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.

@Bizawit well you are lucky you had suitable clothes to breast feed in. Btw the clothes I brought were normal clothes and not special, I just don't tend to wear those type of clothes.

Other women I know also needed to buy and use creams for their nipples, breast pads of different kinds and different bras. And that's ignoring the few who needed to pump because they found they produced more milk than what their baby wanted.

I dont know why people say bottle feeding is hard, you wash up the bottles same as any other dishes and plonk them in a bowl of milton.

boil the kettle and mix the milk just like you would make a cup of coffee, then leave it to cool or make half and fill the other half up with cold.

if your really lazy you buy cartons and disposible pre mixed bottles.

the nappies were more of a faff having to take everywhere. but then I still had a smaller bag then anyone else I knew/saw, it was like a little bowling bag or lunch bag, it comfortably held a folding baby mat, 2 nappies, sample mini sudacream jar I refilled, couple of nappy bags, small pack of wipes, small carton of milk, two bottles (always a boots or tesco etc around if I needed more milk), pack of tissues and later on pack of bickiepegs too.

but so far on this thread I have read that apparently FF babies are sickly and stick out like a sore thumb thanks to funny coloured skin, they have misshapen heads, they are fat and their parents are less intelligent and uneducated.

and the BF mums claim they are being put down?, oh please listen to yourselves its just one patronising insult after another.

[quote BertieBotts]This is really well written, and addresses some of the points made here really well.

www.facebook.com/breastfeedinguncovered/posts/3045295695732090[/quote]
Thanks for sharing that, Bertie - I found it really interesting (I clicked through to the article at the bottom), particularly in what it says about the sibling study which is so often touted as the absolute solid proof that breastfeeding does nothing.

My DF, a statistician in the chemical industry, where risk analysis in the design of chemical manufacture is essential, taught us that statistics where to be treated with caution. You can use statistics to support both sides of any argument.

@lifeuphigh

Even with very slow drinking, ethanol builds up in the amniotic fluid.

Extracted from EarlGrey’s previous post. Either way - it sends a rather dangerous message - that if a woman controls her blood alcohol level by slow drinking then she can also control her baby’s alcohol exposure within safe/unsafe parameters.

Come on it’s a straw man . Oster wasn’t saying “drink slowly and no alcohol will reach feotus”. Her point was that mild to moderate levels of alcohol in your blood has not been associated with negative outcomes according to the empirical data. Drinking slowly is one way to help ensure you blood alcohol levels are more likely to stay lower.

I really disagree with this take. There's actually a lot of evidence out there about the benefits of breastfeeding.

It offers comfort to the child and helps to produce a strong bond between mother and child.
The antibodies in the milk help to protect the child from diseases and infections.
It acts as an antibacterial so helps with things like rashes and sore skin.
It's easier on the child's digestive system.
It reduces the risk of SIDS.

Yes, it also has health benefits for the mother, but it actually does alot for the baby.

There is no difference in the bonding between parent and baby with bf or formula if anything the bond with the parents is greater with formula as the father can give an equal number of feeds.

Just to add that it is completely up to each individual what they'd like to do and no-one should make you feel as though you can't do one or the other.

I breastfeed and it has been a challenge, but for the majority of the time I enjoy doing so. However my LO has also had some formula in the form of top ups due to a low milk supply (initially), and I am happy to give him the odd bottle of it here and there.

I have noticed a difference in how my baby reacts between the two (ie reflux and wind afterwards), but every child is different.

Her point was that mild to moderate levels of alcohol in your blood has not been associated with negative outcomes according to the empirical data

Except mild drinking in pregnancy has been associated with negative outcomes according to the empirical data. It's rare but it happens. My point is that it is irresponsible to put out a message that it unequivocally doesn't. And it is also irresponsible to suggest that mothers can control the alcohol reaching the foetus by consuming alcohol slowly (as I said before, I haven't read the book, so I'm not sure if this actually the message she gives). For very obvious reasons there is no data on outcomes associated with specific blood alcohol levels, we can only look at total alcohol intake.

Anyway. Massive thread derailment!

Except mild drinking in pregnancy has been associated with negative outcomes according to the empirical data. It's rare but it happens

Can you cite a source for this?

@lifeuphigh

Her point was that mild to moderate levels of alcohol in your blood has not been associated with negative outcomes according to the empirical data

Except mild drinking in pregnancy has been associated with negative outcomes according to the empirical data. It's rare but it happens. My point is that it is irresponsible to put out a message that it unequivocally doesn't. And it is also irresponsible to suggest that mothers can control the alcohol reaching the foetus by consuming alcohol slowly (as I said before, I haven't read the book, so I'm not sure if this actually the message she gives). For very obvious reasons there is no data on outcomes associated with specific blood alcohol levels, we can only look at total alcohol intake.

Anyway. Massive thread derailment!

But what you state here is not supported by the totality of evidence, is her point. You can dispute her conclusions, but then you need to produce evidence. It’s not irresponsible at all to give grown women accurate information about the risks of drinking based on evidence.

Anyway yes sorry for thread detail!!!

-*derail

@Bizawit and @TheKeatingFive explanation here:
depts.washington.edu/fasdpn/pdfs/astley-oster2013.pdf

So I've gleaned from this thread this economist thinks it is OK to drink in pregnancy if you drink slowly, deliberately left her tiny baby to cry for 25 mins and sees no benefit in breastfeeding. Sounds about right for an economist - knows the price of everything but the value of nothing. I think I'll listen to actual qualified and experienced health professionals, thanks.

