Alison Stuebe’s no good, very bad analogy between formula and tobacco


Sometimes I wonder if lactivists think what they say before they say it.

Consider this tweet from Dr. Alison Stuebe of the Academy of Breastfeeding Medicine.


Parallels between big tobacco tactics and big formula tactics – look how doubt it being peddled to mother

That tweet is offensive on so many levels that it is difficult to know where to begin.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]I hereby invite Dr. Stuebe to debate me.[/pullquote]

1. The comparison of formula to tobacco is grossly irresponsible. Whereas tobacco is always dangerous and never saves lives, formula is almost never dangerous and saves tens of thousands of babies’ lives each and every year.

2. It is meant to be vicious. The tweet not so subtly implies that women who choose to formula feed are knowingly and willfully harming their babies.

3. It implies that women who don’t breastfeed are dupes. This is not merely an insult to women who choose formula, but it is a denial of their moral agency. This is how lactivists justify ignoring the reasons women give for choosing formula since those women “didn’t choose” to use formula, they were tricked into it.

4. It is an attempt to libel the Fed Is Best Foundation. The implication is the Foundation — which is drawing attention to the very real and deadly risks of relentless breastfeeding promotion — is in the pocket of the formula industry. If Dr. Stuebe has evidence of this, she ought to present it. Otherwise, she ought to stop libeling the Foundation.

5. It is, ironically, projection. Perhaps Dr. Stuebe is not aware that in the wake of the Surgeon General’s report declaring that tobacco smoking causes lung cancer, the tobacco industry tried to deny and induce doubt about the scientific evidence. Now, in the wake of mounting scientific evidence that relentless promotion of breastfeeding is leading to infant injury and death, it is the breastfeeding industry that is trying to deny and induce doubt about the scientific evidence.

How can we address the attempts of the breastfeeding industry to demean women who can’t or don’t wish to formula feed?

I have a suggestion:

I hereby invite Dr. Stuebe to debate me on the issue of the risks of breastfeeding.

We can conduct an debate in print simultaneously on my blog and the Academy of Breastfeeding Medicine blog so that everyone can be sure that both sides are accurately transmitting the views of the other.

I propose that we address three issues:

  • The risks of breastfeeding, complete with actual incidence figures.
  • The moral agency of women who can’t or don’t breastfeed and their right to be respected.
  • Accusations of collusion between those highlighting the dangers of breastfeeding and the formula industry.

How about it, Dr. Stuebe? Surely you can step outside the lactivist echo chamber to engage briefly with those you criticize.

51 Responses to “Alison Stuebe’s no good, very bad analogy between formula and tobacco”

  1. Platos_Redhaired_Stepchild
    April 2, 2017 at 3:48 pm #

    I’d say this was apples to oranges but apples and oranges are both in fact fruit & nutritious. Comparing cigarettes to baby formula is like comparing lung cancer to not-starving-to-death. Or emphysema to a-healthy-well-balanced-diet. Not only are these to things not in the same fricking fruit bowl, they’re not even on the same frickin’ planet!

  2. Roadstergal
    March 27, 2017 at 11:02 am #

    Our lovely regular liar Nikki Lee used this comparison the last time she dropped in.

  3. DirtyOldTown
    March 26, 2017 at 9:04 pm #

    Discussion of c-section meta-analysis study with requisite idiotic comments on reddit for those interested:

    • March 27, 2017 at 12:27 am #

      Because the idea that any woman would request a cesarean and find push back from the public system (due to a perhaps misguided view as to cost of planned cesarean) would turn to the private system is just a little too hard to comprehend.

  4. Mark
    March 26, 2017 at 7:27 pm #

    Other than the unfortunate tobacco analogy, all this person wants to do is get rid of undue corporate influence in formula makers.


    I look forward to a whole bunch of other initiatives in the name of children’s health.

    Shall we start with the candy displays at the checkout counters?

    Commercials for fast food.

    Violence and graphic sex on tv and internet.

    Anti vaccines movements.

