than giving their child a drink which, most fundamentally, lacks antibodies. However against breast feeding you are, you can’t argue that lacking antibodies produced by nature is a good thing. It increases rates of allergies which does have a significant cost to an individuals lifestyle if they choose treatment, plus when children are sick they are difficult to look after. Why not avoid that?

    Increased white matter IS linked to increased intelligence.

    I regret that my mother was unable to breast feed me, and that’s why I made sure I did it, and encourage other women to do so. Why be “good enough” when you can be better? And is it really a parents choice to decide they’d rather have a bottle-feeding lifestyle over their child developing the intelligence and health nature intended?

    Do your kids a favour and put them first. It doesn’t do anyone any favours going on a rampage against breast feeding just because it hurts that you maybe didn’t choose to breast feed your own child – you may have been young or over-worked at the time. But don’t put others off just to make yourself feel better. Work places need to make breast feeding easier for women to accommodate within their careers – it will benefit the economy having more intelligent less disease prone workers. Likewise it benefits our future children when they can use their holidays for actual holidays rather than sick days, or perform at their best at work and school. The only people that benefit from formula milk are the families where the mother cannot breast feed due to health complications and their is no access to a wet nurse or alternative breast milk sources – and the people who make a profit by marketing a product which is completely unnecessary for most families.

    • attitude devant
      July 19, 2013 at 11:11 am #

      “Know your audience” is always a good rule for posting. Dr. Amy DID breastfeed her kids. And no one here is against breastfeeding. We’re just against lactivist sanctimommies who exaggerate the benefits of breastfeeding and anyone who has the chutzpah to tell others how to conduct the most intimate aspects of their lives.

      • The Bofa on the Sofa
        July 19, 2013 at 11:13 am #

        We’re just against lactivist sanctimommies who exaggerate the benefits of breastfeeding

        Like those who claim that stopping BF causes PPD.

        • attitude devant
          July 19, 2013 at 11:17 am #

          Yeah. THAT particular claim from Els still has me gasping for air. The phrase ‘credulous simplicity’ comes to mind. (Good morning Bofa! Nice to see you)

    • Box of Salt
      July 19, 2013 at 11:33 am #

      Els, “Likewise it benefits our future children when they can use their
      holidays for actual holidays rather than sick days, or perform at their
      best at work and school.”

      I assume this means you also speak up in favor of vaccination whenever you can.

  5. MaineJen
    June 11, 2013 at 10:46 am #

    “Baths, shots and eye ointment” cannot possibly be any more traumatic than birth itself.

    • rh1985
      June 12, 2013 at 6:33 pm #

      I’d rather have a hundred shots then be squeezed through a space that small.

      So thankful we can’t remember being born.

  6. Sue
    June 11, 2013 at 2:46 am #

    It seems to be increasingly common to take scientific findings from populations in extreme disadvantage and apply them to privileged communities. In the BF example, the dangers of contaminated formula in impoverished communities inspires a desperate search for BM advantages in the wealthy world, where health outcomes are already excellent.

    Last week I was at a lecture on the development of the fetal kidney (nephron), and the epigenetic changes associated with maternal diet. But they weren’t talking about adding supplements to an already adequate diet – they were talking about severe maternal protein malnutrition – which is non-existent in our developed communities.

    When will we learn about perspective and diminishing returns?

    An adequate diet and good genes are perfectly sufficient for the development of the fetal brain. Adding supplements and playing Mozart will add vanishingly little, if anything. In contrast, just feeding an impoverished mother will make a world of difference to the development and potential of her child.

    We should donate the proceeds of the CAM industry to feeding mothers in impoverished countries.

    • R T
      June 11, 2013 at 2:07 pm #

      Health outcomes are not excellent in the infant stage in the US. We have pretty dismal infant mortality rates in the first year of life. I don’t think it had anything to do with formula feeding though.

  7. R T
    June 10, 2013 at 5:48 pm #

    Actually, I’d say its much easier to prove breast feeding prevents global warming than makes babies smarter! The machines used to process, bottle and transport formula do contribute to global warming obviously!

    • suchende
      June 10, 2013 at 7:06 pm #

      Processing and transporting 100 calories of formula vs. the extra food mom needs to make 100 cals of breast milk? Who knows.

      • Leica
        June 10, 2013 at 9:02 pm #

        I’d have trouble arguing that the two are environmentally similar. There’s food and water for mom with breastfeeding, of course. For formula, there’s food, water, and the environmental impact of a cow (land damage, manure/methane), manufacturing , growing/processing the other ingredients, distribution to stores, then to homes, bottles, waste from formula canisters/scoops/bottles, and water/energy/detergent to wash bottles. If you pump, I’d guess they’re closer, but still probably not equal.

        That being said, I just don’t think it’s relevant. The environmental impact from a year of formula is chump change compared to the impact that new human is going to have on the earth over the next 75-90+ years.

        • Elizabeth A
          June 10, 2013 at 10:26 pm #

          So, actually…

          Food for adults is produced from mostly the same processes that are involved in producing infant formula. There’s food, water, and environmental impact of cows involved in the milk in my cereal, the meat in my stew, and the leather in my shoes. Making formula is not worse then making other food. And other food has plenty of packaging as well.

