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.

@Iamovercome

I'm not suggesting that my experience of breastfeeding wasn't primarily for my own benefit. It puzzles me that there is so much focus on the benefits to the baby and so little advice of the "breastfeeding is great if you can't be arsed with the faff of sterilising bottles" variety.

I think it may be a feminist issue - women conditioned into not considering their own needs. At the end if the day, if a baby is warm, fed and loved, the actual mechanics of feeding are secondary. But for me, breast feeding was brilliant - I could do the night feeds without switching a light on, and get straight back to sleep afterwards. I didn't have to pack bottles etc for a day out. I could, and did, feed anywhere. My periods didn't come back for over a year, which was a major win!

@sevensleeps totally agree with this.

I had a nightmare with my eldest and weight gain. I was under so much pressure to formula feed and no one listened to me when I said it made him sick. It was awful until he was finally diagnosed with CMPA at 16 weeks. I'm so grateful to the support I had to keep breastmilk in his diet as that didn't make him sick.

With my second, the idea of giving her formula terrified me in case she was also allergic. For my mental health EBF was soooooooooooooooooooo much better.

@sevensleeps I also found sterilising bottles stressful, time consuming and tiring so tried expressing just twice and gave up. I was lucky that breastfeeding was easy for us.
So I don’t see formula feeding as “taking the easy way out” - not at all. I think it’s harder work than breastfeeding IF the breastfeeding works well. So no judgement here on how people feed their child - but claiming breastfeeding is hard and time consuming and formula feeding is not is missleading.

@sevensleeps - the point was to explain the saying about womens time being worth something. If you wanted to spend time breastfeeding and you think it was good for your mental health, go you! But it’s not free and it’s not for everyone.

@Villagewaspbyke

Also something that concerns me is the nonsense that if a baby is breastfed it must be “getting all it needs”. Clearly that not true. Breastfed babies can be dehydrated or hungry like any other babies (and indeed as it’s more difficult to see what they have had, probably it’s more likely)

That's not what that means. It means that breastmilk contains all the fluid and nutrients a baby needs. But obviously not if you don't feed it often enough!

Of course It is not more likely that breastfed babies are routinely more hungry and thirsty than bottle fed babies! Yes you can more easily measure how much a milk bottle baby has had, but what does that actually tell you?

if you don’t want to breastfeed you don’t have to. you don’t have to convince yourself it’s just as good for baby to formula feed as it is to breastfeed - breast IS best, but you don’t need a book saying it isn’t to make you feel better about your choice. just do whatever you want with your baby.

@Villagewaspbyke but formula feeding also takes time!

I presume that book weighs up a range of factors to come to that conclusion and is rather biased to what the author thinks is important.

There should be no shame in however a woman wants to feed her baby but let’s not use false ‘facts’ to justify not breastfeeding. Amongst other things breastfeeding is proven to reduce the risk of SIDS by half which is quite a significant amount. www.lullabytrust.org.uk/safer-sleep-advice/breastfeeding/

@Maray1967

Makes sense to me. Ideally you’d breastfeed but I don’t have any concerns that it didn’t work out for me. What you eat in pregnancy and how you wean baby matter far more. There ought to be health benefits but there are significant downsides and if mums are exhausted then it’s not going to go well. There are a lot of posts on here about babies feeding through the night well past 6 months - I’m just incredulous. How on earth can you function normally ?

I could "function normally" as it's normal to breastfeed well past six months.

Who are the pool of people being researched for this? I thought it was common knowledge that pregnancy/newborn baby research is crap because so few people want to actually take part. All here raise your hands if you agreed to intrusive and continuous investigations of your child for the purpose of scientific research, anyone?!

@Twizbe in my case, the pressure to breastfeed was from the NHS, NCT and general society. Same for most of my friends

@Babdoc

The real benefits of breast feeding only apply in the third world, where formula is made up with dirty water from unchlorinated sources, causing diarrhoea and deaths in infants. Here in the UK, it makes damn all difference, and as a doctor I am delighted that a credible statistician has finally published this. Perhaps we can now see the end of poor depressed mothers beating themselves up for “failing” to breast feed. A mafia of midwives and breast feeding mothers has controlled the narrative for far too long, to the detriment of women. Feed your baby by whatever method best suits you, secure in the knowledge that your way is as good as any other. And don’t let anyone guilt trip or pressure you.

I think I love you

@EarlGreywithLemon yes but often less time (especially if someone is struggling to breastfeed) and it doesn’t have to be the mother who does it all the time so she can rest.

What a load of nonsense, OP.

If you don’t want to breastfeed then don’t. That’s okay. But don’t try and feed yourself a load of rubbish to make yourself feel better about not doing so and alleviate your own personal guilt.

