Out of curiosity..

[Charleney]

What is wrong with Formula feeding?

I'm 3 months pregnant with my first so havent done either!
But would just like to know why its bad?

I find that really worrying that twins are treated soooo differently. Well differently is I guess good but unequally.

That's awful! And I'm not suprised the BF one is a little bully if the mother is exhibiting deliberate favouritism like that....

Were they identical twins?

?But people seem to find it very difficult to get their heads round risk / health?

I don?t think they do actually, if the risk\benefit is presented in terms that accurately describes what the actual level of risk \benefit is, in relatively simple terms. Which is what most studies do. They are not as inaccessible to the genpub as they are perceived.

For example, according to recent research, by breastfeeding for more than six months I have elevated my potential to have a particularly aggressive for of breast cancer, should I go one to develop it.

Based on an accurate level of risk, versus the benefits I got from breastfeeding for the second batch of six month, even if I could go back in time I?d still continue to breastfeed for a year (I suspect many other happy breast feeders would say the same), because the real and present benefits to me of breastfeeding (see note) would continue to outweigh the very small risk in real terms of getting a more aggressive form of breast cancer as a result, should I succumb to breast cancer.

NOTE - I was good at it, baby hated all and any form of non-skin nipple, I am chronically disorganized and would never have coped with the all the stuff you have to do with bottles let alone being actually awake at night to feed him, it worked for us and I needed to throw new stuff in the mix on purpose like I needed a hole in the head.

I think the idea that people find it hard to understand risk\benefit gave rise to a paternalistic (or maternalistic if you prefer) tendency to overstate many claimed benefits\risks in the name of rendering the information comprehensible for the poor, little mothers who are too stupid to be able to compare percentage points that are not hugely different, or understand ?weak evidence, of borderline statistical significance?.

That was a low risk strategy at the time with the push communication\lack of public access to primary information landscape that existed back then. A landscape that has changed beyond all recognition with the internet, particularly web 2.0.

Based on their failure to factor in the new dynamic and speed of today?s communications, by not redesigning their message and stance, I think the Breast is Best lobby is courting the mother of all backlashes by continuing to underestimate the genpubs ability to verify, investigate and understand the finer details of the risk\benefit claimed and compare that to the pre packaged message considered fit for public consumption. Then go ?huh ??

You can see from Breast feeding advocates taking the stance that any guilt is of the FF?s own making, that they have no comprehension that the petrol needed to fuel a backlash was created in abundance by the incredibly alienating tone of their message.

I think there is still time for a rework and a launch of a more sophisticated message without too many casualties. I just don?t think it will happen because most bodies of long standing tend to be static and incapable of adapting to developments beyond their control. If anything I?d expect the message over time to become more dogmatic and strident as panic at being questioned sets in.

Very human isn?t it ? ?It worked before so it will work again if we just do the same thing but harder.?. Despite all evidence to the contrary.

Just caught up on postings since last night. Clearly this is a subject that people are passionate about!

My twopenneth is do your best with breastfeeding (first few days are most important anyway aren't they?) but don't give yourself grief (like I did first time 'round) if you can't. Half the nation are FF (no idea of stats, just guessing) and are perfectly fine.

Have to say BF DD2 has thus far not suffered with rotten cold my family had last week. But this posting could come back and bite me on the bum anytime!

"actually there was a woman in our antenatal group who bf one twin and ff the other (she also named the bf one after herself,kept her in her bedroom and played with that one but that's a whole other story!)
the bf one is a big fat bully and the ff one is a little dainty sweetheart..."

Well that is one way to give your children pre packaged "issues" from the word go.

sarahitaly your posts are thought-provoking.

?But people seem to find it very difficult to get their heads round risk / health".

However I do think this is true. There are examples on this thread, and many others like it, of people saying things along the lines of - "my baby was fine, so your baby will be too". Or "I FF one baby, who was healthy, and BF another, who wasn't, so I'm not sure breast actually is best".

