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In Defense of Formula

I must admit I’ve had a lot of trouble approaching this post. So maybe it’s best to just come right to the point: I’m a diehard breast feeder myself, but I dislike the way formula is demonized.

I love nursing, and I’ve really enjoyed that aspect of being a mom. I have not had any trouble with pain, latch, or supply, and I’ve been able to maintain nursing after returning to work by pumping in the supply closet at my job. It’s not the most cozy location, but it allows for privacy. My son was born big, and he’s now grown to a whopping 20 pounds at only five months. I’m proud that I’ve been able to put this weight on him with almost 100% exclusive breast feeding. There were only four times in his life he had formula. Once, in the hospital, he lost almost 10% of his body weight on day three of his life, and our pediatrician insisted in supplementation before my milk came in. And the other times were the result of logistical errors—frozen milk at daycare, Daddy at home, Mommy at work—but now we’ve got our system down and the boy only gets breast milk. I experienced a strange guilt when we had to give formula, and I think this is a negative aspect of the current breast feeding culture.

As wonderful as it is that nursing has come back into vogue, I know friends and relatives who couldn’t hack it because of mastitis, low supply, work schedules, or just feeling plain old oppressed by breast feeding. And you know what? That’s fine. I resent the current stigma against women who use formula, even though I personally have chosen to breast feed. It boils down to almost a pro choice issue for me. I think mothers should choose to feed their babies in the way that is most enjoyable, so that being a mother is a joy. Women who bottle feed tend to speak about it in low tones, as if they’re afraid the breast feeding crazies will overhear. Yet I personally knew few mothers who make it the full year recommended by the AAP.

On an intuitive level, it seems obvious that the best food for baby humans is human milk. But the prevailing sentiment that all women can breast feed, if only given enough “support,” is counterintuitive. Some women do have low supply, and that’s that. And some women cannot keep up with pumping when they return to work. Even with things going swimmingly, nursing is a hell of a commitment. After doing it a few months, I was somewhat amazed that the American Academy of Pediatrics recommends breastfeeding for a year. I mean, really? A year? That seems quite intense. And they’re not even going all the way. World Health Organization recommends two years.

Although I never questioned that breast milk is optimal, facing a year of nursing made me wonder: how optimal are we talking here? I read the AAP’s statement on breastfeeding, which claims that breast feeding can reduce illnesses and may reduce the incidence of SIDS as well as provide a host of other long term health benefits. However, becoming more of a critical thinker means that I can’t accept the ubiquitous phrase, “Studies have shown,” without asking some key questions about the studies. What kind of studies were they? Were confounding factors taken into account in these studies? The claim that breast fed infants have higher intelligence has always seemed especially suspicious to me. First of all, quite anecdotally, the smartest five-year-old I know was formula fed. I can’t imagine her with seven more points of I.Q. She’d take over the world. But more to the point, I believe there must be a behavioral component to such a finding, even if it is the result of sound research. Perhaps mothers who breast feed spend more time with their children, which might lead to increased interaction and intelligence. In that case, it’s not the breast milk itself that confers intelligence.

STATS.org has some excellent information regarding these questions, and Joan Wolf’s paper, Is Breast Really Best, also explores some of these ideas. She does some very sound research to get to the bottom of the very questions any critical thinker might ask. Her findings:

“…for every study linking [breast feeding] to better health, another finds it to be irrelevant, weakly significant, or inextricably tied to other unmeasured or unmeasurable factors. While many of these investigations describe a correlation between breast-feeding and more desirable outcomes, the notion that breast-feeding itself contributes to better health is far less certain, and this is a crucial distinction that breast-feeding proponents have consistently elided.”

Wolf investigates many of the studies on breast feeding and finds them often lacking, for exactly the reasons any skeptic might suspect:

“In breast-feeding studies, potential confounding makes it difficult to isolate the protective powers of breast milk itself or to rule out the possibility that something associated with breastfeeding is responsible for the benefits attributed to breast milk.”

Interesting reading. Some salient points from this paper:

–Many of the studies regarding breast feeding are studies done on older formulas. Formula has been improved since these studies.

–Although some short term benefits, like lower risk of ear infection, seem to be proven, the longer term benefits of breast feeding are questionable.

–It is tough to say what exclusive breast feeding really means, when many mothers pump and bottle feed expressed milk. (This is the case for my family.)

