Interesting in that each generation has it's own "true intelligence" on what's best for infants and mothers. Loved having kids in the 60's free from all Madison Ave's "must haves" for "successful" breast feeding products. Remember reading once kids reach elementary grades hard put to sort out kids by which "method" of getting them there was best.
Also what happened to all the research showing breast milk loaded with carcinogens and even found in cord blood??
Mothers, anxiety on what's best is the worst thing you can do for your own health and the infants.
Relax and use common sense!!
Lovely article, mostly because I adore learning about the biome.
But the article doesn't single out stats connecting poverty and cesareans and formula feeding and their children's lifelong health problems.
Does a woman holding down two or three entry-level jobs have access to a pumping room or long enough breaks throughout her shift to pump, or portable refrigeration to prevent spoilage? Are they, statistically, experiencing significant social and cultural pressure to switch to formula as soon as possible?
Those of us lucky enough to be SAH moms or those able to work from home are not likely to be socially, economically, or culturally disenfranchised (just my opinion, of course).
Although I was able to work from home, I chose to take big financial hits rather than stop breastfeeding.
And pumping for sitters, later, was personally intolerable because I could actually see my nipple pulled into the suction cup (Ugh! So unnatural.) So, I extended my time at home instead of paying a sitter.
I am completely aware that my education, class, and aspirations let me follow my heart and I'm more grateful than I can ever express for having had the privilege.
And although I know other women who were able to stay home, they were all able to absorb the financial hit. And to give me the social support for breastfeeding that I craved.
I would hope that data about poor moms is being studied as a separate category and/or being written about.
Thanks again for the article, Ms Brody.
2
“At this time, vaginal seeding should not be performed outside the context of an institutional review board-approved research protocol..."
Of course! We're lucky the doctors "allow" us to have babies at all without intense medical supervision!
19
Such emotion this article stirs up! I get it. If you had a c-section or couldn't breast feed you feel guilty. This article has added fuel to that guilt. But human infants are adaptable and formula is an excellent food. If we could remove the guilt some mothers feel then this article would just be "more information."
Research needs to be done into these alternatives. We know that colostrum contains antibodies that immediately protect an infant from illnesses the mother has immunities to or develops during breast-feeding. We know that a c-section is (at the least) major abdominal surgery. What else can we learn about alternatives?
As a scientist, I find these studies intriguing. As a mother I can understand how they might trigger anxiety about how best to raise a baby. Every mother wants to be the best possible mother.
I am annoyed by the knee-jerk responses from some of the mothers replying to this article. It's not a personal attack. It's new information. I am also annoyed by the personal experience accounts "well, I did this with my babies and such and such was true so......" Personal experience does not a study make. Only when many babies and mothers are studied using controlled double-blind experiments (as mentioned in the article) will we begin to have answers.
In the meantime, throw away your guilt!! You did what you felt was best for you baby and you at the time. Don't shame this new information. Instead, applaud it
15
Agreed. Enough of the mommy/parent shaming. When will people learn how to share information like this with a more thoughtful approach and language?
4
This study provides all the rationale, if any more were needed, for SIX MONTHS of paid maternity leave. The cost to our medical system of these chronic diseases is so great that any possible mitigation is warranted. And then there is the benefit to the mothers and fathers and their families, which is currently of no interest to our lawmakers.
31
Everyone who reads the NYT is aware that vaginal births and breastfeeding are ideal. For a panoply of reasons, however, these may not be possible. This article just makes stressed new mothers who already beat themselves up about possible missteps at every turn feel terrible. Thanks.
10
@KS
This sounds like projection. I see no place where any such judgment is rendered in the article. Mere consideration of the accumulating evidence does not "make" anyone do anything.
Far from promoting some imagined "ideal," identifying advantageous methods of childbirth and nurturing enables healthier outcomes. Ignoring them would be irresponsible. And is it really a surprise that mechanisms developed over hundreds of thousands of years of human evolution would have such advantages?
6
No mention of how antibiotics eliminate the good bacteria in infants?
10
@Barbie
Yes, what about antibiotics? I'd like to hear more about the effects.
1
In terms of the health outcomes of c section and breastfed babies, has anyone considered that "more difficult", ie babies with inherent health differences are more likely to nobreastfed or be in a position to make it out of the womb? Anecdotally my second much more difficult child needed a c section, needed supplementation by the hospital upon birth, is much more demanding as a toddler making me want to wean earlier. Some of these things can be controlled for in the studies, but I bet a lot isn't.
10
If you read the actual studies, you will find that these things were controlled for. Scientists understand confounding variables.
1. I'm surprised by how many people who read the Times think that their personal experience either supports or contradicts a 2-million size statistical analysis and that this says anything about the study. Maybe we really need to require one stats course to graduate high school. 2.Of COURSE many women don't have choices as to C-sections and length of breast-feeding. But surely one can't go from 1 in 20 women having C-sections to 1 in 3 due to medical necessity in one generation. So for the people who DO have a choice, the study might have something useful to contribute. As far as breastfeeding benefits, the twin study seems like the best one around - the only way to really control for selection bias (who gets to breastfeed as long as they want? they probably already have most of the desirable outcomes). That said, no one ever said the only benefits of breastfeeding accrue to the infant. Even if there are no IQ or health benefits to the child, there may be significant bonding differences or differences to the health (mental or physical) of the mother as well, and more research is needed on this angle - of the rigorous kind.
15
I was delivered vaginally and breastfed - both many years ago. Still, I developed allergies and, later, asthma as an adult. I suspect my asthma was caused more by the second-hand smoke that was so prevalent when I was young. There is less tobacco smoke in the air now, but enough other pollutants to affect young lungs.
Stop blaming mothers for environmental factors not in their control!
10
so your one experience outweighs a study of 2 million births? But of course...
10
"If vaginal seeding is being considered, women should be informed of the risks and tested for infectious diseases and potentially pathogenic bacteria, including group B streptococci, herpes simplex virus, chlamydia and gonorrhea, the committee stated."
And a vaginal birth requires no such consideration?
How myopic.
9
Of course you are tested for all of the above while pregnant and it's the reason women with STDs give birth via C-section to begin with.
7
It does actually! Women routinely get tested for these infectious diseases during their pregnancy, and treated with antibiotics during labor for certain conditions.
2
@Adam
A few minutes with Wikipedia would obviate such a comment. Mansplaining at its finest.
1
The best thing you can do for a little kid is let him/her go out and play in the dirt. Maybe a mouthful of the stuff, as little kids are prone to trying out, should be encouraged. And easy on that Purell use. The immune system needs exposure to common germs early in life to keep it working well.
22
Make mud pies
Eat some of them
Climb trees
Pretend you are a horse, chew grass
Explore skunk cabbage and pill bugs
Life happens
Absorb it
You'll thrive
29
@Lee beautiful! Thank you @erinleucadianp
1
This article regurgitates so much breastfeeding pseudo-science that was debunked by that twin study from a few years ago.
9
I found that my terrible allergies and ER level asthma, possibly my mild vitiligo, the skin condition that bleaches skin, were actually created by poor diet leading to acid reflux. They were all easily controlled with a daily off the shelf antacid. What I thought was hereditary and possibly caused by way of this article was something simple solved by a gastroenterologist.
2
@Scott Kohs Low stomach acid and low B12 levels from daily use of antacids can go on to cause other issues. Be mindful.
1
I remember hearing a Cornell University ecology professor telling us about babies born in a hospital that was so clean that the babies were failing to thrive -- back in 1972. Back then, he said they needed more exposure to microbes. So this is not a new concept.
