It’s hard to believe that a three word phrase could provoke such angst, but that’s what has happened with Fed Is Best.
Milky Mommas is the latest organization to spill ink and anger over Fed Is Best:
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Fully fed with formula is just fine.[/pullquote]
It’s because saying “fed is best” is saying that all options are equal, that infant feeding methods don’t matter. That no matter what you choose, it’s all the same, it’s all “best” for baby. And that is scientifically inaccurate.
I’ve got some bad news for the folks at Milky Mommas:
The choice between breastfeeding and formula feeding DOESN’T matter. No matter which you choose, it IS all the same; in industrialized countries formula is as good if not better than breastfeeding.
I’m sorry that this is hurtful for those who have wrapped their self-esteem around the function of their breasts, but frankly, it is no different — and no less inappropriate — to derive self esteem from lactating breasts than from large breasts. Women should not be judging themselves and each other by body parts. That’s the kind of objectification that harms all women.
The beauty of the phrase Fed Is Best, coined by Christie del Castillo-Hegyi, MD and lactation consultant Jody Seagrave-Daly, RN, is that it punches through all the rhetoric to get to the heart of the matter:
Fully fed with formula beats underfed with breastmilk every time.
Like the most successful mantras, Fed Is Best truly resonates. The first time most people hear it, the response is “Of course! I should have realized that.”
Fed Is Best has the ultimate advantage: it’s actually true. That’s what makes it so dangerous for lactivists. Insisting that “breast is best” for all babies, for all mothers, at all times — the hardest of hard lines — throws the fundamental error of lactivism into sharp relief: a process can NEVER be more important than a healthy outcome.
Diane Weissinger, one of the architects of contemporary lactivism realized that:
When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding …
Weissinger understood that when you tell women the truth about formula feeding — that it is safe, adequate and normal — they won’t feel compelled to breastfeed. Therefore, breastfeeding must be reframed with lies.
The mother having difficulty with breastfeeding may not seek help just to achieve a “special bonus”; but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial baby milk just “to get him used to a bottle” if she knows that the contents of that bottle cause harm.
In other words, contemporary lactivism rests on a deliberate lie; there is no evidence, and there has never been any evidence, that formula is harmful. Yet Milky Mommas blithely repeats the lie without having any idea of its origin:
What we are saying is that there are certain risks associated with formula (well documented in many, many studies) and that it is not a NUTRITIONALLY equal choice to breastfeeding.
There are no risks associated with formula and there never were. Claiming that formula feeding has risks is and has always been nothing more than a marketing tactic designed to promote the employment prospects of lactation consultants. Now Milky Mommas is concerned about the blow to their self-esteem that would come from acknowledging that “breast is best” was never anything more marketing bombast.
What we are saying, is that while we support our members who must use formula, pretending that what our babies are fed doesn’t matter contradicts everything we stand for.
I am sorry — and truth be told, a bit sickened — that organizations like Milky Mommas stand for the proposition that breastfeeding makes them better mothers and women. But the fact that they have chosen to stake their self-esteem on lactating doesn’t strengthen their case; it weakens it.
It’s no different than creationists who feel that evolution contradicts everything they stand for. They reject evolution because it calls their beliefs about themselves and the world into question, but that doesn’t change the fact that evolution is the only scientifically coherent explanation for the world as it exists. Milk Mommas reject the incontrovertible claim that fully fed with formula beats underfed with breastmilk every time because it calls their beliefs about themselves and the purported importance of breastfeeding into question. But that doesn’t change the fact there is simply no population based data that shows that breastfeeding rates have anything to do with infant mortality rates for term babies.
Lactivists constantly invoke mathematical models based on extrapolation from small studies in order to insist that breast is best, but there’s no need to create mathematical models when we have real world data. During the past century, breastfeeding rates have fluctuated dramatically from nearly 90% down to 24% and back up to about 76%. During that entire time, and involving literally tens of millions of babies, there has never been any evidence that breastfeeding rates impact major health indices for infant and children in any way.
Therefore, Milk Mommas is fundamentally wrong in their view of the science and themselves. They claim:
We are here to educate and advocate for the use of human breast milk. We understand the value and importance of human breast milk. That’s the science of health, not a judgement on mothers.