The idea that formula is bad seems to be tied into the idea that formula companies are aggressive in their marketing, especially to Third World countries. The problem lies in the lack of safe drinking water for mixing formula, which has led to the deaths of millions of infants. This tragedy has led many people to regard companies who make formula as evil. I would suspect the truth is more complicated. Many women in these countries could have used the formula, especially in areas where mothers did not receive adequate nutrition themselves. (Any nursing mother knows that we have to eat more to produce adequate milk supply.) The lack of safe water is obviously the problem, not the formula itself. Yet it is clear that corporations have a responsibility to anticipate such a problem.

I understand that breast feeding is natural, but we shouldn’t forget that high infant mortality rates are probably also natural. I’m sure formula has saved many babies from malnutrition. I am glad breast feeding has become accepted in my generation, because it’s enjoyable, good for my son, and well, cheap. I don’t think I’d want to pony up for formula every week. But formula feeding sisters, I’ve got your back. You’ll never get the stink eye from me.

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32 Comments »

  1. Stacy Said,

    November 11, 2008 @ 3:23 pm

    Hear, hear! As more than one medical professional has told me, the best diet is the one the patient will eat – whether that’s affected by taste, allergies, or mom’s willingness to go through the process, it all comes down to “how is the kid going to be best nourished?” and if mom’s unable/unhappy with breastfeeding, formula is a damn sight better than malnutrition and/or starvation due to our culture’s lack of wetnurses….

    WHO’s two year nursing recommendation is based on lots of things including (as you point out) the lack of safe drinking water, the low cost, the immunology benefits (which really are of most use for the first 6 months), and the [admittedly minimal] hormonal birth control offered by continuing nursing. Adhering to WHO recommendations in a first world country like ours where mothers are often separated from their children for hours by jobs and the like ignores the context in which many WHO recommendations are crafted – poor water, minimal food, agrarian lifestyles, etc.

  2. INTJ Mom Said,

    November 11, 2008 @ 3:35 pm

    I’ll 3rd that. My eldest who is now 22 1/2 was formula fed. She’s always had excellent health and is in Mensa. I had a SIL who was a big breast only advocate and her kids were ill every time you turned around when they were growing up, especially with the ear infections. Anecdotal, yes. Mothers should feel free to do what they’ve decided works best for them and their child without having to worry about people constantly sticking their noses in and trying to judge them.

  3. Laura Said,

    November 11, 2008 @ 4:21 pm

    I hated nursing my daughter with an all-consuming passion. I had mastitis and latch problems, so it hurt like a son of a gun every time. Whenever I had to nurse or pump, I just sat there and cried. This went on for four months, while my three older sisters and several of my friends “cheered” me on with stories about how wonderful nursing was, how I was doing the best I possibly could for my daughter, how feeding with formula was a cop-out, etc. etc. etc. Finally my husband said, “Look, this is ridiculous. You are unhappy. The baby is unhappy. Neither of you has slept more than two hours at a stretch for four months. I’m going out for some formula.” He talked me into it. We gave her a bottle that night and she (and I) slept for six blissful hours. We never looked back after that. It was the best decision we could possibly have made, and I have never regretted for an instant.

    I did, however, get awfully tired of the pooh-poohing I got from a number of my friends because I did not nurse past four months. I was told my daughter would wind up overweight, sickly, with lowered intelligence and all sorts of other problems. On the contrary, my daughter is a healthy, happy ten-year-old who has had exactly one ear infection in her life — and that was really just a raging case of Swimmer’s Ear. She is rarely ill, is exceptionally bright and is in no way overweight (in fact she’s a bit on the thin side). No one will ever convince me that I did her a disservice by sticking a bottle in her mouth and making sure she was fed.

    I like your characterization of the issue as a “choice” issue. That’s exactly what it should be: A mother’s choice. Just as I would never berate a woman who chooses to nurse a child, I should never have been berated for choosing to bottle-feed. There are way too many self-righteous folks out there who equate bottle-feeding with bad parenting. I respectfully submit that they mind their own business.

  4. Lisa Said,

    November 11, 2008 @ 9:01 pm

    Breastfeeding is simply the normal way of feeding human children. It’s not an “improvement” or “better” than formula; it’s simply the norm. Consider, then, that it’s not that breastfeeding *increases* a child’s IQ; it’s that feeding babies artificially (infant formula) *decreases* their IQ. Artificial substitutes simply cannot replicate or improve on what nature provides.

    Still, for those who insist on or who must use infant formula, there are ways to support and maximize formula-fed babies’ health.

