Monthly Archives: June 2013

FFF Friday: “I was seriously beginning to question if I was cut out for this.”

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Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts and feelings, and I hope we can all give them the space to do so.

Something that gets lost in the debate over why women “fail” to breastfeed is how the idea that nursing=bonding can be flipped on its head. For some women, the act of breastfeeding (or the struggle to do so, in Kathleen’s case) ends up being counterproductive to the bonding process. Many studies which attempt to link breastfeeding to better social outcomes admit that it may be the responsiveness/emotional availability/oxytocin aspect of nursing that confers the benefits. If this is the case, could it then be detrimental to a baby’s future emotional/social well-being to be constantly interacting in a negative fashion with its mother? 
I personally believe that humans are resilient; I don’t believe that our early childhood experiences have to negatively impact us for life, and that parents can seriously screw up and still have it all turn out great in the end. What I’m more concerned about is how these early interactions can affect mothers – making them fear that they are incapable of the very basics of parenting (to provide food, shelter and love), setting them up for PPD and anxiety. I think Kathleen gave her baby an incredible gift by choosing an option that would preserve her sanity and her child’s comfort. This is what matters most in parenting, and should be celebrated far more than it currently is.
Happy Friday, fearless ones,
The FFF
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Kathleen’s Story
I never questioned that I would breastfeed, but when a friend I knew who was not my idea of the type of mother I hoped to become brushed off breastfeeding like it was the most digusting thing ever and told me she had formula fed I knew more than ever that I MUST breastfeed.
My mother in law told me my milk was “designer” and that God had made it specifically for my baby.
My sister in law told me that once she got the hang of it it was the easiest thing ever.
My friends described it as the ultimate bonding experience.
I was determined I would breastfeed for at least a year.
A family member who was done having kids gave me her breast pump, I bought nursing pads and bras and poured through Babywise. In my mind I was all set.  When I received two samples of formula in the mail I mindlessly stashed them back in the pantry where items we never use, but may need incase of an emergency go.
My daughter was born breech at 39 weeks via c section.  Because the hospital wasn’t sure if I’d had a third trimester HIV test I wasn’t allowed to try to nurse her until they ran my blood.  I was in recovery for about an hour and it was probably an hour 1/2 before I held my daughter for the first time.  The lactation nurses visited that afternoon.  Some were fabulous, some were not.  The first one was not. She took one look at me and explained I was going to have a very tough time nursing…something about flat nipples?  That doesn’t do much for your post partum and post c section self esteem.  She brought me nipple shields and a device to sleep with that would gradually pull out my nipples. We tried to experiment with different positions, but since I had a c section they were limited.  The first night wasn’t too bad.  My husband spent the night with me in the hospital and helped me pump out the colostrum to feed our daughter.  A much sweeter lactation nurse helped her latch on with the help of me and my husband.  Somewhere in the back of my mind I was noting…it took three people to get my daughter latched on.  The second night I was alone with my daughter.  They brought her in to nurse. She was screaming and I had to call for a nurse to help me sit up so I could nurse her.  She was able to form a weak latch with the nipple shield, but instantly fell asleep.
When I was released from the hospital the lactation nurses sent me home with nipple devices, a syringe (I can’t remember what that was even for) and last parting words that even though it would be difficult to nurse my daughter they were available for support.  My husband had to go back to work immediately and within two or three days I was pumping exclusively. Before I resorted to exclusive pumping I would sleep faithfully with the nipple guards, but when trying to nurse my daughter with the shields she would tear them off.  Milk would go flying and I would be hunched over trying to reach the shield that was now covered in dog hair.  Not a pretty or comforting scene.
 I couldn’t pump fast enough to feed my hungry and angry daughter so I would pump in advance and store milk in the freezer. Post partum depression (or in my case anxiety) set in pretty quickly.  Friends encouraged me to keep trying and that breast is best.  While I had and still have no doubt that breast is best I was not bonding with my daughter. In fact, we were both beginning to resent each other pretty quickly.
I felt even more guilty because I was producing massive amounts of milk.  I just couldn’t get my daughter to latch on to drink it.  I kept pumping, freezing, thawing, and crying.  I wasn’t sleeping.  I completely lost my appetite due to stress and I was seriously beginning to question if I was cut out for this.
A few friends gently suggested that I give up, but I was wracked with guilt.  One night I remembered the formula in the pantry and apprehensively got it out.  I was first struck by the directions on the back. I felt like they were geared towards people who had no business even being parents.  Of course I would wash my hands.  Of course I would sterilize the bottles.  Of course my guilt was mounting by the second.
My daughter had no problems tolerating the formula that I mixed in with some thawed out breast milk.  I however, had major problems tolerating the guilt. I’m not sure which is worse or if they just equally suck (no pun intended): having a baby who will latch and not having enough milk, or having a surplus of milk and a baby who will not latch.
The day I decided I’d had enough of the pump I felt both liberated and defeated.  I felt like I was letting down not only myself and my daughter, but my husband, his family, my family, and all the other Mom’s I knew who had pumped like champs and/or nursed.
Today my daughter is a thriving 16 month old and no one ever asks if I breast or bottle fed her.  She’s never had an ear infection, is bright, sweet and we have a wonderful bond that I now know was never determined by a method of feeding. We are expecting another baby girl this June and I have already made my decision.  I will bottle feed.  I plan to pump colostrum at the hospital and then exclusively formula feed.  I know all the reasons why it will be better for me and my family, but I also know that I will feel terribly guilty every time someone asks me if I am breast or bottle feeding and I already feel like I will be letting people down.  I also know that a year after my daughter is born no one will ask anymore and no one will really care either.  It’s a personal choice that I did not take lightly, but it was one that worked best for my amazing family.
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Have a story to share? Email me at formulafeeders@gmail.com.