I’ve challenged a wide variety of lactation professionals to provide real world, population based evidence that breastfeeding makes a difference to infant health and they can’t because such evidence does not exist.
So what are Milky Mommas advocating for if there’s no evidence that breastfeeding has a meaningful impact on infant health? They’re advocating for themselves and their desperate desire to believe that they are better than mothers who make different choices.
That’s not science, just an unattractive facet of human nature.
Another perspective – feeding doesn’t matter because if all you’re doing is pushing your boob into a baby’s mouth for nourishment and not actually connecting to said baby, the baby is not forming an attachment. I have been fostering for over 10 years. We are having an increased number of babies coming into foster care who were breastfed…and RAD is increasing. So these birthmoms were breastfeeding and fully nourishing their child…then neglecting their child the rest of the time who was then unable to form an attachment.
Ugh. talk about a human milk dispenser.
Ooh, that’s awful. Just how much lack of interaction has to occur before a baby develops RAD?
Children need to form a bond with a caregiver by the time they are 18 months. It may not be a secure bond, but if they can form some sort of bond there is more hope. Even if that caretaker leaves and never comes back, they still have the ability to form bonds with new caretakers.
Like I said above, it’s literally leaving them alone all day, just feeding them. No holding, touching or even humans close by. If you want creepy, read about international orphanages. Rows and rows of little babies that don’t cry because they realize their needs do not get met if they cry. That is RAD. And when they finally get a caretaker that wants to love them, they push that person away through violence and threats because they don’t know how to form that attachment.
Thanks. How hideous. I worry about leaving my baby to cry in the jumperoo while I make dinner, but it sounds like a bit more is necessary to really mess up a child. Poor things. And then I’m sure that has consequences when the kid grows up and maybe starts having kids, and not being able to provide good parenting for them.
He’ll probably be fine. I mean there’s steps of Attachment problems between A-OKAY and RAD, (i.e. ‘Insecure Attachment’) but if he’s still both crying for you to come when he’s distressed and then accepting affection when you come to the rescue, you’re doing fine, at least according to Attachment Theory.
Thanks! Six months later, he’s acting like a classical “secure” baby–happy when we’re present, sad when we’re not, easily consoled when we come back.
Untreated Maternal depression? It is a killer of bonding.
This isn’t the moms not bonding with the baby. This is the caretaker not actually doing anything to encourage a bond. These are neglectful druggie parents who feed their baby and then go get stoned. Or get stoned while breastfeeding, then dump the baby in a crib or on the floor and get stoned some more and *maybe* change the diaper one in 24 hours. People who don’t use or don’t have access to birth control and pop out kids. I know one mom who is pregnant with #13, all of her other 12 kids she has had taken from her and this one will be on DCFS custody upon its birth and she has tested positive for drugs multiple times already. She has had plenty of chances for rehab, as do all parents when their kids go in the system.
Just cases of people who should have never reproduced.
I would say that drug abuse is awful–and it is–but the alcoholics and addicts I’ve known generally have something else going on, too.
But you do realize they are given a plethora of help? They go through complete medical and psych exams, are given individualized treatment plans, etc for *free* and choose to ignore them. They are people who refuse to admit they need help and then punish the kids by their indolence and neglect.
And that is what foster care is – the place where kids go when they are screwed over by adults, yet 50% of Americans think foster kids are the ones that did something wrong.
No arguments from me! I know someone who fosters children, and it has been eye-opening, in an unhappy way. I mean, you have parents who don’t bother to show up for visitation or notify the agency that they’re not showing up; parents who basically ignore their kids at visitation; parents who punch walls in front of the social worker at visitation; and I’m sure a lot more stuff that my friend can’t tell me.
fostermom – nothing to add, but I just want to encourage you to stick around. The perspective and insight you have being part of the system is very valuable. Most people can’t imagine some of the dark stuff that is all going on in our communities, and probably don’t want to.
I have just been sworn in as a CASA, and have started to see some of the stuff going on (the best part of training was court observation). It’s really eye-opening.
Thank you for becoming a CASA! Such wonderful people and they do so much for the kids. When I feel like I can’t foster anymore, I plan to become a CASA.