    Peace and good health ~

  5. jedipunk Said,

    November 12, 2008 @ 5:58 am

    Check out this billboard.

    http://whatsinyourbible.blogspot.com/2008/11/babies-were-born-to-be-breastfed.html

  6. Theresa Said,

    November 12, 2008 @ 8:42 am

    Julie, thanks for this post. There are so many factors affecting whether one breastfeeds that it’s unfair to scowl at non-breastfeeding moms as if they are sending their baby outside in winter without a blanket.

    I do not think that “normal” or “natural” are always best — though they are often just fine. However, nature sometimes provides us with insufficient materials and I welcome whatever help we can get from responsible technology (which actually is natural itself because nature is everything, but I digress). Quantity is important, and as Laura pointed out, your mammary glands and the baby’s mouth do not always work together optimally.

    One potential confounder in breastfeeding studies is bonding. I think that the contact I have with my son during feeding is tremendously comforting and nurturing for both of us. When my son was very young I’d take off my shirt when giving him a bottle at home. And even now (14 mo) he will sometimes stick his hand down my shirt while he’s having a bottle.

    As for the anecdotal evidence, my son had both breast and formula for the first 9 months or so. We were fortunate that he happily went back and forth — I’ve read that not all babies will do that. Around 9 months, mummy’s lactation and baby’s nursing intensity coordinately decreased — it seemed like he weaned himself.

    At that point we continued the formula until shifting to organic cow’s milk beginning around 13 months. (I am so happy to have removed formula-making from my nightly chores!)

    My toddler is now 99th %ile in height, 95th in weight, walked at 10 months, and is bright and social (not that I’m biased or anything). No allergies so far either.

    So go figure.

  7. Rob A Said,

    November 12, 2008 @ 8:45 am

    I think a big objection from we breastmilk fanatics is the undermining of breastfeeding by the manufacturers both in developed and developing countries.

    As skeptical rationalists we are wary of quacks selling cosmetics and complementary and alternative medicines to us with sciencey words (quantum homeopathy, RoC Retinal Correxion), and we should be equally wary of formula manufacturers using the same technique (immunofortis, betapol).

    For a woman to make an informed choice she needs information, not advertising. And if her choice is to breastfeed then she needs money spent on support, not marketing.

    As you say, breastMILK and breastFEEDING are confounded, and it is possible that benefits could come from the act of feeding itself as well as the milk. Can you breastfeed without holding your baby close to you, looking at her? I know I’ve seen babies being bottlefed at arm’s length from the caregiver. When do you know he’s had enough? I know I’ve seen babies being bottlefed with an insistence that they finish the bottle. I’d expect such behaviours to have an impact.

  8. A rational conversation about breast feeding and formula « Said,

    November 12, 2008 @ 10:04 am

    [...] to foster uncritical thinking. “Julie” – a “diehard breast feeder” – writes: On an intuitive level, it seems obvious that the best food for baby humans is human milk. But the [...]

  9. Lori Said,

    November 12, 2008 @ 12:12 pm

    I just found this blog, and this is an issue that I’m currently in the thick of and wanted to chime in. #1 was entirely bottle-fed, since she just didn’t really seem to care much about breastfeeding one way or the other. I pumped for three months before giving up, so she got some breastmilk. Bottle-feeding her was always pleasurable, for both me and my husband, and she transitioned easily into whole cow’s milk and then off the bottle entirely. She slept through the night entirely by about 7/8 months. At three years old, she just had her first ear infection/antibiotic.

    #2 is now almost 11 mos. old, has been breastfed exclusively (a bottle was used very early on due to low weight issues, but he refused it at the 4 month point after a month of exclusive breastfeeding). He’s down to Bf’ing about three times during the day, but he’s still nursing at least twice at night, meaning I haven’t had a good night’s sleep in almost a year. Since he shares a room with his sister, his night wakings have the effect of making us all sleep-deprived, and he’s become a bit of a tyrant about getting nursed at night. Obviously, I love him as much as #1 and I’ve enjoyed some of the closeness of Bf’ing, but the fact that he will not take a bottle has meant that my husband hasn’t got quite as close a bond with him as he did with #1 at this same point, and my overall mood has suffered for all the night wakings and feeling that he’s totally dependent on me. And he also just had his first ear infection, which took such a hold that two rounds of antibiotics have been necessary to combat it.

    I’m not advocating for formula, per se, but wanted to note that my own experience has been rather different from that of the popular literature on the subject.