5
Breast feed, sure, if possible, but accumulating evidence does not support exclusive breast feeding for 6 months, indeed the trend is to introduce other foods, including potentially allergic foods, from three months onwards. Some suggest even earlier. Many neonatal, environmental and dietary factors contribute to the microbiome; while these can act early, they also appear to function in later life, as studies of asthma incidence in children and adults migrating from low to high asthma prevalence countries demonstrate.
6
Is it safe to feed babies other foods at three months? I'm asking because I'm pregnant and have wondered about this.
Chuck, it depends on the baby but if yours is ready (showing interest, able to control their tongues and swallowing well), he or she can have bland, soft, non-allergenic foods around 3 months in addition to breastmilk and/or formula. Rice or oat cereal, apples, and squash are usually tolerable. The first couple of months are really for baby to practice eating solids than getting the bulk of their nutrition. Good luck!
What about the effect of women receiving antibiotics during labor and delivery? Many women are administered two doses of antibiotics to prevent group B strep bacteria from transferring to the infant. Does this affect the gut biomes of newborns?
14
@Mary Anne I'm very late with this but it absolutely does! Studies have demonstrated they affect the baby's microbiome in the same way as early antibiotic administration to the babies themselves do, simply on a smaller scale.
1
Who new that breaking with eons of biological and evolutionary habit would
have a harmful result? I've always assumed our doctors knew what they were talking about. Go figure.
You forget that before the onset of modern medicine pregnancy was a risky undertaking for women. Many women died of labor and delivery problems, fevers and disease. Many children also died. Nature isn't kind.
5
Most of the deaths in the past were caused by postpartum (childbed) fever (puerpural fever) which was more common in hospital births than home. Before physicians were aware of the cause of infections, hand-washing, etc was never done and doctors were unwittingly introducing the bacteria to healthy women who had just given birth. It's one of the first things I teach in my intro biology classes.
Childbirth is not without risk, of course. But most births were successful and infant mortality was far higher than mortality of the mother before doctors got involved and no one knew the cause of infections.
2
As someone who works with bacteria and other microbes on a daily basis, and is charged with helping decrease the risk of spread of disease, I know just how easy it is for bacteria to be transferred. Considering how many times babies get kissed, held, cuddled for long periods of time skin to skin, that parents and other caregivers fish things out of their mouths, I have an extremely hard time believing a few of the premises that are promoted here.
First, the brief exposure to vaginal secretions as the baby passes through the birth canal and those special bacteria having a years long effect on the baby strains causality reasoning. Secondly, I am all for breast feeding, with the perfect natural evolution of mother's milk as the only food for months, along with literally pounds of antibodies secreted into the milk. But consider that even with good hygiene, nursing exposes the baby's alimentary canal to the bacteria on the mother's skin many times a day for 5 to 10 minutes has the effect of constant seeding for at least half a year or more.
I wonder if these studies which show at least a casual if not causative effect, have taken into account the family's use of soaps, antibacterial wipes, how much the baby is allowed to pet the cat or dog, crawl around on the floor among thousands of other inputs.
Anyone who has children or studies them knows that infants and toddlers explore the world through touch and their mouths.
More careful analysis needs to be done.
23
Check out the study linked at the end of the article. It reaches some of the conclusions your comments suggest (namely, that the gut biomes of formula vs breast-fed babies look the same by age 2, after introduction of solid foods). This article does a disservice by not mentioning that!
13
Viruses are also important in the picture as well. While no one would recommend exposing infants to highly pathogenic viruses like HSV or rubella one factor in the polio epidemics of the 1940's-1950's was the delay in exposure to the native polio viruses while the infant was under the umbrella of maternal antibodies to them. When the children were later exposed, they had no opportunity to develop their own gut antibodies to polio and the clinical disease erupted. (That was probably how I got the disease!).
5
Yet another story on the threats C-sections pose to our children. If the operation didn’t exist, my daughter would have a lot more to contend with than deficient gut bacteria. She would be dead and so would I. I am tired of the implication that most women have this operation rather than rearrange dates for a golf game.
20
There are cases when C-section is absolutely necessary for the health and safety of mother and infant. There are cases where obstetricians err on the side of caution, recommending c-section rather than a more risky delivery, because heaven forbid that they take risk, as every parent expects a 100% perfect outcome from every birth, and even a minor complication will have the Ob hauled before the courts. And then there are the women who are "too posh to push", and elect to have a c-section without ever considering a vaginal delivery.
The consensus among experts is that the c-section rate is much too high, and it's the purely elective operations that are mainly to blame for that.
11
My predominantly formula fed son is 3 years old. Starting at 3 months old, he went to daycare where they call him the “bionic baby” because he rarely gets even mildly sick. He is 5th percentile for weight but 70th for height (slim). He has not had a single one of the many disadvantages that are claimed/“proven” for kids whose mother’s are unable to breastfeed except for having a mother who was clinically depressed over it.
21
That is great for you (and I'm not being ironic).
But presumably you understand that one anecdote isn't anything near being scientifically conclusive. There are people who have natural immunity to certain diseases. The fact that they don't contract those diseases isn't evidence that other people shouldn't get immunized.
13
THANK YOU for saying this. I was on the brink of depression because I was unable to breastfeed my daughter beyond her first 2 months. I felt like I was failing her as a parent already. Turns out my mum had the same problem, and I've always been super healthy and never had any allergy or chronic disease. Same for my sister and for my husband. Go figure. Now she's in daycare, exposed to all sorts of stuff, and only got sick once - with a cold.
Besides, new guidelines recommend feeding infants allergy-inducing foods such as eggs, nuts, wheat & soy before they're 6-7 months, starting at 4 months - which according to this article would be inadvisable. Go figure.
8
My youngest child was birthed vaginally and was exclusively breastfed AND continued to breastfeed till he was over 2 years old because he had severe food allergies.
He has asthma and lived with 7 anaphylactic food allergies until he was a teenager!!! He still has one food allergy but very quickly his allergies righted themselves as he approached his teen years BUT I did it ALL right according to these doctors. I still had a severely allergic kid. It's all phooey. That have NO CLUE why so many have severe allergies.
21
Nowhere in this article does it say there are any guarantees. Instead of pronouncing the science "phooey," it would make sense to take solace in knowing you gave your kid the best possible chance of avoiding the health issues he faces. Any mom who takes in all this info and still feels the need for a c-section or formula, should be supported in her decisions; ignoring the science and making those decisions is a different story. Why do some people have such difficulty with science? Is it a reading comprehension issue?
9
P, except the science doesn't say what you think it does. There is simply little evidence that c sections and formula have a negative impact on a child's health. All this talk about gut microbiome is full of pseudoscience. My child was a c section and formula fed baby and he is incredibly healthy. No issues. No asthma, no allergies, not one ear infection in his 9 yrs.
6
Your child is only inheriting what you hand down to him (as in, it is the mother's gut who's shaping the baby's). So "doing everything right" does not "guarantee" anything although it probably meant that you were able to prevent even worse outcomes for your child. In a perfect world, your gut would be in perfect shape and so vaginal childbirth/BFing would've been enough for your child to have optimal health. But nowadays so many of us have problems to begin with *before* having kids. So your experience does not actually refute the science; it's just that the journalists fail to mention that you bequeath your own health heritage to your child, warts and all.
6
I'm wondering if there has been any research on the effects of taking anitiobitics for women who deliver vaginally but were positive for Group B Strep and therefore had to take antibiotics during labor. This is a fairly common occurance, and I'm wondering if the antibiotics kill all the good organisms along without the bad.
25
Wow. That seemed like one long study to come to preconceived conclusions. This isn't science.
