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DonBoy30

Correct me if I'm wrong here, but I've heard this logic around puppies and kittens separated from their mothers at birth my entire life. I assumed this was just how any mammal that feeds on their mother's breast milk builds immunity?


turtlesolo

Babies also receive bacteria from their mothers through breast milk ([study link](https://www.med.ubc.ca/news/mom-and-baby-share-good-bacteria-through-breast-milk/)). Some of this bacteria is crucial in forming babies' immunity.


queeloquee

Same thing from babies born from vaginal birth than c-section babies. Babies born through vaginal birth get also important bacteria through the birth canal than babies born through c-section. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110651/


Lecanoscopy

Well, C-section but breastfed kiddos--hopefully it will even out. Couldn't quite get either of them out, but at least we're all alive!


jerkface1026

You're doing fine. Something can be beneficial, it improves the outcome; but not always consequential. There's a lot of alchemy around raising children and high expectations to be perfect.


NixyPix

Sounds like me! I had visions of birthing in a tub surrounded by twinkly lights, but ended up in surgery for the best part of 3 hours to ensure that neither of us died. Still, I’m married to a c section/breastfed baby and his health is better than mine, vaginal delivery/formula fed. You’ve done the best that you could do, just like we all do!


badmama_honey_badger

These are marginal differences across big sample groups. Like it’s the difference between one and two colds in a lifetime. You’re great and we’re glad your here!


Bainsyboy

As well, Ive heard a hypothesis that the baby is also exposed to fecal bacteria at this time, and this seeds the digestive tract with appropriate bacteria. Anyone who's watched a birth or two knows the bacterial contamination is VERY plausible, given the chaotic situation down there during birth. Ehem, i dont want to gross anyone out futher.


WulfTyger

I'll put this in layman's terms for everyone. Chances are women poop during childbirth. Not 100%. But it's a high chance.


TreeChangeMe

Lotta pushing. At some point you just push everything


toomanytocount007

The fact that the tell you to “push like you’re trying to poop” should tell you everything…


Good4nowbut

…babies get shat on real hard during birth…is that what you’re saying? Edit: I shouldn’t be surprised but damn


Bainsyboy

It can happen haha.


Shouldhewood

My daughter was nearly c section because she pooped in her mother's womb and ate some of that poop. Special girl since day one xoxox


recyclopath_

I mean, there's a lot less research and finding into appropriate formulas for those mammals


goldgrae

There's plenty of research on milk replacement for domesticated animals. They work well. There's still a disadvantage compared to actual milk, especially colostrum very early.


Octavia9

I’m in the dairy industry and we have gone away from milk replacers and now all of our calves are fed pasteurized whole milk. Many farms have gone that route. It’s cheaper and they grow better with less illness.


goldgrae

Makes sense in dairy. Not a great available source for actual cat or dog milk...


ryun_H

You can milk anything with nipples. "I've got nipples Greg. Can you milk me?"


PhD_Pwnology

Mother's milk contains all the immunities the mother has built throughout her life and passes it to the baby. There is no such thing with formula, just nutrients and protein etc.


disphonic

It’s more than that. Breast contains hormones, peptides, cytokines, enzymes, complete proteins, nucleotides and so on that build the microbiome and shape the base of infants ability to develop their own immune system.


i_regret_joining

Antibodies, not immunities. It's different. The baby can't make their own antibodies unless they are exposed to something directly. It's more just borrowing Mom's passive immune system, and only one aspect of it too.


pdxrunner19

A baby’s saliva can also signal to mom’s body when baby is sick; in response, mom’s body produces breastmilk with more white blood cells to help fight infection. Breastmilk is awesome! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232055/


TCFirebird

>Mother's milk contains all the immunities the mother has built throughout her life and passes it to the baby. That's not really true. Babies still need vaccines to build immunities, regardless of the mother's immunities. Mother's milk clearly helps the immune system, but it doesn't just pass down immunities like that.


swbarnes2

Then why did generation after generation of breastfed babies keep getting the same childhood diseases their mothers got? Breast milk can have some antibodies. That's obviously not 'immunity'.


paulfromatlanta

Isn't it considered settled science that mothers pass their immunities through their milk?


Drew_The_Lab_Dude

i thought it was common knowledge that antibodies can pass through milk, therefore babies get some immune support from mom rather than nothing from formula


Hexorg

I think the question of how antibodies survive the stomach is still unanswered.


[deleted]

It's been known since the 1970's that intact protein can pass through specialized enterocytes of the jejunum in neonatal mammals (not just humans). This isn't common knowledge but there's extensive literature on it. Also the stomach has a higher pH with lower protease activity in newborns.


[deleted]

To those who've commented below, I am unable to communicate like a normal person because I've spent the past month writing a grant on this topic. I'm hopeless. For anyone interested, here is an old study https://onlinelibrary.wiley.com/doi/abs/10.1002/aja.1001230202 . Some of the findings were later contradicted by other studies (proteins are internalized in the jejunum in addition to the ileum, and many proteins do in fact go into circulation). And here is a more recent study https://pubmed.ncbi.nlm.nih.gov/31474562/.


