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Comment by cromulent | Hacker News Reader

There's a lot of anecdotal evidence in this thread. I'll add something to that: I was formula fed and I am fine. So are lots of other people.

Our kids were bottle-fed with breast-milk. I'm not sure where that fits in the breast vs bottle debate, and I of course didn't do a double-blind controlled trial to work out whether there were benefits - it simply suited our situation.

I have always been surprised at how judgmental people get of mothers and how they feed their babies. Some of the nurses in the maternity ward were amazingly self-righteous about it.

Not every mother can breast-feed, for various reasons (eg mastectomy). Fortunately in many countries there is a viable alternative. The mothers can often feel very bad about it, and having someone ram the obvious benefits of breastfeeding down their throat can be less than helpful, or healthy at that time.

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Very few mothers cannot breastfeed, in the grand scheme of things. The self-righteousness that exists is part of an ongoing effort to turn back 50 years or so of misinformation that existed in North America regarding formula vs. breast milk that caused women to turn away from breastfeeding in droves, mainly under the guise that formula was "better".

Why I agree that the judgments are unwarranted,(in every case) the fact remains that it is scientifically proven that breast milk provides numerous health benefits over formula. If you were fed formula, you have, on average, a higher risk of everything from a childhood cold/flu to asthma to leukemia.

While every mother needs to make the best choice in her particular circumstance, choosing not to breastfeed for the sole sake of some convenience to the mother and/or others is not a responsible choice, in many people's opinions.

I agree that breastfeeding should be encouraged, particularly in 3rd world countries.

However, the mantra of "breastfeeding has been scientifically proven to have benefits" may be less solid than you think.

There is a strong correlation between mothers who choose to breastfeed and lower incidence of many adverse conditions. However, does this imply causality?

"Conclusions: A history of breastfeeding is associated with a reduced risk of many diseases in infants and mothers from developed countries. Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings. Also, there is a wide range of quality of the body of evidence across different health outcomes."

http://www.ahrq.gov/clinic/tp/brfouttp.htm

From your link:

> We found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis...For maternal outcomes, a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer. Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression.

That's right. Associated, not causal. The problem is that mothers who are health-conscious, affluent, educated, etc are more likely to choose to breast-feed, as that is the recommended option by health providers. So, you can't say that the breast milk is the cause, simply that it correlates. Not a scientific proof, I'm afraid.

Surely statistics can be used to correct for this - compare affluent, educated, health-conscious women in both categories, for example?

You're now suggesting that the authors of all of these studies failed to control the most obvious of outside factors?

I'm not sure why you are so resistant to these studies, but it's clear that no amount of scientific research is going to convince you that there are clear benefits to breastmilk.

No, I'm not suggesting that. They do.

Have a look at the WHO study:

http://whqlibdoc.who.int/publications/2007/9789241595230_eng...

For example:

"Even within the same social group, mothers who breastfeed are likely to be more health-conscious than those who do not breastfeed. This may also lead them to promote other healthy habits among their children, including prevention of overweight, promotion of physical exercise and intellectual stimulation. This may be particularly true in high-income populations. Because these maternal attributes are difficult to measure, it is not possible to include them in the analyses as confounding factors. Nevertheless, this possibility should be taken into account when interpreting the study’s results."

I'm not resisting studies - I'm reading them, rather than relying upon misinformation from other sources.

Also: "Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression."

That's what I am talking about as well - mothers can be made to feel irresponsible and guilty when they fail to breastfeed for whatever reason, which cannot be good for postpartum depression.

Sorry, are you now suggesting that someone being overly judgmental and perhaps not minding their business is a cause of postpartum depression?

That, my friend, is going to require a fuck of a lot of citations. You've managed at the same time to deny all of the science behind breastmilk benefits and significantly downplay a known medical condition as nothing more than feeling embarrassed.

> deny all of the science behind breastmilk benefits

I don't think I have done this. I have linked to scientific studies, and meta-studies, that indicate that the benefits are not clear and that more research is needed.

I think that you have denied all the science behind breast-milk not having significant advantages, by posting FUD about GlaxoSmithKlein being linked to all of those studies.

I'm not sure if you are picking up on the difference between association and causation.

I have not said that formula is better, and I don't believe it is. I think that the current dogma around breastmilk being worlds ahead is not justified by the scientific studies.

I am happy to change my mind and apologize for my truculence if I see the scientific data that the benefits are significant, causal, and proven. Got any links?

> significantly downplay a known medical condition as nothing more than feeling embarrassed.

No, I didn't say that.

I have linked to scientific studies, and meta-studies, that indicate that the benefits are not clear and that more research is needed.

Except that they don't. That's why I quoted your link right back to you. While they say that for certain areas like a link to intelligence (which you will note I have not ever raised), they fully support numerous health benefits.

I should note that your link was a study of studies; one giant peer review done right before your eyes. It's pretty conclusive.

There is - supported by links that you submitted yourself - significant scientific evidence to suggest that breastfed babies receive health benefits that formula fed babies do not.

Ergo, breast milk is a better option for a baby. You've presented nothing to support otherwise, beyond your own personal bias.

> Ergo, breast milk is a better option for a baby. You've presented nothing to support otherwise, beyond your own personal bias.

