How about a MOTHER friendly breastfeeding initiative?

Woman Screaming at Anoher Female on White Background

If there’s a bigger oxymoron than the “Baby Friendly” Hospital Initiative, I’m not aware of it. There is nothing baby friendly about efforts to promote breastfeeding to the exclusion of a mother and baby’s actual needs. There is not, and there can never be, anything “baby friendly” about destroying the confidence of new mothers and making them feel guilty about a decision with trivial consequences.

It’s time (actually long past time) for a MOTHER friendly breastfeeding initiative.

What would a mother friendly breastfeeding initiative entail? It would start with some basic truths about breastfeeding and mothering:

1. While breastfeeding has real benefits, those benefits are so small as to be trivial in all cases except premature babies. Understanding and acknowledging this scientific reality is the first step to a safe, sane, respectful breastfeeding policy.

2. The obvious corollary to #1 is this: once a woman has been given accurate information about the benefits of breastfeeding, it DOES NOT MATTER what choice she makes, and therefore hospitals should NOT be devoting copious resources to it. Those resources would be much better spent teaching basic parenting to low income, young women or on programs to prevent prematurity.

3. Formula is an EXCELLENT source of nutrition for babies. There is absolutely positively nothing wrong with it, and no mother should be made to feel guilty for feeding to her child, regardless of the reason for choosing it.

4. Breasts are part of a woman’s body. NO ONE has the right to tell women how they must or should use their breasts. PERIOD.

5. I don’t know of a single endeavor where humiliation produces results. It’s time for lactivists and lactation consultants to acknowledge that and stop the hectoring treatment being offered in hospitals.

6. In my judgment, boosting fragile maternal confidence is an important task of anyone who cares for women and babies. Setting arbitrary standards, ignoring women’s own needs, pretending that every woman can breastfeed successfully are sure-fire ways to undermine self-confidence, not build it.

7. Stop treating new mothers like morons. EVERY women knows that “breast is best.” If a woman decides to formula feed, it does NOT mean that she doesn’t understand the benefits of breastfeeding.

8. Breastmilk does not have magical properties. Its ability to prevent vaccine preventable illnesses is small and easily outstripped by vaccination itself. It does not increase intelligence; it does not prevent obesity; and it does not confer health on its recipients.

9. No one has ever demonstrate ANY benefit to donor breastmilk for term babies.

10. The risks of potentially contaminated donor breastmilk from unregulated arrangements far outstrips any putative benefits.

Why is it critically important to make our breastfeeding initiatives MOTHER friendly?

We have made great strides in understanding the devastating impact of postpartum depression, yet we seem to ignore those insights when trying to promote breastfeeding. Adequate sleep, lots of help and feelings of competence can help prevent and treat postpartum depression. Why then do we pretend that breastfeeding is more important than these factors so critical for women’s mental health?

Contemporary efforts at breastfeeding promotion remind me of the efforts to encourage right handedness among the left handed in generations past. The humiliation and physical abuse associated with forcing right handedness were justified by claims that being right handed is “better” and “easier.” The humiliation and guilt inducing behavior of lactivists and their breastfeeding initiatives are justified by claims that breastfeeding is “better” and “easier.” Humiliation and physical abuse were believed to be “effective” in forcing right handedness when the reality was that it was effective only in inducing despair. Lactivists apparently believe that humiliation and guilt are effective in increasing breastfeeding rates when the reality is that they are effective only in getting women to lie about their intentions or to despair when they can’t realize those intentions.

There is NOTHING wrong with formula feeding, the benefits of breastfeeding are trivial and the harms to women and babies of venerating breastmilk as magical far outstrip any of those putative benefits. It’s time to get real about breastfeeding and to stop the nonsense of “baby friendly” hospital initiatives. Such initiatives are friendly to only one group: lactivists, who are building their own self-esteem by tearing other women down. If we actually care about mothers and babies, we would remove “baby friendly” programs and replace them with accurate scientific information, respect for women’s intelligence and efforts to support mothers regardless of feeding choice.

It’s time for safe, sane and respectful breastfeeding policies. It is time for MOTHER friendly breastfeeding initiatives.

1,127 Responses to “How about a MOTHER friendly breastfeeding initiative?”

  1. Cindy Proctor Schlecht
    July 26, 2015 at 12:30 am #

    OMG just support what the mother wants to do!!

  2. nikkilee
    July 19, 2015 at 7:07 am #

    This is a collection of talks from the Academy of Breastfeeding Medicine that you might enjoy. There are a wide range of speakers: clinicians, researchers, and an economist from the world bank.

    • Megan
      July 19, 2015 at 8:27 am #

      You’re still posting here?? There have been numerous breastfeeding posts since this one. Trying to comment without notice I guess…

      • nikkilee
        July 20, 2015 at 3:56 pm #

        There are too many posts to comment on everything.

  3. Stacy21629
    February 26, 2014 at 7:24 am #

    Stopping breastfeeding and going to exclusive formula feeding when my daughter was 4 months old and 7.5# was the most mother friendly thing I’ve done yet. I have no worries about her welfare and growth now because I know exactly how much she’s eating and she’s gained tremendously and passed multiple milestones. She sleeps better, and I sleep better. I don’t have to worry about making sure my clothes allow “easy access”, that I have a sling or a cover, or where I’m going (I’ve never been one to nurse while grocery shopping so I needed to plan where to feed my baby). I can actually *gasp* PROP THE BOTTLE UP and sweep the floor or start dinner, rather than having to drop everything every couple hours. Sure I still enjoy sitting with her…but honestly I read at the same time too!
    Miracle of miracles, she’s been just fine. No GI upset, no illnesses that everyone else in the house hasn’t had as well.
    Don’t get me wrong – I thoroughly enjoyed breastfeeding my teeny little baby…but this early return to freedom as compared to my other child is really wonderful too.

    • techqueen333
      February 28, 2014 at 7:34 am #

      It may have been a mother friendly decision, but it is not a baby friendly decision

      • PrimaryCareDoc
        February 28, 2014 at 7:42 am #

        Actually, the latest research now shows that it doesn’t make a damn bit of difference. Catch up.

        • techqueen333
          February 28, 2014 at 1:33 pm #

          Clearly, you haven’t read the latest research.

          • PrimaryCareDoc
            February 28, 2014 at 1:38 pm #

            I beg to differ.

            I have read it. Have you?

          • techqueen333
            February 28, 2014 at 3:35 pm #

            Self-reporting on duration of duration of BF and selection bias. These pose questions about reliability and validity. Second, like Horta study the focus of this study is on non-communicable diseases, behavior, and IQ. Again, like the Horta study, it ignores the benefits of BF re: mortality and morbidity due to infectious diseases. You can’t get around the fact that human milk contains immunoprotectuve, anti microbial, and anti-inflammatory agents and formula does not.
            One thing I did like about this article is the plea to change practices and policies around family leave, workschedules, and child care. In the US, we have some of the worst among developed countries.

          • Dr Kitty
            February 28, 2014 at 3:51 pm #

            Stop posting on old posts.
            Once five people post after you and your comment leaves “recent comments” no-one can find it.

            Come and post on today’s topic so we can all find your posts.

            Unless you just want to have the last word and are hoping if we can’t see your nonsense we can’t respond to it…

          • techqueen333
            March 1, 2014 at 3:36 pm #

            I respond to the comments on my phone via the links Disqus provides.

          • PrimaryCareDoc
            March 1, 2014 at 7:40 pm #

            I give you a study, you give me a…blog post? Okay.

          • techqueen333
            March 2, 2014 at 12:14 pm #

            I gave you my own initial response AND provided you with an analysis of the study by other scientists. Just because the analysis is posted on the Internet, doesn’t make it invalid. There are serious, legitimate concerns about the sibling study.

          • NoLongerCrunching
            March 2, 2014 at 12:20 pm #

            Yes there are concerns, as there are concerns with EVERY study. Do you put as much an emphasis on the concerns when the results go the way you want? Breastfeeding is still great, and this study doesn’t take that away. It does however provide some reassurance to moms who didn’t breastfeed. Why are you threatened by that?

          • techqueen333
            March 2, 2014 at 12:29 pm #

            It goes beyond concerns. It’s a flawed study. I am only threatened by the touting of flawed studies by those who want to say that the differences between human milk and formula are trivial. Women who choose to bottle feed or to supplement should understand that the two are not interchangeable. They should know what changes occur when formula is fed to a newborn. And please, don’t respond with more starvation and bilirubin stories. Those are rare and of course mothers have to seek alternatives.

          • NoLongerCrunching
            March 2, 2014 at 12:45 pm #

            But the flaws are no greater than the flaws in many studies that show benefits to breastfeeding. Ii don’t agree with the idea that this is a gamechanger; it needs to be replicated and “breastfed” needs to be more accurately defined, but i am troubled by the knee-jerk dismissal of this study by the community of bf advocates. We have nothing to lose here.

          • techqueen333
            March 2, 2014 at 12:18 pm #

            pS. I’ve given you studies and you’ve just ignored them.

          • Guesteleh
            February 28, 2014 at 1:45 pm #

            Why are you commenting here and not on the most recent breastfeeding post? Any thoughts on the Ohio State study?

      • Stacy21629
        February 28, 2014 at 7:44 am #

        Please enlighten me – in what completely unseen way is my daughter suffering to an early grave, like she pretty much was before formula?

      • Happy Sheep
        February 28, 2014 at 11:52 am #

        How are you still on this article? Dr Amy has posted a new article about recent breastfeeding studies, and yet you insist on bleating the same BS here over and over again.

      • Cindy Proctor Schlecht
        July 26, 2015 at 12:31 am #

        Keeping you baby fed and safe is a “baby friendly” decision

  4. Amy Tuteur, MD
    February 24, 2014 at 5:06 pm #

    I’m not sure why anyone is arguing with techqueen333 and nikkilee. They are lacto-fundamentalists and like all fundamentalists they start from a premise the their “god” is the one true God and absolutely nothing you can say will cause them to question their faith.

    • NoLongerCrunching
      February 24, 2014 at 5:12 pm #

      Because, like with fundamentalists, showing them that others are real human beings that may have some good points, may plant a seed that causes them to treat others with more understanding. Plus, it’s fun. (I don’t get out much.)

      • techqueen333
        February 25, 2014 at 4:42 am #

        Fundamentalist? You really slay me with the name calling. Oh, I love the false assumption about how I treat people. You don’t know me and have no idea what I do.

        • anion
          February 25, 2014 at 5:48 am #

          You’re right, we don’t know you, and you have refused to say what you do. All we have to go by are your comments here, which are rude, unpleasant, insensitive, and filled with idiocy.

          You don’t want us to think of you that way? Don’t behave that way, then. It’s very simple.

          (BTW, that’s not a “straw man,” either. Nor is it ad hominem.)

          I am done having a discussion with you, because you’re frankly boring. But I did want to clarify that running into a forum and acting like a jerk means people are going to think of you as a jerk, no matter how lovely and kind you may be to others in your personal life. We don’t know or see that. All we see is what you show us. That’s Human Relationships 101.

          • techqueen333
            February 25, 2014 at 6:25 am #

            I could care less what you think of me anion. You’ve given me absolutely no reason to care. Your post serves no purpose but to ridicule someone with whom you disagree. Furthermore, you have no evidence to support the assertion that my posts are filled with idiocy.

          • anion
            February 25, 2014 at 7:45 am #


          • techqueen333
            February 25, 2014 at 8:33 am #

            QED from me to you.

          • LibrarianSarah
            February 26, 2014 at 11:03 am #

            Grow up

          • techqueen333
            February 28, 2014 at 7:09 am #

            Ooooooo. Now THAT hurt.

    • techqueen333
      February 25, 2014 at 4:37 am #

      That’s nothing but an ad hominem attack. It conveys nothing but your personal dislike for those who disagree with you.

      • AlisonCummins
        February 25, 2014 at 5:05 am #

        No, ad hominem is “if techqueen333 says it, it must be wrong because she’s a terrible person and so is her husband.” That’s very different.

        • techqueen333
          February 25, 2014 at 6:38 am #

          AlisonCummins, that’s exactly what she’s done with the use of lacto-fundamentalists and “like all fundamentalists.” For someone who is so quick to disparage what she seems to feel is confirmation bias or lack of evidence demonstrated by those who have reached different conclusions than she has she certainly loves her own echo chamber. Pot/kettle.

          • AlisonCummins
            February 25, 2014 at 6:46 am #

            No, she used a syllogism.
            > Fundamentalists cannot be swayed.
            > techqueen333 is a fundamentalist.
            > Therefore techqueen333 cannot be swayed.

            Amy Tuteur, MD did not say you were wrong because you are a fundamentalist (which would be an ad hominem) she said there was no point in arguing with you because you are a fundamentalist. It’s perfectly good logic, not a fallacy at all presuming the premises are sound.

            I’m not opining on the soundness of the premises, just saying that it’s not an ad hominem attack.

          • techqueen333
            February 25, 2014 at 7:08 am #

            She did say we were wrong. She implies such by stating we start from a false premise “one true god”and are impervious to reason.

          • AlisonCummins
            February 25, 2014 at 7:22 am #

            Impervious to reason, yes. Wrong, no.

            For instance, perhaps you believe that Earth’s atmosophere is 78% nitrogen because you accept the sacred text of Azota which reveals it to be so. You are a fundamentalist Azotan and nothing anyone can say could ever dissuade you from this central doctrine. There is therefore no point in arguing with you because your belief in the nitrogen content of air is not based on reason.

            You would, however, be correct!

            That is why an ad hominem attack is a fallacy. “Don’t listen to techqueen333 about the composition of the atmosphere, she’s a fundamentalist Azotan.” That’s a fallacy because no matter who you are, you could still be right and in this case you would be. The composition of the atmophere needs to be discussed on its own merits.

            Amy Tuteur, MD did not state that any particular assertion of yours was wrong because you are a fundamentalist. She just said that arguing with you would be unproductive. If it’s true that you are a fundamentalist and if it is true that fundamentalists are impervious to reason, then it follows that yes, arguing with you is unproductive. That’s not an ad hominem, that’s a syllogism.

            If she had said “There are no antibodies in milk because techqueen333 says there are and tecqueen333 is a fundamentalist,” that would have been an ad hominem and it would have been a fallacy. But she didn’t say that.

          • techqueen333
            February 25, 2014 at 8:59 am #

            Amy began with a false premise. That false premise implies an ad hominem, i.e. You are a fundamentalist and irrational (one true God) and you aren’t capable of processing MY alleged evidence. So arguing is futile. It does smack of syllogism, however, I used ad hominem to highlight the fact that she resorts to ridiculing me rather than addressing my arguments.

          • AlisonCummins
            February 25, 2014 at 9:03 am #

            “Ad hominem” isn’t latin for “calls me names.” It means attacking the person instead of the argument. She wasn’t attempting to refute an argument by calling you names, therefore it wasn’t an ad hominem.

            False premise is fine.

          • Medwife
            February 25, 2014 at 7:36 pm #

            Really enjoyed this exchange and your valiant attempt at explaining those fallacies! Not Latin for “calls me names”. Ha!

          • techqueen333
            February 25, 2014 at 7:40 pm #

            She’s called me a moron and an idiot, a activist, and a fundamentalist. I’d say that’s reason enough to assume she’s attacking me instead of my arguments.

          • NoLongerCrunching
            February 25, 2014 at 7:41 pm #

            Fair point.

          • techqueen333
            February 25, 2014 at 9:04 am #

            It is a syllogism based on two false premises.
            It is ad hominem because she attacks me rather than my arguments.

          • AlisonCummins
            February 25, 2014 at 9:09 am #

            If you say, “You shouldn’t play with Alison Cummins because she’s a poopie pants and she stinks,” that is NOT an ad hominem. That’s a wise caution.

            If you say, “Ad hominems and syllogisms are the same thing because Alison Cummins is a poopie pants and she stinks,” that IS an ad hominem.

          • NoLongerCrunching
            February 25, 2014 at 9:21 am #

            I think calling someone a fundamentalist is somewhat ad hominem. But I’m curious, techqueen333, what if you were shown incontrovertible evidence that in the long run, breastfed and formula fed babies in the US had negligible health diffferences? Like maybe a few more ear infections and colds for FF babies. What would your reaction to that be?

            As a BF mom who has devoted the last 10 years to helping other moms bf, I would be sad because I think BF is really special and beautiful, and I would still help moms who wanted to and encourage my daughters to try it, but I would’t deny the science. Of course science is always learning new things, so that evidence might be overturned later, but I believe we have to act acording to what the evidence shows. Otherwise we are the very definition of fundamentalist.

  5. Dr Kitty
    February 23, 2014 at 12:25 pm #

    Tech queen, what is this “my husband the MD” thing about?
    My husband is a software developer.
    He knows as much about medicine as I do about coding…
    I know almost nothing about coding.

    My doctor friends have spouses who are barristers, engineers, teachers, bakers, podiatrists and artists.
    I’d only trust the spouses of doctors who are actually doctors themselves to dispense medical advice.

    If you are a qualified Lactation Consultant, use that. You don’t need your husband’s career to add credibility.

    • techqueen333
      February 23, 2014 at 7:30 pm #

      I pointed out that my husband was an MD to illustrate that there were two scientists in the house reading the same research and coming to the same conclusions. I am not a certifie lactation consultant, but I worked with nursing mothers on a daily basis for nine years with OB supervision

      • KarenJJ
        February 23, 2014 at 9:40 pm #

        Was this recent experience? Because some of your assertionis of what happens in a hospital seem a bit out of date. I admit to not being in the US so maybe it’s different there. Although judging from the stories I am hearing I suspect it is largely similar.

        • techqueen333
          February 24, 2014 at 2:18 am #

          My own experience is not recent. My daughter’s experience is very recent. My friends’ children have had babies within the last two years and they have all reported issues with formula pushing. Things are not as peachy between nurses and lactation consultants as you think.
          Over the years I’ve seen many a breastfeeding relationship sabotaged by the “well meaning.”

          • Durango
            February 24, 2014 at 9:28 am #

            Given your vocal antagonism, I would expect that everyone you know who experienced even minor issues with breastfeeding initiation will share them with you. I’ve never heard of “formula pushing” and all the new babies i know are breastfed. We see what we want to see, I guess.

            I am curious why you are so cagey about describing your former role in assisting new mothers breastfeeding?

          • Susan
            February 24, 2014 at 2:58 pm #

            Me too! TechQueen what was your role and what years did you have the role? What exactly did you do? A vague reference to what backward region of the US you might be in ( at least breastfeeding wise) would be interesting as well…

          • techqueen333
            February 25, 2014 at 6:29 am #

            That’s really funny, because I am still sought out by friends and their children for help getting started with BF or with solving problems.
            I’m not telling you because it’s none of your business. I can’t see how that information adds anything to this “discussion.”

          • Durango
            February 25, 2014 at 9:34 am #

            Ah. You do realize, of course, that you were the one who brought it up? Just like telling us about your phd (in some random, unrelated subject), your MD husband, your carefully worded sharing of your “work with nursing mothers under OB supervision”–you seek to bolster your statements with (very) vague assertions of expertise. That hasn’t worked out so well for you or anyone (you’ve joined the ranks of the guy who told us his SAT score, and the multiple NCB-ers who have parents who are doctors and nurses). Again, in an online forum, your credentials don’t matter, your words do.

          • NoLongerCrunching
            February 24, 2014 at 12:51 pm #

            Are you saying your friends’ children were happily breastfeeding and a HCP cam in and started pressuring them to give formula? Or was there a valid reason why some supplementation might have been recommended? Maybe you would prefer to use glucose water in that situation, but that is not evidence based care, according to the Academy of Breastfeeding Medicine.

          • lizzo
            February 24, 2014 at 12:59 pm #

            I had a 9+ pound baby (plus a rather delightful C-section) and formula never came up. (I was kind of looking forward to the mountain of free samples I was promised by lactivists, but received none.)

            I feel too like maybe your anecdote is missing some key health information.

          • techqueen333
            February 25, 2014 at 6:28 am #

            My anecdote is missing zero key health information. There were consistent attempts to persuade mothers to give supplemental bottles.

          • ngozi
            February 25, 2014 at 10:17 am #

            But if the baby is healthy and feeding well, then why would they just suggest formula feeding? It doesn’t make sense?

          • Irène Delse
            February 25, 2014 at 7:39 am #

            Indeed. “They were happily breastfeeding”? But were they breastfeeding successfully? Were the babies really getting enough or was it a case of “we want to wait and give sugared water until supply is established”? Because in that case I’m not surprised if nurses weren’t appreciative. Oh, and since techqueen already answered serious questions with flippant jokes elsewhere in this thread, I’m not inclined to take what she says at face value. And *that* is not an ad hominem, btw, simply judging someone by their track record.

          • The Bofa on the Sofa
            February 25, 2014 at 7:42 am #

            Indeed indeed. There MUST have been some reason why the HCP recommended formula. If breastfeeding was going well, there would have been no reason to. The obvious answer is that it was not going very well, despite mom doing it happily.

          • techqueen333
            February 25, 2014 at 9:13 am #

            You are wrong. There you go making false assumptions again. Typically, formula is recommended during growth spurts when baby nurses more frequently. Mothers call to find out if this is normal. Now, we aren’t talking about situations where baby is losing weight, isn’t pooping or producing wet diapers. We are simply talking about frequency while supply builds to meet the new demand. Formula is digested more slowly than human milk and formula fed babies go longer between feeding. Suggesting formula cuts down on phone calls to the pediatricians office but it also is counterproductive in terms of increasing milk supply. Other examples include “helpful” HCP who insist mom should allow dad/mom2 to give relief bottle at night, etc. Concerns about the benefits of exclusive BF are dismissed. Concerns about the effect of giving relief bottles on supply are dismissed. Concerns about nipple confusion are dismissed.

          • The Computer Ate My Nym
            February 25, 2014 at 9:23 am #

            Typically, formula is recommended during growth spurts when baby nurses more frequently.

            Semi-anecdotally, my daughter’s pediatrician never suggested formula at any point. When I was rotating through pediatrics, no pediatrician said, “formula should be used during growth spurts” nor did the textbooks recommend any such thing. For that matter, my mother reports no particular pressure from my pediatrician to formula feed me as a baby. Up to date pushes breast feeding and, if anything, overstates the benefits. So where does this concept that formula is needed during growth spurts (assuming the baby is happy and well fed during them) even come from?

          • The Bofa on the Sofa
            February 25, 2014 at 9:27 am #

            o where does this concept that formula is needed during growth spurts (assuming the baby is happy and well fed during them) even come from?

            Oh, I would not be surprised if the topic came up…when mothers expressed concern. For example, they complained to the pediatrician that their baby just seems to want to nurse all the time, and they can’t deal with it any more. Naturally, the doctor says, let them have some formula to give yourself a break.

            But that’s not good enough for assholes like techqueen. Nope, moms are nothing but milk cows that have to have a baby attached all the time.

            How dare pediatricians offer moms solutions for relief?