Dear Beverly Turner: You do realize the definition of misogyny, right?

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Dear Beverly Turner,

I suppose you could call me the Queen Bee of the Gobby Women, or the Ringleader of the  “Noisy loons creating ‘Brestapo’ caricatures to appease their own consciences“. I’m quite proud to wear these labels, if you’re going to insist on stooping to schoolyard name-calling, but on behalf of my gobby, looney sisters, I wanted to respond to your allegations that we are partly to blame for the recent, slight decrease in UK breastfeeding rates.

The thing is, Ms. Turner, you’re operating under the assumption that we are incorrect in our assessment of current breastfeeding rhetoric. Your experience may not have matched ours, but why is your own truth more valid or weighty than the truths of hundreds of other women – a group so adamant, in your estimation, that we can make an impact on the collective consciousness of your great nation? Do you really believe that we are all just making this stuff up? Perhaps formula feeding correlates with a vivid imagination; I have yet to see a study showing this association, and I’ve read practically every infant feeding related study to hit a peer-reviewed journal in the past 5 years. But considering how you’ve positioned yourself as a master social critic in this arena, I suppose I should bow to your expertise in this matter.

So, let’s go with your theory for a moment. Let’s say that we all are making this up, that none of us have been bullied, shamed, scared, or downright devastated by how breastfeeding is currently promoted. If society is really so bottle-friendly, and formula feeding is “cool”, why would we be inspired to create an elaborate group fantasy to assuage our feelings of inadequacy? I’d assume that if the cool kids were formula feeding, we’d be wielding our bottles of Aptamil with pride, rather than lurking behind our anonymous keyboards, haranguing innocent breastfeeders on Mumsnet.

Or maybe – bear with me for a moment – there really are women who have been thrust breast-deep into severe postnatal depression after failing to breastfeed. Perhaps women truly exist who were raped or sexually abused in childhood, for whom a NCT nurse shoving a breast in a baby’s mouth triggers horrid memories that make a new mom want to throw her babe against a wall. Suppose there are adoptive mothers for whom the constant barrage of articles and admonishments about how superior breastfeeding mothers are to formula feeding ones is like nails on a chalkboard (if the chalkboard was your heart). Consider an alternate universe where some parents really do end up starving their babies to the point of hospitalization because they were worshipping at the altar of the almighty exclusive breastfeeding edict despite a physical inability to produce sufficient milk (there may only be 2-5% of women who are physically unable to breastfeed, but with the current British birth rate around 800,000/year, we’re talking 16,000 women at minimum- nothing to sneeze at).

I won’t discuss my reality or experience here, because I’m American. And honestly, one woman’s experience is hardly important in the grand scheme. However, I can happily point you to hundreds of personal stories British women have shared with me over the years, women who reflect the groups I’ve just “made up” in the last paragraph. I suppose they could all be lying, but I think it’s just as likely that you’re extrapolating a data set of one (yourself) to your entire country, without stopping to think about the women you’re hurting in the process.