    • Gæst
      March 27, 2017 at 9:53 pm #

      And while we’re at it, someone please get rid of the toy car display by the checkout line at Walgreens. The whole family’s health is in danger when buying necessary medicines and supplies comes with an epic tantrum because I won’t buy a car every time we go in there. I avoid buying things to avoid the tantrum!

  5. BeatriceC
    March 26, 2017 at 4:33 pm #

    That analogy really upsets me, considering my recent experiences. Formula is NOTHING like tobacco. Formula is a well balanced food source for infants. Tobacco is a highly addictive substance that can actually change your biochemistry and turn your life into a living hell if you’re deprived of it. I officially quit on January 13th (though started the process a few weeks before that). Still today I had to fight off a craving or two. It doesn’t consume my thoughts every waking second like it used to, but it’s always there under the surface still. This has been the least fun experience of my entire life, and I’ve had some seriously un-fun stuff happen. This woman clearly has no clue.

    • Spamamander, pro fun ruiner
      March 26, 2017 at 4:36 pm #

      Congratulations! I thankfully never developed that habit, but my understanding is that nicotine can be as difficult to quit as heroin. (Which is why I cannot condemn people who can’t kick it.)

      This analogy is so, so wrong, in a million ways.

    • Roadstergal
      March 27, 2017 at 11:31 am #

      I could glibly point out that just about everyone who tries formula goes on to voluntarily give it up within a few years, and ask her how that compares to smoking… :p

      And of course, as you say, the biochemical changes smoking brings about are stark and frightening. (I used to work on an oxidative stress molecule, and blood from smokers was my positive control…)

      • Empress of the Iguana People
        March 27, 2017 at 2:01 pm #

        2nd hand formula is a lot less problematic than 2nd hand smoke, long term, too. (Though anyone foolish enough to imbibe spit up deserves whatever cold the baby may have!)

        • Roadstergal
          March 27, 2017 at 3:35 pm #

          That made me LOL!

        • BeatriceC
          March 27, 2017 at 8:14 pm #

          That made me giggle way more than it should have.

        • J.B.
          March 27, 2017 at 9:08 pm #

          Oh, and I think some breastfeeding advocate told me breastfed babies spit up less than formula fed ones. I was cheated, cheated I tell you! By major spitters.

          • Gæst
            March 27, 2017 at 9:55 pm #

            If secondhand spit up caused cancer, I’d be dead by now, lol.

          • Empress of the Iguana People
            March 27, 2017 at 10:07 pm #

            Dunno about that, my bf’d kid was a -much- more vigorous spit-upper than my ff’d kid.

          • AnnaPDE
            March 28, 2017 at 12:13 am #

            Haha. I’m sure that’s why my cousin had to switch her daughter to formula despite massive supply — the kid couldn’t hold breast milk down. Massive puking all day from it. Fine with formula and solids.

  6. Inmara
    March 26, 2017 at 3:48 pm #

    UK people, this might be for you

    • maidmarian555
      March 26, 2017 at 4:27 pm #

      Alison Thewliss wants formula subject to plain packaging, just like cigarettes. I somehow doubt she’d be interested in my experience, in which supplementing made it possible for me to breastfeed for almost 6 months and how I stopped before that magical date because my son sprouted teeth, kept biting me and not one person could give me any sort of practical solution to make him stop. Her original report contained a large number of pro-breastfeeding comments, with just one that wasn’t anti-formula (from…..the formula industry, obvs). She’s just looking for more lactivists to join her battle cry, she isn’t seeking out balanced opinions on formula use.

      • maidmarian555
        March 26, 2017 at 4:32 pm #

        Here’s the information on the Bill she’s trying to get through:

        It’s been mentioned here before, but it’s cleared the first reading now. The lactivist lobby are so vocal here in the UK, I really don’t hold out much hope for them not being able to get away with demonising formula in this way. There is no good reason for subjecting it to the same marketing restrictions as cigarettes. None.

        • Stephanie Maia
          March 27, 2017 at 5:50 am #

          We’re trying really REALLY hard to stop this at:

          If you’re UK please do come over and take a look. We are desperately looking for more UK infant feeding stories and preparing to launch a petition, open letter and ’email your MP’ thingy this week.

          We’re also on facebook!