          • The Computer Ate My Nym
            February 25, 2014 at 9:33 am #

            Certainly if the mother brought up concerns, but my reading of techqueen’s comment was that it implied that doctors spontaneously recommended formula for a healthy baby who was growing and feeding well and a mother who had no complaints about breast feeding. I guess the statement about helping the mother at night does imply a problem, i.e. not being able to sleep. I don’t see the problem with doing so: everyone will be happier if the mother has more sleep.

            BTW: Has anyone actually seen “nipple confusion” or is there any real evidence that it occurs? My small one much preferred the breast to a bottle (whether expressed milk, pedialyte, or formula) in any circumstance other than when she was starving for lack of milk production on day 2 of her life, but maybe we’re atypical.

          • The Bofa on the Sofa
            February 25, 2014 at 9:40 am #

            Certainly if the mother brought up concerns, but my reading of techqueen’s comment was that it implied that doctors spontaneously recommended formula for a healthy baby who was growing and feeding well and a mother who had no complaints about breast feeding.

            Yes, that is what she is implying, but I don’t believe it for a second. In fact, it was the statement about the “relief” bottle that tipped it off – I have known a lot of people to give that advice, to let dad give a bottle at night. but it always in response to mom being overwhelmed, or to prevent mom from getting overwhelmed.

            That similarly applies to a growth spurt. Having a baby that eats constantly is not easy for mom while she’s breastfeeding. Therefore, supplementing with a bottle can help.

            As for the “it hurts supply” claim, it’s idiocy. If a baby is on a growth spurt and nursing non-stop, giving a bottle so that you can get back to 8 feedings a day is not going to hurt anyone’s supply, for pete’s sake.

          • techqueen333
            February 25, 2014 at 7:49 pm #

            You are incorrect on all counts. Further in almost every case, the mother was complaining about being told to give a “relief” bottle.

          • Young CC Prof
            February 25, 2014 at 9:44 am #

            Mine liked the bottle, but he was exceptionally tiny with an ineffective latch, and I have very wide flat nipples, so I imagine the issue was that he preferred eating something to eating nothing.

          • Irène Delse
            February 25, 2014 at 11:55 am #

            Anecdotally, what I’ve seen in my family was:
            A) Two children were combo-fed for practical reasons (mom working) and had no trouble going from breast to formula bottle until 6 or 8 months of life, after that it was formula with solids introduced progressively. Both never had a pacifier but sucked their thumb from birth until well into toddlerhood.
            B) Two babies exclusively formula fed due to health issues (of the mom for one, of the baby for the other). Both loved their bottles, had no pacifiers and sucked on their fingers instead.
            C) One baby who was near-exclusively breastfed for the first six months of life, with the occasional bottle of pumped milk or formula when mom had to be absent, with solids progressively introduced then in addition to breastmilk, and who continued to occasionally breastfeed as a treat until 2 1/2 years old. Interestingly, that one wasn’t keen on bottles, whether they contained breastmilk, formula, plain water or fruit juice, preferring a sippy cup for water or juice. But that baby also loved sucking on a pacifier when not eating! So here there was no confusion at all, the baby distinguished between the nipples on breast, bottle and pacifier, and expressed clear preferences for one “natural” as well as one “artificial”.

          • fiftyfifty1
            February 25, 2014 at 7:47 pm #

            “BTW: Has anyone actually seen “nipple confusion” or is there any real evidence that it occurs?”

            No scientific support for this idea.

          • techqueen333
            February 25, 2014 at 7:48 pm #

            In nine years of working with breastfeeding mothers on a daily basis, I saw many, many, cases of nipple confusion. This led to extreme frustration for mothers and babies. Of course, you can go ahead and dismiss this and everything else that doesn’t fit your schema.

          • NoLongerCrunching
            February 25, 2014 at 7:59 pm #

            I believe from MY experience that what we used to think was nipple confusion is actually one of two things: 1. The baby had latching difficulties from the get-go, hence the need to introduce the bottle; the bottle did not cause the latch issue but its use was rather the result. 2. Flow preference either because mom has low supply, or a fast-flow bottle was used.

          • techqueen333
            February 25, 2014 at 8:12 pm #

            Neither of those were evident in most of the cases I saw. It DOES take more work for baby to nurse from mom than from the bottle. Babies can develop a flow preference because the milk is always going to come out of a bottle faster, at least until the let down occurs. Some babies develop tongue thrust as a result of fast-flow bottle use and it causes a real problem for latch and efficient nursing.

          • The Computer Ate My Nym
            February 26, 2014 at 10:46 am #

            So if the mother prefers bottle feeding and the baby prefers bottle feeding, where’s the problem?

          • techqueen333
            February 28, 2014 at 7:16 am #

            Breast feeding is superior in terms of nutritional and immunological properties. The differences are not trivial. If mom prefers bottle feeding and chooses that, she should understand that she’s making a conscious choice to provide an inferior food. Information should not be withheld because every wants to be touchy feely. As far as what the baby prefers, since when do we alliow infants to make parenting decisions?

          • NoLongerCrunching
            February 28, 2014 at 8:24 am #

            You’d have to live under a rock not to know that breastfeeding is better. It even says so on the formula cans. But it is obvious through research and parents’ experience that formula is good enough for all practical purposes.

          • techqueen333
            February 28, 2014 at 11:32 am #

            Oh, but it IS obvious through research and frequently there are negative consequences to using formula. The research is simply ignored and HCP don’t push it because it’s inefficient and bad for business.

          • Stacy21629
            February 25, 2014 at 8:31 pm #

            @techqueen…as a PhD married to an MD you understand the importance of research. Please provide us with the research demonstrating the existence of “nipple confusion”. We want to practice evidence-based medicine after all.
            But if you’re going to go on anecdata – both of my children were given their first bottle within the first 5 weeks of life. No nipple confusion at all.

          • ngozi
            February 25, 2014 at 10:16 am #

            I just want to say that my son’s pediatrician didn’t suggest formula even when my son wasn’t gaining enough weight according to what was deemed textbook normal. As long as he was gaining weight, he didn’t feel that it was a problem. He suggested I continue to breastfeed as long as I felt good about doing it. I just want to show that not every pediatrician is pushing formula for every little feeding issue.

          • techqueen333
            February 25, 2014 at 7:46 pm #

            You are right. I oppose relief bottles. You are right, It isn’t good enough considering that often impacts milk supply and deprives babies of benefits of exclusive breastfeeding, none of which are “trivial.”
            I will ignore your name calling.

          • NoLongerCrunching
            February 25, 2014 at 7:49 pm #

            Hence the need for a Mother Friendly Breastfeeding Policy. If a mother wants to give a relief bottle, because SHE FEELS SHE NEEDS RELIEF, who are you to oppose that?

          • techqueen333
            February 25, 2014 at 7:50 pm #

            It’s about the baby. The mother is the grown up in the equation.

          • NoLongerCrunching
            February 25, 2014 at 8:01 pm #

            So she should not get relief even once a day? Way to encourage PPD.

          • techqueen333
            February 25, 2014 at 8:07 pm #

            Way to use hyperbole.

          • Elizabeth A
            February 25, 2014 at 8:27 pm #

            Isolation and exhaustion are real factors in PPD, so denying mothers relief actually really does encourage the condition. Not hyperbole at all.

            But you seem to love throwing the term around, so knock yourself out.

          • Kelly
            February 25, 2014 at 9:37 pm #

            I just decided to exclusively pump and give my daughter a bottle because I was on my to PPD with breastfeeding. (This also happened with my first daughter). Extreme lack of sleep and the stress of breastfeeding were a bad combination for me. I was able to get six hours of uninterrupted sleep as my Mom and husband both took a night feed for three days so that I could finally catch up. Even when breastfeeding, I had my Mom or husband give the baby a bottle to give me some sleep. It is the only reason I was not worse off than I already was. Women should not feel bad about giving the occasional bottle in the beginning in order to stave off depression.

          • Young CC Prof
            February 25, 2014 at 8:07 pm #

            As I previously demonstrated, caregiver violence and accidental injury are the big threats to babies, not disease. Hence, a mother who sleeps enough to be patient and alert is vitally important.

          • Stacy21629
            February 25, 2014 at 8:39 pm #

            Suck it up you weenie! Slap some lanolin on those bleeding boobs, get your lazy butt out of bed and take care of your screaming hungry child! Grow up!

          • NoLongerCrunching
            February 25, 2014 at 8:43 pm #

            No no no. If her boobs are bleeding she’s “doing it wrong” because breastfeeding doesn’t hurt!!!!1! Get that child some craniosacral therapy and cut any frenulum in his mouth you can find, stat!

          • Mishimoo
            February 25, 2014 at 8:53 pm #

            I had a surgeon ask me if that was the current fad diagnosis, because he’d had a few consults about lip ties recently. The mums insisted on having them snipped even though there was no reason to do so. He tried to explain the mechanics involved in suckling and that sometimes it’s just that the mother can’t produce enough milk, but they didn’t want to listen to his suggestion of mix-feeding or changing to formula instead of surgery.

          • NoLongerCrunching
            February 25, 2014 at 9:07 pm #

            IMO tongue tie is way overdiagnosed, so when a real TT-related sucking difficulty occurs, doctors are going to roll their eyes rather than take us seriously. I feel terrible about those babies getting unnecessarily clipped. For truly severe TT, absolutely; but leave the rest alone ffs!

          • Mishimoo
            February 25, 2014 at 9:17 pm #

            I agree! He did take my curiosity seriously though, and that prompted the interesting discussion.

          • techqueen333
            February 28, 2014 at 11:44 am #

            If her nipples are bleeding, she probably is doing it wrong.

          • NoLongerCrunching
            February 28, 2014 at 11:56 am #

            If you truly have experience in this field, you know very well that there are many causes for damaged nipples that have nothing to do with how the mother is breastfeeding (tongue-tied baby, flat nipples, dysfunctional suck, vasospasm etc etc). Not everybody wants to pursue fixing these things and waiting for their nipples to not feel like they’re being stabbed 8x/day for as long as it takes to improve.

          • techqueen333
            February 25, 2014 at 7:44 pm #

            It comes from people who would rather recommend formula than answer phone calls from mothers.

          • NoLongerCrunching
            February 25, 2014 at 7:46 pm #

            Can’t you see how insulting it is to assume those people are putting their own convenience above the health of their patients? Do you like it when HCPs malign lactation consultants? Why not be professional and assume positive intent? This isn’t the 1950s anymore.

          • techqueen333
            February 25, 2014 at 7:54 pm #

            Actually, I got that line from my MD husband.

          • NoLongerCrunching
            February 25, 2014 at 8:03 pm #

            So because he is an MD, that gives him the right to insult his colleages? I doubt he would appreciate being treated that way.

          • techqueen333
            February 25, 2014 at 8:16 pm #

            I’ve heard pediatricians explain it that way and OBs. Doctors go to parties, picnics, and other events. Doctor families exchange babysitting. These things come up.

          • fiftyfifty1
            February 25, 2014 at 8:03 pm #

            You do sometimes find the lactivist doctor-wife couple (somehow it is never a lactivist doctor-husband couple, you can draw your own conclusions about why). In any case, there are a few lactivist doctor-wife couples out there. They tend to be painfully self-rightous and often religion motivated with strict gender roles and firm ideas about what makes a “good woman”. In my experience, they tend to spend LESS time on the phone or in clinic listening to and helping their patients. A lot of “do what I say, I’m the doctor”.

          • techqueen333
            February 25, 2014 at 8:15 pm #

            I’m borderline atheist. So much for that assumption. I have a PhD, taught college and now work as a researcher. My husband is the chief of surgery at a large hospital. Not exactly the Ephesians couple.

          • Elizabeth A
            February 25, 2014 at 8:29 pm #

            You’ve mentioned the PhD a bunch of times. What’s your field? What did you teach? What do you research?

          • fiftyfifty1
            February 25, 2014 at 7:56 pm #

            “It comes from people who would rather recommend formula than answer phone calls from mothers.”

            Please. I spend a lot of time on the phone and am glad to do it. And when I am concerned about a newborn’s feeding status, parents get my home phone number so they can reach me directly after hours if there is a problem. I also recommend formula when it is indicated: a baby inconsolable with hunger and/or an exhausted mom are both excellent indications.

          • techqueen333
            February 28, 2014 at 7:37 am #

            You are an n of one.
            Exhaustion passes once the growth spurt is over. Moms should understand what they are giving up so they can make informed decisions based on science instead of the emotion du jour.

          • fiftyfifty1
            February 28, 2014 at 8:14 am #

            Exhaustion is cumulative and has real health consequences. The mother as well as the baby are my patients. I’m not going to overlook the mother’s health because it is your personal opinion that she is making decisions on a whim. I thought that claiming that women can’t be trusted to make their own decisions because they are at the mercy of “emotion de jour” went out in the 1960s.

          • techqueen333
            February 28, 2014 at 11:43 am #

            Yet you are willing to withhold critical information from her because in your personal opinion a quick fix is better than a long term solution.
            In many situations, critical period is brief. Yet giving baby formula not only denies him/her the immunological and nutritional benefits of exclusive breastfeeding, it interferes with a system that is essentially supply and demand. Those supplemental bottles are often more of a problem than they are worth.

          • NoLongerCrunching
            February 28, 2014 at 12:03 pm #

            Show me ONE study that shows health consequences to a little formula supplementation in a mostly breastfed baby. Adding formula may change the gut flora (which no one has shown to have any long term effect), but it does exactly squat to “deny him/her immunological and nutritional benefits” of the breastmilk he does get.

          • The Bofa on the Sofa
            February 25, 2014 at 9:23 am #

            Wait a minute. You claimed above that they were _pressured_ into giving formula. Now you say that it was just “formula was recommended during growth spurts”?

            Why were the mothers even talking to the doctors if they were happily breastfeeding? Was it because they had some concerns?

            Other examples include “helpful” HCP who insist mom should allow dad/mom2 to give relief bottle at night, etc

            …in response to mom complaining about being exhausted, of course.

            What a sleazeball you are. Seriously. You talk about dismissing concerns, but you have absolutely no concern about mothers in the least. You are absolutely as Dr Amy describes, a complete zealot.

          • techqueen333
            February 25, 2014 at 7:43 pm #

            Multiple reasons. None of which have to do with health concerns.
            Sleazeball? The only thing you’ve done here is ridicule.

          • FormerPhysicist
            February 25, 2014 at 8:03 pm #

            It *was* suggested to me to let my husband give the baby one bottle a day, starting around 6 weeks. I had no complaints about how breast-feeding was going.
            This was suggested along with “if you want your child to be willing to take a bottle at 3 or 4 months, it may be wise to introduce one fairly early.”

          • NoLongerCrunching
            February 25, 2014 at 9:27 am #

            Unless you were there, you don’t know whether it was pressure or just an option that was put out there.

          • techqueen333
            February 25, 2014 at 7:41 pm #

            The mothers described it as pressure.

          • NoLongerCrunching
            February 25, 2014 at 7:42 pm #

            I believe it. But I have seen enough situations to know that the HCPs themselves do not think they are pressuring, but rather trying to help the situation by presenting all options. What a patient hears is not always what was said.

          • techqueen333
            February 25, 2014 at 9:07 am #

            Yes, they were really getting enough milk.
            That comment about the joke while serious topics were discussed is crap. I do remember a Ka-Boom comment from the person with whom I was speaking at the time. You don’t get to dismiss me because you don’t like my attempt to lighten the situation.

          • Anj Fabian
            February 25, 2014 at 9:25 am #

            I find the giving sugar water instead of formula to be mostly a cost saving measure more than anything.

            The first two ingredients in formula are:

            Formula IS sugar water, with additional nutrients.

          • techqueen333
            February 25, 2014 at 6:27 am #

            Yes, I am saying that my friends’ children were happily breastfeeding and HCP pushed formula.

          • Lizz
            February 27, 2014 at 5:39 am #

            What does pushing mean to you exactly? Is it a “here have a sample to take home just in case” or a ” their weight’s down a bit maybe a bottle would help” or are we talking about an honest to goodness and literal “you should be giving them formula right now”?
            To be honest I’ve seen to many people call having an ad up in the office or offering a sample just in case as pushing formula and neither really is.

      • Dr Kitty
        February 24, 2014 at 3:46 am #

        So, without any formal qualifications your husband or another Dr let you “work with” their patients?
        On a voluntary basis like a LLL leader?
        Was it a BF support group that met in a Dr’s office?
        Or were you paid?

        What made you give it up?

      • The Computer Ate My Nym
        February 25, 2014 at 9:16 am #

        So what is your PhD in? What was your thesis topic? Have you published in the field in the peer reviewed literature since?

        • techqueen333
          February 28, 2014 at 7:07 am #

          It doesn’t matter. I had two semesters of quant, one of qual, one of research design. I passed a qualifying exam and wrote a successful dissertation. I have been published in peer reviewed journals and am co author on several books.

          • The Computer Ate My Nym
            February 28, 2014 at 12:01 pm #

            It does matter. If your PhD is in, say, ancient Greek literature or astrophysics, you are no more qualified than any other lay person to comment on medical issues.

  6. February 22, 2014 at 6:44 pm #

    I have a question for nikkilee and techqueen. Do either of you have any reaction to the situation with Jan Tritten and that poor dead baby? It is addressed in the two most recent posts. Have you even noticed things happening outside of lactivist land? Does it affect you at all?

    • Karen in SC
      February 23, 2014 at 10:18 am #

      Apparently not. They will keep their blinders on. What I find interesting is they have not really considered practicalities and the real world. It seems to be techqueen’s belief that low supply is rare and mothers that formula feed are lazy or have been misled. Not at all that for many families, FF is the BEST choice for so many reasons.

      And I say that as a mother who BF two babies for two years each. It’s not magic. It was just easier for me as I was able to be a stay at home parent.

      • techqueen333
        February 23, 2014 at 10:40 am #

        I worked with breastfeeding mothers for nine years in collaboration with my MD husband.
        Keep on deluding yourself that FF is best. It might be for practical reasons, but certainly not for health reasons. They are in no way equal.

        • Dr Kitty
          February 23, 2014 at 10:51 am #

          No…you’re right…
          If you have to return to your low wage job six weeks after the birth,your bosses won’t give you breaks to pump,and the choice is between FF and paying the bills or going on welfare, losing your home and having your kids go hungry.

          “Practical reasons” are in no way equal to a possible 3 point increase in IQ and a slightly reduced risk of allergies.

          • techqueen333
            February 24, 2014 at 2:06 am #

            In many states, employers are required to make accommodations for breastfeeding mothers. If you are working at a low wage job, I’m wondering how you are affording formula.
            There are more advantages to breastfeeding than what you list.

          • Dr Kitty
            February 24, 2014 at 4:11 am #

            And yet, somehow, most women in low paid jobs have done the maths for themselves and have made the choice to use formula.

            Which suggests that practically, it is the choice which works out best for them.

            BF is only free if you don’t count the extra calories and fluid for mum, or her time. If you have to take unpaid breaks to pump, it is going to cost a hell of a lot more than formula.

          • The Bofa on the Sofa
            February 24, 2014 at 10:17 am #

            And yet, somehow, most women in low paid jobs have done the maths for themselves and have made the choice to use formula.

            But see, this is the problem. YOU assume that women, even those in low paying jobs, have thought about the issue and made a careful decision. They are well aware of the breast is best message, but have made a decision based on their own circumstances.

            techqueen assumes that women are mindless morons and too stupid to actually consider it thoughtfully.

            Although she won’t admit it.

          • techqueen333
            February 25, 2014 at 7:02 am #

            I won’t admit it because it’s not true. I never said low income women were stupid morons. That is not what I think at all. What I do think is that you enjoy ridiculing people you don’t like, e.g. me.

          • techqueen333
            February 25, 2014 at 6:18 am #

            Your opinion. Most of the women I’ve met in low paid jobs (and that’s in the hundreds) FF because of cultural norms that communicated that BF was “nasty” or because they didn’t want to pump.

          • AlisonCummins
            February 25, 2014 at 6:24 am #

            How many reasons can you think of for an underpaid worker and mother not to be interested in dedicating hours a day to pumping?

          • Guestll
            February 24, 2014 at 10:05 am #

            Wow, classist, smug, and ignorant. Trifecta of lactivist drivel.

          • techqueen333
            February 24, 2014 at 10:33 am #

            Oh, please. Why don’t you actually say something instead of name calling. Nothing in your statement is even remotely true.

          • Young CC Prof
            February 24, 2014 at 10:45 am #

            Let me put it a bit more nicely. Have you ever asked an employer for a legally required accommodation that he didn’t want to provide? It’s a very ugly experience. Welcome to the back of the promotion line and the top of the shit list. And if your employer decides you are more trouble than you’re worth, even if you are inconvenient for a legally protected reason, he’ll look around until he finds a legal reason to fire you.

            Employment discrimination against women in general is a tiny fraction of what it was a generation or two ago. Discrimination against mothers, however, is still alive and well. And any attempt to judge the choices of other mothers, especially those in precarious economic situations, must take that into account.

          • techqueen333
            February 24, 2014 at 11:17 am #

            Young CC professor
            I am personally familiar with that situation. My daughter is a teacher in a large urban school system. In her state, employers are required to make accommodations for pumping, etc. Her principal did not want to do so. Fortunately, my daughter has the protection of the union, of being tenured, and having the support of parents. She has been able to pump at work without consequence. I can certainly appreciate what you are saying and know others aren’t so lucky. I feel compassion for those mothers. A focus of my activism (in addition to creating a culture that supports nursing) is actually focused on effecting change for mothers in the workplace, paid family leave, and affordable child care. Those are not exclusive.

          • Guestll
            February 24, 2014 at 10:51 am #

            Do you truly fail to understand how and why low income earners afford and avail themselves of formula? If so, that makes you ignorant, and that isn’t just name calling, it’s a statement of fact.

        • MLE
          February 23, 2014 at 11:00 am #

          Once again, WHO SAID FORMULA IS BEST? That’s right, no one. We are only stating that there are marginal advantages conferred by breast feeding but women who cannot or do not want to breast feed shouldn’t be wracked with guilt due to the exaggeration of formula’s perils from insensitive, callous, feeding martinets such as yourself.

          • perpetual lurker
            February 23, 2014 at 11:05 am #

            Dr. Kitty is absolutely right. Karen in SC did not say FF is best. She said when weighing circumstances, risks and benefits, for many families FF is best. Could it be that techqueen333 is using – duh duh duh – a straw man?

          • Karen in SC
            February 23, 2014 at 11:41 am #

            Thanks. I edited my original post to clarify my meaning.

          • techqueen333
            February 24, 2014 at 1:57 am #

            Did I say that Karen in SC said FF was best, perpetual lurker? No. Duh duh duh–a straw man?