          However, formula can be transported as shelf-stable powder (requiring no refrigeration) and reconstituted at the point of use, which is an incredible savings in energy costs. Unless you are really committed to limiting your food miles, formula probably does have less impact then 500 calories per day added to an adult diet.

          • R T
            June 11, 2013 at 2:04 pm #

            Really depends on how you eat I guess. We have a big garden and get all our diary, meat and eggs locally. I’d venture to guess most die hard lactavist are also environmentally conscious. However, I combo feed my son so maybe I break even with our footprint lol?

          • FormerPhysicist
            September 26, 2013 at 8:56 am #

            Really really depends on how and what you count. I have no information about dairy, meat and eggs, but I do recall reading that in terms of fruits and vegetables the added energy (like grow lamps and greenhouses) to grow them locally and/or out of season is a huge amount larger than the energy needed to ship them from overseas.

            Similar to the cloth/disposable debate. If you are in a low-water area (or low on potable water) the calculus shifts.

            Circling back to formula vs. breast – to isolate what is ‘better’ in a complicated system full of confounding variables is neither easy nor intuitive.

        • suchende
          June 10, 2013 at 11:38 pm #

          ” For formula, there’s food, water, and the environmental impact of a cow (land damage, manure/methane), manufacturing , growing/processing the other ingredients, distribution to stores, then to homes, bottles, waste from formula canisters/scoops/bottles, and water/energy/detergent to wash bottles.”

          I don’t know what of these things still isn’t true for mom’s additional calories. Livestock for meat and dairy, processing and packaging for food, energy etc to wash dishes. It’s at least not obvious.

  8. NatalieRW
    June 10, 2013 at 1:13 pm #

    very off topic, but back a couple months ago I used to read/comment here a lot, so I thought I would ask-
    I’m taking my USMLE step 1 tomorrow and would appreciate all the positive energy/prayers you all can afford! Thanks!!
    (crossing fingers I do well so I can be an evil, greedy money-grabbing doc and start playing golf 😉 )

  9. Anj Fabian
    June 10, 2013 at 11:56 am #

    evidence based birth has a post up on “big babies”.

    Unsurprisingly, the mothers who lost babies to shoulder dystocia (with or without macrosomia) or whose babies suffered brain or nerve damage – their stories were not told.

    The women who were told they had big babies and advised to have inductions or c-sections, their stories are told.

    An unintentional irony, instrument assisted deliveries were blamed for more damage than shoulder dystocia.

    • Awesomemom
      June 10, 2013 at 1:31 pm #

      As a mom of giant babies I am so glad I had my csections. No matter what they say in the cherry picked data, it can not be easy on your pelvic floor to push something that big out. Simply being pregnant with a big baby did a number on my hips, they are still achy now and then after my 11 pound son was born.

      • R T
        June 10, 2013 at 5:49 pm #


      • KarenJJ
        June 11, 2013 at 5:37 am #

        I get the achy hips too. I’vr had x-rays for arthritis, but they showed nothing. Suspect it’s lugging around kids, pregnancies and also the extra 10kg I’ve put on since havig kids

      • Therese
        June 11, 2013 at 1:59 pm #

        I had a couple of ten pound babies vaginally and now I can no longer comfortably swing on the swings at the park. How is that for first world problems?

    • Becky05
      June 10, 2013 at 9:12 pm #

      Yes, I was disappointed to see no references to babies that were seriously injured by SD. their injuries were completely downplayed.

  10. GiddyUpGo123
    June 10, 2013 at 12:40 am #

    For the millionth time, I wish I’d discovered this blog before I had children. I wouldn’t have subjected myself to all that agony.

  11. PollyPocket
    June 9, 2013 at 8:45 pm #

    I didn’t feel like paying $30 to read the whole thing for myself, but I did find this in a press release: “Deoni and his team looked at 133 babies ranging in ages from 10 months to four years. All of the babies had normal gestation times, and all came from families with similar socioeconomic statuses. The researchers split the babies into three groups: those whose mothers reported they exclusively breastfed for at least three months, those fed a combination of breastmilk and formula, and those fed formula alone. The researchers compared the older kids to the younger kids to establish growth trajectories in white matter for each group.”

    I would be curious to see if this is in fact accurate.

    Also, are there any long term benifits to rapid myelination?

    • Anj Fabian
      June 10, 2013 at 7:25 am #

      I have not had my coffee yet, but this seems to be an informational article.

    • Lizzie Dee
      June 10, 2013 at 8:40 am #

      I would be very interested in what other neurologists made of those images – most of us would have no clue what they are showing. Up till now,I have found the idea that bf increases IQ DIRECTLY and significantly to be very unconvincing – but this one is a lot less easy to argue with.

      Probably there are quite a lot of things that can enhance or detract from whatever level of in-built intelligence one is born with. Being born into a privileged family that can provide all kinds of stimulus and advantages is clearly a plus. Given the range of things I did in the early years to help my daughter – which may or may not have made a difference – I worry about those infants permanently strapped to their mothers. But is IQ one more thing we have to feel we control or fail at?

      I did my best for my daughter. No doubt at all that I could have done better. But it is that “all things being equal” thing still, isn’t it?

      I followed the link to TFBs page – and found to my surprise that there are a couple of sensible comments on this study.

