Parenting “Experts” are everywhere. They’re there to tell us exactly what to do in just about every situation, usually with the moralistic judgmental attitude of… well, parents. Parents voluntarily subject themselves to these “Experts” and their opinions because parenting is stressful, and it’s nice to think other people have this stuff figured out. In order to examine the ongoing biological, philosophical, moral, and psychological debates that other people have about raising your children, Full-Time Dad presents Parenting Expert Wars. The first article in this series is about breastfeeding vs. bottle feeding. Enjoy!
It is among the first decisions that every parent of a newborn makes: whether to feed your baby breast milk or formula. Even if you’ve never thought twice about it, you probably have a first-blush opinion of it. I certainly did. I am, as a general rule, against pre-packaged foods, especially for babies. Almost every jar of Gerber or every plastic tub of Mott’s is less healthful and more expensive than food you can make at home. Furthermore, breastmilk is a natural human phenomenon, certainly it must be the superior option, right?
Turns out, it’s not that simple. Biology and culture make breastfeeding a horse of a different color.
The Case for Breastfeeding
Simply put, breastfeeding is a naturally-occurring human phenomenon that has occurred for tens of thousands of years. According to breastfeeding advocates1 the benefits of breastfeeding are legion. These include:
- Breast milk provides ideal baby nutrition
- Breastfeeding promotes bonding between mother and baby
- Breast milk passes on antibodies to the baby and helps develop the immune system
- Breast milk is free, formula is expensive
- Breastfeeding provides an important bonding experience that cannot be replicated with the bottle
…and there are dozens of purported other benefits that advocates tout2:
- Breastfed babies have better skin
- Formula-fed babies have lower IQs
- Breast milk decreases risk of breast cancer in mothers and in baby girls
- Formula-fed babies are more likely to die before the age of three
Lactivists believe the research proves that if we choose to give Creature formula, we are setting her back in just about every aspect of life imaginable3. Just as anything within the Parenting Industrial Complex, there is a cottage industry to support the “Breast is Best” lactivist movement. You can spend over $350 on a breast pump, hundreds of dollars on various specialty bras, clothes, and pillows, or pay over $100 an hour for a lactation consultant to tell the best known practices of breastfeeding4. There are dozens of books and websites with the position that formula is, unequivocally, inferior to breastmilk.
The breastfeeding advocacy resources include:
- Pediatrician Dr. William Sears, who literally wrote the book on the benefits of breastfeeding.
- Tipper Gallagher, IBCLC5, based out of Minnesota with her website The Boob Geek.
- Leading international publications like The Economist.
The Case Against Breastfeeding
It is hard to overstate the time commitment required to breastfeed a newborn baby. Due to the small size of their stomachs, but large nutritional requirements, newborns need to feed every two to three hours. That’s nine to 12 feedings at 20-30 minutes a day for months. That means women who choose to breastfeed exclusively will spend anywhere from 4.5-6 hours with a baby or pump attached to her breast every day, without exception. This puts an extreme physical6 and mental toll on the mother until feeding frequency drops as the baby gets older.
Of course, many women today refuse to sacrifice their professional ambitions in the wake of having children. The drive to balance work and family life puts more stressors on new moms in the workplace. The need to regularly pump milk at work in order to maintain a store of food at the ready creates an extra burden on women who are looking to breastfeed. Finding a comfortable, quiet place to pump three or four times during the workday is an impossibility for millions of working moms. Those who are afforded this rare concession are often forced to pump off the clock. As Hanna Rosin said her 2009 column for The Atlantic titled The Case Against Breastfeeding, breastmilk is only free “if a woman’s time is worth nothing.”
Furthermore, the breastfeeding-only approach all but cuts the father out of the feeding schedule, leaving the burden entirely on the mother. This creates a gross imbalance in the family: the father doesn’t have the opportunity to bond with baby, and the mother gets little rest7, which this can cause friction and resentment between mother and father.
Most egregious of all may be the tremendous exaggeration of benefits that breastmilk provides. Courtney Jung’s 2015 article in the NY Times Overselling Breastfeeding lays out many examples8 of the lack of real, hard scientific evidence that the breastfeeding advocates continually lean on.
The truth is there are dozens of correlations for the benefits of breastmilk that require leaps in logic to maintain as causal9, and that’s even before taking into account the incredible weakness in research methodologies.
The Case for Formula
The human body, as it turns out, is neither a perfect machine nor a magical life-giving device. People the world over have flaws10, some of which actually prevent mothers from being able to physically produce, or for the baby to consume, the amount of milk required for newborns to thrive. Enter baby formula.
Formula has been on the market since the late 19th century, developed as a way to curb the shocking infant mortality rate of the day. The products that emerged out of the labs were very successful, and formula became a popular alternative to breastmilk headed into the 20th century. In the 100+ years of product development, the formula companies have created a slew of products that provide the correct amounts of nutrition from a series of different sources, tailoring products to babies with limitations of their own11.
There are many of kinds of formula for newborns: milk-based, soy-based, easy-to-digest version for babies with problem stomachs, specialty formulas for premature babies, powdered, concentrated, and ready-to-drink off the shelf. The choices seem overwhelming, but the products have been created to address the myriad different needs for babies. All babies are different, and there is no panacea.
Aside from the medical/nutritional benefits, formula has the ancillary12 advantage of flexibility. Breastfeeding effectively tethers new moms to a set of baby lips or a breast pump for months; formula cuts that tether. Not only does mom no longer have to be a milk factory, but formula also allows other people to share in the task of feeding baby. Suddenly, the traditional gender roles no longer need apply. Moms and dads can alternate nighttime feeding shifts, allowing for a more rested family. This means fewer conflicts in the house due to irritable adults, yes, but it also means more productivity in parents’ professional lives. And speaking of professional lives, formula-feeding moms don’t need to sacrifice their professional day to hook themselves up to a breast pump multiple times a day.
