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.

@rainbowninja yes I’m looking forward to getting into the research in microbiome.

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

Defensive, possibly yes. I had “breast is best” evangelical infant feeding practitioners push me to keep pumping breasts that produced next to nothing to try and sustain a week old baby still passing bright orange urates and losing weight. This was the second time around having had the same issues with the first. They didn’t listen.

There's a thousand reasons why it is best for some women to use a formula feed. This is 100% fine ✅
It's also just beyond painfully obvious that for ANY species of mammal the optimal situation that it happens between mother and child/baby/offspring of the same species. It's the ultimate designer product, made by nature.
I just can't be arsed arguing and everyone should 100% do whatever they want with their babies.
But please, don't talk shite.

@MadameDragon

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.

This

@CorneliusVetch

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

Defensive of what? Having breastfed? Nobody has ever shamed me or made me feel bad about breastfeeding. Whereas women who give formula ARE made to feel bad by some people, but I think on these threads offence is taken where it’s not intended. Someone upthread suggested there is an self directed disappointment and judgement which is bigger than external comments which perhaps amplify what other people do (I.e. minor comments become severe criticisms of switching to FF). I have friends who FF confidently and exclusively from the outset because they wanted to (no other reason, not tonnes of research, just wanted to) and they have never talked about people judging them or being rude about the way they feed their babies.

I repeat I couldn’t care less how anyone else feeds their baby but breast is definitely best, formula is a great substitute.

@Theluggage15

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

Well, I wouldn't worry about that. The vast majority of mums in the UK FF so if you have a lot of company! Ihave never encountered this superiority though (have fed babies both ways).

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!

Maybe because it’s hilariously inaccurate??
There is absolutely zero link between being formula fed and a baby lying on its back all day and having a flat head.
Or are you making the ‘obvious’ conclusion that mothers who formula feed don’t love their child as much as those who BF and so of course they are just cast aside and left lying alone?

When people state "breast is best" what metrics are they using? Because ultimately isn't this the confusion? I want to know what are the better outcomes I can expect if I breast feed? But I suspect what people really mean is something intangible. Along the lines of, it's fulfilling my role as a woman. It's what a proper does. Or something similar. So people chanting breast is best over and over again are never going to be convinced by some Harvard economist reviewing a load of data. There's very little common ground. But I maintain, the NHS should only be giving out health advise where it's based on hard data not on ideology.

Breast isn't "best" it is a normal way to feed babies. It is free, it can be painful, it can cause embarrassing stains on your tops, it can be an amazing feeling, it can make you ill (4 bouts of mastitis while I fed my 3), it can be really boring, I got really good at plants Vs zombies during hours of night feeds, it can make other people uncomfortable, it can make your nipples bleed, it can feed your babies and give comfort at the same time, it can be impossible for some, but mostly it is just milk designed by nature to feed human young. Not magic.

@Uttoxerley

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

Defensive, possibly yes. I had “breast is best” evangelical infant feeding practitioners push me to keep pumping breasts that produced next to nothing to try and sustain a week old baby still passing bright orange urates and losing weight. This was the second time around having had the same issues with the first. They didn’t listen.

That's completely understandable. However, there are plenty of breast feeding mums of newborns who have formula "pushed" onto them because feeding is going as it "should" and convincing the mum to give formula solves the immediate feeding issue quickly and easily.

@Franca123

When people state "breast is best" what metrics are they using? Because ultimately isn't this the confusion? I want to know what are the better outcomes I can expect if I breast feed? But I suspect what people really mean is something intangible. Along the lines of, it's fulfilling my role as a woman. It's what a proper does. Or something similar. So people chanting breast is best over and over again are never going to be convinced by some Harvard economist reviewing a load of data. There's very little common ground. But I maintain, the NHS should only be giving out health advise where it's based on hard data not on ideology.

This is what I don’t get. So many people on this thread just keep saying breast is best. They firmly believe it and that’s fine but what is it based on?

@IamOvercome

“@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?”

It has been discussed multiple times upthread re gut microbiome and also benefits of colostrum and breast milk in prem and newborn babies. We have also discussed it not being equal in terms of environmental impact which is not to be sniffed at. You sound like you’re keen to give BF a go so definitely do, and don’t stress about whether FF is equal or superior (it’s not). DOI doctor with neonatal care experience

@luxxlisbon

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!

Maybe because it’s hilariously inaccurate??
There is absolutely zero link between being formula fed and a baby lying on its back all day and having a flat head.
Or are you making the ‘obvious’ conclusion that mothers who formula feed don’t love their child as much as those who BF and so of course they are just cast aside and left lying alone?