@VelvetChairGirl I have no issue with how anyone feeds their baby, I'll just try to explain why I did find bottles a faff:

• making sure you wash them properly and no milk remains
• cleaning the bottle brush
• picking up the bottles from the steriliser without touching them
• where to store them afterwards (and how long for) so they remain sterile
• taking pre made formula bottles out with you if you go out - how long do they last until they "go off"

I only pumped, didn't make up formula, but that would add the following faff: making up a bottle every time the baby is hungry and allowing it to cool down. - including in the middle of the night. So no, I don't think formula is at all the easy way out!

[quote EarlGreywithLemon]**@Bizawit* and @TheKeatingFive* explanation here:
depts.washington.edu/fasdpn/pdfs/astley-oster2013.pdf[/quote]
Thanks for sharing.

Absolutely evidence is limited, I don’t think anyone would dispute that; no one can guarantee that drinking in pregnancy is always 100% safe. Different scientists may even look at the same piece of evidence and draw different conclusions. None of this makes Oster’s book ‘bizarre’, wrong or irresponsible. The evidence on drinking and pregnancy is disputed, women should have information on both sides of the debate based on evidence and scientific reason.

explanation here

Clearly 'mild' is a broad church, but many people wouldn't see one drink a day as mild. When most people talk about mild they would mean one or two drinks a week. I've personally never seen any data to suggest this is an issue.

There's also the complicating factor that all this data is based on self reported consumption, which is notoriously unreliable.

Talk about over analysing. The boob is meant to feed the baby - pretty obvious using common sense.

If you don’t want to or can’t, then don’t do it - nobody will care.

You should probably bin the statistics and use your own judgement.

Just to add to my PP, the point of Oster’s book is not to provide women definitive answers about what they should or shouldn’t do, but rather to present information about what the evidence is saying about the level of risk.

@Bizawit the problem is though, she isn't a specialist. She doesn't understand the studies any better than you or I do. As the link I posted from the actual specialist shows very clearly.

[quote EarlGreywithLemon]@VelvetChairGirl I have no issue with how anyone feeds their baby, I'll just try to explain why I did find bottles a faff:

• making sure you wash them properly and no milk remains
• cleaning the bottle brush
• picking up the bottles from the steriliser without touching them
• where to store them afterwards (and how long for) so they remain sterile
• taking pre made formula bottles out with you if you go out - how long do they last until they "go off"

I only pumped, didn't make up formula, but that would add the following faff: making up a bottle every time the baby is hungry and allowing it to cool down. - including in the middle of the night. So no, I don't think formula is at all the easy way out![/quote] ah well I used milton, you just wash your hands before getting the bottles out and they stay in it until needed, fresh bucket of milton on the kitchen side every day.

if you had milk remains in the bottles then either you didnt mix them fully or you left them laying around so long it dried in. I think I only had about 4 bottles and two dummies on the go, 2 large bottles and 2 small ones, not counting the two small ones I kept in the bag for outdoor, all my bottles were Philips Avent.

I had a wonderful bottle brush, used it for years after it was the best washing up brush I ever had (avent).

The standard formular cartons in a litre last about a day in the fridge, but I only used the bottles and cartons when out and about I didnt lug a litre around I bought the small ones, 1 small carton filled the large bottle, or the small one twice, but that was SMA (at the time) some of the others where smaller I remember the cow and gate one being the smallest, but my son couldnt drink that one he kept puking up with it, he drank mainly hipp organic and when out and about SMA.

the pre-made bottles that are for very young babies last months, they are completely sealed and shelf stable, you used to be able to buy them in boxes of around 24 in Boots and hospitals always keep a supply of them.

oh and you just need to make half a bottle and leave it a min, then top it up with cold, its just to sterilize the milk powder.

@TheKeatingFive

explanation here

Clearly 'mild' is a broad church, but many people wouldn't see one drink a day as mild. When most people talk about mild they would mean one or two drinks a week. I've personally never seen any data to suggest this is an issue.

There's also the complicating factor that all this data is based on self reported consumption, which is notoriously unreliable.

Oster is very explicit that she endorses one drink a day: *You should be comfortable with :

• Up to one drink a day in the second and third trimesters.*

From her book.

[quote EarlGreywithLemon]@Bizawit the problem is though, she isn't a specialist. She doesn't understand the studies any better than you or I do. As the link I posted from the actual specialist shows very clearly.[/quote]
She’s an economist and she understands data. That’s all she was claiming to talk about.
As someone who works in research myself, I don’t agree with “experts” having exclusive prerogative to forming opinions about matters that affect other peoples lives. The role of experts is to provide transparent information , interpretation and advice, based on scientific research, reason and evidence, so that people can make better informed choices for themselves.

@VelvetChairGirl I'm not in any way arguing how people should feed their babies- let's be clear on this. It's not my place. I'm also being extremely careful here as I know many people want to breastfeed and can't or find it very difficult for a number of reasons- so I don't want to come across as smug.

But to breastfeed I needed nothing: no bottles, steriliser, milton, cartons, anything. No logistics, no planning. So I'm afraid to me that does sound a faff.

I'm now pregnant again and well aware that breastfeeding might not work out or might not be as easy this time. If I have to formula feed then I have to and I'll do it, of course. But I do know it would be a faff compared to the previous time.

I'm also extremely aware that I just struck lucky with DD- she latched well, my milk supply worked, and that was that. No merit, or effort, or work on my part at all. It's a bit like birth - I believe it's sheer luck if you have an easy or tricky one (I had a tricky one). It's a lottery and I feel really guilty saying I got a good ticket on the feeding, and well aware many didn't.