“Studies have shown,” says the New York Times Gardiner Harris, “that children who are fed formula have increased risks of ear and respiratory infections, obesity, diabetes and even cancer.”
But instead of the link text taking you to the actually studies which purport to show these connections, there are just links to Times query forms, which means you just have to take the reporter’s word for it that studies have indeed shown that children fed formula have increased risks for these diseases.
Unfortunately, in the increasingly overly-simplified, context-free world of reporting on health, the phrase “studies have shown” is often a formula for telling the reader what the reporter assumes has actually been shown.
Consider the studies that the Department of Health and Human Services (HHS) claim have shown a link between formula feeding and diabetes: Yes, the HHS found from a meta analysis that there is a 39 percent decrease in diabetes among those who nursed. But that’s comparing all and some nursing to no nursing at all, so that immediately complicates the picture – especially as one of the key narrative elements in the Times story is on getting mothers to nurse for longer than six months.
Then there is the problem that the groups showing the greatest association between breast-feeding and reduced diabetes are not representative of the general population (Prima Indians, U.S. and Dutch famine survivors); moreover, six of the seven studies in the HHS analysis were on adults, most of whom were drinking formula before the Infant Formula Act of 1980 gave the Food and Drug Administration the authority over the contents of formula. Also, in 2002, DHA (docosahexaenoic acid) and ARA (arachidonic acid) were introduced into some formula; these are both fatty acids that have been found in breast milk – and babies drinking that kind of formula were not included in any of these studies. (Read more by STATS on nursing and diabetes for other confounding factors which limit these studies).
What about serious respiratory infections? The most recent research does not support the contention that formula carries a higher risk, which is again driven by much earlier, and for various reasons, impeachable studies.
Cancer? One study finds that childhood leukemia is reduced by as much as 19 percent for breastfed babies compared to non-breastfed babies. But given that there are approximately 30 leukemia cases per million children, a 20 percent reduction due to breastfeeding avoids a risk of 1 in 150,000 that your child will develop leukemia; of these, 50 to 80 percent survive, depending on the type of leukemia. In other words, insisting that all women breast feed (and, by-the-way for more than six months) would save less than one life in 300,000.
Yes, there is robust evidence that nursing reduces ear infections and diarrhea, and in an ideal world, and with everything else being equal, it would be preferable if all women could nurse. But not all women can breast-feed or can breast-feed all the time.
Nevertheless, the government has decided that women should do so as a matter of public health policy, and the way to get them to do that, it would seem, is to scare them into nursing by over-stating the risks and playing up limited research on the risks of formula. Unfortunately too, the Times has continued to give uncritical support to this campaign by using a journalistic formula of its own.
May 6, 2008 at 11:56 pm |
I have it on good authority that a child who refuses to breastfeed will later use all her parent’s money. Conversely, the breastfed child will be calm and not insist on dyeing her hair at age twelve.
Small sampling, but…
May 10, 2008 at 1:17 pm |
I’ve been saying for quite a while that the public needs to be conversant with the concept of NNTs, in order to prevent such overstatements.
August 22, 2008 at 2:39 pm |
Trevor, I don’t think you focused on the most important weakness of the breast feeding studies, which is that they are all observational in nature. Sure, breastfed babies are less likely to develop a number of health conditions, but is it the breast feeding or something else? As a group, women who breastfeed are very differerent from women who bottle feed. They have more money, higher IQs, etc. Of course their children are going to be healthier (again, as a group – most of the time, you won’t be able to detect any difference at all).
December 1, 2008 at 2:56 pm |
Trevor, why not encourage all women to breastfeed their children. I’ve breastfed and formula fed and the child that I breastfed has never been on antibiotics, has barely even had a cold. The children that I formula fed, had chronic ear infections and even a tonsillectomy/adnoidectomy at three years of age. She has chronic stomach issues and is slightly lactose intolerant. My oldest son, also formula fed, is severely lactose intolerant. Had I been encouraged and helped by my medical practioners to figure out the reason I was having difficulty nursing the first two, the third I educated myself and garnered support from the reasearch that is out there if you just look for it, my older kids wouldn’t be in the situation they are in. You nor the research can prove that there is evidence of NO harm from formula feeding. Your comment that “not all women can breastfeed” is not based on research or fact. The truth be told, only about 3% of the WORLD’S population is physically unable to breastfeed their babies. In those situations, there is pumping as the next preferred way to feed a baby. The third recommended method of feeding a baby is donated milk and the fourth, if all else fails, is formula. Check the American Academy of Pediatrics website for those recommendations. If the myths, misinformation, miseducation and stigma attached to breastfeeding were elimintated, women that “can’t” breastfeed would have a fighting chance at giving their children the best start. Was diabetes and other chronic diseases prevelent when all we could do was nurse our babies. No. The upswing has happened since the invention of formula, vaccinations and other modern medical interventions that take the intuition of the parents out of the equation. The pushing of formula by physicians and formula companies as “equal” or better than breastfeeding is a huge influence on the lack of nursing for the recommended two years.
Lynne, It’s the breastfeeding. Breastfeeding women come from all walks of life, all tax brackets and all education levels. As a group, we come from diverse backgrounds. Breastfeeding should be encouraged more in the poorer communities. Formula is SO expensive and can contribute to lack of money in those communities. I’m the same person I was when I was formula feeding my older kids, just more educated in how breastfeeding works and a little older. My IQ hasn’t increased or decreased since that time, my tax bracket is about the same and my littlest one is the healthiest by far.
February 18, 2009 at 9:36 pm |
Actually, Jennifer, Trevor’s comment that “not all women can breastfeed” is based on research – by those in the field of lactation. LLL has information about this on their website. Please also check out the following links about low milk supply:
http://www.llli.org/cbi/bibinsufficient.html
http://www.obgyn.net/displayarticle.asp?page=/pcos/articles/childers-chats
If you read these links you can see that most lactation researchers put the number of women who have low supply around 5%. That’s 1 in 20 women. Let’s even go with your number of 3%of the world’s population being unable to breastfeed – that would mean, given that in 2007, there were 3,291,805,000 females in the world that 98,754,150 women would be unable to breastfeed.
I think you are misunderstanding the recommendation that pumping be the next best option for these women with low supply. Pumping is less adequate for producing milk supply than breastfeeding. And if a women cannot build a supply by breastfeeding, along with additional supplements and work with lactation consultants, pumping is not going to fix the problem. Donor breastmilk is a great option but unfortunately not covered by most insurance companies and on average, costs $3.50 per ounce. Milkshare is great if one can find a donor.
Unfortunately, a number of women have received bad breastfeeding advice over the years and likely would have been able to breastfeed with the right support. All women should have access to breastfeeding support. But don’t accuse Trevor of spreading “myths” that not all women can breastfeed – because the research very much indicates that this is an unfortunate reality for about 1 in 20 women.
March 9, 2009 at 12:43 pm |
from your second link:
“current estimates run between 2 and 5%. Among the factors I listed above, most are avoidable and/or reversible.”
so, if most are avoidable or reversible, for example, hypothyroidism, then the real percentage is under 2%. so it is rare.
just to point out it depends on how you use words and interpret data. it isn’t 1 in 20 women who can’t breastfeed, it is much less, if avoidable or reversible causes are identified and treated.