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.

I haven't read the book but it's always easy to find research that supports your narrative on any contentious subject. She wants to sell books and so of course she tells people what they want to hear and presents the evidence that supports that.

You feed however you want, but there is very limited research into breastfeeding because it isn’t ethical. I’m pretty certain she states that more research is needed in her book?

@Nsmum14 I couldn't agree more.

@Nsmum14

That quote,

breastfeeding is only cheaper if we don't value women's time.

What an ugly view of motherhood, and of life generally. As if when feeding / nurturing her baby, a woman is making a bad use of her time.

I have a PhD, I don't in any way consider the hours I spent studying better than the ones I've spent nursing my babies. I have travelled and read and worked for different organisations. None of that felt more important than breastfeeding.

I'm sure many women who have
nursed feel similarly.

sounds more like an accurate view of life in a capitalist country to me, time is money and the majority dont have the luxury of choosing how they spend their time, out of necessity to keep a roof overhead and food on the table.

when my mother had me, maternity leave was maximum 2 weeks.

Absolutely op. All the breastfeeding dogma and pressure on women really turned me off the NHS and made me question medical claims much more. I think given the cost to women and guilt and depression many face from not being able to breastfeed, it’s really a feminist issue too.

As you say little to no evidence breastfeeding makes any difference at all.

There is always an expert or, 300 hundred of them, advising people how to deal with feeding a baby,(what to feed, how to feed, and when to feed etc) It would be so awful, to have to have a conversation with some of these experts..

Breast-fed babies do experience fewer allergic reactions, fewer gastrointestinal disorders and fewer ear infections in the early days. There are also benefits for moms in terms of a lower risk for breast cancer

So she acknowledges that BF is advantageous early on, but then claims there are no future benefits. Definitely nothing to do with the fact that she stopped BFing… As a PP said, her “research” and data extrapolation is heavily biased to support whatever her (completely non medical) opinions are

It’s not about finding research that supports her view it’s about showing how outrageously flawed a lot of the research is and how the conclusions are not valid.

If someone came into my university/ workplace with a paper on how caffeine causes miscarriage but didn’t control for sickness which is correlated with high HCG and thus healthier pregnancies or a study on the benefits of breastfeeding v formula that didn’t match on familial charactierierics they would be laughed out of the room and absolutely slaughtered for presenting such flawed results yet somehow much of it has been accepted into mainstream.

@Derbee

Breast-fed babies do experience fewer allergic reactions, fewer gastrointestinal disorders and fewer ear infections in the early days. There are also benefits for moms in terms of a lower risk for breast cancer

So she acknowledges that BF is advantageous early on, but then claims there are no future benefits. Definitely nothing to do with the fact that she stopped BFing… As a PP said, her “research” and data extrapolation is heavily biased to support whatever her (completely non medical) opinions are

Did you look at the actual studies she discusses? The omitted variable bias is outrageous.

@Fairyliz

Ok so I’m really shallow, but does she mention anything about the fact that if you have huge babies like me that are constantly feeding they suck off so many calories you are back to pre pregnancy weight in three weeks? (Ducks and runs for the hills)

Anecdotal evidence should never form part of policy recommendations.

Bottle-feeding involves both arms - one to hold the bottle, one to hold the baby.

Breast feeding only requires one arm, to hold the baby. Leaving the other arm free to hold a book, type one-handed, snack etc etc.

You can take a breast fed baby into a lecture, knowing that if they start to whinge you can just plug them on for instant silence, while you continue to take notes.

Breast fed babies are staring straight at your breast, so you don't need to make eye-contact or interact with them. Which lets you concentrate on good books or crap TV.

I don't think I'd have got my degree if I had bottle-fed.

@SnowdropViolet

Bottle-feeding involves both arms - one to hold the bottle, one to hold the baby.

Breast feeding only requires one arm, to hold the baby. Leaving the other arm free to hold a book, type one-handed, snack etc etc.

You can take a breast fed baby into a lecture, knowing that if they start to whinge you can just plug them on for instant silence, while you continue to take notes.

Breast fed babies are staring straight at your breast, so you don't need to make eye-contact or interact with them. Which lets you concentrate on good books or crap TV.

I don't think I'd have got my degree if I had bottle-fed.

Again that’s a benefit to you not the baby.

@Hankunamatata could not agree more. It has all become so polarised. I believed the same with my first.
Was no way I was going through the trauma a second time so mixed fed from the start. Best of both worlds. Handy when you stayed out longer than expected as no running out of milk but meant no screaming baby while I walked eldest two miles to school. Nice relaxed feed later.
Also agree with the comment about valuing women's time. I know few people who went to such lengths for babies two and three as they simply couldn't be attached 12 hours a day.
Yes there are some benefits that aren't immediately measurable but they are not so significant that any woman should be left feeling a failure

I wonder if her family is anything to do with the makers of Ostermilk, which was one of main manufacturers of baby milk from the 1920s to the 1960s?