  10. Cate Said,

    November 12, 2008 @ 12:58 pm

    I understand why women who formula feed are sensitive about the issue. But its true: breast IS best, and formula simply cannot replicate the benefits. And it’s certainly the prerogative of lactivists and breastfeeding moms to let you know these benefits. Formula feeders’ anecdotal evidence is no more proof than that phrase: “Studies have shown.”
    Because here’s the thing: breastfeeding goes against a gigantic marketing campaign. It’s a word-of-mouth campaign, by care providers, lactation consultants, pediatricians, government organizations (and how much money do those actually put into breastfeeding marketing?), and even women who donate breastmilk.
    Honestly, when I read posts like this, I think: formula feeders, get over it. We’re grown women, grown men. We can’t handle having our choices as parents being second guessed… Really?! Sheesh! You should have been preparing for that when you were pregnant and everyone dumped their horrible birth stories on you. People will always tell you how what you’re doing isn’t right for your child, your family, and make sure you know what they’re doing is better. (Like comparing children’s percentiles, anyone?)

    But please, on a blog dubbed “rational”, don’t make it seem that formula feeders have a hard time. And please, think “rationally” about what we actually feed our *new babies* when we toss them a bottle 0f formula: milk from another species. You want to be rational? Encourage formula companies to get the milk from a closer relative of ours, like the orangutan. Gagging? Yeah, well understand that milk from a v. distant relative makes no more sense than giving our babies chimp milk. Just because it’s been domesticated doesn’t make it more rational, people.

    Let’s also not forget this: breastmilk is FREE, and breastmilk is bisphenol-A free. Formula is neither.

    The truth is that breastfeeding IS better than formula, and studies do actually prove this. You’re not a bad parent if you formula feed, just like you’re not a bad mom if you’re a working mom (which ALL moms are, BTW). We do what we must for our families.
    And as for supposed outdated studies:
    Breastfed babies better behaved (over 100,000 kids between 10 months and 17 years): http://www.washingtonpost.com/wp-dyn/content/article/2008/10/29/AR2008102902182.html
    More intelligent (14,000 kids over 6 years): http://www.mcgill.ca/newsroom/news/item/?item_id=100295
    Premature girls and breathing, with a link to the “study showing”: http://blog.thenatureschild.com/2008/06/baby-girls-breathe-easier-from.html

    I’d be interested in where the funding comes from for the studies that say otherwise. Nestle, anyone?

  11. bap2 Said,

    November 13, 2008 @ 4:42 am

    It seems the definition of “breastfed” by many around here is a moving target. At first, my son was not truly “breastfed” because he would not latch and I pumped every bottle for 2 months. So, even though nary a drop of formula touched his lips, he was “human milk fed.” Then, when he did latch I could claim “exclusively breastfed” until he was a little over 6 months old. But as soon as he happily accepted a few bites of banana he no longer had a “virgin gut.” So you take a step down in people’s eyes. Then when I went back to work I only had one pumping session to his 2 bottle times, so he got 5oz of formula per day. Some told me he wasn’t “really breastfed” anymore. Now as he gets closer to a year he has 2 breastfeeding sessions per day, but because he has mostly formula throughout the day, I’ve gotten the sad head nods of “I see, he’s weaned”. He probably still gets 5-10oz of breast milk a day. Studies have shown that anything over 50ml can still have a benefit–so why the flak?

    Bottom line is, when asked “Is your child breastfed?”, there are MANY of us “mixed feeders” who don’t know what to answer. I guess “No, not really.” is what they want to hear.

  12. Grandma Said,

    November 14, 2008 @ 3:35 pm

    I have been around this breast vs bottle battle for 40 years, being mom to Julie, and Grandma to Zack and 3 other adorable boys.

    I also remember the “stay at home” vs “working mom” battle, which seems to continue on for some strange reason.

    Can’t we all just get along? Is is actually necessary to brand onself as a breast feeder or non breast feeder? We’re all parents. What works for one mom, as Julie says, doesn’t always work for another. That dosen’t make them bad, or wrong, just different.