          • techqueen333
            February 24, 2014 at 1:56 am #

            The advantages are not marginal. Women who cannot breastfeed, cannot. But, women who choose not to should be able to do so in the knowledge that they are denying their babies those advantages.
            No exaggeration of formula’s perils. They are well documented.
            Save me the ridicule…although I am impressed with your vocabulary…martinet…hmmm

        • MLE
          February 23, 2014 at 11:08 am #

          Not to mention that no one cares about your MD husband. It means exactly squat about your level of knowledge. Let your arguments stand or fall on their own.

          • LibrarianSarah
            February 23, 2014 at 3:51 pm #

            You’d think that women have made enough strides in the past 60+ years that we wouldn’t have to glean on to our husbands accomplishments in order to try to give ourselves a heightened perceived status.

            Seriously no one gives a shit that your husbands an MD.

          • techqueen333
            February 24, 2014 at 2:03 am #

            Wow if that isn’t a red herring….
            My inclusion of his opinion has nothing to do with my leaning on his accomplishments. It’s another qualified voice.
            You don’t give a shit because he doesn’t agree with you.

          • Guestll
            February 24, 2014 at 10:03 am #

            No, we don’t give a shit because we don’t give a shit.

            He may be another voice, but it’s not him writing here.

            Your argument is either worthy of merit, or it isn’t.

          • techqueen333
            February 24, 2014 at 10:35 am #

            I don’t see what this personal attack contributes.

          • Guestll
            February 24, 2014 at 10:45 am #

            I’m not attacking you personally. I’m saying we don’t don’t give a shit that your husband’s an MD, because he isn’t the one posting, and your words either have value or they don’t, irrespective of your husband’s education.

            If I wanted to make this personal, I’d tell you that it’s because I listened to militant know-nothings like you that my daughter dropped from the 90th percentile into FTT, that I took Domperidone for 14 months in order to make enough milk to give my hungry child the bare minimum, that I tortured myself for not being good enough, because people like you and their bad science convinced me that formula would ruin her life. That would be making it personal.

          • techqueen333
            February 24, 2014 at 11:41 am #

            I’m truly sorry for your terrible experience. However, I didn’t do it to you and do not deserve to bear the brunt of your anger. Nor do I merit being included is your broad generalization called militant know nothings. Nor do I rely on bad science.

          • techqueen333
            February 25, 2014 at 6:58 am #

            You really enjoy saying shit, don’t you? Maybe you’d prefer to spend your time reading Rabelais or studying the mating habits of coprophagic beetles to posting here.

          • Susan
            February 24, 2014 at 3:21 pm #

            TechQueen– I am also married to a highly educated professional. Not only would I not say ” he thinks so too” I resent it when people think I know X, Y , Z simply because I somehow through osmosis have his opinions or knowledge base. I don’t always share is opinions and though what we know overlaps a bit its far from the same knowledge base. I recommend you not say “my husband is a doctor and he thinks….” to bolster your position. If you want to talk about your experiences as the spouse of a doctor that’s valid, but using his opinion as a way to make your own seem more valid really accomplishes the opposite.

          • techqueen333
            February 25, 2014 at 6:40 am #

            I’m irritated by this false assumption. I am not saying that my husband is a doctor to bolster my opinion. I’m sharing his opinion along with mine.

          • LibrarianSarah
            February 26, 2014 at 10:27 am #

            I don’t give a shit because your husband’s degree (as well as your own) is a textbook red herring you massive hypocrite. It is completely irrelevant to the topic at hand. Arguments stand and fall on there own. And seeing that Young CC professor had to hold her hand and guide you thought the process of actually making an argument I think it is time for you to go back to school. Unfounded claims are not arguments. Copying and pasting abstracts is not an argument. Randomly posting logical fallacies is not an argument. Appeals to authority is not an argument.

            Go out and find what you feel is the best study that makes your point, link to it, and summarize what you think it says and why it supports your point. Then we can have a discussion on why we agree or disagree with you. If you can’t handle that gtfo and stop trying to have the last word.

          • techqueen333
            February 28, 2014 at 7:23 am #

            Nice vulgarity and name calling. In what ways does inability to control your anger and express yourself civilly moves this discussion forward?
            That wasn’t a red herring, dear. It was a direct response to a question put to me.
            Further, Young CC Professor guided me through NOTHING. I simply decided to take the time to respond to his/her question in a different way because she/he was civil and because I had more time that day.

          • techqueen333
            February 24, 2014 at 2:02 am #

            His voice is just as important as mine. Why should his vote be ignored just because he isn’t typing in the boxes?

          • KarenJJ
            February 24, 2014 at 8:10 am #

            Then he can post in here and argue with us. We can only go buy the words you write in here.

        • Karen in SC
          February 23, 2014 at 11:51 am #

          As my Chem Eng professor Dr. Grice told me many years ago:

          There’s the joke about the mathematician and engineer who find themselves in a room with a beautiful woman. She fluffs her hair and says, “Either one of you can have me–”

          She holds up her hand as they start to rush forward. “But to touch me, you have to go half the distance to me, then half the distance that’s left, then half the distance after that, and so on.”

          The mathematician throws his hands up and walks away because he knows he’ll never get there…but the engineer keeps going because he knows he’ll get close enough for practical purposes.

          You imply that formula is vastly inferior, even sub-human from the posts you’ve written. Probably most of the posters who replied have actually breastfed themselves (or their wives) but we don’t think that way. We believe formula is “close enough for practical purposes.”

          • techqueen333
            February 24, 2014 at 2:01 am #

            “Sub human?” I don’t think I said that.
            I do not agree that formula is close enough for practical purposes.

          • Karen in SC
            February 24, 2014 at 8:22 am #

            Well, I wrote that you “implied” it, not said it. And it’s my opinion that you are implying that formula is not fit for humans, ie sub-human.

        • Box of Salt
          February 23, 2014 at 12:36 pm #

          techqueen333 “It might be for practical reasons”

          You HAVE to deal with the practical reasons.

          Exaggerating the “health reasons” beyond the truth cannot help families find solutions for the practical issues.

          • techqueen333
            February 24, 2014 at 2:00 am #

            No one is exaggerating the health reasons. I am all for trying to resolve the practical issues. I just prefer to resolve them without formula use, where possible.

        • LibrarianSarah
          February 23, 2014 at 3:45 pm #

          “Keep on deluding yourself that FF is best”

          Now THAT techqueen333 is a strawman.

          • Young CC Prof
            February 23, 2014 at 3:52 pm #

            Wish I could upvote this more than once. I’m a little tired of hearing every counterpoint inaccurately described as a straw man. Turning “breast milk is only slightly better” into “formula is better” is a prime example of a straw man. Completely changing someone’s argument in order to counter it more easily.

          • techqueen333
            February 25, 2014 at 6:56 am #

            I know what a straw man is, Young CC Prof. You are a cc prof (I’m assuming that stands for community college). I was a liberal arts college prof (16 years) and am now a researcher at a major university. I’d say there’s a good chance my vocabulary is at least as good as yours. In this case, I perceive that people responding to my posts here ARE consistently attempting to change my arguments in ways consistent with building straw men. Typically, they take one point, twist it and then build their argument. I read their response and say, “What? That’s not what I said!!!!”

        • Jocelyn
          February 24, 2014 at 1:10 am #

          “Keep on deluding yourself that FF is best. It might be for practical reasons, but certainly not for health reasons.”

          Techqueen333, due to medical conditions that I have, I am normally on a very limited diet. Recently we have discovered that my four-month old daughter has food allergies, and to continue breastfeeding I have had to cut almost everything out of my already very limited diet. Just in the past few weeks I have dropped almost six pounds (almost into the “underweight” category for my height) and it is very clear that I am not getting the nutrients that I need. For the time being, we have switched my daughter over to a formula that has entirely cleared up her allergies, including her thick, red, itchy, bleeding rash and her constipation.

          Tell me, which option was better for our health?

          • techqueen333
            February 24, 2014 at 3:04 am #

            For you to review your diet with a nutritionist. It is probable that you could have added things back in. You may not have eliminated the right thing.

            My daughter was allergic to cow’s milk, soy, and peanut in my diet. I lost a lot of weight by eliminating everything containing those things, but was able to work with a nutritionist to find substitutes.

            In this case, I was actually encouraged to continue nursing by the pediatrician. Her feeling was that even if they were able to find a formula she could tolerate, she might develop an allergy to that to. Then we would have been screwed. I (me personally) saw this happen many times during the nine years I worked with nursing moms. The mom would quit and then find out the baby couldn’t tolerate formula. Re-lactation is not easy…but had to be attempted in these cases.

            You might get lucky in your daughter’s case and you might not.

    • The Bofa on the Sofa
      February 23, 2014 at 10:30 am #

      They’ll just tell you to look it up

    • techqueen333
      February 23, 2014 at 11:15 am #

      I find the use of the word “lactivist” pejorative. It makes me not want to read your question.

      My first reaction to the Jan Tritten question here is that it’s a separate issue entirely. We were talking about breastfeeding. Do you assume that because you disagree with me on one issue that we will disagree on all issues related to birth and childcare?

      I’m not a fan of home births where they can be avoided (remote rural, emergency, etc). I say that even though (a) I am suspicious about the correlation between the huge jump in c-sections (which has remained high) and the malpractice crisis during the 70s and 80s, (b) though I disagree with certain hospital protocols and practices, (c) I’m aware of staph and other dangers in hospitals. I’m sure I will be flamed for each of those comments. My husband and I read the research, which shows some scary data re: mortality and other bad outcomes of home birth. We took into account concerns about regulation of midwifery (where is the accountability). We considered that despite fears about hospital germs, we knew the germs in our clean home (with pets) stood to be worse. We didn’t want the mess. I am also not convinced (not based on data, only my feelings and my knowledge of my children) that is was desirable or necessary for them to watch their mother give birth. We came to the conclusion that hospital births in birthing rooms would be safer, yet would address our desire for a certain type of setting.

      I am not intimately familiar with the specifics about the Tritten case. I only know two things: 1) she collaborated with other midwives on Facebook on a high risk the case and 2) her decision making ended in the unspeakable horror of a baby’s death. I think the birth should have occurred in the hospital where better monitoring and greater resources for dealing with emergencies are available. Any questions?

      Before you ask, I’ll anticipate your question about vaccinations. I am militantly pro vaccination. Again. I’ve read the research. Go ahead and flame me for it.

      • February 23, 2014 at 11:29 am #

        Flame? No way. Those are actually some pretty reasonable reactions. I’m surprised, given your posts here. Well, clearly you can indeed do some research. I don’t know what’s the deal with how incredibly off base your breastfeeding arguments are, but this an overall pretty reasonable response. Defensive, but that’s reasonable enough all things considered. Good for you, no sarcasm.

      • Young CC Prof
        February 23, 2014 at 11:37 am #

        Wow. You explained your reasoning, including your reasonable anxieties about hospital birth and why you chose it anyway. I am very impressed.

      • Susan
        February 24, 2014 at 3:12 pm #

        Me too. Great explanation and reasonable!

    • nikkilee
      February 23, 2014 at 11:16 am #

      I have all I can do to deal with breastfeeding, already a hot topic. Going into another arena is too much for me.

      • Box of Salt
        February 23, 2014 at 11:57 am #

        nikkilee, “I have all I can do to deal with breastfeeding”

        Is this why you can’t acknowledge the gains already accomplished for breastfeeding?

        Honestly, you need to re-examine your goals, your attitudes, and your tactics.

        What exactly are you trying to accomplish? Mandatory breastfeeding for all women and babies, whether or not the mother is capable or desires to do so?

        If you goals are more nuanced, such as better support of breastfeeding for those who want to from both medical staff and the public, your arguments need to be more nuanced. You can’t continue recycling the same talking points from the previous century. Many of those are simply no longer accurate.

        You also need to step into the real world, and take a look at the real reasons women do not breastfeed, or stop breastfeeding earlier than you’d like. Why not focus your energy into lobbying the federal government for longer, paid maternity leaves which would allow breastfeeding women to continue past just a few weeks without fearing loss of income?

        The “breast is best” message is already here. What’s needed is better ways to implement it. None of them require exaggerating harms from formula nor inflicting guilt and punishment on women who use formula.

        • nikkilee
          February 23, 2014 at 12:39 pm #

          I meant that I have a full plate educating people about breastfeeding so it becomes a cultural norm, so that women don’t have to hide when their infants need to eat outside the home, and so that families have all the information about feeding choices. As birth is another loaded political arena, I’ve chosen to pick my battles for my own comfort level; even though the consequences of labor and birth have an impact on breastfeeding.

          Industry does not give all the information about its product; industry actually derailed the HHS breastfeeding promotion campaign of 2003, because if the public knew all the information about the health risks of formula, they might not buy as much and industry needs profits.

          That ad campaign is discussed in detail in this article by the Washington Post; the article is well-referenced.

          • Captain Obvious
            February 23, 2014 at 12:44 pm #

            You didn’t answer the question.

          • nikkilee
            February 23, 2014 at 12:46 pm #

            What I am trying to accomplish is culture change.

          • Captain Obvious
            February 23, 2014 at 12:49 pm #

            I think all women know breastfeeding is good. Weigh that to some people have difficulties, go back to work, husband wants to participate, etc etc , women decide what works for their situation. It doesn’t have to be the cultural norm.

          • Anj Fabian
            February 23, 2014 at 12:55 pm #

            Women know that breastfeeding is good.
            Women know that formula feeding is good.

            It’s all good.

            The problem I have is when an activist or sanctimommy (It’s difficult to tell them apart, much like it’s difficult to tell a formula fed baby from a breastfed baby.) tell women that one of those choices is not good, or not good enough.

          • techqueen333
            February 25, 2014 at 6:51 am #

            But breastfeeding and formula feeding are not equal. It is intellectually dishonest to claim they are.

          • AlisonCummins
            February 25, 2014 at 6:53 am #

            Who said they were equal?

          • The Bofa on the Sofa
            February 25, 2014 at 7:40 am #

            Well, at least she’s backed off from the “quit saying formula is better” nonsense.

            It’s the same old problem we always see. “Formula is ok”

            “Stop saying formula is better than breast milk!!!!!!”

            It has to be the #1 strawman that comes up here, and techqueen fell right for it.

          • Dr Kitty
            February 23, 2014 at 12:58 pm #

            The only people who need to support your choice to BF are you and your partner.

            Haters gonna hate. Ignore them.
            I BF my daughter until she was over a year. Locally les than 10% are breast feeding at 6months.My solution to the culture of FF being normal was not to GAF what anyone else thought about my choices.
            People might have given me funny looks, I couldn’t tell you, I wasn’t paying attention. Certainly no-one actually SAID anything to me, because most people aren’t assholes.

            If you are really, truly sure you are doing the right thing you don’t need other people to validate your choice, you just get on with it.

          • nikkilee
            February 23, 2014 at 5:54 pm #

            Not everyone has the lovely GAF attitude you describe. When families are unsupportive, when employers and neighbors are negative, when hospital practices and healthcare staff derail breastfeeding out of ignorance, mothers lose confidence and/or have miserable experiences that lead to bailing out. Especially when it is a first breastfeeding experience; many women have never seen a breastfeeding relationship, and this also makes initiating that relationship difficult.

          • Young CC Prof
            February 23, 2014 at 6:11 pm #

            “Many women have never seen a breastfeeding relationship, and this also makes initiating that relationship difficult.”

            In the USA in 2014? I can’t imagine that. I was breastfed. My younger brother was breastfed. I saw my cousins breastfed. Heck, I’ve seen women on the bus discreetly feeding their infants.

            This was a real problem in the 1970s, and possibly today in areas of the world. But I can’t begin to imagine that it’s a common problem now.

            Unsupportive employers? Absolutely. But neighbors? Relatives? I really doubt it happens much.

          • nikkilee
            February 24, 2014 at 8:00 am #

            It very much depends on the community where she lives. Not all states have laws protecting a baby’s right to eat wherever it is. Nowadays things like “Hooter Hiders” are sold, and women are still harassed for breastfeeding outside their home, even if they are wearing a blanket over their should. There was an incident in Victoria’s Secret recently, where a mother who had just purchased some bras asked to use a dressing room to nurse her baby and was asked to leave the store!


          • KarenJJ
            February 24, 2014 at 8:03 am #

            This stuff makes the news now. How often did that happen 40 years ago?

          • Irène Delse
            February 24, 2014 at 8:17 am #

            The telling point is that it’s uncommon enough to makes the news, and public opinion sides with the mother! Not exactly a cultural environment that discourages breastfeeding.

          • Dr Kitty
            February 24, 2014 at 4:04 am #

            My point is that it would be more effective to support these women by saying “ignore that nonsense! You keep doing what you feel is best and tell them to go to hell!” Rather than to try and “educate” everyone to be nice, or shaming women who decide that, actually BF isn’t best for them.

            No one “has” to use a nursing cover or feed in the car. It is YOUR response to the negativity that determines your actions, not the negativity itself. Indeed, sometimes there IS no negativity, and the woman pre-empts any possibility of it when, in fact, nobody would have given a damn if she had BF in that venue.

          • nikkilee
            February 24, 2014 at 8:30 am #

            Not all women have the psychological makeup, cultural background or learning style to do that.

          • Young CC Prof
            February 24, 2014 at 10:24 am #

            Guess what, if you have kids, people are going to disapprove of the way you raise them. If your two year old throws a tantrum in the store because you didn’t give him cookies, people are going to decide he lacks discipline. However he’s dressed, some people will think he’s too warm or too cold. Whatever you feed him, someone will think it’s unhealthy.

            You can’t please everybody, so what’s the big deal about a few people (and it is just a few) being unhappy with you breastfeeding?

          • Box of Salt
            February 23, 2014 at 1:26 pm #

            nikikilee “What I am trying to accomplish is culture change”

            But that’s happened already. The culture changed. It’s not the 1970s – most people view breastfeeding as normal. Perhaps you are so focused on the pockets of resistance that you can’t see the forest for the trees. Have you failed to notice the Baby Friendly Hospital Initiative and New York City’s Latch On NYC?

            I’ll repeat what I posted before: get out into the real world, and find out why most women aren’t exclusively breastfeeding at 6 months. It’s not because you personally have not put enough effort into fearmongering about the evils of formula.

            The cultural pendulum has swung. Apparently, it hasn’t swung enough for *you.* But if you want to keep it swinging, you need to lay off pushing the extreme arguments, and find nuanced solutions to the more subtle problems.

          • nikkilee
            February 23, 2014 at 6:02 pm #

            As someone who has worked in this arena for nearly 40 years, I must respectfully disagree with you. Yes, there are good changes coming. . .and still far to go.

            One challenge is that people sometimes take evidence about the risks of formula, and the benefits of breastfeeding to mothers, babies, families, and the environment as a personal attack.

            There has to be a big dose of kindness and respect introduced into this infant feeding discussion in our country. It is never about judgement, at least from me; it is about possibility and informed choice.

          • Young CC Prof
            February 23, 2014 at 6:41 pm #

            When a mother has spent days or weeks doing everything possible to breastfeed her child, and ultimately has to admit it will never work, yes, lectures which exaggerate the benefits of breastfeeding and use words like “danger” to refer to formula feeding are attacks. There’s no kindness in humiliating a mother who is desperate to help her child.

            There are two ways in which I fundamentally disagree with you:

            1) After a thorough review of the literature, I believe there is no evidence for a link between infant breastfeeding and a significant difference health outcomes in adulthood. You believe otherwise.

            2) I believe that continuing to tell people that breast is best and formula is harmful is going to upset people without increasing the rate of breastfeeding. Most women already want to breastfeed.

            And as far as demonizing infant formula, remember that the perfect is the enemy of the good, and combination feeding is surely better that no breast milk at all. If combo feeders are alienated, will they give up on the breast entirely? Here’s another saying: You’ve got to meet people where they are if you want to help them get somewhere else. For many families, long exclusive BF just isn’t going to happen, and women who have smaller breastfeeding goals are still more likely to attain them if they have support.

          • nikkilee
            February 24, 2014 at 8:10 am #

            Evidence and belief are two different things. Did you review the thousands of studies and still feel confident refuting every single health organization’s recommendation in the world. Did you check out Table I in the Surgeon General’s Call to Action to support breastfeeding? Is there something behind all the governmental support for breastfeeding. Remember too that breastfeeding doesn’t make money for anyone, so there is no profit motive. Industry can not say that.


          • KarenJJ
            February 24, 2014 at 8:16 am #

            It makes money for lactation consultants.

            I do believe that there is something behind the government’s support for breastfeeding. What there is though is not compelling evidence for individual women to make a decision that they may feel will be detrimental to them in some way. People are going to weigh the risks and take into account their own circumstances.

          • nikkilee
            February 24, 2014 at 8:33 am #

            Few lactation consultants, unless they are working full time in a hospital, can make enough money to live. Whereas the infant formula industry made $3 billion in North America in 2010.

          • anion
            February 24, 2014 at 6:56 pm #

            And I imagine the clerks at Babies R Us who sell tubs of formula aren’t getting rich, either. You can’t compare individual earnings to the profits of an entire industry. How much did all the lactation consultants and makers of supplements for breastfeeding moms and nursing bras and breast pads and nipple shields, etc. etc. combined earn in 2010?

          • nikkilee
            February 25, 2014 at 6:06 am #

            There is no comparison. Outside of hospitals, I don’t know a single lactation consultant in my region that is able to make a full-time living at this work. When one of us did, it was a major event in our community. Only hospital LCs get a regular salary. Being a lactation consultant in private practice is not a way to get rich!

          • Young CC Prof
            February 24, 2014 at 10:04 am #

            Check out how much nursing-product companies like Medela make before you conclude the motives of nursing advocates are untainted by corporate profit.

            And yes, I do feel comfortable in stating that the long term benefits for first-world infants are undetectable. The Surgeon General’s Call to Action is a tertiary source, and your link is essentially an exercise in pure mathematics which assumes a link between breastfeeding and heath outcomes, it doesn’t provide evidence.

            Have you read the actual original studies? Gone through the details and seen whether they were done well or poorly? Because so far I’m not seeing a lot of primary source material.

          • nikkilee
            February 24, 2014 at 4:19 pm #

            What you are asking for is the condensation of all the evidence that I have been following for years. When I present summaries from leading health authorities, those are rejected. Go to a medical library and read all the studies yourself. Do you think that the Surgeon-General of the US is making this up, along with the AAP and the ABM? I offered a link to the governmental meta-analysis of the Maternal and Infant Benefits of Human Milk in Developed Countries, and that was rejected by folks on this list.

            All the medical documents I have submitted have enormous bibliographies. You are welcome to check all those studies. When the same findings emerge from lots and lots of studies, there is something to it.

          • Young CC Prof
            February 24, 2014 at 4:32 pm #

            “All the medical documents I have submitted have enormous bibliographies.”

            That’s exactly the problem, ENORMOUS bibliographies. It would take hours for me to sort through all of the studies, many of which may be unavailable, and tell you the precise weaknesses of each one. Why don’t we pick ONE specific advantage and one or a few primary-source studies addressing it?

          • NoLongerCrunching
            February 24, 2014 at 4:40 pm #

            May I suggest this HUGE meta-analysis focusing on developed countries?