    • Sue
      June 11, 2013 at 2:51 am #

      This is what is known as test-based – rather than patient-based – research. Quite apart from methodological issues with the actual work, it’s not looking at outcomes – only at a test result. Even if the methods were sound, they haven;t shown whether the finding has any practical significance.

    • Lizzie Dee
      June 11, 2013 at 6:30 am #

      I didn’t read the whole thing either, – but sentences like this beg a lot of questions which the full report may have answered. 133 is a very small sample. How many of them were pre-verbal infants? What, exactly, do they mean by “normal gestation times”? 38-42 weeks? I didn’t quite get the focus on white matter, either, as I thought the “bits” that constitute intelligence lurk in the folds of the grey matter, which do not show up so prettily on MRI. At that stage, I have to conclude “What do I know?” and wait for an expert.

  12. amazonmom
    June 9, 2013 at 8:15 pm #

    Now I can get these studies, read them, and be ready to counter the lactivists at work. When being chided by them that my child might lose as many as FOUR IQ points because I formula fed her after two months I tell them that I have an IQ of 150 and hubby has an IQ of 135. I’m sure she can afford to lose four points. That really pisses them off!

    • suchende
      June 10, 2013 at 12:07 am #

      In fact the “sweet spot” of success isn’t at the tippy top of IQs. If I remember correctly it’s somewhere around 110-130.

      • amazonmom
        June 10, 2013 at 12:10 am #

        I can tell them I want my kids to hit the sweet spot! Perfect!

    • Dr Kitty
      June 10, 2013 at 5:34 am #

      What does 4 IQ points actually even mean, assuming that you don’t have a learning disability? Will it stop you getting into the university
      or course or career you want- probably not, if you apply yourself and have realistic goals.

      The difference between 80 and 85 or 95 and 100 might be very meaningful, the difference between 120 and 125, not so much.

      4 IQ points won’t matter as much as learning to work hard, going to a good school or having parents who are actively involved in helping them achieve their academic potential.

      I also find it odd that the people who will quote these studies may be choosing to “unschool” their kids- which is MUCH more likely to have an impact on their academic performance and achievement.

      • realityycheque
        June 10, 2013 at 6:29 am #

        So, let me get this straight… they’re willing to downplay the severity of time spent in the NICU with a hypoxic brain injury, spend a trip to hospital (while their newborn is being airlifted to the NICU) thinking “I did it!!111oneone” about their vaginal birth and barely bat an eye-lid at having to revive their own dead child following a hb gone wrong… and yet here they are going on about FOUR IQ points?

        I wonder how many of these HB babies have lots IQ points, suffered moderate to severe brain injury and even lost their lives due to their irresponsible birthing choices, and FORMULA is the thing being held up as evil?

        For crying out loud, a bit of perspective goes a long way, not to mention a damn good reassessment of priorities.

        • Wren
          June 10, 2013 at 6:33 am #

          You’re assuming that they are actually basing their decisions on outcomes, rather than justifying their decisions after the fact.

        • Amy Tuteur, MD
          June 10, 2013 at 9:09 am #

          A little logical thinking would go a long way, but that seems to be in short supply in the NCB crowd.

        • amazonmom
          June 10, 2013 at 10:13 am #

          Yes, it’s insane what the crazies think is important. I don’t think formula feeding reduces IQ. I don’t think four points amounts to a damn thing at all. I really just like to find ways to get the lactivists to shut up and that flippant reply works! I should say hubby and I were formula fed too. We were!

        • Sue
          June 11, 2013 at 2:58 am #

          Great point, realitycheque. How about a study comparing FF vs intra-partum hypoxia?

      • ol
        June 10, 2013 at 7:46 am #

        I think the point is to control things that you can control and it will decreases anxiety from uncerainty and complicated chaotic world. If I know the main thing (how the world is done, what is best and right) and I can control it (give birth naturally, breastfeed, eat something right and so on), I’m sure I’m doing all right and everything gonna be ok. I can’t control schools, teachers, schoolmates, government, doctors, they can be good or bad, they can be evil, they can make mistakes… But I’m doing what I can do and what it is right.

        • ol
          June 10, 2013 at 8:17 am #

          and I want to add – you, skeptics, want to deprive me of this feeling of certanity and security? The idea that the life is more complicated and unpredictable is dangerous for that feeling and it’s not easy to reject the full and simple picture of the world.

        • fiftyfifty1
          June 11, 2013 at 9:23 am #

          ” I can’t control schools, teachers, schoolmates, government, doctors,”
          …but that doesn’t mean I don’t try….

      • LibrarianSarah
        June 10, 2013 at 6:45 pm #

        I think you mean “Intellectual Disability” a Learning Disability requires someone to have an average IQ or higher (think dyslexia).

        • Lizzie Dee
          June 10, 2013 at 7:50 pm #

          In the UK, dyslexia is referred to as a “specific learning disability” The intellectual impairments are referred to as mild,moderate and severe learning disabilities. Mild is an IQ between 70-90 as far as I know.

          Don’t know much about the testing methods for very young children. Does anyone?