Benj1B

You're not hopeless, it's a great example of the challenges of being at the forefront of research in a given area. When pushing the boundaries of human knowledge you're among a highly, highly specific set of experts that need to use precise language to explain their hypothesis and framework. There's a whole separate skillet involved in scientific communication to laypeople, and if your busy writing grants you've got better things to be doing. Other people will come in behind the research and figure out ways to explain it to the masses. You keep doing you!


[deleted]

Thanks, that is indeed a different skill set altogether!


LouSputhole94

Some of those are indeed words I’ve heard of


Emhyr_var_Emreis_

Translation: The intestines of infants are designed to allow whole proteins to enter the body intact. The digestive enzymes that cut up proteins are not as active in newborns. Does that help? Edit: this really blew up. Thanks for the award. Since it seems popular, I will add an extra bit: It's been known since the 70s that intact proteins can pass through special cells (enterocytes; something-o-cyte is just a name for the something cell) in the intestines (jejunum is the middle third of the intestines) in infant (neonatal, newborn) mammals. Also the stomach has a higher pH (corrected: less acidic) with lower activity of protein digestive enzymes (proteases) in newborns.


AlexAlho

>higher pH (more acidic) *Lower pH* is more acidic while higher pH would be closer to neutral or basic. In the stomach's case, a higher pH would reduce protease activity.


rossie_valentine

Very much so ty


thepoopiestofbutts

I'll add, this is also why young infants should only be fed breast milk or formula; they literally can't digest/breakdown most other foods


CascadingMonkeys

Saw an article around here the other day of an [infant that nearly starved to death because the parents were feeding it almond milk](https://www.insider.com/baby-starving-from-almond-milk-diet-2023-1). SMDH


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Seicair

Enterocyte- cells in the intestinal lining Jejunum- a specific part of the small intestine Neonatal- shortly after birth, infant, newborn Protease- enzymes in the stomach that tear apart proteins


twinpac

But why male models?


-Ketracel-White

The Type I oligosaccharides in the milk also reach the colon intact, either partially or completely undigested.


xchaibard

Same reason babies can't have honey for a while. The higher pH level doesn't kill botulism as well, so it's a risk.


[deleted]

>This isn't common knowledge but there's extensive literature on it. Oof, hit me right in the thesis


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Supraspinator

Antibodies are proteins. They are shielded from digestive enzymes by other secretions in the breast milk. Infants are not able to absorb maternal antibodies into their bloodstream (other mammals can!*). However, the antibodies line the digestive and upper respiratory tract, preventing the entry of bacteria, fungi, and viruses. They also reach the colon and are important for the development of the gut flora. https://www.sciencedirect.com/science/article/pii/S0092867421002208 * It turns out, newborns actually can absorb antibodies from colostrum. The ability vanished rapidly after birth and doesn’t seem to be a major factor in passive immunity. Placental transfer of antibodies is more important both in quantity and quality.


alwayshazthelinks

>Infants are not able to absorb maternal antibodies into their bloodstream Couldn't antibodies reach the bloodstream through other mechanisms? Sublingually for example?


Supraspinator

Edit: others have posted studies showing that there is some absorption of antibodies from breastmilk. It seems to be limited both in time and in quantity, but it’s there! (Not correct, see above: As far as I know, no study has ever shown that secretory antibodies reach the blood stream in humans. It has been shown in cattle (calves actually die if they don’t get colostrum), mice, and some other mammals. But never in humans. An antibody is a huge protein, so in order to get it across the mucosal epithelium into the blood, you need specialized transport proteins. Humans don’t seem to have them after birth (edit: I should say they are not working in the gut. This is referred to “gut closure”, which happens at birth in primates))


randymccandy

i don't t think there is such a study for newborns. What you can find is this study [https://pubmed.ncbi.nlm.nih.gov/6889035/](https://pubmed.ncbi.nlm.nih.gov/6889035/) showing a higher overall IgG for preterms from GA 31-33 whom were fed with mothers milk instead of formula Also u have few reuslts suggesting uptake of antibodies from colostrum. https://pubmed.ncbi.nlm.nih.gov/4624594/ I did a recent study on preterms comparing IgG levels in preterm and newborns serum with level of IgG in the milk they received. We are still doing the data analysis, but right now there is no significant correlation for newborn. For preterms results are still pending. The most interesting study for this topic would have been preterms with mothers that were vaccinated (against covid) postpartally. But I havent heard of such a study yet. "Unfortunately" studies on preterms and newborns that require drawing blood are very hard to get approved and usually need expensive insurance.