          • nikkilee
            February 24, 2014 at 6:31 pm #

            Because I don’t see the point of so much work. Your mind is made up. I suggest you create or join a journal club near you to discuss these things with other people. That’s a fun thing to do.

          • Young CC Prof
            February 24, 2014 at 6:44 pm #

            OK, sure. But, even if you believe every single thing I say about breastfeeding is wrong, please do take one thing away from all this.

            Please remember what I’ve tried to explain about evidence. You seem like a great person, you’re very smart, but you seem to have some trouble with reading hardcore science. This is normal, almost everyone does who doesn’t have a relevant doctoral degree! It’s only because I respect you that I took the time to explain exactly where you were making mistakes.

            -Read the entire original study, not the abstract, not the rewrite in a magazine that was probably written by a reporter who didn’t understand it either.

            -Look for sample sizes, statistical significance, and p-values.

            -Publication dates matter. Something 20 years old isn’t a good source unless it’s still being actively cited and no significant work has been done since.

            -Confounding variables are a big problem. This one is a real challenge even for scientists.

            -Finally, what you’re doing is important, but don’t forget to enjoy the challenge.

          • nikkilee
            February 24, 2014 at 6:47 pm #

            It is also important to look at the tables within studies, as there are often surprising findings that aren’t addressed in the body of the paper.

          • Expat
            February 24, 2014 at 4:56 pm #

            Nickilee, a lot of people here have phds in various topics that make interpreting research easy. Many people here have looked at the research about breastfeeding and come to the same conclusion that Dr. Amy has made: there are significant benefits to preemies, but the benefits to term babies are small. IQ, obesity, diabetes, allergies, eczema. You will find studies that reach different conclusions on all of those topics, but a review of all of the studies, with an eye for confounders, shows a negligible benefit from breastfeeding compared to formula feeding for term babies. Negligible: so small as to be practically meaningless.
            I breastfed all 3 of my babies without problems, but i still found the hospital lactivist lectures obnoxious and annoying. A mom who can’t or doesn’t want to breastfeed shouldn’t have to be pestered like that.

          • anion
            February 24, 2014 at 7:00 pm #

            So all these government agencies and health organizations recommend breastfeeding, but there’s “no support” for it?

          • Mishimoo
            February 24, 2014 at 7:29 pm #

            Indeed! There is such little support for breastfeeding that over here, it’s required to be written on every single formula can/box of sachets in bright red letters that (paraphrased) “Breastmilk is best, consult your doctor before using this product.”

          • nikkilee
            February 25, 2014 at 6:10 am #

            Support depends on who she is and where she is and what resources she has. If a mother has private insurance, is aware that help is available, has that help within easy access in her community, and can afford it, then okay. The national goal is to make support (i.e. practical advice and encouragement) available to all women everywhere. Currently, that is not the case. Not all hospitals offer breastfeeding support or adequate support.

          • Box of Salt
            February 23, 2014 at 6:46 pm #

            next time you edit your comment, could you please make a note of it as others do?

            The comment as it appears NOW, more than 5 hours I posted my reply directly below yours, is NOT the one to which I replied.

            You added two full paragraphs!

            I suppose I should be pleased that you are listening to my criticism, but rephrasing your argument after someone responds is dishonest.

            You could have replied to me instead of editing your earlier post.

          • nikkilee
            February 24, 2014 at 8:27 am #

            Thank you. I only just figured out how to reply directly when the background is completely black. I have to guess where the reply button is. I would rather reply somewhere than not at all.

          • anion
            February 23, 2014 at 7:31 pm #

            The problem is that at some point, “wanting cultural change” means “wanting to make mothers do what I say whether they like it or not.”

            If a woman on the street is resistant to breastfeeding, it’s frankly lousy to insist that we as a culture should be pressuring her otherwise instead of assuming she has her reasons, and they are considered and legitimate.

            Frex, I had a friend who suffered severe, long-term sexual abuse. She’d worked with a therapist for years and was doing much better, but the thought of breastfeeding gave her traumatic flashbacks. More than once she was accosted in public by strangers who felt the need to lecture her on how she should be breastfeeding and how much better it was for the baby and how awful formula was. Those encounters left her in tears. You seem to be suggesting that the behavior of those busybodies was appropriate somehow, because we as a culture ought to be applying more pressure for women to breastfeed, and making mothers who do not feel even more abnormal. That’s a shameful and abhorrent idea. There is already plenty of cultural pressure to breastfeed.

            You can talk about wanting “ALL mothers to get the encouragement that they need,” until the hot air which fills you is expended, but what you mean is that you want ALL mothers to feed their babies in the way which you prefer, regardless of their feelings, and you want those who do not obey your dictates to feel alone and ashamed. and to be without support.

          • Young CC Prof
            February 23, 2014 at 12:45 pm #

            “I meant that I have a full plate educating people about breastfeeding so
            it becomes a cultural norm, so that women don’t have to hide when their
            infants need to eat outside the home, and so that families have all the
            information about feeding choices.”

            I kind of think your job is done. Breastfeeding is a norm, the majority of new mothers at least try to breastfeed. Compare this to 40 years ago! Nursing in public is legal, and it’s socially acceptable almost every place where holding a baby is acceptable. (I wouldn’t nurse while driving, for example, but I wouldn’t hold my baby while driving either. I’d put him in the carseat.) Hospitals all have policies to support breastfeeding.

            The primary reasons that women don’t breastfeed NOW are physical difficulties of some kind or another, and the need to return to work quickly.

          • nikkilee
            February 23, 2014 at 12:51 pm #

            Breastfeeding is not the norm.. . .yet. More babies get a sip of breastmilk in the hospital before going home, but exclusive breastfeeding rates at 6 months are only about 15%, when the Healthy People 2020 Goals seek 25%.

            The American Academy of Pediatrics is undermining breastfeeding on one hand, putting their logo on a formula discharge bag, while saying they support breastfeeding on the other hand.

            If a mother comes to the hospital and wants to bottle feed formula, 100% of moms get what they want. If a mother comes to the hospital and wants to breastfeeding, only 65% of moms (in my region), get what they want.

            We still have a long way to go when well-educated health care professionals insist that there are minimal benefits to breastfeeding!

          • Young CC Prof
            February 23, 2014 at 1:03 pm #

            But how many women are still breastfeeding a few times a day at 6 months, even if breast milk is no longer the only food the infant has ever had? That might be a better measure of breastfeeding success.

            But the key question is WHY do women have trouble breastfeeding? When women want to breastfeed and fail, the solution is not to tell them over and over again why breastfeeding is good. This makes exhausted and emotionally vulnerable new mothers feel even worse and does nothing to increase breastfeeding.

            One piece of the solution is to make sure that women who have potentially solvable technical difficulties like bad latch have access to good, evidence-based advice. There’s so much breastfeeding advice out there, and it seems like half of it contradicts the other half. We need research on what really helps and guidelines to make sure that all LCs are practicing in an evidence-based manner.

            The other piece is paid maternity leave and other family friendly public polices, so that new parents are relieved of economic stress and can concentrate on being great parents rather than just getting by while they keep a roof over the family’s head.

          • nikkilee
            February 23, 2014 at 5:56 pm #

            You nailed it!! Currently very few medical/nursing/nutrition programs teach students anything about breastfeeding. Support after hospital discharge is not available for every mother, and depends on many factors.

          • Young CC Prof
            February 23, 2014 at 6:16 pm #

            Really? Because the lactation consultant who came to me in the hospital was utterly useless, but the evening shift nurse that day really helped us a lot.

            What I’d like is a study of different interventions and which result in more women attaining their own breastfeeding goals. That would really be awesome.

          • nikkilee
            February 24, 2014 at 8:03 am #

            Another professional embarrassment is when IBCLCs provide insensitive or unhelpful care. Breastfeeding help in hospitals is still very much about the luck of the draw, about who is working that shift.

          • techqueen333
            February 24, 2014 at 2:57 am #

            The last sentence of your post is obliterated. Please repost.

          • Young CC Prof
            February 24, 2014 at 2:59 am #

            The other piece is paid maternity leave and other family friendly public
            polices, so that new parents are relieved of economic stress and can
            concentrate on being great parents rather than just getting by while
            they keep a roof over the family’s head.

          • techqueen333
            February 24, 2014 at 3:18 am #

            I agree with this last paragraph completely. I believe there are good examples in countries like Australia. The USA where I am located claims to be family focused, but has few family-friendly policies. Paid maternity leave is either of short duration or non-existent (my daughter had to bank sick days for years before she and her husband could afford to have a baby).

          • KarenJJ
            February 24, 2014 at 8:00 am #

            Paid maternity leave helps (I’m Australian). Exclusive breastfeeding rates in Australia are not all that high because paediatricians advise introducing solids between 4-6 months. Most babies have already started solids by six months.

          • Box of Salt
            February 23, 2014 at 1:04 pm #

            nikkilee,”exclusive breastfeeding rates at 6 months are only about 15%”

            When women have to return to work to support their families after only 6 or 12 weeks, most will not be exclusively breastfeeding at 6 months.

            If you want to increase exclusive breastfeeding for 6 months, your efforts are focused in the wrong place.

          • FormerPhysicist
            February 23, 2014 at 1:06 pm #

            Exclusive breastfeeding rates at 6 months are crazy high, actually. What are the rates of breastfeeding (some, not necessarily exclusive) at 6 months?
            I bf my babies for years, but none of them were ‘exclusive’ at 6 months.

            Many infants are ready to start food earlier, and mothers are only guaranteed 12 unpaid weeks by FMLA (less after the birth if there are problems necessitating leave before the birth), and then only if the mothers are employed by a large company.

          • The Bofa on the Sofa
            February 23, 2014 at 1:22 pm #

            Neither of our kids were exclusively breastfed at 6 mos. By then, my wife was back working part time.

            For my older, my wife couldn’t pump enough to keep up with feeding him EBM, so we did a mix of milk and formula.

            With my younger, he refused to take any breastmilk from a bottle. Not even 1 part in 10. We tried. So when he was in daycare, he was getting formula during the day 3 times a week, and then breastfed the rest.

            Now, what should have we done different? Should my wife not have gone back to work?

          • nikkilee
            February 23, 2014 at 5:59 pm #

            You did the best in the situation you were in.

            It would be fabulous if maternity leave was paid and longer, as it is in many other countries.

            Another option is this: , although it is not possible for every work situation to permit the baby to come to work with mamma for a while.

          • The Bofa on the Sofa
            February 23, 2014 at 6:26 pm #

            You did the best in the situation you were in.

            Why do you assume that everyone else is not doing similarly? They are all doing the best _for their own situation_?

            Actually, I provided our story to highlight an important point: it’s REAL easy to sit back and throw out vague potshots about how not enough women are breastfeeding. However, as soon as you get a real life example? Suddenly then, you back off and accept that, yeah, whether breastfeeding works or not depends on everyone’s personal situation.

            It’s just like the “too many c-section” nonsense. That’s really easy to say, but ask the question, who’s c-section should not have been done (without resorting to hindsight), and suddenly, that’s a lot harder.

            Why do you assume that women who choose not to breastfeed, or to supplement are not doing it because that is the best for their own situation?

            It would be fabulous if maternity leave was paid and longer

            Well, my wife has her own business, and therefore there is no one to give her “maternity leave,” unless you are going to propose that the government pay for it (and, if that is the case, the government is paying for EVERY post-partum woman). And she is out working with clients in different locations all the time, so “permit the baby to come to work with mama” is completely unwieldy.

            I absolutely support initiatives to support working mothers who are trying to breastfeed, but to think that is going to solve the problem in the lease is completely crazy.

          • resaurus
            February 24, 2014 at 12:09 am #

            It seems many aspects of women’s health care is stained with that kind of exceptionalism.

            “My C-section/abortion/formula feeding, etc. was necessary and justified in a way you could not possibly understand whereas *your* C-section/abortion/formula feeding, etc. was the result of…any number of individual vices, failings and shortcomings.”

            Seriously, we need to stop using women’s bodies as moral battlefields.

          • KarenJJ
            February 23, 2014 at 10:50 pm #

            My work involves going into areas with high voltages. There is absolutely NO WAY I would take a baby in there. Substations and power stations are no places for babies.

          • techqueen333
            February 24, 2014 at 2:55 am #

            Breast pumps use voltage.

          • Young CC Prof
            February 24, 2014 at 2:58 am #

            That’s kind of a non sequitor. I’ve never heard of someone being electrocuted with a breast pump, and it doesn’t go on the baby in any case. She’s not concerned about some nebulous exposure, she’s concerned about accidental electrocution!

          • techqueen333
            February 24, 2014 at 3:13 am #

            I was being facetious. It is, after all, 3 a.m. here. Ironically, I am up with what is probably food poisoning.

          • Irène Delse
            February 24, 2014 at 4:33 am #

            In other terms, you’re throwing BS at random while pretending to have a conversation. Sorry for your food poisoning, but there’s got to be better ways to cope than spreading misery.

          • techqueen333
            February 25, 2014 at 6:45 am #

            I was not throwing BS at random. I was trying to lighten the conversation.

          • KarenJJ
            February 24, 2014 at 3:08 am #

            Yes they do. 12V. Not 330kV.


          • The Bofa on the Sofa
            February 24, 2014 at 9:30 am #

            You know what?

            You just need to stop. You are so friggin ignorant about so much that you embarrass yourself.

            Best stay away from discussing topic that you know nothing about. The best answer would be, “Oh, I hadn’t thought about that. Sorry.”

            And then we can move on. But instead, you stick your ignorance out for everyone to see. It shows you a moron.

          • Guestll
            February 24, 2014 at 9:53 am #

            You…didn’t just say that.

          • Young CC Prof
            February 24, 2014 at 10:31 am #

            Yup. She did. And then tried to claim it was a joke. I don’t get it, so I suspect she didn’t get it either.

          • The Bofa on the Sofa
            February 24, 2014 at 10:47 am #

            Yeah. So even if it was really meant to be a joke, it went over very poorly, and my advice below stands: just stop.

          • techqueen333
            February 25, 2014 at 6:06 am #

            I have no motivation to take your advice. You haven’t impressed me as someone from whom I should take advice. You are at least as much of a bully as you accuse me of being.

          • techqueen333
            February 25, 2014 at 6:05 am #

            It was a joke. There was no trying to claim anything. Your suspicions are unfounded. I suspect you enjoy ridiculing someone with whom you disagree. Interesting, considering your insistence that those of us who support exclusive breastfeeding be tolerant of those with whom we disagree.

          • techqueen333
            February 24, 2014 at 10:38 am #

            Yes, I did. I was being facetious. I’m sorry that wasn’t obvious to you.

          • Guestll
            February 24, 2014 at 10:40 am #

            Well, considering the source and all…

          • techqueen333
            February 25, 2014 at 6:02 am #

            There’s nothing wrong with the source, Guest. I guess it’s just too tempting for you to take an opportunity to ridicule someone with whom you disagree.

          • Dr Kitty
            February 24, 2014 at 3:52 am #

            I worked in a paediatric ER when I returned to work.The place was full of babies, but I wouldn’t dream of taking my daughter there.

            I pumped when I could, but, funnily enough, a kid who’d been in a car accident or a suspected meningitis case took priority over my breast pump.

            I was working in the mist BF friendly, child friendly environment…but the job constraints meant that pumping was impossible some shifts.

          • nikkilee
            February 24, 2014 at 8:11 am #

            Yes, this is true for many healthcare workers. Physicians have high rates of breastfeeding initiation, and low rates of duration for that very reason, job constraints of scheduling and workload.

          • Box of Salt
            February 24, 2014 at 4:33 am #

            nikkilee, did you click on the “Babies at Work” link on that site you posted? Did you look at the lead photo?

          • nikkilee
            February 24, 2014 at 8:31 am #

            I went to the link and the home page looks like a bulletin board. Tell me what you mean.

          • Box of Salt
            February 24, 2014 at 11:12 am #

            nikkilee, click on the “Babies at Work” box on that bulletin board and tell me how the baby in the lead photo (top left) is likely to be fed.

            By the way, I will also point out that the bulletin board style home page does not exactly suggest an air of professionalism for those folks who are bringing their babies to work.

          • nikkilee
            February 24, 2014 at 4:26 pm #

            I am curious about what you mean. Are you referring to the photographs of babies at work?

          • Poogles
            February 24, 2014 at 6:17 pm #

            I believe Box of Salt is referring to the pictures that show the babies at work with Dad, rather than Mom – obviously those babies are going to be fed by bottle (whether those bottles contain formula or pumped milk).

          • nikkilee
            February 24, 2014 at 6:37 pm #

            Thank you Poogles. My point is that bringing babies to work is a viable option in certain circumstances. Dad would be bottle feeding, yes. Although sometimes Mom can come to the workplace and breastfeed. Families are creative with exploring different ways to meet their goals. If mamma isn’t there, the baby will have to be bottle fed. What’s in the bottle will depend on the mother’s choice and circumstance. Some women use bottles of formula during the workday, and breastfeed whenever they are home with their babies. They can do this for years and it is their best option.

          • techqueen333
            February 25, 2014 at 6:08 am #

            That’s interesting Box of Salt. I know Carla Moquin of BaW and she is a major advocate for breastfeeding and of breastfeeding accommodations at work.

          • Playing Possum
            February 23, 2014 at 3:10 pm #

            If only 65% of mothers ‘get what they want’, maybe there’s an unmodifiable reason why the other 35% don’t get it. Maybe there’s a trade off between underfed babies and diabolically stressed mothers. Maybe it’s not your place to make that decision for these mothers.

            All of the posters here will acknowledge the benefits of breast feeding. That isn’t under debate. Why won’t you acknowledge the benefits of formula feeding? The endless proselytizing from the ‘breast feeding at all costs’ has now led to formula feeding mothers feeling ashamed in public. Was that the goal? What does that achieve? It’s bad recruitment tactics for a start.

          • Irène Delse
            February 23, 2014 at 3:52 pm #

            Or unrealistic goals? Because insisting on exclusive breastfeeding at all costs is counterproductive. It’s like the lactivists were looking for new battlegrounds after succeeding in making breastfeeding the norm after the 1970s!

          • nikkilee
            February 23, 2014 at 6:10 pm #

            Babies have to be fed; if the mother is unwilling or unable to breastfeed and if there is no human milk available, then of course formula will be used.

            However, there are no health benefits to formula feeding for either mothers or babies. Industry knows that too. The challenge is that the public doesn’t know that as industry is keeping that information as hidden as possible.

            Industry has a history of hiding truth from the public. Think about the Ford Falcon and the Ford Pinto, both dangerous cars and it took industry years to admit it and take them off the market. Think about tobacco, and that it took 50 or 60 years before this cause of preventable death and illness was controlled.

            Most of the people who talk about the risks of formula are the breastfeeding helpers; not a good thing because it puts breastfeeding helpers in a poor light.

          • LibrarianSarah
            February 23, 2014 at 6:36 pm #

            ” there are no health benefits to formula feeding for either mothers or babies”

            I’m sure not suffering from dehydration or death is a health benefit of formula for the baby. I’m also sure that being able to sleep at night because the baby isn’t crying all night in hunger is a health benefit for the mother. I am also sure that not falling into crippling poverty because mom can leave the baby with grandma and go to work is a heath benefit to both.

            And are you really comparing formula to tobacco and cars that explode? Really does your sanctimony know no bounds?

          • The Bofa on the Sofa
            February 23, 2014 at 6:43 pm #

            This is the problem that we often encounter. It is always an issue of “what is the alternative”?

            As I noted below, for my wife to breastfeed, she could not have worked. Consequently, we would have to sell our house because we couldn’t afford the mortgage. You don’t think that such things have any health consequences? Especially long term?

            Losing our house would have a huge effect on our life, and that would absolutely have an effect on our children.

            As I say all the time, absolutely, all else being equal, breastfeeding is better than formula. But all things are never equal. What’s best for the child depends on everyone’s own circumstances.

            As I said above, it’s easy to throw out vague generalizations. But when it comes to specific cases? All of a sudden, it’s a lot harder to find gaps.

          • LibrarianSarah
            February 23, 2014 at 7:00 pm #

            Exactly, I sometimes think that lactivists live in the “Leave it to Beaver” 1950esqe dreamland where poverty doesn’t exist, mothers don’t ever work or if they do they can quit as soon as baby arrives because hubby always make enough to support everyone, mothers always make adequate milk, is never on medication, never develops PPD or any other health problem that needs to be medicated, baby always latches perfectly, mommy never dies, adoption and foster care isn’t a thing and any other aspects that I have yet to think about off the top of my head.

            Only if all of those things are true could you honestly say that formula has no health benefits for mom and baby. I didn’t grow up in that universe so maybe I just don’t get it.

          • techqueen333
            February 24, 2014 at 2:53 am #

            Lactivist? What a tiresome cliché. No one is making any of the claims you outlined here. I can only conclude that your point was just to say something mean.
            No one ever said that in dire situations or where the mother isn’t there (adoption, death, surrogacy), formula shouldn’t be an option. No one said women shouldn’t work. Oh..and BTW, most stay at home1950s moms were bottle feeders. To be able to afford formula was seen as a sign of having made it.

          • Irène Delse
            February 24, 2014 at 4:47 am #

            You may add: babies are never allergic to human milk. One more instance of evolution by natural selection doing an imperfect job that leaves enough of a generation alive to perpetuate the species, but at the expense of the ones that die. Or would have died if clever people hadn’t developed adequate formula.

          • techqueen333
            February 24, 2014 at 2:49 am #

            Many people breastfeed and work. In many states the workplace is required to make accommodations for pumping, etc.

          • MLE
            February 24, 2014 at 2:55 am #

            This statement is so dismissive and ignorant, it’s staggering. I work from home for Pete’s sake, and it was incredibly time consuming and difficult to BF. There is no chance that it would have worked if I were going into the office every day. What a relief that my work environment saved the world from another dimwitted diarrhea sufferer!

          • The Bofa on the Sofa
            February 24, 2014 at 10:08 am #

            My wife pumped. It didn’t matter, as I explained.

          • techqueen333
            February 24, 2014 at 2:48 am #

            Librarian Sarah-Dehydration and starving are extreme conditions. No one is advocating for ignoring them. No one is advocating for denying a baby nutrition via formula once every effort to provide breastmilk, or in the case of a very short term situation, glucose solution, has been exhausted.

          • Box of Salt
            February 24, 2014 at 3:09 am #

            techqueen333 “No one is advocating for ignoring [dehydration and starving].”

            It’s a side effect of the extreme attitudes you are promoting.

            “No one is advocating for denying a baby nutrition via formula once every effort to provide breastmilk. . . .has been exhausted.”

            Exhausting every effort to provide breastmilk does in fact imply dehydration and starving.

          • techqueen333
            February 24, 2014 at 3:14 am #

            Rather than implying, you might just state what you mean.