          • maidmarian555
            March 27, 2017 at 9:17 am #

            Thank-you! I was thinking about writing to my MP about this but, to be frank, it’s still quite an emotive subject for me. Whilst personal anecdotes can be powerful, in this instance I really think that pointing out the enormous holes in the ‘science’ behind the benefits of breastfeeding would be more useful. Alison Thewliss and her supporters keep trying to say that they aren’t deliberately trying to draw comparisons between formula and cigarettes, yet that is exactly what they are doing and I can’t help but feel it’s deliberate (and pointless- if they stop formula companies advertising formula, what’s to stop them ploughing their marketing budget into their other products in order to get their branding into parents homes?). It would be really helpful to have some sort of template to follow that highlights the facts and helps me avoid going off on an emotional tangent.

          • Stephanie Maia
            March 27, 2017 at 10:37 am #

            We will absolutely be getting more out there so please stick with us. One went up today on this type of subject.

            I think they’re completely reliant on the idea that women won’t speak out but we have to make it easier so it actually happens.

      • OttawaAlison
        March 26, 2017 at 5:23 pm #

        I’m not a douchy Alison I swear!!

  7. lawyer jane
    March 26, 2017 at 1:25 pm #

    I doubt formula consumption would change at ALL if there were a complete marketing ban. A marketing ban might change some admittedly shady practices like making claims that a certain formula stops colic, etc. But it is just so totally offensive that she’s saying that taking reasonable measures to ensure a newborn’s health is ANYTHING like the tobacco industry. Formula is FOOD. That babies need. And/or that mothers use because they are free do decide what to do with their bodies.

    • Cartman36
      March 26, 2017 at 7:59 pm #

      It wouldn’t. Contrary to what Alison Stuebe may believe I don’t buy formula because of the shiny packaging. I buy it because it meets my baby’s nutritional needs and I find formula feeding more convienent and better for my family.

      • Empress of the Iguana People
        March 26, 2017 at 8:46 pm #

        it’s not like they have such adorable packaging anyway. The one I buy doesn’t even have a picture of blocks or a teddybear or anything.

        • Cartman36
          March 26, 2017 at 10:07 pm #

          Agreed. I use the Costco formula and the package is really plain

      • Kelly
        March 27, 2017 at 4:44 pm #

        I went online and figured out which formula was the cheapest and bought that one. I did not care about the marketing or the package.

        • Gæst
          March 27, 2017 at 9:57 pm #

          I did the same thing. Parent’s Choice for the win!

    • Sheven
      March 26, 2017 at 11:03 pm #

      If you look at certain industries, ad bans are a boon and not a burden. Fast food companies, candy companies, and tobacco companies don’t want to spend money on advertising. They had to advertise because their competitors did. Forcing all companies to cease certain types of ads let them keep the money for themselves. And none of these companies are as necessary as formula. An ad ban could be a jackpot for formula companies.

      • Roadstergal
        March 27, 2017 at 11:34 am #

        I wondered about that. Will the negative effects of this fall on women (no more free samples) rather than formula companies? Is the ‘boon to formula companies’ a better approach to oppose it, politically? :

    • Mariana
      March 27, 2017 at 4:38 pm #

      Formula advertisement is banned in Brazil. And guess what? It still sells! The only people who don’t buy formula are those who can’t afford it. They have to resort to regular powdered cow milk (Nido from nestle, called “ninho” here) or regular cow mill (uht or fresh). And guess what? All these products come with a warning that they shouldn’t be used for babies. I don’t worry about the babies who get formula… But I do worry about those who get cow’s milk…

      • The Bofa on the Sofa
        March 28, 2017 at 9:44 am #

        Remember that formula was invented, not as a replacement for breast milk, but as a replacement for all the crap that women were using instead of breast milk.

        • Roadstergal
          March 28, 2017 at 11:48 am #

          Instead of saying ‘breast is best,’ formula cans should say ‘formula is the only safe breastmilk alternative.’

  8. TsuDhoNimh
    March 26, 2017 at 12:45 pm #

    Do they even have any solid numbers for the numbers of women who do not produce sufficient milk?