Regardless of who is right, I would like to see these masses of vocal harpies who are crushing the hopes of expectant mothers hoping to breastfeed. I am curious why they would lobby for the NHS to cut funding for breastfeeding support, considering they tried to breastfeed and couldn’t; one would think that better support would have been welcomed by these “failures”. Claiming that the current state of breastfeeding support is harmful is not synonymous with being anti-breastfeeding; quite the contrary. With the right kind of support, not only would more women be able to meet their breastfeeding goals, but those who chose not to or could not breastfeed wouldn’t feel sufficiently disenfranchised to spend hours arguing with people like you online.

Instead of trying to understand where we are coming from; instead of listening to our experiences with an open mind and accepting that just because we dislike the posters on the maternity ward walls, we still love breastfeeding moms (and many of us wish we could have been one), instead of trusting your fellow women – you threw us under the bus.

Lastly, speaking of misogyny, I assume you know that the definition of the term is a “hatred, dislike or mistrust of women”. The only person I see hurling hatred and mistrust towards a large group of women (because formula feeding mothers who rail against a systemic failure to support our efforts while simultaneously shaming us are, in fact, still women, despite their lack of lactational abilities) is you.

Sincerely,

A particularly noisy, gobby loon (and proud of it),

Suzanne Barston

FFF Friday: “I succeeded because she made it clear whatever I could handle was okay…”

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Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts and feelings, and I hope we can all give them the space to do so.

Before Catherine sent me this FFF Friday post, she emailed me to make sure it was kosher, considering that her baby gets 100% breastmilk. Obviously I said yes; heck, I wish I received more submissions from mothers who exclusively breastfed, combo fed, or exclusively pumped (as Catherine does). The ethos of this page has nothing to do with feeding method – you can just as easily be an FFF if you’ve never used formula as you can if you’ve never breastfed. What we stand for here is flexibility when it comes to parenting in general, especially when it comes to early parenthood. FFFs don’t believe dogma belongs in breastfeeding promotion or practice, and we believe that formula can be a conduit to breastfeeding “success”, however you choose to define it. What matters to us is that mothers and fathers are supported and educated in feeding and caring for their babies in a way that works for their family. I think Catherine’s attitude exemplifies this, and I’m really excited to share her story this week.

Happy Friday, fearless ones,

The FFF

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Catherine’s Story

I had my daughter at the beginning of March, and almost immediately she was labeled a “champ nurser” by everyone in the hospital.  Two lactation consultants came by over the course of my stay, and they told me that my milk was already in and my body could teach classes on nursing. I was pleasantly bewildered–I had no idea why everything was going so well, but I wasn’t about to complain.

Things changed the day after I got home. Rapid engorgement, fussy baby, unfilled diapers. I pumped and nothing came out. I went to see a lactation consultant just in time to avoid mastitis.
We ended up making several visits. My daughter latched perfectly and seemed to be nursing just fine, but when the LC weighed her afterward she’d sometimes only have gotten two or three mls. The LC didn’t know what was wrong, but she put me on a strict nursing-pumping-feeding schedule, gave me a breastflow bottle for the pumped milk, and filled a bag with ready-made formula to supplement with. She said I needed to offer the baby 2 ounces of formula at every feeding, because the most important thing was that she get enough calories.
Then, my supply disappeared due to all the time I’d spent getting engorged while my daughter wasn’t pulling enough milk. We ran out of the ready-made bottles and had to go buy some more. It was one of the saddest grocery runs of my life, reaching for the can and seeing “BREAST IS BEST” written prominently on the front of it.
Thanks. Like I wasn’t already trying not to cry in public.
Two weeks later, things hadn’t really improved. My supply was up a bit, but my husband was headed back to work full time and my mother was going home. The baby still wasn’t nursing well. I was exhausted from a 45-minute routine that had to be performed every 2.5 hours around the clock. We went back to the LC and I told her that at 3 weeks postpartum I was ready to give up.
“I don’t blame you,” she said. “You’ve done pretty much everything you can at this point.”
She told me that continuing to pump was an option even if I cut out the attempts to nurse, that my daughter would still get the benefits from breastmilk even if I supplemented with formula. She gave me a schedule for shortening and dropping pumps if I decided that I did want to quit altogether. Her only note of caution was that formula was expensive. She said I could call her anytime if I just needed someone to talk to.
I decided that if I dropped the nursing, pumping alone might not be so bad. We gave my daughter breast milk and formula in tandem for a couple of weeks until my supply was high enough that we could cut the formula altogether. My daughter is almost four months old and it’s looking like I’ll be able to pump milk for her until she’s 12 months at least.
I guess the militant breast-is-best crowd would call it a success story, of sorts. But why did I “succeed”? I succeeded because the lactation consultant shoved a ton of formula at me when my daughter was in distress. I succeeded because she made it clear that whatever I could handle was okay. I wish more people understood this–every time you lock up the formula, every time you make a mother dole milk into her newborn’s mouth with a tiny spoon to avoid “nipple confusion,” every time you tell her that even ONE bottle of formula will be the end of her milk supply, you are setting her up to fail. Your very inflexibility will drive her to exclusively formula feed her baby once she crashes and burns and can’t take it anymore.
I’ve done the best I can for my daughter, but some people still don’t think it’s enough. It has to come straight from the tap, you see. Fresh but bottled is slightly inferior, refrigerated even more so. The antibodies deactivate.
It was around this point that I realized that this is ridiculous. It’s insane. It has very little to do with the well-being of babies and everything to do with how women need to feel about themselves.
Yes, my baby gets breast milk. But I work half-time from home, and I cut holes in my bra so I can pump at the computer. I have to pump every two hours–if I worked in an office it would be absolutely prohibitive. I am not some mama bear earth goddess. No one is. I am fortunate because my circumstances allow for it, and more women need to realize that that’s all there ever is to it.
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If you have a story to share for FFF Friday, please email it to me at formulafeeders@gmail.com.

