Monday, November 16, 2009

Le Sigh.

Fearless Formula Feeders, strap on your armor. We have a new battle coming.

There's a documentary hitting the blogosphere called "Formula Fed America". From the look of the trailer, it's nothing new- just the same old characters (i.e., Jack Newman...god, how much is this guy raking in on our boobs?) and a few holier-than-thou sounding moms who cite the fact that nursing can stop a temper tantrum as a benefit, and blame the obesity epidemic on formula. Really just the same stuff we've been hearing for years. But people are Tweeting about it like it's the second coming, and I'm sure it will get press as being innovative or what have you.

Just thought I'd warn you.

Sunday, November 8, 2009

What do formula, IVF, pregnancy after 30, and working moms have in common?

Some critics of this blog have taken issue with the fact that I "promote" formula feeding as a legitimate choice. It's alright to support those who tried to breastfeed and failed for some medical reason, they say. But no mother should knowingly put her child at risk by opting for the bottle. 

I realize that most of the FFFs who are frequent readers of this blog fall into the first category. I do, myself. However, a friend of mine - one of the strongest, most amazing women I know - made a conscious choice to formula feed from day one because her husband was deployed at the time and she realized it would be a better decision for her family. Another friend (also a beautiful person and superb mother) just had her second baby, and was torn about whether or not she should try and nurse - her first daughter had a host of issues that made breastfeeding impossible, and caused a lot of stress and concern, and she wasn't sure she wanted to risk that again; on the other hand, she couldn't help but feel guilty about those feelings. (For the record, she breastfed for about 24 hours just for the heck of it, then switched to formula, and reports that she feels relaxed, happy and not a bit guilty.)


These women don't deserve to be chastised any more than the woman whose baby had a severe milk protein allergy, in my opinion. As parents, we make all kinds of choices that require cost-benefit analyses, and I honestly believe that breastfeeding is just another one of these choices. There are some very real, very wonderful health benefits to breastfeeding that formula can't match - I don't dispute that. But I also do not think that any of the "risks" one might take by formula feeding are severe enough to justify driving yourself crazy. If you live in a place where clean water is plentiful, and can afford formula; if you commit to cuddling your baby while bottle feeding (and let's be honest, any parent who find snuggling a newborn a chore will probably not bond that well with their kid regardless if there is a plastic or actual nipple in said baby's mouth); if you make other healthy choices to counteract the slight increase of potential stomach upset and ear infections (like not allowing your baby to drink lying down, as liquid can pool in the ears, or making sure you find the right formula for your particular child, as certain blends are easier to digest than others); if you encourage healthy eating habits as they grow up to keep childhood obesity at bay (this is assuming you believe that formula fed kids are more prone to obesity, which I personally think is a b.s. finding completely muddled by confounding factors)... you get my point. Any slight statistical advantage can be counteracted.


I have hesitated to bring something up for awhile now, because the LAST thing I want to do is cause anybody undue worry or insult. But I do think it's important to consider the following: 

There are other choices women make that put their children at equivalent "risk", which most people are too P.C. to bring up. 

And for the record - I think that all of the following statistics are just as irrelevant and disputable as the breastfeeding ones - my point is simply that the stats are out there, and could just as easily be used to take away other choices from women. Which is why I intend to support formula feeding as a choice, irrelevant of the reasons behind that choice. My hope is that the ridiculousness of the following statements will bring some perspective to why I feel as I do.


Other Parenting Choices That Incur Risk to Children


1. Waiting too long to have kids 





  • From March of Dimes: Women ages 40 and older are more likely than women in their 20s and 30s to deliver prematurely,  are about 2 or 3 times more likely to have a stillborn baby, and have a significantly higher risk of chromosonal problems like Down Syndrome
  •  The risk of seven of the 10 most common childhood cancers increases slightly, about seven to 10 percent, with every five-year increase in maternal age, according to a study from the University of Minnesota.
  •  Women who put off having children until after the age of 30 are twice as likely to develop hereditary breast cancer, experts have warned. (I found this particularly interesting, considering breastfeeding also lowers the same type of breast cancer risk. So basically, you get the same protective effects by having kids a bit earlier as you do from breastfeeding. There's a choice for you.)