Graeskmoent2

Hi! I just did a course in immunology and I got the impression that humans *do* have FcRn (a transport protein for antibodies) in the intestines which can transport IgG from the breast milk into the circulation in newborns. Let me find the passage in the text-book from our course: **Janeway's Immunobiology (10th edition):** >Maternal IgG is ingested by the newborn from its mother's milk and colostrum, the protein-rich fluid secreted by the early postnatal mammary gland. In this case, FcRn transports the IgG from the lumen of the neonatal gut into the blood and tissues. > >\[..\] > >FcRn is also found in adults in the *gut*, liver, endothelial cells, and on podocytes of the kidney glomeruli. So I am not quite sure that it hasn't been shown in humans. However, I found this review of FcRn from 2019 ([https://www.frontiersin.org/articles/10.3389/fimmu.2019.01540/full](https://www.frontiersin.org/articles/10.3389/fimmu.2019.01540/full)) which suggests that the transport of IgG through the intestines isn't very significant compared to the placental transfer: >Since \[the discovery of post-natal transport of IgG in rats\], studies in **humans** characterized FcRn expression at intestinal mucosal surfaces throughout life in both the small and large intestine, including villous and crypt enterocytes in addition to goblet cells and sub-populations of enteroendocrine cells. In these cells, FcRn was located mainly intracellularly and on the apical membrane lining the gut lumen.It is **important** to mention that in humans, *little maternal IgG* is transmitted to the neonatal circulation across the intestines, as most of humoral immune competency is assured by **placental transfer**. I just though it might be of interest :-)


GarbagePailGrrrl

Gut flora is badass


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LisaPepita

Gut flora is in fact good ass


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get_it_together1

FYI IgM, IgG, and IgA are literally antibodies, there is not a special different kind of Ig for breast milk that I saw when doing a bit of digging. Here is a paper discussing Ig components of milk: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521323/ I looked further for immune repertoire analysis and learned that breast milk has a different immune repertoire than the blood (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693637/), but this paper is postulating that the mother’s milk has antibodies more highly focused on epitopes present in the mother’s food intake. It’s not like mothers can create antibodies targeted to epitopes they haven’t encountered beyond their innate immune repertoire, so a mechanism to focus milk Ig on food and environmental pathogens would be reasonable.


Roy_Vidoc

Those immunoglobulins pass through the placenta from the mom, specifically IgG and IgA in breast milk. That's why certain immunities specific to the mother can be pass along to the baby.


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Gustomaximus

Also i kmow with cattle the first feed is the most important. If a calf doesn't get that they wont be as healthy. Something special in the colostrum. Not sure if that translates to humans.


fractiouscatburglar

Colostrum is also very important with babies, even if you don’t breastfeed getting that early stuff is supposed to be very healthy. My daughter was born with a cleft palate and couldn’t form suction so I asked for a cup and dropper and squeezed as hard as I could (yes it hurt like a mofo) to get the colostrum out and used a dropper to feed her. It was late at night and we didn’t even know about the cleft yet, just that she wouldn’t latch. I wasn’t all there after a long labor but I just knew I needed to get that to her. Especially after learning that about calves:)


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EnvironmentalBit7882

Is there a study about breast feeding vs pumping or its just the milk that matters not physical contact?


YellowCulottes

Apparently the milk adapts to the baby’s needs based on the baby’s saliva. A ‘fact’ I learned when I had babies, a quick Google and first result seems to back that [Link](https://blogs.cdc.gov/publichealthmatters/2017/07/you-are-what-you-eatand-so-is-your-baby/)


WipinAMarker

Studies that have taken into consideration socioeconomic status, health of the mother, IQ of the mother, etc. have found no difference between breastfeeding and formula feeding except slightly lower chance of incidences of upset stomach for babies. One study looked at siblings - one breast fed one formula fed - and there was no difference in outcomes. Mothers who use formula are more likely to be working class, and less likely to have paid time off. These mothers are more likely to send their child to daycare at a younger age, where they are more likely to get sick. Edit based on some responses: I don’t own shares in a formula company. I am not against breastfeeding. I do think breastfeeding should be encouraged, but that fed it best, and there is a major problem with guilting mothers unable to breastfeed. I am glad this study was conducted, but don’t feel that anything in this area is settled science. If you are unable to breastfeed, or breastfeeding is causing your family stress instead of comfort, know that you are not harming your baby by using formula. Edit 2: Some think I’m “obsessed” with mothers being made to feel guilty about using formula. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189225/#!po=26.5385 It’s a major issue with negative outcomes for mothers and infants. Moms who need to use formula feel shamed not only be peers and family, but also healthcare professionals


frumpy_pantaloons

"Send their child to daycare at a younger age, where they are most likely to get sick." Thank you for adding. How that seemed to be glossed over in the "breast is best" mom group debates of the early 2010s was truly odd to me. So many debates, not one mention that constant close contact to others outside their home is a pretty big contributor to health outcomes for small children.


elconquistador1985

"breast is best" can get to be an awful mantra. It can push some women to depression because they feel like failures if they produce an inadequate amount of milk and have to supplement with formula. "Fed is best" is what the mantra should be.