FFF Friday: “How about we try supporting ALL mothers?”

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Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts and feelings, and I hope we can all give them the space to do so.

It’s been an interesting week. Images of babies were banned from European formula tins. Formula fed babies monkeys ended up metabolically stressed. Brain scans showed that breastfed babies were smarter, according to every major news outlet, none of which acknowledged that the study didn’t control for maternal or paternal IQ. And the producer of one of the most inflammatory, mom-shaming documentaries ever made wrote a HuffPo piece about ending the mommy wars – at least for those mothers who agreed with her world view. 
Throughout it all, there was one theme emerging: no one should feel guilty for denying their children their birthright of mother’s milk; instead, they should feel angry, because society didn’t support them, and that is presumably why they “failed”. But I’m not sure there’s much difference between guilt and anger. Both are negative emotions; both require us dwelling on the past, over-thinking our actions, and casting blame either on ourselves or others. 
You can’t insist that everyone hate formula and formula companies, just because that’s how you feel. You need to understand that for some, formula is always going to be seen as a lifesaver, as the knight in shining (milky?) armour that saved us from endless days of pumping, pain, and depression; that rescued our babies who were starving or sick when their “birthright” failed to nourish them the way it was supposed to. Instead of focusing so much on the negative- negative feelings about formula, negative studies that suggest negative things, negative blog posts that make formula feeding mothers feel that they need to be self-flaggelating or they are somehow the enemy – maybe we can try focusing on the positive for a bit? See how it goes? Spend the energy we waste fighting over something that really only affects you and your family (because the public health “threat” of formula is an outright fallacy – better we worry about the poor quality of food available to those in underserved areas, the lack of good quality medical care, the over-abundance of media in our lives, the cutting of PE and gross school lunches and so on and so forth) on creating positive interactions with those around us.  When we make formula feeding and breastfeeding such a major issue, we divide mothers from the beginning. What would happen if we put the same sort of energy into setting an example for our children by owning our choices and not insisting others follow them as well? If we embraced differences, not just in religion, ethnicity, gender, body type, dietary preferences, world view, sexual orientation and political beliefs but also parenting styles. 
In that spirit, I bring you Kathy’s FFF Friday, with it’s common sense take on all of this mommy war bullsh_t.  She’s a great example of what I want my kids to be when they grow up – non-judgmental, caring, and reflective. Funny – I don’t think those qualities can be conferred by bottle or breast. 
Happy Friday, fearless ones,
The FFF
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Kathy’s Story
Before my daughter’s birth I never felt particularly strongly about breastmilk versus formula, and I certainly never judged anyone for using formula. I was surprised during my pregnancy that so many women asked me if I was going to breastfeed, as I wondered why they cared, but it didn’t really bother me. I was bombarded with a LOT of pretty one-sided ‘breast is best’ information during pregnancy, particularly during prenatal classes, but I thought I had remained objective. I think that’s why I was really shocked to realise how much this information had affected me, and to feel so much grief and distress, when I was unable to breastfeed my daughter.

