Comment by Grustaf | Hacker News Reader

Comment by Grustaf | Hacker News Reader

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> They trot out headlines from questionable studies from totally different living environments in the world that indicate some 3 IQ point increase in kids that were breastfed and then they act like it's proof that formula feeding is child abuse.

Breastfeeding, apart from being cheap, convenient and natural, has been shown to have numerous benefits, not just to intelligence but overall health, even for the mother. There is such an abundance of evidence for this that it's just silly to even question, but you can always research it for yourself.

Regarding women feeling anxious. Since refraining from breastfeeding is a significant risk factor, similar to not properly medicating, I think it's reasonable to view it in the same light. I.e. if you refrain from breastfeeding without a very good reason, you are increasing health risks for your child.

Some interesting statistics can be found here for example. Formula-fed children have about twice the risk of vomiting or diarrhea during their first year. Breastfeeding is about as efficient as antibiotics in preventing ear infections. Etc.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2998971/

General references:

https://www.who.int/health-topics/breastfeeding#tab=tab_1

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781366/

Almost every study on breastfeeding will have a disclaimer like the one in this meta-analysis (or ought to if it doesn't).

"Because almost all the data in this review were gathered from observational studies, one should not infer causality based on these findings. Also, there is a wide range of quality of the body of evidence across different health outcomes."

I don't understand why the issue of breastfeeding in particular seems to cause people to entirely forget that correlation usually doesn't indicate causation.

https://www.gwern.net/Causality

Also "Formula-fed children have about twice the risk of vomiting or diarrhea during their first year."

Yes, that's bad. But it's not that bad. Try your best at breastfeeding, and if it doesn't work out, so be it. Better to focus your energy in being a good parent in other ways that you can excel at than dwelling on what isn't working for you.

Good advice, as far as I'm concerned. The decision to skip breastfeeding is irreversible if you stop producing milk, whereas you can always switch to formula. So it makes sense to try breastfeeding first and see if it works for you.

Make sure you get help. Breastfeeding isn't obviously easy, even though it seems like it should be. There are a lot of tricks need to get the baby to take it.

Don't give up easily. There is a reason formula samples are free in the early days, it doesn't take too many "just this once since it is on hand" events and mom is unable to produce any milk. Then you discover that formula is not cheap when it is too late.

That said, bottles are only slightly worse if at all. So if you need to use it, do so.

Yes, my wife had so many problems in the beginning. The newborn had to stay in the hospital for a week to treat an infection and there it was bottle fed. The milk wasn't going so the breasts needed massaging to clear the ducts and get it started. Then the baby wouldn't latch properly, she was also weak and sleepy from jaundice. We had to buy those little silicone nipple shields and that helped. It was a lot of struggle and my wife almost gave up on several occasions. But now after 11 months she's still breastfeeding and hasn't even used her breast pump or given formula ever. There is a friend of hers who pretty much gave up immediately and started using formula. It seems to be a trend, since we always get praised by our pediatrician and other doctors for continuing breastfeeding.

That was more an example of the SIZE of some of these correlations, rather than how bad diarrhea is. The effect is huge. Breastfeeding is more effective than a lot of medicines.

The same is of course true for almost any long-term factor, yet most people would accept that e.g. getting an education boosts your earnings even without a randomized double blind study.

When there is a strong prior reason to believe one thing is better, we don't need too many studies to tell us it is so. If, a-posteriori, we saw that you couldn't tell too much difference between college graduates and not by looking at their income, or if you couldn't guess whether someone was EBF as a baby by their health status, you might start wondering if the effect sizes are really so large, despite your prior beliefs.

Its very difficult to control for all factors when comparing breast-fed to bottle-fed babies. In 2014, a study [0] was published at Ohio State that compared babies over a long period. When looking at only sibling-pairs (babies in the same family where one was breastfed and one was bottle-fed), the differences in outcome disappeared.

Quote from the link:

"As expected, the analyses of the samples of adults and their children across families suggested that breast-feeding resulted in better outcomes than bottle-feeding in a number of measures: BMI, hyperactivity, math skills, reading recognition, vocabulary word identification, digit recollection, scholastic competence and obesity.

When the sample was restricted to siblings who were differently fed within the same families, however, scores reflecting breast-feeding’s positive effects on 10 of the 11 indicators of child health and well-being were closer to zero and not statistically significant – meaning any differences could have occurred by chance alone.

The outlying outcome in this study was asthma; in all samples, children who were breast-fed were at higher risk for asthma, which could relate to data generated by self-reports instead of actual diagnoses."

[0]: https://news.osu.edu/breast-feeding-benefits-appear-to-be-ov...

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