I think it also depends on the country. If you are in a country where there aren't means of sterilising bottles properly/storing baby milk powder properly and in date or not enough money to buy enough baby milk then yes, breast is significantly better because the damage to your baby from poor hygiene and not getting enough to eat....
However in the UK and other well developed countries the benefits might be less easy to quantify.

However, anecdotally for me:

PROS:
Cuddly soft squidgy time with baby and watching their little face go sleepy on the breast is beautiful.
Easy when going out - nothing to pack except me!
Quick! In the night can just whip out the breasts.
Financially cheaper
Breastfeeding high! (It was like being all blissed out and wobbly in the head after a feed)

CONS:
Emotionally overwhelming as a first time mum to have to be the sole feeder.
Painful for the first few weeks.
Engorged boobs are a 👎🏽
The gross/outdated/sexist opinions and looks of others.

I didn't put night feeds in there as a con because actually yes, partner can help with this and DH did help by passing me baby and getting me night snacks.

@bigbluebear1

if you don’t want to breastfeed you don’t have to. you don’t have to convince yourself it’s just as good for baby to formula feed as it is to breastfeed - breast IS best, but you don’t need a book saying it isn’t to make you feel better about your choice. just do whatever you want with your baby.

Can you provide me with a peer reviewed study that shows this? One that properly controls for socioeconomic and familial characteristics. Or is it just your opinion @bigbluebear1 ?

I would imagine that breastfeeding is quite bad for the economy on the basis that we can’t be flogged a load of rubbish we may not need in different colours God forbid a baby boy should be given a pink bottle and vice versa.

Obviously other posters are touched on the point that the mother‘s nutrition is going to be paramount. Purely from getting enough hours in the day to make sure my baby actually got fed by the time I got to number three breastfeeding was a lifesaver.

Nipple confusion was disproved years ago. Literally about a decade ago. More even.

@Bananabutter

What a load of nonsense, OP.

If you don’t want to breastfeed then don’t. That’s okay. But don’t try and feed yourself a load of rubbish to make yourself feel better about not doing so and alleviate your own personal guilt.

Again @Bananabutter please provide evidence breast is best?

@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.

I love this

www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/benefits/

it’s right there:

“Breastfeeding has long-term benefits for your baby, lasting right into adulthood.

Any amount of breast milk has a positive effect. The longer you breastfeed, the longer the protection lasts and the greater the benefits.

Breastfeeding can help to reduce your baby's risk of:

infections, with fewer visits to hospital as a result
diarrhoea and vomiting, with fewer visits to hospital as a result
sudden infant death syndrome (SIDS)
obesity
cardiovascular disease in adulthood
Some studies have also found that breastfeeding for at least 6 months may reduce your baby's chance of getting childhood leukaemia.”

but yeah, cow & gate is no different right?

People shouldn't be guilt tripped to breast feed when they are clearly struggling. But this book sounds like an analysis of outcomes, based on cold, hard data. The complexity of child rearing and human relationships cannot simply be measured or reduced to 'successful or unsuccessful outcomes' in the same way that positive human emotions don't have a recipe for success, and how you bond with your child comes into this.

The real criticism should be directed at the whole industry around the promotion and marketing of formula, and the way that society expects women to fit into the demands of work rather than the other way round (ie providing enough time, financial support and opportunity to breast feed, rather than having to resort to formula feeding in order to hold down childcare and a job).

I think what EO understands, which isn't always pointed out, is that in the Western world, especially in the US where she is based, being able to breastfeed beyond the first couple of months hinges on so much other privilege. If you you breastfeed your baby for a year it means that you've been able to take a year at home with your baby, which in turn often means that you've got probably got more money and more support.

Middle class mothers are more likely to breastfeed for a multitude of reasons, which clouded the data about outcomes for a long time.

I really enjoyed Expecting Better in the sense that I felt it was free from judgement. I understand that some parents feel that it undermines their achievement in breastfeeding but I really don't think that is the intention.

@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)

I suspect that falls under "reduced breast cancer risk". Obviously there may be a breast-specific effect to breast feeding, but not going into menopause obese is a big independent reduction in cancer risk.

Having seen how miserable my babies were with D&V when I stopped BF to send them to nursery I don't think any other incentive is needed. Yes it's unlikely to kill them in this country - although it still kills countless thousands of other mothers' much loved babies in the developing world. But halving your risk of such a common, nasty abs sometimes serious condition is well worth doing in my book.

As for the other possible long term benefits? Who knows: it's all but impossible to separate from the confounders.

@Teastheword - seeing how much of a bottle a baby has taken in tells me how much of the liquid in the bottle has been drunk by the baby. It’s difficult to impossible to tell how much an ebf baby has taken in.

Not to say breastfeeding is necessarily bad for a baby unless there is some sign (eg dehydration) that it’s not working. But the idea that breastfed babies are magically getting everything they need is nonsense abs could be dangerous nonsense in the wrong hands.