At first everything was fine. I was surprised that breastfeeding was so painful, but the nurses in hospital were helpful and while I can’t say I ‘enjoyed’ it, I did get used to it, and supply was never an issue for me.  However at 3 weeks of age my daughter began screaming in agony for several hours each day, and things only deteriorated. Our child health nurse incorrectly advised me that it was just ‘colic’ and would go away, and that my daughter’s constant feeding (every 2 hours or more) was no cause for concern. My daughter’s pain (and her comfort feeding) continued to escalate, to the point where at her worst, she was screaming (not crying, but screaming) for between 6 to 10 hours per day. There was a month or more (before diagnosis and while we were adjusting her treatment) where we honestly could not put her down for even a moment, except for nappy changes, as it caused her too much pain- we had to take shifts sleeping on an upright recliner while holding her. Of course, as the only one who could feed her and as her mother, this mostly fell on me although I must say my husband was truly wonderful.

Fortunately our wonderful paediatrician diagnosed gastro-osophogeal reflux disorder (a severe form of ‘acid reflux’) at 6 weeks, and we were able to begin treatment with medication, which helped to some extent. I tried an elimination diet for several weeks, due to our doctor’s suspicion that my daughter had a dairy or protein intolerance, but this didn’t help so at 9 weeks of age, we began feeding our daughter a hydrolized formula in the hope that it would be easier to digest. Luckily in Australia, this specialised formula is subsidised by the government if you have a prescription, so it didn’t cost an arm and a leg. The change on formula was amazing and almost immediate- my daughter did indeed have protein intolerances, and due to the formula, her pain was halved! It still took us 2 hospital admissions, a number of medication adjustments, and a number of new management techniques, to fully control her digestive pain and acid reflux, but it was clear from the outset that giving her hydrolized formula played a huge role in her improvement.

Despite this obvious benefit, I was terribly upset that I had to stop breastfeeding my daughter. I cried every time I had to ‘pump and dump’ to reduce my supply, and I cried at the dreadful irony that others were desperate for breastmilk and had none, while I had buckets of the stuff and all it was doing was making my daughter sick. I really felt I had failed because I was unable to nourish my baby with my body.

Now I can see how ridiculous this was- even at the time I knew I was being irrational, but I couldn’t help how I felt. I am a well educated woman with access to plenty of information, my husband and family supported my actions, heck, even my daughter’s paediatrician and paediatric gastroenterologist told me I was doing the right thing, but I still felt guilty! No doubt the stress of a difficult pregnancy (9 months of vomiting), a long birth, and 3 months of sleep deprivation while caring for a very sick child, played their part, but aren’t we all at our most vulnerable after childbirth? I worry about how much worse it must be for those who don’t have the support I had, and face direct judgment and discrimination. I think that if just one of the professionals who told me that ‘breast is best’ during my pregnancy, had also had the sense and compassion to also say ‘but please be aware that in a small percentage of cases, breastmilk is NOT the best thing and there is a possibility, however small, that your baby might fall into that category, and if that occurs, your baby may still thrive on formula’, I would have felt SO much better. I still would have done my best to breastfeed but if it didn’t work out, much of the trauma I suffered may have been avoided. Why can’t this information be given to all pregnant women and their partners?

My daughter is now a healthy, thriving 7 month old and I feel no guilt whatsoever for feeding her formula- in fact, I’m proud that I pushed for treatment, and got her what she needed without any further delays. However I am angry that mothers who ‘choose’ to formula feed (for whatever reason) are facing so much judgment in our society.  I feel that like those with supply issues, I really had no ‘choice’ in the matter. However, having breastfed myself for a short period, and knowing that is it no walk in the park, if another mother told me that she ‘chose’ to formula feed because of mastitis, exhaustion, depression, or the need to care for other children, I would sympathise and never judge her. In fact I wouldn’t put her in that position by even asking why she was using formula.