    • evidencebasedbreastfeeding
      March 28, 2017 at 9:14 am #

      That’s a really interesting question in my opinion. Here is one study, quite old now, but it struck me as taking quite a sensible approach to the question:

      Birth. 1990 Mar;17(1):31-8.
      The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain.
      Neifert M, DeMarzo S, Seacat J, Young D, Leff M, Orleans M.

      Basically what they did here was to define breastfeeding success – Babies who are gaining well with exclusive BM alone; babies who don’t gain well, or who do gain well between week 2 and week 3 visits, but who also have formula, couldn’t be defined as their mothers having got to the point of meeting baby’s milk needs on their own milk alone.

      319 mothers and babies studied (primips), 15% had persistent milk insufficiency by week 3, “despite intensive intervention”.

      I have read other stats for this “number” however, I don’t think there is any clear definition accepted by all on what “sufficient milk” or “breastfeeding success/failure” means and how it would be calculated. The above study takes a functional view, a bit like defining infertility (if a man and a woman have lots of unprotected sex, but no baby results after 2 years, we can say they are infertile; we don’t know whether the woman’s physiology is at root, or the man’s, or both). Similarly, difficulties reaching full milk supply might resulted from the mum’s physiology or the baby or both. All have to be factored in, whereas many discussions of this problem only factor in the mum at the heart of it. (Eg, let’s calculate how many mums have prior breast surgery and/or breast tissue hypoplasia, and say that is all we are including in the numerator. But that’s not a functional definition and thus excludes many potential causes, including the unknown causes, of BF problems). So would result in an underestimate.

      The final thing I would highlight, is that many discussions of this Q assume this is a “fixed number”, across populations/settings and fundamental to female physiology (eg: 1% of women can’t breastfeed. Therefore 99% can). Clearly that is nonsense, as many factors influence BF problems that are affected by demographics, culture and setting – eg, age of mum, % that are primip, ability to rescue baby thru C-section, % babies born thru infertility assistance etc etc. In many cultures where BF rates are high, prem babies might not survive, C-sections aren’t available, mums give birth younger and have more babies, there is no infertility trt, etc etc which changes all the demographics and the stats. So “the number” (which I think is really an artificial construct with little meaning and divorced from cultural considerations) will vary considerably between settings. Rant/ramble over….

  9. OttawaAlison
    March 26, 2017 at 11:34 am #

    That analogy actually upsets me to the core – formula helped my daughter thrive. Tobacco was a contributing factor to my dad’s death.

    • March 27, 2017 at 1:59 pm #

      Yup. Formula has been a critical component in keeping my son on a healthy weight gain in spite of being a micro-preemie.

      Tobacco smoke would make him dangerously sick.

  10. March 26, 2017 at 10:34 am #

    Women lose so much of themselves in the process of becoming and being mothers, why should they care about whatever final bits remain? Because when you have lost so much, what little that remains matters a great deal. Mothers deserve to, at the very least, remain the masters of what they do with their own bodies. To arbitrarily deprive them of that, where it doesn’t matter – is a deep travesty.

    • lawyer jane
      March 26, 2017 at 1:26 pm #

      Well said. At a certain point, the public health push for breastfeeding just starts to bear a distinct resemblance to the Handmaids Tale.

      • Steph858
        March 26, 2017 at 2:14 pm #

        It’s more than a resemblance. I don’t have a copy to hand so I’m quoting from memory so please excuse me if any of the words are out of place:

        Offred notes that, having given birth, Ofwarren “Will be allowed to stay for a few months – they believe in mother’s milk – and then moved on to another family.”

        • Spamamander, pro fun ruiner
          March 26, 2017 at 4:38 pm #

          And now I’m even more horrified. I haven’t read the book, I plan to in preparation for the series on Hulu, but the absolute coldness of that- she can be a milk dispenser on top of a womb before being jerked away to breed again- gives me chills.

          • LaMont
            March 26, 2017 at 6:26 pm #

            Have you seen the new trailer?? It is creeptacular & amazing (I’ve read the book, but ages ago, and rereading it is proving VERY hard – it is way too real). I may need some moral support in the form of friends to help watch the show with me. The trailer looks like the show delves way deeper into the actual mechanics of the *transformation* from liberal democracy into theocracy than even the book does, and it is horrific.

