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.

@TheKeatingFive

I did an NHS feeding class at the hospital, a feeding class at NCT and discussed feeding with several midwives and the health visitor. It was confirmed by all of them

I've done consumer research on this for a formula company and in real life, this advice is followed by virtually no one. Making up for later refrigerating is how basically everyone does it, unless they have a perfect prep or ignore the guidelines entirely.

This is totally true, but in my experience what people do is often different from the official guidance. Which in cases like this is often simply impractical.

I think that's an important element with a lot of these decisions around data. There may be some benefit or risk, but there are also other things to weigh. We all accept risk, and if we think we aren't, we are probably just refusing to look at our decisions honestly. So there is likely less chance of issues if you make up formula right when you use it, but for most people that does not outweigh the fact that they need to drop off made up bottles with the sitter.

The same with foods the mum eats, having a beer, whatever. Yes, they are a risk, but how do they compare with going for a bike or car ride, or taking a holiday in Mexico, or other things we do for health or enjoyment and don't worry about?

[quote EarlGreywithLemon]@Bizawit I take plenty of responsibility thank you- hence why I looked into EO’s claims very carefully and decided they are “wishful thinking” (I’m being polite).

For what it’s worth, EO doesn’t give examples from any of the studies she cites either- we have just her word for them, unless we look them up. Anyone can also look up the scientist and her database. And I’ll say it again- EO also offers no indication f what she means by one drink a day, which can span anything from a glass of fortified wine , or half a bottle of wine, to a glass of shandy.

I’m not sure there’s much point continuing this discussion to be honest, especially as it’s derailing away from breastfeeding. I can’t convince you, you can’t convince me, and we’re just going round in circles.[/quote]
But EO cites studies - which are readily available. I had not heard about this scientist or her database before. Is the data publicly available? I’m very interested and will look it up,
So thank you for that information.

EO provides no details on what she means by one drink a day when she makes that specific statement , but I think her meaning can readily be inferred from the context , using basic common sense . Her book is conversational in style and not intended to offer specific medical advice!
On the other hand if a scientist is trying to provide solid evidence that drinking “one drink a day” can cause FAS they really do need to define what they mean by one drink a day.

Anyways , sure , happy to drop this, to avoid derailing the thread further. I have certainly learned something new from this conversation , that I’m interested in looking into further. So thanks for that.

In terms of us persuading each other of anything , to clarify I wasn’t trying to persuade anyone that drinking alcohol in pregnancy is or isn’t harmful, only that the claims in EO’s book (imv) weren't irresponsible, bizarre, false or unreasonable based on the evidence we have.

This is the last bit I'll say: the scientist replied to EO's "one drink a day" claim so used the same terminology. She's also not the only one who believes this to be the case - hence the current NHS advice is that there is no safe limit for alcohol consumption in pregnancy.
I'm afraid I do think EO's book does make some bizarre and irresponsible statements I'm afraid. Also my opinion. But let's agree to disagree at this point I think.

So you think it's the same re highly processed food Vs organic. Obviously and scientifically human milk which contains antibodies is healthier than highly processed milk from another mammal for a human baby. Also bm adapts itself if the mother is ill, so for example if I have a virus the body recognises this and adapts itself.
It's such a bizarre thread to start . You are aware that the vast , vast majority of women formula feed? You'll be in very good company op. Im in Ireland and pretty much no one bfs anymore, we have one of the lowest rates in the world.

Formula has been around for only 50 years or so , very much in it's infancy. Even if it has minimal benefits which I don't believe, it is a lot better for the environment , accessible ( think about how the world is now , supply change, unknowns, accessibility to use for a newborn if you can't get formula) and free.

@Owieeee

Formula has been around for only 50 years or so , very much in it's infancy. Even if it has minimal benefits which I don't believe, it is a lot better for the environment , accessible ( think about how the world is now , supply change, unknowns, accessibility to use for a newborn if you can't get formula) and free.

It was invented in 1865. 🤷‍♀️

I always detect a big fear of impending motherhood in these threads...

Formula has been around for only 50 years or so

Formula was not invented in the 1970s 😂

@ZoeCM

If there are only minimal benefits to breastfeeding, why does the NHS recommend that even smokers' breastmilk is better than formula? The NHS isn't exactly pro-smoking when it comes to babies!

Smoking around a baby is (I think) the biggest risk factor for SIDS. Since breastfeeding is understood to be a protective factor for SIDS (or not breastfeeding another slight risk for SIDS - whichever way you prefer to look at it) , the NHS recommend that smokers breastfeed if they can. But yes, it's certainly agreed to be a 'benefit' of breastfeeding, although there is still debate as to why that is.

EO excludes studies that don’t agree with her narrative on the basis that the studies are flawed yet includes plenty of flawed studies that agree with her narrative. She cherry picks studies. I would trust systemic reviews compiled by experts in their field.

If you have a partner and family around then FF is much easier. Most of my friends who FF didn’t do any of the night feeds for the first week and so were able to fully recover from giving birth. After that they shared the night feeds. I think that is the real benefit of FF.

It was invented but only used on a widespread basis since the 1960's/70's, it was more evaporated powder substitutes before. So bizarre that ppl are adement in posting how the benefits of bf are overstated, look around you and the evidence in the UK and Ireland ; it's a tiny proportion of mothers who bf anyway. Formula is the dominate way to feed a baby.