2. Undergoing IVF

A 2003 article on MSNBC discussed a myriad of studies about babies born through Assisted Reproductive Technologies, showing that they were:
  • "more than twice as likely as infants in the general population to be born underweight (6.5 percent vs. 2.5 percent), putting them at risk for breathing difficulties and other potentially deadly health problems at birth as well as developmental difficulties down the line."
  • "more than twice as likely as naturally conceived infants to have major birth defects (9 percent vs. 4.2 percent), including problems with the heart and urinary or genital tracts."
  • privy to a  "five- to seven-fold increased risk of a rare form of eye cancer known as retinoblastoma."
 Another article in The Guardian warned that kids born through IVF and other fertility treatments:

  • Were four times more likely to have autism than those born to fertile parents.
  • Had a higher risk of more minor problems - the incidence of attention deficit hyperactivity disorder (ADHD) rose by 40%, and other medical conditions affecting hearing and sight nearly doubled.

Side note: the MSNBC article went on to explain that "Common sense would say that a lot of people have been through this and most of their children are doing well...It's really a question of subtlety and small differences."

I wonder what would happen if a doctor said the same about the breastfeeding studies?



3. Working

  • A British study found that children of working moms are at greater risk of becoming obese than offspring of those who stay home.
  •  Another British study claims that children of working mothers are "more likely to do worse at school, become unemployed and to suffer mental stress than youngsters whose mothers stay at home to bring them up...According to the study, the impact of having a full-time working mother on a child's education is similar to growing up in a single-parent family..They also reject the idea that a child is helped if the father stays at home, showing that his absence has little effect on the child's educational success."



Imagine the uproar that would happen if these studies were used to guilt women into not working, or sacrificing other goals to have kids earlier, or not having kids at all. I'd be on the front lines of those protests. I bet a lot of other lactivists (many of whom are self-proclaimed feminists as well) would be too.

This is why I think it's important for someone to be offering a bit of devil's advocation regarding the breastfeeding hype. Even if you believe each and every study that says that formula feeding causes obesity, cancer, autism, etc... equivalent risks have been shown in other studies examining other choices we make as parents. We're all doing our best, and who am I to judge another woman's "best"?

So, yeah: I support every woman who chooses to formula feed. It's just food. It's good food. It may not be organic, pure, human milk. But it's a good enough substitute that will nourish our kids well, and we are lucky to live in an age when this is an option. We are living in an age when a woman whose husband is at war can choose to feed her baby in a way that reduces a little of her (understandable) stress. When a second-time mom can look back on a bad nursing experience and decide to proactively protect her new baby (and herself) from that hell. When there is a wonderful thing called the Internet, where these women can find support for these loving, wise choices.

 I hope that answers the question. But I'm gonna go out on a limb and guess that it doesn't. :)



Monday, November 2, 2009

Oh. My. God.

Why haven't I ever seen this article before??

I actually just contacted Joan Wolf, who told me her book will be out next fall and will, I hope, really shake up the proverbial bottle.

But seriously guys: print this piece and post it on your fridge for those dark days. I am so excited I could burst. :)

Formula is the "4th best choice" and other fallacies

FFF Brooke recently wrote an amazing blog post on her breastfeeding/formula feeding experiences. She says some extremely profound things, like this:

We have become a Breast is Best society without realizing that we are causing a backlash of incredible mommy guilt when the breast doesn't work out. And for some families it doesn't work out because of nonmedical reasons. If I was working full-time, I wouldn't pump. In my opinion, one of the benefits of breastfeeding is that bonding time, and excuse me if I don't feel the same way toward the plastic parts suctioning my breast. (And for what it's worth, I think it's possible to have the same bonding time when bottle-feeding.)

Formula did for moms what the pill did for those not wanting to become moms (at that moment). It gave them a choice. I think it's time we stop judging others for those choices and making them feel like formula is a punishable mommy offense. I shouldn't have to defend my choices the same way you shouldn't have to defend your right to nurse in public.

I stood up and applauded after reading this (and by the way, Brooke's blog is always great, so check it out if you have a chance). Unfortunately, an anonymous commenter had to weigh in, completely missing Brooke's point and putting a damper on the beautiful mood this post put me in.