My claim was that breastfeeding should be encouraged, and that your claim of scientific proof was less solid than you might think. I agree that I have not presented evidence that breastmilk is not a better option - I don't think that, and I certainly haven't said that, hence my lack of presentation.

I've asked for causal evidence that there are significant benefits from breast milk. That study's conclusion specifically warns against inferring it.

You've now changed your claim from "proven" to "suggest". I'm happy with that - I agree that evidence suggests it is a better option, I disagree that there is proof that people who are breastfed are healthier due to the breast milk. I know it is often repeated, but it is not true.

Full disclosure: I was breast-fed and am perfect in every conceivable way.

"The self-righteousness that exists is part of an ongoing effort to turn back 50 years or so of misinformation that existed in North America..."

Isn't this exactly the point? Nearly everything we've ever known about nutrition has at some point been 'proven' to be completely, 100% wrong. Maybe we shouldn't be so judgmental of people who make different choices?

I'm also not convinced the choices are always for "convenience".

http://news.bbc.co.uk/2/hi/health/8443904.stm

Sven Carlsen, the author behind this and basically every other study that forwards that breastmilk isn't as wonderful as it is (he's a lone voice) has questionable ties to GlaxoSmithKline.

I would agree that there is much misinformation out there.

I would also suggest that very few mothers choose not to breast-feed solely for convenience.

I am not as sure as you that it is a scientifically proven fact that breast milk provides numerous health benefits.

Whilst the recommendation nearly always is to use it (and no modern study suggests that formula is better) the studies are not as conclusive as I would accept as fact.

The confounding and self-selection effects in the studies, and the differences in formula and ethical considerations since the long-term studies were started cast uncertainty on any conclusion.

However, I understand that the majority of the information out there leads people to believe that it is a fact, and agree that the safe option is breast milk.

Edit: "basically every other study...has questionable ties to GlaxoSmithKline". Really? The WHO also says that the benefits are moderate, rather than "wonderful".

I would also suggest that very few mothers choose not to breast-feed solely for convenience.

Are you a recent parent or are you otherwise directly experienced in witnessing the choices mothers make? I ask not only because the statement is little more than random opinion if you are not, and because I'm surprised that someone who is experienced would come to such a conclusion. It isn't the obvious path in a country where women return to work 6 weeks after giving birth.

the studies are not as conclusive as I would accept as fact.

Then you are self-selecting to support your own bias. The other link you provided in this thread made pretty clear assertions regarding this topic.

The research is pretty strong. Stronger than most other areas. While that doesn't mean it is perfect, it does mean that all signs point to the fact that formula is not an equal replacement in certain key ways.

> all signs point to the fact that formula is not an equal replacement in certain key ways

That's a much softer position than "the fact remains that it is scientifically proven that breast milk provides numerous health benefits over formula. If you were fed formula, you have, on average, a higher risk of everything from a childhood cold/flu to asthma to leukemia." and one I could agree with.

Why I agree that the judgments are unwarranted,(in every case)

Like I said, I don't agree with people being judgmental, I'm saying it exists to counter years of what can best be described as corporate propaganda.

I was adopted at 3 months old, and I have many friends who were also adopted in their infancy.

I remember my friends mother recounting a story in which she was feeding my infant compadre in a shopping center, and a woman came up out of nowhere and pretty much berated her for not breast feeding. It is such a war between these women, and its ridiculous, since most mothers who don't really and honestly can't.

And quite frankly, as part of an army of formula fed humanoids, I'd like to think we all turned out just fine.

"And quite frankly, as part of an army of formula fed humanoids, I'd like to think we all turned out just fine."

The woman you describe was rude, and I'm sure you did turn out fine. But the impetus for the debate is scientific evidence on what, statistically, is best for babies. "This isn't best" is not a personal slam to you or your mom, and "I turned out fine" isn't a counter-argument.

Of course "bottle-fed with breast-milk" is equivalent to breast-fed.

I think people are judgmental when a mother chooses to not breastfeed for no "good" reason, or no reason at all. Reasonable people would be fine with someone not breastfeeding if they absolutely couldn't or it was extremely difficult.

My wife breastfed and it was quite difficult at the beginning and then got easier and easier. She wanted to quit a few times, but pressed on. It's hard for her (and most people in the same situation) not to get judgmental when she hears of some mom having a rough day in the first week of the baby's life and throwing in the towel and switching to formula.

> Of course "bottle-fed with breast-milk" is equivalent to breast-fed.

I thought that too, but I was told off by a passing lactation consultant.

There are some studies that point to many benefits of the act of breastfeeding itself, but I think from a health/scientific perspective I think it's stretching things to suggest that putting your milk in a bottle and then into your baby's mouth somehow reduces the benefits.

Obtuse bitches that happen to be employed as lactation consultants notwithstanding.

The studies I have heard of talk of the benefits of skin-to-skin contact while feeding, which can easily be done with a bottle too. I'm not aware of any studies that point to any benefit of nipple vs. artificial nipple.

There is the issue of failing to go back to the breast once established on bottle, but like I said, not overly important in the larger picture.

Those women who have difficulty producing enough milk should know that (in the US at least) that there are mother's milk donation programs that can help out. Those women who can should donate.

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