How much better is breastfeeding?

by Harry on March 12, 2009

Hanna Rosin in the Atlantic.

One day, while nursing my baby in my pediatrician’s office, I noticed a 2001 issue of the Journal of the American Medical Association open to an article about breast-feeding: “Conclusions: There are inconsistent associations among breastfeeding, its duration, and the risk of being overweight in young children.” Inconsistent? There I was, sitting half-naked in public for the tenth time that day, the hundredth time that month, the millionth time in my life—and the associations were inconsistent? The seed was planted. That night, I did what any sleep-deprived, slightly paranoid mother of a newborn would do. I called my doctor friend for her password to an online medical library, and then sat up and read dozens of studies examining breast-feeding’s association with allergies, obesity, leukemia, mother-infant bonding, intelligence, and all the Dr. Sears highlights.

After a couple of hours, the basic pattern became obvious: the medical literature looks nothing like the popular literature. It shows that breast-feeding is probably, maybe, a little better; but it is far from the stampede of evidence that Sears describes. More like tiny, unsure baby steps: two forward, two back, with much meandering and bumping into walls. A couple of studies will show fewer allergies, and then the next one will turn up no difference. Same with mother-infant bonding, IQ, leukemia, cholesterol, diabetes. Even where consensus is mounting, the meta studies—reviews of existing studies—consistently complain about biases, missing evidence, and other major flaws in study design. “The studies do not demonstrate a universal phenomenon, in which one method is superior to another in all instances,” concluded one of the first, and still one of the broadest, meta studies, in a 1984 issue of Pediatrics, “and they do not support making a mother feel that she is doing psychological harm to her child if she is unable or unwilling to breastfeed.” Twenty-five years later, the picture hasn’t changed all that much. So how is it that every mother I know has become a breast-feeding fascist?

At some point, when I was a little bit obsessed with this topic myself, I looked a handful of studies and my experience was like Roisin’s; they all showed very small benefits, but I noticed that none of them tried to control for the socio-economic status of the mothers. Ever since I have been rather skeptical about the benefits, but have dutifully supported the breastfeeding of my kids, despite the difficulties that both they and their mother endured. Breastfeeding meant that for the first several months of each of their lives their primary relationship was with their mother, and everything I did with them had to be scheduled around the need for them to feed. With the first two, both of whom screamed pretty much constantly while awake for 4 months, I—and my wife—frequently went against our instinct that they were hungry, and refrained from giving them any formula (as the books tell you to), causing, I suspect, far more misery for all of us than was necessary.

My favourite La Leche League story (frequently referenced in Rosin’s article) is a from a friend who teaches high school. She asked a La Leche League counsellor how she could pump, given the brief breaks between classes, and the time it takes to let down. “well”, said the counsellor, “that’s easy, you just massage your breasts for 10 minutes before you pump”. “But I’m teaching in front of 30 teenagers in that 10 minutes before I pump, I can’t massage my breasts in front of them”. “Oh yes you can, they’ll soon get used to it”.

Siobahn, to whom I owe the link, says that her favourite line of the article is this:
“This is why, when people say that breast-feeding is “free,” I want to hit them with a two-by-four. It’s only free if a woman’s time is worth nothing.”

Update: see Laura’s excellent follow-up/summary, and ensuing discussion.

{ 92 comments }

1

dsquared 03.12.09 at 2:46 pm

In related news, the fact that nobody has done a controlled experiment on pregnant women to determine the threshold at which fetal alcohol syndrome is caused, does not mean that “there is no such thing as a safe amount of alcohol” in pregnancy.

2

Barry 03.12.09 at 2:56 pm

The problem of controlling for confounders might be a total block to getting conclusive results. As Hanna and Sioban have pointed out, breastfeeding is not a trivial thing (in a world without refrigeration and easy access to fresh, clean formula and milk, it’d probably be far more easy for the mother, but that’s not the case in the first world).

3

Alison P 03.12.09 at 3:00 pm

On the other hand breastfeeding is much quicker and easier and less stressful than bottle feeding, which is good enough for me. Bottle feeding would have had to have a substantial nutritional advantage to persuade me to muck about with sterilising bottles and heating formula.

4

Anderson 03.12.09 at 3:02 pm

I think it’s possible to be too either/or on the subject.

For example, if the dad’s feeling left out, let him give a bottle of formula now and then. I don’t see how a primary diet of breast milk is enervated into nullity by some formula supplementation.

5

hardindr 03.12.09 at 3:17 pm

6

Siobhan 03.12.09 at 3:22 pm

On the other hand breastfeeding is much quicker and easier and less stressful than bottle feeding, which is good enough for me.

I personally would not describe getting at most 1.5 consecutive hours of sleep for at least a month as easier and less stressful (not to mention the cracked and bloody nipples, poor supply, etc. that many women struggle with). Luckily any decent dishwasher has a sterlization cycle and most babies will take a bottle anywhere from lukewarm to right out of the fridge.

7

ajay 03.12.09 at 3:31 pm

breastfeeding is not a trivial thing (in a world without refrigeration and easy access to fresh, clean formula and milk, it’d probably be far more easy for the mother, but that’s not the case in the first world

Women who live in such a world – ie most women – also normally have to work jolly hard for most of their waking hours (as do the men, for that matter), and so I’m not sure that your statement is correct. Bottle feeding in such a world would be less safe, and also more expensive, but would it be less convenient?

8

bianca steele 03.12.09 at 3:39 pm

I haven’t read Rosin’s article yet, and I’m hesitant to post personal info, but I have one piece of advice for expectant mothers: see a lactation consultant if at all possible before the baby is born. Not necessarily a La Leche League consultant — my pediatrician recommended a very good consultant in private practice, who promised to be available for as long as necessary. The group classes run by hospitals give very helpful advice but in my opinion they are not enough (they won’t examine you individually, for one thing). It isn’t surprising to me that Rosin would have found huge disconnect.

Jill Lepore wrote in the New Yorker a few months ago on the same subject, incidentally.

9

Laleh 03.12.09 at 3:46 pm

When in the middle of the night you have to wake up to breastfeed a hungry kid, then breastfeeding is not “much quicker and easier and less stressful”… From the moment I stopped breastfeeding, my husband could share the burden of sleeplessness and night-time feeds. I am so totally pleased about this article!

Also, dsquared, right on! God, there are so many things women are not supposed to do when pregnant that it makes me wonder if this is just the scientific inflection of “women must suffer because of eve”…

10

MH 03.12.09 at 3:51 pm

“sterilising bottles and heating formula”

They make disposable liners so you only have to wash the case, ring, and nipple in regular soap and water (though boil them to sterilize before first use). As for heating, just boil about 2/3s of the cup of water in microwave and plunk the bottle in the hot water for a couple of minutes.

11

Alison P 03.12.09 at 3:58 pm

Who wants to get up and go to the kitchen and boil a kettle and make up formula at 4am? If you share a house (or a ward) with formula fed babies they cry on and on for about ten minutes while the mum is stumbling about swearing in the dark. I’m not bothered about the baby having to wait – it’s the mother’s extra work that just makes me feel tired. Seriously – I am a lazy person, I couldn’t have coped with the extra work.

12

Matthew Kuzma 03.12.09 at 3:59 pm

Even if breastfeeding has only a slight edge in studies, it also has a slight edge in unknown or untested factors, since the system that’s been around for millions of years is more likely to be without flaw than the invention of some decades of science. Also, I don’t disagree with the inconvenience factor, but the fault lies elsewhere. Breastfeeding is a natural and inherent part of the mammalian lifecycle and if there is any social construct that doesn’t mesh well with it, it’s the social construct that is inconvenient.