Look at the hysteria surrounding ecstasy (not without its - well documented - risks of course, but actually a relatively harmless thing to do) compared to the complete lack of hysteria surrounding living with cars around us. We know cars cause death and bad health (it was estimated that tens of thousands of - already vulnerable - people died in the French heatwaves a few years back and this was partly attributable to pollution, some of which would have been caused by cars). However people generally don't get hysterical about the risks associate with cars, because we like the benefits, and probably because you can't actually see pollution in action.

I'm not saying everyone should take ecstacy and stop driving! But that people's perceptions of risk often aren't strictly logical.

And what about the MMR hoo-hah? The way it's been dealt with didn't help of course, but you have some people really misunderstanding risk there. An otherwise perfectly sane friend of mine still hasn't let her 2 year old have the MMR. She has no reason to think that her child would react badly to the vaccination but she's scared that the jab might cause autism because of the media hype. Therefore she (like many others) is putting her DS at a much more real risk of getting sick.

Really hope I haven't let out a can of worms . Lets not get sidetracked into the vaccination debate! I only used it as an example.

Anyway must stop procrastinating and get back to some study now!

OP, whatever you do, I'm sure you will choose the best thing for you and your little one.

Yes...Congratulations, OP, and good luck.
It's going to be the scariest, most BRILLIANTEST and most amazing time of your life.
With added poo!!!
(NB: I got told that BF baby's poo wasn't as smelly as FF baby's poo. Having done both, I can categorically state that this is bollocks: it is all poo. It all stinks.
Awww...sniff...

but you have some people really misunderstanding risk there

Yes. (inc. self for a while )

But not because they can?t understand accurate information when presented in context (especially when prior to any misinformation muddying the waters).

They ended up with a misunderstanding because they were bombarded with high octane, very emotive propaganda which appealed additionally by being suspicious of the government. There were so many levels of manipulation that it was well placed to set a seed of doubt even when not swallowed whole. That is why vaccine scares tend to go like wildfire and have lingering effects even after the initial claims have been thoroughly debunked. Different vaccines in different countries have ?enjoyed? the same phenomenon.

It has been particularly difficult to counteract because challenging people?s multi faceted attraction to the initial message they got is not as simple as saying ?actually the risk is not huge as claimed, see, it?s 0.9% without the MMR and 1.2% with the MMR, but that is only for children with genetic disposition to autism, for everybody else the small risk of developing autism is the same, whether you give them the MMR or not?. Debunking the MMR claims is a bit more complicated because you have to deconstruct the methodology of the study, the ethics of it, as well as the findings. Whereas demonstrating the overstatement you tend to see in Breast is Best claims is a relatively simple process.

One of the most interesting things (well for me anyway) about the MMR story is how it precipitated ?Skeptic? more visibly into the role that ?Alt? used to hold. Alt has become so mainstream that it is no surprise that it was ripe to be usurped by something oppositional taking its former place as the pace setter of change in attitudes.
The MMR story provided the ?jumping the shark? moment for Alt and things appear to be slowly snowballing from there.

sarahitaly, three things:

www.phdinparenting.com/2009/05/14/the-scientific-benefits-of-breastfeeding/

The authors have done just what you wanted -- a comprehensive meta-review of the research literature. They concluded that the benefits were real. I think the benefits they uncovered were also substantial.

I have neither the time nor the expertise to review all the evidence, so I rely on the kind help of others. And here, I prefer to rely on their summary of the evidence instead of yours.

1. Risk/benefits: the genpub does struggle to understand these, and indeed many scientists struggle as well, and fail to put them across properly in papers. It's one of the things that Ben Goldacre rightly gets exercised about. Humans are bad at estimating risks, understanding risks, comparing risks and managing risks.

1. I don't understand why you would suggest your qualifiers re the harm that is or is not caused by formula (properly prepared etc...). It doesn't make sense to ignore compliance / adherence. We need to look at what happens in the real world, not a world where every bottle is perfectly prepared or indeed every breastfeed is perfectly given. Stomach upsets from ineffective sterilisation are a harm resulting from formula feeding in the same way that breast damage from a poor latch is a harm resulting from breastfeeding. I have no idea if there are studies comparing relative harms in this way. Obviously, the use of formula in developing countries does lead to significant levels of harm for populations, because there is poor access to safe sterilisation -- but this is a separate issue from the UK story. And the question of relative health benefits of BM vs formula is probably best disambiguated (which you have done implicitly but other posters have not).