4
I found it fascinating to read through the comments especially from the woman who suggested that doulas are somehow making out like bandits (ha!). I wonder why women are so defensive when this article is simply offering information on recent scientific research. Moreover, it's as if women have forgotten we are mammals and that like all mammals, we are built to feed our babies by breastfeeding. It has nothing to do with shaming and everything to do with the fact that we are still part of the animal kingdom. The human body is an amazing thing and a woman who is able to give birth and feed her child, like every other mammal is also able to offer the child important nutrients and micro-organisms that support its growth and protect it from the harsh world. It seems to me that the women who have knee-jerk reactions are simply feeling bad about their choices versus contending with the realities of being animals who are built to do this work.
Others do make valid points about the difficulties for working women to breasted and support their children - these are legitimate concerns that do need to be addressed, because it is not fair how we treat women in this country. We want women to have babies, work, and do it all with a handful of days to a few weeks (if lucky enough to have any kind of maternity leave policies).
That said, instead of feeling shamed or blamed (because this article objectively did neither), I implore women to think critically about the data being presented.
43
Be careful when you start using the word “choices” to refer to mothers whose ideal birth plans end in Caesarian, or for whom breastfeeding ends up being a lost cause despite interventions and all manner of expensive attempts to make it otherwise. I desperately wanted to breastfeed my child exclusively, but was unable to; it had been my plan and my whole hearted intention to do so. Despite knowing that I tried everything in my power to make it happen, I still carry a feeling of failure about it. I don’t think it will ever go away.
I find articles like this unhelpful. They don’t help mothers who don’t have the “choices” everyone assumes they do, and they push a spurious interpretation of science that is yet unproven, only speculative, and may only ever show correlation, not causation.
I highly recommend the book “Lactivism,” by Courtney Jung for a well-written and researched examination of the false science being used to push the cause of breastfeeding.
6
Women get defensive about their choices. They shouldn't. Articles like this are giving information to consider in making choices. Slight health benefits of vaginal deliveries and breast feeding are something to consider when making decisions, along with your personal preference, job situation, logistics, finances, etc.
21
I read the Danish study. When the authors wrote that children born by c-section were "significantly more likely" to develop asthma and other conditions, they were talking about statistical significance. The paper (unlike Ms. Brody) gave quantitative information, including the PARFs. The PARF for c-section induced asthma was 3%. In other words, the paper estimates that 3% of all asthma cases can be attributed to c-sections; the remaining 97% were caused by something else. (And that's assuming that the researchers accounted for all cofounding factors...) What's more, of the 1.9 million children in the study, only a 103,800 had asthma. Eliminating c-sections would reduce the overall risk of asthma by 0.17%.
The rest of this article is an exercise in fear-based conjecture. Maybe the mix of bacteria in a baby born by c-section or given just one bottle of formula suppresses gut maturation... which might lead to an impaired immune system...which might lead to Type 1 diabetes...which might..gah! Look what you've done! You gave your baby a bottle of formula while you recovered from your c-section, and now he's doomed, doomed, I tell you!
70
The NYTimes also published a study on discordent siblings, where one child was breastfeed and the sibling wasn't, showed no diffferences were found in health, intelligence or obesity. The reason the sibling study was important was because it eliminate income and racial differences. Most of the time, it's SAHM or women with supportive jobs that can breastfeed. Poorer women who work in fast food restaurants wouldn't have the luxury to breastfeed.
https://well.blogs.nytimes.com/2014/03/04/is-breast-feeding-really-better/
Correlation is not causation.
Also, your body your choice. Not sure why a woman's autonomy of her body suddenly goes away when she's pregnant.
31
Neither Brody nor the study talked about forcing mothers to either deliver vaginally or breast feed. This provides information that may be useful to decision making, especially for mothers who DO have a choice.
20
Great article. "Emergency cesareans" are becoming the norm. Women want to labor naturally and when the pain is too fierce take fentynal and then get an epidural. These are opioids that reduce breathing rates/heart rates. The babies heart rate falls as a result and an e-cection is performed. What is needed is a safer pain alternative. Women should be able to have something to manage pain instead of being told either you do it natural with nothing or you take potentially deadly drugs. High potency cannabis THC/CBD administered below the belt (no-psychoactive effect) could be the answer one day!
6
The recommendation against vaginal seeding is infuriating. I requested this “procedure” (ie, smearing vaginal secretion that should be on the baby, had birth occurred naturally, on to the baby born by C-section...gasp!) be done after my non-scheduled C section...and was of course denied by the hospital. So I had my husband help me do it once the nurses left us alone. And yes, I did ensure that I had been screened for dangerous pathogens.
Anecdotal data is nearly worthless, but this baby has no food allergies (knock on wood), unlike her sister. I’m desperately waiting for the trials to catch up with common sense so that more mothers can have help transferring their microbes to their babies even if they are unable to deliver vaginally.
8
There is so much more to allergies then just a mother's pathogens. Heredity plays a huge roll. Anecdotally, 3 kids, all have childhood asthma to varying degrees. Father a life long asthmatic, controlled with drugs. All 3 outgrow the asthma. Later, in late teen years one develops a food allergy (shrimp) and sensitivities to many tropical and citrus fruits and vegetables (always was a picky eater). One is taken to the allergist for testing. He is basically allergic to everything and is taking medication to help with breathing, etc. His allergy sheet is exactly identical to his fathers. Exactly! Other kid has no problems, takes after me! What does this prove? Nothing. Just wanted to say, your other baby would probably have had problems anyway.
1
If breast is so best, what's being done to support mothers who under-produce? The problem is real, the only USDA approved drug doesn't do much, and depression is a major side effect.
11
Seems like this problem happened to you. If so, I'm sorry. I do hope you've made peace with it. But regarding your question, the answer is sadly evident. We, as a society, a country & as a health care system don't really give a fig about mothers & infants. The lower your socio-economic status, the worse it is. It is a national disgrace! And we have 3 more years of the current administration. Maybe someone will begin a "me too" type movement to bring this shameful situation to a broader public awareness.
7
Anyone who has breastfed has quickly learned that supply responds to demand. A severely dehydrated or undernourished or exhausted mother may have difficulty establishing reliable breastfeeding patterns and successful breastfeeding will also be difficult if the mother develops cracked nipples or mastitis - both more common in the era when good breastpumps were found only in hospitals. Underproduction is largely a function of underuse, not a condition found in an otherwise healthy new mother.
Emerging research on the importance of vaginal delivery, skin-to-skin contact, breastfeeding, and the microbiome should have us all extremely concerned about lifelong health of the growing number of babies who are taken into state custody at birth when born to an opiate-addicted mother. I'm not saying they should stay with their birth parents (of course it has to be a case-by-case basis), but I am saying that these vulnerable children, who have so much to overcome already at such a young age, are also often the sickest. They deserve the very best our society has to offer in health care, good nutrition, childcare, education, advocacy, and loving families. Would that it were so. If Big Pharma is ever held accountable for the opiate crisis, let's tack on a few billion more to the settlement for these kids.
12
You’re correct. Leaving a substance exposed infant with mom is finally gaining some traction as the best (obviously) for baby. Even breastfeeding is best for these moms... here’s on article but there are more. https://journals.lww.com/advancesinneonatalcare/Abstract/2011/08000/The_...
I grew up on a large cattle ranch in the tropics. My mother believed in natural childbirth -without painkillers. She breastfed us and put us on the floor as soon as we could crawl and bathed us afterwards. She also allowed us and encouraged us to play outside as long as we wanted. In my early teens I would often return home covered in cow manure, horse sweat and mud from my favorite pastime rounding up cattle.
