My little piggie: formula and fat

My son is a little chunker. He was a growth restricted baby, so by all estimates, he should have been about 8 lbs at birth (instead he was born around 6 lbs, which is HUGE for an IUGR baby). He didn’t start gaining until I began pumping expressed breast milk and bottle-feeding him, at which point we went from weight checks to weight-gain warnings. All of which was just the doctors being stupid, because he had a lot of catching up to do, and once we got his eating issues straightened out, he was able to finally gain what he needed. He has remained in the 60th percentile for weight ever since, and skyrocketed up from the 25th to the 70th in height.

Now, I’m a strong believer that you cannot overfeed a newborn – they will spit up whatever is too much, and the whole comfort eating thing is hogwash in my opinion, since most bottle-fed babies will suck on a pacifier for comfort just like breastfed babies will use non-nutritive sucking. (My son never had a problem shoving the bottle away when he was done, and screaming for more when he was hungry. But then again, he’s always been rather opinionated and never shy about letting us know what he wants.)

But with the recent craziness over those overweight and underweight babies denied health insurance, I’ve been seeing a lot of comments on how “breastfed babies can’t be overweight” while formula fed babies can be. Looking at this logically, I just don’t get it. You take two babies of the exact same weight and height percentile curve, and you’re telling me that the formula fed one is overweight while the breastfed one is not? Again, hogwash. Calories are calories, guys. You can get just as fat on organic, whole grain pasta as regular old pasta. (Sadly.)

I also really hate all those studies saying formula feeding leads to childhood obesity. My child is going to be raised a vegetarian with some fish. We use organic, fresh foods in our house, never eat fast food… I come from a family of slim people with a propensity towards eating disorders. My husband is a big eater, to be sure, but he also eats healthier, on average, than any other man I know (heck, he was the one who forced us to do a raw food fast that led to me losing the last stubborn 5 pounds of pregnancy weight, god bless him). Somehow I don’t think my kid is destined to be obese. I don’t care if your kid was exclusively breastfed until he was two, if you start feeding him Cheetos and soda after that and let him sit in front of the Wii for hours on end, you’re gonna be dealing with some health issues. Nutrition over a lifetime is important, not just what you feed them in the first year.

So I was intrigued by this post from

“Researchers studying the influences of body composition in early childhood found that, indeed, babies who were breastfed longer had a lower fat mass that could not be accounted for by genetic differences or height.
But the study isn’t another “Breast is Best” pitch….Just as influential, researchers found, was a child’s weaning diet — both those being weaned from the breast and those being weaned from formula.

Kids who had the better diet during weaning — you know the drill, more fruits, veggies, whole grains and lean proteins — also had greater lean mass by the time they were four years old….while the findings are evidence supporting some claims that breastfeeding reduces the risk of obesity in babies, they also show you can undo the breastfeeding bennies rather quickly by going from num-nums to three meals a day of chicken nuggets and Goldfish crackers.And also, good nutrition is good nutrition, no matter what you ate in your first year of life.”

I would also add that this probably suggests that even if you are formula feeding, instilling healthy eating habits in your kids can undo the potential of any adverse affects towards future obesity. I have a feeling that these findings linking formula and childhood obesity are more likely due to confounding factors, like the fact that children of well-off moms are more apt to be breastfed, and wealthier moms can afford better quality food (it’s important to note that obesity is also a much larger problem in certain socio-economic and cultural groups than others), but even if they aren’t – rather than worry too much about it, why don’t we all just make it a point to focus on good nutrition for our kids as they grow older? Seems rational.

Thanks to Lifeandtimesofstella for sending me this link. Just like in so many other studies of its ilk,  I love how we don’t hear the caveat at the end of this study. That “oh yeah…and” is often so important, especially for formula feeding moms. It often entails an extra finding that is reassuring in its own way, a little fact or two that makes things seem a bit more rational and less biased. The media loves to ignore these. But don’t worry, guys – that’s what I’m here for!