How have you stuck it out for 10 years?
Because the kids need me. They have been thrust into a shitty situation that is in no way their fault, and they are the ones that are screwed over. The bioparents get complete medical care, housing, therapy etc when they are the ones that messed up. Then let them make demands of the people who are actually doing to raising of their children, 100% free childcare, and force them to bend to the will of the bios.
The kids end up in homes where foster parents are in it for the money or treat the kids as outsiders. And even in loving foster homes, the kids may end up in a new school away from friends and stability, in a situation where it is pretty damn obvious that their foster parents are not the bios due to racial differences.
Honestly, its the most unfair system out there: give all the goodies to people who are basically child abusing criminals, and punish the victims of those crimes.
Not painting all bios with this broad brush, there are a lot who basically fucked up realize it, and work their asses off to fix themselves. A lot of them were former foster kids who aged out and never were given the resources to know better. It is the ones who know what they did is wrong, don’t care, and think the county and the foster parents are theirs to order around.
Thanks for being there for a vulnerable population.
Interestingly, I know those who went the other way – started as CASA and then became foster parents.
OT fell off my bike and went to the ER. Chipped a bone in my thumb ( not very painful) scraped my elbow raw and bloody ( very painful). I am looking for suggestions as to how to alleviate the tortuous burning sensation while my elbow/fore-arm heals
ouch! hope it heals quickly!
It hurts more now 4 days after than it did initially. I can not sleep.
Is there any sign that it is infected?
OMG Yes I ended up with a raging infection ( the ER visit was a complete waste of time) I went to my own doctor and was treated with an oral anti biotic for 10 days.
Anti- inflammatories and opioids?
Painkillers are good for pain.
https://target.scene7.com/is/image/Target/12279597?wid=520&hei=520&fmt=pjpeg
This stuff is amazing on scrapes, burns, and other superficial skin injuries. It stinks to high heaven, but it works wonders. Just make sure you don’t have an infection, as Dr. Tuteur said below.
I had ER docs kind of annoyed at me because I gave my daughter Tylenol before bringing her in. Her primary symptom was fever, and she had no fever when we showed up.
I tell parents all the time: treat your child’s pain or fever. But TAKE THEIR TEMPERATURE. Don’t tell me they felt warm. Feeling warm and having a fever aren’t necessarily the same.
Oh, absolutely. I had taken her temperature repeatedly, and also taken her to the pediatrician. He sent us to the ER for UTI testing, and I gave her the Tylenol before making the trip. But I had an exact number to give them for her temp. They still seemed annoyed that I dosed her.
Same here, which once culminated in a 7 hour wait even though I had been told to bring her back to A&E immediately if she had a fever, and other patients complaining (which got us seen) when my child threw up 3 times. So grateful for the emesis bags!
I read the entire editorial by Dianne Weissinger and it was truly disgraceful. The comparison between formula feeding and smoking, the dismissal of fully informing mothers, the elevation of a method above outcomes, it was beyond the pale. I also had a look at the Milky Mommas post and found it interesting that they say they share evidence, studies, and statistics, yet a cursory glance at the links at the bottom of the page does not reveal a single primary source – they’re all fact-sheets. Out of interests, do lactation consultancy courses provide any training on understanding and critiquing research? Or do they just read the press-releases of studies?
OT: Hi I wanted to introduce myself (on-and-off lurker and first-time poster). I’m currently doing my honours in psychology (working towards a masters in clinical or health psychology), and the rhetoric around “Breast is best” recently caught my eye, when I stumbled across the tragic story of Landon Johnson. From the perspective of someone interested in psychological health (as well as someone who will one day have to stand up against the rhetoric personally), I must say I’m appalled by what I’ve seen so far. However my ire led me to Dr Amy’s blog, where I discovered this wonderful community of critical thinkers. I’d just like to say that I admire the way Dr Amy and her community engage with this issue, as well as the personal support you give one another. (Hopefully I can provide a more positive representation of my fellow Aussies, who have brought you the likes of the Jen and the Milk Meg.)
No idea if LC training includes understanding research. A lot of them started as nurses, though, and they ought to have, if us history majors can’t get out of bachelor’s training without a vague intro to our own journals. ‘Course, when you convert to a religion, as the worst LCs seem to have, you often leave your critical thinking skills at the door.