I read a study (I wish I could remember the details) that concludes that where parents expressed an intention to breastfeed while pregnant but had been unable to or chosen not to afterwards the outcome for the babies wasn't statistically different at all from those who did breastfeed their babies - which shows up the influence of socioeconomic factors so clearly.

I did an NHS feeding class at the hospital, a feeding class at NCT and discussed feeding with several midwives and the health visitor. It was confirmed by all of them: I’m afraid the advice really has changed - recently. Not all NHS pages are regularly updated unfortunately.

Highly unlikely that education for midwives, feeding specialists etc has all been updated and they haven’t bothered to update the nhs guidance on the website.

You know they currently make and store formula in the fridge in maternity wards and children’s ward?
If it was at all not advised that would be the one place to stick to the guidance.

I can't imagine how a custom made diet especially for your baby for the exact developmental stage - changing daily isn't of more benefit than a processed diet made from the milk of another species.

Formula is a good alternative but how can it be better? (As long as there are no other issues).

But it is only a part of it. Their diet after they wean will also play a part.

I breastfed mine and I'm happy about it but I wouldn't have been worried if I couldn't. In the same way that I would rather my kids eat fresh veg and fish etc every day but they also have processed food and they're fine.

In terms of intelligence

Formula is the dominate way to feed a baby

Has been for a long time. Breast feeding almost died out in the 50s according to my mum.

Do you think that's a good thing @Blossomtoes. Also if it's "almost died out" why are people stating how much pressure they are under to bf if hardly anyone does anyway? Op why do you think these health bodies insist on giving information that it's healthier when you know human milk isn't anyway healthier or minimally anyway than processed cow derived formula? What are the actual ingredients in formula?? What's in it exactly?

@Owieeee

Do you think that's a good thing *@Blossomtoes*. Also if it's "almost died out" why are people stating how much pressure they are under to bf if hardly anyone does anyway? Op why do you think these health bodies insist on giving information that it's healthier when you know human milk isn't anyway healthier or minimally anyway than processed cow derived formula? What are the actual ingredients in formula?? What's in it exactly?

We’re not living in the 1950s, which is the time my mum was talking about. 🤷‍♀️

The issue with evidence relating to women's health and associated areas is the research tends to be very poor.
It is very hard to find robust research which produces tangible evidence.
So as with all evidence it is only as good as the research which is notoriously poor in this field.

The trouble is, the 'benefits' of BFing get regularly trotted out by every HCP in sight and loads of advertising to try and get mums to do it. And to keep struggling thru challenges and keep on doing it. The BFing support group I went to mostly seemed to exist so the mums could egg each other on because the benefits were so worth it. No HCP would even discuss formula.

Yet BFing when you have problems like low supply is utterly miserable and soul-destroying. When you wake in the early hours knowing your entire day and into the next night is going to be full of innumerable BFs and you'll loathe every single one. When you haven't bonded with your baby because you're BFing her and you hate it. When BFing has given you PND. That's when ridiculously tiny 'benefits' like the possibility of maybe one less cold per year for her really don't seem worth putting yourself thru that.

As a woman, can't I demand that advise from a government funded health service, be based on high quality data. And if it's not based on high quality data, shouldn't that be explained to me? Why is this not a given?

If you have to go to such great lengths to justify drinking alcohol during pregnancy then you have a problem with alcohol.
Also, breastfeeding is the default setting for all mammals. Without it there would be no mammals. No amount of research can change this statistic. It would be interesting to see how much actual parenting the economist does and how much the hired childcare does. Judging by how much time she has on her hands to research her book I suspect her nanny is quite involved.

I don’t think anyone has said formula feeding is better for nutrition? I’m not sure why people are spouting this. The argument was that is only minimally different - definitely not better. Feeding a child with milk, whether it’s formula/breast/or cow later on is such a small time in the child’s life. So just do what’s best for you and stop making mothers feel guilty for how they feed their child at this stage - breast or bottle. How they are fed from 1yr until they can provide food for themselves is surely the bigger issue.

If you have to go to such great lengths to justify drinking alcohol during pregnancy then you have a problem with alcohol.

I'm not sure why assessing the data equates to going to 'great lengths'. Isn't it important to understand what's actually going on?

Smoking around a baby is (I think) the biggest risk factor for SIDS. Since breastfeeding is understood to be a protective factor for SIDS (or not breastfeeding another slight risk for SIDS - whichever way you prefer to look at it) , the NHS recommend that smokers breastfeed if they can. But yes, it's certainly agreed to be a 'benefit' of breastfeeding, although there is still debate as to why that is.

I think that for most mums, a reduction in SIDS would be a MASSIVE benefit. The death of a child is most parents' worst nightmare.

Not sure why people keep banging on about what happens in the animal kingdom and it being a justification of why it’s the ideal for humans. There are a lot of things that aren’t pleasant that happen in the animal kingdom, that as a woman, I wouldn’t be so keen to happen to me. We are humans and we have social structure and technology so why can’t we use all options available that are best for us. Nobody here has slated breastfeeding that I can see, so why the vitriol?