Breast cancer and breastfeeding: misconceptions or misrepresentation?

Zealots of any kind bug me. I am a big fan of the happy medium, of mediation, of meeting in the middle… even when it comes to issues that I feel strongly about, I get easily alienated if “my side” is coming on too strong or seeming irrational or hypocritical.

Aside from being annoying, I think zealotry can be extremely harmful. I am seeing this more and more in the case of breastfeeding “advocacy” – it can cross the line into religious fervor, rather than being for the more altruistic cause of allowing women to take pride in their bodies’ natural abilities and have the freedom and resources to use these abilities.

Case in point: there was a study that came out in August about breastfeeding cutting the risk of breast cancer…Okay, great news! A wonderful benefit to an already rewarding (for some) natural process. However, I recently saw a Tweet on Twitter (do you capitalize “tweet”? I have no idea) from some woman saying she didn’t need a mammogram b/c she “breastfed 3 babies”. I wanted to reach out through the computer screen and beg her, “for the love of god, go get a freakin mammogram so those 3 babies will have a mom around for a good long time!” Unfortunately, she wasn’t the only one I’d have to beg… I’ve seen women touting breastfeeding as a cure for breast cancer all over the Internet since the study came out.

It scares me that studies get blown out of proportion in this age of electronic, fast-paced, global social media. Some other woman will see that Tweet, or one of the many others filed under “#breastfeeding”, and think hey, I guess I don’t need to worry about breast cancer! Woohoo! But let’s take a closer look at the what the study really says, according to US News and World Report:

Breast-feeding conferred nearly a 60 percent lower risk of premenopausal breast cancer on women who had a family history of the disease…There are, though, a lot of caveats to this study. First of all, it shows a protective effect only against breast tumors that develop before menopause. Yet the vast majority of breast cancers occur well beyond a woman’s 40s. What’s more, the study of 60,000 nurses who had given birth found that the protective effect extended only to women already at elevated risk of breast cancer—namely, those who had a close relative (mother, sister, grandmother) who’d been diagnosed with the disease. Women with no family history of breast cancer didn’t get any extra protection by breast-feeding.

Even more interesting to me, as a formula feeder, was the following:

One particularly interesting finding is that women who took drugs to dry up their milk seemed to be similarly protected from breast cancer. These drugs prevent engorgement of the breasts, which can cause inflammation of the breast tissue

thought to trigger the growth of cancer cells. The researchers speculate that taking the drugs may stop that inflammation. Women who breast-feed and wean their babies gradually would also avoid this engorgement. Postpartum women who opt not to breast-feed and don’t take milk-suppressing drugs usually experience painful engorgement that lasts for days before the milk dries up.

Telling women that there are great benefits to the baby and mom for breastfeeding? Great. Misleading women to convince them that breastfeeding is a cure-all? Dangerous. Telling women that it’s fine to keep breastfeeding during the H1N1 craze? Wonderful. Convincing them that breastfeeding will offer their children 100% protection from this flu strain? Irresponsible.

Now, I understand that certain formula companies (clears throat….rhymes with Schmestle..) have a history of horrible corruption, misleading entire populations of uneducated, poor women into unwillingly killing their babies. Others have suckered women into buying their products by making formula seem superior to breastmilk, and we all know breastmilk is the “gold standard” for most people. (Although to be clear, FFFs, my personal stance is that formula is a really great substitute; a better choice for many for a variety of perfectly adequate reasons and definitely lifesaving in many of our cases, physically and emotionally.) But just because some big corporations were looking at the bottom line like all big corporations do, does not mean that breastfeeding zealots should feed women another type of propaganda. No matter what you believe, breastfeeder or formula feeder, I hope we call all agree that two wrongs do not make a right. Zealotry is bad, even when its coming from an altruistic source.