13

dsquared 03.12.09 at 4:05 pm

Who wants to get up and go to the kitchen and boil a kettle and make up formula at 4am?

Nobody, but it’s a job that dad can do instead of mum, sometimes, as a very special favour which I he will never stop going on about.

Breastfeeding is a natural and inherent part of the mammalian lifecycle and if there is any social construct that doesn’t mesh well with it, it’s the social construct that is inconvenient

Requiring eight hours’ sleep isn’t a social construct, and it doesn’t mesh well with breastfeeding.

14

MH 03.12.09 at 4:08 pm

If it takes ten minutes to get a bottle ready, you need to upgrade your technology and/or procedure.

15

Alison P 03.12.09 at 4:09 pm

Requiring eight hours’ sleep isn’t a social construct, and it doesn’t mesh well with breastfeeding

You still have to wake up and feed the baby whether you do it by breast or bottle. Also, in fact, needing 8 hours consecutive is a social construct. You could have two hours in the daytime, and six at night, or eight hours spread over twelve overnight.

16

Siobhan 03.12.09 at 4:10 pm

Alison P, here’s what we did: you make up the day’s formula at once, and dispense into individual bottles. This takes about 10 minutes each day (it took us even less time, because we only made enough to supplement EBM). For the night, you pack however many bottles you think you’ll need into a small cooler and leave it in the nursery. When the baby is hungry, you put the bottle in a bowl of hot water from the upstairs bathroom tap for a minute (or less if your child, like ours, loves cold milk).

Friends of ours came up with an even better shortcut — you just leave the next bottle out during the current feeding, and it’ll be room temperature when you need it in a few hours. It stops working once they’re consistently sleeping in 4+ hour blocks but for the first few months it’s genius.

17

Paul 03.12.09 at 4:10 pm

If a woman wants to breast feed her child then very well, but please we have a lot of more pressing issues right now in the world don’t we? Academicians never cease to amaze me!

18

Alison P 03.12.09 at 4:13 pm

It just seems to me that anything which makes life easier for women is automatically suspect. If a solution is less pleasurable, and more tiring, it must be ‘better’.

19

MH 03.12.09 at 4:17 pm

I always used the bottle warming time for a quick diaper change. At that age, they always needed a diaper. I’d also be a bit leery of using a bottle that had been out for a couple of hours, but I have strong food spoilager fears.

20

Rich Puchalsky 03.12.09 at 4:25 pm

I highly recommend the book The Nurture Assumption by Judith Harris. It’s not about breastfeeding per se, but its take-home message is that unless you actually abuse your kids, how they grow up won’t depend much on what you do.

21

MH 03.12.09 at 4:28 pm

Rich, I’m not sure whether to find that reassuring or depressing.

22

dsquared 03.12.09 at 4:32 pm

You still have to wake up and feed the baby whether you do it by breast or bottle.

“You” is ambiguous here; it refers singularly to the mother in the context “breast” but generically to either parent in the context “bottle”. Or in other words, my missus can dig me in the ribs and say “your turn” to give a bottle, but no amount of nagging will cause me to grow lactating breasts[1].

[1]I have not actually tried this.

23

MH 03.12.09 at 4:40 pm

A dubious surgeon can get you breasts that look good in a sweater.

24

Righteous Bubba 03.12.09 at 4:58 pm

unless you actually abuse your kids

Counting neglect as abuse I’m sure.

25

LizardBreath 03.12.09 at 5:20 pm

One more vote for breastfeeding having been easier than I think bottle feeding would have been, but of course that’s a matter of individual preference. If I’d been trying to bottlefeed it would have involved a whole lot of rummaging confusedly through kitchen cabinets at three am trying to figure out if there were any clean bottles, rather than going back to sleep with the baby nursing. And good lord is formula expensive.

OTOH, it seems clear that the health benefits of breastmilk rather than formula (assuming clean water etc.) can’t possibly be all that great, or there’d be easily noticed effects in the generations where most people were breastfed. And pumping really does seem like a misery; I’m surprised anyone has the commitment to do it consistently for a long period of time.

26

eudoxis 03.12.09 at 5:21 pm

Lifetime benefits of breastfeeding are scarcely tractable to epidemiological studies, realistically. I’m inclined to think that it’s hard to improve on evolution, so the nutritional and emotional benefits are superior to formula feeding for that reason.
But, by all means, do what feels good for you and your child.

I breastfed our children and didn’t do it because of studies showing improved vision or increased antibody titers. I truly enjoyed it. Even while a graduate student/post doc. The emotional benefit to the mother is often ignored by so much of squeamish society.

27

Chuchundra 03.12.09 at 5:32 pm

The system I cam up with is to sterilize all the bottles/nipples/etc. and then fill the bottles with just-boiled and filtered water, close and cap them. Since everything is sterile, and all you have in the bottles is water, you can leave the filled bottles in the pantry. No need to put them in the refrigerator.

When my baby is hungry, I just take one of the prepared bottles, mix in the formula, shake it up and away we go. No need for heating.

28

Glen Tomkins 03.12.09 at 5:57 pm

Look at the effect size

It’s probably wise to be skeptical of any medical recommendation concerning life styles. Inherently, we can only do observational studies of such questions as the health implications of drinking red wine, getting a certain amount of exercise, losing weight, and yes, breast-feeding. You can do a placebo-controlled randomized control trial of an anti-hypertensive, because taking pills (well, anti-hypertensive pills, anyway. Of recreational pills, deponent saith naught.) is not a part of anyone’s normal life, so you can randomize them into treatment groups. But you can’t, in any numbers, and with people who are at all normal, randomize them into a group that smokes, and one that doesn’t, or one that loses weight, and one that doesn’t, or one that breast-feeds, and one that doesn’t. You can only compare groups of people who do and don’t do these things of their own volition, and letting their volition into the picture lets in biases, including biases you can’t correct for because you can’t measure their effect size.

This does not mean you should reject all results of observational studies. The idea that smoking causes lung cancer is based entirely on observational studies, yet it is incontrovertible. This is so, while the idea that breast-feeding does any measurable good is dubious, because smoking has a huge effect size, while the observational studies of breast-feeding find only marginal effect sizes.

The key determination to make in deciding whether to take the advice of an observational study, is how likely any biases are to overwhelm in magnitude the effect size found by the study. All of the case-control studies of cigarrette smoking and lung cancer found odds ratios in excess of 10:1. There simply are no sources of bias large enough to explain that away, not when the studies were repeated in many different populations to make sure we weren’t dealing with some unusual bias limited to just one small population. But a case-control of breast-feeding that found that it was associated with a 1.5:1 better outcome in a given child health parameter, could be explained as readily by the idea that women who take the trouble, who can afford to take the trouble, to breast feed, can probably also take the trouble to do all sorts of other things that improve their child’s health outcomes, compared to women who don’t or can’t take the time and trouble to breast-feed.

This does not mean that breast-feeding has no health outcome benefits, just that they could only be so small as to not be provable with observational studies. An improvement of 1.5:1 would still be worth achieving if the outcome in question were at all important. The problem with the low effect size isn’t that it means the desired outcome is less desirable, it just means that proving that there is any real improvement at all, that the apparent benefit is not entirely an artifact of bias, becomes impossible.