I played in the mud, got stung by bees and all matter of tropical insects, drank unpasteurized milk that father fed me, and ate all sorts of wild plants and protein my father hunted.
As an adult, I am know for having an iron gut and a very strong immune system, and I don’t seem to catch anything. And, when I do, I get over it quickly.
Yes, I think it is a great idea to expose your babies to the environment and let them play in the mud while they are still very young. They will grow up to be healthier adults and they will thank you as an adult.
Thank you mom.
24
If mother's could stay home with pay and job guarantee for at least a year after having a baby like in many other industrial countries, I bet it would do a lot for breastfeeding and increased well beings of both babies and mothers. Maternal leave policy in the US is nonexistent.
57
thats a whole lot of positions in one article. I have to say that when I see several related 'trendy' positions in one article (cesarean bad, breast feeding good, microbitoa blah blah) I generally treat the article with great skepticism. which is bad because they're all sensical arguments/practices that I'm using with my children. just poor editing I guess.
3
How is vaginal birth and breast feeding trendy. It’s the way we were made. Come on don’t Trump everything.
10
I find it ridiculous that the doctors in this article warn against vaginal seeding because it’s supposedly dangerous. The bacteria and viruses you transfer to the baby are EXACTLY the same, from the same source, that a baby is exposed to during vaginal delivery. I assume their are generally in favor of vaginal delivery and do not warn their patients against it because of the possible transfer of pathogens. Are they just scared of being sued?
14
My thoughts exactly.
Yes! Also, what pregnant woman hasn't already been tested (for me, tested multiple times because I switched providers!) for chlamydia, gonorrhea, herpes, group B streptococci, etc. If you're not a good candidate for vaginal seeding, you will know.
3
For certain. We tend to venerate the degree of MD without ever considering that there are plenty of bad doctors, plenty of illogical doctors, plenty of doctors who have no understanding of statistics. Similarly, there are plenty of reporters who don't have the ability to drill down to the level of understanding on particular studies to understand what makes them newsworthy and question the studies' construction and results.
2
I'm definitely an advocate for breast feeding. I have not read these articles to see if they are properly controlled but one should be careful drawing conclusions that the absence of breast feeding may increase the likelihood of developing obesity for the simple reason of selection bias. Mothers who have the time and ability to breast feed tend to be of a higher socioeconomic class and also tend to have access to healthier foods. Therefore they might be able to raise healthier children, who are less likely to develop obesity. And vice versa. I believe breast feeding is healthier, but watch out for drawing conclusions from studies that may have selection biases.
24
If 27% of women breastfeed their babies for a significant time, then 73% of mothers must be doing something right, even if they hide the fact that they are not adhering to these impossible breast feeding standards. Children today have so many benefits — more vaccinations from terrible illnesses, better nutrition, more attention from their parents, better education and enrichment. This concentration on breastfeeding is just overblown nonsense. Enjoy your children. Let them play outside a lot, with other kids, with animals, mucking about in the garden, etc. And stop worrying about creating a perfect environment for your children.
22
Impossible breastfeeding standards? What? The American Academy of Pediatricians has not set any impossible "standards," they have used science to guide the recommendations of children's care givers, health care policy, & to balance the ridiculous hysterical statements from Mothers who failed, whether from their own fault or not, to exclusively breast feed their baby for a minimum of 6 months. And while focusing on a mother's "right to choose," do not forget that the infant has a RIGHT to receive exclusive breast feeding. Time to advocate equally for the infant.
7
I hope that Ms. Brody recognizes that she has been wrong in past articles to downplay the clear and undeniable benefits of breastfeeding (https://well.blogs.nytimes.com/2012/07/23/the-ideal-and-the-real-of-brea.... This is research and science; most of the comments here are personal anecdotes that are not statistically relevant. In every personal case, there are factors that play a role in determining what is best but it would be foolish to draw conclusions from anecdotes. It doesn't help to complain about poor situations in the past; we should look to the future and be stronger advocates for policies that promote and conditions that support long-term breastfeeding. You may personally have children or grandchildren who would benefit from this, and society as a whole will be healthier for it.
16
let's just make more reasons for mothers time feel guilty Iver thuings they can't control. I was breastfed for a year and still have asthma.
16
The liberty taken with the citations in this article is impressive. The final link used to support the statement that "even small amounts of formula supplementation can shift the microbiota away from a breast-fed pattern" is a complete misrepresentation of the review article. In that article neonate gut colonization is achieved through many different measures including physical contact with parents and the environment, AND in the preparation of formula. It is incredibly important that infants are exposed to microorganisms, per the hygiene hypothesis, but let's please not further contribute to the "breast is best" fallacy when it is simply not supported by the literature.
15
Making parents fearful of giving even a small amount of formula while moms milk is still coming in will lead to even more dehydrated, hypoglycemic, jaundiced babies. As a pediatrician I see and admit to the hospital these starving babies and their exhausted, terrified moms.
Other research has shown that early, limited formula supplementation as a bridge while milk supply is being established is correlated with a longer breastfeeding relationship even months down the road. Making parents even more fearful of formula than they already are, when the science is barely developed, is irresponsible.
14
Both of my kids were born vaginally, breastfed to 9 months and I have never been obsessive with hand sanitizer. (Not sure if they wash their hands as instructed after they use the restroom). Having said that, I can count on 4 fingers how many colds or illnesses my now 17 year old and 12 year old combined have ever had.
7
I believe kids oughta stay kids as long as they can
Turn off the screen, go climb a tree, get dirt on their hands
I believe most people are good
And most mama's oughta qualify for sainthood
- Lyrics by Luke Bryan "most people are good"
7
No doubt the bowel bacteria is important, very much so. Bacteria are passed from mother to child throughout the pregnancy via the placenta. Mouth bacteria are important and gum disease should be prevented. At birth there are important bacteria passed in the vagina but also many potentially harmful viruses can also be passed. it would be important to select those bacteria that are helpful (bacterodies)and use these and avoid the vagina as a source. Breast milk is also an important source of antibodies and bacteria and the mothers diet key. Lots of fiber supplements as well as a plant based diet and perhaps addition of some supplements such as alpha 3 omega. I would say ,at tis time, fiber supplements during and after pregnancy is vital . Polydextrose a complex water soluble fiber, can easily be added to food each day.
See letswakeupfolks.blogspot.com-fiber, for complete discussion.
1
Probably shouldn't be an entirely plant based diet.. just a whole food diet.. which can include high quality animal protein (for a baby this should obviously be minced) and fats. Everything else you mentioned is fine
3
As a full-time working, breastfeeding mother to a baby that just turned 1, these articles serve as encouragement and reinforce some of the decisions I've made the past year. Ultimately everyone should do what is best for their family. With that said, the breastfeeding statistics don't lie. About 27% of babies are breastfed at 12 months. I personally almost gave up several times. As I read the defensive, sarcastic comments, I understand too well the inherent guilt that comes with not being able to do the best for your baby. However the blame should not be put on women. After one year of pumping I can confidently say that society and most employers do very little to help a new mother re-enter the workforce. I could start a blog with the countless horror stories I've heard so the fact that the statistics are where they are is not surprising. I'm one of the fortunate ones that have a dedicated pumping room (not a closet) with restricted card access, microwave for sterilizing, sink and refrigerator. Most companies are run by men so it's not shocking that they know nothing about breastfeeding. It takes a village to raise a kid and if we want to change the numbers we need to have an honest conversation where the only factor being considered is not just the mother. It places blame on women and achieves nothing. Let's get employers and healthcare companies involved. Families need doulas, midwives, lactation consultants, work life balance, affordable childcare available to all!