Hello OP - if you're still here :)

Congratulations - welcome to the great adventure!

FWIW I thought before giving birth to littlemad that the whole idea of breastfeeding wasa bit eeurrgh and didn't think I'd be able to cope.

I decided to hold back from a final decision about what I was going to do until her was born, reasoning that actually I couldn't know how I would feel.

Honestly, truly, after he was born there was nothing that was going to stop me bf him.
We had a bit a struggle to get going but some odd instinct - the same one that prevent you leaving them on the bus...oh that's it, 'Motherhood' kicked with me and it just seemed so strightforward and simple.

Hold on to your hat - this will be the first of very many things you won't know the answer to - and this is one of the easy ones :)

Good luck and enjoy your pregnancy!

And here, I prefer to rely on their summary of the evidence instead of yours

Fair enough love. I'm not a guru looking for converts, so I am not going to take it personally ( =

I got a 404 on the blog post but I did read her profile and it's not my cup of tea. I?m not accusing her of misrepresentation, I couldn?t read her post and so can?t comment. But according to her profile she has some fairly firm positions when it comes to pregnancy\birth\child rearing and I prefer to get my information from secondary sources when they appear to be as free from potential bias as possible.

There is no justification in discounting all and every work that appears to be at risk of bias, but it does require a tedious amount of fact checking as a back up when you have the potential for doubt.

When I read secondary sources it is because I want to AVOID the time consuming fact checking, so I tend to go to secondary sources where the author is more on the same page as me. Which is basically ?whatever (perfectly reasonable choice) works for that particular mummy/baby combo?.
That way I can save time and effort.

Because the chances are they don?t mind how other mummies feed their babies either, as long as both mother and child are doing well. So the likelihood is their interpretation isn?t at risk of being unconsciously swayed.

If thereis any predudice that I?m likely to share with secondary authors it is the loathing of manipulation or misrepresentation of findings in order to promote a pressure group?s interests.

I am somthing of an old hippy at heart and very much into ?love and peace and lets all get together and insist on being told the truth by the Powers That Be so we can support each other in our diverse, but perfectly reasonable, choices in bringing up the little lives we made, as happily and coexisingly as possible?man?

It's one of the things that Ben Goldacre rightly gets exercised about

I was under the impression that he was cross that the public finds it hard to understand risk\benefit because it is persistently misrepresented to them by science journalists, interest groups and industries who make outlandish claims that are not supported by the evidence that they appear to be referring to.

I'll tell you what though. I'd love nothing better than for him to get involved in this particular debate.

I don't understand why you would suggest your qualifiers

It's because I would like the insistence that formula itself is harmful to be backed up.

There is nothing wrong with highlighting any risks of contamination, inadequate hygiene practices and the danger of inappropriate dilutions, backed with accurate information to demonstrate what those risks actually are and more importantly, how they can be avoiding if somebody wishes\needs to FF.

Surely that is the priority no ? Making sure that people who FF have all the information they need to keep their baby safe, well nourished and free from avoidable infections.

If some people considering FFing read the risk factors and come to the conclusion that they are much like me, too disorganized and hygienically challenged when sleep deprived, to take what would become an elevated risk and chose to try breastfeeding instead, that is all fine and good. But it is a very secondary consideration compared to the primary consideration of ensuring that FF babies do not suffer avoidable infection because of a lack of quality information, education and support.

To be honest focusing on dilution and hygiene (which are exclusive to FFing in a way that contamination is not) makes the case for buying sterile, liquid formula that gets plugged into a disposable, sterile bottle and nipple just as adequately as it does for breastfeeding.

More so I should imagine if you are finding breastfeeding difficult or unappealing.

I honestly don't make a habit of posting in debate then buggering off.

In my defense I never intended to get sucked into such an interesting exchange it just happened and unfortunately was linked to a massive case of procrastination.