          • Box of Salt
            February 24, 2014 at 3:22 am #

            techqueen333 “you might just state what you mean”

            This is what I mean: you have been posting from an extreme viewpoint, and your reply Librarian Sarah failed to back off that extreme.

          • techqueen333
            February 24, 2014 at 3:24 am #

            She asked a question. I answered it. I have experienced a similar situation. I described how I handled it and why. I’m sorry you see that as extreme.

          • Box of Salt
            February 24, 2014 at 3:45 am #

            techqueen333 “She asked a question. I answered it.”

            For the record, Librarian Sarah’s questions read:
            “And are you really comparing formula to tobacco and cars that explode? Really does your sanctimony know no bounds?”

            And you are right: by answering that you would exhaust all efforts at breastfeeding before using formula does in fact tell us that your sanctimony knows no bounds.

            My impression was you were going for a more moderate answer.

            Please re-read your own words, and try to think about why I find them extreme.

            And don’t forget that I’ve read your other comments on this thread.

          • techqueen333
            February 25, 2014 at 6:21 am #

            I think you find them extreme because they disagree with your point of view.

          • Young CC Prof
            February 24, 2014 at 3:13 am #

            But how long will exhausting those options take? A healthy newborn has about 3 days IF colostrum is flowing. Otherwise, or if the newborn has any health issues, hours.

            Plenty of women who wind up giving formula after nursing problems would have loved to keep trying, but just couldn’t let their baby suffer any longer, either because he WAS on the brink of dehydration or because he was constantly screaming with blood in his stool from food allergies she couldn’t identify after days on an elimination diet and working with multiple doctors.

          • LibrarianSarah
            February 26, 2014 at 10:14 am #

            You have to work on your reading comprehension. Nikkilee said that there was no health benefit to formula. I pointed out the most obvious health benefit, that it allows people to feed their children if they can’t make milk for whatever reason. In a world without formula, those babies would die.

          • techqueen333
            February 28, 2014 at 7:29 am #

            There’s nothing wrong with my reading comprehension. No one is suggesting babies be allowed to starve.

          • Stacy21629
            February 28, 2014 at 7:48 am #

            Except you just told me below that it would have been more baby to allow my daughter to starve.

          • techqueen333
            February 28, 2014 at 1:35 pm #

            I most certainly never said you should let your baby starve.

          • nikkilee
            February 24, 2014 at 8:06 am #

            My only point is that industry does not tell the truth about its products, until so much harm has been generated that they are forced to do so. It doesn’t matter what the product is: pacemakers, cars, cigarettes, infant formula, or hip replacements.

          • The Bofa on the Sofa
            February 24, 2014 at 9:25 am #

            Industry does not tell the truth? You are just making this shit up.

            Jesus, when formula commercials are advertising “breast is best” it’s really hard to believe any nonsense about how they are not telling the truth.

          • Playing Possum
            February 23, 2014 at 9:36 pm #

            Wow. You are comparing formula feeding to smoking? Are you suggesting that formula companies have evidence (beyond the giant, worldwide retrospective trial called the last 30 years of safe, appropriate formula) that formula is dangerous, yet are actively hiding it? Any credibility you once might have had just dissolves with that kind of ludicrous, untrue blather. You are the vocal, irrational minority that agitate for impossible goals, and then berate people for failing to achieve them. Babies need to be fed, full stop. What’s the point of ignoring a safe, available resource (formula), in favour of expensive, possibly infectious, (in the case of donor milk), possibly psychologically destructive or even unobtainable breast milk?

            Possum out. All I’m reading now is ‘teh conspiracies!! Big pHARMa!!11!!’

          • KarenJJ
            February 23, 2014 at 9:47 pm #

            But when people raise reasons for not breastfeeding, people such as yourself judge these reasons as not good enough. It’s impossible to say anything in such a black and white argument such that you are presenting here. Many women have issues, such as sexual abuse, medication, work, personal reasons that they are not going to go into. Demonising formula the way you have been at it here weakens the message of breast is best because long term we can see that the results are marginal. It makes you appear untrustworthy. By all means support breastfeeding and breastfeeding mothers. You can do that without demonising formula to the extent that it has been here. It is a food source, it is not the same as a randomly exlpoding car or a known carcinogen. There is no reason to prefer an IV or sugar water over formula to help ease the hunger and distress of a healthy newborn.

          • techqueen333
            February 24, 2014 at 2:45 am #

            The results are not marginal. That is the statement that pisses me off so much. It’s simply not true for young babies.

            That latest WHO meta-analysis, the reference to which I can no longer find on this thread, focused on only four or five conditions. One of those Type II diabetes. Due to the limitations of the studies reviewed for the meta-analysis, this warrants further study. Another was obesity. I think there are differences in the components of breastmilk and formula that could influence obesity. This warrants additional longitudinal studies using reliable length of breastfeeding times. Still, I would think that dietary habits post weaning and genetic factors could override the benefit.

            For example, on the genetic factors: rs5082(C;C) is associated with increased Body Mass Index and food intake in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) Study. news Tufts University scientists said they discovered men and women carrying the CC genotype demonstrated higher body mass index scores and a higher incidence of obesity, but only if they consumed a diet high in saturated fat. Well, heck…

            I would also raise an eyebrow at the IQ studies. That is one area where I would definitely be looking out for the dreaded confounding factors. The one meta-analysis, I believe, mentioned the propensity of bf mothers to be more attuned to their babies or something like that..but that is something bottle feeders could learn to do better, if that is an issue.

            However, this meta-analysis does not review any studies of breast feeding and allergy, and of communicable disease. That’s where the gut environment issues come into play. There’s also the issue of otitis media. Actually, that meta-analysis accepts previous research that demonstrates the benefits re: these issues.

            I understand that there are issues of medication a mother can’t go without, inability to lactate, blah, blah blah. But for someone who can breastfeed who simply doesn’t want to…I’m sorry, but I’m not going to pat her on the back and tell her how glorious her choice is. I’m not going to go up and insult her, either.

            Your concern seems to be that mothers not be given false or exaggerated information. That is also my concern. I am frustrated that so many low income women are victims of cultural norms that tell them that breastfeeding is “nasty” or that ff is a sign of having “made it.” Aside from the health benefits for babies living in less than optimal conditions, the economic hit for ff is huge. In these situations, poor families struggle to buy expensive formula or the taxpayers foot the bill. The cultural paradigm needs to shift. Blog posts like Amy’s are detrimental to that cause.

          • Young CC Prof
            February 24, 2014 at 3:07 am #

            Thank you for a great post! THIS is how you argue on the Internet, and now we can have a great discussion!

            If you can’t read the whole post, click the “see more” button at the bottom.

            So yeah, we agree that the WHO meta-analysis found little evidence of a link between breastfeeding and certain chronic diseases. In fact, the authors concluded that the best studies found no link.

            Now, you’re right that the authors did not examine contagious diseases or allergies, and in fact the authors accept the contagious disease benefit flatly. For contagious diseases, yes, breastfeeding provides moderate risk reduction, but only up to age 1. After that, even if breastfeeding continues, it no longer supports the immune system, since the baby’s digestive system is now mature enough to digest the antibodies rather than absorbing them, and the baby is producing antibodies on his own.

            Allergies were not included in that meta-analysis at all as far as I can tell. The PROBIT study found no reduction in allergies among breastfed children. Still, we can discuss breastfeeding vs allergies if you want, it’s a legitimate question.

            As for the cost of formula, well, let me look it up. I see a 40-oz package of Target brand powder for $25. That’s almost 300 ounces prepared, which a 10-day supply, so $2.50 per day. A breastfeeding mother might easily consume an extra $2.50 in food every day! I’m not overwhelmed by the economic argument. (Yes, some infant formulas, especially the “convenient” single-serve ready to feed packages, are more expensive, but the cheapest option is pretty reasonable.)

          • fiftyfifty1
            February 24, 2014 at 8:11 am #

            The obesity issue is one that suffers greatly from confounding. In developed countries, rich people tend to be thinner than poor people. Poor people tend to formula feed.

            But when breast vs bottle was RANDOMIZED in the PROBIT study, it was found that overweight and obesity were more common in the BREASTFEEDING intervention group! This effect was apparent in infancy, and the most recent followup shows that it is still statistically significant at age 11. Over 20% more likely in the breastfeeding group at age 11.

          • NoLongerCrunching
            February 24, 2014 at 1:22 pm #

            > I am frustrated that so many low income women are victims of cultural norms that tell them that breastfeeding is “nasty” or that ff is a sign of having “made it.” Aside from the health benefits for babies living in less than optimal conditions, the economic hit for ff is huge. In these situations, poor families struggle to buy expensive formula or the taxpayers foot the bill. The cultural paradigm needs to shift.

            I worked for WIC, and this is a gross misrepresentation of what is going on, at least in the community I worked in. These mothers are very well aware that breast is best (you’d have to live under a rock not to know that at this point), and very open to learning more about breastfeeding. However, breastfeeding exclusively for more than a few weeks is almost never a workable option, given the challenges facing these moms. Criticizing their use of formula is the worst way to support these moms.

          • ngozi
            February 25, 2014 at 10:59 am #

            “However, breastfeeding exclusively for more than a few weeks is almost never a workable option, given the challenges facing these moms.”

            Thank you, thank you, thank you. This is something that gets SO overlooked!!

            I’d just like to add that the WIC program also bends over backwards to help breastfeeding moms, even GIVING them an electric breast pump.

          • An Actual Attorney
            February 25, 2014 at 10:32 pm #

            A lot of moms in higher SECs too. My mail carrier had a baby same time I did. She was back at work in 2 weeks because she didn’t have paid leave. Putting aside how physically demanding her job was for 2 weeks post birth, what was she supposed to do? Pump in the back of the truck?

            Or cops — bullet proof vests don’t come with boob room. OK, they should, but they don’t. So street cops have to choose between stopping BFing so their breasts will go back to what they were or BFing and not being able to work because they can’t wear a required uniform.

          • fiftyfifty1
            February 23, 2014 at 10:10 pm #

            “However, there are no health benefits to formula feeding for either mothers or babies.”


            Benefits to baby: reliable nutrition source, better source of Vitamin D and lower chance of rickets, better source of iron, much lower chance of dangerous levels of bilirubin, lower chance of re-hospitalization for dehydration with all that entails, protection against transference of communicable diseases such as HIV and CMV, can be given to those babies with metabolic abnormalities that preclude human milk.

            Benefits to mother: More sleep, decreased anxiety, avoidance of D-MER, no contraindication to any and all meds, reduced pain, improved dyspareunia, prevention of mastitis and breast abscesses

            And these are in addition to the economic benefits of returning to work–higher economic class is strongly associated with improved health outcomes.

            What is the healthiest for any individual baby and mother depends on that individual baby and mother. Health benefits that may be important in my case may not even be issues in yours. That’s okay! But to say that those health benefits don’t exist because they weren’t important to YOU, makes you seem selfish and out of touch.

          • KarenJJ
            February 23, 2014 at 10:24 pm #

            I started looking at breastfeeding in a lot more detail when I was trying to decide on whether to take an important medication after the birth of my second child. If I didn’t take that medication I was at risk of damaging my hearing and eyesight. It was a risk I would take for a few months for important benefits for my child.
            It is critical that people are honest with the risks and benefits of breastfeeding because every woman is trying to weigh up her own set of risks and benefits that are important to her. For me, reading the risks and benefits meant that formula feeding was by far the optimal solution for my situation. If formula feeding really did lead to terribles outcomes, such as my baby randomly exploding due to a faulty fuel tank, I’d have done my best to try and breastfeed and not taken the medication.

          • nikkilee
            February 24, 2014 at 8:22 am #

            The iron in formula is an overdose as it is in a form that babies can’t easily metabolize; this is identified as one reason formula fed babies are at greater risk of infectious disease as the iron that isn’t metabolized stays in the gut and feeds pathogens. Mothers who choose not to breastfeed have greater chances for breast cancer, cardiovascular disease, and metabolic syndrome. Breastfeeding mothers get more sleep and a better quality of sleep than mothers who practice either mixed feeding or exclusive formula feeding. Dr. Kathleen Kendall-Tackett has published extensively on that topic. Her website is

            Formula-fed children have twice the risk of SIDS. That is something I wish that everyone knew.

            A mother who chooses to feed formula, after knowing about both sides of the feeding choice, deserves practical advice and encouragement to support her choice without hassle or further discussion.

            When I worked as a lactation consultant in several hospitals, I would go to see the formula feeding mothers. They were initially suspicious about why I was seeing them. I offered them suggestions about how to get through the drying up phase with the most comfort. Once they became aware that I wanted their comfort, then they relaxed and we could have conversations. I would ask them, “How did you know to make the decision you did about feeding your baby?” Many women would say things like, “I just didn’t like the idea of breastfeeding” or “I wanted to bottle-feed.” I never pushed; I was truly curious. The really interesting thing was that about half the mothers I saw chose to use formula out of ignorance. They thought the medicine they were given for pain after their cesarean section would harm their baby. Or they were concerned about smoking cigarettes and breastfeeding. They were making their decisions based on their beliefs about what was best for their babies. Awesome. However, once they learned that all the medicines they were taking were compatible with breastfeeding, or, that there were ways to breastfeed and reduce infant smoke exposure, some chose to change their minds.

          • Karen in SC
            February 24, 2014 at 8:27 am #

            Why do you even visit formula feeding mothers? Don’t think for a minute that most of those mothers won’t feel the guilt you are heaping on them with that “honest” question. That same question from a friend =/= to that question from an LACTATION consultant for pete’s sake. Let the nurses help her with drying up the milk.

            There are plenty of resources for pregnant women. And isn’t nicotine in breastmilk?

          • nikkilee
            February 24, 2014 at 8:38 am #

            Still better for a baby to be breastfed, even if she smokes tobacco.

            I visited every mother because every mother deserves care. The visits were always well received, once mothers got over the initial shock that a lactation consultant would visit them. We had good conversations. I asked if I could visit with them. They granted permission for me to sit with them; once in a while a mother would refuse my visit. That was fine too.

          • Karen in SC
            February 24, 2014 at 9:14 am #

            I did a quick PubMed and Google Scholar search. I found one study that concluded breastfeeding cancelled out negative effect from low SEC for mothers in that group. There was not description of how they reached this conclusion.

            In a second study where the method was described and actual data taken (including amount of nicotine in breastmilk) the conclusion follows:
            CONCLUSIONS. An acute episode of smoking by lactating mothers altered
            infants’ sleep/wake patterning. Perhaps concerns that
            their milk would taste like cigarettes and their
            infants’ sleep patterning would be disrupted would motivate lactating
            to abstain from smoking and to breastfeed longer (Pediatrics , Breastfeeding and Smoking: Short-term Effects on Infant Feeding and Sleep, 2007)

          • techqueen333
            February 24, 2014 at 11:49 am #

            For the record, I do not agree with Nikkilee on this. Studies show that babies receive nicotine and other toxins from their smoking mothers through BF. Unfortunately, this means BF would be contraindicated unless the mother quits smoking.

          • me
            February 24, 2014 at 12:05 pm #

            Except they are going to receive nicotine and other toxins anyway. Even if you don’t smoke in the baby’s physical presence, smoke clings to your clothes, hair, and skin. The baby will be exposed regardless. Even the “mainstream” organizations do not say smoking is contraindicated for bfing, only discouraged – the same way it is discouraged for all parents.

          • nikkilee
            February 24, 2014 at 4:14 pm #

            AAP Rethinks Its Opinion

            In 2001, The American Academy of Pediatrics (AAP) changed its official position on smoking and breastfeeding. The change was attributed to new research findings, as well as to an overall effort at the AAP to encourage an increase in US breastfeeding rates. Additionally, the committee stated, the removal of nicotine from the list of drugs of abuse not compatible with breastfeeding may afford physicians and their patients a greater opportunity to discuss cigarette smoking because: “Pregnancy and lactation are the ideal occasions for physicians to urge cessation of smoking.”

            The AAP report explained why doctors should discuss breastfeeding with mothers who do not wish to stop, or cannot stop smoking:

            It is recognized that there are women who are unable to stop smoking cigarettes. One study reported that, among women who continue to smoke throughout breastfeeding, the incidence of acute respiratory illness is decreased among their infants, compared with infants of smoking mothers who are bottle fed. It may be that breastfeeding and smoking is less detrimental to the child than bottle feeding and smoking. The Committee on Drugs awaits more data on this issue.

            Previously, nicotine was on the list of contraindicated drugs of abuse during breastfeeding due to documented decreases in milk production and infant weight gain, infant respiratory illness, and transfer of nicotine and other compounds to the babies from the milk of mothers who smoke. The 2001 report, however, stated that the committee found no evidence to document whether the amount of nicotine that passes to the infant through a mother’s milk is harmful, and it awaits further study on that issue.

            Batstra L, Neeleman J, Hadders-Algra M. Can breast feeding modify the adverse effects of smoking during pregnancy on the child’s cognitive development? J Epidemiol Community Health 2003 Jun;57(6):403-4.

            In this study, researchers examined school results of 570 nine-year-old children who were born in a Dutch hospital between 1975 and 1978 and whose mothers smoked during the pregnancy. Per the researchers, “Our results indicate that negative effects of maternal smoking on children’s cognitive performance were limited to those who had not been breast fed.” The children who had not been breastfed had decreased cognitive performance compared to the children who were breastfed. The researchers suggested that breastmilk promoted brain development and helped to counteract the adverse effects of cigarette smoking during pregnancy.

            Of course it is better not to smoke. And if she smokes, she should keep 2nd and 3rd hand smke away from the baby. However, her baby will still be better off getting her milk than not.

            This next study found that nursing babies of mothers who smoked tobacco had levels of cadmium in their bodies. Cadmium is in the same group as mercury and zinc; it is toxic.

            For some reason,the researchers Luck and Nau went on to test cadmium levels in two formulas that were not identified by name in the study. They discovered that the cadmium levels were, much higher in formula and formula fed babies than they were in the breastfed babies.

            Cadmium was used to make formula white.

            Toxicol Lett. 1987 Apr;36(2):147-52.

            Cadmium concentrations in milk and blood of smoking mothers.

            Radisch B, Luck W, Nau H.


            Cadmium concentrations were measured by flameless atomic absorption spectrometry in blood and mature milk of 15 nonsmoking and 56 smoking mothers during the nursing period. Both blood and milk concentrations increased with increasing cigarette consumption. The median blood and milk concentrations in nonsmokers were 0.54 and 0.07 microgram/l, respectively; these values rose to 1.54 and 0.16 micrograms/l in blood and milk of mothers smoking more than 20 cigarettes per day. Milk concentrations of cadmium were approximately 10% of corresponding blood concentrations. The cadmium exposure of infants nursed by nonsmoking as well as by smoking mothers was far below the exposure of formula-fed infants or the provisional acceptable weekly intake level set by the WHO.

          • Young CC Prof
            February 24, 2014 at 10:17 am #

            “The iron in formula is an overdose as it is in a form that babies can’t
            easily metabolize; this is identified as one reason formula fed babies
            are at greater risk of infectious disease as the iron that isn’t
            metabolized stays in the gut and feeds pathogens.”

            That is absolutely biologically impossible. Everything you swallow is either digested and absorbed through the gut, or passed through the gut and defecated. When a child or pet swallows an inedible object, it comes out. (And if it doesn’t, it can cause bowel obstruction, which is a medical emergency.)

            Have you ever taken iron supplements? What happened? That’s right, your stools turned dark and possibly harder. (Don’t believe me, try it yourself.) The same thing happens to babies when the formula contains more iron than they need. The extra iron just comes out the other end a few hours later. That’s partly why bottle-fed babies have darker stools.

            And uppitysciencechick is not a source of anything. Does this person have any qualifications? I can’t tell.

            You really seem to struggle with basic biology and with what constitutes a reliable source.

            And as far as which medicines are compatible with breastfeeding, did you talk to a pediatrician? Many medicines are, but there are some that are definitely not.

          • The Bofa on the Sofa
            February 24, 2014 at 10:24 am #

            You really seem to struggle with basic biology and with what constitutes a reliable source.

            DIdn’t Dr Amy discover that she advertises herself as a “holistic lactation consultant”? Sounds par for the course…

          • AlisonCummins
            February 24, 2014 at 10:35 am #

            Actually, it’s true. There is excess iron in the gut temporarily as it’s on its way out, and it can be a problem in some circumstances.

            When refeeding malnourished people for instance, iron is the last nutrient to be introduced. If ferritin has dropped because of protein deficiency, gut flora will have an advantage over the gut itself in scavenging the iron. This can be a problem. As the individual’s protein requirements and stores are built up their anemia will cause them to produce very high quantities of ferritin giving the individual a relative advantage over the flora in scavenging the iron and it becomes safe to reintroduce.

            A healthy term infant is at very low risk for this effect. If an infant is considered to be at risk, then they should be given a low-iron formula.

          • Young CC Prof
            February 24, 2014 at 10:37 am #

            Interesting. I don’t think that’s what Nikkilee was thinking of, though. I think she’s one of those folks who believes that colon cleansing is a thing.

          • Box of Salt
            February 24, 2014 at 12:12 pm #

            Young CC Prof re Uppity Science Chick. From her “paper” though the Mother’s Sleep Survey button:
            The Uppity Science Chick’s qualifications are listed as Ph.D., IBCLC, RLC, FAPA, and her survey has two other PhDs as coauthors. Yes, it’s a survey: “[For a full description of the study participants, see (Kendall-Tackett, Cong, & Hale, 2010).] php?id=5&journal_id=1
            Sample Recruitment
            The sample was recruited via announcements and flyers distributed to WIC Breastfeeding Coordinators, U.S. State Breastfeeding Coalition Coordinators, Lactation Consultants and La Leche League Leaders. The investigators described the study and asked for assistance in recruiting mothers. Flyers and cards were distributed electronically and via hard copy, with a Web link for the survey. This survey was open to all mothers with babies 0-12 months of age, regardless of feeding method.”

            Yes, it’s just a survey!

            I don’t have the time to look into it any further right now.

          • nikkilee
            February 24, 2014 at 4:23 pm #


            Dr. Kendall-Tackett is editor of several professional journals, and an international expert on sexual abuse survivors and breastfeeding, on postpartum depression, and on the role of inflammation in disease.

            A whole new medical text, Iron and Infection, cites hundreds of recent studies showing that excess iron in the body enables infections to flourish (Bullen JJ, Griffiths E. Iron and Infection New York: John Wiley & Sons, 1987.;Weinberg ED. Iron and susceptibility to infectious disease. Science 1974;184:952.;Weinberg ED. Iron and susceptibility to infectious disease. Science 1975;188:1038.).

            A good example of this occurred in California in 1979. There was an outbreak of 60 cases of infant botulism. Researchers compared breast-fed babies (receiving no supplemental iron) with babies fed iron-supplemented infant formula.

            The breast-fed babies all had milder cases of the disease and none died. The formula-fed babies all had severe cases of the disease and ten died. (Emory T. Iron and Your Health: Facts and Fallacies Boca Raton, FL: CRC Press, 1991).