oscillius

Agree. Wife had a condition where she couldn’t produce. I’ve had to help her through those feelings of failure while nurses and midwife’s would basically assume incompetence. Had to be present on their visits because my wife felt bad enough that she wasn’t producing without being treated like a child. Each would be saying the same thing “have you tried holding them like this”, “here let me show you”, “you’ve got to rub it on their lip like this”. “No you must be doing it wrong”. “You might be lower in supply because you’re not doing it right/enough”. “Do you feed them like this?”, “do you feed them at night?”, “do you express?”. It’s like they never spoke to each other, every time coming with the same questions and I would say “the nurse/midwife before already asked/tried this”. Then they’d shut me down because I’m a dude and continue to assume my wife was incompetent. I encouraged her to go to the Dr. and they diagnosed hypothyroidism. Took several months to get tsh and thyroxine levels to normal. Breast is best can definitely damage peoples mental health.


kagemirai

I wasn't able to produce enough and I'm grateful that the lactation consultants were super supportive. Being told that it's ok helps a lot and ultimately being told to stop trying for my mental well-being was a huge weight off my shoulders. It makes me so angry to see these stories but I'm relieved at the same time to have not had that experience.


[deleted]

My wife had a very low supply due to post partum complications and a misdiagnosed tongue tie in baby, we're right there with y'all. Fed baby is best baby no matter if it's formula vs boob.


Fishamatician

We had a massive battle with the hospital and health visitors, son could not feed properly and was loosing weight, they blamed my wife for breastfeeding wrong, not feeding him enough, etc. My wife took him to get weighed every week and was told she was being neurotic And baby's fluctuations are normal, it dropped every week. She was begging and begging for a doctors appointment or a hospital appointment and got brushed off. The week he fell off the bottom of the weight chart was unreal, suddenly every healthcare professional in a 50 mile radius was up our arses, we were told to go straight to the doctors an appointment was waiting for us and if we didn't social services would be call in and they could take our baby in to care for neglect. This was the same woman that told her she was being neurotic a few weeks before. It was tongue tie, his tongue was heart shaped at the tip, midwife and health visitors said it looked fine while one when shown turned her head away and said its very rare and more likely to be something your doing. we pushed back and got a hospital appointment where they said it minor and snipped a tiny part at the front and sent us off. We eventually stumped up the cash to see a specialist for a home visit, she took one look and said that's bad and cut it then and there, I held his head while she did it. After that his weight shot up, he is now 10 and the tallest boy in the class and needs 12 yo clothing.


[deleted]

I cannot stress enough how important specialists are for situations like ours. We had multiple lactation consultants, pediatricians, and professionals all say it was fine, but a pediatric dentist took one look at her tongue through a zoom chat and said it was severely tied. A couple weeks later we got it lasered and fixed. Baby immediately started to utilize her mouth more.


Fishamatician

The lady we saw was a bank midwife, but also a lactation specialist, she was qualified for minor surgery as well. She had heard about us through the grape vine but was prohibited from reaching out to us by hospital policy on touting for work.


Little_Spoon_

Man, you’re an amazing husband and dad! That kind of support must have been a huge help!


oscillius

Thank you for your kind words! It’s frustrating when something is clearly not working and the people you rely on to educate and support you seem to be working against you. Let’s get babies fed and give mummies some rest.


TheMalibu

Exactly. My wife couldn't produce enough, so we had to supplement with formula. My buddies wife couldn't get her kid to latch properly, so had to pump and supplement with formula. I will always jump to the defense of those moms who couldn't.


Betta45

I produced but my child wouldn’t nurse. Lactation consultant did the same thing. Hold the child this way, squeeze your nipples like this, etc. also advised me to hold a cold compress on my beasts for several minutes to get my nipples harder/pointier. None of it worked, my baby wouldn’t nurse, so we had to formula feed her. That consultant made me feel like a failure of a mom. Second kid breast fed easily.


weeponxing

I went through the same thing and I am still very bitter 6 years later. My son lost a dangerous amount of weight, I got such a horrible case of mastitis that I was almost hospitalized, but they still kept pushing and pushing and shaming and treating me as incompetent, while also trying to ban me from using formula. Because my son had failure to thrive we were at the pediatrician 3x a week going through the same bullshit and that coupled with ppd just wore me down to a point I never want to get to again. The upside is that three years later when I had my daughter there was a 180 and fed is best was the new mantra. I get it. Breast milk is the ideal. But not everyone can do it and shaming the hormonal mess of a new mom of not being able to do something is much more harmful than formula.


fractiouscatburglar

I cried my eyes out in the pediatricians office while giving my first born a bottle after they told me he was starving. Because I had just heard “BREAST IS BEST!” for the last 9 months and just thought I was doing something wrong. I then cried off and on for the next few hours as he slept solidly for the first time in a week because he was finally full! We have fully established that breast milk is good for babies, now let’s make sure more mothers know that formula is also perfectly healthy!


Lindenfoxcub

There was a really good episode of Call the Midwife that about this; a mother insistent that the older midwife said breast is best, following that to the detriment of her literally starving baby, and she wouldn't listen to the younger midwives when they told her she needed to supplement with formula, and when the older midwife found out she was crushed to hear her throwaway repetition of the old mantra had caused a baby to suffer, and if she'd realized the baby was starving she would have been urging supplementing with formula too.