29

Zora 03.12.09 at 6:28 pm

If the child is sleeping right next to you, you don’t necessarily have to wake up to breastfeed. The kid just reaches out and latches on. Didn’t work exactly that way for me; I had to wake up, sit up, and nurse (too full-breasted; flat-chested moms have the advantage here). But I didn’t have to get out of bed and I could go back to sleep immediately afterwards. No crying, ever. I could sense my daughter getting restless and I’d wake up before she cried. Problems getting her out of the family bed? None. She made the transition in one night.

Does breastfeeding mesh well with the way work is organized in Western society? No. Does that mean we have to give up breastfeeding? No. It means work has to be reorganized.

30

Daniel 03.12.09 at 6:47 pm

If the child is sleeping right next to you, you don’t necessarily have to wake up to breastfeed.

if your husband is sleeping right next to you, you don’t necessarily have to wake up to bottle feed.

31

David Weman 03.12.09 at 7:10 pm

Dad bottlefeeding isn’t relevant to if mom should do it, is it? Unless he does all the bottlefeeding.

32

Rich Puchalsky 03.12.09 at 7:24 pm

Counting serious neglect as abuse, yes, RB. But really, no one who cares about whether breastfeeding is good for their child or not is ever going to neglect their kid to that extent.

33

Pencils 03.12.09 at 7:33 pm

It doesn’t take ten minutes to get a bottle ready. It takes less than one, if the bottles are already sterilized and you’ve pre-boiled the water. Which my husband and I do once a day. My daughter is perfectly happy with room temperature formula, she’s never known anything else. She’s a healthy, happy baby who has never been sick a day in her nearly six months of life and is ahead on all her developmental milestones. Formula is a perfectly good option and women should not be shamed into breastfeeding (or continuing breastfeeding) if they would rather not. BTW, this was not my choice, I wanted to breastfeed, but it didn’t work. I’m just glad it worked out well in the end.

34

John Emerson 03.12.09 at 7:38 pm

People shouldn’t throw up softballs for Dsquared. Us regular trolls have to do all the work ourselves.

35

JRoth 03.12.09 at 8:19 pm

“It’s only free if a woman’s time is worth nothing.”

Yes, whereas bottle feeding takes no time whatsoever.*

What an asinine bit of smugness.

* IME, breastfeeding is much faster per feeding, but I’m sure it varies.

36

Ingrid Robeyns 03.12.09 at 8:23 pm

I have spent countless hours trying to reserch the scientific ‘evidence’ behind what is in the popular books (not just LLL but also the leaflets handed out in hospitals etc.) and have found it extremely hard to find evidence that would back up the strong claims of the large advantages that mothermilk would have. I once dared to ask on a breastfeeding internet forum what difference it would make if one were to breastfeed ‘only’ 4 months rather than the magic 6 months (which all mothers in the Netherlands should see as a minimal target if we are to believe the leaflets handed out to pregnant women), and the women on the forum took some offence at my question – but apart from linkss to -again- the popular slogans I didn’t get any other evidence. It really is a belief, rather than evidence-based knowledge.
The evidence I eventually found (but I didn’t find much on many questions) showed that several of the proclaimed effects are very small, and other effects (e.g. on cancer prevalance in mothers) only become significant if one breastfeeds for very long periods, say at least 18 months. But then one would have to control for other effects – and I can testify that I never ate as healthy as when I was pregnant and breastfeeding, hence surely if one then continues this for long periods it may decrease the risk of certain types of cancer that are also related to healthy livestyle. So the usual problems with controled experiments, controlling for other factors, etc. etc.

YET despite all this scepticism, I did breastfeed both my children for 6+ months and think this was the right choice. As Matthew Kuzma (at 12) says, we don’t know what ‘good stuff’ there is uniquely in mothermilk that studies have not shown yet.

On the practical side, I had two very different experiences – with the first child I counted each day that I breastfead him as a victory, since I was so exhausted and weakened from the whole childbearing process. It was a real struggle and if I would not have been able to work mainly from home (another 3 months after 14 weeks of fully paid maternity leave) I would certainly not have managed. With the second child it was no burden at all, it was easy and it was a joy. With both of them, whether it was hard or not, it also had very beautiful daily moments of intimacy that one does not have with bottle feeding. I know that the breastfeeding maffia is saying this so this is reason enough for suspicion, but I can only say that it was my experience too. I really think that in this debate we need to hear more the ambigious voices, and the sad thing is that those voices which are dogmatically pro (the breastfeeding maffia) or univocally against, are heard more frequently than the voices of women with very mixed and ambigious experiences and judgements.

I think the crucial social/political issues are:
(1) complete and evidence-based information to all pregnant mothers
(2) women decide. No social or moral pressure to change or influence their decisons after they have made an informed choice.
(3) support for mothers who wish to breastfeed, e.g. no stigma on feeding in public and availability of advisors. I know women in Belgium who wanted to breastfeed but had no professional support network and therefore gave up.
(4) in those countries where it is needed, change of labour market/ welfare state provisions that allow mothers to stay at home for at least 6 months with their newborns, which will make breastfeeding much easier (I am not commenting on fathers here, but have posted on this about a year ago).

Perhaps something is missing, but this could be a start.

37

JRoth 03.12.09 at 8:26 pm

From the moment I stopped breastfeeding, my husband could share the burden of sleeplessness and night-time feeds. I am so totally pleased about this article!

If he wasn’t doing this during breastfeeding, then he was a jerk, and you were a chump (no offense). Over the course of 2 entirely-breastfed children, I’d say my wife took on maybe 10% more overnight responsibility than I did*, balanced by pretty much all non-nursing daylight care being my responsibility.

* I would fetch the child, change it, bring it to bed, then return it to its crib once it fell asleep. If it failed to fall back asleep (an all too common occurrence, esp. with our first), then I was on duty until it fell asleep or another 90 minutes had passed.

38

Ingrid Robeyns 03.12.09 at 8:28 pm

btw, thanks to hardindr (@5) — I will check out this Cochrane Library to see what they say in terms of the size and significance of the beneficial effects of mothermilk. I heard only about the Cochrane Library after the period in which I looked for this information — perhaps it would have saved much time.

39

JRoth 03.12.09 at 8:35 pm

FWIW, I suspect my wife would describe her experience as similar to Ingrid’s in 35 – #1 wasn’t a hard pregnancy or birth, but she had a bad latch and was (and is, 5 years on) a slow eater. #2 has been much closer to the positive images around breastfeeding, but still not exactly mystical. My wife is probably more committed to nursing than I am.

My inclination is that, if every known health effect is positive, even if small, then that predisposes pretty strongly in favor of nursing. Not that I approve of the moralism of LLL types, but I think it’s a bit silly to say, “Well, every (health)* factor is either pro-nursing or even, so that’s a wash.” We don’t think this was about other issues.

* Obviously, you need to balance out personal issues of comfort/practicality. But those aren’t the underlying facts, those are the immediate circumstance.

40

harry b 03.12.09 at 8:39 pm

I agree with all Ingrid’s 4 issues. Thanks for all that Ingrid.

JRoth — yes, I did all that for the first two. But, the key thing is that if I had fed them, she could have slept, rather than both of us being exhausted. For the third, I did all the fetching and carrying etc, but really tried to grab all the sleep I could otherwise for efficiency reasons. The point about mother’s time being worth nothing is that men can bottle feed, and then the mother doesn’t have to do anything. The comment is neither asinine nor smug.