My sister is flying over in just over a day and I have painted nothing and the house is a tip, so I have to cut and run and at least shove things under beds and whip the dyson around a bit.

Oh god, I also have to put their bed together and make it.

Many apologies for bailing rather than sticking around to answer responses.

well I'd say getting up in the night to prepare bottles was a huge negitive, esp when the alternative is just rolling over & viola!!! Sleeping & feeding = bliss. I'm a lazy moo & BF suited me to a T!

404 was due to a random ampersand
Try this

The review the blogger cites was done by a bunch of scientific reviewers. In case you're still having difficulties with the 404, you can find the review itself here:

www.ahrq.gov/Clinic/tp/brfouttp.htm

It was done by the AHRQ, which is a publicly funded US agency. You may or may not choose to think of that as biased. I've posted the abstract below, in case someone wants to read without following the link.

1. My reading is that Ben Goldacre does not say that it is solely because science journalists misrepresent data that the public struggles to interpret risk. Instead he says it is inherently hard to interpret risk and made harder by misrepresentation. I would also like to hear from him on this debate, but I don't think he or anyone else is the final authority, and I'd still tend to prefer ARHQ to him.

1. Qualifiers -- hum.

This came up when you quoted someone who said "I'm afraid you're not in a position to advise the OP that FF won't harm her child, just because of your personal experience"

To which you said: "As far as I am aware there has not been a single proven case of formula having harmed a child."

By your logic, you replied with a non sequitur, because she was talking about formula feeding and you replied with a comment about formula itself.

1. On your other point about qualifiers, I think whether to prioritise "here's how to feed safely with formula" over encouraging people to breastfeed instead of using formula in the first place depends precisely on the issue at hand, ie how significant one thinks the benefits of one form of feeding vs the other are. You don't see particularly great benefits in BF vs FF, thus you would prefer to expend effort on educating on safe FF; I see great benefits, and would rather the effort went into encouraging people to BF in the first place.

Good luck with the cleaning etc.

Review abstract:

Structured Abstract
Objectives: We reviewed the evidence on the effects of breastfeeding on short- and long-term infant and maternal health outcomes in developed countries.

Data Sources: We searched MEDLINE®, CINAHL, and the Cochrane Library in November of 2005. Supplemental searches on selected outcomes were searched through May of 2006. We also identified additional studies in bibliographies of selected reviews and by suggestions from technical experts.

Review Methods: We included systematic reviews/meta-analyses, randomized and non-randomized comparative trials, prospective cohort, and case-control studies on the effects of breastfeeding and relevant outcomes published in the English language. Included studies must have a comparative arm of formula feeding or different durations of breastfeeding. Only studies conducted in developed countries were included in the updates of previous systematic reviews. The studies were graded for methodological quality.

Results: We screened over 9,000 abstracts. Forty-three primary studies on infant health outcomes, 43 primary studies on maternal health outcomes, and 29 systematic reviews or meta-analyses that covered approximately 400 individual studies were included in this review.

We found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. There was no relationship between breastfeeding in term infants and cognitive performance.

The relationship between breastfeeding and cardiovascular diseases was unclear. Similarly, it was also unclear concerning the relationship between breastfeeding and infant mortality in developed countries.

For maternal outcomes, a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer. Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression. There was no relationship between a history of lactation and the risk of osteoporosis. The effect of breastfeeding in mothers on return-to-pre-pregnancy weight was negligible, and the effect of breastfeeding on postpartum weight loss was unclear.

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

For future studies, clear subject selection criteria and definition of "exclusive breastfeeding," reliable collection of feeding data, controlling for important confounders including child-specific factors, and blinded assessment of the outcome measures will help. Sibling analysis provides a method to control for hereditary and household factors that are important in certain outcomes. In addition, cluster randomized controlled studies on the effectiveness of various breastfeeding promotion interventions will provide further opportunity to investigate any disparity in health outcomes as a result of the intervention.

Wow.. thankyou for all your replies, apologies im not getting back until now.

Probs gonna get alot of s**t for this but at the minute, have thought about it and i think im gonna FF.

