Emily Oster on Breastfeeding - minimal benefits.

[IamOvercome]

I am pregnant with my first and am an economist so I was recommended books by fellow economist Emily Oster. The books don’t give advice. They review the statistical studies underlying pregnancy advice and whether they are any good or not.

It’s been such an eye opener. For example it is pushed pushed and pushed some more that breast is best. But when you review the evidence there is minimal evidence for benefits of breastfeeding for babies. The strongest evidence is actually for mothers that it can marginally reduce chance of breast cancer in later life.

Same with not introducing babies to bottle to confuse them when breastfeeding. Literally no concrete evidence for it.

Yet this is all pushed as clear cut facts by midwives and other health professionals.

That would be surprising. Any other gems?

Antibodies, comfort, less cost.
The list of benefits goes on

Do what you want, you don't need books written by so called experts telling you what you want to hear.

These books were a godsend to me during my pregnancy - I thought they were very good. Agree that a lot of info given is not necessarily the ‘best option’ in terms of statistical evidence. I thought the book was very good for that. The bit about baby weight gain in relation to c section or vaginal delivery also was greatly useful to me and my baby just after birth. I get the impression that as midwives are practitioners in their own right, a lot of their advice can be very subjective and Osters’ books were very reassuring & informative. I’d highly recommend! X

There are other benefits to both that are hard to quantify imo.
Breastfeeding - convenient particularly during the nights in the early weeks and months. The downside to this is that feeding stays more erratic compared to bottle feeding.
Big downside is no one else can do the feeding if they refuse a bottle, which many breastfeed babies do. Hard to have any freedom as it’s difficult to leave the baby with anyone for more than an hour.
Breastfeeding is significantly cheaper though if you don’t also want to pump and bottle feed on occasion.
Some sources say they health benefits are overblown and some still maintain that the benefits are there.
Just do what you want.

First of all, how you choose to feed your baby is your business and your business alone.

Secondly, I think breast is best but the benefits are marginal and only observable at a population level. Whether you bottle or breast feed will not make a material difference to you / your child. If you take a class of pre-schoolers, teenagers, or a university cohort you will have no way of telling who was breast or bottle fed.

Breastfeeding is great, but it doesn't guarantee your child will get into Oxbridge any more than bottle feeding condemns your child to a life of crime.

I thought it was well known that the benefits of breastfeeding are minimal at the individual level, it is at the societal level where they are important.

I also suspect that Emily's assessment is influenced by her own difficulties with breastfeeding.

@Danikm151

Antibodies, comfort, less cost. The list of benefits goes on

This is it- actually in the book she looks at a wide range of studies that analyse elements like these- and for example the research overall finds that children who are formula fed are not ‘more ill’ than children who are not. She provides links to research and more so how to read research findings understanding the methodology behind the studies etc.

I would imagine most of the breastfeeding benefits are hard to measure.

Main benefit to me was not lugging bottles around or having to get out if bed at night. Main benefit to baby I'd imagine was instant food!

Can't really put them into statistics.

Almost all the the 'benefits' of breastfeeding are actually socio-economic. It has been well recorded for a long time just many people don't seem interested in a balanced debate.

She’s an economist rather than in the medical field and where she’s writing on topics I have worked on she makes lots of errors so I have to assume the other chapters are similarly affected. I like the research driven approach but it should be written by someone in the field.

A lot of the evidence picks up associations but can’t prove causation. That’s particularly true when you start to see longer term outcomes. There are also studies that can find benefit at a population level but not an individual one.

I've done both breast and bottle and breast
was way easier and I remain more bonded with the breast fed child many years on. There's also just the simple fact that we have breasts to feed babies. Of course do what you want, but the idea human experience can be boiled down solely to measurable outcomes (which are purely materialist in nature) alone is such an impoverished way to look at life.

I found Expecting Better a fascinating read. Wish I had read it when I was pregnant with my first (although now pregnant with my second some of the stuff seems more instinctively true to me now).

I am not sure who she is, but you say she's an economist. I think you would be better off getting medical advice from a medical professional.

I've seen an interesting quote on here a few times - breastfeeding is only cheaper if we don't value women's time.

The problem I suspect is that most of us come at this from our own subjective experience and your likelihood of breastfeeding successfully is affected by how much support you have and socio-economic factors, which may translate into better outcomes for babies generally. So it's interesting to hear about someone looking at the statistics behind it.

Breastmilk is nutritionally optimal for your baby, but breastfeeding as a whole, taking into account all factors isn't best for every mum and baby. Formula is also absolutely great and your baby will have all that they need from that. Lots of studies are outdated in that formula is more tightly regulated and has advanced since lots of the studies were done, there's also some dubious memes on social media with no research to back them which seem to have been accepted as reality- and none take into account things like social disparities in concluding outcomes. As I say breastfeeding is incredible, bloody clever and fantastic benefits (also some benefits to mum like lowering risks of certain cancers), but we can celebrate those whilst accepting reality.

The trouble is that decent statistical evidence for anything breast feeding related is hard to come by because large scale studies of the kind, that are scientifically valuable like double blind, controlled etc are ethically impossible to conduct so as an analyst you are always dealing with data which is likely collected for another reason and contaminated by uncontrolled variables.

@Teastheword But medical advice that is contradictory, unproven or simply not backed up by objective statistical fact should be treated with caution no?

@Teastheword

I am not sure who she is, but you say she's an economist. I think you would be better off getting medical advice from a medical professional.

She's good at looking into data and extrapolating information from research that's relevant, you don't need to be medical to do that.

The real benefits of breast feeding only apply in the third world, where formula is made up with dirty water from unchlorinated sources, causing diarrhoea and deaths in infants.
Here in the UK, it makes damn all difference, and as a doctor I am delighted that a credible statistician has finally published this.
Perhaps we can now see the end of poor depressed mothers beating themselves up for “failing” to breast feed. A mafia of midwives and breast feeding mothers has controlled the narrative for far too long, to the detriment of women.
Feed your baby by whatever method best suits you, secure in the knowledge that your way is as good as any other. And don’t let anyone guilt trip or pressure you.

This sibling study is interesting - when taking sibling outcomes into account, it suggests that socioeconomic factors are what influence child outcomes rather than how they were fed.

www.ncbi.nlm.nih.gov/pmc/articles/PMC4077166/

Feed your baby however you want to.

We are mammals meaning we birth live young which are fed by milk from our own bodies.

Our breasts have evolved with the sole purpose of feeding babies with milk that has evolved to be the perfect nutrient for them. In that sense breastmilk is 'best' for baby.

That's on a population level, individually that might not work out so well. A consequence of the greatly improved maternal and infant mortality rate is that babies and mothers are surviving that in previous generations wouldn't have.

None of this means that it is bad or wrong to formula feed. Nor should a women feel shame or guilt if she isn't able to or doesn't want to breastfeed.

Biology and society don't always match.

Reading this makes me feel a little less guilty - I was unable to produce enough milk to sustain either of mine. No idea why I feel guilty as the signs were there that my boobs just weren’t normal, it’s not my fault. It just feels like a weight off my shoulders that I haven’t necessarily doomed my kids to a life of ill-health, obesity and the rest because I couldn’t breast feed.