I am very skeptical about Matthew Kuzma’s comment for some large number of babies. Until the discovery of antibiotics nature would have rendered my first child motherless, and prevented the birth of the other two. A large proportion of babies living in the developed world are descended from at least one person who, in nature, would not have been breastfed by his or her mother. So, for example, when counselors say with complete confidence that no breastfed baby is ever underfed, I think to myself, “really? Even babies of mothers who were under major anaesthetics for the 30 hours preceding birth and the first 60 hours after birth, and who should, in nature, have died in childbirth. Are you really sure about that?”

41

JRoth 03.12.09 at 8:39 pm

It just seems to me that anything which makes life easier for women is automatically suspect. If a solution is less pleasurable, and more tiring, it must be ‘better’.

This statement seems premised on the idea that formula was developed at a time when women and their efforts were valued more highly. When was this, exactly?

42

JRoth 03.12.09 at 8:43 pm

The point about mother’s time being worth nothing is that men can bottle feed, and then the mother doesn’t have to do anything.

So is the men’s time, then, worth nothing? Do the women never feed the babies (day or night)? I’m baffled as to how using a bottle suddenly takes no time from anyone whose time has value.

News flash, people: child-rearing involves uncompensated labor. All we can do is hope that the little bastards grow up wealthy and kick back a sharedarlings grow up happy and healthy.

43

harry b 03.12.09 at 8:43 pm

Ok, well taking up JRoth’s challenge in #38 (and basically repeating what I say at Laura’s blog). The studies (which I distrust) focus on physical health. But emotional health and development are at least as important (more important once some threshold of physical health is reasonably secure). Breastfeeding is VERY stressful for some mothers, and the feeling that one must persist despite any difficulties may contribute to a descent into depression (I’m convinced I’ve seen that happen a couple of times) that is bad for the mother and for the baby, especially if the baby is being cared for mostly by the mother. This possibility is not discussed at all in the parenting books/magazines I read during #s 1 and 2 (didn’t bother to read anything for #3, maybe that’s why he is so happy and energetic and hard to deal with), and often gets left out of these discussions. So, to address what you say directly, the studies are only about one dimension of health, and they refrain from addressing another dimension that seems relevant to choice. I think that numerous smart well-educated women who are confident in other areas cede to the experts on this question rather than acting on what would be their own judgment, taking into account their own emotional needs, as well as those of their babies.

44

MH 03.12.09 at 8:43 pm

For us, we found that when it comes to sleep 2+2+2 < 3 + 3 < 6. Things got much better when figured out the alternating schedule so that we each got at least two nights of longish sleep a week. (Even with shifts, there are always problems that wake up the whole house.)

45

harry b 03.12.09 at 8:44 pm

#42 — The observation that breastfeeding isn’t free does not imply that bottle-feeding is. Why would you think that is implied?

46

Ingrid Robeyns 03.12.09 at 8:48 pm

when counselors say with complete confidence that no breastfed baby is ever underfed
well, then they are bad counselors. In this country, in any case not all counselors are assuming that breastfed babies cannot be underfed or overfed (perhaps no counselors are assuming this, but I do not know). I have been asked quesitons by counselors to analyse both potential undernourishment and potential overnourishment, with breastfed-only babies. In both cases they concluded nothing serious was going on, but they took the possibilities seriously (based on length/weight statistics).

47

Russell Arben Fox 03.12.09 at 8:48 pm

From my observations sleeping next to my wife over the course of her nursing our four daughters–for 2 1/2 months in one case, 6 months for another two, and 11 months for the last–everything Zora says in #29 is correct. For the record, I’d get up, retrieve the baby, Melissa would nurse her while dozing in and out, the baby would detach and fall asleep, I’d return the baby to her crib, all would continue as normal until the next round of feedings. Yes, you get less sleep when there’s a newborn that needs to be fed, just as you get less sleep once you have children, period. This is news?

48

Dan Simon 03.12.09 at 8:51 pm

Ahh, it’s begun…I predicted a couple of years ago (as we were being hounded by the breastfeeding martinets after the birth of our first) that it was only a matter of time before the pendulum swung back, and formula became the universally acknowledged superior option. Recognizing the bogosity of the claims for the miraculous properties of breast milk is only the first step–soon, we’ll be hearing about the supposed health advantages of formula, too. (Around here, for example, breastfeeding babies all have to get vitamin D supplements, because most adults are deficient. The drops apparently taste terrible, because babies hate them and tend to spit them out. Formula babies, of course, have no such problems.)

Anyway, I agree with most of what’s been said here. Formula’s perfectly satisfactory, and so’s breast milk. Fathers should pitch in and feed. Mothers should do what works best for them. And the kids will be just fine.

49

MH 03.12.09 at 8:56 pm

Just how often diapers leak until their little legs get chunky enough to fill-out the holes was news to me. Also, the effects of the continuing lower level of sleep were news to me.

50

bbartlog 03.12.09 at 8:57 pm

they all showed very small benefits, but I noticed that none of them tried to control for the socio-economic status of the mothers

Hmm. This doesn’t match my experience: if you don’t control for SES, you can actually see some rather impressive-looking effects (e.g., I’ve seen studies that didn’t control for anything claim a 10 pt IQ advantage for breastfed infants). These turn small and sometimes disappear after SES is controlled for, which some studies have tried to do. Unfortunately, ‘controlling for SES’ only gives us one, fairly accessible variable, when we can imagine that there are a lot of other things we would want to control for.
As an aside, this is true only in a first-world context. For women in areas without clean drinking water, exclusive breastfeeding provides great protection against infant death from diarrhea (which still kills millions).
Those who are curious and want to do their own numbercrunching might want to look at the youth data from NHANES III (see here, you’ll want the youth dataset). There’s enough data on things like race, poverty, marital status and so on (alongside the data on how long kids were breastfed) that you can control for quite a lot.

51

Russell Arben Fox 03.12.09 at 8:59 pm

…didn’t bother to read anything for #3, maybe that’s why he is so happy and energetic and hard to deal with

I love this comment, Harry; it contains a great truth. Growing up in a large family, having changed diapers and bottle-fed babies and babysat for just about all my growing up years, I was fortunately mostly immune to the strange lure that parenting/childrearing books and magazines and other nostrums seem to have on so many. Still, from those that I have consulted, it appears that easily 75% could be accurately filed away as “disciplining the child to fit into your life.” I think it’s bullshit, most of it. Breast feed them for at least a while if you can, feed them healthy food once they can keep it down, keep their bums wiped, patch them up when they bleed, read and talk and play with them all the time, give them hugs, and if you’re blessed enough to have a child whose physical and mental operations are all mostly in order, nature will pretty much take care of all the rest.

52

dsquared 03.12.09 at 9:04 pm

Over the course of 2 entirely-breastfed children, I’d say my wife took on maybe 10% more overnight responsibility than I did

I presume you mean “entirely breast milk fed children”, rather than literally “entirely breastfed”, and suspect that this little bit of pedantry is at the root of quite a few cross-purposes in this thread.

53

JRoth 03.12.09 at 9:07 pm

43: Very good point. I’m in absolute agreement that there needs to be more openness to the difficulties many women face in nursing. In my personal circles, this is widely discussed, but I understand that, in general, there’s a lot of pressure to breastfeed no matter what (of course, almost half of American women never try at all, so let’s not exaggerate the pressure). I certainly feel contempt for those who presume to judge others on their nursing.