I also wanted to say that the idea that you bond more with your child when you breastfeed, was not applicable to me. I bonded with my daughter from the moment she was born, and it did not end when I gave her a bottle. I know our circumstances were unusual but in fact, in our case, it was only when my daughter was formula-fed and no longer in pain from digesting breastmilk that did not agree with her, that she could feel well enough to show me her beautiful smile.
I’m pregnant now with a second child and have no idea whether I will breastfeed this time around. I do know that my husband and I will do what is best for us and our baby, and it is not for anyone else to judge. I had a ‘natural’ birth but I certainly don’t think I’m any better or any more a mother than my friends who had ceasearean deliveries, and I think the same should apply in the breastfeeding arena. I’m absolutely 100% in favour of support for breastfeeding mothers, but how about we try supporting ALL mothers. It seems to me that we are all trying hard to do the best we can for ourselves and our babies, so let’s try supporting each other and giving other mums a break!
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Share your story – or just say “hi”. Email me at formulafeeders@gmail.com.

Let’s talk about SES, baby: a critique of three studies getting far too much attention in the news this week

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If I didn’t hate conspiracy theories so much, I’d start this post out reminding you that a recent systematic review from the World Health Organization (WHO) had the nerve to be realistic about the health benefits of breastfeeding. The results shouldn’t have been surprising to any of you who read this blog regularly; basically, they found that most infant feeding studies show modest benefits to breastfeeding, and are bogged down by research pitfalls like endless confounding factors, self-reported data marred by poor recall, and the impossibility of conducting the double blind, randomized, controlled experiments we need to make absolutely sure we aren’t confusing causation with correlation. But considering that this analysis came from WHO, an organization that has been fundamental in the popularization of breastfeeding advocacy and research, it must have ruffled a lot of feathers.

So, one could argue that the media push of three rather sloppy studies is simply a flurry of flapping wings, trying to distract from the presumably disappointing WHO statement. But one won’t, because one gets seriously annoyed when one hears people engaging in similar conspiracy theories about Big Formula. Although one could also argue that viewing these studies as a ploy would be a less offensive interpretation than assuming people actually think they are worth spreading around. One is also very exhausted after a 4-am wake-up from one’s two-year-old and one is discussing oneself in a grammatically incorrect, rather disturbing third-person. Let’s move on, shall one?

The three studies include one about metabolic function and gut microbiome; one about maternal deaths attributed to not breastfeeding; and one about child cognitive function. We’ll start with the the metabolic/gut microbe study, Early Diet Impacts Infant Rhesus Gut Microbiome, Immunity, and Metabolism, because it involves rhesus monkeys and they are just so damn adorable.

For this study, the researchers fed rhesus monkeys either breastmilk or infant formula, and concluded that “metabolic and gut microbiome development of formula-fed infants is different from breast-fed infants and that the choice of infant feeding may hold future health consequences”. I don’t think it’s even worth explaining what the implications of this finding are in humans, because, well, these were monkeys. They were presumably fed monkey breastmilk and human infant formula, or human breastmilk and monkey formula, or some other combination of the two. But no matter what, they were comparing apples to oranges. Or humans to monkeys, as the case may be. True, rhesus monkeys are considered a great stand-in for human subjects, but if monkey milk was that similar to human milk, I expect we’d see the WHO hierarchy of infant feeding change to include “rhesus money milk” after human donor milk, ahead of formula. (I wonder if anyone has ever looked into this, come to think of it… ) To quote some of my favorite lactivist memes, cow’s milk is for cow babies. Human milk is for human babies. Therefore, wouldn’t feeding monkeys either human milk or formula made to emulate human (as opposed to monkey) milk confuse the results?

Consensus: not worth worrying about unless you are super concerned about the metabolic and gut function of rhesus monkeys being used as lab rats. (If you are, contact your local animal right’s group, because frankly I think using innocent animals for this sort of “research” is on par with using them to test mascara.)

Next up, we have a study from the same researcher who brought you the infamous “Burden of Suboptimal Breastfeeding” study which was the direct cause of a permanent dent in the master bedroom wall of our old house that bears an uncanny resemblance to the shape of my forehead. This new study, Cost Analysis of Maternal Disease Associated With Suboptimal Breastfeeding, uses the same type of statistical model as its ugly stepsister and reports:

If observed associations between breastfeeding duration and maternal health are causal, we estimate that current breastfeeding rates result in 4,981 excess cases of breast cancer, 53,847 cases of hypertension, and 13,946 cases of myocardial infarction compared with a cohort of 1.88 million U.S. women who optimally breastfed. Using a 3% discount rate, suboptimal breastfeeding incurs a total of $17.4 billion in cost to society resulting from premature death $733.7 million in direct costs, and $126.1 million indirect morbidity costs.

