Let the flamewars begin.

I was very lucky that DD latched on right away. I nursed and pumped till she was 19 months old and she weekend and evening nursed till 2 years old. Although I do think breast milk is best, it is the difference between an A and A+. Not enough to make any one agonize if they have problems. I do think women beat themselves up about this. And the reality is that there has been whole generations of relatively healthy people brought up on formula exclusive. Formula is not poison. And women should not view it that way. I do wish more women would give nursing a try. It may be hard at first but the emotional rewards were worth it to me. But if it is not working for you, ditch the pump and be happy with your healthy formula fed baby. The emotional state of mind is more important then a few less ear infections. DD did not get sick till 13 months old. I do think that is because of nursing. But hey a few ear infections versus every day he** with the pump, seems like a reasonable trade off for some.

"I do think women beat themselves up about this."

And women beat up other women about this, too.

Breastfeeding is normal feeding for a baby! Not 'best" or A+. Formula feeding puts a baby at risk for health problems, as a baby and as the child/adult he/she will grow into. Not breastfeeding puts the mother at health risks too!

From the AAP:

"Extensive research, especially in recent years, documents diverse and compelling advantages to infants, mothers, families, and society from breastfeeding and the use of human milk for infant feeding. These include health, nutritional, immunologic, developmental, psychological, social, economic, and environmental benefits.

Human milk is uniquely superior for infant feeding and is species-specific; all substitute feeding options differ markedly from it. The breastfed infant is the reference or normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short- and long-term outcomes.

Epidemiologic research shows that human milk and breastfeeding of infants provide advantages with regard to general health, growth, and development, while significantly decreasing risk for a large number of acute and chronic diseases. Research in the United States, Canada, Europe, and other developed countries, among predominantly middle-class populations, provides strong evidence that human milk feeding decreases the incidence and/or severity of diarrhea, lower respiratory infection, otitis media, bacteremia, bacterial meningitis, botulism, urinary tract infection,and necrotizing enterocolitis. There are a number of studies that show a possible protective effect of human milk feeding against sudden infant death syndrome, insulin-dependent diabetes mellitus, Crohn's disease, ulcerative colitis, lymphoma, allergic diseases, and other chronic digestive diseases. Breastfeeding has also been related to possible enhancement of cognitive development.
There are also a number of studies that indicate possible health benefits for mothers. It has long been acknowledged that breastfeeding increases levels of oxytocin, resulting in less postpartum bleeding and more rapid uterine involution. Lactational amenorrhea causes less menstrual blood loss over the months after delivery. Recent research demonstrates that lactating women have an earlier return to prepregnant weight, delayed resumption of ovulation with increased child spacing, improved bone remineralization postpartum with reduction in hip fractures in the postmenopausal period, and reduced risk of ovarian cancer, and premenopausal breast cancer."

Everyone should do what is best for themselves. Period.

It may be that "breast is best" statistically overall but that does not mean that a child will not thrive on formula. I know several children breastfed for nearly a year and who are sick ALL the time (ear problems, viruses, allergies, etc.) In contrast, I know several bottle fed children who are all healthy. All of these children are bright kids.

It is my PERSONAL belief that the benefits of breastfeeding are over-stated and the pressure put on women to do it unreasonable (and the resulting judgments intolerable). No one will ever convince me that breastfeeding will make the difference between a child who is a super-immune nobel laureate and one who is not.

It is also my personal opinion that breastfeeding is not the only way to bond with your child and that you can bond just as much through bottle feeding (holding baby close, looking into baby's eyes . . .) I don't want to get too terribly anecdotal so I'll refrain from further stories and just leave it at that.

All this being said, I do not care one way or the other whether someone else chooses to breastfeed or not. (Nor should anyone else, in my opinion, since it is really no one else's business). You like it and believe in it as the only way to nourish your child? Great. You feel as I do? That's great too. Do what is right for you and your child.

Can't believe I get to comment early on this one.

When DD was born at Andrews AFB almost 11 years ago, I thought the idea of nursing was a little gross and unsavory. I read about the benefits to the child, and thought I would give it a shot but kept the free formula samples to have on hand in case it didn't work. Andrews had an amazing lactation consultant from Jamacia who showed me how to hold DD and helped her to latch on. No significant problems, and she nursed (NO formula) until 15 months. I have had two more children, and neither of them ever touched a bottle, going straight to sippy cups.

Study after study has proven that breastmilk is better than formula. I think it is improper to frame the question as "what's wrong with formula." There is nothing wrong with formula. It is a safe and healthy alternative. However, formula IS a substitute, an alternative, a second-best choice. I am sure that this topic discussion will include dozens, if not hundreds, of anecdotes of bright, happy formula-fed babies. In the aggregate, scientific studies have proven time and again that the healthiest alternative is breastmilk.

I have known awesome mothers who sacrificed a ton so their children could have breastmilk, the way Stacy did. A former classmate pumped every day for her preemie's hospital bottles. After the child left the hospital, she couldn't learn to latch on and continued to need a bottle, so my friend continued to pump for more than a year! That exclusively breastmilked (if not breastfed) very premature baby has excellent health. What an amazing gift. I wish that, instead of possibly instigating a judgment-laden festival of finger pointing, Stacy had framed the discussion as, "tell us what sacrifices you made so that your child could benefit from breastmilk."

I was born in an era where breastfeeding was socially frowned upon (the 50s). My mother did not breastfeed me. None of my friends, or their friends and relatives, were breastfed. Yet, we grew up healthy, normal, kids, went to college, some of us obtained Ph.D.s, and most of us are successful at our chosen path. The breastfeeding police should stop harassing women.

I remember before my daughter was born a friend of mine asked if I was going to breastfeed her - I think I responded that while I wasn't really crazy about the idea, I was willing to give it a shot because "I mean, duh, I can read."

Everyone seems to agree that breastmilk is the "perfect" food for babies, and that there are health benefits to nursing. What I'm not seeing is that there are any "detriments" to not nursing.

I think it's just part of our time - the uber-health-conscious keeping-up-with-the-Joneses wanting-to-be-the-best at everything that makes people feel so horrible about not nursing their children if they don't want to or aren't able to.

(We managed to keep it up for about 7-8 months although my supply took a major hit when I got sick a couple times after returning to work. For the record, I was thrilled to have nursed for as long as I did and was not at all disappointed when I had to throw in the towel and start with the formula full-time, although we had been supplementing with it for several months prior as my supply had been dropping).

I think people need to just back off (particularly other moms - gosh, they can make you feel so crummy) and realize that there is more than one way to skin a cat.

My daughter would not have survived her first year without formula, because I had low milk supply. We thought she just wanted to nurse all the time, around the clock. Then, the first and second lactation consultants thought my milk was late to come in due to an emergency c-section with general anesthesia. We finally figured out with the third LC that I just didn't produce much milk, probably due to insufficient glandular tissue. Lovely. By that time, we had agonized for weeks about why our daughter had lost a lot of weight, then plateaued and was not gaining ANY weight with constant nursing and light supplementation, which was what the first two LCs recommended.

In spite of the struggle, I still hauled a hospital-grade pump to work every day for five months and managed to partially BF until my daughter was over 8 months old. She got about 25 percent breastmilk on a good day, probably. I was lucky to have an office with a door and time to pump.

It was incredibly stressful and disappointing for me not to be able to provide enough breastmilk for my daughter. And I do think she would have probably had fewer ear infections and other illnesses had she been 100 percent breast-fed, so I have a lot of guilt and feelings of inadequacy.

When people get all high and mighty about breastfeeding, they should remember that not everyone CHOOSES to use formula. Sometimes that choice is made for them, either because they cannot physically BF, need to take medication that precludes it, or have a job that absolutely will not accommodate pumping.

As with most health messages, we stress that breastfeeding is the best, but do nothing to provide assistance to nursing mothers. We could afford to pay hundreds to the lactation consultants and rent the expensive pump--neither of which was covered by insurance. Many families are struggling just to buy diapers for their newborn.

I think women, especially those "well educated" in the DC area are very competitive and have made breastfeeding the hallmark of the optimal mother.

It's a serious blow to the self esteem of a mother who can't pass breastfeeding 101, despite the pain and effort on top of the exhaustion. And then if you mix in the words "failure to thrive", what you get is one seriously depressed mother.

Well, there is this stuff called formula. It could be the cure.

I thought these words were interesting:
"a parent who's frustrated by nursing
is not calm and relaxed.",
because I always thought it was the other way around:
"A mother who is not calm and relaxed will be frustrated by nursing."

The problem with giving other people advice on the nursing v. FF debate is that there's a very fine line between being supportive and undermining.