As for your skepticism, I’d be more inclined to share it if any of the studies went the other way. Is every study crap? There are none (apparently; I assume if they were there they’d be highly touted in this post) that show formula babies doing measurably better. So you have to throw out a good chunk of all the studies even to get to a wash, and you’ve got no studies that show a direct health benefit to formula. I just don’t see how to get from there to a blanket dismissal.

54

JRoth 03.12.09 at 9:10 pm

The observation that breastfeeding isn’t free does not imply that bottle-feeding is. Why would you think that is implied?

Because the observation that breastfeeding isn’t free relies exclusively on valuing time spent by parents that is, more or less, identical to time spent bottle-feeding. Since people who talk about the expense of bottle-feeding aren’t referring to the time spent actually giving bottles to babies, it’s, well, asinine. Along the only axis of cost difference*, breastfeeding is, well, free (not that I, personally, have ever used this argument. I was shocked when, for various reasons, we ended up buying some formula for #1 and discovered how really expensive it is, but I’m not a moralist on the point).

I think that most people recognize, going in, that they will be spending time feeding their children. Some people also choose to spend money buying the food.

* Obviously, pumping is a different story. Anyone who would claim that buying a pump and freezer bags is free is an idiot.

55

LizardBreath 03.12.09 at 9:17 pm

Breastfeeding is VERY stressful for some mothers, and the feeling that one must persist despite any difficulties may contribute to a descent into depression (I’m convinced I’ve seen that happen a couple of times) that is bad for the mother and for the baby, especially if the baby is being cared for mostly by the mother

Part of what’s going on in these cases, I think, is that breastfeeding can be very resistant to parent-set scheduling, and modern life involves a lot of scheduled activities. Some days, the kid is just going to want to nurse all day, twenty minutes out of every hour; growth spurt, a need to increase supply, whatever. And if you’ve got competing obligations that mean you can’t spend the day sitting around and nursing, you’ve got an unhappy, hungry baby and you’re setting yourself up for supply problems. This isn’t every day, or most days, but it happens and you can’t schedule for it.

I thought nursing was easier than the alternatives, but I had the luxury of a six month maternity leave (well, six months not working) with each kid, and a full time nanny taking care of my toddler when I had my second baby. For someone who’s trying to do anything other than infant care, I can see it being very, very difficult.

56

JRoth 03.12.09 at 9:18 pm

51: Presumed correctly. Actually, #1 got a lot of pumped milk, but #2 has gotten it only incidentally – basically, enough to allow my wife to go out occasionally without the baby (this sounds horrible, but I hardly go out without the baby, either, except when we split up and I have #2 while she has #1). Maybe 20-odd bottles in 8 months.

I’m curious about 44. Did you actually alternate nights during which one of you was on-call? I guess some sort of blend. Sadly, nursing aside, that would have only limited effectiveness for us – my wife is terrible at falling back asleep. Sometimes I’ll get up, go calm the baby, come back, and fall asleep, and all the while she’s lying there awake. I can’t tell you how many nights we’re awakened at 4 or 5 am and she never falls back asleep (again, independent of whether she’s nursed).

57

harry b 03.12.09 at 9:32 pm

#53; but that’s Rosin’s point; people who say it is “free” just aren’t bothering to count the mother’s time.

On scepticism about studies — lots of studies finding that left handed people die earlier, combined with some that don’t find any difference would not make me give the ones that find they die earlier the benefit of the doubt if I noticed that they weren’t taking some significant relevant piece of evidence into account. But with the breastfeeding studies I should have been clearer — I do give them the benefit of the doubt, in the sense that I’m willing to believe it is better for many, or most, babies, but see no reason to think it is enough better for all to create a strong and intrusive social norm.

58

MH 03.12.09 at 9:34 pm

JRoth, it wasn’t at set schedule. By 9:00 p.m., it’s pretty obvious who needs sleep the most.

59

Ana Folpe 03.12.09 at 9:52 pm

The tenor of this article is much the same as LePore’s article in The New Yorker a few months ago, and another one about a year ago in the WSJ. A few (of many) thoughts:

1) Yes, breastfeeding is time and money, yes it is valuable, messy, contradictory, sometimes infuriating work. That society doesn’t value it in a monetary sense shouldn’t be a surprise. That some people are hostile to your decision to breastfeed shouldn’t come as a surprise, either. Having kids is work, and on some days, like breastfeeding, it’s nothing less than a political statement. It ain’t for wimps, none of it. I’m sorry, but let’s just get that on the table and stop whining about it. If you wanted to spend your time doing something valued by society, you might not choose to have kids or breastfeed, ever.

2) Traditional western medicine does not value nutrition as much as it should, it is largely the demoted province of nurses and female ‘nutritionists’ for the most part, not the glamour world of celebrity chefs. The longer I live, and the more I look around, the more I believe good nutrition is the key to both preventive medicine and the larger issue of environmental health.

Just why organic food is good for us, other than tasting good, is not much understood or studied, to some degree because this research has never been systematically done and/or has been squelched by the conventional food industry. The same is true for breastfeeding. Breastmilk is a live food, the components of which have never been comprehensively studied. Most pediatricians don’t know much about it, they get a couple of days’ rotation training in it as residents. If people have breastfeeding troubles, the doctors send them to a lactation consultant, or just assume formula is just fine, and of course, calorie-wise, it appears to be. Medically, it is not considered something worth knowing about, and certainly not trustworthy, even though recent ad campaigns have gone over the top in promoting the health benefits of nursing. Those ads are an example of the schized-out relationship the medical community has with breastfeeding and breastfeeding management (note the difference).

3) As some of the earlier commenters suggest, it is typical human hubris to think we can recreate in a few decades a substance it has taken millions of years of evolution to distill. Until we understand all of the complex components of breastmilk, how and when they are supplied, and how these change over the course of a child’s early life, we are really without a good argument as to whether breastfeeding is only marginally better than formula feeding.

Formula is a pharmaceutical product, and can be equated with a drug, as it is a replacement substance for something the body can produce. Dr. Jack Newman, the Canadian breastfeeding researcher, says as much on his web site, but of course this is an unpopular view. I breastfed my kids partially because, despite the issues with body burden chemicals, I didn’t know what was in even organic formula and I didn’t want these folks getting my nickel.

These concerns are not unfounded; soy and milk-based formulas both contain body-burden chemicals from the cows, and pesticides from the soybeans, unless they are truly organic, and even then. High fructose corn syrup is used in conventional formulas, and I have learned that it, as well as the DHA and ARA now found in many food products, are derived using industrial solvents like hexane and in some cases mercury. Basically I didn’t want my kids to be part of this aspect of the industrial food chain. There are now organic formulas that use water-derived DHA and ARA, as well as plant-based sugars, but they are not widely available. BPA and formula feeding is obviously another issue, one that I was able to avoid to a large degree by breastfeeding. Refer to the importance of nutrition in health, above.

4) Why did Rosin quote Sydney Speisel from Yale…that man is on a mission to disprove the value of breastfeeding. He was interviewed on Salon and is quoted all over the place, and no one challenges him, despite the reams of data from Jack Newman and La Leche and the Journal of Human Lactation. Just anecdotally, I live in a rural area and folks who raise cows here tell me that when cows have twins, usually the cow will give one up as that is not the norm. There apparently are many fewer medical problems with the nursed twin than the bottle-fed twin, and of course one would assume the bottle-fed twin is getting cow’s milk! With my kids, the immune benefits have been considerable, and very different from my own upbringing as a formula-fed baby.