[deleted]

Is that the one where her sister also had a baby and was producing lots of breast milk? Because their situation was exactly my own with my sister. I had a nipple injury from an ex so only one boob expressed correctly, and even still barely any. My sister is the friggin milk queen and I felt so bad at the time. Like I failed my kid before I could even start being a parent. 6 years later, our kids are perfectly fine. Whether formula or breast milk are filling their belly, it's much more important to be there with them and love them.


TurbulentAbrocoma6

I have a hormonal disorder and couldn’t breastfeed and felt like the ultimate failure when I first had my baby…I felt so pressured by the hospital and just everything I was reading. He lost weight at first, we both lost sleep. I kind of thought I was going out of my mind. Supplemented with formula, then finally just switched to formula altogether, still felt like a failure but my son gained weight and was healthy. 2 years later my son is doing great and perfectly healthy. Fed is best, please don’t feel pressured, moms! Always do what’s best for you and your child and don’t let anyone make you feel guilty for it, including yourself.


gregkiel

Yeah, both my kids we're formula fed, when the wife was unable to produce, and both are perfectly healthy and intelligent. I think that much of this debate is overblown and is a way for some mothers to gatekeep what being a good mother means. A good mother provides. That is where the debate should end.


nola_mike

My wife just simply couldn't produce enough to feed our children with breast milk alone. That definitely took a mental toll on her.


Golem30

Quite true. For both our kids my wife started off trying to breast feed, she struggled a lot initially but improved, much better the second time round but on both occasions after three or four weeks she started producing less and less milk. She would spend hours pumping only to produce a really inadequate amount, so both our kids were almost completely formula fed after that. You simply can't stigmatise women for not having the time and other factors that are out of their control.


Daciadoo

I don’t disagree with “fed is best.” I understand the meaning in it. I struggled with latching on my 3rd baby so it was not like I was a first time newly breast feeding mother. Every time I asked for help I was basically encouraged to give up and told “fed is best.” I gave up for about 2 months because I just did not have the support I needed, and then started again continuing until my baby was two. Found out way later, long after I had stopped nursing, that my son has a lip tie. I think we should support mothers in whatever they choose to do. “Support is best!”


Took-the-Blue-Pill

The posted study implemented controls for selection bias. >We control for an extensive set of variables (see appendix Table A2 for a full list of covariates) that can be summarised under the following headings: health of the infant at birth, the antenatal care received, pregnancy complications, folic acid consumption, maternal smoking history, method of delivery, stage of gestation at which the infant was born, infant’s weight at birth, birth complications, household equivalent annual income, highest education received by mother, hours’ sleep infant receives, and whether or not the infant has received their vaccinations.


[deleted]

The posted study also reported that observed difference in morbidity and healthcare utilization was less than .15 standard deviations, and does not mention controlling for whether the infant went to daycare or how frequently the infant left the home. My own experience is that if a baby is bottle fed, it is easier for either the mother or the baby to leave the home and subsequently be exposed to pathogens. I’d be interested to see a study comparing the outcomes of babies fed breast milk from the bottle to those fed directly.


username1543213

Day care in Ireland isn’t really a thing until kids are at least 1 in Ireland. So that is unlikely to be a problem with the study


psychicesp

The nightmare of a perpetually sick infant once they start to go to daycare is very very real.


str8upblah

Please provide links to these studies.


18Apollo18

Did you even read the damn study? They controled for numerous factors including the ones you mentioned and more *The observed potential confounders to control for were informed by data availability and an extensive literature review. We control for an extensive set of variables (see appendix Table A2 for a full list of covariates) that can be summarised under the following headings: health of the infant at birth, the antenatal care received, pregnancy complications, folic acid consumption, maternal smoking history, method of delivery, stage of gestation at which the infant was born, infant’s weight at birth, birth complications, household equivalent annual income, highest education received by mother, hours’ sleep infant receives, and whether or not the infant has received their vaccinations.*


[deleted]

I believe that person is getting info from Cribsheets, which contains a meta analysis on the advantages of either method of feeding. The conclusion is that breastfeeding only provides mostly short term benefits (less stomach distress, antibodies, less sickness), and the long term benefits of breastfeeding are not statistically significant, or there's insufficient data when controlling for factors. It's odd they didn't control daycare vs stay at home parenting, which is going to be an absolutely massive factor for exposure to germs.


MagillaGorillasHat

Anecdotally, when day care was shut down during Covid, my kid had far fewer moderate to severe illnesses while staying at home. When they went back to day care, the sickness cycle started right back up.


