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Breast milk versus formula is an intensely studied issue, and despite all the study the proven advantages of breastfeeding are extremely tenuous. WHO recommendations to breastfeed have far more to do with poor water quality in developing countries than health benefits of breast milk over formula.

See: http://www.ntnu.edu/news/breastfeeding, http://www.sciencebasedmedicine.org/index.php/are-the-benefi..., http://jhppl.dukejournals.org/content/32/4/595.full.pdf+html, http://www.dailymail.co.uk/health/article-1200943/So-breast-..., http://www.bloomberg.com/news/2012-07-02/breast-feeding-is-n..., http://www.halfsigma.com/2007/11/breastfeeding-d.html

From the last article: "In one analysis of multiple studies, combining data from more than 5,000 children, the IQ differences associated with breast-feeding were eliminated when the mothers’ characteristics were taken into account. Among 332 pairs of siblings in which one was breast-fed and the other bottle-fed, researchers also found no difference in IQ."

At the same time, breastfeeding is insanely expensive. It is insanely difficult for a working woman to breastfeed, and breastfeeding makes it extremely difficult to share the child-rearing burden between the mom and the dad.

Like with most recommendations having to do with child-rearing, those involving breastfeeding are both unscientific and aren't subject to cost-benefit analysis. Given the extremely tenuous proven benefits of breastfeeding, a baby is almost certainly better off in the long run from the mom's increased earning power from not having to downshift her career to breastfeed.




"The risk of developing either diarrhea or ear infection increased as the amount of breast milk an infant received decreased."

http://pediatrics.aappublications.org/content/99/6/e5.short

"The crude incidence density ratio (IDR) revealed a protective effect of breast-feeding on respiratory illnesses (IDR=0.66; 95% confidence interval (CI), 0.52 to 0.83), on gastrointestinal illnesses (IDR=0.53; 95% CI, 0.27 to 1.04) and on all illnesses (IDR=0.67; 95% CI, 0.54 to 0.82)."

http://www.ncbi.nlm.nih.gov/pubmed/7844664

"Overall, children who were ever breastfed had 0.79 (95% confidence interval [CI]: 0.67–0.93) times the risk of never breastfed children for dying in the postneonatal period"

http://pediatrics.aappublications.org/content/113/5/e435.sho...

"Infants exclusively breastfed ‘at discharge from the obstetric hospital’ (odds ratio [OR]=0.52, 95% confidence interval (CI):0.35–0.71) and during the last 2 days (OR=0.65, 95% Cl:0.46–0.91) had a significantly lower risk of SIDS than infants not breastfed after controlling for potential confounders."

http://ije.oxfordjournals.org/content/22/5/885.short

"Exclusive breastfeeding (EBF) may substantially reduce breastfeeding-associated HIV transmission."

http://journals.lww.com/aidsonline/Abstract/2005/04290/Early...

Exclusive Breastfeeding Reduces Acute Respiratory Infection and Diarrhea Deaths Among Infants in Dhaka Slums

http://pediatrics.aappublications.org/content/108/4/e67.shor...

Breastfeeding improves survival, but not nutritional status, of 12-35 months old children in rural Bangladesh.

http://europepmc.org/abstract/MED/2606091/reload=0;jsessioni...


> "The risk of developing either diarrhea or ear infection increased as the amount of breast milk an infant received decreased."

Yes, but by less than a factor of 2 for a digestive condition that, while a killer in the developing world, is at most an inconvenience in the developed world.

> "The crude incidence density ratio (IDR) revealed a protective effect of breast-feeding on respiratory illnesses (IDR=0.66; 95% confidence interval (CI), 0.52 to 0.83), on gastrointestinal illnesses (IDR=0.53; 95% CI, 0.27 to 1.04) and on all illnesses (IDR=0.67; 95% CI, 0.54 to 0.82)."

It's interesting that you leave out this part of the text: "The protective effect of breast-feeding on respiratory illnesses persisted even after adjustment for age of the infant, socioeconomic class, maternal age, and cigarette consumption (adjusted IDR = 0.78; 95% CI, 0.61 to 1.00)." There is no reason to ever report IDRs not adjusted for socioeconomic class, maternal age, and cigarette consumption, because breastfeeding rates are not uniform among these groups. So the first set of numbers is meaningless. An IDR of 0.78 is not a big benefit. It means that if something happens to bottle fed infants 10% of the time, it'll happen to breastfed infants about 8% of the time. And remember, this is just the first six months of life--the available studies show these sorts of effects diminishing as the child gets older.

> "Infants exclusively breastfed ‘at discharge from the obstetric hospital’ (odds ratio [OR]=0.52, 95% confidence interval (CI):0.35–0.71) and during the last 2 days (OR=0.65, 95% Cl:0.46–0.91) had a significantly lower risk of SIDS than infants not breastfed after controlling for potential confounders."

The number of babies that die of SIDS each year in the U.S. is about 2,500 out of 4,000,000+ births each year. With an OR of 0.65, we're talking about a roughly 0.075% risk versus a 0.050% risk. For comparison, your child has a 1.2% chance of ever dying in a car accident.

> "Exclusive breastfeeding (EBF) may substantially reduce breastfeeding-associated HIV transmission."

This is the only one of the lot that's actually worth talking about. We're talking about OR's of 2.5-4 for something that has an overall incidence rate of 12.1%. So if you're HIV positive, exclusively breastfeeding can substantially reduce your chances of transmitting the virus to your child.

Your Bangladesh (my home country!) example is irrelevant to people in the developed world. The water in Bangladesh is full of arsenic and disease. Of course breastfed infants, who don't drink the water, are going to be much healthier than bottle fed infants who do.


"And remember, this is just the first six months of life--the available studies show these sorts of effects diminishing as the child gets older."

Sure. Your area of concern seems to be the over-selling of breast-feeding in the developed world. Mine is the over-selling of infant formula in the developing world, including China, to the point of people never breastfeeding their infants. The above was a fairly cursory attempt to find a few examples of recent, post advertising ban, research on the subject.

By the way, you may not be aware of this, but the Daily Mail is a tabloid and the author of:

http://jhppl.dukejournals.org/content/32/4/595.full.pdf+html

is a professor of Women's Studies.


A lot of those links completely ignored caveats he said. The Bangladesh one in particular is DIRECTLY addressed in the comment you're replying to.




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