August 5, 2013

Breast or Bottle - Some Myths Investigated

First, a few disclaimers, since I have found in my research that any blog/article that says anything other than "all babies should be breastfed as long as possible" is met with quite a bit of criticism.  I am not anti-breastfeeding.  I think if it is working well and is right for your family, do it.  There is literally no research saying that breastfeeding is bad, and I don't think it is bad either.  Also, know that I was unable to breastfeed, hence why I started researching the truth behind breastfeeding research.  My kiddo is happy, smart, and healthy and has always been fed formula.

Now, I feel like in today's world there is such a large push for breastfeeding that it leaves mothers who are unable  or choose not to breastfeed with intense guilt that they are not doing what is best for their baby.  Even some hospitals are creating policy's where women are not given the choice to feed their infants formula.  So, I wanted to look into some of the things I read and heard while pregnant about breastfeeding superiority and determine how much truth there was to the ideals.

Myth number 1:  ALL women can breastfeed. 

Many books and classes tend to lead you to believe that with enough practice or the perfect lactation consultant, that all women can breastfeed.  There is a general consensus among researchers that approximately 5% of women are physiologically unable to breastfeed.  Some of those women do not produce enough milk (10% in one study needed help producing, and with help 5% were still unsuccessful).  Some of those women have breasts that are not well designed for breastfeeding or infants whose mouth size or shape inhibits proper latch.  Bottom line, not everyone can breastfeed and if you can't, it is so much harder to be told that you can with enough work.

Myth number 2:  Breastfeeding makes for smarter kids.

This is a myth not because it isn't true, but because it is exaggerated.  It seemed like everything I read talked about the vast cognitive gains of breastfed babies.  Being in the business of caring about cognition, it grabbed me.  Who doesn't want a smarter kid?  Here the real stats that I gathered from several studies including two meta-analyses (studies that compare studies).  In many (and I mean many) studies, the statistics are not controlled for other factors that we know increase academic/cognitive outcomes.  Families that breastfeed also tend to have above average income, two parents, and higher parental education.  Mothers who breastfeed are usually older and are less likely to smoke or ingest any other dangerous substance during pregnancy.  Babies who are breastfed are often higher in birth weight and frequently first children are breastfed longer.  All of these factors alone have also accounted for academic gains.  Studies that don't control for these factors report gains of 5.32 point which is the equivalent of having a 100 vs 105 IQ.  Both are average and differences would not be noticeable without testing.  When you control for these factors, the gains drop to 3.16 points (100 vs 103).  An even smaller difference.  While there are gains that are technically statistically significant, they are just not significant in practice.  If I put a child with a 100 and a 103 IQ in a room and asked them to solve a puzzle, there would not be a difference in the speed or accuracy they solved it.  That difference is within the margin of error on most IQ tests, meaning that if I tested the same child twice, I could get a 100 one time and a 103 the next time.  There is a difference, but it is not as grand as I was led to believe.

While there are myths, there are also truths.  First, breastfeeding is cheaper.  After formula feeding for almost a year now, there is no doubt in my mind that breastfeeding is cheaper, even after considering the cost of a pump and storage supplies.  Man, formula is expensive.  There is also significant proof that breastfeeding decreases gastrointestinal infection rates; however, my formula fed kiddo has never had any major GI issues.  The bottom line for me it that breastfeeding is a choice.  Like many choices parents make (diapers, toys, sleeping arrangements) it is a personal one.  Formula is a valid choice and you are not doing your baby a great mis-service by making it.  Do I think we need to be okay with women breastfeeding in public? Yes.  Do I think that we need to provide support to women who want to breastfeed in the hospital through lactation consultants?  Yes.  But do I think you are not a good mother or not trying hard enough if you can't or choose not to breastfeed?  No.  You have to decide what is best for you, your baby, and your family.

There is another great article about this kind of thing here.

Also, here links to a couple of the studies I mentioned:

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