Anyway, one thing we can say for sure: if it's not your kid and you weren't specifically asked for advice, don't tell someone they should have been breastfeeding.
Anyway, one thing we can say for sure: if it's not your kid and you weren't specifically asked for advice, don't tell someone they should have been breastfeeding.
I wish you would back up such a strong statement. In medical school we were taught the complete opposite. From my notes:
- there's a x36 decreased risk of Sudden infant death syndrome if the child has been breast fed a single(!) time compared to no breast feeding.
- no breast feeding vs only breast feeding: x15 risk of pneumonia, x11 risk of diarrhea
- x14 lower risk of premature death compared to no breast feeding
Other pros include: optimal composition of nutrients, doesn't constipate, creates a connection between the mother and child.
While formula may be nutritionally complete, it does not include immune component. Breast milk literally contains antibodies that a new born is able to pick up and use.
https://fivethirtyeight.com/features/everybody-calm-down-abo...
> In the first camp — the randomized trial camp — we have one very large-scale study from Belarus. Known as the PROBIT trial, it was run in the 1990s and continued to follow up as the children aged.
And then later
> The researchers analyzed the impacts of breastfeeding on allergies and asthma; on cavities; and on height, blood pressure, weight and various measures of obesity. They found no evidence of nursing’s impacts on any of these outcomes.
If you go to the PROBIT trial, you see it clearly stated that they did find an impact from nursing:
> Conclusions: Our experimental intervention increased the duration and degree (exclusivity) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life.
Apparently so, did you read the post you are criticizing?
> This is not to say that there aren’t some benefits to breastfeeding. In poor countries where water quality is very poor, these benefits may be very large since the alternative is to use formula made with contaminated water. In developed countries — the main focus of the discussion here — this isn’t an issue. Even in developed countries, there are a few health benefits of breastfeeding for children in the first year of life (more on this below).
I wish I had links to actual publications. I copied the numbers from a lecture given by a senior obstetrician.
Doesn't mention any studies with effect sizes larger than 4x. And it is concerning habitual breastfeeding or other feeding treatments. If breastfeeding a single time provided a 36x safety factor, these kinds of results would be impossible. A 14x reduction in infant mortality is similar far beyond the reasonable belief.
Personally I wouldn't toss out a claim like that without strong evidence to cite.
The median income of a breastfeeding mother is probably at least 1/10th of US median per capita GDP. E.g. Rwanda has some of the highest breastfeeding rates in the world.
I think the general consensus (WHO, CDC, American Pediatrics, etc) is that breastmilk is beneficial and reduces the risk of things like asthma, digestive issues, SIDS, etc, but there are a lot of questions of whether it needs to be exclusive and for how long it needs to be to get the benefits.
I'd have to read up to even speculate about the SIDS risk.
I'm a supporter of breasfeeding but there's approximately a 100% chance that this is correlational and not causal; wealthier parents with time and resources to breastfeed also have lower SIDs prevalence because they drink less, smoke less, are less obese, have less drug use while pregnant and generally practice safer sleep habits.
The conclusion that formula is for sure just as good as breast milk would also be shocking given that breast milk was designed by evolution over millions of years to be exactly what the developing baby needs. The human body does a lot of miraculous things that our technology isn't yet quite capable of matching (or even fully understanding).
Edit: this one somebody else linked is better. https://fivethirtyeight.com/features/everybody-calm-down-abo...
The first study cited only looked at height, weight, and blood pressure after breastfeeding, which are not the variables I would expect to see gaps in for breast fed vs bottle fed (other metrics are much more important, in my opinion)
The second study cited concluded that breastfeeding "had a significant reduction in the risk of 1 or more gastrointestinal tract infections (9.1% vs 13.2%; adjusted OR, 0.60; 95% CI, 0.40-0.91) and of atopic eczema (3.3% vs 6.3%; adjusted OR, 0.54; 95% CI, 0.31-0.95), but no significant reduction in respiratory tract infection (intervention group, 39.2%; control group, 39.4%; adjusted OR, 0.87; 95% CI, 0.59-1.28).".
The third study had similar results: "Our experimental intervention increased the duration and degree (exclusivity) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life."
The fourth linked study on IQ concludes: "These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development."