I think for the baby there are similar benefits that are difficult to capture and measure. You can see how instantly soothed babies are at the breast (most of the time haha!). How much they like breast milk. How peaceful it is for them. Toddlers also can often show or tell you more directly what it means to them. I don't want to talk too much about the IME very powerful bonding and emotional security (again instantly available when needed- invaluable IME on rough days for example) that are part of BF because it is so often taken as FF bashing or something. That's not how I intend it at all, but equally that doesn't mean that it's not the case that it means a lot to a baby

I am due in June and I want to breastfeed but I want a plan B in place that I am comfortable with and in control of, in case I can't for any reason.

My midwife will not engage in that conversation with me. If I struggle to breastfeed, she thinks plan B is that she'll come to my house every day until I have got it right.

That is not a plan B that I feel comfortable with and in control of.
My personality is one where I like to have everything planned as far as possible and where I am not reliant on other people to help me enact those plans.

I like my midwife well enough and breastfeeding remains my first option, but I do desperately wish she would just let me talk about my back up.

My back up, quite simply, is that if my baby hasn't fed properly within a suitable time frame, I will put her onto Aptimil. I have already purchased the emergency formula and 6 bottles. Hopefully, I'll be able to donate it to the Foodbank, and the breastfeeding will go amazingly but I just want to be prepared. Why is talking about these preparations such a taboo thing?

I think there is minimal research which equals minimal evidence as with many ‘women’s issues’. But you’re right, considering the evidence there is, the conclusions drawn by health professionals is surprising.

I loved her books. So good and a breath of fresh air compared to paternalistic NHS. I bf mine and would again if I could but I appreciated the evidenced based approach. It’s I recall the problem is that middle class mums are more likely to breastfeed and therefore bf benefits get conflated with other things like reading, nutrition, parental education. It’s obviously very hard/unethical to have a blind study, random allocation etc.
So overall the evidence for the benefits of bf are weak in a quantitative sense. Qualitatively, there are many benefits if it works well (as various people have attested to upthread). If it’s going wrong and mum is depressed and sleep deprived it may not be worth it. I don’t think that’s particularly controversial.

I think alot of the benefits of breastfeeding are hard to measure and also there's no financial gain to proving the benefits of breastfeeding.

Sure @IamOvercome but then it sounds like she's pointing out that there are a few bad studies (I haven't read the book but the caffeine one has been mentioned twice here)? That doesn't discount all the decent studies that do look at confounding factors, meta analyses, etc.

@sevensleeps

I think for the baby there are similar benefits that are difficult to capture and measure. You can see how instantly soothed babies are at the breast (most of the time haha!). How much they like breast milk. How peaceful it is for them. Toddlers also can often show or tell you more directly what it means to them. I don't want to talk too much about the IME very powerful bonding and emotional security (again instantly available when needed- invaluable IME on rough days for example) that are part of BF because it is so often taken as FF bashing or something. That's not how I intend it at all, but equally that doesn't mean that it's not the case that it means a lot to a baby

Have you comparatively fed a sibling formula though ? Without that how can you know the breastfed baby is more peaceful than formula fed baby whilst controlling for all other factors?

@Derbee

Breast-fed babies do experience fewer allergic reactions, fewer gastrointestinal disorders and fewer ear infections in the early days. There are also benefits for moms in terms of a lower risk for breast cancer

So she acknowledges that BF is advantageous early on, but then claims there are no future benefits. Definitely nothing to do with the fact that she stopped BFing… As a PP said, her “research” and data extrapolation is heavily biased to support whatever her (completely non medical) opinions are

She is commenting on existing research, not providing her own - there are sibling studies which suggest that the advantages shown by most breastfeeding studies amount to correlation rather than causation, as socio-economic factors massively affect how likely a women is to breastfeed. There are studies which say this, she is not extrapolating anything.

Same with not introducing babies to bottle to confuse them when breastfeeding. Literally no concrete evidence for it.

Anecdotally my experience with this is correct. Once bf was established well, I introduced a bottle at 2 & 3 weeks respectively because I was going back to work after 4 months. Neither of my babies, nor any other babies where a bottle/pacifier was introduced early had any nipple confusion.
Started with 1 feed a day from the bottle, then built up from there.

The bigger issues came when parents would try and give a baby a bottle for the first time at 6 months and baby would refuse.

As far as I can tell, the earlier you introduce a bottle (once baby is gaining weight etc), the easier it is - babies learn pretty quickly to adapt their latch to either.

I read similar when I was pregnant OP. As well as going through forums of breastfeeding mums. The amount of stories I read from mothers who really, really struggled and felt like failures despite being in horrendous pain was shocking. I promised myself then that I'd give it a good go but if for whatever reason it didn't work out or I didn't want to continue, that was that and I'd use formula. Those experiences weren't enough persevering through for such a small advantage.

Why are so many people so desperate to "prove" that there is no benefit to breastfeeding?