  13. clinpsych Said,

    November 14, 2008 @ 6:51 pm

    OK – as a clinical psychologist who specializes in working with children and who spends a good deal of her time administering IQ tests – two responses on here really bugged me – Cate and Lisa. Regarding the oft-qouted notion that breastfed babies are more intelligent (or that formula-fed babies are less intelligent), the evidence that breastfeeding leads to higher IQ is very, very, far (I mean uber far) from incontrovertible. Cate and Lisa, if you believe that such research is factual, you need to take classes in research design, statistics, and tests and measurements. These studies are severely flawed. Amongst a ton of other methodological issues, they do not control for critical confouding factors – namely, parental IQ – the most significant factor influencing a child’s intelligence. One recent well-performed sibling analysis, published in the British Medical Journal, that actually controlled specifically for maternal intelligence, demonstrated that there is either little or no evidence for an association between breastfeeding and cognitive performance in children. This study also showed that, in looking at silbling pairs where one child was breastfed and one was bottlefed, there were no differences in IQs between the siblings. It is clear that maternal intelligence is a major confounder in the studies on relationship between breastfeeding and cognitive development. It is clear that maternal intelligence should be controlled for separately from socioeconomic status and maternal education in any studies of breastfeeding and cognitive development.

    Breastfeeding clearly has immunological benefits – well-controlled studies have demonstrated these benefits. Lactivists should focus on those well-designed studies that do show statistically significant advantages and not trumpet meaningless data as though it is fact – when you do that, it weakens your overall argument

  14. clinpsych Said,

    November 14, 2008 @ 7:11 pm

    Oh, and I forgot to say that, if you really think that any research study that concludes with a result different from your expectations must be sponsored by Nestle, then you should start your own blog called “Rationalizing Moms”

  15. agfmama Said,

    November 17, 2008 @ 2:31 pm

    I have a 15 month old who is still breastfed. She eats a ton of regular food, but she refused to give up her milk…I can’t even get her to drink cow’s milk.

    That said…where I live, you get looked down on if you do breastfeed. I can’t tell you the number of people who were shocked when they found out I was breastfeeding past SIX WEEKS!! They’re all like “WIC will give you formula if you can’t afford it…I don’t know why you bother.” Grrr. It was the best decision I’ve ever made for my child. She’s never been sick, except for 1 cold in her entire 15 months of life. Is it the breastfeeding?? I like to think so. She walked at 9 months and this mama thinks she’s ever so smart. Of course, 90% of the kiddos around here are formula fed, and a lot of them are healthy and smart as well…
    So, if formula feeding moms think they have it rough, being judged by others, think of what some of us breastfeeding moms go through as well. We’re all in this together.
    I know my post may not flow very well, but I have a hungry toddler pulling at my shirt… :)

  16. Rebecca Said,

    November 18, 2008 @ 11:14 am

    Thank you for this post. I am currently sitting at my desk at work with the pump attached. My daughter is 7 months old and has not had formula, but I have to pump four times a day and am still not keeping up with how much of my milk she has at daycare each day. The reserves I built up while on maternity leave are almost gone, and unless I have a big surge this week she will have to start supplementing with formula by next month.
    After my husband found me in tears on our couch over two lost ounces of pumped milk, he and I had a talk where he tried to convince me that I’m being unreasonable, and way too hard on myself. So I went to Target to buy some formula, and as I stood there reading the labels (so many of which claim to have this or that similarity to breast milk) I just couldn’t do it. I couldn’t buy formula. I vowed to try harder at pumping, and went home.
    But this is irrational. I’m wrong. I don’t need to try harder, I need to accept that it is ok for my daughter to have some formula in addition to her breast milk. So I’m very grateful to your post, I feel validated and supported. I think my wonderful community of moms who supported me in my “natural” childbirth and my organic, homemade baby food, etc, have given me an unnatural anxiety over formula. No, I shouldn’t blame them: I’ve done it to myself. I need to get over it.
    By the way, breast feeding isn’t free if you’re pumping. The cost of the pump itself is high, of course, but I feel like I spend almost as much as I would on formula on various Medela products. And it’s not free if I had decided not to go back to work – that would have been the most expensive thing of all.
    Maybe this is for another post, but I’d like to get it off my chest (ha!) as well: While breast feeding is beautiful and makes me feel like a star, pumping is always mildly humiliating for me. The noise, the machinery, the freaky, elongated nipples pulsating… I won’t miss it.

  17. Cate Said,

    November 18, 2008 @ 11:51 am

    Well, if you’re a clinical psychologist, I suppose I should take your word for it. You’re an “expert” with degrees, and I’m only a stupid mom….who can read:
    “Half the mothers were exposed to an intervention that encouraged prolonged and exclusive breastfeeding. The remaining half continued their usual maternity hospital and outpatient pediatric care and follow-up. This allowed the researchers to measure the effect of breastfeeding on the children’s cognitive development without the results being biased by differences in factors such as the mother’s intelligence or her way of interacting with her baby.”
    Adjusting for the mother’s IQ. And can you point me to your fabulous studies, or are you just going to refer to them?