All you need to know about this study is in the abstract (something I never thought I’d hear myself say). This is not a study, but an elaborate guesstimate, based on “modeling cases” of specific diseases the authors believe to be caused by not breastfeeding “using literature on associations between lactation and maternal health”.

Consensus: Not worth worrying about, unless you are taking economics and want to challenge yourself by figuring out how they came to their conclusions, as I expect it would be an interesting exercise. See how I’m looking out for your cognitive development? Which is a great segue to our last study of note…

… Breastfeeding and early white matter development: A cross-sectional study, by Deoni et al, which claims to:

…(P)rovide new insight into the earliest developmental advantages associated with breastfeeding, and support the hypothesis that breast milk constituents promote healthy neural growth and white matter development.

 

Here, the researchers performed MRIs on a bunch of babies and toddlers who had been breastfed, formula fed, and combo-fed, and found that the exclusively breastfed kids showed more white matter in their brains, as well as a few other differences in brain composition that suggested enhanced cognitive ability. The study is being applauded for doing two important things: showing the advantage of breastmilk on the human brain without having to rely on IQ tests and performance assessments, and for (supposedly) controlling for the ultimate confounding factor of socioeconomic status, or SES. This is because all of the babies they used were born full-term, healthy, and to mothers in the same socioeconomic group, based on the Hollingshead Social Status Index.

Ideally, this would lead people like me to throw up the white flag, as we can’t start arguing that maternal education or income has anything to do with the benefits observed in breastfed babies. If all the mothers were of the same social status, and they controlled for health issues in the babies (which they did) then the breastmilk has to be what’s influencing the results, right?

The trouble is, in this case, the researchers failed to control for what is, arguably, the most important factor of all – maternal and paternal IQ. They try to explain this away, stating that “(w)hile maternal IQ was not specifically measured, the combination of education and SES was believed to provide an adequate alternative.” Now, it could be my sleep-deprived brain (speaking of white matter, I bet if I had an MRI right now the image would look like swiss cheese) but doesn’t this seem rather obtuse for people smart enough to be conducting neurological studies? Having a superior education does not mean that your IQ is high, and if you’re talking about wealth in the same breath, the reality can be even trickier. Enough money can buy you an pretty impressive education – followed by a high-status job. There are extremely smart mechanics and extremely average CEOs. Status begets status, and IQ may beget IQ, but the two don’t necessarily have anything to do with each other.

This is a long way of saying that maternal SES (speaking of which – it really twists my knickers that none of these child cognitive studies ever mention the dad’s role. What about paternal IQ? Paternal SES? Paternal involvement?), while undeniably important when measuring things like access to healthcare, is not an accurate assessment of the quality of the child’s early learning and home environment,  or his/her genetics – two important pieces in the intellectual development puzzle. A recent study using similar techniques as the one in question discovered that “the more mental stimulation child gets around the age of four, the more developed the parts of their brains dedicated to language and cognition will be in the decades ahead.” Considering that the Deoni study did not even control for childcare – i.e., whether the child was primarily in daycare, with an in-home but non-parental caregiver, or with a parent (mother or father) – how can we possibly know if their environment had any effect? Women in the U.S. who choose to/are able to exclusively breastfeed for a lengthy amount of time – something that often requires a physical, emotional and in many cases professional/financial burden – might also be more willing to invest in their children in other ways that can affect early learning. Not to mention that EBF women are more likely to be full-time caregivers to their babies – the elephant in the room, especially for a working mom like me who has made a decision to combine career and family. True, I don’t want to hear that staying home with your babies gives them cognitive advantages (and I also think there are plenty of ways to skin a cat or however that horrible saying goes, and there are advantages to having a mother who is professionally fulfilled and satisfied, also) but I also think it’s subliminally sexist not to talk about this- because it certainly doesn’t have to be the woman who stays home. Anyway, I digress… but the point is, this study doesn’t control for what it needed to control for.

Consensus: Given the fact that they didn’t control for much besides health and SES, I don’t think this study “proves” or even “suggests” anything important, except that the people studying these brain scans might want to assess their own critical thinking skills. I wonder if that can be seen on an MRI?

 

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