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Comment by Ovah | Hacker News Reader

> There is very little good scientific evidence that it is important to breastfeed.

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.

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Emily Oyster wrote good books about how a lot of the popular claims around giving birth / raising children have quite a severe lack of data that supports those claims. For breastfeeding in particular there isn't much data to separate whether breastfeeding is actually helpful at all vs being in an economical position that would allow someone to breasfeed.

https://fivethirtyeight.com/features/everybody-calm-down-abo...

Did this author even read the papers she cites?

> 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.

> Infants in the treatment group — who, remember, were more likely to be breastfed — had fewer gastrointestinal infections (read: less diarrhea) and were less likely to experience eczema and other rashes. However, there were no significant differences in any of the other outcomes considered. These include: respiratory infections, ear infections, croup, wheezing and infant mortality.

Apparently so, did you read the post you are criticizing?

The author made it seem like breastfeeding had no impact, but rather they just cherry-picked the conditions to look for from the study, making no mention of things that were impacted.

The author did not make it seem like that, they explicitly pointed out otherwise, the 5th paragraph:

> 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).

They literally linked to a study, said "this is the best study", then said "this study didn't show benefits in [any] these areas", without mentioning the benefits the study did show. Belarus is/was not a country at risk of contaminated water, even after the collapse of the USSR.

You are replying to a thread that already contains 2 direct quotes from the author specifically discussing the benefits that the study did support.

Huh? That's consistent, isn't it? No impact on cavities, height, blood pressure, etc. but an impact on GI tract infection and eczma. Well, those don't sound like serious problems so maybe it's not worth it.

John Hopkins has a bunch on this: https://www.hopkinsmedicine.org/health/conditions-and-diseas...

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.

> 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

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.

I’m not a doctor, but these stats sound completely ridiculous. Would love to see the source material.

Which of the stats do you think sounds ridiculous? SIDS for example is pretty rare to begin with (33.3 deaths per 100,000 per Google). At the end of the day I'm guessing the advice maybe saves a few lives on a population level, but only gives a slight statistical advantage to a proactive parent.

I wish I had links to actual publications. I copied the numbers from a lecture given by a senior obstetrician.

The effect sizes are implausibly large. Breastfeeding would not be a live debate if the causal effect was that large. For example, a 36x risk of SIDS is really just too much to believe. This lit review: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/apa.13...

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.

Breastfeeding once reduces SIDS risk by 36 times? If that’s even remotely accurate, which I doubt, I’m 100% sure it’s correlation not causation. People who breastfeed are much more likely to be higher income, more informed about keeping toys and blankets out of the crib, have baby sleep on their back, etc.

> People who breastfeed are much more likely to be higher income.

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.

So the study (is there a study?) that found this result included Rwanda, and found that Rwandan kids suffer less from SIDS?

Correlation doesn’t imply causation. Can you speak to the causal link that would make any of these statements compelling?

I'm neither an obstetrician nor a researcher in that field. But if I had to guess, this Wikipedia paragraph sumarizes things nicely regarding infection: "Passive immunity is also provided through colostrum and breast milk, which contain IgA antibodies that are transferred to the gut of the infant, providing local protection against disease causing bacteria and viruses until the newborn can synthesize its own antibodies." https://en.wikipedia.org/wiki/Passive_immunity

I'd have to read up to even speculate about the SIDS risk.

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