          • NoLongerCrunching
            February 24, 2014 at 4:47 pm #

            I’d love to know what you made of that article on the risks of co-sleeping I posted before. Here is is again just in case:

            And this one, about how formula supplementation can increase breastfeeding:

          • nikkilee
            February 24, 2014 at 6:32 pm #

            I’ve already posted Dr. Alison Steube’s critique of the formula supplementation study. As for bed-sharing, that’s another whole can of worms that I don’t want to get into. I have all I can do to discuss breastfeeding in this forum.

          • Young CC Prof
            February 24, 2014 at 5:00 pm #

            25-40 years ago is recent? OK. And for the first one, why link to the news article rather than the original journal article?

            I’m a little tired of the breastfeeding debate, and I’m just trying to teach you how to do science at this point.

          • nikkilee
            February 24, 2014 at 6:34 pm #


          • anion
            February 25, 2014 at 5:52 am #

            Thank you for addressing that; it sounded utterly nonsensical to me. I pictured my stomach full of iron that’s been there since my infancy. Like chewing gum, perhaps.

          • NoLongerCrunching
            February 24, 2014 at 12:18 pm #

            >Formula-fed children have twice the risk of SIDS. That is something I wish that everyone knew.

            Yes. Mothers deserve to know this before making a decision. However, bed sharing also increases the risk of SIDS; do you agree mothers should be aware of this as well?


          • Mishimoo
            February 25, 2014 at 6:51 am #

            Yes, feeding every hour on the hour for the first week, and then every two hours for the next 4 months definitely contributed to my quality and quantity of sleep.

          • KarenJJ
            February 23, 2014 at 10:26 pm #

            “Babies have to be fed; if the mother is unwilling or unable to breastfeed and if there is no human milk available, then of course formula will be used.”
            There is an enormous grey area between women being “unwilling or unable”. That you refuse to see this means it is incredibly difficult to have a reasonable discussion with you.

          • NoLongerCrunching
            February 24, 2014 at 11:30 am #

            >If only 65% of mothers ‘get what they want’, maybe there’s an unmodifiable reason why the other 35% don’t get it. Maybe there’s a trade off between underfed babies and diabolically stressed mothers. Maybe it’s not your place to make that decision for these mothers.

            Exactly this. I work with breastfeeding moms too…and sometimes judicious use of formula *saves* the breastfeeding relationship. A baby who is not getting enough breastmilk for whatever reason is not going to be vigorous enough to stimulate a full milk supply. A little formula and pumping can help them to go on to exclusively breastfeed. Would you say that mom “didn’t get what she wanted”?

          • Susan
            February 24, 2014 at 11:05 am #

            Maybe you still have that fight where you live. Here no… A mom who comes with a plan to formula feed is exceedingly rare. If that is her plan we question her on her reasons to be sure she doesn’t believe a myth about breastfeeding. I know for certain some women simply say they are planning to breastfeed who have no interest but don’t want to appear to be “bad mother” to staff. It’s far harder for a mom to ask for formula here, let alone recieve it, than you think. I agree with you breastfeeding needs to be socially acceptable everywhere. If you live in some odd regional pocket then great BUT don’t accomplish the positive by shaming formula feeders. It’s been done and it’s cruel and in my mind the shaming is done by meanspirited bullies who want to wrap themselves in self righteousness. It’s ugly and not good for moms or babies.

          • Captain Obvious
            February 23, 2014 at 12:51 pm #

            So there are health risks with formula. There are health risks with food in general. Should we breast feed forever?

          • Susan
            February 24, 2014 at 10:56 am #

            What region do you live in? Here it’s the norm… It’s the formula feeders who feel they can’t feed their babies in public without being scolded.

          • nikkilee
            February 24, 2014 at 4:24 pm #

            No mother should be scolded in public for how she feeds her baby.

  7. ABCD
    February 20, 2014 at 10:31 pm #

    Baby-friendliness and the “breast is best” rhetoric are not about the welfare of babies (and certainly not about the welfare of mothers.) This rhetoric is about controlling the behavior of women, especially mothers. Just as the anti-choice rhetoric is not about the welfare of fetuses, but about controlling women.

    • techqueen333
      February 20, 2014 at 10:47 pm #

      That’s BS.

    • February 20, 2014 at 11:21 pm #

      If it was about babies, there wouldn’t be any of this “iv feeding a baby is better than formula” insanity.

      • KarenJJ
        February 20, 2014 at 11:29 pm #

        If it was about mothers it wouldn’t be about using an IV to solve feeding issues either.

        • anon13
          February 21, 2014 at 11:14 am #

          It seems to me that the long term medical solution for people of any age who aren’t able to eat via their mouths due to strokes or birth defects is not an IV. These patients are fitted with opening in their abdomens and fed an age appropriate formula.

          • AlisonCummins
            February 21, 2014 at 11:38 am #

            If the gut works, use it. If they can’t swallow then they’re tube fed, usually through the nose, usually something like the cans of Boost or Ensure you can buy at the drugstore. (That is, age-appropriate formula.)

            If the gut is temporarily not working they get parenteral nutrition which is a completely hydrolyzed solution of sugars, amino acids, electrolytes and so on, into a peripheral vein. The drip is slow because the solution irritates the vein. This method can only supply a relatively small portion of nutritional requirements. Getting adequate calories into a preemie this way is really hard. Different things have been tried including alcohol which has 7 kcal/g vs only 4 kcal/g for sugar.

            There is also total parenteral nutrition which is through a catheter into a central vein so that the solution is mixed quickly with a large quantity of blood in the heart. In theory this can be kept up indefinitely.

            Parenteral nutrition has a high rate of complications and is avoided whenever possible. If the gut works? Use it!

            If the goal of the IV is to nourish the baby so that it can quickly eliminate bilirubin, and not just rehydration, we’re talking parenteral nutrition. This is as artificial and risky as feeding gets. There is no imaginable way it can be construed as preferable to formula.

          • The Bofa on the Sofa
            February 21, 2014 at 11:46 am #

            The suggestion that one should resort to IV nutrients just to avoid formula is completely mind-boggling.

          • ngozi
            February 21, 2014 at 12:14 pm #

            You took the words right out of my mouth.

          • anion
            February 21, 2014 at 12:37 pm #

            “Doctor, I’m not producing any milk for my baby.”

            “Don’t worry, that’s what IVs are for!”

            “But wouldn’t formula–”

            “No, you don’t want that, formula is just a man-made mix of stuff. What we’ll intravenously feed your baby is a totally different man-made mix of stuff. Awesome, right?”

          • Young CC Prof
            February 21, 2014 at 12:53 pm #

            Except that most infant formulas have MILK as the first ingredient. IV nutrients don’t have any natural ingredients!

          • techqueen333
            February 22, 2014 at 1:49 am #

            Straw man.

          • nikkilee
            February 22, 2014 at 8:28 am #

            Milk from cows, a different protein from human milk. Or juice from soybeans, that is not milk because it doesn’t contain lactose.

          • AlisonCummins
            February 22, 2014 at 10:47 am #

            1) IV solutions have no natural ingredients. Please explain why you think such a drastic medical intervention is necessary to treat straightforward hunger.

            2) The proteins in cow and human milk are not a perfect match, but they are very similar with different proportions of whey:casein. In formula the proportions are those of human milk.

          • nikkilee
            February 22, 2014 at 1:38 pm #

            Formula is static; human milk is dynamic, always changing in composition with infant’s age, time of day of feed, beginning and end of feed.

          • AlisonCummins
            February 22, 2014 at 3:11 pm #

            You haven’t explained why you believe a major medical intervention is needed to treat hunger in a child who can eat.

            When I address your protein claim, you ignore it and change your claim to an irrelevant one about dynamism. Please address your protein claim either by agreeing that you were wrong about it or by explaining why I am wrong.

            Regarding your new claim that formula is static:
            1) so is donor milk;
            2) there is no evidence that time-of-day variation in milk composition makes any difference to a child, and absolutely no reason at all to imagine that it could make any difference in the timespan we are talking about —a week or so out of a human’s life;
            3) that à mother’s M

          • AlisonCummins
            February 22, 2014 at 3:13 pm #

            3) that the composition of a woman’s milk is different after a year of lactation has no bearing at all when we are talking about the timespan of a single week.

            Stick to the topic. The topic is a newborn whose mother’s milk hasn’t come in yet and what to do about the fact that it is starving.

          • nikkilee
            February 22, 2014 at 6:49 pm #

            Feed the baby. The mother has milk: hand express and feed it to the baby. Keep the baby skin to skin so mother’s body will provide metabolic stabilization. If no milk from mamma, use donor milk.

          • fiftyfifty1
            February 22, 2014 at 9:56 pm #

            “Keep the baby skin to skin so mother’s body will provide metabolic stabilization.”

            Metabolic stabilization can be attained by skin-to-skin contact?! Amazing! I can’t believe that this whole time I did not know that dehydration, hypernatremia, hypoglycemia, hyperuricemia, hyperbilirubinemia and other metabolic instabilities could be prevented by skin to skin! Too bad nobody passed that bit of wisdom onto people who starved during famines. Strip down and cuddle people!

          • nikkilee
            February 23, 2014 at 7:48 am #

            I thought we were talking about babies. Skin to skin care was first discovered as a way for premature infants to survive in countries, specifically Colombia, where there were no ICUs. First studied in the 70s, it is an intervention that has been the subject of hundreds of research studies. Skin to skin in the OR after cesarean section keeps babies warm, with excellent blood sugars. Skin to skin is used in more and more intensive care units around the world, in rich and in poor countries. At the Brigham Women’s and Children’s Hospital, the chief of OB Anesthesia has a whole protocol for a Gentle Cesarean birth that includes a transparent drape and immediate skin to skin care (if baby is medically stable). More hospitals and intensive care units are using skin to skin care after birth, and in recovery room because it is enormously effective, doesn’t increase nursing workload, and reduces pain in mothers and babies. Nurses report that mothers require less pain medication in recovery room when their babies are skin to skin. Skin to skin care is the closest thing to a magic wand.

          • fiftyfifty1
            February 23, 2014 at 8:15 am #

            Yet another example of you getting caught making unsupported exagerrated claims and then trying to change the subject. You claimed that skin-to-skin “provide[s] metabolic stabilization” and suggested it as a treatment for medical problems due to inadequate intake in the neonate. But really it does nothing at all for metabolic problems, dehydration or starvation- It merely keeps the baby warm. If skin-to-skin is your idea of “magic wand”, there’s going to be a lot of babies in serious trouble.

          • nikkilee
            February 23, 2014 at 9:42 am #

            Skin to skin care does far more than keep the baby warm. Here’s a power point presentation from the March of Dimes that gives a lovely overview of the evidence and benefits:


          • Young CC Prof
            February 23, 2014 at 10:45 am #

            The nurses actually asked me to do skin-on-skin with my son, who was borderline premature and very small. Why? Because they were worried that he might not be able to maintain his body temperature. Since he was breathing well, skin-on-skin kept him warm. Otherwise, they would have had to separate us to put him in a warming bed in the special-care nursery, and they didn’t want to do that.

            I looked through that document. It was intended for NICU staff caring for very sick and fragile newborns, and many of the benefits were psychological benefits for the parents. Now, having had a child in the NICU briefly, I can say that the parent’s emotional state can be very fragile and I much appreciated everything the staff did to support parents, including facilitating holding. However, that’s not really an issue for term babies.

            The direct benefits to the babies were regulation of body temperature and some improvement in breathing and heartbeat. Healthy babies regulate their breathing and heartbeat just fine with or without kangaroo care.

            In a poor country where incubators are unavailable, kangaroo care can save the lives of preemies, at least those who are able to breathe without machines. In the first world, it provides a boost to preemies and helps mother and child bond. I can remotely believe that it might help regulate blood sugar in a brand-new baby who has low blood sugar only because his body hasn’t quite adjusted to the outside.

            It’s not going to fix or even ameliorate lack of food.

          • nikkilee
            February 23, 2014 at 11:20 am #

            You and your baby received good care. The benefits of skin to skin care are for term babies as well; good things for babies don’t have a “use by” date on them. Term babies can have some challenge to adjustment after birth due to birth interventions (operative delivery, labor medications, induction). In addition, there is not one single study that supports taking a healthy term baby away from its mother after birth.

            Here’s a bibliography of most of the articles about kangaroo care/birth skin to skin. It is compiled by Dr. Susan Ludington, who has been a technical expert on the subject for the World Health Organization.


            Names for the interention vary from study to study. Skin to skin at birth is recommended by the American Academy of Pediatrics and also by the Academy of Breastfeeding Medicine.



          • Young CC Prof
            February 23, 2014 at 11:33 am #

            But does it make up for lack of feeding?

            Also, you say “benefits of skin to skin care are for term babies as well; good things for babies don’t have a “use by” date on them.” I would say that needs evidence. For example, preemies often need lung surfactants, a special moist room-temperature oxygen cannula, and even mechanical ventilation. They need a very special sterilized environment. Are these things appropriate for most term babies? No, of course not. That would be silly. Just like antibiotics are good for a baby with a serious infection, but will do no good and possibly some harm in a healthy baby.

            So, a study that shows something is beneficial to preemies cannot necessarily be generalized to healthy full term babies. I’m not saying skin-on-skin is bad, it’s certainly a nice way to bond. But you can’t assume that it produces measurable health benefits in a term baby just because it helps a preemie.

            By the way, don’t be upset. I’m not fighting with you, I’m debating. You are an interesting person to communicate with.

          • nikkilee
            February 23, 2014 at 12:34 pm #

            Thank you Young CC Prof. I enjoy this good debate.

            Benefits of skin to skin for term newborns are not generalized; they are measured. One example is the work done by Bystrova et al. who found that babies who had gone skin to skin at birth had better state regulation at 1 year of age.

            There is more in the study than made the abstract. The study was all about term infants.


          • Young CC Prof
            February 23, 2014 at 12:55 pm #

            The full article is behind a paywall, and the abstract only said that newborns kept skin-on-skin right after birth warmed up better than those kept on nursery cots. It also says that the difference in foot temperature disappeared within a few days.

            Can you quote a few lines from the full paper that referred to effects at 1 year?

          • nikkilee
            February 23, 2014 at 5:13 pm #

            ABSTRACT: Background: A tradition of separation of the mother and baby after birth still
            persists in many parts of the world, including some parts of Russia, and often is combined
            with swaddling of the baby. The aim of this study was to evaluate and compare possible longterm
            effects on mother-infant interaction of practices used in the delivery and maternity wards,
            including practices relating to mother-infant closeness versus separation.

            Methods: A total of 176 mother-infant pairs were randomized into four experimental groups: Group I infants were placed skin-to-skin with their mothers after birth, and had rooming-in while in the maternity ward. Group II infants were dressed and placed in their mothers’ arms after birth, and roomed in with their mothers in the maternity ward. Group III infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group IV infants were kept
            in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal
            numbers of infants were either swaddled or dressed in baby clothes. Episodes of early suckling in the delivery ward were noted. The mother-infant interaction was videotaped according to the Parent-Child Early Relational Assessment (PCERA) 1 year after birth.

            Results: The practice of
            skin-to-skin contact, early suckling, or both during the first 2 hours after birth when compared
            with separation between the mothers and their infants positively affected the PCERA variables
            maternal sensitivity, infant’s self-regulation, and dyadic mutuality and reciprocity at 1 year
            after birth. The negative effect of a 2-hour separation after birth was not compensated for by the practice of rooming-in. These findings support the presence of a period after birth (the
            early “sensitive period”) during which close contact between mother and infant may induce
            long-term positive effect on mother-infant interaction. In addition, swaddling of the infant was found to decrease the mother’ s responsiveness to the infant, her ability for positive affective involvement with the infant, and the mutuality and reciprocity in the dyad.

            Conclusions: Skin-to-skin contact, for 25 to 120 minutes after birth, early suckling, or both positively influenced mother-infant interaction 1 year later when compared with routines involving separation of mother and infant. (BIRTH 36:2 June 2009)

            Key words: delivery ward practices, skin-to-skin contact, early suckling, early separation,
            swaddling, mother-child interaction, sensitive period

          • Dr Kitty
            February 23, 2014 at 5:32 pm #

            Wow…you can’t see ANY possible flaws with that study?

            Can you quote the P values?
            Since we’re talking about less than 50 dyads in each group it would be great to see them.

            I assume all the births were normal, spontaneous vaginal deliveries with no neonatal illnesses or maternal complications?
            That rates of maternal postnatal depression in each group were mentioned and controlled for?

            Otherwise the “study” is less than useless.

          • Young CC Prof
            February 23, 2014 at 6:07 pm #

            I agree with Dr. Kitty. The total sample size is 176, and now we’ve got 4 subgroups and multiple measures? Definitely I’d need to see some p-values. Also, I’d want to know how many endpoints the study initially had, how great the differences were, and whether these mothers expected to get their babies immediately after birth or not.

          • nikkilee
            February 23, 2014 at 6:11 pm #

            You can find the study. Remember this is only one of many. Check out the bibliography.

          • Young CC Prof
            February 23, 2014 at 6:13 pm #

            I found it was behind a paywall. Think of my questions as examples of the questions that need to be asked any time anyone reads a study…

          • nikkilee
            February 24, 2014 at 8:01 am #

            There are plenty of valid and reliable study designs that are not randomized clinical trials.

          • Young CC Prof
            February 24, 2014 at 11:18 am #

            True, but what does that have to do with my critique? I said that the sample size was too small.

          • Elizabeth A
            February 23, 2014 at 9:19 am #

            Skin to skin care is associated with good blood sugar levels, but there is no mechanism by which it affects blood sugar. Correlation is not causation.

            A baby that is well enough to be held skin to skin, with a mother who is well enough to hold the baby, will often be fine and nursing will often be initiated without problems, but if nursing isn’t going well, skin to skin won’t magically increase the baby’s blood sugar.

            Also, those studies on kangaroo care in developing nations? Those studies showed that, in cases where NICUs were so direly underequipped that most babies in them died, skin-to-skin improved survival rates to levels that would cause a first-world NICU to be burned to the ground by angry mobs.

            (My daughter spent her first 32 days of life in the NICU at Beth Isreal, smack in between BWH and Children’s, and part of the same hospital system. They are really damn clear on the benefits and limitations of kangaroo care. They were happy to have me hold my daughter, but they didn’t expect it to have any effect on her assorted medical problems, and they certainly didn’t see it as a substitute for feeding her.)

          • AlisonCummins
            February 25, 2014 at 1:50 am #

            If skin-to-skin can treat dehydration, hypernatremia, hypoglycemia, hyperuricemia,
            hyperbilirubinemia and other metabolic instabilities in infants, why wouldn’t it be able to rehydrate an adult?

          • Nikki Lee
            February 25, 2014 at 6:58 pm #

            I have no idea. Skin to skin can’t rehydrate a baby. Skin to skin keeps babies in parasympathetic mode, calm and content so their stress hormones are at the lowest levels.

          • NoLongerCrunching
            February 25, 2014 at 7:14 pm #

            You wont find any argument here on the value of colostrum and skin-to-skin. Nevertheless, hyponatremic dehydration is common among breastfed newborns. ( We can try all we want (and we do in my hospital, yet it happens despite best efforts). In those cases where breastfeeding frequently is not enough, formula supplementation is the standard of care, because it is quite clear that whatever risks there may be, the risk of failing to do this is worse.

          • Nikki Lee
            February 25, 2014 at 7:21 pm #

            Hypernatremic dehydration, physiologic jaundice, and excessive weight loss are symptoms of insufficient breastfeeding. You never find any analysis of the breastfeeding in these articles; no evaluates breastfeeding frequency or baby’s ability to transfer milk. Dr. Lawrence Gartner talks about “lack of breastfeeding jaundice.” One’s bilirubin goes up during starvation. Not fair to blame breastfeeding until a complete evaluation is done of the whole picture.

          • AlisonCummins
            February 25, 2014 at 7:26 pm #

            You’re trying to evaluate the whole picture while an infant is starving. What are you going to do for the infant while you try to figure out whether or not milk production can be improved?

          • Nikki Lee
            February 25, 2014 at 8:05 pm #

            Feed the baby. Best is to prevent the situation in the first place; easy enough to do.

          • NoLongerCrunching
            February 25, 2014 at 7:29 pm #

            Did you read the article? The authors state that 16% of breastfed infants born to primiparous women had weight loss exceeding 10% by day 3, despite education and support provided by a lactation consultant. You can quibble about whether that LC was an IBCLC or other details, but my point is that this is happening, despite the increasing breastfeeding education being done in most US hospitals.

            So we can do more of the same, with more babies being readmitted for dehydration, thus disrupting the mother-baby pair, or we can accept it and prevent it with careful use of formula supplementation. Donor milk is not usually available. We live in the real world, not in a magical world where breastfeeding always works out perfectly with no glitches and copious donor milk is available.

          • Nikki Lee
            February 25, 2014 at 8:08 pm #

            The abstract doesn’t give any evaluation of breastfeeding. We aim for the best in our care. Most US hospitals are not on board with best practices to support breastfeeding; this is measured in the CDC’s mPINC biennial mPINC survey (maternity practices in infant nutrition and care.)


          • NoLongerCrunching
            February 25, 2014 at 8:41 pm #

            Um…you do know you need to read the whole paper to have any clue about the findings, right?

          • AlisonCummins
            February 25, 2014 at 7:16 pm #

            You propose skin-to-skin as superior to formula for starving babies whose mothers’ milk hasn’t come in yet or is coming in too slowly.

            That sounds awfully like you think skin-to-skin can rehydrate an infant.

          • AlisonCummins
            February 25, 2014 at 1:27 am #

            No, the mother does NOT have milk. We are talking about the example where HER MILK HAS NOT COME IN YET. The baby is hungry, dehydrating and starting to develop jaundice.

            Skin-to-skin does not feed the baby, rehydrate the baby or clear bilirubin.

          • Nikki Lee
            February 25, 2014 at 6:56 pm #

            Mothers start making milk in pregnancy, as long as they have breasts. (I am thinking about breast cancer survivors who may become pregnant, and who may lack one or both breasts.) The term “milk coming in” is a misleading misnomer and refers to milk volume increase that occurs when hormones shift after complete delivery of the placenta. I would personally like to stamp out that phrase.

          • nikkilee
            February 22, 2014 at 6:25 pm #

            Sometimes a baby’s blood sugar is so low that IV supplementation is used because it quickly raises blood sugar levels. This is especially important if the baby is symptomatic.

            Some parents will choose this option for a transient condition.

          • fiftyfifty1
            February 22, 2014 at 9:48 pm #

            “Some parents will choose this option for a transient condition.”

            Yes, parents who have been misinformed by the likes of you.

            If the gut works, use it.