66
Yes! I have two children and both were born at home with the help of a certified nurse-midwife. My recovery was fast--I wasn't laid up at all because of the peaceful nature of both of my births.
What really helped me was my midwife came to my house every day for the first week and then twice weekly for two weeks after that. She taught me how to breastfeed my oldest, and believe me, it is not innate! Because of the environment into which my children were born, breastfeeding was not stressful. I have heard so many breastfeeding horror stories from friends who had hospital births, and they all involve an exasperated nurse.
I strongly agree with you that the conversation needs to change; support is so important, and new mothers in most situations really aren't given support.
3
All that is fine. But how are families with little to no maternity leave supposed to achieve six months of breastfeeding? It takes monumental effort. It is an unfair burden on families, with little alleviating public policy support. This discussion is incomplete without talking about how societies can ensure that babies are breastfed, as much as possible.
34
With the arrival of my first child also came an incredibly enhanced sense of danger. Suddenly everything that worried me in normal times (i.e. pre mother hood) now acquired the threat level of a medium biochemical attack. Exhaust fumes while pushing my daughter's stroller - terrifying, possibly lethal. Dust in the house, fluoride in the water, BPA in bottles, what if I'd eaten too much tuna all those years, and on and on.
Everybody isn't able to breastfeed, due to various reasons. And considering that breast milk contains not only what was in today's sensible lunch, but every toxic chemical you came in contact with over your lifetime so far that is stored in your fat cells - well, I personally would suggest we all take a deep breath and try to be sensible about this.
Breast milk may be best even with all those chemicals in it, and in a perfect world all new moms would be healthy enough, rested enough, and paid enough (in order to afford the previous two), and have PAID family leave through their jobs, and everybody would be happy all the time, to savor this very special, precious time in their lives where they bond with their new child.
In real life however we do our best with what we have available. And for a lot of new mothers, that's formula. Choose a good formula, use BPA free bottles, do NOT under any circumstances use tap water, keep fluoride out of formula water, and buy organic whenever you can, and you should be all right.
8
Hear, hear!
Everyone needs to chill out. We do need to do our best, but let's remember that many of us commenting were fed formula. It's just the way it was.
4
Nope. Not going to feel one bit guilty about my 3 c-sections (all for different reasons). Moms...my advice: you do you. Stop feeling guilty and thinking we can possibly control things that are often out of our control. This is just one more thing piled on to us, and I'm not going to shoulder it.
26
You as an individual should not feel guilty about your previous cesareans, but as a physician who has seen all manner of excuses concocted by doctors and hospitals (and yes, sometimes by patients) in our for-profit, fee-for service health system to do a c-section, I can only say that its high time we invoke science, consider the wisdom of evolution and use common sense rather than inflicting the potential long term health problems on our children. There is no question that some individuals need c-sections, but the US rate of 33% is indefensible from a public health standpoint. Medico-legal concerns, convenience and cosmetics are no reasons for c-sections. Research has shown than a rate greater than 10% confers no population based benefit and may indeed cause harm, of which the adversely altered micro biome is just one example.
15
Mothers who whatever reason do not breastfeed--do not feel guilty! (I'm one who did sixty years ago!) but this is not the point, or should not be the point! Science is discovering the importance of the microbiome! for all of us. Rejoice for medical science.
9
So EVERYONE should get screened prior to birth, natural or C-section for the listed pathogens and then it's MICROBIOME away!!! How absurd to put fear into the equation when all that is needed is a simple screening for the "seeding" approach. Question: IF one was born vaginally, had normal "dirty" upbringing, exposure to dirt, cows, siblings, etc...was thin for most of their lives and THEN got zapped with massive amounts of antibiotics in adulthood and THEN starts showing symptoms of the "western chronic" diseases (like millions of us) are RIGOROUSLY screened FMT donors and extended infusions the solution? I mean until the pill form of human probiotics developed? I had Lyme and too many antibiotics. Then the TROUBLES began. This is my answer: https://etcfmt.com It's also very possible that Dr. Martin Blaser and company's "step-down" theory on massive extinction of essential microbes over generations of C-sections, antibiotics, sterile urban life styles, might mean that we are ALL starting out with fewer microbes species.
1
I think the answer here is to have your babies in Denmark or Finland.
http://www.businessinsider.com/countries-with-best-parental-leave-2016-8...
9
This article is infuriating. My son is 18 months old, was delivered via c-section after pushing for 4 hours and not budging and was breast and formula fed. He's gotten a few colds from daycare, but that's about it. I'm so sick of the mom-shaming surrounding these issues! The amount of guilt I, and many other women I know, felt around not being able to breast feed completely took so much joy out of early motherhood. Many people complain about the formula industrial complex, but there's a HUGE breast feeding industrial complex too - how else would all of the lactation consultants stay in business?? If it wasn't for formula, my son would have starved. I could have gotten donor milk but many women don't have access to those kinds of resources. Really, FED is best, end of story.
103
I really wonder if in other countries they agonize as much as we do over all these child rearing related issues. Is this a cultural thing that mothers tear each other apart over breast vs formula, work vs staying home mom, helicopter vs. free range style, etc. It's just seems crazy. Why are we always dealing in absolutes?
8
Keep piling on the guilt. Moms are to blame for everything!
29
Any idea if a high-forceps delivery has an influence on gut microbiota?
3
No, but learning differences can result from it. The pressure on the brain seems like a much bigger deal than any gut microbes.
1
Although both my son and daughter were normal vaginal deliveries and breast fed (son 10 months; daughter 2-1/2 years), my son is the one with asthma and eczema but my daughter seems to have escaped it. Wonder if boys are more prone than girls to allergy asthma and immune system disruptions or she just got lucky?
1
Great- more things to feel guilty about- my c-sections!
13
Just one more article to make moms feel bad............
9
There seems to be a lot of defensiveness in these comments. The article is describing the best case scenario based on the known data. It is not shaming women for choosing other routes. In other words, here's what's probably best, but do what's best for you.
44
This article is presenting speculation as evidence. It is demonization of C-sections and formula masquerading as science.
9
You must be new here. Whenever the NYT publishes a health related article, regardless of the findings or recommendations, the knives are out in the comments section. Outraged professionals decrying the methodology, indignant patients offering anecdotal evidence, cynical observers noting contradictory studies, everyone has a slant.
35
I think that C-sections, formula feeding, and the women who choose them (or who have no other choice) are often demonized. It's a shame. But this isn't one of those times. If you react with outrage every time someone tries to have a discussion about the pros and cons of these subjects, your point is taken less seriously. And I say this as a person currently feeding formula to a three month-old.
9
What about the microbiota acquired from obese mothers? Good, bad, indifferent?
5
Obese mothers have "bad" bacteria. It is known that these bacteria set the infant up for many metabolic problems in the future. Obese mothers are a danger to their offspring.
3
Let's go hysterical about this and then see women move on to avoidance of childhood vaccinations? Prevention in concrete form versus the varied medical issues surrounding birth and feeding of newborns.
I was formula fed, and I suffered with weight issues and ear infections and too many colds my whole life. I don't, however, blame my mother for this at all. She had serious issues that made it impossible for her to parent me during my first year on this earth. Without formula, I would have died. Because I could, I wanted better for my daughter. I was vigilant about exclusive breast feeding, and she has never had an ear infection and is a slim, energetic child. Knowledge is power. If we know breast is best, let's get formula pushers out of hospitals, insist that most babies share rooms with their parents in the hospital, employ more lactation consultants, strengthen family leave and paid maternity and pay it forward so the newest members of our society, who will inherit all of the problems we weren't able to effectively solve have the best possible health outcomes.
