Aibu? to be pissed off at this: "The cost and social implications of using an infant milk should be considered when deciding how to feed your baby."

[Selyna]

WTF do Hipp mean by social implications?

Both methods of feeding a baby are acceptable so fuck off with the whole acting like ff is poison! my dd is perfectly fine but i hate this constant making me feel like a failure because i failed to bf although i tried so so hard!

Sorry 'haven't controlled'

god this thread makes for depressing reading.
But then I'm still smarting.

Did I miss something stealth? What happened now? I haven't even read it all back today

Welcome to the flat earth society Kayano.

Flat earth society

whatme, I have already mentioned several cohort studies which show bf/ff compared - you can search for them yourself. Nothing 'illusory' about the effects they find.

So no one is going to mention my post just a few up from here which showed how you had misrepresented what I had said?

I still don't know how I say this on many threads?

I don't honestly know why you are being so rude to me

anyone fancy picking this apart for me?
Please note the controls for mother's educational status, which I would assume is a fairly good indicator of socio-economic status.

The thing I don't get - these studies you are so sneering of. Loads of stuff that affects you - the drugs you take, chemicals in the food and environment are affected and controlled by the results and recommendations of the same sorts of studies you rip to shreds when it concerns the outcomes of infant feeding. Are you also as cynical about everything else? Or just infant feeding?

Do you all, for example, believe smoking causes cancer, and if so can you point me to the evidence and tell me how it differs from the infant feeding studies?
(and please do not use the words "common sense" or I will scream lots)

I'd be really interested in the answer to this one - assuming you do believe this, what are the differences in the evidence available to you? Does the poster who said there's never been an RCT to show that "breast is best" believe there were groups of people who were sent away with their own personalised smoking schedule, as part of a huge study?

ah but tiktok only rcts count. Which is why they're ALWAYS used, and everything else is just woo.

Sorry, Kayano - I accept I exagerrated your position, and maybe conflated your views with others; not fair.

SPB, probably it was me who explained why there's never been an RCT for feeding - and why there never can be :)

This is, as you suggest, only a weakness in the research to those who festishise the RCT as the only way.

Tik Tok I'm sure I remember seeing an RCT comparing outcomes for preterm babies randomised to receive donor breast milk or fortified formula. Breastmilk babies had lower rates of NEC and lower cholesterol and bp in childhood. Am I misremembering this?

Yes, there are a handful of RCTs with pre-term babies - the most oft-quoted one and the one you're remembering about NEC is about 15 years old now and if it wasn't late I'd look for it - published in the BMJ, IIRC. The bp thing was a different study (might have been the same cohort - can't remember); can't recall the cholesterol one. There's another that looked at visual acuity (development of eyesight).

That's all a useful addendum to the literature, but it's not the same as breastfeeding in real life over several weeks and months; these studies do at least show that bf makes a difference to health and development.

anyone fancy picking this apart for me?

Well, I read it - it is at first sight a summary of all the good news. So, I says to myself, how can this be so if all these studies are supposedly conflicted. The first reference paper I clicked on was "Otitis Media" - which I'd never heard of, so was curious - where this researcher says says:

"Approximately 44% of infants will have at least 1 episode of otitis media in the first year of life, and the risk among formula-fed infants is doubled (95% confidence interval [CI], 1.4?2.8) compared with infants who are exclusively breastfed for more than 3 months"

So off I went to the referenced paper (over here) - it was a review.

"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" it said. That is a huge piece of work.

And....well sure enough, there was her data - otitis media confirmed. It also found there were weaker links to: 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.

Sadly, the study also found there was no causal link with intelligence, cardiovascular problems, infant death, depression, weight and a few other things

So she basically picked the one major positive of that study and ignored all the zero correlations. That's the same trick in that other study - say it showed evidence og higher CVT and ignore the zero findings in 14 other areas.

I'm sure if she picks and choose well enough over enough studies, she then get the litany of Breaast benefits she writes about.not academia, that's propaganda.