The Giant Misunderstanding Behind Breastfeeding “Guilt”

The blog war over breastfeeding advocacy and the “guilt” it heaps onto formula feeders rages on…

I recently got on Twitter (I know, I’m like 10 years behind the times, but I’m a Gen X-er, we’re slackers) and found that if you search “breastfeeding”, you can find links to all sorts of interesting sites. I’ve been commenting on a lot of these, trying to offer another point of view. I’ve noticed that only people who agree with the blogger tend to comment on many blogs, which is why I am so happy when someone of an opposing opinion makes their way over here – what’s the good of a debate if we never hear the other side?

For example, in reading some of the recent blog posts about breastfeeding advocacy and how it makes formula feeders feel guilty, I’ve learned a lot. I never really thought about why lactivists got so incensed by the guilt argument. On my end, my anger came from this article on by Jack Newman MD (I love this man. I really do. He inspires me to write like no other, because every time I read anything he writes, the feminist, factivist, and human sides of me get so fired up that the words come pouring out…),where I felt like he was essentially making my argument for me, even though his intent was the polar opposite.

He says:

Finally, who does feel guilty about breastfeeding? Not the women who make an informed choice to bottle feed. It is the woman who wanted to breastfeed, who tried, but was unable to breastfeed who feels guilty. In order to prevent women feeling guilty about not breastfeeding what is required is not avoiding promotion of breastfeeding, but promotion of breastfeeding coupled with good, knowledgeable and skillful support.

Notice the bold text. The woman who wanted to breastfeed, who tried…. she’s the one who feels guilty. 

That is the crux of our argument, lactivists! We’re not mad that you are promoting breastfeeding- that is great. More power to you. Seriously. But if the only people who are feeling guilty are the ones who tried what you wanted them to try, and failed for whatever reason, then why the heck wouldn’t you care that those women feel guilty? They’re in your camp! They did what you thought- what they thought- was best. Mission accomplished. In some cases, better support might have helped; but in others, breastfeeding is filed under “things that weren’t meant to be”.

Encouraging breastfeeding does not have to make anyone feel guilty. You know what made me want so badly to breastfeed? The bonding benefits. The idea that I could be my child’s only food source. That sounded pretty darn awesome. If you believe in the inherent goodness and intelligence of womankind, then I think that stressing these things would work wonders. Using scare tactics is not the way to go. I recently talked to a fascinating woman who studied guilt appeals in advertising, and she explained to me that when you go too far in an ad, scaring or guilting someone into buying your product, there is a “boomerang” effect – the consumer gets angry. Not only will she avoid buying your product, but she also might boycott your company altogether. I think this is similar to what is happening with the breastfeeding “backlash”.

So guys- please listen. Here’s what does not make us feel guilty:

  • Empowering women, encouraging them to breastfeed, or informing them, in a non-judgmental manner, of the facts (but with the caveat that these facts are really facts, not just hypotheses gleaned from one or two observational studies that show something you want them to show.  

  • Talking about how much you love nursing. I love watching my friends nurse, hearing how rewarding it’s been for them. It makes me happy as a friend and a woman. It’s amazing what our bodies can do.

  • Proudly nursing in public. You should have this right, and I will gladly kick anyone in the shins who stares or makes you feel bad about it.  

What does make us feel emotions like guilt, and anger, is:

  • Telling us we are bad mothers for not breastfeeding. 
  • Preaching to us when we have already made our decision (or had it made for us, depending on the situation). We might feel 100% confident in our choices, but having to constantly defend those choices gets tiresome. Maybe guilt isn’t the result, maybe it’s anger. And maybe that anger makes us protective of other women who may be in our position in the future, thus making us sensitive to actions that might induce guilt in other moms.
  • Overstating study results and then telling US that we are distorting the “facts”. Who does this help? It just makes you look desperate, rather than providing an intelligent, balanced argument for why we need better support for nursing mothers.

    I also think “guilt” has been used as a blanket term, when maybe some other emotions are coming into play. Anger, like I just said. Fear, when we think that maybe breastfeeding could become a mandatory, government-controlled act. Or that our employers could have a say in how we feed our kids. Sometimes the actions you take, or the statements you make in your zeal, suggest that this is the world you want to live in. That sounds scary to some of us.