30
I was formula fed. I've never had an ear infection and was not a sick child, nor do I get sick now. All 5 of my children are formula fed. No ear infections. Crazy huh
16
I had the pleasure of seeing SIX lactation consultants when my child and I shared a room in hospital and only the very last one had any clue that the latch was wrong. Literally five people who have "know about breastfeeding" as their job couldn't see an issue. I'm happy a "formula pusher" gave me a bottle to feed my son when my body couldn't, and my formula fed child is healthy, has had no ear infections, and is "slim and energetic" like yours. Let's not pretend there are any studies comparing apples-to-apples about breastfeeding, k?
14
Perhaps the change is with the doctors who want some control over their own lives, not the women. In this misogynist environment, where it is highly likely women would be forced to bear unwanted children and may well be imprisoned to do so, it is important to remember that not all fetuses plant properly in their mother's womb, not all fetuses can be carried to term, not all fetuses live, not all children can be born vaginally without killing their mothers, not all women make sufficient (or any) breast milk and some children are born transgender or gay. Keeping some rationality is necessary before you talk about changes that "should" be made.
15
Not the entire story! The abusive use of antibiotics including animal feeds is a huge problem. We see "anti-bacteria" hand-wash stuffs all over the places. The "natural environment" around us are tamed and sterile. Of course autoimmune diseases are becoming problems. Our way of life is unhealthy! Our bodies were built for the Amish way of life but we have abandoned our root. "Civilization" will come to an end because we got it so wrong and it is not sustainable.
It is just puzzling why we are doing all these stupid things. To me, community farming is a major way moving forward. You want less immigration, sure, try community farming. You want more physical activities, sure, try community farming. You want fresh and local food, sure, try community farming. You want more human interactions, sure, try community farming. BTW, remove the stupid lawns is a good start. Both white supremacists and liberal environmentalists should love my idea.
I really hope developing countries will learn the lesson and develop a different path but not blindly following the American way of life. SAD!
5
My son was born two months early via c-section due to a placental abruption, and by the time he was able to eat on his own my milk production had dwindled to almost nothing. So what do I do? Should I feed him more yogurt? More sauerkraut? Avoid other foods? Please give me something more to do other than just worry.
15
There are things to do. First, fiber is key to promoting good bacteria. Add about 20 grams of water soluble fiber (polydextrose, corn bran) each day to foods. Use probiotics as often as you can, yogut, kifer,etc.Try and avoid sugars and meat as much as possible (bad bacteria thrive on this). Add as much green leafy vegs as possible. Avoid antibiotics as much as possible. Question the docs when they want to use these and avoid non organic meats and dairy (lots of antibiotics).
See letswakeupfolks.blogspot.com-helping our bacteria and the fiber blogs for details.
3
You can buy human breast milk. You could take hormones and start producing your own breast milk, you might have to get or rent a breast pump. Be creative. You could hire a wet nurse like they did in the not too long ago.
1
First - talk to a pediatrician. Don't listen to anyone who gives you advice in the comment section of a NYT article. No one with credentials would risk them, and you don't want advice from anyone without credentials.
9
Finally we --meaning male researchers, mostly--are beginning to take seriously the idea that the health of the mother might have something to do with the health of the baby. Better prenatal care would lead to fewer Cesarians, yes? And by prenatal, I mean we should start paying attention to the health of girls throughout their developing years. Then maybe the next generation will have fewer of these serious problems!
8
Good point-Changes in teenage girls (and boys) during ova and sperm development are passed onto next generation. Obesity, poor diet (fast foods), smoking etc. changes the bowel bacteria and can actually change activity of genes that can cause problems. These changes effect the sperm and ova and can be the source of metabolic diseases in next generation.Teenagers are the garden for bad bowel changes.
1
On a purely anecdotal level, I've been shocked at how few mothers here (especially the young ones — 19-, 20- and 21-year olds) breast feed their babies or even seem to be encouraged by their families and healthcare providers to breast feed. Many don't even consider trying to breast feed so it doesn't seem to be an issue of having difficulties breast feeding although I've heard more reasons that you can possibly imagine for why women don't breast feed here. Even my mother-in-law (in her 80's) said that she didn't breast feed her three children because "her breasts were too small." There almost seems to be a cultural or social taboo against breast feeding that I just don't understand. It seems like the norm is formula — and when you look at the rates of obesity here, it really makes you wonder about the link between the two.
9
Not just lack of breast feeding but many mothers have such a poor diet that the milk is suboptimal. Studies show tribes in South America have much better breast milk (health wise) then middle class US mothers. They eat mainly plant based foods and lots of fish (alpha 3 omega levels 40X US mothers). Lots of meat, sugar, and low fiber are bad for milk. Even 5-6 pound of extra weight has bad metabolic changes. Most mothers are overweight before, during and after pregnancy and the bowel bacteria and milk is not optimum.
Really? In Alabama, you think the answer to the question "Why is everyone so fat?" is lack of breastfeeding? Have you looked at the average person's diet and portions? Believe me, it ain't the formula.
1
Wait a minute.... breast is best???? I had no idea! After I schedule my c-section (based around when is most convenient for me and my manicure appointments), I plan on just stocking up on formula because breast feeding seems icky and time-consuming.
Do people really think that women are thinking like this? Please. This article is ridiculous.
59
I am a doula who serves hundreds of new moms per year. You'd be surprised how many women think formula is an easier, more convenient wY to feed a baby.
4
Not everyone bottle feeds bc they can’t breastfeed. Not every c-section is necessary. More importantly, this article is not primarily about women making individual choices—it’s about insurance & medical systems/structures/cultures that sometimes—for fear of liability, for convenience of scheduling, etc—promote unnecessary c-sections, and commercial interests that push product (hello free samples and coupons for formula distributed in hospitals).
14
I have worked in Maternal-Child nursing for many years and continue to do so now and I can say with absolute certainty-YES woman of means who have the financial ability to pay a private physician to schedule a C-section at their mutual convenience do so every day! The first month of successful exclusive breastfeeding is VERY demanding on a tired sleep deprived mother who can’t hand feeling over to a partner- but you can sleep if baby eats formula.
For at least 35 years AACOG and the insurance companies vowed to penalize doctors who were performing C-section deliveries without medical reason. Nothing has changed-$$$ rules.
14
There is definitely truth to this article- we do too many unnecessary c-sections and breast milk is truly the best thing to feed your baby. But this is such a complicated issue. Some c-sections are necessary- for breech babies, for babies in distress, etc. Sometimes moms don't produce enough milk for their baby or the baby needs formula supplementation for some medical reason. Breastfeeding is hard work. We have horrible maternity leave in this country and that makes it very difficult for some women to breastfeed. Some women don't get a break to pump milk at work. If we really want to increase breastfeeding rates then we have to start changing maternity leave policies. I had two vaginal deliveries and breastfed my first for 13 months working full time. My 2nd is 21 months and still nursing. It is possible if you have a supportive work environment. But despite the vaginal delivery and over a year or breastmilk my oldest has asthma! There are so many things we still don't know about the effects of the microbiome on health but this is a good place to start.
44
Many politicians are pro-life until birth and that is one of the reasons we have poor maternal and child care.
28
I agree about the total lack of support for women who want to breastfeed, but not generally about breastfeeding being hard work. I breastfed my kids and always found it so much easier than getting up, measuring the water, mixing formula, warming it up, cleaning the bottles, sterilizing the bottles etc. In fact, I would quite seriously say that a good part of the reason I kept breastfeeding for as long as I did was sheer laziness. And no, I don't feel guilty about that.