What she should have done of course is set up a matrix of all finding across all studies, as more neutral academic reviews have done, not cherry pick.

But there's more - I looked at the reserachers' conclusions in teh study she referenced, and what did I find? You know what's coming next, don't you? It concluded, and I quote:

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.

The bold lettering is mine.. That by the way is scientist-speak for "the data we reviwied is by and large a crock of shit".

Seems our eager researcher missed that bit.

How odd :o

Whatmeworry

Researchers build on bodies of evidence and compare and contrast studies. With this type of research they can never really say from a positive paradigm point of view that X causes Y because unless you conduct a laboratory study which controls for all the variables you cannot definately say for sure. You miss the point entirely and come at this from a very middle class point of view.

Having worked in areas of high deprivation, where many people I see can't even read, have no money, never mind work out how to boil and cool water to 70 degrees, or understand any research and feed their children quite poorly because they don't have choice and knowledge once they get older, the impact of breastfeeding is huge on these children. You must understand that, that is why there has been research into this area. If you think FF is so great, where are the articles saying that it is nutritionally better than BM. With the amount of funding provided by SMA etc... surely we would be seeing those articles by now. We aren't because FF is nutritionally inferior to BM.

I'm puzzled. Why would an increased risk of ear infection not be something worth knowing about? (BTW, that's otitis media - why are you even reading research into infant health when the words 'otitis media' are new to you, whatme? It makes me wonder what other basic stuff you are missing - like your zero knowledge of lactation physiology). It cannot be inferred as directly 'causal' and good research acknowledges this - explaining it's cannot be inferred as causal is not the equivalent of saying it is a 'crock of shit'. What a strange way of interpreting health research.

'Weaker' links between all the other stuff you pick out seem to me to be useful info - why would it not be a good thing for HCPs (and parents) to know even about weak links with morbidity? You don't mention the maternal health aspects - also part of the paper.

You also don't mention the authors comment on additives in formula: "Cochrane meta-analysis concluded that most well-conducted randomized trials showed no benefit of LCPUFA versus control formula on visual acuity or neurodevelopment among term infants".

I have a research background, too - I am well used to pulling apart papers. This one seems to me to be careful not to overstate its evidence, and it makes a good case for HCPs and hospitals to work out what they can do to support breastfeeding better.

I'm a parent, but educated to post graduate degree level and understand research papers. I'm sick and tired of people coming on this site and saying that FF is just as good as BM or that the risks aren't there or are overstated. That is factually inaccurate and shows a lack of understanding of scientific research. I work in health and social care and see adults with chronic health problems. I see the cost of poor health, both in terms of personal misery and to the NHS and social care. Most HCP's understand the research as well which is why they support BF'ing. To deny the risks of formula is weird, it's like saying the sky isn't blue, la la la. So la la la away but every time someone la la's it just insults women who do desparately want to breastfeed but haven't had the support to do so.

I thought WhatMe was a wonderful example of brilliant rhetoric, actually. But that's not the same as a good point.

Her dismissive preface of "which I'd never heard of" sets the stage for the reader to conclude "irrelevant, practically esoteric condition- any relative risk increase for this would still be a tiny absolute risk".

But, eh, how dare those edu-ma-cated people tell anyone that they're wrong, eh? Don't they know we're parents? We have "gut instincts", don't you know?

I hate Britain anti-education and anti-knowledge attitude, and I don't even have a degree, so it's not self-interest speaking.

I am educated and a ff

I feel my baby was better off having formula and not being a shaken baby
[shrug]

Risk is all relative. You can discuss the benefits of bf over ff and it won't make a jot of difference to some people. (like me) it's overly simplistic to say
Breast milk is better so more people should do it if they physically can. What about mentally? It's a horrible position to be in.

Kayano - you did what was right for you and weighed up the risks for yourself and your baby, that's totally different to people who deny that risks don't exist.

Kayano, no one is saying that overall there aren't circumstances where formula is better. However, that's different to convincing oneself that overall, for most people and babies, breast milk is far superior to formula milk.