    None of this means you should stop advocating for breastfeeding. But please, don’t lump us together as some weak, needy, guilty group. That’s not who we are. All we want is to be able to feel happy with our choices without you telling us that we have chosen wrongly. That’s all. I believe that as women, we are strong enough, smart enough, and sensitive enough to find a way to achieve our goals without putting each other down.

    PS:  I had to rewrite this entire post this morning, Lesson learned? Don’t ever blog past midnight when you’ve just spent 4 hours on a plane with a 10-month-old. Apparently, I write like a fifth grader under those circumstances. Yikes.

    Hanna Rosin Inspires a Breastfeeding “Action Campaign”

    Back in April 2009, I was still struggling to come to terms with my feelings on switching to formula feeding. Practically every night, I would find myself searching online for some sort of support or reassurance, but I found little to none. (I was up, mind you, because despite the rumors, formula does not help all babies sleep better at night – my son was still waking every 3 hours like clockwork at four months old.)

    And then one night, a night like any other, I logged on to my pregnancy loss message board, so often a source of solace during the trying time I was, well, trying – and there I saw it: a post about an article in the Atlantic Monthly, called “The Case Against Breastfeeding”, by a brave woman named Hannah Rosin.

    I’m sure this is old news to most of you, so I won’t waste time rehashing what Rosin said (basically, she questioned some of the science behind the breast-is-best campaigns, and examined how nursing became a measure of good parenting in her social circle). If for some reason you haven’t read the article, go do it. Now.

    Back already? Good. If you’re a formula feeder, say a big “thank you” to Ms. Rosin for taking a heck of a lot of crap for saying what she did. I don’t completely agree with her tone – I think it may have come across a tad adversarial, which just made it too easy for the other side to slam her –  but I will forever be grateful to her for making me feel less alone. Plus, I think it is always good to ask questions, especially about something that touches such a nerve in so many women.

    Unfortunately, not everyone thinks so.

    The United States Breastfeeding Committee, independent nonprofit organization, a “coalition of more than 40 organizations that support its mission to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding”, has four ongoing “action campaigns” listed on its website. These include three campaigns that essentially ask for government assistance in making breastfeeding a public health issue. The fourth, well…

    A storm is brewing against breastfeeding with the publication of Hanna Rosin’s article “The Case Against Breast-Feeding” in the April 2009 issue of the Atlantic. Rosin was also featured on the Today Show on March 16 with NBC News Chief Medical Editor Dr. Nancy Snyderman. Although their discussion deplorably misrepresented the medical research on breastfeeding, it also appropriately highlighted a much bigger issue: it can be very challenging to achieve optimal breastfeeding recommendations in the United States.

    The United States Breastfeeding Committee has sent a letter to the editor of the Atlantic, co-signed by many of our members and other national organizations. But we also need your help to bring an end to this unnecessary and irresponsible “debate” about the proven health risks of not breastfeeding, and to reframe the discussion to focus on what’s really at stake: support for mothers and families.

    No matter what you think of Rosin or her article,  I can’t believe that anyone who supports free speech can take this “call to action” seriously. They really want to waste time and resources lambasting this woman, who has already endured six months worth of personal and professional attacks? Do they actually fear her questions that much? And what exactly do they expect to get out of this – a retraction from the Atlantic Monthly?

    The Atlantic Monthly is a well respected magazine. Hannah Rosin is an experienced writer. I am sure they triple checked their facts. And regardless, the piece was an Op/Ed. That means opinion or editorial. She was expressing an opinion, much like people express political opinions during election years, and are often seen as “distorting” the facts by the opposing side. The truth is, well, truth is relative. We all see things through our own lens. (A wonderful lactivist blogger, Birthing Beautiful Ideas, recently talked about this quite eloquently – and she actually referenced Rosin’s article and made a valid argument about her claims, as well.)