I think that poster got it confused. Breastfeeding in certain positions (side lying / feeding the baby tummy to tummy) can prevent flat head syndrome. But it’s def not linked to formula feeding. But I suppose it’s an excellent example of making the research fit your opinion which is, incidentally, what Oster did

I breast fed @Teastheword and then did mixed feeding. And my babies are in their early twenties. And some of the superiority is demonstrated on this thread and on every other breastfeeding thread.

The colostrum always strikes me as an evolutionary overhang like an appendix. We needed it further back in the evolutionary tree but we don't now. The human immune system is built in the womb where it passes across the placenta. The micribiome stuff is something of nothing last time I looked into it. But that was a couple of years ago now.

@FlemCandango

Breast isn't "best" it is a normal way to feed babies. It is free, it can be painful, it can cause embarrassing stains on your tops, it can be an amazing feeling, it can make you ill (4 bouts of mastitis while I fed my 3), it can be really boring, I got really good at plants Vs zombies during hours of night feeds, it can make other people uncomfortable, it can make your nipples bleed, it can feed your babies and give comfort at the same time, it can be impossible for some, but mostly it is just milk designed by nature to feed human young. Not magic.

I agree. Feeding a human baby human milk is normal. Natural. In an ideal world all mums would be able to try it for a while to see how it goes. This idea that ff is superior to bf just because it’s measurable is ridiculous. Arguments like this is exactly why it tends to be the older / wealthy/ educated women who tend to bf - because they can often unpin the bullshit around bf in a way others just can’t.

I hope the U.K. and the US are lumped together in this research. The US’s lack of maternity leave and lack of support for breastfeeding mothers is an absolute disgrace.

It's based the fact that on a blue whale mother's milk is best for a blue whale calf. A mare's milk is best for a foal. A cat's milk is best for a kitten. And so on. A cow's milk can be adapted to suit a human baby, as we know, and goat's milk works well for some babies too.
But it's headbangingly obvious that a human's milk is always going to just be more suited.

@Franca123

The colostrum always strikes me as an evolutionary overhang like an appendix. We needed it further back in the evolutionary tree but we don't now. The human immune system is built in the womb where it passes across the placenta. The micribiome stuff is something of nothing last time I looked into it. But that was a couple of years ago now.

The latest research suggests bf is associated with lower levels of obesity because of gut biome. The research is fascinating

[quote Caneparrot]@IamOvercome

“@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?”

It has been discussed multiple times upthread re gut microbiome and also benefits of colostrum and breast milk in prem and newborn babies. We have also discussed it not being equal in terms of environmental impact which is not to be sniffed at. You sound like you’re keen to give BF a go so definitely do, and don’t stress about whether FF is equal or superior (it’s not). DOI doctor with neonatal care experience [/quote]
There is clear evidence of benefits of breastfeeding for premature babies but a lot less clear for term babies. Research on gut microbiome seems to be very new - is it conclusive and peer reviewed?

Environmental impact isn’t for baby so I wouldn’t include that.

@Summerfun54321

I hope the U.K. and the US are lumped together in this research. The US’s lack of maternity leave and lack of support for breastfeeding mothers is an absolute disgrace.

I agree, yet the US somehow has higher rates of breastfeeding than the UK and Ireland, which have the lowest rates of breastfeeding in the world.

www.britishscienceassociation.org/news/breastfeeding-rates-in-uk-are-the-lowest-in-the-world

Environmental impact isn’t for baby - so, who's it for? Which world is your baby going to be born into?

Anecdotally, I bf until all my babies until they were 1 and they seemed to pick up fewer bugs as babies than many of their peers and they are still very rarely ill as older children. I have no actual evidence to back this up though. It was handy not having periods for a while and convenient. But I wish more midwives were realistic when talking about how natural bf was. The first weeks each time were absolute hell. Toe-curling pain, mastitis and feeding every hour all day and night. The exhaustion sent me to the brink. How this can be good for mother or baby is beyond me and when I look back, I wish I'd felt more able to do my what I felt was right for me and the babies, not what I felt others wanted me to do.

@Theluggage15

I breast fed *@Teastheword* and then did mixed feeding. And my babies are in their early twenties. And some of the superiority is demonstrated on this thread and on every other breastfeeding thread.

Could you give some actual examples of breast feeding mums' having a superior attitude?

@DomesticatedZombie

Environmental impact isn’t for baby - so, who's it for? Which world is your baby going to be born into?

@DomesticatedZombie in terms of babies health. Which is lauded as why women should breastfeed. The environmental impacts or benefits to mother don’t have anything to do with the health benefits to the baby.