          • techqueen333
            February 23, 2014 at 9:43 am #

            No, parents who don’t want their baby’s gut environment compromised by cow’s milk or soy formula. The mother can pump in-between feeds and the iv, if actually needed, should be very short term. The formula shoved down my grandson’s throat was totally unnecessary. My daughter was able to pump and did so after the incident. However, she wasn’t even asked!!! The nurse just happily informed her she had given the baby formula. Awful.

          • AlisonCummins
            February 25, 2014 at 12:55 am #

            We aren’t talking about blood sugar, we’re talking about clearing bilirubin.

            I cannot imagine an MD going along with this option for a healthy infant who could suck.

          • The Bofa on the Sofa
            February 22, 2014 at 3:27 pm #

            But this is total red-herring.

            For example, if that were the case, then we have to completely reassess your idiotic claim that donor milk should be used for non-preemies. In fact, it calls into the question of using donor milk for preemies, since, because lactation is so dynamic, then you have to insist that the only donors for preemies are those with preemies, because as their babies progress, their dynamic milk production will have progressed past the preemie stage.

            Similarly, if dynamic ability is so critical, then any donor milk that you advocate for newborns can only be given by newborns.

            Jeez, you think there is a short supply of donor milk now, imagine if we had to restrict donors to those with newborns?

            So here’s the problem: if the dynamic changes with breastmilk are truly critical, then you can’t accept milk from the mother of a 2 mo old for a newborn. Shit, you went on about time of day mattering even. If that really matters, are you screening donor milk for the time of day that it was expressed?

            Because you can’t claim that the dynamic properties of breastmilk are important while at the same time, dismissing it for donors with an excuse “but any breastmilk is good enough.”

            Is the dynamic makeup of breastmilk important? Or is it not? And if it’s not, why bring it up, if other than to change the topic?

          • nikkilee
            February 22, 2014 at 6:46 pm #

            Some milk banks in the country do organize milk by the age of the donor’s baby, so there is a choice of premie or full term milk. Many milk banks will not accept milk from a donor whose baby is more than a year old. Human milk, even when cultured, pooled, pasteurized, and frozen is always best for babies. While some factors disappear (like the lipases) most are still present; and it is still species specific protein.

          • The Bofa on the Sofa
            February 23, 2014 at 9:41 am #

            Do you approve of giving a preemie donor milk from the mother of a non-preemie?

            Do you approve of giving a newborn donor milk from the mother of a 4 mo old?

            If yes, then your “dynamic milk supply” argument just got tossed out the window.

          • nikkilee
            February 23, 2014 at 9:46 am #

            Two things can be true at once. Human milk composition during breastfeeding is dynamic, changing during the feed, during the time of day, and during the duration of breastfeeding. And human milk, regardless of the age of the donor’s baby, is better for premature infants and newborns than formula because of the protein specificity, immune system boosters, and all its’ other components.

          • AlisonCummins
            February 25, 2014 at 2:04 am #

            If the dynamism of human milk composition is irrelevant to the discussion of what to do for a two-to-three day old baby whose mother’s milk has not come in yet, then just don’t bring it up.

          • AlisonCummins
            February 25, 2014 at 1:23 am #

            The question is not whether human milk is best, the question is what to do in the specific case when it is UNAVAILABLE.

          • AlisonCummins
            February 22, 2014 at 3:17 pm #

            We’re still waiting for your reply to Bofa on the Sofa explaining the effects of formula on “the infants gut environment.”

          • nikkilee
            February 22, 2014 at 6:43 pm #

            An exclusively breastfed baby’s gut is more acidic than the formula fed baby. Balmer and Bullen in Australia found that gut pH had not returned to physiologic levels by 6 weeks after a baby had ingested 1 ounce of formula every day in the hospital.

            Breastfed babies have guts that grow lactobacillus and bifidus bacteria that are not dominant in the formula-fed babies.

            “Moreover anaerobic bacteria detected by molecular biology have shown that the 2 types of feeding cause differences in gut flora composition never before suspected.” (“Postnatal Development of Intestinal Microflora as Influenced by Infant Nutrition” Lorenzo Morelli
            J. Nutr. September 2008 vol. 138 no. 9 1791S-1795SJ

            Altered gut pH is one reason that babies, especially premature infants develop Systemic Inflammatory Response Syndrome. Another reason to give nothing but human milk to premature infants. But why would the value of human milk for the gut stop once a baby has reached its due date?

            “Indeed, formula-feeding induces intestinal hypertrophy and accelerates maturation of hydrolysis capacities; it increases intestinal permeability and bacterial translocation.”

            Nutr Res Rev. 2010 Jun;23(1):23-36. Epub 2010 May 10.
            “Breast- v. formula-feeding: impacts on the digestive tract and immediate and long-term health effects.”

            Just a few of many, many such studies showing how feeding method changes the infant gut.

            Cesarean section also alters the infant gut microbiome, as the newborn becomes colonized with the flora of the operating room staff who handle the baby, instead of being colonized with its mother’s flora. Some researchers and physicians suspect this explains why babies born surgically (NOT all babies, and not yours. . .but in a large sample, most), have more allergies.

            This is a whole new area of exploding research and is why giving probiotics is recognized in pediatric journals as a treatment for colic.

          • KarenJJ
            February 22, 2014 at 7:29 pm #

            Systemic Inflammatory Response Syndrome? What is this?

            I have a genetic auto-inflammatory syndrome and I have to say that although the chronic inflammation has done a fair bit of damage it sure beats starving. But I don’t see many kids suffering stresses from chronic inflammation and nor did my attempt at breastfeeding my first save her from the effects of chronic inflammation from inheriting the same syndrome.

            So how can you extrapolate from Systemic Inflammatory Response Syndrome and make it meaningful to the rest of the population? In what way does it affect healthy infants?

          • nikkilee
            February 22, 2014 at 8:55 pm #

            “Systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body, frequently a response of the immune system to infection, but not necessarily so. It is related to sepsis, a condition in which individuals meet criteria for SIRS and have a known infection.

            It is the body’s response to an infectious or noninfectious insult. Although the definition of SIRS refers to it as an “inflammatory” response, it actually has pro- and anti-inflammatory components.”

            In infants, it can trigger necrotizing enterocolitis, a potentially fatal condition. Formula feeding exposure can have the consequence of colonization of pathogenic bacteria.

            “Figure 4-3 shows some of the measures that might be used to prevent NEC. The safest and most efficacious practices in the prevention of NEC include maternal breastfeeding, judicious advancement of enteral feedings, and careful infection control measures.”

            From the

            ‘Prematurity, Necrotizing Enterocolitis, and Systemic Inflammatory Response Syndrome’ chapter in:
            Gastroenterology and Nutrition: Neonatology Questions and Controversies
            by Josef Neu

            I have heard Dr. Paula Meier, from the NICU at Rush Hospital in Chicago talk about this at a conference. She said that SIRS can trigger NEC, diabetes and Crohn’s disease. I know about this only because I am called on to defend the role of human milk in the Intensive Care Nursery as part of my work.

          • KarenJJ
            February 22, 2014 at 9:00 pm #

            So a good reason for premature babies to have access to breastmilk. Little reason to recommend feeding via IV for a healthy term infant that is starving and not getting enough breast milk.

          • Young CC Prof
            February 22, 2014 at 10:38 pm #

            Um, yeah. We all know that breast milk reduces the risk of NEC in preemies. The original post states it and every person on this thread agrees.

            NEC doesn’t generally show up in term infants. Hence, we believe that the very limited and inadequate supply of donor milk should be for preemies first.

            And who are these people fighting you on human milk? Are you sure you aren’t tilting at windmills? I think most of the hospital staff want every baby to get breast milk if possible, though they might have slightly stricter definitions of possible.

          • nikkilee
            February 23, 2014 at 7:49 am #

            You are right, although not all hospital staff are on board yet. From what I have read on this blog, the people fighting human milk are here.

          • KarenJJ
            February 23, 2014 at 8:20 am #

            I will and have stood up for the right for women to breastfeed in my workplace.

            I will and have stood up for women that are being told falsehoods, exaggerations and moralising tales about breastfeeding. You are boxing at shadows here, tilting at windmills.

          • techqueen333
            February 23, 2014 at 10:48 am #

            Your statement that women are being told falsehoods and exaggerations is a false premise.
            Nice metaphors, BTW, but they don’t add much.

          • AlisonCummins
            February 25, 2014 at 1:54 am #

            I haven’t seen anyone fight human milk. I’ve seen people ask what you propose to do about a child who is starving whose mother’s milk has not yet come in. If the mother had milk we wouldn’t be having this conversation, but she doesn’t.

            Nobody is saying that donor milk is bad in this circumstance. They are saying it is unavailable because preemies need it more. “Bad” and “good but unavailable” are two very different concepts.

          • techqueen333
            February 22, 2014 at 9:31 pm #

            Who said anything about kids starving? Talk about hyperbole. Wow..
            Why don’t you do a study?

          • KarenJJ
            February 23, 2014 at 8:07 am #

            I’m not a medical professional. My newborn baby took 6 weeks to get back to her birth weight. That isn’t hyperbole.

          • techqueen333
            February 23, 2014 at 9:28 am #

            That’s one case. I don’t know what kept you from lactating or if it was a case of sabotage. It’s not the norm (not to be able to produce an adequate supply).

          • Durango
            February 23, 2014 at 9:31 am #

            Why do your anecdotes count but others’ don’t?

          • techqueen333
            February 23, 2014 at 10:46 am #

            I don’t think my anecdotes count as research. I was damned earlier for not showing any personal knowledge.

          • The Bofa on the Sofa
            February 23, 2014 at 10:54 am #

            Where are your “studies” for your assertion above that “formula is the panacea for everything”?

          • Durango
            February 23, 2014 at 1:05 pm #

            No one here counts their anecdotes as research either, but you blithely dismiss them all while thinking yours are important. You have been challenged because you keep making unsupported statements with a single anecdote-laden post and a few abstracts. Though you want us to believe you simply because you have a phd and you’re married to a doctor, you’re argument style has been exactly the same as a completely ignorant, unschooled person (who could easily go to any pro-breast feeding site, copy the abstracts found there and paste them here, then claim they support your argument). Your credentials don’t matter (and who counts their spouse’s credentials??), how/what you claim does.

          • techqueen333
            February 24, 2014 at 3:27 am #

            I’m not counting anecdotes as research. That’s the difference.
            I’m not sure why it took six weeks for KarenJJs baby to regain her birth weight. She didn’t say.

          • fiftyfifty1
            February 23, 2014 at 10:43 am #

            No, it’s not “the norm”, but it’s a common enough problem that it needs to be taken seriously. If you went to your doctor and he or she said “well your thyroid tests are really low, so that could explain all your symptoms, but having low thyroid is not “the norm” so I’ll dismiss these findings” how would you feel? Insufficient milk production has approximately the same prevalence as hypothyroidism: About 1% making almost none at all and 10% making some, but not enough for optimal health.

          • Young CC Prof
            February 23, 2014 at 10:55 am #

            And what bad LCs don’t understand is that the prevalence of primary insufficiency is generally HIGHER in the population of women who seek help with lactation. Now, I’m sure many clients have lots of milk and are just struggling with things like latch issues, but quite a few have genuine supply problems.

            Just like the population of people who are tested for thyroid issues due to symptoms are more likely to actually have thyroid issues than someone getting a blood test as part of a routine physical.

          • fiftyfifty1
            February 23, 2014 at 11:56 am #

            Exactly. It’s the concept of pre-test probability. Women who make plenty of milk don’t make appointments with the LC due to low milk. It’s the bottom 20% who do. Some of those can be helped by ensuring proper technique, frequent feeding, pumping and other measures. But a large percentage medically CAN NEVER, and WILL NEVER produce enough milk no matter what measures are used and MUST give formula.

            It’s as if an endocrinologist said “Hypothyroid is less that 1% of the population! How can half the people on my schedule today be here for low thyroid? They must all be hysterical hypochondriacs! Tell them to make sure to eat plenty of seafood and used iodinized salt and send them all home!”

          • Young CC Prof
            February 23, 2014 at 12:20 pm #

            While in fact nearly half of the endocrinologist’s workload IS thyroid problems. The other nearly half is diabetes, with the occasional other very interesting case thrown in.

          • AlisonCummins
            February 25, 2014 at 1:57 am #


          • AlisonCummins
            February 25, 2014 at 1:45 am #

            Starving is exactly the example we are discussing. Baby was born two or three days ago. Milk still hasn’t come in. Baby is screaming with hunger, dehydrated, hypoglycemic and becoming jaundiced.

            Wnat are you going to do? Donor milk is not available to healthy term infants because it is reserved for preemies. Parenteral nutrition is far too risky.

          • techqueen333
            February 25, 2014 at 4:44 am #

            Where did you come up with this example? Most women’s milk takes two or three days to come in. Until then, babies get colostrum.

          • fiftyfifty1
            February 22, 2014 at 9:44 pm #

            ” But why would the value of human milk for the gut stop once a baby has reached its due date?”

            By that logic, all of us, including adults, should insist on being 100% breastfed.

          • techqueen333
            February 23, 2014 at 8:14 am #

            No, it doesn’t. And, we are talking about newborns here. Read the literature.

          • fiftyfifty1
            February 23, 2014 at 8:47 am #

            I’ve read the literature and come to the same conclusion as Dr. Amy: Breastmilk has significant benefits for small preemies, but it has only marginal benefits for the term neonate.

            (Hey I *wish* breastmilk really was a magic wand like you seem to think. When my first was born, the only breastfeeding studies available at the time showed correlations with better outcomes.I knew they were all poor quality and observational, and suspected the good outcomes were due to confounding, but I decided on breastfeeding anyway, just in case. As luck would have it, my son had a very abnormal suck, which triggered a series of events that gave me crush-injury raynauds and a number of other problems. So I ended up pumping. To keep my supply up I had to do it for 30 minutes, every 3 hours round the clock. I did this for an entire year. It was torture. And then the randomized Belarus PROBIT study came out confirming that breastmilk has only minimal benefits in the term newborn. What a waste! I really regret sacrificing what I did to provide that milk. It was not worth it. Breastmilk is food, not magic. Formula is food, not liquid-devil.)

          • techqueen333
            February 23, 2014 at 9:26 am #

            Better go back to the literature. Obviously, you’ve cherry-picked just like Amy. Formula is food, but it’s inferior food for situations where breastfeeding isn’t possible. It should not be considered an equal choice. Kind of like when you feed your kids spaghetti-os instead of a nutritious, healthy meal.

          • fiftyfifty1
            February 23, 2014 at 10:30 am #

            No, it’s not cherry picking, it’s simply giving more weight to large, well designed, randomized, controlled studies rather than poorly designed, small observational studies subject to confounding. It’s the same reason that when my female patients ask for my opinion on post-menopausal hormone replacement, I base my opinion on the findings from the Women’s Health Initiative study rather than on all the hundreds of observational studies that came before that found that hormone replacement was associated with superior outcomes.

          • Playing Possum
            February 23, 2014 at 1:23 am #

            But doesn’t an unfed gut cause increased mucosal permeability and increased infectious complications? IIRC delayed feeding is suggested to be one of the inciting factors for NEC, and certainly early enteral feeding of appropriate composition is pushed in all at groups. The choice of colonising bacteria is of somewhat less importance than a serious illness.

            And don’t gastrointestinal flora shift to a household level after a period? So everyone has everyone else’s? So … eventually the baby will end up with the same or a similar clone?

          • nikkilee
            February 23, 2014 at 7:54 am #

            It doesn’t seem to work that way; the initial colonization seems to prime the gut. Risk factors for NEC include prematurity, blood transfusions, and formula feeding. A small dose, 1cc, is called a ‘trophic feed’ and will be given to a premature baby to help mature the gut. The way the research is heading seems to point that the choice of colonising bacteria leads to the subsequent illness. However, this area of study is developing and we will know more as time goes on.

          • Playing Possum
            February 23, 2014 at 2:57 pm #

            Ok, so what’s worse? We are all in agreement that premature babies benefit from the most from human breast milk and rationing of this resource. So in a term, otherwise completely well neonate, what is the worse option? Increasing the short term risk of potentially catastrophic complications from starvation and using only IV, or feeding them formula and increasing the risk of long term allergic (and unpredictable, nebulous) consequences.

          • nikkilee
            February 23, 2014 at 6:04 pm #

            Give them human milk; from companies like Prolacta and Medolac, from donor milk banks, and from informal sharing networks like Eats on Feets or HM4HB.

          • Young CC Prof
            February 23, 2014 at 6:44 pm #

            Informal milk sharing isn’t safe, and how many times have we said the milk banks don’t have enough? Is this why you run into problems at work, because you want donor milk for every baby not being breastfed and other folks tell you that’s impossible? Guess what, it’s impossible.

          • nikkilee
            February 24, 2014 at 8:26 am #

            Informal sharing, when done responsibly, as described on the Eats on Feets website, is less risky than formula and the choice I would recommend, based on nearly 40 years of working in this area: teaching, practicing and researching. I would do it myself; I would suggest it to my daughters. One can pasteurize milk at home; one can visit the donor and see how she lives and how her baby is doing.

          • Elizabeth A
            February 25, 2014 at 8:18 pm #

            I donated milk informally, because I’m ineligible for formal donation in the US (due to residence in the UK in the mid-nineties). I would NOT recommend it.

            No one ever asked a darn thing about my lifestyle or how my babies were doing. They certainly did not ask to visit me and check things out.

            The only questions I was ever asked were where, when, and what do you want for it. Recipients came to my house, at my convenience, took breastmilk, and left. Some of them drove for hours to do this. And they have to have been getting milk from multiple women like me, because I wasn’t producing THAT much. Clearly, it was very important to them, but it seems to me to be a huge effort, for very small benefits.

            When I stopped pumping for my own baby, I went to the grocery store and bought her formula. If I were to have another baby (now that I’ve had both mastectomies) I would go straight for formula. When my sister was having trouble breast feeding, I recommended formula. I would again.

          • Nikki Lee
            February 26, 2014 at 5:47 am #

            Interesting. As you say, it was important to them, who were making the choice and doing the work. Some sharing networks encourage buying locally and making a relationship between donor and receiver.

          • Elizabeth A
            February 26, 2014 at 8:04 am #

            All the networks encourage that, but that encouragement consists entirely of saying that it would be nice if you chose local, and great if you could be friends.

            Practical reality is that donors give to the first person who provides what they want. For me, a mom of two with intractable oversupply, I wanted my freezer back. I wasn’t charging, but I had a baby at home and one in the NICU. I didn’t have time to stand around making friends, and I wasn’t going to start anything that might make me feel guilty about cutting back my pumping schedule, or weaning so I could switch antidepressants.

            Edited to add: if you think donors aren’t also doing the work, that’s one of many reasons why there are so few donors.

          • Nikki Lee
            February 26, 2014 at 9:58 am #

            Donors are working; adding pumping to a busy day takes energy. Thanks for your wisdom.

          • KarenJJ
            February 23, 2014 at 8:15 am #

            I know that whatever benefit my eldest got from breastmilk, the added gut flora from the potting mix I caught her gnawing on probably undid it.

          • techqueen333
            February 23, 2014 at 9:38 am #

            We are talking about newborns, KarenJJ. Pay attention.

          • Durango
            February 23, 2014 at 9:45 am #

            Yes, but newborns grow up and gut flora evolves over time (and may I also add that the research in gut flora, while exciting and interesting, is still very preliminary, with few, if any, clinical recommendations). It is reasonable to point out that other things will influence a child’s gut.

          • Young CC Prof
            February 23, 2014 at 10:21 am #

            My brother at least once ate sand from our sandbox, that probably served as a cat-box for stray cats. I’m sure that had interesting effects on his developing biome and immune system.

          • fiftyfifty1
            February 23, 2014 at 10:36 am #

            “But doesn’t an unfed gut cause increased mucosal permeability and increased infectious complications? ”

            Indeed it does. This is why the adage of “If the gut works, use it”. Not just because you CAN use it, not just because it’s easier than an IV, not just because it doesn’t have the risks of an IV. You should use the gut, because it NEEDS to be used.

          • Young CC Prof
            February 23, 2014 at 10:56 am #

            Ever notice how often a baby poops in the middle of or immediately after a feeding? There’s a reason for that, and it isn’t “annoy Mommy.”

          • techqueen333
            February 23, 2014 at 9:37 am #

            Read the literature, Alison. I’m not going to do it for you. It’s there.

          • The Bofa on the Sofa
            February 23, 2014 at 9:38 am #

            Can you summarize it?

          • techqueen333
            February 22, 2014 at 1:49 am #

            anion, why don’t you learn about the differences in the guts of newborns who are exclusively breastfed and those who aren’t. It has nothing to do with formula being “man made.”

          • anion
            February 22, 2014 at 2:11 pm #

            Techqueen, why don’t you NOT assume I don’t know anything about the whole “virgin gut” theory? I once believed it. I added probiotics to the occasional formula bottles my breastfed baby got. Either that worked just fine or the theory is nonsense, and given the scientific evidence I’m inclined the believe the latter. Either way, “preserving gut flora” is hardly an appropriate reason to feed an INFANT intravenously. FFS, what kind of sadist advocates putting tubes in the veins of babies like that instead of just giving them a bottle?

            And the “man-made” thing is a common anti-formula argument. Not everything is about you personally–especially things in comments which were not replies to you.

          • techqueen333
            February 22, 2014 at 9:25 pm #

            What kind of sadist screws up an infant’s gut flora and ph when they don’t have to?

          • Amazed
            February 22, 2014 at 9:58 pm #

            What kind of sadist brings her child to the point of needing an IV just to save the precious gut flora?

          • techqueen333
            February 23, 2014 at 9:37 am #

            Sadist? Hardly. Your name calling only serves to illustrate that you have no argument.

          • Amazed
            February 23, 2014 at 9:44 am #

            Make an argument? Why should I bother when you make my argument for me. Bofa’s for him, Young CC Prof’s for her and so on?

            Oh, and I don’t believe for a moment that you actually have a grandson. teenqueen333.

            Anyway, thanks for making our arguments for us.

          • Young CC Prof
            February 23, 2014 at 10:18 am #

            I agree with you on this. Definitely a teenager making things up. I’ve never seen an adult with such poor communication skills, and it’s definitely not a language barrier.

          • techqueen333
            February 23, 2014 at 10:44 am #

            Your persistent use of ridicule only exposes your lack of an argument. I’m well over fifty and have a PhD from a major research university. I have three grown children and one grandchild.

          • techqueen333
            February 23, 2014 at 10:45 am #

            I haven’t made any arguments for you Amazed. Again, your use of ridicule only exposes your lack of an argument.

          • Amy Tuteur, MD
            February 22, 2014 at 10:40 pm #

            What kind of self righteous moron thinks that formula feeding is sadism?

          • techqueen333
            February 23, 2014 at 9:36 am #

            Ridicule and straw man argument. Woo aren’t you the tough guy. What kind of “MD” cherry picks research and gives patients false information?