1
Breastmilk is ideal because it is nutritious, full of natural antibodies, and free. Well, mostly free. The breast pumps cost quite a bit, and I needed the help of a lactation consultant. But it is significantly cheaper than formula. Every time nursing got tough (not enough milk, teething child decides to go chomping on breast, etc), I would look at the main ingredient of formula (corn syrup) and soldier on. One child - the c section one - had severe allergies (she outgrew it), one child - the vaginal birth one - had allergies too (also outgrew it). Not sure if breastfeeding helped, but it was cherished times of bonding (minus the times when breast was abused as chew toy). Every parent try their best. And this article tries to inform new parents what they can do to start the children off to a healthy future: try to avoid the c-section, breastfeed as long as you can. I would add to this: No need to sterilize everything to the hilt (as I did with the first child). Garden dirt is good for them.
9
Corn syrup solids are only in some specialized soy or lactose free formulas for babies who who can't tolerate lactose in regular formula. Even so sugar is sugar and babies need sugar to grow and to fuel their brains. There's nothing wrong with corn syrup solids. You might feel superior for having breast fed but in reality it makes no difference. I guarantee you my formula fed babies thrived just as well as yours. Here is a shocker too my son was not only formula fed but was a c section baby and guess what he has no issues. Nine years old and in perfect health.
17
Breastfeeding is only "free" if you assume the mother's time is not worth anything. There's nothing dishonorable about a mother who cannot, for any reason, take on the full-time job of breastfeeding -- whether that's due to needing to work a full time job to take care of the baby, taking care of multiple children, or whatever else may interfere.
4
Adri - you numpty! Sugar, alas, is not sugar. Please read, for example, how maltodextrin is metabolised and increases the risk of NEC in baby piglets. They have different chemical make ups. Come on, you formula obssessives all claim to 'science'.
And once you say nonsensical things like 'you breastfeed just to feel superior' your arguments lose any credibility.
1
Sadly, we seem to have become unhinged around the issues of C-sections and breastfeeding. Both are presented as of critical importance despite scant evidence to support those claims.
The C-section rate has risen steadily to 32% and perinatal mortality rates have fallen. Italy has a C-section rate of 42% and a lower neonatal mortality rate then the US. And while the maternal mortality rate has risen, the cause appears to be lack of access to high tech interventions, not too many interventions; the leading cause of maternal death is cardiac disease.The breastfeeding rate has tripled in the past 40 years and there has been no demonstrable effect on mortality rates of any babies except the extremely preterm.
Since no one can demonstrate any effect on mortality rates, advocates of natural childbirth and breastfeeding have resorted to fear mongering in regard to the microbiome and epigenetics. Both fields are in their infancy and neither has yielded any clinical guidelines that are supported by evidence.
We need to take a good look at what is driving the hysteria around C-sections and breastfeeding. It has nothing to do with what is good for babies and everything to do with controlling women, creating more mothering “requirements,” ... and more employment opportunities for the natural childbirth and breastfeeding industries.
We have literally no idea what a normal infant microbiome looks like so it is irresponsible for anyone to claim that C-sections or formula harms it.
104
Italy is #3 in OECD country C-section rates; it is high, not representative. The US can have both high overall C-section rates while certain populations don't have access to medical technology (namely poor women and women of color).
At a population level, US C-section rates are well above evidence-based recommendations of the World Health Organization, 10-15%. Every mother should have access if needed but C-sections come with extra cost and health impact to mother and child.
The article is not about advocacy, politics, or hysteria or what an individual women should do. It's about evidence and points to the need for systematic change. And a two-million person study makes it strong evidence.
9
The WHO C-section recommendations are not evidence based and the WHO has publicly acknowledged this. There never was any evidence that 10-15% is an optimal C-section rate. They just made it up. The best evidence to date shows that a MINIMUM C-section rate of 19% is necessary to achieve low perinatal and maternal mortality.
7
And what exactly is the basis for the WHO 10-15% "recommended" rate? Answer: nothing. Because there is no data that allows us to calculate an "ideal" rate.
In fact, it can perfectly reasonably be argued that a planned c-section is the safest way of giving birth both from the baby's and the mother's standpoint. So the recommendation could just as well be 100% c-section rate.
Conclusion: yes, this article definitely has a bias and a hidden agenda.
5
Every few weeks, a relative, friend or acquaintance of my generation (Generation X) will remark about how "when we were little, we didn't know anyone with a peanut allergy - now every other kid seems to have one - why?"
Seems the huge rise in c-sections has a lot to do with it.
10
You are reaching. Correlation does not imply causation. Guess what also has increased at the same time as peanut allergy rates? Breastfeeding rates.......so maybe breastfeeding is increasing peanut allergies. See I can make things up too. Breastfeeding rates have increased though. My c section child is in perfect health, no allergies whatsoever.
37
That's just idiotic. Neither one of my c-section born children has any allergies of any kind.
4
Peanut allergies increased dramatically due to recommendations that parents avoid giving their young children peanut based products for the first few years of life based upon a well intended but misguided effort to stamp out peanut allergies, which can obviously be quite distressing. A well designed trial published in the last few years found that exposing to kids to peanut based products at around six months of life actually dramatically reduced the future rate of peanut allergies in those children. Infants need to be exposed to various foods and bacteria - sequestering them from the world can lead to stunted microbiota and immune systems.
24
Mothers and more importantly BABIES deserve accurate health information be discussed frankly and honestly. I am so tired of people soft-pedaling best practices so as not to offend people.
It will never be easy for the moms who, for a variety of reasons, did not or could not follow 'optimal' pathways, when such optimal pathways are identified. Yet the next new Mom needs to know what is actually best for her child, so she can make an informed choice.
Biology dovetails with evolution. Breastfeeding has a million years of co-evolution behind it. It is a live substance with live white cells, macrophages, immunological properties, etc in it. Of course it is the healthiest way to feed a baby. (Duh!)
Sorry if another mother did not breastfeed, but I did -- and I am glad to see my choice validated. And I want my pool of future daughters in law to know the science, because it will probably influence their choices.
We have a society in which 20% of teens have a mental illness. This is the result of a lot of parenting choices missing the mark of what children really need to thrive. This is a mental health crisis-- so I think we need to scream best practices from the rooftops! If it hurts the feelings of some grown women that's an acceptable consequence.
21
How much of that mental illness the the result of the current "parent think" of oppressive aggressive artisanal helicoptering?
I have a friend whose daughter did a year and a half at UVM. Quit mid 2nd semester sophomore year (they live in Westchester Co.) The girl was home from March through this past January. She went to a school only 1 hour away; and mom went to see her on day 6. THEN the student came home the following weekend. Co dependency. Neurosis.
The child was breast fed.
5
Right. Because back when 100% of the population was breastfed, there was no mental illness.
And I'd be very careful about sharing your version of "science" about breastfeeding with your daughters-in-law if you want to have any sort of relationship with their babies.
The actual "science" shows that the benefits for babies in places with clean drinking water wrap up at about 6 weeks.
God bless my mother-in-law for probably biting through her tongue when I was a new mom and making all sorts of mistakes. She just showed up whenever called, usually with a casserole and multiple boxes of diapers, and asked how she could help. I would walk on glass for her.
76
There has always been some number of mentally ill kids and teens. But back when mothers raised tiny babies, it sure wasn't 20%.
1
We have to be careful about recommending ONLY breastfeeding for the first 6 months. Offering a little bit of solids may help reduce food allergy. We don’t know how small amounts change the gut flora.
2
no solids till the first tooth -- because you don't have the digestive enzymes to break them down yet. one tooth? offer farina, and other mushy stuff -- egg yolk; blended oatmeal, etc.