I, too, had a very hard time with nursing for the first 15 weeks of DD's life. During that time, well-meaning friends and family kept advising me just to formula feed. To me, those comments sounded more like "you're a nutcase for nursing" than "hey, do whatever's best for you." People who offered support and comiseration without opinions were much more helpful.

I have worked with lactation advisors in the developing countries and usually the problem with formula is in the water used to mix formula, not formula itself. Poor water can transmit various diseases. Poluted water will have a negative affect on a baby. However, in the US, this is not much of an issue. Most public water is clean. If filtered and then boiled, the water is top quality. Also, one can used bottled water. In developing countries and most likely in this one, one negative aspect of breast feeding is the nutrition of the parent. Parents pass on nutrients to their babies through breast milk. If parents don't eat a good, nutritious, and balance diet, than breast milk will adversely affect the growth of the baby. Also, it takes some days to weeks to create sufficient breast milk. In some cases, these first crucial days are important for the health of the child, and feeding them adequately and accelerating their growth increases their chance of survival. Formula can provide the nutrition for accelerated growth.

Both methods have positives and negatives. I have found that hospitals tend to push breast feeding, and the lactation consultants are very outspoken to their dislike of formula. This should not be the case.

I have two healthy boys who were both formula fed by choice. I make no apologies about it. Neither one have had ear infections and are actually sick less often then a friend's breastfed kid. I don't care if women choose to breastfeed. It is a personal choice. Why do the breastfeeding police care? At the end of the day, it comes down to good parenting as to how well the child does in school, not whether they were BF or not.

I was formula-fed out of necessity (my sister and I were adopted) and we both turned out 100% fine. Never sick, no allergies, etc. I'm sure there are plenty of formula kids out there who can say the same, just as I'm sure there are plenty of breast-fed kids who are similar. I say whatever works for you and your child/family...and leave the guilt trips out of it either way.

Ditto to NewSAHM. Even the introduction to this post seems to be of the "formula is the solution" school, which is wearing. Not because no child should ever receive formula, but because breastfeeding rates in this country are shockingly low, and telling frustrated mothers *who*want*to*nurse* that there's nothing wrong with formula is a cop-out. If someone says, "Staying at home with the kids is tough," or "I feel stretched really thin by working while raising children," do you tell them to do something else?

My wife, Frieda is a Lactation Consultant with 25+ years of practical experience. She has no doubt in her mind that, in aggregate, BF is best feeding. But the main issue for her is that the baby is thriving. Failure to thrive is obviously the worst outcome and certainly there are women who cannot produce enough milk and babies who are lactose intolerant. Sometimes it does take some time and many consultations to figure the whole BF issue out.

She strongly believes that BF is the "Gold Standard" and encourages women to BF but has no issue if the mother is not able to do so for any reason.

BTW, both Frieda and I were bottle fed and we seem to be OK.

Finally someone said it. and i cant THANK YOU ENOUGH for it.

As a mother of a 3 month old, its been such an uphill path thanks to the breast-feeding police, most of them well meaning people no doubt but a pain in the a** nonetheless.

From the minute i came out of sedation to take her in my arms, the might of the hospital's nurses, the gynec, the paediatrician, landed on me. It took me and her 2/3 days to learn how to do it - she was a premie, too small, couldnt latch properly, got tired sucking and fell asleep hungry - yet the second i asked for formula, i was made to feel like i was asking for crack.

It got so much that even my m-i-l was psyched about my not wanting to do it for some vague, beauty-related (and thus placing self above baby...ultimately demeaning for any mom) reason.

I exclusively breast fed her til one day i realised she was just too thin and always hungry. My mom opined i had to give her The Bottle ...Im ashamed to admit i debated this with her a 100 times, 90 of them defensively and rudely.

Despite the obvious being just too obvious, i still felt like scum when i had to supplement my milk with The Bottle. A mention of this to the ped earned yet more censure instead of the counselling and advice on correct amounts and feeding-times that i wanted.

Now she's on the bottle and my milk and doing good.

So bully to all those who rush first time moms like me - breathless battling the day's emergencies - into adding yet another thing to stress and obsess about at such a delicate time.

"I have found that hospitals tend to push breast feeding, and the lactation consultants are very outspoken to their dislike of formula. This should not be the case."

Then you'd love the hospital where I gave birth. Despite the lip service paid to breastfeding in my prenatal classes, they turned out to be extremely pro-formula. I was told I was starving DD when my milk hadn't come in 18 hours post-birth, made me wait hours for a pump and two days to even see the lactation consultant, and they loaded us down with formula as we left, "just in case." I was also told that I'd probably never be able to breastfeed because (I kid you not), my nipples weren't big enough.

Is it any wonder that most of the women I know who gave birth there were formula feeding, in whole or in part, within weeks of giving birth?

I have to agree with the poster from 8:14...this came up in a conversation among my friends recently and we realized that (for various reasons) none of us were breastfed 30-odd years ago when we were born. We seem to have all turned into healthy, functioning adults and show no signs of deprivation.

My mom breastfed me and also breastfed my sisters. She was a working mom (in the 70's) but she thought it was important. My grandmother did not believe in breast feeding yet my mom and her siblings are healthy. My sisters and I are all healthy and normal.

My husband was not breastfed nor was his brother. My mother-in-law, who was a pediatric nurse (in the 60's and 70's) did not choose to or could not. I have not asked her why she went that route. My husband is extremely healthy and is in great shape for being almost 36 years old.

I would try to breastfeed if we were to decide to and then could get pregnant. But it is not because I think I would have a sickly baby if I did not breast feed. In fact, the idea that non breast fed equals a life of illness is so stupid that it does not even deserve the time I spent writing this.

Yes, I think it is somewhat "selfish" to not try REALLY hard to generate and then feed YOUR offspring breast milk. It was not selfish years ago when moms had less info about the benefits and genuinely thought that formula was awesome. But this issue is one that has raged for many years and different people have different attitudes.

People enjoy finding fault in others and then illustrating why they are "better". We do it with finances, emotional health, careers, etc. Why is anyone surprised that mothers are beating other mothers up because of choices that have been made??

"I was also told that I'd probably never be able to breastfeed because (I kid you not), my nipples weren't big enough."

Wow! that is a new one on me! (I know more about BF than any man outside a nurse or dr. should know about BF) I will have to ask Frieda about this one.

Ditto what restonmom and some of the others have said, that not all people using formula wanted to be. I am glad that I breastfed my daughter, but from the beginning, I have battled low milk supply. I simply was not making as much milk as she needed, and not for lack of trying (constant nursing, pumping after feeding, etc.) I finally came to the realization that while breastmilk was better than formula, adding formula was VASTLY better than letting my daughter go hungry. Because I'd so thoroughly "drunk the koolaid" that breast is best and anything else = bad mom, it was devastating to have to give her formula (in retrospect, more so than it should have been.) But once we started supplementing her a little, she got stronger and able to nurse more effectively, and we both started thriving.

Nine months on, I pump at work and we nurse morning and night. My baby gets every drop I make. If I don't pump enough, I fill in the rest with formula. And that is what is best for US.

I breastfed both my kids for over a year but I had a lot of problems with my daughter (my first) and almost gave up. What saved me was that many, many moms had told me it would be hard. I was under no illusions that it was going to be this easy, natural thing. Moms need to be given the real story (just like expectations about "perfect marriages" or "perfect children"). Breastfeeding is a big commitment. You really have to want to do it. You cannot go into thinking, well if I like it and it works, ok. Because it's too easy to give up. I do believe they are health benefits and I got a lot of satisfaction from it (after all the difficulties). I really miss it now. I think if women knew what they were getting into, they might stick with it. But, like many other issues I do think women beat up on themselves (and other women) too much on this issue. If it's not good for a mom and her child, then let her do something else - live and let live!

I am very curious about the links between breast feeding and breast cancer. I have read and seen several posters in my pediatricians office stating that breast feeding decreases a woman's risk of breast cancer and that the more years a woman spends breastfeeding the more her chances of developing cancer decrease. One of the pediatricians implied that this was why there was so little breast cancer in communities that exclusively breastfeed. When I inquired what communities she went on about tribal communities. Which are so differnt form our own that I was not sure that other factors may come into play.

I have trouble discerning in this debate what is real and what is propaganda on both sides. So any medical types out there know the truth on this particular point.

Isn't this whole discussion just a rehash of three or four discussions held on "On Balance" in the last six months?

Personally I think it is pretty disgusting and prefer people not do it in public. It causes uterine contractions, which in effect is an orgasm, so when you're feeding your baby in public you're having orgasms along with it. I'd prefer not to see that. I don't know and I don't care if I was breastfed or not. We never discussed such things in the family. I do know a co-worker who was uptight and neurotic as hell to begin with and said her infant son fought and struggled with breastfeeding. So, she just filled a bottle with formula and he was perfectly OK with that. I wish people would stop telling other people what to do. It's your kid, your breasts, and your life. Get over it.

