What's best: breast milk, bottle or a mix of both
14 things we should all agree on
Recently on Twitter, I said something about breast feeding and my feed exploded. In this post, having reviewed the evidence, I offer a series of nuanced points.
It's completely reasonable to *gently* encourage breast feeding, and teach (not guilt) new mothers to do it.
Businesses should make it easier for nursing mothers. Providing space, time, etc. (the world should be better to mothers generally).
Pumps should be covered by insurance, and other supplies.
Breast feeding is not all or nothing. There is a huge continuum from 100% breast to 100% bottle feeding.
Breast feeding probably helps a mother reduce weight postpartum, bond with the child, and gives a little immunity (short term).
There is no credible evidence breast feeding improves IQ (even the one RCT that *spuriously* claimed this lost that claim in follow up).
There is no credible evidence exclusive breast feeding improves ~ all long term health outcomes.
It's totally ok to give children bottles when tired.
It's totally ok to throw in the towel on breast feeding and bottle feed a child.
People who work in this space are often zealots. Ironically, the most credible individuals are the people who have studied this issue recently.
Observational studies are generally useless because the women who do not have the opportunity to breastfeed are often marginalized.
Studies from countries without good drinking water are also useless. For obvious reasons.
It would be interesting to also study the impact of breastfeeding policies on conceiving and having children in the first place.
Hospitals that use breastfeeding as a quality metric for OB/GYN are making an error.
What do you think?
How would you change my principles?
I don't have academic expertise on this topic but I breastfed four children and think you should add that if you make it past about month 3, it can be far more convenient to breastfeed than bottle feed even if you have to pump a few times at work. Your breasts are always there, yay! Breastfeeding is even more convenient and enjoyable if you read up on the AAP guidelines on co-sleeping and realize they make no sense if you don't have a sleep or substance use disorder and you are able to keep the baby between mom and a sleeping net (not a partner or other child). No waking up to sit there and breastfeed and then comfort a baby back to bed in some other space. Just help the baby find your breast and go back to sleep. Everyone is happy (except the pediatrician)
While there are definitely benefits to breastfeeding, there has been way too much shame surrounding those who either cannot or choose to not breastfeed….to the point where moms feel horrible about themselves when they either have to supplement or cannot do it at all. Encourage it, make it easier by providing time, place and pump but no shaming!