          • LibrarianSarah
            June 10, 2013 at 8:00 pm #

            In the US, “specific learning disability” is mostly a legal term for ADA representation while “intellectual disability” has replaced mental retardation as the term for people with low IQ. The DSM V also refers to low IQ as “intellectual disability.” I am not sure if this is used in the UK

            Learning disabilities are encompass all the “mild” cognitive disabilities such as dyslexia, dysgraphia, dyscalcula, Nonverbal learning disability, etc. Using “learning disability” as a synonym for “mental retardation” would greatly offend a lot of people with these conditions for obvious reasons.

            The test used to determine IQ for children ins known as the WISC or Wechsler Intelligence Scale for Children. The WISC also is used to test for learning disabilities and ADHD.

          • fiftyfifty1
            June 11, 2013 at 9:22 am #

            ” I am not familiar with any IQ test for children before “speaking age” though. ”
            Oh I am. You look to see if the child is in a sling and then you inspect his or her stools and if they have the mustard-curd look and the fresh fresh healthy natural scent of a fully breastfed baby you have all the proof you will ever need of superior intelligence.

      • Dr Kitty
        June 11, 2013 at 5:01 am #

        I use the terms I am used to in the UK, where LD= developmental disability, and is the preferred and accepted term.
        Dylexia would be described as a learning difficulty and is considered an educational rather than a medical diagnosis in the UK, as Educational psychologists rather than neurologists diagnose and manage it.

        I have to occasionally course correct your US terms and realise you mean something different than I first thought, you might have to do the same for me sometimes and remember I’m not American and while we both use English, it isn’t always the SAME English.

        I’m happy to use Developmental Disability or Intellectual Disability for clarity in future.

      • fiftyfifty1
        June 11, 2013 at 9:17 am #

        If there even is a 4 point difference! At this point there is no proof of that.

    • Lizzie Dee
      June 10, 2013 at 9:01 am #

      Well, yes. Me, my husband and my second daughter are all around the 150 mark. Is it worth the hassle (if it is a hassle) to boost that to 154? Given that the level required for a Ph.D doesn’t stop some women buying into the nonsense that is NCB extreme woo, what exactly are we talking about here?

      I have mentioned before my favourite doctor who observed that my first daughter must’ve started out with a pretty good brain to have so much left after considerable damage.

      I have a mild and not particularly disabling form of dyspraxia which I tend to attribute to being a premature, fragile twin. It is a lot less of a problem than dyslexia might have been. Not sure that anyone has yet figured out the connection between brain structure and intelligence, IQ and accomplishment. I thought white matter had more to do with motor disabilities than LD?

      • amazonmom
        June 10, 2013 at 10:23 am #

        I have trouble with rote memorization after a car accident at 17. Accident not my fault. It hasn’t changed my abilities but people really do think its weird. Wish I had knowledge of how my brain changed . No imaging was ever done.

      • anon
        June 10, 2013 at 4:08 pm #

        My oldest has very mild dyspraxia as well and a seizure disorder, after being bf for a year and worn in a front carrier by necessity for most of her first six months (hideous colic). Must’ve been the evil epidural.

        Off topic, when I asked her neurologist if we should be concerned about her dyspraxia, she told me that she’d been given some sort of test in HS and told she had the motor coordination of a “mental vegetable”. She said, with faux-outrage, “So, NO, I DON’T think it matters!!”

    • Alenushka
      June 10, 2013 at 10:51 am #

      Everyone in my family is above average. I am not bragging. It is just the way our genes are. We all were fed in different ways, but we all have IQ in the neighborhood of 140 and above. You would thinks we were all Nobel Prize winners etc. We are not. IQ is not everything. We have junkies and Fulbright scholars, veterinarians and high school drop outs, attorneys and chronic couch surfers. Too much emphasis is put on IQ and very little on executive skills.

      • Sullivan ThePoop
        June 10, 2013 at 1:46 pm #

        I completely agree. I also come from a family with obviously inherited high IQ and some of the members of my family who score off the IQ charts really have some psychological problems. My oldest daughter has a very high IQ and she was formula fed, sometimes I think another couple of IQ points could have put her in the range of psychological problems.

        • Amazed
          June 10, 2013 at 7:51 pm #

          My mom says I never licked as much as a drop of formula, even in the L&D. I never knew I was a genius.

          Brother started spending money as soon as he was born, with his formula and powdered milk until he could be breastfed. I always said I was smarter than him. Now I know why that is. Sadly, no one will believe me. We’re as unscientifical as they come, it seems.

    • amazonmom
      June 10, 2013 at 11:16 am #

      They are always trying to get me to say why I quit breastfeeding.

      • AmyM
        June 10, 2013 at 12:20 pm #

        Think “Blue’s Clues” here:

        It is none of your business,
        It is none of your business.
        It is none of your business,
        so go piss up a rope.


      • Sue
        June 11, 2013 at 2:55 am #

        My suggested answer: ”I had to stop because we were worried that our baby might be so exceptionally gifted that he/she might never be accepted by society.”

        Then ask: ”Why did you feel the need to persist for so long?”

        That might silence the questioners.

      • Jennifer
        June 20, 2013 at 4:22 pm #

        I read a study abstract that reported an average 3 IQ point decline among kids whose moms who were depressed during their early childhood than those whose moms were not depressed. So it seems your child has likely seen about equal intellectual results either way. Also, I have read that the margin of error in most IQ tests is +/- 3 points. Ultimately, especially when you’re talking about kids who are likely at least average to highly above average intelligence, 3 points doesn’t make a difference. “Oh, your IQ is 137? Mine is 140. I’m so sorry your mom didn’t love you enough to breastfeed.” Anyone stupid enough to say that is evidence that IQ does not measure intelligence.