BTW, I think we have an Aussie doc who occasionally comments. 🙂
At least a basic idea of understanding research should be taught to everyone as a basic life skill. These days we are so inundated with information branded as science (regardless of the quality) that we need to know when to be skeptical of what we’re told. I admit that when I decided to study psychology, I had no idea my entire undergraduate degree would revolve around research. Now that I have this knowledge however, I can’t believe I ever got by without it.
And I’m so glad there’s another Australian around! We’re actually pretty good people for the most part.
It should, but high school teachers have a lot of stuff on their plates. Science often gets shortchanged as it is.
I completely agree that understanding research should be taught as a basic skill, it’s part of why I’m working on my bachelor’s of info studies. (Also hi fellow Aussie!)
G’day!
Me too – great to have you join us! (waves)
I’ve lost count of the number of times I’ve seen people argue by posting links to discredited sources, or studies they can’t see beyond the abstract, let alone understand – least of all, critically review.
One of the great things about this community is the informed discussion of research.
Yes– for IBCLCs, at least– there is a very basic and very minimum requirement of one academic credit* in introductory clinical research education included in the fourteen health science subjects needed to apply for the IBLCE exam.
*at least a one semester, trimester, quarter, etc. course provided by an accredited institution of higher learning
—————————–
From IBLCE:
https://iblce.org/wp-content/uploads/2017/05/health-sciences-education-guide.pdf
“Introduction to Clinical Research
IBCLC certificants need a good understanding of basic research methodologies, critical reading skills and familiarity with statistical measurements.
● Courses that focus on research outside the health sciences will not be accepted.
● For example, a research course that focuses on English literature, economics, marketing and/or legal research will not meet the introduction to clinical research requirement.
The table below describes typical courses that meet the introduction to clinical research requirement.”
https://uploads.disquscdn.com/images/7591b8a5630555ba91071b93bcef443574af6a55c610e2d5eb48fe98a85d7185.png
Fed is Best is taking so much shit because they’re not challenging a set of claims or a fractured system (they ARE).
They are challenging dogma. Ideology. Ingrained beliefs. Fairytales. They are challenging a religion, quite frankly. (I subscribe to a major religion myself, believe in God, but can still appreciate the whole ‘opium of the masses’ bit).
The only time you get people _this_ pissed off and hysterical is when you challenge the made-up, never the factual.
That’s a very good point. It was the similarity to religion that gave me pause when I first noticed the “Breast is best” rhetoric. It seemed a little too “This way to salvation” to be evidence-based.
That being said, I don’t think there’s anything wrong with choosing to breastfeed for emotional reasons as long as you (a) recognise that’s what you’re doing, and (b) are not so blinded by your emotion as to put your child at risk. When I have children I want to breastfeed. I don’t have any good reason for wanting to do so, other than the fact I like the idea of it. In a situation where the alternatives are equally acceptable, that’s fine, as long as it doesn’t prevent you from engaging with logic when things go pear-shaped.
A lot of us here have breastfed, many enjoyed it, and many of our babies were happily full each time. I only supplemented my first until my milk came in 5 days after his 40+4 birth and after that it’d take more than a single feed to drain one side. Oversupply. My second was formula fed because i am still touched out from bf’ing the first one and bf’ing became a trigger for my ppd. sigh.
I suppose it would be too much to expect such a logical approach to infant feeding from advocates and policy-makers.
Logic is not a skill that many have, regrettably.
Schools need to spend a bit less time on endless rote memorization of facts and a bit more time on critical thinking skills.
Coming from someone who hates maths with a passion (and hated high-school science with almost equal ferocity), I was endlessly grateful that maths and science were not compulsory in the senior years. However, I would wholeheartedly support mandatory senior maths and science if they had courses that taught basic statistics and scientific literacy.
