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.

1. It's completely reasonable to *gently* encourage breast feeding, and teach (not guilt) new mothers to do it.

2. Businesses should make it easier for nursing mothers. Providing space, time, etc. (the world should be better to mothers generally).

3. Pumps should be covered by insurance, and other supplies.

4. Breast feeding is not all or nothing. There is a huge continuum from 100% breast to 100% bottle feeding.

5. Breast feeding probably helps a mother reduce weight postpartum, bond with the child, and gives a little immunity (short term).

6. There is no credible evidence breast feeding improves IQ (even the one RCT that *spuriously* claimed this lost that claim in follow up).

7. There is no credible evidence exclusive breast feeding improves ~ all long term health outcomes.

8. It's totally ok to give children bottles when tired.

9. It's totally ok to throw in the towel on breast feeding and bottle feed a child.

10. People who work in this space are often zealots. Ironically, the most credible individuals are the people who have studied this issue recently.

11. Observational studies are generally useless because the women who do not have the opportunity to breastfeed are often marginalized.

12. Studies from countries without good drinking water are also useless. For obvious reasons.

13. It would be interesting to also study the impact of breastfeeding policies on conceiving and having children in the first place.

14. 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?