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.

@NameChange30

"To me, it all reads like a big list of justifications for Emily's own choices!"

Completely agree with this. I read the pregnancy book and found bit of it helpful but I really disliked the idea that it was supposed to be an objective look at the research. It wasn't.

Agree with all of that. It's annoying that people feel like they need to justify how they feed their child though. We're all just mums doing the best we can. It's unnecessary to discredit something just because we can't or don't do something the same way.

[quote dumdumduuuummmmm]@FudgeSundae are you honestly suggesting that if using your leg caused you discomfort for a period of a few months you would amputate that leg and use a prosthetic? Perhaps you didn't think your analogy through. [/quote]
It’s not my analogy! I’m merely pointing out that for those for whom breastfeeding was perfect and natural and lovely and easy, that’s fab. But if you’re going to equate formula use to using a prosthetic leg use them the rest follows.

I love Emily's books - I'm on Cribsheet now - one area I am curious about is sleep training - I'm not as convinced that her conclusions from limited data here were as fair and not just what she wanted to believe. She decides to sleep train her baby from 10 weeks and leaves him to cry it out for 25 mins. I think this is partly cultural and very few British mums would get on board with this

Oster breastfed her children. She’s pointing out that the benefits are minimal.

The studies she uses for alcohol consumption - though valid studies - don't say what she thinks they say. I won't go into it in too much detail so as not to derail the thread, but the Danish study includes preschoolers only, whereas some of the effects of alcoholic consumption in pregnancy won't have shown up by then.

I know you don’t want to derail but what does she say about alcohol? I’ve just finished doing a lit review on teratogens and I was quite shocked by how enormous the impacts of alcohol consumption are (looking at both the biological mechanisms and the outcomes); when I was pregnant it was still considered acceptable to drink a bit during pregnancy - not sure if that is still the case - but after doing that piece of work, no way on earth would I touch booze if I ever got pregnant again.

@ChampagneLassie

I love Emily's books - I'm on Cribsheet now - one area I am curious about is sleep training - I'm not as convinced that her conclusions from limited data here were as fair and not just what she wanted to believe. She decides to sleep train her baby from 10 weeks and leaves him to cry it out for 25 mins. I think this is partly cultural and very few British mums would get on board with this

that's so horrible. my son is 4 months old and I would feel sick listening to him cry for 25 minutes

@ChampagneLassie

I love Emily's books - I'm on Cribsheet now - one area I am curious about is sleep training - I'm not as convinced that her conclusions from limited data here were as fair and not just what she wanted to believe. She decides to sleep train her baby from 10 weeks and leaves him to cry it out for 25 mins. I think this is partly cultural and very few British mums would get on board with this

I don’t understand. You ‘love her books’, but are not convinced by what she says?

25 minutes of crying it out for a 10-week old?

I’m not surprised you’re questioning her. I’m very surprised that you love her books, on the other hand.

Not sure I can respect anyone who leaves a 10week old to cry for 25mins. The poor love.

This entire thread is about a woman who questions whether breastfeeding does actually have any benefits for the baby.

I’m not sure that she has a huge amount of credibility about infants’ best interests, given this latest revelation.

Her books are amazing. I'm only sorry Cribsheet wasn't published until DD was a toddler as I learnt so much from it and it would have dramatically improved my birth, postnatal and first year experience (EBFing made my baby seriously ill, huge pressure to BF, no support for using formula, ended up with severe PND because of all of this).

I love her approach - presents the evidence but doesn't tell you what to do. Wish it was recommended read for everyone antenatally (and some midwives would read it too!).

@Zilla1 you were aware social scientists were part of sage? People aren't machines and to understand them in a health/medical context social sciences are involved.

@NurseBernard but statement is illustrating your cultural beliefs and ethics due to the society you were brought up in.

BTW a PP pointed out Oster breast fed her children.

I love her books too. It sent me mad when I fell pregnant hearing all this seemingly alarmist advice from the NHS. I just couldn't imagine all these claims were true. It was a godsend to read het books and to have all the risks put into perspective. I'd known nothing about breastfeeding before getting pregnant apart from knowing I didn't want to do it. The first thing many friends said to me on learning I was pregnant was how important breastfeeding was. I just thought all their claims were insane. I'm so glad her books exist and always recommend them to pregnant friends. I remember one pregnant friend looking panicked at an egg on a dish we were sharing in a restaurant. No woman should be so scared by NHS advise that they have that reaction to an egg ffs. Pregnant women and new mums should be supported not scared witless by busy bodies.