    Also, the fact is that corporations sponsor many studies that give favorable outcomes to their products. One recent issue of note is the FDA relying on industry-funded studies (2) rather than the NIH and over a hundred independent studies for their decisions about the endocrine-disrupting chemical BPA. It happens all the time, and NOT just because I don’t agree with the position.

    Hmm, clinpsych. You didn’t take so much issue with my pointing out that we feed our children milk from another species. I suppose that because you “administer” IQ tests, you are and expert on IQ only (though you didn’t take the time to read the entire page I linked to), and not the other various health benefits.
    I can point to many many more health benefits (obesity, food palette, babies’ respiration), but you seem stuck on one point. One point that actually DID adjust for mothers’ IQ and was a wide reaching study: 14,000 kids.

    Also, let me remind that I also said that BFing is against a huge marketing campaign. I get as hard a time for BFing my son as others get for formula feeding. Just get over it! Someone will always judge parental choices! I’m reading some pretty hateful posts against the natural birthing community as I work today. There’s always an argument about who is right, and I’m just simply tired of people saying it’s the same. Formula is NOT the same. That’s all. It should be treated as a supplement, not a substitute.

  18. Julie Said,

    November 19, 2008 @ 10:38 am

    Rebecca,

    Thanks for commenting. I’m happy that my post helped you. It’s quite impressive that you made it seven months with no formula, even while working. My maternity leave frozen stores were gone quite a while ago, and my son is only five months old. I also experience anxiety when supply dips. Yesterday I thought my son would have to have some formula at daycare. I had to take deep breaths and remind myself that it would be okay. He made it through without the supplement, but we did have to give him a few ounces at home recently. I am trying to pump more and do all the things we’re supposed to do to maintain supply. But I’m also trying to let go of a standard of perfection for myself. It is not easy to work and continue nursing. But work I must! I try to think about how helpful the formula is really. We should be grateful for it, instead of beating ourselves up. It’s like supplementation is this huge challenge to my ego. The anxiety over exclusive breast feeding may be unreasonable, but I have struggled with it myself.

    On the other hand, I have met a woman who was so against formula that she let her baby go hungry when she had low supply. The baby would wail and wail. I found this situation to be totally horrifying. This is an example of the insistence on exclusive breast feeding taken too far. I mean, you have to feed the baby, people. That mother finally came around.

    I hope you will continue to read our blog.

  19. clinpsych Said,

    November 19, 2008 @ 8:59 pm

    1) I never said that formula was the same as breastmilk -where are you getting that from my post?

    2) I don’t feel the need to comment on your observation that formula comes from another animal species because, umm, isn’t that obvious?

    3) I also don’t feel the need to comment on your other points about the health benefits of breastfeeding. As I said in my previous post, the immunological benefits of breastfeeing clearly have been demonstrated in well-designed studies. I never disputed that breastfeeding has health benefits for mothers and babies. How is it that, because I responded to the often-quoted idea that “breastfed babies are smarter” by pointing out the serious methodological issues with these studies that you’ve somehow decided that I don’t support breastfeeding or that I doubt it has benefits? Why are you conflating the two? Can you imagine that it might be possible to support breastfeeding but take issue with people claiming that, as you said, “breastfed babies are more intelligent” based on flawed, poorly designed, or inadequate studies? Or does it have to be all or nothing for you – we’re either “with you” or “against you”??

    4) As you said, my post was stuck on one point because it WAS my point.

    5) Yes, of course you can read. But you are not clear on what you are reading – because the article you linked to did not offer a clear explanation. The McGill study you are talking about is a randomized trial. Half the mothers were randomly assigned to Group A: which encouraged prolonged and exclusive breastfeeding and the other half assigned to Group B: the usual hospital care. This was to avoid a selection bias – e.g. avoiding having a sample in Group A made up only of women who CHOSE to be in Group A because of a belonging to a certain socioeconomic group, parenting philosophy, intelligence level, etc. – thus, making them a non-representative sample. This is NOT the same as actually controlling for maternal (or parental intelligence).