"The thing is FF shouldn't (be) a choice. What I mean by that is if a medical condition or a true supply issue comes up in your Breastfeeding relationship that isn't a choice "you" made. You HAD to give formula for the health and well-being of your child. That to me wasn't a choice it was a matter of life or death really. But people who chose to give formula from day one...those people know they are giving their children second best(actually 4th best). It is to me like saying well I am going to chose to buy my child a second rate car seat because well I can it is my choice after all."

 Oy vey, Anonymous. Seriously? As I said in my response to Brooke's post, this "4th best" rhetoric is utter crap. According to this theory, the order of preference for infant feeding substances is as follows:

1. Breastmilk (fed directly from the breast)

2. Pumped breastmilk
3. Donated breastmilk (from some other woman or a milk bank)
4. Formula

(Oh, and just to add insult to injury... Jack Newman likes to talk about how formula may not even BE the fourth choice over cow's milk; that it is only "theoretically" superior to cow's milk for an infant. Are you KIDDING me? Cow's milk can cause kidney failure in babies. Formula can't. What is theoretical about that?)

There are a few things that strike me as idiotic about the order of these substances. First, the fact that breastmilk and pumped breastmilk take up two different slots. Considering there are very few stay-at-home moms in this day and age, this is basically saying that the efforts of millions of working moms are only somewhat valiant. How would it make you feel to read that you are giving your baby the "second" best while hooked up to a pump for the 3rd time that day?

As for the third option... when I responded to Brooke's anonymous commenter that using banked milk is cost prohibitive for most women (this will run you around $100/day, which makes my kid's hypoallergenic formula look downright cheap), she directed me to Milkshare.org, a site that encourages random women to donate milk to each other.

The ethical, legal and medical repercussions from this boggle my mind. I personally cannot fathom giving my child milk from some woman I do not know, without some sort of advanced screening process involved. But I digress. If you feel comfortable doing so, that is absolutely your choice, and more power to ya. However, this site contains a plethora of terrible, inaccurate propaganda that I (of course) can't ignore. Like this lovely nugget of wisdom:

Formula is static, is often not tolerated well, and does not contain live white cells and antibodies to fight diseases like breast milk does. In contrast, breast milk is species-specific for humans and changes according to the infant's needs!

That may be true, Milkshare. But considering you are telling women this information in order to encourage them to use donated breastmilk rather than formula, don't you think it would be nice to explain that the milk they will be feeding their babies from another woman, which has been stored, frozen, etc, probably doesn't have many "live" cells left, if any at all?

According to a 2004 study from the Fetal and Neonatal Edition of the Archives of Disease in Childhood that examined stored breastmilk, antioxidant levels are severely impacted by the storage process:

But while antioxidant levels of formula milk remained stable whether refrigerated or frozen, levels in fresh human milk fell the longer it was stored and the colder the temperature at which it was stored....Compared with fresh milk, human milk frozen for seven days had the lowest antioxidant levels. And refrigeration for seven days was equivalent to freezing for 48 hours in terms of the effects on antioxidant levels.

They conclude that in order to preserve its antioxidant content, expressed breast milk should be stored no longer than 48 hours at refrigerator temperature, and that it should not be frozen.


Now, this study concerns antioxidants, not live blood cells. But here's another excerpt from a 2004 study on the composition of breastmilk after storage:

To conclude, our study has shown that storage of expressed breast milk caused a decline in vitamins A and C concentrations after 24 hours in a refrigerator (4 °C) and a decline in vitamins A, E and C after 1 week in a freezer (–4 to –8 °C)....Further studies are needed to understand the effect of different temperatures and durations of storage on different constituents of expressed breast milk.

 My point is simply that before stating that donated breastmilk (oh, and the above study also explains that milk varies from woman to woman and day to day - kind of negates the whole "breastmilk adjusts to meet the needs of the baby" thing if you aren't using your own milk) is a vastly superior choice to formula, making women feel that they need to take financial or liability risks to get this "liquid gold", we might want to do a wee bit more research.

Wednesday, October 28, 2009

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 Strollerderby.com:

"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!

Sunday, October 25, 2009

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.

Friday, October 16, 2009

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 pissy about the guilt argument. On my end, my anger came from this article on Kellymom.com 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 wrong, 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.