I've been following the breastfeeding debate with interest because my first baby is due in another 2 months, and I've decided that my goal is to get through 2 weeks. I want my son to get those first big doses of antibodies and stuff - beyond that point, I'll try to remember that the point is to get him fed whatever way is best for both of us. I'm another formula success story (soy formula no less) because my mom ended up in the hospital for a while after I was born and couldn't feed me herself. I like the A vs. A+ analogy - yes, breastmilk is babies' natural food, but humans can survive and thrive on different diets. We're not naturally vegetarians either, but vegetarians and vegans exist and do extremely well. All any mom can do is her best to get her child fed while not killing herself either physically or emotionally.

PLEASE PEOPLE!!!! Most mothers these days are well equipped to make these decisions without consulting anyone. Why can't we let them without judging them?

Formula is much better quality these days then back in the day. Yes, I agree that breastmilk is the perfect food for our babies, but formula is not going to kill them.

The argument that "that's the way we did it in the 60's/70's and you all turned out fine" is one that gets to me because it is illogical. To say that everybody was bottle-fed back then, we all turned out fine, what's the big deal is to ignore that the people it didn't turn out fine for maybe aren't around anymore. Or they don't realize how their lives would have been changed if something different had occurred. For example, the configuration of crib railings has been changed. I personally slept in an old-fashioned crib and never got my head caught in the slats. Because I survived, does that mean that change was unnecessary?

What about car seats? We didn't have them in the 1970's, and we all survived, right? Well, what about the many children who were killed in car accidents but would have lived had they been in car seats. They aren't here to plead their case.

Actually, I have heard this kind of thinking from my mil a bit and it hits a nerve. Would you want your heart attack or cancer treated with the methods/knowledge that were available in 1975? We should welcome and embrace advancement in science and learning, not pooh-pooh them, saying well, it worked for me.

This has fascinated me, because I didn't even know this debate existed until recently (I'm due in a month). Besides the fact that being pregnant seems akin to wearing a t-shirt that says "tell me what you think" I don't get why individuals outside the medical community feel comfortable asking women about their feeding methods and then commenting on them either way. I know that it's better for parents not to be obese (especially for moms not to be obese before they get pregnant), but I would never imagine commenting on the fact that they should lose weight or model a healthier lifestyle for their children. Same with being married to the child's father, having a stable home, etc. We all know these things have been broadly proven to be "better" for children, but they don't seem to solicit the comments (and fervor) that feeding a child does.
Also, the wierd thing is that every time I ask someone who has very strong supporting feelings towards BFing, what the NNT (number needed to treat) is for some of the benefits of nursing is, I either get blank stares, or comments like that doesn't really matter...In fact, for one example, the AAP notes that there isn't a big enough study to prove that BFing lowers childhood cancer rates (which is a wierd thing people seem to keep telling me), that you have to aggregate the numbers of a few studies and do a meta-analysis(as Fred noted earlier). And then, after the studies' results have been aggregated, they estimate it takes 9000 women to BF to "potentially" prevent ONE case of leukemia. When the numbers are broken down like that, I can certainly understand some women would say "I don't want to risk one in 9 million, much less one in 9000 chance for my kid to get sick" which is completely understandable, but I think people are getting clubbed over the head with statistics they might not understand. It just strikes me we're in the throes of a pendulum swing with regards to this, way at the other end of the formula feeding era, and it strikes me as odd the self-righteousness that comes across with this topic. With so many other factors that can contribute to a child's long term well being, why are we so focused on this?

I was not breastfed...and now, as a grown man, am obsessed with breasts. I think it's because I was denied the breast as a child. Well, I'm off to Camelot...

"...disgusting and prefer people not do it in public." Well, the next time I am breastfeeding I will be sure to announce the fact so that you can move yourself to someplace else. And where did you get the whole like a whole orgasm thing? Unbelievable.

I don't know. I was bottle fed along with my brother and sister. We are two lawyers and a doctor and all of us are great athletes. Back when I was little (late 60s, early 70s) parents bottle fed, and I would wager that most adults now over 30 probably were bottle fed. So this breast feeding movement is a little overblown, in my opinion. My wife breast fed all three of our children and she really enjoyed it--largly because it was easy for her. I agree with the author, though. The most important thing you can do as a parent to a new baby is to enjoy your baby. That will produce benefits for baby and parents that far outweigh those that a baby will gain from breast milk alone.

So women, take it from a man who has never breast fed. Give it a good try. It is cheaper than formula, and can be easier (no bottles, etc). It can also be a good way for mother and baby to bond. But if it doesn't work, stop, bottle feed, ENJOY YOUR BABY, and don't look back or apologize to anyone.

I didn't try breastfeeding because I didn't want to. I needed to be able to get back on a "regular" schedule pretty quickly after my daughter was born. Formula was great for us--my husband could feed her at night or I could, and as a result my husband and I both got regular sleep by going the formula route.

My daughter has been quite healthy for her entire 6 years. I do not see any ill effects from choosing to give her formula.

My OB and pediatrician respected my decision because it was mine to make--not theirs.

to 9:01. Well, having an orgasm while breastfeeding certainly seems much more enjoyable to sore and bleeding nipples, infections and exhaustion. I guess with this statement many more women will be willing to BF.

I certainly never got to experience an orgasm while I was trying to BF. Boy did I miss the boat on that one!!!

Stacey, I don't believe that anyone should "harass" anyone about breastfeeding, but what the government is doing is trying to combat previous decades' efforts to eradicate breastfeeding.

However, your statement, "They grow up and they're no different than their breast-fed friends", is wrong. The point of the breastfeeding campaign is that many studies have shown that there are differences between formula and breastfeeding in terms of the kids. Does that mean that EVERY kid who breastfeeds is better off than EVERY kid who has formula? Of course not. Studies examine AVERAGES (and variability, for you stats gurus). What that means is that, as a group, breastfed kids score better on some measures than formula-fed kids (e.g. a variety of health measures). It doesn't mean anything about one individual vs. another.

So, the fact is, Stacey, there ARE differences between the two groups. Please don't give such blatantly wrong information.

Personally I think it is pretty disgusting and prefer people not do it in public. It causes uterine contractions, which in effect is an orgasm, so when you're feeding your baby in public you're having orgasms along with it. I'd prefer not to see that. I don't know and I don't care if I was breastfed or not. We never discussed such things in the family. I do know a co-worker who was uptight and neurotic as hell to begin with and said her infant son fought and struggled with breastfeeding. So, she just filled a bottle with formula and he was perfectly OK with that. I wish people would stop telling other people what to do. It's your kid, your breasts, and your life. Get over it.

Posted by: | March 27, 2007 09:01 AM

You MUST be joking!! Yes, in the beginning, there are uterine contractions when you breastfeed which helps the uterus return to its normal size. Not an orgasm.

Anonymous 9:01 writes, "It [BF] causes uterine contractions, which in effect is an orgasm"

I had the opposite happen to me. Everytime I had an orgasm after my baby was born, it triggered the letdown response and my milk poured out even though my baby wasn't latched. The more sex, the more milk. Maybe TMI, but I've never read about this anywhere and thought it was worth mentioning.

I am very pro-breastfeeding and I work in the medical community. Obesity has grown in our society with the concurrent use of formula. There's the proof that we need more breastfeeding. Breastfed babies are markedly leaner as children and much less likely to become overweight or obese as adults.

I'm shocked at how many Moms will insist on feeding their children organic baby food, but will settle on chemicals in a bottle instead of breastmilk.

To those who say the breastfeeding police should stop harassing women--the pharmaceutical companies who market formula should stop aggressively marketing to women in health-care settings, particularly those in hospitals who have just given birth. The power and money these companies have far outweighs the influence of breastfeeding advocates.

Ultimately, choice to breastfeed or formula feed is the parents'. As far as well-educated DC area mothers go, my pediatrician who had come here from another part of the country was very surprised at the low bf rates in the pediatric practice she joined (and this practice did retain a lactation consultant's services for those who needed help).

The United States did not adopt the WHO discussed below.

From a peer-reviewed journal on Pubmed:

"For example, in 2000 the Department of Health and Human Services put out a Blueprint for Action on Breastfeeding as the basis for organizing its breastfeeding promotion activities. It acknowledged:

The marketing of infant formula negatively affects breastfeeding ... The International Code of Marketing of Breast-milk Substitutes and a subsequent WHO resolution delineates guidelines for formula marketing to ensure that it does not interfere with the establishment of lactation. The International Code stipulates the responsibilities of manufacturing industries regarding their role in promoting breastfeeding and appropriate infant feeding practices [47], p17]."