I wanted to highlight a classic logical fallacy in the Milky Mommas argument: “pretending that what our babies are fed doesn’t matter contradicts everything we stand for…”
This is a bait and switch, or strawman. They’re claiming a position for their opponents which those opponents do not take: of course what babies are fed matters. (You feed an infant cheesy puffs and lemonade and they’re not going to do so well.) But of course no one is suggesting anything even remotely like that, or any wretched diet. They’re suggesting that a perfectly good diet be used if you don’t want to breastfeed or if there is any problem with breastfeeding. But honestly arguing against that would be difficult at best, so they take the dishonest road. People arguing by using – whether consciously or not – logical fallacies are a big red flag that those reading or hearing their arguments should always recognize.
OT: My 7-month-old has his first fever today. The ibuprofen is working, and right now he seems right as rain. Before I gave the ibuprofen to him, he was fussy and uncomfortable.
You may be wondering: What’s the point of this comment? Do you want a medal for seeing that your baby is sick and giving him something to feel better?
My baby’s improvement reminded me how much I hate the “fever is goood” crowd that would advocate allowing him to suffer unnecessarily. I mean, let’s say this develops into something nasty; okay, we’ll go to the doctor and go from there. But in the absence of any contraindications, why in the world would I not want to ameliorate my poor kiddo’s suffering?
Because it builds character. Or something./s
I thought there was scientific evidence that fevers do in fact help rid the body of viruses? My pediatrician advises not treating a fever just for the sake of treating it. If the baby/child has discomfort, then yes. My son had a very high fever around 8 months of age, his first. But he seemed oblivious to it – I only noticed because he was burning up when I touched him.
Bacteria, I thought, because the higher temp impedes some aspect of their metabolism… but I don’t have a citation handy. A lot of babies (as long as they aren’t newborns) are happy and fine with an apparently high temperature. If baby doesn’t need pain relief, I think it’s fine to let them be.
Absolutely. But a baby who’s feeling lousy should be treated.
Okay, bacteria. An MD I am not!
I’m a bit skeptical about fever “killing” bacteria – because it’s part of an immune response that includes a range of other factors.
No arguments from me. But I hate it when parents see their kids suffering and then don’t ameliorate it, because it’s natural.
I wonder how much it really help to let the kid have a fever. Does it raise the chance of complications in any significant way if you lower it? Does it makes you sick longer?
Because having a fever absolutely suck and makes you miserable. I’ve never not treated my own fever. Having a fever is so horrible, i’d rather be sick twice as long than not treating it. I dont see why i’d let my kids endure a fever unless it had a very significant negative effect.
I’m fine with most fevers as long as I can be curled up in bed or on the couch. Everyone is different.
This. Treat how they look, not just the number.
It depends. Just as babies have much smaller reserves, and can easily become dehydrated in far less time than a larger child or adult, the infant hypothalamus is not as good at regulating temperature and so babies can have febrile convulsions more quickly and unexpectedly than adults. No fever should be unmonitored, even if drastic treatment is not immediately indicated.
I was totally confused when they sent home my nephew from the ER with a high fever (but in good spirits), so I checked the literature. It turns out lowering the temperature doesn’t reduce the risk of febrile seizure. It’s another correlation-causation conundrum: something else present in the fever state causes seizures in some kids. http://adc.bmj.com/content/88/7/641
A mild fever, sure, I’ll let that go, but if she is suffering, I will treat it. I don’t think it’s ethical to withhold a safe and effective treatment on the off chance that her suffering might be good for her.
Just to clarify, my comment was in no way meant to criticize your approach, Gaest. If your LO wasn’t suffering, it only makes sense to wait and see.
He was so young I had to wait for the ped to call back because the correct dosage for his age wasn’t on the bottle, and that’s when I found out the ped was against treating except in cases of marked discomfort (iirc, he said only if he couldn’t sleep, but also call immediately if he had a seizure). I much later learned that you can look up the dosages for young children online.
BNF
Seriously.
I do not keep paediatric doses in my head because I do not have room. This is where I look them up.
I am not suggesting you treat your children with unlicensed or prescription medication without a doctor’s ok, but if you have something OTC and you aren’t sure of the dose, this will keep you right.
Yeah, at this point I use it for things the ped know I am giving them, but I have forgotten what dosage he recommended/can’t find the visit summary. Mostly it’s a non-issue, but when my kids are uncomfortable I give them pain meds!