    The letter that USBC sent to The Atlantic Monthly complains:

    “Inconsistent associations are common in medical research—study designs may vary widely, and it is difficult to design a “perfect” study, especially when dealing with human subjects. It is unfortunate that the comprehensive analysis of medical experts is so often boiled down to a “sound bite” on the latest newsworthy twist in health research. Non-profit organizations like USBC exist to serve as a collective expert voice, distilling the best, evidence-based information and advocating for support for families without the bias of profit-seeking motives.”

    I agree with the first half – there are definitely inconsistencies in medical research. But my reading of Rosin’s article just supported that assumption. I didn’t see it as her saying breastfeeding wasn’t good or beneficial (other than the title, which I agree was inflammatory and unnecessary, but as a former magazine editor, I can tell you that there is huge pressure to come up with startling headlines, so maybe that played a role…), just that the studies had been overstated. The USBC letter referenced a 2007 independent review of the studies that showed a “lack of breastfeeding was associated with a statistically significant increased incidence of several acute  and chronic diseases affecting both mother and child.” This may be true. But according to Wikipedia, the term statistically significant “is different from the standard use of the term “significance,” which suggests that something is important or meaningful. For example, a study that included tens of thousands of participants might be able to say with very great confidence that people of one race are more intelligent than people of another race by 1/20th of an IQ point. This result would be statistically significant, but the difference is small enough to be utterly unimportant. Many researchers urge that tests of significance should always be accompanied by effect size statistics, which approximate the size and practical importance of the difference.”

    Anyway. Confusing. Wikipedia sucks.  But the point is, I don’t think Rosin did anything irresponsible as a journalist. (And I do think I am qualified to weigh in on journalistic integrity, since it is my field, unlike medicine or statistics.) She interviewed a variety of experts, quoted them, and gave her opinion. It was not a news piece. It was an editorial.

    But if the USBC has nothing better to worry about, then I guess that is a positive sign for breastfeeding advocacy. So at least that’s good.

    Postpartum Depression and Breastfeeding: It’s Real, and It’s Not Spectacular

    In the wake of my blog battle with Nursing Birth (due to me commenting that it was irresponsible to connect not breastfeeding with PPD without explicitly discussing the many levels to why there might be a link between the two – for example, maybe depression effects milk supply, causing many women with PPD to have difficulties nursing; or, maybe the fact that they are unable to breastfeed for some reason is part and parcel of their PPD – so yes, while many women with PPD also do not breastfeed, that does not mean that if you choose not to breastfeed, you will get PPD, and I feel like many interpretations I’ve seen of this study are suggesting that to people who may not understand the subtleties here… but I digress), I was beyond ecstatic to see this superb post on Postpartum ProgressFrom Boob to Bottle: Postpartum Depression & The Unnecessary Shame of Quitting Breastfeeding.

    Read through the comments, and you will find that this is such a common experience. I think it is important that we talk about this, and all things having to do with baby blues. Even if you aren’t unlucky enough to get an actual case of postpartum depression, many moms still deal with tears, anxiety, fear… lots of emotions that make for an experience nothing like the ones movies portray – those first dewy days of motherhood? More like a waking nightmare, for some.

    The author, Katherine Stone, explains:

    I tried all those other curious contraptions that you wrap all around your boobs so that you can succeed at doing THE-ONE-THING-EVERY-MOTHER-MUST-DO-NO-MATTER-WHAT!  I read the how-tos and followed them step by step.  It didn’t matter.  Plus, what little breastfeeding I was able to eke out had me so worried about how much milk he was getting I practically had anxiety attacks.  So I quit.  And I felt enormous relief.  And I felt guilty that I was so relieved… 

    Not everyone needs to quit, of course.  Some people find breastfeeding is the only thing that helps them hang on to what’s left of their sanity.  Others, like me, find quitting helps them on the road to sanity. Just make the right choice for you and know that we are on your side, whatever side that is.

    Amen, sister.  A big, rousing, cheering “amen”.

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