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1481608

Ryan, one of the important to thing to note is that a lot of the positive attributes of BF is only showing correlations not causation. For example, slightly higher IQs with BF children versus FF. But the theory is more educated mothers/parents choose BF has a feeding option. So the slightly higher IQs can be explained by genetics more then BF in itself makes you smarter. Again, except for some immunities, they have not found a causal link to most of the claimed attributes of BFs. Just wanted to clarify that I did BF and found it wonderful. But I don't think women should spend needless time worrying about it, if they don't find it tolerable. You should try it but if it doesn't work, don't sweat it.

"It causes uterine contractions, which in effect is an orgasm, so when you're feeding your baby in public you're having orgasms along with it."

If this were true, I'd still be breastfeeding my 5-yr-old.

The World Health Organization pushes breastfeeding (I can't use BF, it sounds so vulgar) in Third World countries is that women do not have ready access to prepared formula and they don't have much else to do but sit around all day like sows and suckle their young. We are a modern and wealthy country. Therefore, we have access to prepared formula, we have jobs to hold down and lives to live. We can't just sit on our butts for hours on end with a kid latched on (another term I find vulger).

"When people get all high and mighty about breastfeeding, they should remember that not everyone CHOOSES to use formula. Sometimes that choice is made for them, either because they cannot physically BF, need to take medication that precludes it, or have a job that absolutely will not accommodate pumping."

Thank you so much for this! I have a 3 year old and am pregnant again. I was all set to BF with my son, but he was a preemie, had jaundice, and wouldn't latch on. In addition, I had extremely low supply--like I pumped 8 times a day and had --at the end of the day--1/4 oz! 3 weeks after giving birth, I was rushed to the hospital with bleeding due to placental remnants left in me--turns out my body still thought it was pregnant.

However, in those 3 weeks, my self esteem had taken an incredible bruising, partially due to spending time in the NICU surrounded by "Breast is Best" posters. I will be forever grateful to the one lactation consultant who gave me permission to forgive myself--saying that the 2 hours a day I was hooked up to the breastpump were 2 hours I wasn't holding my son. And I remain bitter about the hateful people who told me how much harm I was doing to my son by formula feeding.

I heard a kindergarten teacher say that she could never tell who was breastfeed, but she could tell who was read to at home.

Yes, I plan to TRY to BF my second, but I refuse to let myself be beat up again if it doesn't work.

this debate was going on 28 years ago when i had my first child (BF) and it will likely go on 28 years from now when my granddaughter (BF) has her first child (which would be cool since I'd be a young-ish great grandma! but i digress...)
i BF my kids, even #2 who had a cleft lip and palate--that is, i pumped out the breast milk for 10 weeks until he was big enough for his first surgery. immediately following the surgery, my milk dried up. i couldn't go any further but felt i'd given him the best i could for 10 weeks and that was better than nothing.
i had no experience with BF before my first child but formula wasn't an option...it was too expensive and we didn't have the $$ for it. i learned with babies 1 and 2, you can do almost anything you want or have to do, if you want and have to enough. sore nipples, obnoxious people in your face telling you that you shouldn't BF or pump, breast infections...i heard it all. it didn't matter. i did what was best for our family.
as adamant as i was about breastfeeding my children, i think the same respect for the individual decision should be accorded those who choose to formula feed. it's really no one elses business.

Indy Mom- I think obesity in society is more related to fast food than breastfeeding. I have 3 exclusively breastfed children. The 2 that were born overseas and less exposed to McD's are thin as a rail, and the one born here and fed fast food(my fault, I know, but I had 3 kids in 4.5 years and I was tired and went the easy route) had a terrible chubby period. All my kids have hayfever, which was inevitable, because both my husband and I both have it. My oldest son needed tubes in his ears, which was because of poorly formed eustatian tubes. He never had ear infections, just fluid in his ears that never drained. I found breastfeeding easy, and was a great supporter until I called a friend after her baby was born. I went on and on about how she should be BFing, and she let me. About a half hour later, a mutual friend called to let me know what my friend couldn't tell me herself, she had been diagnosed with breast cancer in her last trimester and was physically unable to BF any more. I never lectured ANYONE about breastfeeding again.

Rule number one is Feed the Baby. By whatever means necessary. Breastfeeding, formula, supplementing, eye dropper, doesn't matter. Feed the baby. When you've mastered rule number one, you can go on to rule number two, which is Don't Drop the Baby.

To Ryan: How do these studies that you refer to isolate breast vs formula from the thousands of other factors (both genetic and environmental) that contribute to a child's development and overall health? For any study to disregard everything except this one factor and make a judgement that vilifies a whole group of mothers who formula feed either by choice or by circumstances is just wrong.

My son will be 1 year old tomorrow and he has been on formula since he was three weeks old. He's extremely healthy and hitting developmental milestones by the book. I, on the other hand, spent four days in the hospital and needed surgery to treat a severe case of mastitis because of the problems we had with breastfeeding early on. The option to nurse was taken out of my hands, and in the long run we were both better off -- my son got not only the nutrition he needed, but also a healthy (and much happier) mother. Don't make me feel like a criminal because of it.

Pumps alone are a viable option, if actual breastfeeding is uncomfortable. I did it for three kids.

Also no one has pointed out yet that formula is EXPENSIVE, while breastmilk is free.

Just a reminder (even for you folks "in the medical community") that "concurrence" does not equal CAUSATION. (This is with regards to "Obesity has grown in our society with the concurrent use of formula.")
The previous posters who noted the distinction between high IQ parents choosing to BF and IQ of child (rather than the act of BFing itself) and the importance of NNT - number needed to treat - make very salient points. The science is certainly there, this isn't a case of global warming/no global warming, but I'm not sure the science is clear enough to be used as a tool to bludgeon people.

The key word in all of this is choice. In some poorer countries and in the animal world there is no choice. If a mother does not produce sufficient milk or cannot nurse the infant dies, human or animal. The fact is there are pleanty of women who simply cannot nurse and formula was developed to help pwith this issue so that those infants can eat and are not left to die. What is so wrong with that? We have scientifically created a way to keep kids healthy if a mom can't or because of work issues or personal choice can't nurse. Would anyone say we shouldn't use a cancer drug that can cure cancer because it is not natural? It is helping people survive....that is what formula does. In our society science is always used to do things to counteract nature.

Both my kids were formula fed and did just fine. But as they got older the boys did hear all this hoopla about breastfeeding being the better option and thought I had denied them... WOW. What a bad Mom since society was dictating I'd picked the worse option for them. How you feed your child is a personal choice. And no one should be made to feel bad about picking one option over another as long as the kid was not harmed. I personally never regretted not breastfeeding. However, the mother of their new half-sibling apparently is breast feeding, so I guess all these feelings of how bad of a mother I was to my kids for formula feeding them will resurface. Geezzzzzzzzz.

Agreed that this debate is tired. Yes, it is better to nurse your baby than to give your baby formula - but as foamgnome said, just a little better. And having a happy mom is best - better than formula, and if mom can't do it or doesn't want to, then baby will be unhappy.

I nursed both my kids about 13-15 months. Child no. 1 never gets sick. Really doesn't at all. Started preschool/day care at 2 1/2 and brought home all the colds, but never got sick himself. In the hospital with him, my dr. gave him formula cause his blood sugar was low and that was the best thing that happened - I was GUNG HO that I was going to nurse - but then I thought: hey, it's fine if he gets some formula, I'm going to nurse also (so he got formula once in a while - not even weekly - I never bought it, only used the samples from the hospital and dr).

With no. 2, he got more breastmilk than no. 1, even though I went back to work when he was about 6 months old. I pumped and pumped. And pumped. It was exhausting, but I was committed (or maybe, should have been?). But he gets sick - a lot, at least from my perspective, but is probably normal.

It really depends on the kids - and yes, on average, nursing is better. But no kids are the 'average' child. If your kid is one who will get ear infections, maybe the child would get one or two more because they weren't nursed, but who knows? There's no real control group for ONE CHILD.

My mom, who had baby nurses for our first years, told my sister that she gave us formula cause she didn't want to be 'tied to the baby.' But we were born in an era where the dr. was king and knew best, and moms were told that formula was better than breastmilk (because the formula companies told them so!). My sister had no interest, so she convinced herself she couldn't do it. What are you going to do? That's her decision...