1
Kids vary very widely with the age of first tooth, so that's not a good way of telling when a baby is ready for solids. Where is it written that teeth coincide with maturing disgestive enzymes?
My first got his first lowers at 4 months, and there was no way I was going to feed solids that young. I waited until the (then--1985) recommended time, 5.5 months, and it worked well. No asthma, even though I (a vaginally-delivered and breast-fed child of the 50's) and others in my family have it.
His sister didn't have a tooth in her head until after 10 months, and that's too late for most kids. Consider all the factors, not just one.
4
The American Academy of Pediatrics actually recommends only breastfeeding until 6 months of age. They don't need solid foods until 6 months.
6
When I had my first two, both of which were supposed to be vaginal births, I had testing for strep B. Surely that would be easy enough for women who want to do vaginal seeding now?
Glad to hear testing is about to be done on whether or not it works to change outcomes. That will be interesting to read about in the future.
2
That part struck me too.....I'm thinking, wait a minute, they just said best to come out vaginally.......but women should worry re introducing that same environment to a c section baby?
3
While the whole field is still pretty new as gut biome can only be studied in details since cheap genetic sequencing became available, it is worth pointing out that there are other forms of exposure that matter.
E.g. similar results correlation have been obtained relating the age at which a child goes to pre-school relates inversely with a simila set of health problems. It seems too much hygiene is unhealthy for our youngest in the end.
10
Thank you for differentiating between scheduled and emergency C-sections. I had the "worst" of all possible worlds, though my son was never in danger. Four hours of pushing, followed by an hour wait for a more serious C-section need, and then a C-section. My son was larger than expected (hence my inability to push him out). Despite the ordeal, I do hope that my four hours of pushing actually got him some beneficial microorganisms!
4
And if he didn't I'm sure he still grew/is growing up to be a fine son.
My four hours of pushing yielded completely red eyes and a "salad tongs" baby, as my husband enjoys calling it. And his only excuse, at 7,2, was a slightly tilted head; in addition, he was a Taurus born in the year of the bull--but I don't believe in that stuff, do you?
6
I have 2 kids in college, both delivered vaginally and breastfed for approx 5 months. I was a stay-at-home mom for 10 years; kids did not go to preK until around age 2.
Both were always sick; the youngest had tubes in her ears at 13 months because both eardrums burst. The oldest was so sick as a baby we feared sepsis. So much for the microbiome and breastfeeding. (We had a dog, too. That didn't help, either).
I think alot of these new initiatives in obstetrics and pediatrics are like the constant fads disrupting public education: ultimately ineffective and stressful for everyone involved. Couple that with the reality that many things (like asthma) can be genetic, and you see things in better perspective.
Regardless of how babies emerge into the world or where their milk comes from, love them, read to them, take them outside, and vaccinate them and they'll be fine. Enjoy them without guilt.
141
I agree with the gist of your comment, but we can never really know how much a certain beneficial circumstance might have been the thing that kept a child from becoming even sicker.
It's like the flu shot. Even if you get the flu, there may be a softening of effects, but there's no real way to tell.
My friend's mom, a farm wife with six sons, used to say that every kid needs to eat a peck of dirt. As long as you let them get dirty they are probably fine!
And there is always someone to say that you need two pets in the home to avoid asthma, allergies, or whatever. That's what I heard, and we had multiple cats and dogs. My daughter, vaginally delivered and breast fed for five months, was sickly and it turned out allergic to milk for the first years of life. But just think how sickly she might be without the pets! And she might never would have developed her love of animals.
7
How is your one anecdotal experience proof that what the researchers found is not generally true. And how do you know your children would not have been even sicker had you not done what you did.
I also breastfed, although after an emergency C section, and stayed home with my child until pre-school, never sending her to daycare. (I taught at a law school so had great flexibility and so we did not need day care.) My child never developed the constant ear infections of the children we knew in day care. She did have an allergy to cow's milk and so needed goat's milk once she was no longer exclusively breastfeeding until she outgrew her cow's milk allergy. No formula except in the hospital while I was still recovering from the C section. Unfortunately that experience of being initially bottle-fed made it difficult for her to adjust to breast feeding at first, but I was determined and had a terrific no nonsense and trusted pediatrician who encouraged and supported my efforts and we soon made a successful transition. But I have to wonder if I would have continued to struggle as hard if I had not read about all the advantages of breast feeding. I am glad I had access to that material.
5
I find these articles about how mothers who make reasonable personal or medical decisions will doom their kids for life unhelpful. "Even a little bit of formula" leading to lifelong health issues? What a way to terrify a new mother who is having milk supply issues, or has to go back to work right away!
Why don't we start with better policies about family leave and better pay for our lower and middle class workers, and then we can talk...
Or perhaps we can just compare infant mortality rates today with those 300 years ago, when everyone breast fed and half the kids didn't live until five?
Enough already.
166
I agree with the pointlessness or heartlessness of saying that even a small amount of formula will have lifelong consequences. It just seems utterly unhelpful. My baby got mostly breast milk for months and months, but needed formula in the beginning because gen couldn't eat. Shouldn't I have just thrown in the towel on day two when he drank formula?
18
Why ever would you be offended about learning about information that could help children throughout their lives. This information will not change the decisions of mothers who can't change because of financial need to work that is incompatible with breastfeeding or for mothers who may not have sufficient milk supply, but for mothers who have a choice, it may encourage breastfeeding, and if mothers are having difficulties, it may provide a little more encouragement to struggle with overcoming the difficulties. Withholding the results of studies like this because some people might feel happier continuing in ignorance is unethical.
9
White Buffalo - this isn't encouragement, it's pressure. This is a scare-mongering article without a single quantitative statement about risk.
4
Not really, women are making decisions for convenience. These decisions are being shown to have lifelong health consequences for the BABY.
5
No they do not. There is no actual scientific or real world evidence that shows c sections and formula have any negative life long consequences. You will not find any evidence to prove your claim because it doesn't exist. My son was a c section and formula fed baby and he is extremely healthy and top of his class smart. He has no issues.
8
Where? Show me a study that actually compares children with the same two parents where one was a c-section, formula-fed baby and one wasn't -- because the few I know of that actually do that show it doesn't matter. Everything else is comparing apples to oranges.
5
Can we just stop with the breastfeeding fantasy here in the US until we have substantial paid parental leave like the civilized countries have.
201
I am sorry but can the condemnation of scheduled c-sections stop already. If your baby is in breech you will have a scheduled c-section and there is no way that a breech vaginal delivery would be safe for mother or child. Similarly, babies with heart-conditions may be delivered via scheduled c-section because they may not survive a vaginal delivery, ditto children with any other type of congenital problem that is significant enough to deem vaginal delivery dangerous. I think what you are trying to say is this "women who choose a scheduled c-section" - and you know what, that too is nonsense. Their are a number of other factors at play that cause asthma, just stop already. My body, my choice.
48
The article states very clearly that there are plenty of good, justifiable reasons for scheduled delivery. It does not "condemn" the practice as a whole. So don't try to twist that around just because you think the complete freedom of choice is more important than anything else, including medical concerns about the consequences of questionably justified scheduled deliveries based on "choice" and not on a medical need.
49
The American College of Obstetricians and Gynecologists has this FAQ page called "If Your Baby is Breech" - https://www.acog.org/Patients/FAQs/If-Your-Baby-Is-Breech. External cephalic version is explained here and is an option for women who have a breech baby.
4
Reading this article I find that it plainly articulates medical current knowledge and in no way condemns caecareans. You are free to make your own choices of course, but denying fact is not helpful.
Allow me to be sarcastic. You are free to smoke during your pregnancy or drink alcohol. Your body your choice.
19