I mix fed my first as I found BFing hard, so she had formula too. But I'm still BFing my younger child at 13m, and I love it. It really is so much easier.

Charleney - it is worth remembering this is not something you have to decide right now, and if you change your mind later it's no problem either.

Take care of that bump :)

Honestly, i personally do not like the thought of breastfeeding. I dont know why i just dont. I wouldnt ever think twice about anyone else doing it i just dont think its for me but was starting to wonder why alot of MNers are so against it.
Have took a look at my 2 brothers and little sister who were all formula fed and they are fine, never had any problems as far as i know.
My 14 year old brother is taller than me now and im 22! lol.

But thanks i will take care of my lil peanut hehe.

"As far as I am aware there has not been a single proven case of formula having harmed a child"

[hhmm} You mean apart from the dead babies in China, at least six dad and over 300,000 ill? Or how about the countless babies who have died in developing countries due to aggressive promoting of formula without the clean water or money available to continue it properly? What about the 85 babies who died in Nigeria from contaminated formula? They don#t matter at all?

Try looking at some actual facts for a change; try the http://www.who.int/child_adolescent_health/documents/lancet_child_survival/en/index.html Lancet series on child survival which estimates that 1.3 MILLION under-5's could be saved EVERY SINGLE YEAR worldwide by greatly improved breastfeeding rates.

Or maybe you were just talking about your lucky Western baby, formula never harms them right? You could read the NICE report based on a long term study that says a 10% improvement in BF rates could save;

? about 17,000 cases of otitis media avoided at a saving of £509,000.

? almost 3900 cases of gastroenteritis being avoided, at a saving of £2.6 million

? over 1500 cases of asthma being avoided, at a saving of £2.6 million.

? a reduction in the cost of teats and formula of £102,000

BF or FF, who gives a fuck. But the facts don't change just because we aren't supposed to mention them for fear of upsetting the FF'ers, who incidentally outnumber those who BF past 6 months by over 9;1.

Obviously it's your choice. I am admittedly biased but I would strongly suggest just trying it - just the first feed is really beneficial. And you never know, you might love it :)

Thanks Freudian, hey maybe i'll change my mind when the time comes.

Thanks for giving advice and not thinking im a crap person for it!

"Hey, calm down, calm down".
Take care, Charleney.
As you can see it's a debate that will rage on and on... and it's certainly not one that's black and white.
Keep us all posted on how it all goes!
xxxxxxx

Just try it once, even if you don't intend to continue. It really is lovely having that tiny new baby on your chest having that first feed.. I only BF'd for 6 days, expressed for 2 more weeks, and then went to FF. I love the memory of having DS on my chest when my milk came in, the look on his face was amazing. I didn't last long, and I would have liked to, but those memories are lovely

Good luck, whatever you decide :) (FF is obviously fine, don't let yourself feel bad/bullied by some of the posts on this thread, it's an incredibly emotive subject. Just make sure you prepare the formula properly

Charleney, some of my best friends are formula feeders!

Agree with Jareth. If you are in hospital anyway with a newborn, you might as well just give it a go. Now, I do come from a family of bfers, my Mum and all my aunts bfed so in fairness, there wasn't much chance that I wasn't going to at least try. But I was expecting it to be difficult and painful. It wasn't. It felt nice.

I have to say, I was also swayed by SILs experience of ffing but bursting into tears when her dd nuzzled into her breast anyway looking for milk. I knew I couldn't handle the guilt if that happened to me. It didn't sway SIL I have to say, she didn't change her mind and also ff her other 3 children!

I intended to bf for 8 weeks. In those days maternity leave in Ireland was 16 weeks max and the thinking was that you took some time to get the baby used to bottles.

8 weeks came and went and I was still bfing. Then I read a single sentence in a baby book I had that said. "It is perfectly possible to work and breastfeed" So I did. Ds1 and ds2 were bf for 1 year. By ds3 I had discovered MN and ds3 and ds4 were both bf for 2 years each. So my 8 weeks turned into 6 years in total.

Whatever you decide, congratulations and best of luck with the beanie!