I found, though, after a month or two, maybe, that it was SO MUCH EASIER to nurse, since I just had to grab a bag and go. Never had to mix anything, or bring ice packs, or worry about if there was enough food or how long I was going out with the baby - I always had enough. I could always find a place to nurse the baby (and no one ever complained to me. sometimes people would be talking to me and not even know there was a baby there or think he was asleep until he moved or something).
But that was what worked FOR ME. I have been very supportive of friends and relatives who wanted to nurse (since they can't go to mom or MIL for advice - since neither typically have nursed) but when they couldn't, it was up to them to stop, and no judging here. It's like smoking - everyone KNOWS it's bad for you, so if you tell someone: hey, it's bad for you - it's like calling them an idiot.
Same with nursing (not that I'm calling formula the same as smoking, not by a longshot! - it's just an example! Really!) - everyone has read the same studies and articles - and if they choose to use formula, then it makes NO SENSE to tell them YET AGAIN anything regarding what is good for the kid - they know what is best for them.

has it occurred to anyone that maybe one of the reasons that many of the countries in the world have lower obesity and greater logevity than we do despite less access to quality healthcare is that most of them breastfeed their children?

Very few women are physically unable to breastfeed, many are unwilling. It is a comittment and lots of moms are unwilling to make it. Just like on balance - do whatever makes you happy and all world happiness will flow from you. Baloney!

Not a mom yet - hubby and I still trying to decide if a baby fits into our lives (we have some circumstances that could make having a child more difficult than it should be).

At any rate, if I have a child, I know I will try to breast feed. I say try because a friend of ours recently only got 6 weeks in with her child before he refused the breast (for what appear to be some TMI reasons). She had fully intended to breast feed for at least 6 months but it just didn't happen.

But my Mom raised my sibs and I on formula in the late 60's and early 70's. Partially because it was the style, more because my mother's pregnancies were all difficult (on her and us) and breast feeding wasn't recommended. And guess what? We're all (basically) healthy, well-adjusted, successful, happy people.

So formula feeding is not the end of the world for your child. A drain on your bank account perhaps, but not the end of the world. ;)

People quote study after study about how unhealthy formula is. Guess what? I was a formula fed baby and I am just fine. I am 30 years old now. I didn't have ear infections as a kid, I have never been hospitalized, I have never taken medication on a regular basis. I am thin, and by all accounts extremely healthy. And so is my 27 year old brother. I think that it's all in the genes. If you are going to be healthy, you're healthy, if not, then you're not. Formula feeding in infancy has NOTHING to do with it. SO please, moms, if that was your choice, DO NOT feel guilty.

Everyone who was formula fed is fine - except those who arent. Everyone thinks they are fine. Same with car seats and helmets: "I never used a car seat and I'm fine" - true except for the dead ones, they are pretty quiet.

9:42: In regards to all statistical studies, you can build statistical models that can isolate certain factors (such as BF versus FF) and see if it contributes to different outcomes. Like this y=person gets breast cancer=BF as child + genetics+ income +... (any number of variables) + error term. Then you can see which affects the rate of getting breast cancer. This is probably more math then you wanted. The trick with all of these studies is building the correct model. I have not read the in depth methodology of most of these studies but the quick and dirty look shows some correlation but no causation based on BF. The only ones that show a direct causation is the transfer of immunities from mother to child. So to answer your question, you can isolate the BF vs FF and see if mathematically it affects certain outcomes. But you are also right that there may be thousands of different variables that affect the model and it would be difficult to include all of them in the model.

My daughter was born slightly tongue-tied, and she had problems with latching on. I remember sitting in bed trying to nurse her a few days after she was born with cracked and bleeding nipples, and I had tears streaming down my face because it hurt so much. But the nurses, lactation consultants, doctors, and my own family (including my husband) would not let me give up. The lactation consultant told me that I should pump and (get this) finger-feed her using a syringe so she wouldn't get "nipple confusion" for a bottle. Each feeding that way took an hour or more and I HATED pumping. Finally when she was around a month old, I switched to formula. Instantly, feeding her became something I looked forward to instead of dreading it. She was happier and less frustrated and so was I. I only wish I had done so sooner...her first month I was completely miserable. I'm just lucky that I didn't spiral completely into PPD.

My sister-in-law, who has hypothalicemia (severe anemia) wasn't able to produce much breastmilk at all after her son was born. Still, she continued to try to breastfeed until her 9.5 lb. baby boy weighed less than 8 lbs. She finally switched to formula and her son is doing much better.

Sometimes the "breastfeeding police" can do more harm than good.

And yes, from what I have read, supposedly women who nurse have lower probability of breast cancer. BUT, from what I understand, it's more of the number of times you ovulate that is a causation - i.e., if you are pregnant a lot, but don't nurse, you will have a lower incidence of breast cancer. AND, what they don't say with many of these studies - if you go on the pill, you will also NOT OVULATE, so your incidence of breast cancer will be lower.
But I don't think most people are like me, who at the end, only nursed in the mornings (because I was lazy - baby was tired, baby was hungry, couldn't wait for food - mom nursed and held baby in bed for a while longer rather than preparing breakfast) - I did not get my period until several weeks after the last time I nursed (even when nursing once a day). Whereas I know this was not true for many people I know - who got pregnant when they were nursing (impossible for me).
I know - TMI TMI TMI!!!

AND - from what I have read, being on the pill actually can increase your risk of ovarian cancer, which is what mom died from, so what's a woman to do???

"And why do moms who can't nurse for whatever reason feel so guilty, as though they are depriving their children of something? "

Well the child is deprived of quite a lot-- BUT why do the mothers feel guilty? Why aren't they ANGRY?
Why don't health insurance companies pay for lactation consultants?
Why aren't new mothers allowed to stay in the hospital until her baby is nursing well?
Why aren't doctors giving out information about how important breastfeeding is? Breastfeeding is a health issue, not a life style choice.
Why don't mothers get a real, protected maternity leave from work (6 months) like other countries?

Why aren't we angry at not getting the support we and our children need?

It may be worthwhile to note that the benefits of breastfeeding were not just nutritional, but also in time and effort.

There was a bit of a learning curve and some physical discomfort, but I managed to breastfeed my son. We have now weaned him to a bottle, and I am realizing how much more difficult it is to bottle feed than breastfeed.

While we were breastfeeding, my son's food was always with me, always the right temperature, and always immediately available. Bottle feeding requires so much equipment and so many variables that it's really quite a hassle.

Kate:

My insurance company (and most) paid for a lactation consultant. One came to my room (after both kids were born) in the hospital - and I was able to go back to the hospital a week or two after kid was born (or more, can't remember) for a consultation - I did not pay for it, so I'm assuming the hospital did. And I could have kept going back. So yes, most insurance companies pay for a lactation consultant. Fred - can you weigh in?

The hospital I went to is very gung ho for nursing, tho.

What about moms of multiples? They get the crazy pressure to breastfeed that every other mom gets, but are faced with needing to produce twice as much milk (at least) and spend twice as much time breastfeeding. It's not even possible for some of them.

kate: no kidding! One definitely produces the milk they need, so with multiples, technically, your supply is supposed to increase. Of course, disclaimer for those who don't make enough milk.
AND - of course, it is SO MUCH more exhausting with more than one. I can't even imagine.

I did think I wanted twins the second time around, but after having my baby, I was thinking: what was I thinking? Am I insane? I can hardly handle one more!!!

Hey, Posted by: | March 27, 2007 09:42 AM, how in the world did I make you feel like a criminal? What could I have said to do that?

You know what gets me about this debate? People get upset at the truth. I wrote that no one should be harassed about breastfeeding. I also wrote that Stacey made incorrect statements. At no point did I say that NOT breastfeeding was criminal. Some of you need to get a grip on reality.

Foamgnome, there is more evidence than you realize. While a true experiment would be difficult to do, we know more than correlations. We have mechanisms -- i.e. we know HOW it is that breastmilk could confer health benefits on kids that formula could not (e.g. variety of antibodies in the breastmilk). So, please don't make the evidence some sort of purely subjective thing. I agree that correlational studies are always weaker than experiments, but in humans, we often must take them. When you have many, many, many correlational studies that take into account many, many, many variables and that all point in the same direction, scientists find this to be about as good as it gets.

So, I stand by the studies. Plus, the logic of breastfeeding certainly helps as well. Again, however, I would not condemn people who choose not to breastfeed, but I do think it is important that everyone be told the truth (and the full truth) and that everyone be given as much support as possible for breastfeeding. Our society has worked incredibly hard to stamp it out and we need to do everything we can to be supportive of it and reverse the anti-BF sentiment out there.

The amount of milk obtained using a breastpump is not an indicator of supply. When my daughter's pediatrician saw the breastpump in my hospital room, she said, "Who put THIS in here?" She could see that the pump was causing me stress and interfering with my daughter and me learning the process.