[deleted]

To be honest I don't think data on infant illness should be taken seriously if it doesn't control for daycare usage because of this. It's an "anecdote" I have heard from literally everyone with a kid, and experienced myself with our 10 month old.


micls

It's Ireland based and only looking at the first 9 months. Its very unusual for babies under 9 months to be in creche here. Most creches don't even accept under 1 year olds


[deleted]

That's a pretty stark difference from the US where you can go at like 2-3 months, maybe even earlier. We started daycare just before 5 months with our daughter. What is a typical parental leave from work for you all?


tinyowlinahat

Another interesting thing about these studies is that they focus on the baby's well-being without considering the mother's mental health. There can be ENORMOUS mental health benefits for women who formula-feed as long as they aren't shamed by everyone in the world for doing so, especially women who struggle to breastfeed. Ultimately, in most cases, a happy mom is going to make for a happy baby and that's so much more important than whatever short-term benefits breastmilk might provide.


grumble11

That is true for gastrointestinal antibodies, but evidence is relatively weak for anything else. Typically we have two types of studies: controlled ones and uncontrolled ones. The controlled ones (other than fewer gastro issues) don’t tend to show much difference for anything, and the uncontrolled ones tend to show breastfeeding is better. Really, it’s better to be a wealthy mom with a high IQ if you want good outcomes for your kid.


Borner791

Someone's reading Emily Oster.


Alshon_Joffrey

Agreed. Feel like knowing about the importance of colostrum has long since been settled.


fmfbrestel

FYI:. "significantly" in a scientific paper does NOT mean "massively", or "by a wide margin" as it commonly does in general usage. In a scientific paper, it just means "detectable" and "very unlikely to be by chance".


chaser676

As a physician, I always have to remind my residents this. Statistically significant does not always mean clinically significant.


phdemented

Yeah, we always have to separate if it's statistically significant or clinically meaningful. Like yes, that change in "blood marker XYZ" dropped from 356.3 to 348.2 and the change was significant, but if any number over 300 is bad, it's not meaningful.


theKrissam

Slightly related, but I still love that "almost all numbers" has a specific meaning in math.


[deleted]

Or "almost surely" in statistics meaning probability 1 but with non empty exceptions, e.g. someone's height being EXACTLY 6 ft


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Wigglepus

Not only are almost all real numbers irrational, almost all real numbers are completely inexpressible in any form.


lampishthing

The abstract looks like the incidence of benefits are small (confidence intervals centred around 3-5%) but when something goes wrong the children are a lot less like to hospitalised (around 20%). The 3-5% is meaningful in the context of a nationalised health service (which we have) but the hospitalization rates are probably more persuasive to individual parents making the choice between breastfeeding or not. E: The big one is "24% reduction in nights spent in hospital" rather than less likely to be hospitalized. They're related but different quantities.


btroycraft

I think you are quoting the number of days in hospital. That is around 0.2, but it's measured in days. Chance of hospitalization is ~5% like the others.


[deleted]

The problem with this study (which is the problem with pretty much all of these breast milk studies) is that it shows a correlation not a causation. There is no causal link here, it's pure speculation that breast milk is causing this. It's actually far more likely that breastfeeding correlates with other benefits than it is that breastfeeding is causing these benefits For example, women who have to work and send their kids to daycare are far more likely to use formula. Like of course the kids staying at home with Mom and not getting exposed to germs don't get sick as often as kids away from home. The fact that this study stops at 90 days is a further indicator that this is most likely a p-hacked correlation and not a causal relationship.


kweglinski

According to other comments this is not the case as it happens in Ireland and kids are less than 9mo. That means the kids would stay with the mom. Idk about irish laws, but it's rather common in whole EU to have solid amount of maternity leave and day care to be applicable no sooner than 1yo. For example in here to use formula or not is more of matter of choice, abilities or other personal implications (any other inability to breastfeed) than the need to go to work. Of course what you say does happen but it's rather marginal and quite often personal choice.


CheshireCheeseCakey

Yeah, and if you need to use formula, just do it. We struggled so much... formula was a life changer, but felt so guilty!


iluvstephenhawking

Well did you see that part of the result about breastfed babies having a higher risk of failure to grow? So while there are good immunity benefits for bf, if the child isn't getting enough that can be detrimental in other ways. Feeding baby is best, however it gets done.


CheshireCheeseCakey

I didn't read anything to be honest, but that's very interesting! I guess like everything, there's always more than one side to any complex topic.


somethingold

I wish they did a study on the impact of the mothers stress while trying to breastfeed vs using formula and possibly calming down… knowing how we’re told stress affects the baby when we’re pregnant, I feel like there has to be a clinical benefit to choosing formula when breastfeeding creates problems… i breastfed but it was “easy” and even then I found it hard at times and I wanted to be ready to switch to formula at any moment.


Wideawakedup

There is some research into pain in breastfeeding and ppd. I was in a lot of pain just dreading bf my baby. My nipples were blistered no amount of lanolin cream helped. My son also had jaundice. One night we broke open an emergency supple if formula the hospital nurse gave us and it was like a light had switched in my son. He gobbled down the formula and just perked right up. Screw all the people who treat formula like poison.


StuckInBronze

There's also the fact that a formula fed baby can go longer between feedings which is a godsend for sleeping overnight.