Keep in mind, too, that kids are vaccinated now, too, and that is part of the picture of the early human immune system. By all accounts breastfeeding facilitates this process, and to some degree the benefits of breastfeeding might be altered by the aggressive American vaccination schedule. Vaccinations are very important in the medical community and of course in the pharmaceutical community, yet this important interaction of drugs and breastfeeding, in the early years of life, is not very well understood or studied.

5) Generation X-ers have to some degree inherited the radical wave of La Leche League activists who reclaimed breastfeeding for the art and good practice that it is. Did they go a little nuts at first? Perhaps, but revolutionaries sometimes have to overshoot to prove a point. What I have seen in the past few years is a backlash associated with nursing. Thirty-something folks have kids, are told it’s a good thing to do, are successful, then realize how much work it is, and how little the average medical system and workplace will support this rhetoric.

My response is, keep on breastfeeding and pumping until it does become socially normative and a family and society/work issue, not just a women/work issue. If you want to feed your child formula, so be it, but know what you are feeding and how. Nutrition is the foundation of human health and well-being. Full stop. Garbage in, garbage out. Choose the best products and the market will follow.

6) If you think about it, breastfeeding is a fulcrum of so many issues about work-life balance in modern life. Why is caregiving of children seen largely as a woman’s issue, still? Why do we expect people to raise their kids well and yet work full time? Isn’t having a family just as important as other kinds of work? Why is there such a bright line between the workplace and the home, when for many, the home is both? Many of Rosin’s discontents are a reflection of putting the ideals of the prior generation into practice, and in turn reaching for more ideals. I really feel our kids, and we, will only benefit from trying to square all of these circles as we, and our families, grow.

60

Cian 03.12.09 at 11:05 pm

My brother was dangerously allergic to formula.

61

Phil 03.12.09 at 11:42 pm

see no reason to think it is enough better for all to create a strong and intrusive social norm

I think this means less than it appears to. (How sure would we have to be, of how much of an effect, to justify creating a strong norm rather than a weak one? How intrusive is intrusive, or rather how intrusive is too intrusive for our current level of uncertainty about the level of the effect?)

I’m very suspicious of pieces like Rosin’s: it’s one of those “aren’tcha just sick of being a well-meaning liberal and not having any fun” pieces, addressed to a well-meaning liberal audience (the Graun abounds in them). As such it’s overstated thanks to the zeal of the convert and overstated for novelty-controversy shock value. It’s basically alarmist, however jokey the tone (“breast-feeding fascist”, indeed – would those be liberal fascists?).

62

Phil 03.12.09 at 11:46 pm

(Sorry, didn’t finish that thought.)

What seems like a Big New Threat is very often an existing threat that’s just got slightly larger, or that’s just impinged on the consciousness of the writer, or that the writer has just started to worry about. All of this is fine & to be expected – the first of these in particular can be genuinely interesting – but it doesn’t add up to saying that a Big New Threat actually is a threat that’s new and big.

63

notsneaky 03.12.09 at 11:54 pm

“Breastfeeding is a natural and inherent part of the mammalian lifecycle”

I don’t ever want to see you on an airplane. I mean, the inability to fly is a natural and inherent part of the mammalian lifecycle (except those stupid bats).

64

Anna 03.13.09 at 1:38 am

What about all this BPA containing bottles? What will be the next thing which is bad for kids? While mom’s breast is mom’s breast.

65

harry b 03.13.09 at 2:41 am

Wait for my next post, in which I ask why people don;t make their kids wear crash helmets in the car

66

MH 03.13.09 at 2:53 am

Because everybody drives better than average?

67

Daniel 03.13.09 at 7:58 am

Just why organic food is good for us, other than tasting good, is not much understood or studied, to some degree because this research has never been systematically done and/or has been squelched by the conventional food industry

There has been a load of research done, and the conclusion tends to be that there’s surprisingly little evidence that organic food is better for us.

Also, when cows have twins, the twins are usually sterile males and so the question of feeding them doesn’t really arise.

68

dave 03.13.09 at 8:46 am

OK, so how does the cow know her offspring are sterile males, and what instinct prompts her not to feed them?

Meanwhile, breast or bottle, live and let live fercrissakes.

69

Katherine 03.13.09 at 9:01 am

What an interesting way around everyone is looking at this – at the “benefits” (apparently small) of breastfeeding. The formula manufacturers have done a fantastic job of convincing us that formula feeding is the “normal” against which breastfeeding should be measured as (perhaps) better.

How about we switch it around and look at the damage caused (apparently small) of formual feeding? Looks a bit different from that angle.

PS quite apart from time costs of breastfeeding versus formula feeding (and I’m in the breastfeeding-is-quicker camp, but I can indeed see the legitimate arguments either way), there is also the simple fact that it costs money to buy formula, and bottles, and teats, and sterilisers etc etc. I wonder who is making that money, and who might be the people funding the research.

70

Cian 03.13.09 at 10:02 am

Daniel, that’s not really true about organic food. It depends upon what the food is. But organic food tends to be denser nutritionally (part of the extra “growth” is simply water for both meat and vegetables) and have more minerals. Also nitrates and pesticides in small doses are almost certainly not good, and certain foods (root vegetables in particular) tend to have quite a lot of these in them.

When it comes to organic meat. The benefit is probably not so much the “organic” part, so much as that industrial production of meat results in some very scary practices and outcomes.

71

Alison P 03.13.09 at 12:11 pm

Me: ‘It just seems to me that anything which makes life easier for women is automatically suspect. If a solution is less pleasurable, and more tiring, it must be ‘better’.’

JRoth: “This statement seems premised on the idea that formula was developed at a time when women and their efforts were valued more highly. When was this, exactly?”

The development of formula isn’t really the issue – it will surely always have its place, and be very useful to some women and babies, and its development is not to be denigrated. It’s a life saving substitute when milk isn’t available.

However, I think the elevation of bottle feeding as superior to breast feeding (and breast feeding as peculiar and amusing) is linked to the undervaluing of women and women’s pleasure and labour.

72

John Emerson 03.13.09 at 1:39 pm

I’m pretty neutral in the food / back to nature wars, but one fact that springs out is that industrial pork is apparently free of trichinosis. According to the CDC, cases of trichinosis in the US are in the very low double figures annually, and almost all cases are from free-range hogs, wild boar, or wild bear. Presumably this is mostly from longstanding regulation and inspection, but industrial production of pork prevents the hogs from eating carrion, which is what spreads the disease.

73

JonJ 03.13.09 at 3:05 pm

I’m surprised that no one in this discussion has mentioned adoptive parents. My first wife and I raised two adopted sons, now in their twenties and quite healthy, on nothing but formula. I gather that there are ways of getting a woman who wasn’t pregnant to lactate, but we never even gave that a thought.

We got a sterilizer and bottle warmer in preparation for the first baby, but soon found that neither one was necessary. Our pediatrician assured us on our first visit that washing the bottles the way we wash all of our dishes was perfectly OK, and we soon found that the kid didn’t mind formula right from the refrigerator at all. He was hungry!

Like a couple of commenters, I have to smile at the argument that formula is “not what nature intended” and is “a pharmaceutical product.” Do such arguers do without all pharmaceutical products (I am diabetic and would be in a sorry state today without several such products)? The relevant question, as always with technology, cost vs. benefits, or disadvantages vs. advantages, and the answer is not always obvious.