I don't think that parents who choose formula are harming their children. I do think that women are not always given good support at the hospital. It takes time and effort for hospital staff to help with the mechanics of breastfeeding. They don't really have that much time to give to a mother having trouble. I really credit our pediatrician for coming up with some practical solutions like giving a little formula after a bf session. This kept the baby's strength up and ensured that she wouldn't become dehydrated. In the first few days home, we scaled back the formula to nothing as we both got the hang of bf. Some LCs would say NEVER to give formula. Giving a little at the beginning turned out to be a practical solution that worked, and I nursed my DD for well over a year.

In the past, women learned breastfeeding from mothers or other female relatives with experience. Our generation is less likely to have older relatives with experienced breastfeeding nearby.

Many working women end up using a combination of breastfeeding and formula. With my first baby, I was not able to get any kind of adequate amount of milk by pumping. If I had been working, I would have used formula. For some reason (maybe I was more relaxed), with my second child I was able to get a lot of milk with the pump.

So, no, I don't think it says anything negative about parents when they decide to feed formula. It doesn't have to be all or nothing. Our culture and medical setup do make it too likely that some women will not perservere. Of course, some women have terrible difficulties and for them the difficulties outweigh the benefits. I just think that women aren't prepared for the early difficulties and sometimes don't get proper support in the hospital. I'm sure that there are some great lactation consultants out there (Fred's wife, I'm sure!). Sadly, the two I've encountered in hospitals weren't that helpful to me.

Ryan, OK, I am a statistician and I am not a Dr. But I can tell you that correlation is not causation. And you can say that things move in that direction. And there is probably merit to that but medically you can't prove that it in deed is the reason for it just because it is highly correlated. That is just a mathematical fact. I am not saying that BF does NOT do those things. I am saying they can't prove that it does MOST of those things. Again, except for the passing of immunities, none of these studies PROVE that BF is the reason for the other positive attributes.

I really don't understand the black and white mentality of the BF zealots. The U.S.A. has one of the lowest infant mortality rates in the world for a reason. The availability of quality alternative means of feeding. I'm not saying that it is the ONLY reason, but I would wager that it's up there. Failure to thrive is the most preventable affliction in the U.S. Is breastfeeding best under good conditions? (good conditions being that mom's milk supply and quality is good, baby doesn't have an allergy/lactose intolerance, etc., baby is able to latch properly) Sure. I don't think anyone can reasonably debate that. The antibodies passed from Mom to baby are very helpful in warding off a lot of nuisance infections. That has been proven. However, anything beyond that such as prevention of SIDS and some of the more ridiculous claims I've seen and heard are purely suggestive and without hard scientific fact. My point is, we should be concentrating on FEEDING the child, which will allow it to grow/thrive and be able to produce its own defenses. The means by which the child is fed are, by and large, irrelevant until substantially proven otherwise.

I'm from a family of 9 -- some of us were BF-ed and some were not. You could never guess which were, and which were not based upon our academic achievement, emotional well-being, physical health, or BMI. And I question whether some of the benefits of BF-ing apply to expressed breastmilk served in bottles -- for example, the baby does not get benefit of the physical act of nursing, and the baby is exposed to any chemicals leached from the bottle (which, given what we now know about hormone-imitating chemicals that leach from plastics, could be a contributing factor to obesity in bottle-fed babies). That said, I have made tremendous efforts to BF my baby (who not quick to the breast as a newborn), including daily pumping at work. It's one of those marginal benefits I am trying to give my child -- like buying the organic babyfood.

Moms feel guilty BECAUSE OTHER MOMS MAKE THEM. I am not a mom but watched a good friend go through this when her baby was breast-feeding; her milk was low and she was so stressed about it (because she had read all kinds of these types of uber-pro-breast-feeding comments on urbanbaby.com and the like). I really did feel it was counterproductive to her mental health and to the mom-baby connection.

I actually read a woman write on a blog once with regard to this topic that there is NO SUCH THING as low milk production, that nature made sure every woman had exactly enough milk for her baby and any woman who said she was having that problem was lying. Are you kidding me?!? Of course, what La Leche League zealots like these maybe don't comprehend is that way back in the day - and in some places in the developing world, probably still - if a woman couldn't produce enough milk, which DID happen, then she'd turn to a fellow breast-feeding sister or cousin who had more than enough. Too bad that spirit doesn't hold up in modern times; instead some women apparently prefer to bash each other and act smug if they have enough milk and someone else is having trouble.

foamgnome, or others with knowledge in the stats or medical field, are the effects of other dietary issues determined to the cause of illnesses or only correlated? Like all the news on transfats in food and how it is realted to coronary disease.

I ask because I think in the end BF and FF are questions of nutrition which means moderation and balance. You need to balance potential positive and/or negative effects on health, which includes stress levels. And make the best decision for your family. And each family is likely to make different decisions. I've read that the average family eats take out much more often than my family. Based on our time commitments and our nutritional goals we cook most nights and to balance our time commitments with our nutritional goals we eat take out occasionally.

Most people on this blog (and the on balance ones on the same topic) seem to be informed and striving to take a balanced approach based on the needs of their family. I am more concerned about the families that aren't engaged in the discussion who appear (and we never really know what is happening in other families) not to be informed and make decisions of convenience or ignorance.

While I don't want the probreastfeeding movement to add to the guilt of the modern family, I hope that it will reduce the number of families who make uninformed decisions.

Women should know that it's totally OK to both breast feed and supplement with formula (or visa versa) and later, solid foods. You do whatever works for you and baby.

Breast feeding is like tango--it takes two. Sometimes mama's boobs and baby's latch just don't work together optimally.

I had problems early on with my first and child. At first I pumped like crazy but that was stressing both me and my child out when I was home alone. So I used a supplemental feeder to encourage my son to nurse more aggressively (this involves a gravity feed of formula thorugh tiny little tubes taped to one's nipples--very sexy, but it worked). Later, I dumped the supplemental feeder, and would nurse then give him formula in a bottle

As my son grew, I wound up doing everything==formula, solids AND breastfeeding. I'm glad I was able to continue breastfeeding--for the comfort and the antibodies that my body could provide him.

At about 22 months of age, due to a head cold and teething pain, my son stopped nursing cold turkey. I considered this an act of God for which I was grateful, despite the fact that my breasts immediately became engorged.

So I agree with those above who say the most important thing is that you and your baby thrive and enjoy each other.....there's no "right" solution. Everyone finds their own way through it.
Muddle On!

Again Ryan, I did say except for passing antibodies, none of the rest has proven causation. So I am not doubting that one. I am doubting the other supposed positive outcomes (lower rates of obesity, lower rate of Breast cancer, higher IQs, lower rates of other diseases). Of course things like lower rates of stomach virus, diaherra etc... is due to the passing of antibodies. Again, I agree that has been confirmed (proven causation). I agree that women need more support for BF and frankly you are preaching to the choir. I choose to BF. But I choose to knowing that the only proven benefit is the passing of antibodies.

It amazes me how we can opt for anything OTHER than breastmilk for our babies! Formula is an inferior subsitute. Did you know that breastmilk provides antibodies for the baby's immune system? Did you know that it evens provides protection against HIV??? These are scientifically proven. Mothers who choose 'organic' formula over breastmilk are even more ridiculous in their mindset. Did you know that cow farmers always make sure that calves get their mothers' milk right after birth? It's proven best for their growth and development. Meanwhile, humans choose to give cow milk, soy milk, etc to their babies.
Those who cannot produce enough milk should of course supplement, but they are definitely a minority. Everyone else should realize their selfishness and give their baby the best thing out there- exactly what nature intended.

The pill does NOT increase your risk of ovarian cancer. In fact, it is a standard recommendation or preventative treatment for women with an increased risk of getting OC. Check out the Ovarian Cancer National Alliance or the Gynecologic Cancer Foundation for more information.

To JS:
Everyone should not do what is best for themselves, but rather what is best for their BABY. That's the problem right there...

Concerning size of nipples being a problem with bfing, a friend of mine has to use an "adaptor" (I am not making this up) in order to bf on account of having too small nipples. It works for her, might not for someone else. I agree with disinterested observer...Rule #1: Feed the baby. End of discussion.

Thank you, 10:19 - I had read that a while ago...

How is saying women should breastfeed any different than saying we should eat 5 fruits and veggies a day?

mamamimi: I am not sure I understand your question. I think you are asking does nutrition contribute to certain illnesses? I am not a bio statistician and no very little about dietary effects. But my off handed guess is yes they probably do. The problem with most of these studies is getting a large enough sample and resources to conduct them. Except for medical clinical trials, it is hard to look back and do these studies. Meaning most of these studies are more observational studies versus a controlled study. I mean who the heck is going to agree to eat tons of trans fat for 30 years, just to see if they might have an increased risk of ovarian cancer. So most of these studies show mere corellations versus true causation. I do think that there could be more done in the field of biostatistics to isolate factors and show their true impact on diseases. But I imagine it is a matter of money and a lack of statisitical knowledge and good data. It is simply hard to find a large enough data base to look at some of these issues.

