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.

“And I do believe I can spot some (not all) formula fed kids by their head shape! They often have misshapen heads due to long spells of laying on their backs. People will hate me for saying that one!“

Complete and utter rubbish.

What data is it based on? What controls were used and how was the study set up?

As you've alluded to yourself, ethically, it would not be possible to set up such studies & control the variables.

I'm on the fence about Emily Oster. For all her claims to be data-driven, she employs a lot of 'anecdata' too (and a lot of it is exactly the same experiences we all have, especially in her new book, where she deals with screen use, phones & tech, and regularly admits, there's not enough evidence either way).

Back to breast feeding, breast feeding is best in the widest interpretation of that statement. In terms of benefits for mother & baby, including oxytocin release when feeding, helping to bond mother & baby, to the composition of milk adjusting to what the baby needs (eg on a hot day you can feed your baby & the breast milk will be much weaker, more like water. Not possible with formula, so you need to introduce water, which most babies don't like).

Very few people believe that in sheer health terms, it's better, and are aware that there are many other factors at play.

One of my friends b/f her 3 DC, and all of them were so sick till about 2 with recurring bronchitis and other respiratory conditions, regularly in hospital. Not a surprise as their mum was & is similar in terms of recurring chest infections, asthma etc.

[quote IamOvercome]@DomesticatedZombie this is the issue with this research. I read that paper in full has a ton of omitted variables. It doesn’t control for

• physical activity of the child
• hours of television watched by the child
• food eaten by the child and diet
• child health issues or disability
• mothers bmi at time of birth
• family income

All of which have been shown in other studies to impact on obesity. You cannot conclude from that study that obesity is associated with formula. It’s incredibly flawed.[/quote]
Here's the link to the full study.

www.karger.com/Article/FullText/500425

'Among the modifiable risk factors for childhood obesity in the first 1,000 days of life, breastfeeding has been shown by a large body of evidence to be a protective factor [6-11]. A meta-analysis found that breastfeeding was associated with a reduction of 13% in the odds of overweight and obesity [9], and Harder et al. [12] found that each additional month of breastfeeding was associated with a 4% reduction in the prevalence of overweight.'

• the numbers reference other studies, all linked there within the paper.

It’s not about putting breastfeeding ‘down’, it’s about discussing the evidence behind the breast is best mantra. Clearly, for you, any questioning whatsoever of BF is ‘putting it down’. You’re very sensitive, aren’t you?

To me, giving birth and breastfeeding are fundamentals to being a woman

Yikes!

A mafia of midwives and breast feeding mothers has controlled the narrative for far too long, to the detriment of women.

That's an insane statement.

In fact, in Britain & Ireland, many women continue to report they are unsupported to breast feed, and many give up early.

There is of course no problem with those who choose to formula feed, but your use of hyperbolic language is ridiculous.

@LabiaMinoraPissusFlapus

I can't believe that breastfeeding and formula feeding are almost equal in benefit I am afraid, having been presented with evidence to the contrary for years as I work in this field. To me, giving birth and breastfeeding are fundamentals to being a woman. Maybe some people don't hold these 'achievements' as important, but those who consider them valuable should be listened to and it shouldn't just be drawn back to data and studies. The medical model of health has long been male dominated, and women have been and continue to be controlled by it. Holding these capabilities as a woman, and the importance they have for me, is one of the reasons I don't accept trans women being referred to as women. And I do believe I can spot some (not all) formula fed kids by their head shape! They often have misshapen heads due to long spells of laying on their backs. People will hate me for saying that one!

Sorry but this doesn’t make a lot of sense to me. How else can we look at population level impacts of a medicine or treatment if we don’t use data and instead rely on feelings and what random people believe?? Would you have been happy if the Pfizer vaccine trial was someone saying their friend had it and was ok so Pfizer feel like it’s fine to give it out.

“Breastapo” is like the Godwin’s law of Bf/FF threads

How else can we look at population level impacts of a medicine or treatment if we don’t use data and instead rely on feelings and what random people believe??

But breastfeeding is neither medicine nor treatment.

It's a way to feed a baby.

It's not wrong to choose another way. But clearly our bodies are designed to breast feed, and where possible, this is preferable for a range of reasons, which may be experiential, for mother & baby, rather than data-driven.

Data cannot show everything.

@MadameHeisenberg

It’s not about putting breastfeeding ‘down’, it’s about discussing the evidence behind the breast is best mantra. Clearly, for you, any questioning whatsoever of BF is ‘putting it down’. You’re very sensitive, aren’t you?

no there have been derogatory and insulting comments aimed directly at breastfeeding on this thread but nice try.

I think it was a formula company who started the breast is best message because of course the majority of us aim for "good enough" in life and formula is that "good enough". In a developed nation with clean water and made up properly of course. Funny how that message makes millions for companies whereas breast milk is free.

Maybe the message should be, breastfeeding is biologically normal but formula is fine.

Feed your baby how you want but formula is powdered cows milk with additions and cannot replicate the antibodies in breast milk nor change to meet babies needs (more watery on a hot day for example).

How did the author feed her baby?