      • Els
        July 19, 2013 at 9:49 am #

        Past partum depression can be triggered by stopping breast feeding early as your body goes into mourning, thinking the infant has died. Its biological hard-wiring.

        • theadequatemother
          July 19, 2013 at 10:38 am #

          citation please! I’ve never heard this before. I’d even accept a published case study.

        • attitude devant
          July 19, 2013 at 11:07 am #

          Absolute bullshit. (and I TREAT post-partum depression so, believe me, I KNOW that it’s bullshit.)

        • Box of Salt
          July 19, 2013 at 11:21 am #

          Els, how do you explain the fact that in the comment to which you appended your absurd hypothesis, the onset of PPD happened first?

        • Lizzie Dee
          July 19, 2013 at 3:18 pm #

          Who on earth told you that?

    • melindasue22
      June 10, 2013 at 5:29 pm #

      The fact that people even address your child’s IQ is just strange.

      • amazonmom
        June 10, 2013 at 5:31 pm #

        I know! It’s not like I bring up the topic of IQ or formula feeding EVER. It’s my current pregnancy that seems to bring the woo pitchers out of the woodwork.

        • The Bofa on the Sofa
          June 10, 2013 at 7:47 pm #

          We know that socio-economic status is one of the most important factors affecting IQ, right?

          Second, aren’t most of the couples seeking to adopt pretty well-to-do? That’s especially the case for those couples who are advertising in every newspaper in the country, pretty much.

          So if the goal is to maximize everyone’s IQ, shouldn’t we be insisting that poor mothers give their children up for adoption to these wealthier parents?

          Pretty stupid, right? But as soon as you admit that, then you have admitted that there are, in fact, considerations that matter more than just maximizing the child’s IQ. From there, it is merely a question of where you draw the line of how far you need to go.

          Sure, all else being equal, a 4 point improvement is preferable to not. However, as I am wont to say, all things are never equal. Parents who have chosen to not EBF have made that choice for a reason.

  13. June 9, 2013 at 8:08 pm #

    Unfortunately, many prospective parents and journalists are unable to do what you just did – dismiss the results as junk because of fatal flaws in analysis. As a result, the junk gets digested as fact – and women who make different choices (ie. formula feeding) continue to be disparaged as making choices that are harmful to their children. It’s really no different than the garbage that people use to deny women the choice of cesarean delivery – substitute bad evidence (evidence on largely emergent cesareans) for reasonable evidence (evidence on planned cesarean deliveries) and pretend like the judgement of choice is reasonably justified when it is not.

  14. Box of Salt
    June 9, 2013 at 7:59 pm #

    A question for those more qualified in biological science than I: the Bartick paper is based on Monte Carlo simulations. Way back when, I used those methods for modeling . . . how chemical bonds affect the overall shape of a molecule. I will admit that at this point, it’s a bit of black box for me (i.e., use or lose it, and it’s been well over a decade since I used it).

    Is this – Monte Carlo simulations – an appropriate method to use for making predictions about human biology?

    • Eddie
      June 10, 2013 at 2:24 am #

      This paper seriously uses Monte Carlo simulations? I used them significantly in my particle physics dissertation, but I assert that particle physics is significantly cleaner of confounding influences than biology. How can you meaningfully simulate something where you do not understand the causal relationships between the variables? I’m open to the idea that it’s possible to do this in a responsible way, but I’d have to be convinced.

    • anonymous
      June 10, 2013 at 3:00 pm #

      I don’t think that Monte Carlo simulations aren’t used for this kind of thing. Wikipedia has a nice article on it but in this case, where you aren’t looking at coupled degrees of freedom I don’t think it’d be useful or appropriate.

  15. rh1985
    June 9, 2013 at 7:38 pm #

    So I am one of three children and my siblings were both exclusively formula fed, while I never had a drop of formula (started cow’s milk at 9 months because my mother was DONE, that was okay back then, and I apparently loved milk and hated formula) and I am the shortest of us three by a lot. And I mean A LOT. WTF no fair! (just kidding)

    • Anj Fabian
      June 10, 2013 at 7:28 am #

      You should see MY family! Breast fed, every single one of us! We are also below the average height. I’m certain it was the breast milk and has nothing to do with our parents’ physical stature.

    • Happy Sheep
      June 11, 2013 at 1:00 pm #

      I wasn’t breastfed and neither were my two brothers. I’m 5″4 and chubby, and both of my brothers are 6″3 and lean.
      Can you imagine how tall and thin my brothers would have been with breastmilk? I would be model thin and I might have been able to reach the top shelf if I had gotten that magic elixir, sigh.

  16. Kalacirya
    June 9, 2013 at 6:28 pm #

    Ugh, a homebirth midwife (a CNM at least) opened up shop down the road from me. From her website: “Michelle is a trained craniosacral therapist and offers homeopathy, massage, hydrotherapy and other midwifery modalities.” *puke* So despite being a properly trained midwife, she’s a total quack.