          • BeatriceC
            March 26, 2017 at 6:43 pm #

            I read an interview with Margaret Atwood where she says the series goes a lot farther than she did with a number of topics. My overall impression was she thought this was a good thing, but made it even more terrifying.

          • LaMont
            March 26, 2017 at 6:55 pm #

            So far that’s my experience of it!

            Though I do wonder, on a practical level, how the far-right would really get away with banning and limiting obstetric care. Thought experiment: All obstetric care is banned because God is presumed to have better care in mind for pregnant women than those malignant, abortion-loving doctors. When women experienced skyrocketing rates of pregnancy loss and childbirth catastrophes, would those losses be considered tests from God or would women themselves be blamed? HT seems to posit “test from God” but idk…

          • yentavegan
            March 27, 2017 at 8:01 am #

            I signed up for Hulu because I want to see the Handmaids Tale series. I read the book and I remember the reason women lost their human rights had more to do with nuclear fallout from a bomb? and pregnancy rates have plummeted to the point where society /civilization needs to use women for breeding purposes only.

          • LaMont
            March 27, 2017 at 7:06 pm #

            There was also a massive religious-right movement during this time, the war seemed to follow from the infighting on that front. But yes, there was also a fertility crisis happening.

          • Steph858
            March 27, 2017 at 9:50 am #

            The book says that “They don’t believe in pain relief” for childbirth, but the narrator only sees one birth (Ofwarren’s) which, aside from the fact the baby later turns out to have genetic defects, goes well; the book doesn’t say whether proper medical care will be provided in the event of labour not going to plan or whether they believe that women should be left to die in childbirth if that’s God’s will.

            I thought it would be the latter, but then on the other hand babies – especially healthy ones – are rare and highly prized. The precious baby is more likely to die in a birth gone wrong than the womb with legs. So I don’t know whether the ‘no pain relief’ philosophy extends to ‘no interventions ever’. Also unanswered in the book: would incubators etc be provided for babies who are born premature but otherwise healthy, or do they believe that if kangaroo care can’t keep the baby alive then it’s God’s will that the baby should die?

            The book hints that they aren’t against proper medical care from doctors; the ‘malignant, abortion-loving’ ones have long since been executed. The doctors who are left are trusted to test handmaids’ fertility and to classify babies as healthy or ‘shredders’; they’re also trusted to sterilise the Jezebels and test them for STDs.

            Anyway, to answer your question, the women themselves would be blamed. They’re blamed if they’re unable to fall pregnant. Another quote from memory, when a doctor testing Offred for fertility declares it’s “The perfect time,” and tries to seduce Offred by saying “Some of these older men can’t make it any more:”

            “What he’s just said is heresy. There are fruitful women and there are barren women.” They can’t even admit that some (if not most) of the men are sterile; if a woman doesn’t fall pregnant it’s all her fault. So I assume this blame would extend to miscarriages and stillbirths.

            But then again, consistency isn’t a strong point with these people. Early in the book, Janine is blamed for ‘leading on’ a group of boys who gang raped her, implying they believe that rape is almost always the victim’s fault in some way or another. But later, when a political prisoner is handed over to be executed by the handmaids, he is said by Aunt Lydia to be a rapist. Aunt Lydia doesn’t say anything like “While the handmaid clearly led him on and must share a portion of the blame, he has still sinned and must die for his sins.” She just says he violently raped 2 handmaids, one of whom miscarried as a result, and that’s that. So they blame the victim or the rapist according to whichever suits their purposes at the time.

          • Gæst
            March 27, 2017 at 9:59 pm #

            i have never been able to reread it, and my first read was back in the glorious 90s when I never dreamed this was possible.

      • OttawaAlison
        March 26, 2017 at 5:24 pm #

        I’m finally reading it. I freaking love the word play Atwood does. Still horrifying how quickly people adapt to such a wretched government.

      • yentavegan
        March 26, 2017 at 8:48 pm #

        Everytime my debit card takes a wee bit too long to be approved at the grocery store I think ..Ut oh…it is finally happening..

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