Foamgnome, I believe there were several studies in England that controlled for the want-to-breastfeed factor by finding a group of women who intended to breastfeed but were unable to for medical reasons (for example, after birth they had to go on certain medications that prevented breastfeeding). I'll try to dig them up if I can, today.

I had both my kids in DC-area hospitals. One hospital (an Inova hospital) was extremely unfriendly to breastfeeding. They took my daughter away for long periods of time though we wanted her to room in (and we're pretty sure they gave her formula since she was never hungry when she came back), and when I hauled my postpartum butt out of bed to go to the "breastfeeding class" the lactation consultant refused to watch my baby latch on and instead gave me some pamphlets and talked only about all of her products I should buy. It still makes me angry to think about it.

The other hospital (not Inova) was incredible in their awareness of and support for breastfeeding.

Breastfeeding support should start in the hospital. This is one of the main ways that breastfeeding can become easier-- working out latching-on problems BEFORE there is pain for the mother.

Restonmom, you wrote: "And I do think she would have probably had fewer ear infections and other illnesses had she been 100 percent breast-fed, so I have a lot of guilt and feelings of inadequacy."

I know it doesn't mean much coming from a stranger, but please don't feel too guilty! I breastfed my first son exclusively for 7 months... he had a number of ear infections and had pink eye a few times, too! I was all, "Hey, where's that immunity he's supposed to have?!"

With my second child, I've had to supplement with formula due to my supply issues (maybe 1/4 of his "meals" are formula rather than breastmilk). I don't want to jinx anything, but so far, he's had fewer illnesses than his big brother (knock on wood).

Why is everyone so quick to condemn La Leche (and I have no affiliation-never even attended a meeting) and to let pharmaceutical companies promoting formula (their product!) off the hook?

Those companies are buying the neonatal nursing staff lunch regularly in most hospitals. One paid the City of New York $1 million (in the 70s) for the privilege of exclusive formula distribution in public hospitals. You think La Leche has an agenda!?! When I said no thank you to formula samples in the cute little bag, the LPN refused to take no for an answer. I left the bunny bag in the room.

Foamgnome, since you're not a statistician or a doctor, don't you think it's a little weird that you're arguing with me about this?

Anyway, since you desperately want an experiment, I thought I'd go to Pubmed and look up studies on breastfeeding.

The second article that popped up was (drumroll, please) an EXPERIMENT on breastmilk in which babies were randomly divided into two groups: those receiving breastmilk and those receiving formula. The babies were then evaluated during adolescence (yes, it was even a long-term study) and various atherosclerosis measures were taken.

The results: Adolescents who had received breastmilk as babies had lower LDL/HDL ratios, lower ApoB to ApoA-1 ratios, and lower CRP concentrations. All of these are indicators of atherosclerosis and indicate that breastmilk reduces the likelihood of atherosclerosis in the long-term.

The article is by Singhal et al. (2004) from Lancet, in case you would like to read more about it.

Now, I could waste my entire day finding more experiments and more data for you, foamgnome, but I hope that one will suffice.

I was happy enough to have the bag and the samples from the hospital. Between what we got in the hospital and what I got from the pediatrician, I only bought formula once or twice.

So it worked out well!

It does NOT cause orgasms! Uterine contractions with breastfeeding feel like cramps. Orgasms are not uterine contractions, they're contractions of the vaginal wall.

ryan,

I think it is a well established fact that foamgnome is a statistician. What she said is she is not a *bio*statistician.

And, what she is saying is basically true - since it's hard to isolate the causes.

But there is a study out there that says that babies who are nursed are less likely to die in their first year, due to *any* causes, even accidents.

Ryan, I am not a doctor. I am a statistician.

Hey, maybe we can merge the two disussions going on today - this one and OnBalance about daycare. Perhaps the BF SAHM's can slam the bottle-fed daycare-kids WOHM; or WOHM but still BF-ing can rationaize that their daycare kids wont' be the 'disruptive' ones. SAHM bottle feeding? What loser, right?? Enough already!!!!

"So yes, most insurance companies pay for a lactation consultant. Fred - can you weigh in? The hospital I went to is very gung ho for nursing, tho."

Frieda works for the state health dept so she primarily sees WIC mothers. She does have "outreach" hours available for any interested mother. She has been on the staff of the local hospital so she has worked with private patients. But her pay came directly from the hospital, I do not know how the hospital handled billing for her work. I do know that some LC are in private practice but know nothing of their billing mechanism.

As for an individual hospital being very pro or blasé about BF, I think it has a lot to do with the attitudes of the OB's and the pediatricians on staff. Both OB's where we live (yes, a very small town) are very supportive as well as the pediatricians. The hospital where our 3 of 4 children were born was so-so about BF. The hospital that Frieda interviewed at, after the hurricane, was very supportive and was actively looking for a new LC for its staff. But we were not there long enough to accept the job.

Here is my BIG POINT. Don't wait to talk to a LC after birth. Start a conversation with one well before your last trimester. Frieda regularly sees women from the first trimester.

Ryan,
I just tried to google that article and could not find the full article. You needed a journal subscription to read the full article. So if you could post the link, I would appreciate it. Again, I did not say that BF was not correlated to a number of different things. I said that medically they have not proven that it was the cause of anything other then the transfer of antibodies. But what you wrote here:
. The babies were then evaluated during adolescence (yes, it was even a long-term study) and various atherosclerosis measures were taken.

The results: Adolescents who had received breastmilk as babies had lower LDL/HDL ratios, lower ApoB to ApoA-1 ratios, and lower CRP concentrations. All of these are indicators of atherosclerosis and indicate that breastmilk reduces the likelihood of atherosclerosis in the long-term

may only show correlations. It doesn't show causation. I explained statistically how they can isolate certain factors and tell you that it is what is actually making a contributing factor. I won't know if that study actually proved causation, till I read the methodology section of the report. But Ryan, you are still missing the point of a correlation and proven causation. We can show any number of correlations and not show that BF was what caused that event to happen.

Fred,

yes, my hospital had a breastfeeding class - three hours, I think - that we took one Saturday AM.

I think I had personally done enough research that I didn't need it - but it was helpful for many reasons.

Also, every other class I went to there (either childbirth, or other parenting classes) you could tell that BFing was very important there.

Ryan, to put it simply.
The results: Adolescents who had received breastmilk as babies had lower LDL/HDL ratios, lower ApoB to ApoA-1 ratios, and lower CRP concentrations. All of these are indicators of atherosclerosis and indicate that breastmilk reduces the likelihood of atherosclerosis in the long-term

May have been caused because people who BF tend to have healthier diets, exercise more, (ie live healthier lifestyles to begin with). Therefore their children tend to have healthier lifestyles etc... I doubt the article can actually prove that BF does all these things. Simply because it would be difficult to isolate all the factors involved.

I remember talking to my son's pediatrician about switching to formula entirely. We had dealt with one problem after another in breastfeeding. The doctor waved his hands in front of my face and said I was obsolved of all guilt and to go forward and give him formula. Bless that man.

No, foamgnome, an EXPERIMENT is what demonstrates causation. As a statistician, you must know the difference between an experiment and a correlational study, right?

The study I cited was an EXPERIMENT. They used an independent variable (breastmilk vs. formula) that they were able to control and had a dependent variable (in this case, measures of atherosclerosis).

I'm sorry that you have never learned what an experiment is and how it is different from a correlational study, but the fact remains that any other scientists on here like me know the difference and know that an experiment is exactly the one kind of study that CAN demonstrate causation.

By the way, I can't get you the full article because you need to have a subscription, as most biomedical journals require. I can look at it because I'm a scientist at a medical university and we have a university subscription.