    • PollyPocket
      June 9, 2013 at 9:29 pm #

      She can’t be any worse than a chiropractor for treatment of plagiocephaly and craniosynostosis!

    • Lizz
      June 10, 2013 at 2:02 am #

      I was looking through the store. I’m trying to picture what kind of a person would buy the snuggie with her business logo on it?

      • theadequatemother
        June 10, 2013 at 8:31 am #

        the kind that wants an excuse that will allow them to start talking to strangers about their magical homebirth…the kind that hopes the logo on the snuggie will lead to a polite inquiry that will allow them to proselytize.

        • Lizz
          June 10, 2013 at 6:06 pm #

          Oh I thought that most people kept their snuggie use to inside their houses. All except for my Husband’s crazy uncle who rides his motorcycle in his(we think that the meth did more to his brain then anyone could have imagined). But assuming you where it around the house it just becomes an annoying reminder of you “accomplishment” to close family members.

    • yentavegan
      June 10, 2013 at 5:41 am #

      I have lost all respect for an organization i used to admire due to their recommendation of craniosacral therapy for infants with “latch” problems. Where unicorns frolic with mermaids science is not on the menu.

    • Anj Fabian
      June 10, 2013 at 7:31 am #

      “Some unforeseen events may result in an unexpected outcome.”
      WRT planned homebirth.

      That’s one of the vaguest references to injury or death that I’ve ever seen.

      • Sue
        June 11, 2013 at 3:01 am #

        The worry is if some of these ”events” SHOULD have been foreseen. Disclaimer won’t help then.

  17. Kalacirya
    June 9, 2013 at 6:23 pm #

    The white matter study is an odd one. It’s highly technical, and mostly dependent on pretty complex image analysis software. It’s not clear to me, reading the methodology on the imaging, how accurate or precise one can expect the image processing to be. And all the white matter measurements depend upon that image processing.

    The portion that’s not dependent on the imaging process is done with the testing of the children. And the results there are completely non-compelling.

    Let’s say my argument is that breastfeeding makes kids smarter, and I have three study groups: exclusive breastfed, breastfed and formula, and formula only. When comparing behavior test scores in order to get a sense of the children’s intelligence: comparing formula only and breastmilk only, only in one of the areas of measurement, receptive language, is a statistically significant (p-value .0019) difference between the groups detected. But for the breastmilk only and mixed groups, in only two areas (of four) differences are seen, in receptive language and visual reception. Then no differences are noticed between formula fed and mixed. This is not exactly a compelling set of evidence that breastfed children are going to be more intelligent than non-breastfed children.

    Then there’s a question if extra growth in those areas makes any different in the long term.

    • auntbea
      June 9, 2013 at 6:38 pm #

      At least they are open about their data mining?

    • PollyPocket
      June 9, 2013 at 9:33 pm #

      Clinically, MRI is completely insufficient at determining function. That’s what functional MRIs are for.

      Also, there are known risks to sedating children for procedures like MRIs. I did not read the entire article myself, but I assume children were repeatedly sedated, increasing the risks of learning disabilities independent of all other factors. What a horrible study.

      • KarenJJ
        June 9, 2013 at 10:12 pm #

        My daughter had an MRI at 18 months and had it done under a general anaesthetic.

        • PollyPocket
          June 10, 2013 at 12:32 am #

          In my career, I’ve seen one three year old sit still enough for an MRI. Some 5-year olds can do it. I actually do “projects” with my kids (like making plaster of Paris masks) that require them to lay very still for 20+ minutes so that if they ever require an MRI they can do it without sedation.

      • anon
        June 10, 2013 at 4:12 pm #

        Not having read the study (lazy thing that I am, not my fault, I was formula-fed as a baby 37 years ago), was that the only purpose for the MRI? Or did they piggyback the study on kids having brain MRIs for other reasons?

  18. Gretta
    June 9, 2013 at 6:04 pm #

    Ugh. Have you seen th graphics with that study? The poor formula fed kid is using like a quarter of his brain it looks like. Holy Toledo, that alone could make a mother feel like crap for feeding her baby formula.

    • auntbea
      June 9, 2013 at 6:28 pm #

      Or perhaps his formula-fed brain is so efficient he only needs a little bit of it to work at any given time?

    • PollyPocket
      June 9, 2013 at 9:35 pm #

      The image is not an fMRI, it can’t show function (ie what’s being used). The graphic shows myelination, which occurs in the first years after birth, regardless of how a child is fed.

      • Gretta
        June 10, 2013 at 1:20 am #

        Agreed. But does the average mom being smacked in the face with this study know that?

        • Sue
          June 11, 2013 at 3:03 am #

          That’s the problem, and that’s why Amy’s blog is so important.

  19. realityycheque
    June 9, 2013 at 5:52 pm #

    Disgraceful. Such poor quality studies that will no doubt cause more women to put themselves through hell with ‘mommy guilt’, and give the sanctimommies (who have no capacity to discern a quality study from a crappy one) more fuel to shame and belittle formula feeders.

    Do these women even bother to read these studies before shouting their ‘results’ from the rooftops? Apparently not.

    • Eddie
      June 10, 2013 at 2:27 am #

      Read … do you think they care to understand the studies? If it says what they want to hear, it’s good.