No breast milk in the fridge? Dad’s turn to feed the baby? Grandma is over and wants to bond with her new granddaughter? Family friend is babysitting for the night? Formula provides the means for consistent feeding no matter the social situation.
It’s not just about convenience and flexibility: formula has changed the very social dynamic of the family for the better.
Resources for formula advocacy include:
- Suzanne Barston at Fearless Formula Feeder
- Dr. Amy Tuteur, OBGYN at Skeptical OB
- Courtney Jung’s new book Lactivism: How Feminists and Fundamentalists, Hippies and Yuppies, and Physicians and Politicians Made Breastfeeding Big Business and Bad Policy
The Case Against Formula
There is nothing convenient or flexible about having a baby. This idea that moms are somehow entitled to convenience is selfish. Your baby needs you and needs the nourishing breast milk to thrive and no amount of processed, marketed powder will ever be able to replace the benefits of breastmilk.
Formula is developed and marketed by big businesses with only one goal in mind: increasing the bottom line. Companies like Nestle have been accused of unethical business practices in order to push expensive formula on unsuspecting populations. Companies have proven time and time again that they can get you to spend more money in the furtherance of providing for your child. They are marketing geniuses, and know how to push your personal panic button.
But even if the companies were perfect, ethical organizations, there is no way that a science can replicate the benefits of breast milk in toto. Studies have shown, again and again, that formula-fed babies are exposed to health risks and face developmental challenges that breastfed babies avoid. More examples of this include:
- Formula-fed babies are more likely to develop allergies
- Formula-fed babies have a higher risk of developing Type I diabetes
- Breast milk lowers babies have lower risk of developing asthma
- Formula feeding is linked to a higher risk of Sudden Infant Death Syndrome
- Formula feeding is linked to a higher risk of obesity
What We Are Doing in Our House
Both sides of the debate do agree that breastmilk is the superior option. The disconnect lies in the degree of superiority. Lactivists say it’s inarguably tremendously superior, while formula feeders say the improvement is minimal, but the ancillary benefits of formula far outweigh anything you potentially sacrifice by not breastfeeding.
The truth is nobody really knows. The science on this is, frankly, bad science. Real controlled experiments are unethical and impossible, making findings such as “breast milk means higher IQ” or “breast milk means lower risk of obesity” utterly worthless. There are so many other environmental factors that go into these factors13.
So that means we have to go with our beliefs. Personally, I do believe that breast milk is probably better, but I don’t think formula as a category is some evil conspiracy brought down upon us by big business in order to suck money from our wallets and poison our children. I don’t believe that parents choosing formula are actively making a bad decision, nor do I believe that parents who exclusively breastfeed are the model of the Perfect Parent. My knee-jerk response is to lend some credence to what even I admit is a logical fallacy14: since breast milk is natural, it’s probably better for babies. But I’m also not going to throw a hissy fit if we buy a can of Similac.
Kathleen and I have the luxury of ignorance and convenience on our side. Since Creature is still waiting backstage, we get to plan the best case scenario. Kathleen works from home, so she can pump in private without fear of losing out on valuable work time. Theoretically, this means a large store of breast milk for Creature, and the feeding shifts can be doled out fairly. The Affordable Care Act15 mandates that health insurance covers the cost of a breast pump, and feeding Creature breast milk saves us $150-200 month. These are, of course, the best-laid plans.
What if Kathleen isn’t physically capable of producing enough milk for Creature? What if Kathleen finds pumping all day to be uncomfortable or painful? What if Creature has special nutritional requirements that breast milk alone can’t provide? What if we, as parents, just say “screw it”?
Gun to my head, I’m going to guess that we’ll eventually do some sort of hybrid of breast milk and formula. I’m not going to question the toll that breastfeeding/pumping takes on Kathleen. If she’s rolling with the punches, then it’s certainly possible that we’ll breastfeed Creature exclusively, but it’s not an expectation.
- Sometimes referred to as “lactivists.” I’m having a hard time determining if this is a sarcastic label or not.
- You can see a long list of the purported benefits here. I’m sure the advocates don’t consider the comprehensive.
- And Kathleen won’t reap the myriad benefits, either
- I don’t mean to imply that these products and services lack value. Simply that markets spring up around just about everything, and as a new parent, it’s hard to differentiate the necessary from the superfluous.
- International Board of Certified Lactation Consultants
- Breastfeeding can be extremely painful, as babies have surprisingly powerful suckling capabilities
- Working moms get even less rest.
- Even more in her recently-released book.
- One of the worst violations of intellectual honesty in any debate is the conflation of correlation and causation. I don’t know if the people screaming and pointing at data supporting their argument genuinely don’t understand the difference between correlation and causation or if they do know and choose to ignore it. Frankly, I’m not sure which is worse.
- Poor nutrition, medical conditions, genetic limitations, and a litany of other issues.
- Special nutritional requirements and allergies, for example.
- And arguably more valuable.
- Take obesity, for instance. What is the household’s approach to food, overall? What is the activity level of the family? Of the child? What about the child’s exposure to food habits at school and through peers? Without kidnapping hundreds of babies and mothers and running them through rigidly-controlled Truman Showesque life experiments through childhood, even the act of implying a causal link between the two based on extant information makes you either ignorant or an asshole with an agenda.
- Appeal to nature.