[quote Nevermindthefragglerocks]@Tilltheend99
I fuck it - my first "this" and I quoted the wrong thing 🤦‍♀️
I was referring to the part about depressed mothers being made to feel like they have failed their babies. I was very much made to feel this way and I think that was way more damaging to my child than formula feeding ever could be. [/quote]
this^

it was the attitudes on here the pushy BFs and their judgement that made me give up and go to the other place all those years ago.

Breast is best. Mixed feeding is fine. Exclusively FF is not equal to BF no matter how many studies you do.

I personally don’t care how anyone else feeds their baby, because their baby is not my baby, but chose to breastfeed my baby rather than give manufactured milk/make up bottles in the middle of the night/pay for something my body was producing naturally. Health benefits to myself and baby were a definite added bonus (though from reading this thread apparently they’re all made up..!).

Wouldn’t have beat myself up in the slightest if I hadn’t been able to do it, but really happy I could.

I think people who end up FF against their wishes are the ones who get shouty and defensive on these threads, and I understand the OP is not one of those and was merely starting a debate about evidence or perceived lack thereof.

I think this is really interesting OP and I applaud you for doing the research before you give birth, I winged it I'm afraid.

I do think that the latest research on the gut microbiome and it's links to health supports the idea that breastfeeding is more beneficial to the baby. There is also the James Nestor book on 'breath' which links breastfeeding to the development of a child's mouth and the impact on their breathing throughout their life.

From my own perspective I suspect breastfeeding my daughter contributed to me becoming quite depleted in energy and nutrients. If I had my time again I would breastfeed but I'd eat a lot more healthily to support myself to do it!

To me, giving birth and breastfeeding are fundamentals to being a woman

now thats just insulting.

Not just insulting, it’s plain stupid and factually wrong. How embarrassing that someone came out with such nonsense!

And I do believe I can spot some (not all) formula fed kids by their head shape! They often have misshapen heads due to long spells of laying on their backs. People will hate me for saying that one!

I don’t think they’ll hate you so much as wonder what on Earth you’re talking about.

How do you think people give babies bottles?!

So many of the comments are so sad on here

Women feeling deep guilt

That they'll "save time"

That their time isn't free

That they suffer horribly breastfeeding

That they won't sleep breastfeeding

I mean, your family should be helping make things easier for you as a new mother. Bringing meals, cleaning. Why do they always rush in with "give them formula"? My mum did this to me. I told her some women were telling me to spend a week focusing on breastfeeding at home, not worrying about going out or cleaning. She said that was ridiculous, but it wasn't at all. What was more important then spending time with my hard earned newborn baby? Recovering from birth and feeding her?

I struggled with breastfeeding, but breastfeeding wasn't actually the problem, it was people like my mother constantly undermining me. "She can't need feeding again" "it's not normal" pushing formula on me. Why?

Women are pressured to breastfeed its true, the issue is there is virtually no help to do it, not that they're pressuring you.

I like statistics too OP, I read a lot of them when planning my birth. I don't know, I just don't think that the benefits your talking about are really important.

My relationship with my daughter is symbiotic. We need each other, it has tied us together. I have grown her and that relationship continued after birth. It has given me calm and patience and love. It has greatly helped my mental health as a new mother.

I've read both Oster's books and enjoyed he approach. Much like the OP I'd found thr claims for breastfeeding benefits rather over-blown to say the least. So I was pleased to see someone review the evidence in the way I would have if time allowed. My take from all this is that it's appalling that these state funded organisations make these pronouncements to attempt to influence our behaviour without proper attention to what negative effectives they might inadvertently cause. Here we talk about pressure on women to breastfeed and resulting depression etc...... which I don't want to get bogged down in as its done to death. But the advice to never wean a baby before 6 months looks likely to increased the instance of nut allergies is one example that stands out to me. Despite increasing evidence suggesting a link, the NHS has yet to change it's guidance. It makes you wonder what other NHS guidance is dubious. SIDS risk and having the baby in your room for 6 months is another bit of guidance where I don't think the data justifies the message.

I think people who end up FF against their wishes are the ones who get shouty and defensive on these threads

I actually think the more defensive group is mothers who breastfed who are outraged at having their superiority challenged

I actually think the more defensive group is mothers who breastfed who are outraged at having their superiority challenged

Absolutely this.

Reading this thread, i think some of the breastfeeding mummies are under the impression that formula fed babies are all poor filthy urchins who are dressed in sacks and left in a drawer all day

@DomesticatedZombie I read the full paper. It doesn’t control for many factors that affect obesity. So you can’t rely on the conclusions.

@RedRobyn2021 but you don’t know the counterfactual. If you hadn’t breastfed you may have felt exactly the same about your daughter. You just attribute it to breastfeeding.

@Caneparrot Breast is best. Mixed feeding is fine. Exclusively FF is not equal to BF no matter how many studies you do what are you basing that on?

Yes some women definitely thInk that the breast is best message means they are superior to those who FF. So stupid.

God, its a while since there has been a proper BF vs FF bun fight on Mumsnet - I'm here for it!