I’m a midwife and appreciate that she offers a critical alternative to some of the scaremongering and cultishness that parents (especially mums) hear. However, she is an economist and not a healthcare provider; as such, I believe she misses both general healthcare knowledge and nuance and presents things in a narrow way. I would trust her on my household budget but not to make decisions regarding my health (or someone else’s)!

remember one pregnant friend looking panicked at an egg on a dish we were sharing in a restaurant

Nobody is advised to avoid eggs in pregnancy. Your friend misunderstanding NHS advice isn’t a ringing endorsement of a non medical individual giving their opinion and their own manipulation of data to support their own theories.

@Floomobal the NHS advice changed about eggs during one of my friends' pregnancies.

You are / we're advised to avoid uncooked eggs unless they had a red lion stamp due to salmonella risk. In a restaurant you don't know if it's red lion stamped or not.

I wonder if she (or the OP and others who love her books) thinks there’s ANY benefits to other baby mammals feeding from their mothers? Or is it all a pointless evolutionary waste of time and they’d all be better off on man made concoctions instead of the milk that has occurred naturally to feed them?

I think it's a good point though, there are loads of books about pregnancy and babies, are they regulated? Is the content checked?

What is wrong at the moment is women are pushed to EBF, without any info about the risks and the downsides, but an awful lot about the benefits, many of which have a dubious evidence-base or are very subjective (eg it being free/cheap, great for bonding, convenient).

I went into EBF expecting it to be an amazing experience that we'd love, that would provide all my baby needed until six months old etc.

The reality was a seriously ill baby admitted to SCBU because my milk didn't come in, even when my milk came in (at 8 weeks!) BFing was always something that felt rather crap and miserable, whereas I enjoyed making up bottles and sharing feeds with DH. Bottle feeding was a lovely bonding experience.

Yeah I loved bottle feeding. No idea why people think it's so faffy. You wash them up and stick them in the steriliser. Takes minutes. We made extra and stuck them in the fridge for overnight. They only night feed for a few weeks so it's hardly a big deal. I think we were on to one dream feed by maybe week 6 if I remember correctly? Plus you can share it. My mother in law looked after our second baby the first night we came home from the hospital so we could catch up on sleep. And if you can't be bothered to store a bottle correctly to take it out, buy pre made and pour into a bottle when needed. There's so many options to make it work if you want to bottle feed. Why make such a fuss about it being so hard. There's a certain technique to slow the bottle down when the baby is first born which is a bit tricky and needs to be taught. But after that any idiot can do it. The family loved feeding our two.

What is wrong at the moment is women are pushed to EBF, without any info about the risks and the downsides, but an awful lot about the benefits, many of which have a dubious evidence-base or are very subjective (eg it being free/cheap, great for bonding, convenient).

@RidingMyBike that is exactly my issue.

Also before I had my own DD I heard horror stories of women who needed emergency surgery and had blood loss but were told they had to breast feed. Others who need medication that was contra-indicated if you breast feed who said they were encouraged by midwives not to take it.

Luckily because I am related to and know children's health care professionals who had their own children, I knew mix feeding was a valid and workable choice.

Yep, I found bottle feeding far more convenient - could share feeds with DH, washing up takes a few extra mins once a day, sterilising is really easy - once a day in a microwave steriliser. Feeds are lovely because you can look into your baby's eyes.

Whereas BFing (I BF to 3.5 years) you have to be there (unless you go thru faff of expressing which doesn't work for all anyway) which isn't my definition of convenient. Have to be wearing something with boob acccess. Can't take anything remotely useful medication-wise eg for a cold (and I had to have a different drug for PND because I was BFing which had worse side effects).

@lifeuphigh her conclusions are:
“ There is no good evidence that light drinking during pregnancy negatively impacts your baby. You should be comfortable with :

• Up to one drink a day in the second and third trimesters.
• One to two drinks a week in the first trimester.
• Speed matters: no vodka shots!
• Heavier drinking could have negative impacts, especially in the range of four or five drinks at a time. This should be avoided.”

These quick links explain my thinking shoot that: depts.washington.edu/fasdpn/pdfs/astley-oster2013.pdf

well.blogs.nytimes.com/2013/08/19/pregnant-and-disputing-the-doctor/?mtrref=www.google.co.uk&gwh=63F549BCFFDAB33E09E120D62676D167&gwt=pay&assetType=PAYWALL
I pasted the NYT link because it discusses her bizarre claim that if you drink slowly enough the fetus is not exposed to alcohol (?!). I’d be very curious to hear your professional opinion about that (whilst hoping not to derail ).

@EarlGreywithLemon I was told by a couple of paediatricians is that they simply don't know. Also as it is unfeasible but more importantly unethical to test this in lab conditions we will never know. (People's measurements of units is completely off.) The main thing is to stop women who don't plan their pregnancies so didn't know they were pregnant until further along from panicking about how much they drunk. No one should be encouraging women to drink during pregnancy, plus if you talk to older women who were told they could have a drink when pregnant lots of them couldn't stand the smell of alcohol.