As for the expense and time involved in formula-feeding, rearing kids involves a lot of work and expense any way you do it, as several commenters have pointed out. Breast- vs. bottle-feeding, it seems to me, is largely six of one and half-a-dozen of the other, though I grant that many mothers have very strong feelings about the attachment aspect of breast-feeding. As a man, I have no experience at all of that, but I will say that I was quite attached to both kids through bottle-feeding (and yes, even through diaper-changing).

Also not mentioned above is the case, increasingly common, of two gay dads. Should we assume that their kids will necessarily grown up sick and deprived?

74

harry b 03.13.09 at 6:16 pm

But who was saying that bottle feeding is better? Generally? No-one here has said that. People have said that in some circumstances it is at least as good, all things considered. And that breast feeding has a down side (at least, I think its a down side, but people who don’t care about this might think it is an upside) of making gender egalitarian marriages harder to achieve.

75

dutchmarbel 03.13.09 at 6:28 pm

I tried to breastfeed all three of my kids, but had to switch to formula after a few weeks. AFAIC there are advantages and disadvantages to both so you have to decide which ones matter most for YOU in YOUR situation. Breastfeeding has an attachment advantage for mothers, bottle feeding means that dad can share the attachment. Bottle feeding is more expensive, breastfeeding means more dietary restrictions for mom. Bottle feeding means easier time with sports (smaller breasts, no leaking), breastfeeding means always baby food available. Breastmilk changes due to dietary demands of the baby, formula has added vitamins in it and it’s easier to keep track of how much the baby eats. Etc. etc.

For me, the most important thing is that the baby has happy parents. If breastfeeding is really hard, the baby is better of with a rested and less stressed-out mother. If not breastfeeding makes you really unhappy, you should have the opportunity to breastfeed – even if you work, or shop, or are taking a walk with the baby.

76

MH 03.13.09 at 7:07 pm

One thing I forgot, if you do use formula (at least American versions) and get it spit-up on your shirt, treat the shirt immediately. It will make a stain like tomato sauce if it sits.

77

Alison P 03.13.09 at 9:00 pm

Harry B: I would say that when the rest of parenting work is divided on an egalitarian model, then perhaps breastfeeding will be a barrier to a complete 50/50 split between the father and the mother’s contribution. And to be honest, I’d rather have a 45/55 split than give up that experience.

But parenting is nowhere near that in real life. And I think it’s harsh on women to say it’s our breastfeeding that is ‘making gender egalitarian marriages harder to achieve’. Actually, I think in a more egalitarian and generally pixie-dust scattered world, the organisation of things would flex to accommodate such a nice part of life.

78

Xanthippas 03.13.09 at 9:17 pm

I don’t suppose I have much to offer on this subject that’s useful, except some measure of personal experience. My wife has breastfed our two children while working, and while frequently taking care of first one, and then two, while I was in law school and then working out of town, while also working full-time herself. Often, this necessitated measures like strapping a breast pump to herself as she drove from one location to another for her job. She did this because she considered it a labor of love, and not simply because a parenting book told her to. To each their own, but her experience has inclined to make me skeptical of those who find breastfeeding to be entirely too difficult or inconvenient to continue for any length of time.

79

Ano 03.13.09 at 9:31 pm

Harry b @74

Great point about the egalitarian-marriage-enhancing properties of bottle feeding. This brings up an interesting point about how many factors there are to consider in making this decision:

1) physical and emotional health of child
2) physical and emotional health of parents
3) cost in money
4) cost in time
5) social acceptance of our practices
6) distribution of above effects among mother and father

What’s fascinating is that parents have to weigh tradeoffs between all of these. I’m sure no one could actually state their family social welfare function about all this. Luckily we come equipped with portable fuzzy logic matrix algebra machines (or however our brains work) for making these decisions using these factors!

80

Phil 03.13.09 at 10:07 pm

breast feeding has a down side (at least, I think its a down side, but people who don’t care about this might think it is an upside) of making gender egalitarian marriages harder to achieve

If the mother feels put-upon and resentful when she’s breast-feeding, she probably shouldn’t do it. Once you (plural) have committed to breast, there’s a huge element of childcare which the father is never going to be part of, and there’s no real way of making it up. With our kids – especially the first – I was the resentful one, sitting downstairs wondering if this was it for the evening; my wife saw feeding as something she ought to do, was happy to do and enjoyed doing (mostly – early mornings were tough).

81

roy belmont 03.13.09 at 10:47 pm

#67:
There has been a load of research done
Load of.
Organic farmers having achieved total parity with the agro-industrial complex sometime in 1987 that research should be all we need to hear about that.
#72:
one fact that springs out is that industrial pork is apparently free of trichinosis

One of the first clues that pigs could infect people with MRSA came in the Netherlands in 2004, when a young woman tested positive for a new strain of MRSA, called ST398. The family lived on a farm, so public health authorities swept in — and found that three family members, three co-workers and 8 of 10 pigs tested all carried MRSA.

NYTimes
The social context in which this debate takes place is one that saw breast-feeding mothers arrested for public obscenity for feeding their children in restaurants a few decades ago, when it was a revolutionary act, and unthinkable previously.
That’s straight up pathology, endemic, culture-wide.
Have we emerged far enough from that sickness to guarantee absence of residual, subliminal bias?
Cheers and big ups to Ana Folpe for cogent, articulate, and inspirationally reasoned argument.

82

Katherine 03.14.09 at 10:28 am

Alison @ #77 – well said. I and my husband strive mightily to achieve a “gender egalitarian” marriage, and I don’t personally find breasfeeding to be more of a barrier to tha than every other thingthrown at us by the world. Yes, I am physicaly tied to our child in a way that he is not, but since his view is that being a father is wonderful thing, he is as much mentally and emotionally tied to her as I am physically tied.

Gender equality doesn’t mean both parties doing 50% of everything all the time – if one thing is 60/40, or another 45/55, or whatever – as long as you are conscious of the differences, and have made self-aware choices in respect of those difference, and it evens out to 50/50 overall, then I’d say that works out to something approximating equality to the extent allowed by the modern world. That’s the way it works with everything surely, not just the feeding of one’s child.

83

Jane 03.15.09 at 3:16 am

Her article reminded me of the global warming deniers. “Oh, well, this study had these problems, so we really don’t know anything. And those ‘experts’ are just politically motivated.” Meanwhile ignoring perfectly good data (like the 17,000 Belarus infants) for a significant, if modest, benefit, because it didn’t support her inclination.

Her inclination being: this seems unfair! It puts a lot of burdens on women! It shouldn’t be true that this is better! And then, magically, it’s not better.

Is she 5?

84

harold 03.15.09 at 3:34 pm

Breast feeding may have marginal benefits for the individual but at the same time the social benefits could be substantial. It seems to me that similar arguments can be made against bottle feeding that can me made against bottled water. It constitutes privatization of a resource that is or ought to be local, healthful, and free.

Also, I have an old friend who is a scientist, who tells me that they are always planning or considering putting something new in formula — more vitamin D, “beneficial bacteria” and so on. This makes you think that if there’s something wrong or inadequate about formula it has the potential to affect millions of infants because of the centralized source of the product. This friend (male) won’t buy anything made by Nestle because of their pushing formula in third world countries. He studies human perception in infants and he says that studies confirm the baby can perceive what the mother eats through breast milk (and in the womb), so that if all babies are drinking formula, they are getting a grayed-out standardized taste palate, made to please babies (like the sugar they put in Macdonalds hamburger), but at a cost to human culinary cultural diversity.