Fever is part of an inflammatory response to an infective organism – but I’m not convinced that the fever itself is adaptive (ie that it helps kill the infection – as opposed to the other elements of the immune response).
There is a common fallacy that everything the human body does “naturally” must have evolved with some purpose. This isn’t correct: take period pain, for example. Evolution results in survival of a species – not perfection.
That’s a long way of saying that fever most likely is not “beneficial” and, like pain, should be relieved if it makes you feel lousy.
There have always been treatments for high fever – both external cooling and herbal remedies – from the days of Sumerians:
https://academic.oup.com/cid/article/31/Supplement_5/S154/332580/Brief-History-of-Antipyretic-Therapy
Your link is just as much a fallacy as appealing to nature – you’re appealing to tradition. Do you know of scientific studies that have proven the fever itself does not improve illness outcomes? Because the reason I changed my practices on fever treatment was because of studies done, not because I believe that everything natural is better.
I’m not a doctor, but it seems you made a reasonable choice. According to the article below, fevers are not as dangerous as commonly thought, but it’s also unclear whether or to what extent fevers may be healthy. Reducing fever may be often unnecessary for safety or healing but sometimes helpful for comfort.
https://sciencebasedmedicine.org/fever-phobia/
I went looking for evidence that some people who promote breastfeeding are anti vaccines.
http://www.foodrenegade.com/cdc-advises-delayed-breastfeeding-boost-vaccine-efficacy/
Warning
Reading the above link will cause a loss of brain cells and one’s faith in humanity will be impacted.
Some of the comments make up for the butchered science of the article.
But the main idea of the article is if you breastfeed your baby you can delay getting vaccinated.
Stupid.
The article also talks about how researchers could improve the immune effects of breastfeeding?????
Dunning Krueger anyone
So depressing
Store-bought formula is normal. Breastmilk is normal. Homemade formula hasn’t been normal in decades. For a good reason that *isn’t* Gerber wanting to kill us all.
There’s nothing at all wrong with “adequately fed at the breast.” It’s equal to “adequately fed with formula.” The real issue is not the source, but the adequate part.
Stated for those who want to argue that this anti-breastfeeding. It’s not. It only criticizes exclusively breast fed when there is a problem getting enough breastmilk into the baby. Only then.
“perfectly balanced for optimal infant nutrition”
Only if the amount is adequate. It’s better to have enough of an adequate nutritional source than be starving with inadequate amounts of the “optimal” food.
And it’s not even perfectly balanced. It lacks iron and vitamin D. Some women produce milk that’s lacking in other things, like fat. I spent a lot of time in NICU’s with my babies, and made friends with a lot of moms during my three tours as a NICU mom. Lots of us had our milk analyzed for one reason or another. So very many came back with milk that was low-fat, low calorie, lacking in specific nutrients, etc. Now granted the sample of “moms who have had babies admitted to NICU” isn’t a representative cross sample, but we’re going for proof by contradiction here, and that only requires one example of less than ideal nutritional composition to prove the entire premise false.
I did not know this. I knew, in principle, that evolution is a process not a result and so there’s no reason for breastmilk to be perfect any more than, say, sperm is perfect. It just has to be good enough in enough people to keep the population stable or growing instead of shrinking. But having specific examples is even better.
You are raving, madam! Breastmilk is pure, perfect and able to adapt on the fly, from second to second, to make sure baby’s every need is met in the best, optimal, most natural way! It is even prophetic, sensing any potential illness and immediately calling into being the EXACT components your baby will require in the future./sarcasm.
I’m now having visions of the nipple being some sort of autonomous miniature bioengineering unit, sucking up the baby’s spit and analysing it for microbiogical content.
Who balanced it?
The same faultless body processes that produce perfect birth experiences, of course.
What about the nonsense of “you CAN’T overfeed a breastfed baby”?
And that’s a lie too, even if there is enough breastmilk. All my friends who have breastfed said that their babies needed Vitamin D drops. And we live in freaking San Diego, home of sun and surf and they do take their babies out a lot. Still needed the drops.
Breast milk is also low in iron. For the first month of life the baby has reserves; afterwards supplements are needed. Vitamin D drops are given in Israel also, which certainly isn’t short on sunshine either.
Not to mention Vitamin K.