    Studies that control for maternal intelligence also test the IQ of the mother, along with her child. First, they look at any differences in IQ between the two groups of children (formula feeding and breasfeeding). Then, they adjust for maternal intelligence by looking at the effect maternal IQ has on the IQs of the children in the study. For example, a study could show that the average IQs of breastfeeding children hover around 120, while formula feeding children’s IQs, on average, hover around 114. That would seem like a big difference. But when their mothers’ IQs are factored into the analysis, the difference between the breastfeeding and formula feeding IQs disappears – i.e. the results are a function of the mothers’ intelligence – or rather, if a mom has an IQ around 120, her child’s IQ would likely be around 120 – not because of formula feeding or breastfeeding but because of genetics. This is controlling for maternal intelligence. The McGill study you cited did not do this. All studies that neglect to do this create a huge methodological problem, even if they have a large, randomized sample. Correlation does not equal causation. In fact, the only way to really control for these particular problems is: 1) test the IQs of mothers and fathers 2) use a reliable and valid IQ comprehensive IQ tests for parents and the kids.

    6) you said: “I’d be interested in where the funding comes from for the studies that say otherwise. Nestle, anyone?” Despite the fact that corporations may fund studies that give favorable outcomes to their products does not mean that a study that does not support a link between breastfeeding an IQ must be sponsored by Nestle.

    7) The link to the study I mentioned in my previous post in the British Medical Journal that controlled for maternal intelligence is: http://www.bmj.com/cgi/content/abstract/bmj.38978.699583.55v1

    Of note, the authors of the British Medical Journal said the following: “We would never suggest that any woman should choose not to breastfeed on the basis of our findings,” Der says. “Clearly, there are many good reasons to breastfeed.”

    If you want to continue to tout flawed studies about IQ and breastfeeding as “fact” – go ahead.

  20. clinpsych Said,

    November 20, 2008 @ 5:03 am

    Also, here is the link to the article about the British Medical Journal study and the author’s remarks about the importance of breastfeeding: http://www.foxnews.com/story/0,2933,217773,00.html

  21. Vanessa Said,

    November 21, 2008 @ 2:31 pm

    I formula feed 100% and it seems other Moms had a problem with it. One mother tried to guilt me into it. Her child is a picky eater and gets up every hour at night still at a year old. He has been sick several times as well,

    My child is 100 percent formula fed, slept through the night at 8 weeks old. Eats anything and is a happy and healthy baby. He has never been sick.

    I figure I eat crappy foods and I wouldn’t want him to eat that just eat. So formula was the better option for our family.

  22. Mark M Said,

    November 22, 2008 @ 7:06 am

    As a stay at home dad with the three best children on the planet (I’m sure yours are all a close second), I have very mixed feelings on the matter. My wife is the sort who will go on a two week business trip with a plane flight a day with a carry0n, her pump, and a growing bag of frozen milk. This may be great for our kids, but the hassles by airport security and confused hotel staff looking for a bag of breast milk in their freezers can’t be good for my wife; however, she does what she feels she must do. Especially, if it allows her to have a closer relationship with our kids than she might have otherwise given career demands.

    That said, it is sometimes unpleasant being the stay at home dad trying to comfort a crying, hungry baby, because your spouse will want to feed them when she gets home in a half hour or a little bit longer. Whether valid or not, I can’t help feeling at those times that it adversely affects the bond I have with the kids. Daddy is the one that lets them go hungry sometimes. For better or worse, I suppose we are still such a minority that it doesn’t rank as an issue, but it should and I’m sure it eventually will.

    So to the extent that devotion to breastfeeding interferes with the larger family life and well being, I say break out the formula if you need to and breastfeed when you can. I’m sure my wife would disagree with me …

    One important caveat – living in Asia and having seen all the Chinese brands of milk products including formula pulled from the shelves over widespread melamine contamination which killed some infants and hospitalized many, many more in China, I’d be careful about where my kids’ food comes from.

  23. Laurie T. Said,

    November 22, 2008 @ 10:17 pm

    Julie,
    Thank you for writing this post. It is important to remember that we need to consider issues like this critically, and not just believe what we want to believe, since it is a very emotional issue.

    One issue that agfmama touched on is the fact that many people in the middle of this country exclusively bottle feed because that is what everyone else in their family, and even in their socio-economic group, does and has done for years. Breastfeeding, in many parts of the country, is a new-fangled trend, practiced mainly by the upper middle class. Many people don’t breastfeed because they don’t know the benefits, and they aren’t encouraged to by healthcare workers or by family or friends.

    There are huge ad campaigns in favor of bottle feeding, but very few in favor of human milk.

    Plus, there is this American fixation on the breast as only a sexual organ, that makes people feel uneasy about breastfeeding.

    So, while some bottle-feeding moms are undoubtedly feeling pressure from human milk advocates, there are many more who aren’t. And they probably stare if they see a mom nursing her child at the mall. There just isn’t as much education about the subject as there should be.