          • perpetual lurker
            February 23, 2014 at 10:37 am #

            Oh FFS, it’s not a straw man. You JUST said, “What kind of sadist screws up an infant’s gut flora and ph when they don’t have to?” So you JUST effectively sad that choosing to formula feed makes a person a sadist. I know you love to throw around terms from your logic 101 course but you should really learn what they mean first.

          • techqueen333
            February 23, 2014 at 10:42 am #

            I was being sarcastic. It was a response to the person who called me a sadist for suggesting that an iv could be a better short term solution to an acute situation than FF. Sorry you didn’t understand that.
            Hahaha on the logic 101. You really think you are clever, but you are not. I’ve very clear on the meanings of those term.

          • perpetual lurker
            February 23, 2014 at 10:53 am #

            Lol, I see, so you respond to someone calling you a sadist by repeating that phrase and you are being sarcastic, but then Amy does the same and she is using a straw man? Yep, makes sense to me. I guess it took me a minute, you know, with the whole thinking I’m clever but not being clever thing.

            You really are something else on this thread. Keep it coming!

          • techqueen333
            February 22, 2014 at 1:48 am #

            Why don’t you check out the effects of even small amounts of formula on the infants gut environment. I would absolutely do everything I could to avoid having my infant receive formula. If the baby were six months old, or if the situation were dire, that would be a different story.

          • The Bofa on the Sofa
            February 22, 2014 at 9:03 am #

            Why don’t you tell us all about these “effects” on the “infants (sic) gut environment”?

            My children both had formula within the first 6 weeks. Please explain what is wrong with their “gut environment”?

          • Karen in SC
            February 22, 2014 at 9:08 am #

            Or my gut flora. Been working great for decades.

          • techqueen333
            February 23, 2014 at 9:24 am #

            Why don’t you actually read the literature instead of ridiculing things in ignorance?

          • DaisyGrrl
            February 22, 2014 at 9:30 am #

            Formula to a baby’s gut environment is like acid rain on the boreal forest. Only unicorn tears will save your children now!

            Or they could be okay. Yep, they’re fine.

          • techqueen333
            February 23, 2014 at 8:12 am #

            Ignorant comment Daisy.

          • The Bofa on the Sofa
            February 23, 2014 at 9:37 am #

            But more than you have actually said.

          • DaisyGrrl
            February 23, 2014 at 11:33 am #

            Which part? That Bofa’s children are fine? I have only his word on it and I’m inclined to take it.

            The part about equating formula to acid rain? From your posting, that’s my take away. I haven’t seen a serious discussion of the research from you and as a layperson I am not equipped to interpret the studies myself. Since others on the thread have parsed the numbers in various studies and explained what they mean in simple terms that I can understand, I am more inclined to believe them when they say that the current state of evidence shows marginal benefits for breastfeeding. So if all else is equal, bf. Otherwise, don’t beat yourself up about ff.

            Now, if you (being *such* an expert) would care to translate the research that uses all the big words and scary numbers into something that a person without scientific training can understand, I’d be very grateful. I’d then be able to evaluate your counter-argument and come to a decision on what I believe are the relative merits. Linking to study abstracts is meaningless to me.

            Back to my ignorant comment. Could it be the part about unicorn tears? You’re right. Bofa, I forgot to mention that there should be pixie dust mixed in with the unicorn tears in order to have the desired effect.

          • techqueen333
            February 23, 2014 at 8:12 am #

            There are quite a few studies that discuss this. You can find them in PubMed or even by using the Google Scholar database.

          • MLE
            February 23, 2014 at 8:24 am #

            Still referring people to PubMed and Google even after all these days? You have to a) cite the relevant paper, and b) note the SPECIFIC data from that paper which backs up your assertion. This was explained elsewhere on the thread in greater detail if you need it. Copying and pasting the author’s conclusions is not good enough.

          • techqueen333
            February 23, 2014 at 9:33 am #

            I’m not going to do your work for you. I don’t have the time. I’ve posted abstracts. Go read the study.

          • The Bofa on the Sofa
            February 23, 2014 at 9:36 am #

            I’m not going to do your work for you.

            Hey, YOU brought it up, pal. You made the claim, YOU do the work.

            Besides, I’m a neophyte and don’t have the expertise to understand the papers. Why don’t you just tell me. You shouldn’t even have to go to find the papers, since you are so confident that there are such huge problems that have been caused, you should be able to explain them to me.

            What is wrong with my kids’ guts because they had formula in the first 6 weeks?

          • techqueen333
            February 24, 2014 at 2:10 am #

            I don’t have the time to do your work for you. If I post citations or abstracts, I get flamed. You wouldn’t be asking me to do this if I said the research supported your actions.

          • Box of Salt
            February 24, 2014 at 2:42 am #

            techqueen333 “If I post citations or abstracts, I get flamed”
            yes, if you just post a citation.

            How about if you pick a study (not behind a paywall) to use as an example, chat it up with your in house sounding board, and come back and post a short summary of what that study is telling you.

            This is not doing work for others – it’s just showing your own work.

            Let us know *why* you think what you think. With sentences *and* links.

          • techqueen333
            February 24, 2014 at 3:06 am #

            I don’t have time to do that. I don’t see why you can’t read the studies for which I post citations or abstracts yourselves. I’m involved in several large program evaluations involving multiple universities and have a concert to prepare.

          • Young CC Prof
            February 24, 2014 at 2:46 am #

            Like Box of Salt says. Pick one study, then explain why it supports your point. You don’t need to write a research paper, a few sentences plus a link to the original source will do. This is how you argue well on the Internet.

          • The Computer Ate My Nym
            February 25, 2014 at 10:18 am #

            If I post citations or abstracts, I get flamed.

            No, you get challenged to support your interpretation of the study as well as the quality and generalizability of the study. And have frequently shown yourself unable to do so.

          • Elizabeth A
            February 22, 2014 at 3:42 pm #

            TeHqueen, do you even know what iv nutrition looks like? What it takes to get it in place, what it does to the veins? Or what gut flora look like in a person not using their gut?

            There are worse things then changes in gut flora, and you seem totally oblivious to that. Formula is a solid means of keeping a situation from getting dire and iv supplementation and parenteral nutrition are options for dire situations.

            What you’re saying is that you would expose an infant to pain and risk of infection rather then alter that infant’s gut flora, even though we know that people come through just fine with all kinds of gut flora… and that treatments for infection are MORE harmful to gut flora. This is not logic for good medical decision making.

          • techqueen333
            February 22, 2014 at 9:23 pm #

            Yes, I do know what it looks like.
            Do you know the difference between then and than?
            I would make sure that my child actually needed the intervention and it was not just another case of a doctor overdoing it due to fear of litigation. When my son was born, he was over nine lbs. They wanted to supplement to keep his blood sugar up. Reasonable. So, we used syringe (no needle) and sugar water. No formula. When my daughter had her large son, she had the same situation, but the nurse gave him formula without asking. We were all furious.

          • Elizabeth A
            February 23, 2014 at 12:31 am #

            This is the first time you’ve mentioned syringe feeding sugar water as an alternative to formula – I had been arguing against IVs for infants who can take food by mouth, and you had been insisting that said IVs were preferable to feeding babies who can eat readily available, age appropriate food.

            So, okay, you think sugar water by mouth is preferable to formula for babies with blood sugar concerns. Please explain why sugar water is a better choice then formula for syringe feeding. Why is sugar water better then a formula that contains fat and protein as well as sugars? Is sugar water equally appropriate in cases where there are concerns besides blood sugar (like jaundice)? For how long is it appropriate to administer sugar water if there is insufficient breastmilk available? Also, can you describe the effect of sugar water on an infant’s intestinal flora?

          • February 23, 2014 at 1:32 am #

            “Sugar water” [what percentage of sugar?] could have led to really severe hypoglycemia, btw. It provokes production of high levels of insulin, which means that once the sugar overload is dealt with, there is too much insulin in the blood, which causes a rapid and severe drop in blood sugar, in other words, perpetuating the problem.

            The correct response was to test the blood sugar at frequent intervals, and supplement with formula or expressed breast milk as needed.

          • techqueen333
            February 23, 2014 at 8:11 am #

            The “sugar water” was provided by the hospital and they determined the appropriate concentration. Again, you use hyperbole. Neither my son nor my grandson were “severely” hypoglycemic. In my case, the hospital readily offered the sugar water. In my son’s the nurse took it upon herself to give formula…it must be part of their protocol without asking the family. My daughter had clearly specified that her baby was NOT to receive any formula. After the incident, they only used expressed milk.

          • February 23, 2014 at 9:06 am #

            Then it was 5% glucose. That’s OK; I thought you were making it up yourself.

            A few feeds with that [and babies like it because it’s sweet] are OK, but it isn’t a substitute for proper food over a long time. 5% glucose solution is meant as a supplement, not primary nutrition.

          • techqueen333
            February 23, 2014 at 9:23 am #

            No one said anything about it being a long term solution. Obviously, in the unlikely case a woman can’t lactate or can’t lactate enough (not that she was sabotaged, or doesn’t want to), formula is the only option.

          • techqueen333
            February 23, 2014 at 8:08 am #

            I was talking about iv use as a solution to very short term problems as opposed to exposing newborns to cow’s milk or soy proteins and to disrupting the neonatal gut flora and pH.
            Syringe feeding a large baby for whom there are blood sugar concerns right after birth (a problem quickly resolved) avoids iv and formula. I do not know the effect of sugar water on gut pH and flora (don’t have time today to look for studies, either…find your own), but I do know it allows mothers to avoid exposing their newborns immature gut to cow’s milk or soy proteins.
            Obviously, I would not recommend feeding babies whose mothers could not lactate (a very small number in reality) or who were adopted, etc. a sugar water diet.

          • Elizabeth A
            February 23, 2014 at 9:26 am #

            I do not know the effect of sugar water on gut pH and flora

            So there’s a chance that sugar water impacts gut flora just as much, or even more, then formula. You don’t know, but you nonetheless prefer that unknown impact to the impact of formula, even though the change in gut flora caused by formula is inconsequential for most babies.

            Reflexive opposition. Awesome.

          • techqueen333
            February 23, 2014 at 9:32 am #

            Unlikely. Formula contains cow’s milk or soy, both of which are potential allergens given an immature newborn gut.
            The change in gut flora caused by formula is most definitely NOT inconsequential. Where the hell did you get that? Read the literature!
            Reflexive opposition? pot/kette, Elizabeth A.

          • Elizabeth A
            February 23, 2014 at 10:23 am #

            It is nigh impossible to tell the exclusively brest fed children from the children who received formula as newborns by the time those children are as little as a year old, so while the changes in gut flora may be drastic, they also appear to be without consequence. There are some special cases here, of fragile infants, or infants with specific health concerns, but in the vast majority of cases, inconsequential is accurate.

          • me
            February 24, 2014 at 12:34 pm #

            When I had my second child four years ago, she was over 9 lbs. They encouraged me to bf frequently, and they checked her blood glucose a few times. Once they saw it was normal and remaining stable, they stopped checking. No one ever mentioned formula.

            Perhaps your grandson actually did have low blood sugar? If that were the case formula would be preferable to sugar water – formula has sugar as well as fat and protein. Sugar alone just causes a blood glucose spike and subsequent crash. Combined with protein and fat, sugar elevates the blood glucose level, and fat and protein help slow the metabolization keeping the blood sugar more stable hours later.

          • NoLongerCrunching
            February 24, 2014 at 12:46 pm #

            >just another case of a doctor overdoing it due to fear of litigation

            I am so tired of this meme. It is insulting to the vast majority of doctors who make decisions they think are best for their patients’ health, not from fear of litigation.

          • AlisonCummins
            February 25, 2014 at 1:43 am #

            You are the one suggesting IV nutrition — not just sugar, but a parenteral nutrition solution containing protein — to help a hungry baby clear bilirubin when the mother’s milk has not yet come in.

            The doctor would NOT be recommending parenteral nutrition for a healthy tern infant. Litigation would happen if it were done, not if it weren’t done.

          • Melissa
            February 23, 2014 at 1:40 am #

            Especially because the changes to gut flora will happen at some point when the child is weened. Everything I have seen about the different gut bacteria in bf v. ff. make clear that the differences end when solid food is introduced. In other words, the benefits of breastfeeding do exist but do not have lifelong impacts. Which means that it is perfectly reasonable to decide that it’s better to introduce those evil gut bacteria a few months ahead of schedule if it prevents the child from being in pain from hunger or from needing an iv.

          • techqueen333
            February 23, 2014 at 8:02 am #

            Pushing formula is not good logic for medical decision making.
            Concerns about changes in gut flora and ph are not relevant to older babies. We are talking about newborns here.
            BTW, all of you who are so concerned about the pain of starting an IV….did you have your sons circumcised?

          • KarenJJ
            February 23, 2014 at 8:05 am #


          • Mishimoo
            February 23, 2014 at 8:14 am #

            I didn’t realise that my son’s genitals were any of your business. Please, do elaborate on exactly why I should discuss them with a stranger on the internet?

          • Durango
            February 23, 2014 at 9:16 am #

            For someone who regularly characterizes others’ comments as logical fallacies, you sure like to use them yourself.

          • fiftyfifty1
            February 22, 2014 at 9:38 pm #

            Do you know what a line infection is?

          • techqueen333
            February 23, 2014 at 8:00 am #


          • NoLongerCrunching
            February 24, 2014 at 12:43 pm #

            There is NO evidence that the gut flora of a FF baby causes him any harm long-term.

          • techqueen333
            February 25, 2014 at 6:43 am #

            What evidence do YOU have to support that statement? Why would you want to risk harm in the short term?

          • NoLongerCrunching
            February 25, 2014 at 7:31 am #

            It’s impossible to prove a negative (e.g., prove there is no God). If you are asserting something causes harm, the burden of proof is on you.

            I would not choose to give formula, but many mothers do, and there is no reason to be needlessly alarmist about something that is theoretical. If they cannot be convinced on the proven merits of exclusive bf, then there’s really nothing you can do.

            Also, *if* changing the gut flora does end up having negative consequences, that will need to be compared with the risks of withholding supplementation in cases where there is a medical need.

          • fiftyfifty1
            February 22, 2014 at 9:37 pm #

            “If the gut works, use it.”

            Yep, this is medicine 101. So important, for so many reasons, at every age.

      • rh1985
        February 22, 2014 at 8:51 am #

        IVs freaking hurt if given when dehydrated. Those poor babies.

        • techqueen333
          February 23, 2014 at 7:59 am #

          Stop with the dehydration hyperbole. Formula is pushed as a panacea for everything.

          • Durango
            February 23, 2014 at 9:13 am #

            Placing an iv in a newborn is a big deal. No one is going to do it just to “top up” a baby. If the baby is needing iv fluids or nutrition, it is extremely likely to be dehydrated. It’s not hyperbole. And trying to find a vein on a dehydrated adult is hard enough, I can’t even begin to imagine how much harder it would be on an infant.

          • techqueen333
            February 23, 2014 at 9:21 am #

            I understand about the difficulties of starting an iv in any dehydrated person and certainly in an infant. Babies are hooked up to ivs and given formula as a precaution…long before they are dehydrated. That was what happened to my grandson…who was not dehydrated (my daughter had great colostrum flow) and who was only slightly hypoglycemic. I have to wonder how many of these protocols were developed out of fear of litigation rather than actual necessity.

          • Elizabeth A
            February 23, 2014 at 9:26 am #

            But babies are NOT hooked up to IVs as a precaution. Babies are only placed on IVs when IVs are needed – IVs are tough to place in babies, and babies with IVs require closer monitoring and (usually) NICU admission.

            Yeah, babies are given formula on a precautionary basis fairly often, because if you can keep a baby from tanking, why wouldn’t you?

          • Anj Fabian
            February 23, 2014 at 11:05 am #

            Keep a baby out of the NICU? Of course!

            Give formula to a baby to keep it out of the NICU?
            Of course!

            I’m having problems wrapping my head around the POV that not feeding a baby something from column B is worse than the baby becoming so poorly that it needs to admitted to an intensive care unit.

          • techqueen333
            February 24, 2014 at 2:08 am #

            How did you go from zero to ten that fast Anj Fabian? Who is saying that one must do nothing until a baby is admitted to the NICU? Formula should not be the first option.

          • Anj Fabian
            February 24, 2014 at 10:27 pm #

            Baby is losing weight, becoming dehydrated and jaundiced.

            Mother’s milk has not come in.
            Formula supplementation is suggested.
            Lactivist advises mother to refuse formula supplementation.
            Mother and baby are discharged with a bili light blanket.
            Mother’s supply is low. Mother still refuses to supplement on advice from lactivist who insists that putting baby to breast will cause supply to increase.
            Baby becomes lethargic, nurses poorly.
            When mother takes baby in to have the bilirubin levels checked, not only haven’t those numbers improved, baby’s weight has continued to fall and baby is now dehydrated.

            Doctor wants to admit baby to NICU for continued bili light treatment, IV fluids and monitoring.

          • techqueen333
            March 1, 2014 at 3:34 pm #

            And this is an example of an extreme case. Nice slippery slope argument.

            Mother’s milk doesn’t come in for several days. DUH. In most cases, milk comes in fine if not interfered with through supplementation. In most cases putting the baby to the breast DOES cause the supply to increase. It is a supply and demand system.

          • Ainsley Nicholson
            March 1, 2014 at 4:01 pm #

            What Anj described is almost exactly what happened to my daughter. However, by the time my milk came in (and oh boy did it!), she was already quite sick. She ended up back in the hospital for almost a week. Bilirubin can build up in be brain and cause a form of cerebral palsy. I believe my daughter’s odd movements when she is excited, and her inability to stay dry thru the night until she was almost 10 years old, are the result of a mild form of cerebral palsy due to her severe dehydration and jaundice shortly after birth. I wish I had listened to the doctors and given her a bottle or two of formula.

          • techqueen333
            March 1, 2014 at 5:52 pm #

            An extreme case, not the norm at all. Do you have citations for any studies showing a direct relationship between bilirubin levels ( you don’t specify why she was sick or what her levels were) or dehydration and cerebral palsy? Or did a HCP attribute your daughter’s behaviors to any of these? Or, is this just your guess?

          • NoLongerCrunching
            March 1, 2014 at 6:13 pm #

            Wat. What happened to Ainsley’s baby should NOT have happened. Period.

          • techqueen333
            March 1, 2014 at 3:35 pm #

            Uh…sorry…Elizabeth A, but I was there. The baby was not in the NICU and the treatment was described as a precaution.

          • Dr Kitty
            February 23, 2014 at 10:55 am #

            How do you know he wasn’t dehydrated?
            What were his urea and creatinine and sodium levels?

            If he was hypoglycaemic despite “great” colostrum flow there was clearly a problem.

          • techqueen333
            February 24, 2014 at 2:14 am #

            I don’t remember what his levels were. He is now six months old. He was slightly hypoglycemic right after birth. We were told he was given the formula as a precaution. They had no right to do that without asking. My daughter had given clear instructions that she didn’t want her baby to receive formula.

          • Durango
            February 24, 2014 at 8:56 am #

            I do wonder if, given your extreme views on the evils of formula, you and your daughter will ascribe every health blip of your grandson to the bolus of formula he received. A cold? He wouldn’t have gotten one if he hadn’t had formula! Ear infection? The formula did it! Asthma? It was the formula!

          • The Computer Ate My Nym
            February 25, 2014 at 10:13 am #

            “Only slightly hypoclycemic”? Hypoglycemia can kill. Especially in newborns. Not something I’d want to risk my child or grandchild by playing around with.

          • The Bofa on the Sofa
            February 23, 2014 at 9:32 am #

            My first had trouble eating when mom’s milk let down, and ultimately his jaundice got so bad he had to spend a day under the bili light.

            During this, never once was formula suggested as an option, much less as a panacea.

            You are full of shit.

          • Box of Salt
            February 23, 2014 at 11:39 am #

            Stop with the “formula is pushed” hyperbole. It’s not. It wasn’t 10 years ago, and it isn’t now.

      • techqueen333
        February 23, 2014 at 7:59 am #

        Red herring. IV feeding to solve a short term problem (where one really exists, i.e. is not about the paranoia of a litigation fearful doctor or hospital policies that serve to sabotage nursing) and greater concentration on making breastfeeding work is better than formula.

  8. The Computer Ate My Nym
    February 20, 2014 at 4:14 pm #

    On rereading this post, it occurs to me that Dr. Tuteur’s points are:
    1. Breast feeding has some marginal benefits and significant benefits in premature infants. Women should be informed of the facts as they are, without either minimizing or exaggerating the effectiveness of breast feeding.
    2-8. Once informed of the facts, it is the patient’s right to decide what to do. She should not be pressured, shamed, or otherwise harassed for making the “wrong” decision.
    9-10. Donor milk is unregulated and potentially dangerous, except in the context of carefully tested donor milk used for preterm infants. Don’t buy bodily fluids over the internet.
    Obviously, I’m simplifying significantly. But the bottom line is, Dr. Tuteur is making a case for patient autonomy and science based policy. Why are so many people, most of whom are not regular commentors and don’t seem to read the site regularly, so outraged about this that they have to come here to specifically say that they don’t want Dr. Tuteur as their OB?

    • techqueen333
      February 20, 2014 at 10:27 pm #

      1) She is making false assertions.
      2) It is the patient’s right to decide. However, they should have correct information
      3) Agreed on the point of carefully tested donor milk. Disagree on limiting its availability to preterm infants.
      She is not making a case for science based policy. She thinks she is, but her claims are false. It is very frustrating and potentially harmful.

      • Elizabeth A
        February 20, 2014 at 11:26 pm #

        No one is limiting donor milk to preemies out of spite, they’re limiting it to preemies because there’s not enough of it. Do you have a plan for increasing the supply there? Because otherwise, availability is absolutely going to stay limited.

      • Happy Sheep
        February 21, 2014 at 9:28 am #

        You can disagree all you like, however there is a shortage of reliable breastmilk to feed the preemies. Ensuring the most vunerable and most benefitted population receives a limited resource first is just good sense.

      • The Computer Ate My Nym
        February 21, 2014 at 10:15 am #

        Which assertions that she’s making are false and what is your evidence? And how would you prioritize the distribution of safe donor breast milk if not giving it to premies first?

        • techqueen333
          February 22, 2014 at 1:43 am #

          For example…Her assertion that the benefits of breasfeeding are marginal and that formula is an EXCELLENT source of nutrition. It is an inferior substitute that should only be used in cases where breastfeeding is impossible (e.g. no milk, failure to thrive, allergy, adoption or death of the mother).

      • The Computer Ate My Nym
        February 21, 2014 at 11:34 am #

        Dr Tuteur claimed that breast feeding had marginal benefit for term infants that wanes over time. You posted three abstracts demonstrating…marginal benefit in term infants that wanes over time. If Dr. Tuteur is making false assertions, why do your references back her up?

        • techqueen333
          February 22, 2014 at 1:40 am #

          None of the references I posted back her up.

    • ngozi
      February 21, 2014 at 9:13 am #

      Since she is retired, she probably doesn’t care that they don’t want her as their OB.