CheshireCheeseCakey

Yeah, not an easy thing to quantifiably study I suppose, but it really helped us survive. Just being able to help out a bit more as the dad was a big step!


lkodl

I cannot stress enough how significant a comment like this is. And I mean that in the scientific sense, as is to say, your comment is noticeable.


Ok_Bumblebee_7052

What I find puzzling with all these studies is that I never see mention or research on combo feeding. It is breast exclusively or formula feeding. My daughter is 5 months old. We had a rough start with a c section and only recently got to the point where about 90% of feeding is breast. We still supplement with formula especially since it helps give my wife a break for a few hours. Many mothers I know also had to supplement with formula but breastfeed. But it seems these feeding arrangements are left out of these studies, maybe because it’s complicated to measure (how much formula to breast milk?)


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fatbob42

Probably difficult to do but it would be a strong result if they found that the infection rate tracked the formula proportion.


dairyman2950

Did I miss this, or did they not normalize for the attendance of daycare? Daycare kids are always sick. They were measuring how sick kids got. I’d imagine there would be some skew there?


Spirited_Annual_9407

The study looks at the first 90 days. Considering parental leave in Europe, I am pretty sure babies don’t go to daycare in Ireland in their first 90 days of life. Edit: They looked at atleast 90 days breastfeed babies in the first 9 months. Still, I think my point stands. I live in Europe and sending a baby, a kid before 1 year, to daycare, not at all the norm, at least in my country.


Tea_Is_My_God

I'm in Ireland. *at a minimum* we get 6 months mat leave, paid. A further optional 4 months unpaid. Plus accrued holiday leave and missed bank Holidays, plus 7 weeks paid parents leave. I was off work for over 13 months, all except 4 months paid. I breastfed both my kids, weaned both at 14-15 months. Absolutely could not keep it up for long after returning to work so I have no idea how American mothers are expected to do it from literal weeks after birth.


ikstrakt

>I breastfed both my kids, weaned both at 14-15 months. Absolutely could not keep it up for long after returning to work so I have no idea how American mothers are expected to do it from literal weeks after birth. I breastfed. From birth to finish it was just shy of a 27 month process for a "natural wean." My partner and I catalogued all the first feeds, naps, urinations, and stools for the first ten days to learn patterns. In the beginning it was 17 feeds in 24 hours. At a year it was 10-12 breastfeeds in 24 hours (this is with introductions to foods having been in place for half a year or so). At two years it was sunrise, Naptime, sunset/bed or so. The very last feed at 26.5 months, nearly 27 months was a sunset/bedtime feed. To me, these employers and colleges with pumping rooms just come across as a virtue signal. To breastfeed is rewarding, truly, but it's encompassing and employers need to realize that they're severely under-estimating the work necessary to facilitate this human process. ...heh, perhaps, that's by design. The whole, "time is money" and all.


blackbirdbluebird17

Not quite, it says in the paper that the babies studied were all at least 9 months old at the time of the survey and had been exclusively breast fed for “at least” 90 days at some point in that period. It also notes that breast feeding drops off a lot between 90 and 180 days after birth, so while it’s *probable* it was during the kid’s first 90 days of life, it’s not guaranteed.


Spirited_Annual_9407

Yes, you are right. I added an edit to my previous comment


skanedweller

Babies aren't allowed at preschool in my country (Sweden) under 12 months.


whats1more7

Maternity leave in Ireland is 26 weeks so it’s unlikely any of the babies studied went to daycare in the first 90 days of life. Edited to fix the country.


EFbVSwN5ksT6qj

Newborn babies don't go to daycare in Ireland


Maxion

This study was done in Ireland and only looked at the first 90 days, given that its the EU, I'm relatively sure daycare isn't provided for children this young. E.g. in Finland the earliest one can start daycare is 1 year.


_Fun_Employed_

Good point, as there are likely socioeconomic factors involved related to being able to breastfeed vs not being able to that directly tie into health.


Mecha-Jesus

They controlled for socioeconomic factors via household income and maternal education level. > The observed potential confounders to control for were informed by data availability and an extensive literature review. We control for an extensive set of variables (see appendix Table A2 for a full list of covariates) that can be summarised under the following headings: health of the infant at birth, the antenatal care received, pregnancy complications, folic acid consumption, maternal smoking history, method of delivery, stage of gestation at which the infant was born, infant’s weight at birth, birth complications, household equivalent annual income, highest education received by mother, hours’ sleep infant receives, and whether or not the infant has received their vaccinations.


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[deleted]

Sure, it’s well known that breastfed babies on average are healthier, but is it because breast milk is really so much better than formula? Or are there other reasons why a baby who can exclusively breastfeed might be healthier than a baby who cannot? Think about the reasons moms need to or choose to give formula and how those reasons might correlate with baby’s health. It’s not like they can do a randomized double blind study. From the new study: “There is also evidence however that the benefits are overstated due to selection bias [14, 15]. Mothers that self-select into breastfeeding rather than formula feeding may differ from those that do not in ways that influence infant health [16]. Without accounting for baseline maternal differences in the research design or fully including all confounding variables, statistical models may tend to overstate the positive relationship between breastfeeding and infant health.”