  20. yentavegan
    June 9, 2013 at 5:27 pm #

    I am a typical mother, in so far as i believe without any need for outside confirmation that I have the smartest, most thoughtful insightful children in the world. But then again all my friends and relatives and acquaintances and fellow schoolmates also have children far above normal or average. Many of my peers did not exclusively breastfed and many of my relatives did not nurse at all, yet they too are blessed with remarkable offspring, just like me and you and everyone I know.

  21. Dr Kitty
    June 9, 2013 at 4:42 pm #


    I quite liked this, especially the last two paragraphs.

  22. fiftyfifty1
    June 9, 2013 at 4:36 pm #

    But Poverty and Aging are such complicated problems. What a drag! It’s so much easier to pretend that there is a magic bullet. And so much more fun, because then we can both blame the victims and at the same time pat ourselves on the back for our own superior actions.

  23. ChrisKid
    June 9, 2013 at 2:51 pm #

    In a country where increases in formula feeding correlate with the Flynn Effect on IQ scores, it would take extraordinary evidence to prove that breastfeeding has any measurable effect on intelligence.

    • Amy Tuteur, MD
      June 9, 2013 at 3:40 pm #

      Maybe bottle feeding increases IQ.

      • Michellejo
        June 11, 2013 at 8:17 am #

        That’s easy enough to theorize.

        Since as a rule, formula fed babies sleep more than breast fed ones in most people’s experience, and the brain develops best at rest, formula fed babies should be brainier than their breast fed counterparts.

        Now we need a few idiots like the ones who did the latest studies to orchestrate some studies to prove that.

  24. LynnetteHafkenIBCLC
    June 9, 2013 at 1:21 pm #

    Well…given that formula is made from massive amounts of cow’s milk or soybeans, plus all associated transportation costs, it could contribute a tiny smidgen to global warming. Of course, if it does, which is debatable, I’d much rather support babies getting fed than people driving SUVs.

    • theNormalDistribution
      June 9, 2013 at 3:49 pm #

      And, if you’re going to factor milk/soy production and transportation costs into formula’s contribution to global warming, you should also consider the contributions from extra food that the mother is eating to produce breast milk.

      • fiftyfifty1
        June 9, 2013 at 4:26 pm #

        I would guess that if you did this, formula feeding would decrease global warming in comparison with breastfeeding. A woman needs to eat more than 500 Kcal (of shipped in food typically) to produce 500 Kcal of breastmilk.

        • desiree
          June 9, 2013 at 4:40 pm #

          I have fast metabolism no doubt, but I needed easily 1,000 extra calories per day while BFing. I used to sit on the couch with a quart of ice cream and eat as much as I could every night so that I wouldn’t lose any more weight.

          • prolifefeminist
            June 9, 2013 at 5:39 pm #

            I envy you! I had the opposite problem – I had to go back to my pre-pregnancy diet just to avoid gaining weight while I was nursing. I still made plenty of milk even without eating any extra calories. I guess I just have a crappy, slow metabolism.

          • realityycheque
            June 9, 2013 at 6:02 pm #

            My body wasn’t interested in dropping a gram of weight while breastfeeding. It’s disingenuous to suggest that breastfeeding will cause the weight to melt off for all women.

            From variations in menstrual cycles to the rate at which our hair grows, our bodies aren’t one-size-fits-all at any other point during our lives, why should breastfeeding be any different?

          • desiree
            June 9, 2013 at 9:29 pm #

            Don’t envy me! I can eat whatever I want, but I honestly am incapable of gaining any weight. And my poor, tiny bosoms could really use some!

          • Lizzie Dee
            June 10, 2013 at 8:11 am #

            That used to be me. I was thin and flat chested at a time when it was less fashionable to be thin and flat chested, and lost weight if I skipped breakfast. I didn’t like it, and didn’t understand how lucky I was! I used to joke that I looked forward to middle age spread. Even that didn’t work, and I hit 60 before my metabolism slowed down. NOW I know how lucky I was.

          • desiree
            June 10, 2013 at 7:39 pm #

            You don’t have to answer if it’s too personal, but did your boobs grow when you hit menopause? It seems like some women just keep getting bigger and bigger as they age, but something tells me that’s a privilege reserved for women who don’t want it.

          • Lizzie Dee
            June 11, 2013 at 5:16 am #

            Don’t exactly remember – but I don’t think so. I had a relatively early – and interminable – menopause, starting in my late forties, but my boobs didn’t change much until I did FINALLY gain some weight much later. I have mentioned that my children loved cuddling up to more cushioned relatives, but didn’t seem to regard themselves as deprived – and I don’t think they would have swopped.

            I was lucky though, and didn’t realise it. Now I am like everyone else and could do with losing a bit. Can’t understand the fashion for stick-thin, but clothes do look so much better, and I was pretty fit. (Pregnancy aside.)

            Just as an aside, when I was young, the menopause was a Great Unmentionable (like pelvic floor injuries.) As a liberated young woman, I thought this was a nonsense – it would not faze me. It was a lot more ghastly than I had bargained for, and still doesn’t get talked about much.

        • Elaine
          June 9, 2013 at 10:27 pm #

          Yeah, but how much food does a cow need to eat to produce enough milk to make 500 Kcal of formula? Probably it’s comparable. Soybeans may have a lesser impact.