85

Mike Crichton 03.16.09 at 5:53 pm

harry b said:
A large proportion of babies living in the developed world are descended from at least one person who, in nature, would not have been breastfed by his or her mother.

In a pre-invention-of-baby-formula society, they would have been breastfed by someone else, or they would have died soon after the mother.

Dan Simon worte:
Around here, for example, breastfeeding babies all have to get vitamin D supplements, because most adults are deficient. The drops apparently taste terrible, because babies hate them and tend to spit them out.

Wouldn’t it make much more sense for the mothers to take the supplements? That way, both people benefit from the same pills.

86

Zeba 03.16.09 at 6:00 pm

In a straw poll of siblings, friends and colleagues born between 1955 and 1970, none of us (a sample of 25) were breastfed. Not one. We all have university degrees, good overall health (except for one individual currently in treatment for breast cancer thought to be caused by exposure during the Chernobyl incident) and few allergies beyond the occasional incidence of hayfever.

That said, I breastfed my two children, I enjoyed doing so and found it much easier than dealing with bottles, largely because I kept trying to sterilise bottles and bits and pieces, forgot I’d left them on the stove and was later alerted by the fragrant scent of burning plastic. My nipples never needed sterilising. On the other hand, most of my friends and relatives have used formula either from birth or had to turn to it because the breast feeding didn’t work out. My breast-fed elder son had atrocious eczema, my formula-fed nieces and nephews seem to have had many more ear and throat infections. I don’t know that their primary food source as babies made that much difference. What I do dislike is the idea that any family should be made to feel bad about the choices it makes based on its own situation and circumstances regarding breastfeeding. Because in the long run, I don’t think it matters that much. I have never heard of anyone having diabetes or heart conditions or cancer because of what they were fed as babies. And we have had sufficient generations of non-breast fed babies to know that it doesn’t matter.

What does enrage me is situations like Nestle in Africa/India trying to persuade poor mothers who can ill afford it to buy formula when their breast-milk is essentially free and they do not live in sufficiently sanitary conditions to keep the kit sterile, causing unnecessary illness in small babies. And then of course there was last year’s Chinese baby-milk scandal.

87

lisa 03.16.09 at 7:42 pm

I always suspected there is some kind of ideology going into the hammering home of the benefits of breast milk at every turn. I admit, I welcomed this when I was breastfeeding because I felt like, the more people believed that breastmilk is an absolute necessity, and formula a deadly poison, the less I would be harassed for feeding my baby in public. (Of course, there are always those people who expect women to confine themselves to the home if they are breastfeeding and don’t understand that sometimes you actually have to go out into public, with your infant.)

This is a very difficult thing, feeding your baby in public. There were many places I did it where I would feel this frisson of fear that I would be kicked out of wherever I was. It wasn’t that I cared if anyone saw my breasts. That was not the issue for me. The issue was all the stories I heard about women being harassed or ejected from stores, restaurants, airplanes. Jon Stewart even ridiculed a woman for breastfeeding during some political meeting on CSPAN. This made me cry for hours (post-partum weepiness).

I breastfed primarily because it was free, convenient and my baby loved it. The fact that formula was supposed to be bad for babies did deter me from giving more formula than I did, but we did supplement. A comparison between formula fed and breastfed people I knew made it kind of clear my child would not become some super-being, free of all disease, by breastmilk.

Breastfeeding did not hamper egalitarianism. In a way, my marriage became inegalitarian when I was breastfeeding because my husband started to do the laundry then and years later, he’s still doing it. I got a hand-free thing to wear and pumped out a lot of breastmilk while I was also working. My husband did a lot of bottle feeding.

A strange side-effect of breastfeeding that I rarely hear people discuss is that, when you breastfeed, your body produces certain kinds of hormones that relax you and also make you sleep. So as a lifelong insomniac, I had this instant sleeping pill.

88

harold 03.16.09 at 8:06 pm

I saw a clip of Roisin this morning and I don’t think her article was sincere. She is breastfeeding her third baby and never had any intention to stop or to consider switching to formula. She is posturing. And her posture is that other people but not she are making mothers who use formula feel guilty. “Formula is great if you can’t or don’t want to breast feed” is the (non) message. And of course, it follows that the makers of formula have only the best interests of women at heart.

89

lemmy caution 03.16.09 at 8:43 pm

It probably is not the case that breastfeeding improves babies’ IQs:

http://www.medscape.com/viewarticle/545523

Apparently, if you control for parental characteristics, there isn’t any IQ benefit.

I highly recommend the book The Nurture Assumption by Judith Harris. It’s not about breastfeeding per se, but its take-home message is that unless you actually abuse your kids, how they grow up won’t depend much on what you do.

That book is awesome.

Here is the latest in “It doesn’t matter what parents do” news:

http://econlog.econlib.org/archives/2009/02/food_and_the_fa.html

Apparently, there is almost no parental environmental influence on kids BMIs.

90

Will Roberts 03.17.09 at 10:11 pm

a) No matter how you feed your child, it will very likely be extremely stressful and time-consuming.
b) No matter how you feed your child, you should not expect to get enough sleep for many months on end.
c) No matter how you feed your child, finding some sort of equitable way of dividing the labor will likely be quite difficult, and will be exacerbated by a) and b).
d) The Rosin article was complete shit, imho, in that it only managed to show that breast-milk will not usher in the long-awaited age of love, harmony, and kool-aid seas.
e) The absence in the US of anything like a humane family leave policy is a far bigger problem for women’s equality than is breast-feeding.

91

Mnemosyne 03.18.09 at 12:51 am

What about all this BPA containing bottles? What will be the next thing which is bad for kids? While mom’s breast is mom’s breast.

Mom’s breast is likely to have things like perchlorate in it, so you still can’t make a definitive declaration that giving formula to a child is tantamount to feeding them poison.

Yes, I’m still annoyed that the La Leche fascists berated my friend until she cried because she couldn’t breast-feed. You know what? It’s not your fucking business what other women are doing. Do what’s best for you and your child and STFU about your horrible neighbor who’s permanently damaging her children by giving them formula.

92

Karen 03.18.09 at 3:22 am

My experience was similar to Mnemosyne’s friend. When my first son was born, I attempted to breastfeed. Andy never latched, never got any food, and cried for three nights straight, and since labor started at midnight on May 14, that meant I didn’t sleep AT ALL for FOUR MOW##$^^$ING NIGHTS. The mother@#$%ng LLL counselor was completely unsympathetic, and said that “well, obviously your diet is wrong. Normal women have no problem with this.” At this point my six foot five father cornered her and demanded that someone get the baby a bottle. My husband , who had been with me the whole miserable way, gratefully accepted an Enfamil package. My inadequate breastfeeding meant that my son had a serious blood sugar disorder and we had to stay one more day, using formula. The formula fixed his blood sugar issues, and he is a happy, healthy 10 year old honor student today. His brother got formula from the start, and is a happy, healthy 7 year old. Bro, incidentally, didn’t have an ear infection until he was two, despite exclusive formula feeding and being in daycare from 3 months.

I have now calmed down to the point that I no longer want to douse the LLL with gasoline and set them on fire, merely hurl large rocks at them. In first-world countries and among middle class and up women, where there are no sanitation or water quality issues. what the baby eats should be entirely up to the parents.

Comments on this entry are closed.