  24. Dr. Chuck Said,

    November 23, 2008 @ 6:41 pm

    Great discussion! I am a pediatrician who advocates breastfeeding and supports mothers wholeheartedly who wish to breastfeed. I also support mothers who choose not to breastfeed and those who are unable to breastfeed for various reasons.

    What has not been mentioned is that all breastmilk is not the same. It may sound blasphemous to some that a pediatrician would say it, but breastmilk does not always contain the perfect balance of nutrients. The evolutionary drive is not to produce perfect breastmilk, but to balance the survival and health of the infant with that of the mother. With the possible exception of calcium, breastmilk from mothers whose diet is deficient in a nutrient is also generally deficient in that nutrient. DHA, ARA and iron are three good examples. Also, even the most well-nourished mothers produce breastmilk with substandard amounts of vitamin D. This has prompted the AAP to recommend vitamin D supplementation for all infants of breastfeeding mothers. (Historically, infants received more sun exposure than today and adequate amounts of vitamin D were manufactured in the infant’s skin. The combination of living indoors and the migration of humans, especially those with darker skin, to more Northern latitudes has caused the problem.)

    It is true that certain aspects of human breastmilk can never be replicated by artifically produced formulas, but breastfeeding mothers must also take care to ensure that their infants nutrient intake is optimized.

  25. kristi Said,

    November 25, 2008 @ 8:02 pm

    Thanks for this post. I’m not surprised that it brought out some unhappy responses. I tried to breastfeed both of my children, but no matter what I did, my supply was inadequate. I got a frustrating amount of flack from other mothers and from breastfeeding coaches, insisting that I must be doing something wrong, that if I didn’t keep messing up, it would all mystically start working the way nature intended. I continued to breastfeed both after I started with formula, mostly out of misplaced guilt. (Due to my medical issues, they weren’t getting enough breastmilk to justify doing that.)

    Looking back, I can’t believe I felt so much guilt over something my doctor told me was not my fault. I do agree that breastfeeding is best when it works. I just think that some of the claims are unrealistic, and can lead to a lot of heartache when breastfeeding doesn’t work out.

    Oh, and if my kids had another 7 IQ points, I would not be able to keep up with them.

  26. Cate Said,

    November 28, 2008 @ 10:29 am

    http://news.moneycentral.msn.com/provider/providerarticle.aspx?feed=AP&date=20081126&id=9408651

    http://www.enviroblog.org/2008/11/melamine-in-formula-here-we-go.htm

    Choose wisely. 90 percent of formula is affected by this. Once again, I ask: Can anyone tell me precisely what is in infant formula?

    Please don’t blindly trust the FDA with your child’s health.

  27. Rational Moms » Blog Archive » “You do not walk up to a complete stranger and criticize their parenting” Said,

    December 4, 2008 @ 12:17 pm

    [...] and that the skeptic crowd is more willing to allow for a range of right ways to do things (see the post on formula, for example, or even some of discussion in my post about public transportation [...]

  28. LauraR Said,

    January 31, 2009 @ 1:12 pm

    “Can you breastfeed without holding your baby close to you, looking at her?”

    I can’t tell you how many times I see women posting on message boards and explaining typos by saying NAK (nursing at keyboard). That’s pretty darn detached if you ask me, and hysterical that they think it’s providing superior bonding to being fed through a bottle.

  29. Shin Merrill Said,

    March 14, 2009 @ 1:51 pm

    Super-Duper site! I am loving it!! Will come back again – taking you feeds also, Thanks.

  30. miriam Said,

    May 2, 2009 @ 3:54 pm

    I’m going to breastfeed because I’m cheap and lazy.
    Sure, breastmilk is better– but formula is by no means an unacceptable solution. I just don’t feel like paying for it after lugging around these 5 lb milk bags of mine for the last 6 months of my pregnancy. And mix formula at 2 am? I think NOT!
    That all being said, if I can’t seem to get a good latch or pump enough, that’s exactly what I’ll be doing.

  31. To wean or not to wean? Said,

    June 15, 2009 @ 5:01 pm

    [...] copyright on this information is from 1997, which is a little dated by now, and as I posted once here, while breast feeding is great, to say that not breast feeding is “deleterious” is a [...]

  32. A New Study on Breastfeeding Said,

    April 17, 2010 @ 11:41 am

    [...] I first wrote about formula feeding on this blog, I had actually posed the question to Harriet Hall while researching: okay, so [...]

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