I am so glad you wrote this column! I just don't understand what is really behind the government's motivation to tell women that breast feeding is best and to make women who use formula feel guilty. First of all, it is not "best" under any and all circumstances. Breast milk carries everything the mother has and passes it on to baby. That means if mom is sick, nervous, upset, tired, etc. her milk might turn sour and poor baby. In today's world, mom has enough to do without adding this factor to baby's health. If all women just laid in bed all day and were served by maids and cooks and other people to take care of everything, and mom ate only the very best foods that make good milk, then maybe mom's milk would be really good for baby. Otherwise, no way. This is why in China, if a woman (or a family) wanted baby to get really good milk, they hired a nurse-maid who was treated like royalty and didn't do anything except nurse the baby. Breast feeding in the poor undeveloped countries of Africa is very, very unhealthy for baby because moms are so ill-nourished. Formula is so healthy and sanitary and unless baby is allergic to something in formula, then it's definitely better. Anyway, the American way of life is not conducive to breast feeding unless a mom has about three months at home without anything else to do or any other kids to take care of or a husband to fuss over. Women need to tell others to bugger off and do what you can do and what's easiest and best for you and your family. The baby will be healthier and happier if you're not in pain or fretting aout a lack of milk or anxious about what you're eating. Besides, babies who are breast fed for more than three months get so attached to mom that dads are second choice and forget about baby sitters. So think big picture, moms, and don't let the government and all these advocacy groups push you into this. I'm not saying that some women are perfect for breast feeding and have no problems at all and love it. That's your choice. But if you're not, don't feel guilty. Your baby will probably be more healthier and happier in the long run.

"not to be informed and make decisions of convenience or ignorance"

Like using disposable diapers?

What a bunch of smug, self-righteous hypocrites!

Sorry to disappoint you, 10:55, but I used cloth.

No, just because you run a clinical trial doesn't mean that proves causation. Again, you need to mathematically isolate the factor to determine causation. Being an clinical trial does not prove it. It is the statistical model that proves it. I can't tell in that study because I can't read the article. Like you said, you need a subscription. If the article does as you say it does, then yes, in this case it does prove causation. But how would anyone know that without reading the methodology section of the article. So I will add that to my list of proven (shows causation) to my BF argument. But how the heck can you expect anyone to sort through this with causation studies linked around BF. Especially if we can't read the article.

Mimi wrote:
"Breast feeding in the poor undeveloped countries of Africa is very, very unhealthy for baby because moms are so ill-nourished. Formula is so healthy and sanitary and unless baby is allergic to something in formula, then it's definitely better."

What an ill-informed statement. In Africa thousands of babies died after Nestle distributed free formula to mothers.
After the samples ran out, mothers tried to stretch the powder by mixing too dilute solution and feeding their babies. Thousands died of dysentery because the water used to mix the powder was not potable for babies. The only benefit of feeding a baby in a developing country formula is if the mother is HIV positive.

In my experience (my own and that of several friends), NOBODY picks formula over breastfeeding because of a lack of information. They "choose" it because it is the only choice they have, dictated by their own health, their baby's health, constraints of a job, or other family obligations. Therefore, breastfeeding zealots who quote (questionable) study after (questionable) study does amount to harassing. We all know the studies, thanks.

"Concerning size of nipples being a problem with bfing, a friend of mine has to use an "adaptor" (I am not making this up) in order to bf on account of having too small nipples."

Women who have flat or inverted nipples can sucessfully BF using breast shells. This may well be the adaptor referred to. Frieda has never seen a case of too small nipple-itis. There are techniques and/or medical devices that can help.

Mimi,
You are SO off base. Nothing makes mom's milk *sour.* In fact, if mom is sick it is MUCH better for baby to be nursed, because the baby then gets the antibodies that the mom is making and although the baby is exposed to the cold (or whatever) the baby typically is getting antibodies and doesn't get sick.
Happened to us quite a bit with our sons. Where I'd get sick but the kids wouldn't...

Do you work for the formula companies?

My kids love their dad, and, as I have said before, I nursed them each for 13-15 months. Second one was home with babysitter from 6 months and couldn't adore her more.
You are the one spreading propaganda, not the feds - they are just trying to get information out there, because most women have a mom and MIL who are telling them how wonderful formula is, not to mention the formula companies.

I've posted before on On Balance on this topic and it is one I have become passionate about. My story: I talked to all of my doctors - ob, perinatologist, pediatrician, regular doctor about this decision. All of my doctors told me it was my decision and none ever uttered the horrible words "Breast is Best." We talked a bit about different studies, anecdotes, etc and then weighed pros and cons for my family. All were perfectly comfortable with our decision to choose formula. Fast forward to me with new baby being asked constantly by friends, relatives and people I barely know asking me if I'm breastfeeding. I had no idea it was going to be such a big topic and that it was everyone's business. I felt a bit ambushed by the attention to my breasts and the 'Oh, hmmm' responses I often received when I answered honestly that my baby was on formula. Fast forward again to my return to work when I started reading Mommy blogs ... that is when I found out what a Terrible Mom I was for not breastfeeding, and I started to lose it from all the backlash, opionated people and lack of studies that made sense. One conversation that really changed me was with a good friend who had delivered her baby 2 weeks before mine. She sent me tons of info about nursing, never once asking if I would be nursing - just making the assumption that I would. When we spoke on the phone and I gently explained to her that I was not, she listened to my reasons (why did I feel I had to defend my choice, ugh) and she responded... "Well, I still think breast is best, but ... " Needless to say, that friendship has not been the same.
One more piece of the story and then I'll sign off... at a baby basics class the instructor gave out diaper bags from a formula company. She told us to go home and throw out all the formula, but to use the bag, and then repeat after her 5 times "Breast is best." My husband and I sat in shock. In retrospect, we wish we had asked everyone to donate the formula they were going to go home and throw away to us... the Not Best parents in the room.
To sum it all up, we become so vulnerable after we have babies - we obviously want to do only what is best and we are constantly bombarded with messages about what is right, what is wrong... all the black and whites, that you realized a little too late there just aren't black and whites when it comes to raising kids. I've learned not to go by Always and Nevers and a year later I try to ignore the "breast is besters." But thinking back on the first six months of my baby's life I am saddened by the effect they had on me.
Needless to say, my daughter is thriving. Has had less ear infections than a friend who nursed for a year, blah blah blah. She's happy and healthy, I'm happy and healthy (albeit a bit tired!). A happy mommy makes a happy baby and if your nipples are bleeding and your baby is losing weight and you're crying and frustrated all the time - I question if your breasts are really best.
Out.

Ryan,

Foamgnome is correct. There is absolutely NO WAY to account for all variables and have the ONLY differences between two sets of people be that one set was given breastmilk and the other set was given formula.
You can't account for every other possibility and ONLY point to how they were fed as infants.

Only in America would we be upset about the medical community sharing information about what is best for us because we don't like it. Do you feel guilty about not exercsing because the gov't encourages that? Should they not encourage people to exercise and eat right? Only in America would mother's reject a vaccine that will prevent cancer because her daughter might have sex. What is wrong with you people?

Ryan, an experiment does not prove causation. An experiment can help isolate factors to build your statistical model. Just out of curiosity, what kind of scientist are you? There are many flawed clinical trials out there. Again, the number one rule of statistics is causation does not prove correlation. Number two rule of thumb, is your results are only as good as your data. Most studies (medical or non medical) are reaped with data problems. You should know that if you are a research statistician.

I meant to stay research scientist.

Amen Mimi! Thank you!

BadMom and others tormented by the militant BF crowd:

How about telling people it's none of their business how you feed your child? Why try to justify your decision? You know what's best for your family, so there is no need to be defensive about it. You have absolutely no explaining to do to anyone.

There are always people like that out there, whether you are talking about parenting, school, work, etc. Some people think they know what's best for everyone, and you just can't let it get to you.

Some people need to be told to mind their own business and have a nice day. I don't put it that nicely when I have to send that message, but you get the idea.

I guess I had it easy. I breastfed for 6 years(3 kids, 2 yrs each), and never had cracked or bleeding nipples. As noted above, breast milk doesn't sour, but foods can cause it to cause gassy babies. Broccoli seemed to be the worst offender, much to my chagrin. Funny, my kids still don't like broccoli. I was a SAHM, and money was tight, so formula was not really an option. It was a long time ago(my kids are 20,19 and 16), but I don't remember getting anything from the hospital but a pacifier. Of course, my kids were born in military hospitals, so maybe it's different. I do know that I got a lot of coupons in the mail from formula companies after my 3rd one(the only one born in the states).

My OB recommended, when registering on the formula sites for free formula (kinda like registering for a free crack hit), to fill it out that I was going to exclusively breastfeed - in that way, I would get more formula from them.

"Bad Mom," I am really sorry that people have been judgmental with you. It must feel terrible. Sounds like you made the right decision for everyone in your family.

I think parents can't really win-- someone is always judging their decisions. I got flak for choosing to breastfeed-- that it's gross, not modern, will make my boobs flabby, I'm wasting my time, etc. You'd be surprised at the rude things friends and family will say to nursing moms (actually, you probably wouldn't!). This increased as my kids got a little older (they stopped nursing at 14 months and 19 months). Then I got the "they'll be nursing in college" insults-disguised-as-jokes.

Hey indymom - you are an idiot

It's interesting that the formerly breastfeeding obsessed mothers in my neighborhood are now content to feed their offspring sodium filled, low nutrient junk food becaus