If these are the best studies that an article whose goal is to debunk the breastfeeding narrative can find, it looks like a clear win for breastfeeding to me.
> The fourth linked study on IQ concludes: "These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development."
https://pubmed.ncbi.nlm.nih.gov/18458209/
The study was cited with criticisms of its method and strong reason to believe the study result is implausible. The effect size is far too large: there is no way that EBF causes a 24 point jump in IQ, when observed correlated effects are so much smaller. That effect is so large that it would be immediately and apparently obvious who was breast fed. In fact, you could guess someone's EBF status simply by knowing how smart they are. Intelligence would be multimodal around who was breastfed and not.
I'm not sure exactly what they screwed up when running the study. Possibly an overreliance on the power of random cluster trials? After all, if you run 31 clusters in total, then it wouldn't be too surprising that you find weird statistics, since N=31, not the number of human participants. But whatever the case, the whole thing is completely compromised because the result is so implausible.
Anyway that's the best and only random study of EBF and intelligence if 538 is to be believed. Which means we essentially have no randomly controlled evidence at all that EBF improves intelligence.
American scientists in the 1950s pushed all manner of highly-processed food products on the public because they had "figured out" nutrition.
Except for micronutrients, probiotics, most of what we understand now about biological pathways, etc.
Barring overwhelming evidence from replicated experiments -- "peer review" is and has always been garbage -- I bias hard to "what we have evolved to do by instinct is probably the best course of action".
That'd be breastfeeding. It's counterproductive to shame mothers that use formula for any number of legitimate reasons, but "prefer breastfeeding if at all possible" is an entirely reasonable statement.
It would also help if infant formula in the US wasn't absolute garbage by law, compared to what's commonplace in Germany and Japan.
There's quite a lot of evidence that breastfeeding improves health outcomes for newborns. Reduces the rate of gastrointestinal infections, etc. Regarding the probable mechanism of action for that, breast milk provides an ongoing source of antibodies from the mother to baby. You won't find that in formula.
That said, evidence about the benefits of exclusive breastfeeding, is much weaker. And a fixation on breastfeeding exclusively can easily result in underfeeding if formula isn't used when all signs suggest it should be. A hungry baby is the worst outcome here, of course.
That said, breastfeeding is the only way babies were fed for almost all of our species time here. IMHO, if anything needs scientific evidence in its favor before I believe it’s good are alternatives to breastfeeding.
My aunt, born in 1941, was switched to formula after failing to nurse well. Despite those infant formulas being nowhere nearly as good as modern ones, she still grew up to be academically bright and athletic, and her younger sister, my mother, was witty and socially gifted.
If my grandmother hadn’t had that option, maybe my aunt would have eventually gotten the hang of it before my grandmother’s milk dried up, but being undernourished for however long that took might not have led to a woman who could get a geology degree - or any child who survived to adulthood.
So you're saying the WHO and UNICEF are basing their recommendations[1] on very weak evidence?
Even when they think the benefits outweigh the risks[2] of nasty pollutants in the breast milk?
[1]: https://www.who.int/news-room/fact-sheets/detail/infant-and-...
I don't mean this in a hostile way, I just want to know if you're talking from experience or not.
And it will become annoying to be constantly confronted with a viewpoint about your most intimate choices. Like relatives repeatedly asking an intentionally childless couple when they will have kids.
I’ve had to train a couple of young men to never ask a follow up question to a “no” when they ask if a female colleague has kids (and that actually, that’s a risky question to begin with.)
Nothing burns it into their little brains quite like hearing, “don’t ask anything that could be translated as, ‘so what’s your sex life like?’”
Worst: when a slightly older new male colleague, within 15 minutes of meeting me, asked if I had kids, then upon a negative answer, replied “why not?!”
The risk is cut by about half, depending on how long breastfeeding continued for. This effect is not explained by socioeconomic factors.
Is there? How were the controls selected in that study? Were they from people who were called on the phone, meaning the controls were from a group of people willing to talk to strangers about something as as deeply personal as having a child die of SIDS?
In this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2351639/
The controls were visited by the same home-visiting nurse, and it found no correlation.
Some places say six weeks gets you most of the benefits, others say twelve years minimum. You’re right though that the studies are less conclusive than some would like you to believe.