          Then also factor in the energy used to package formula and to wash and sterilize bottles. If a mom is working and pumping, there is energy used to operate the pump, and some bottle washing, though not as much for a formula-feeding mom unless she is EPing.

    • realityycheque
      June 9, 2013 at 5:59 pm #

      If you drive a car, catch a bus, eat meat, have ever caught a plane, wear leather shoes or make any number of common everyday lifestyle choices, you’ve got no place complaining about formula feeding impacting on global warming.

      Most of us will drive a car for a significant portion of our lives, we (potentially) drink formula for what, 18months MAX? It’s such a non-argument.

      • Kalacirya
        June 9, 2013 at 6:26 pm #

        Some of these parents are vegan, ride fixed gear bikes, and only wear stylish thrifted clothes. What about them?

        • realityycheque
          June 9, 2013 at 6:45 pm #

          Even in the event that someone could miraculously state that their existence had zero impact on the world we live in, I don’t see that it gives them a right to chastise formula feeding mothers using ‘global warming’ as an excuse. Really, there are a thousand other things that have a greater impact on the environemnt and global warming than infant formula, to use that as an argument is to grasp at straws.

          Beyond that, these self-righteous types are so often a combination of classist and ableist that I don’t even know where to begin. Arguments against formula feeding, pram use and cesarian birth are inherently ableist in and of themselves. There is no room for psychological, mental or physical handicap in the world of NCB. Mental health isn’t always visible from the outside, yet that doesn’t stop the sanctimommies from spewing their venom.

          • Kalacirya
            June 9, 2013 at 6:50 pm #

            Well I was making a hipster joke, not raising a point. I apologize if that was not obvious. Given some of your spellings I’m guessing that you are not from the USA, so maybe you aren’t familiar with this particular cultural movement.

          • realityycheque
            June 9, 2013 at 6:55 pm #

            Oh, sorry if my response came across as being über serious. Part of me thought it was a joke about self-righteous vegan hipster douchebags, but you can’t be sure sometimes!

          • Kalacirya
            June 9, 2013 at 6:56 pm #

            I was hoping that fixed gear bicycle would give it away.

          • realityycheque
            June 9, 2013 at 7:09 pm #

            Well, in truth I wasn’t actually aware that fixed gear bikes were a thing with hipsters until this moment just now. Although I’ve spent my entire life living in a mountainous range that is entirely incompatible with that sort of bike, so that may be why I was never aware of their popularity. That, and I’m just not cool.

          • Kalacirya
            June 9, 2013 at 7:12 pm #

            I live in a small city that’s set on the slope of a valley next to a river. So part of the city is flat, and the rest is one big hill. Still, hipsters kids my age have fixed gear bikes. It kind of blows my mind.

          • realityycheque
            June 9, 2013 at 7:29 pm #

            Actually, in retrospect, the sarcasm in your post was so blatantly obvious that I’m embarrassed to have even been in two minds about it. Somehow my brain overlooked the whole ‘fixed gear’ part of the bike mention and I was left trying to establish whether or not you were serious based entirely on the inclusion of the word “stylish”.

            My formula-fed status is showing.

        • fiftyfifty1
          June 11, 2013 at 9:34 am #

          “ride fixed gear bikes”
          Well then their kids really do need every extra IQ point they can scrape up.

    • Antigonos CNM
      June 10, 2013 at 12:22 am #

      Of course bottle feeding contributes to global warming! Just think how much hot water is needed to clean those bottles et al! How do we get hot water? In most places, using fossil fuels of some sort to either heat the water directly or to provide the electricity which heats the water! The carbon footprint of bottle feeders must be enormous! Now, in breast feeding, all one needs to do is to wash one’s nipples which can be done in cold water. QED.

      How anyone, with even a smidgen of common sense, can assume that height or intelligence is not due to a multitude of factors, is really amazing. Does repeatedly playing “Baby Mozart” during the first year of life have an impact on height, for example? I am forced to the conclusion that the authors of both studies must have been bottlefed and are dwarves.

      • AmyM
        June 10, 2013 at 6:32 am #

        And that all short people are morons, and tall people are brilliant, if infant feeding is the one factor that determines both. No need for standardized testing to get into Harvard, just a measuring tape.

  25. Rebecca
    June 9, 2013 at 12:43 pm #

    It’s interesting that the same crowd that is terrified of prenatal ultrasounds and infant vaccinations is perfectly accepting of MRI imaging of infant brains.

    • PollyPocket
      June 9, 2013 at 9:46 pm #

      Children with more than 2 exposures to anesthetic (including light sedation used for MRIs) are 59% more likely than the general population to develop learning disabilities. So the risk of participating in this study is known and quantifiable.

      • Eddie
        June 10, 2013 at 2:41 am #

        I notice this toward the end:

        They also could not exclude the possibility that the underlying conditions for which surgery was performed were responsible.

        Also, the uncertainties on this were huge. One sigma is 33% if my math is right, so that’s 59 +/- 33%. I wouldn’t take this to be definitive!

        • KarenJJ
          June 10, 2013 at 3:23 am #

          That’s what I was wondering. My daughter’s MRI was looking for evidence of brain inflammation. If there are learning difficulties I don’t know that it would be due to the GA, but I can easily imagine it is more due to the chronic inflammation.

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