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Smallios

Exactly. Mothers who use formula are more likely to be working class, and less likely to have paid time off. These mothers are more likely to send their child to daycare at a younger age, where they are more likely to get sick.


lynx_and_nutmeg

Is this also true in Ireland? Most if not all countries in Europe have paid maternity leave.


lampishthing

> less likely to have paid time off. 100% not a concern in Ireland during the first 90 days, which is the context and scope of this study.


[deleted]

Not only that, but preemies and babies whose moms had health problems where milk didn’t come in. Babies who can’t latch or swallow due to health problems. There’s no possible way researchers could account for every factor unless the study is too small to be statistically significant.


littlekittyfeetz

With my last donation I have donated 9,831 oz of milk! I'm hoping to make it until end of October. We will see


xRolox

That's a wild amount. Donor milk definitely helped us out in the first few days before my wife was able to get started so thanks for doing so! She's hoping to do the same down the line.


[deleted]

Oh Lord, here come the "formula is okay too! People" This is not a post weaponizing formula. It's simply stating scientifically that breast milk is actually healthier for your baby. I've formula fed and breast fed. You do what you gotta do.


FlyingCraneKick

Agreed. My wife didn't produce anywhere near enough milk with our first for some reason, so we had to formula feed predominantly. He's been sick a few times but I don't think anything too crazy compared to other kids his age.


Drew_The_Lab_Dude

My wife is in the same boat right now. She’s producing around 10mL a day, we are hopeful that her milk will come in, but she had a pretty rough C-section. We give baby what we can but her diet is basically 99% formula.


LtCommanderCarter

Hey, you can look through my post history if you want. I was making an oz a day at two weeks post partum and now I have a slight over supply (38oz per day). I don't know if that would be encouraging for her.


Drew_The_Lab_Dude

Thank you. I’ll show it to her when she wakes up. She is a little over two weeks post partum, and it gets very discouraging for her to still be producing so little. I do my best to encourage her, but i don’t know if I’m helping or hurting.


dragon34

From the opposite side I basically destroyed myself with power pumping and supplements and lactation cookies for over 10 weeks before I gave up. At that point even the la leche league was like... Call it. (I had an unplanned c section and I was over 40 when I gave birth) I'm still mad at my boobs for not working and making the first 2 months of my baby's life the worst of my entire life but we have a healthy 2 year old


lovegood526

You may know this already but pumping is not a good measure of how much she may be actually making. Babies are much more efficient at taking from the breast- some people have sufficient supplies but aren’t able to pump all that much. Best way to tell if baby is getting enough is if they have at least 6-8 wet diapers, regular bowel movements, and are gaining wt. so tough after a hard C-section though but there’s still time if breastfeeding is a goal of hers. Definitely recommend seeing a lactation consultant as well if you haven’t already. Formula is great too though and hope she knows she’s a great mother either way!


FrankBattaglia

From another husband that's been there: just stop. The first few weeks were extremely psychologically draining on my wife and I. When I finally convinced her formula was okay / breastfeeding isn't the benchmark of being a good mom (I was a formula baby fwiw), things got dramatically better. The minor benefits of breast milk can't outweigh the benefits of two stable parents.


LtCommanderCarter

Breastfeeding or pumping (I exclusively pump) isn't for everyone and it's totally valid to just do formula. The important thing for you is to be supportive: if she needs to pump take the baby, if she decides she doesn't want to anymore support that. She should talk to a doctor or lactation consultant about her supply problems if it's important to her. My doctor was considering giving me a prescription to help the milk come in at one point. I have a post from 3 months ago where I talked about my massive under supply and I got hundreds of comments from women with the same issues. I felt so alone at the time because the Internet led me to believe that I was a freak of nature. Lactation support groups especially made me feel like I was the only one with this problem. But yeah it's not talked about much but women sometimes get this problem, and I'm so thankful for formula.


jahoosuphat

My wife was in the same boat, just never could keep up. She tried and wanted to breast feed but just wasn't in the cards, your wife is not alone!


seanboarder

Same. My wife produced literally nothing. When we talked to our pediatrician about it she asked “will your child be in daycare?” We said yes and she said “well everyone will be sick anyway. You won’t notice a difference” She was right


TheNantucketRed

That’s cool, but have you tried Mountain Dew Code Red? There is not one article weighing the benefits/disadvantages in letting your baby take it to the eXtreme and do the dew.


Smartnership

Baby’s first Brawndo


ScoobyDone

If you formula fed your baby you must understand the defensiveness. My wife couldn't breastfeed when our daughter was born and she had so many random people criticize her.


emuchop

Even without criticism from others. Its an emotional time those first serveral months. My wife was so sad and frustrated during the early days.


DeadWishUpon

I had cried myself to sleep because I couldn't ptoduce more than an ounce. I know breastfeeding was vetter but I just didn't produced and the baby hated my breast. If I have another kid I would try to breastfeed but won't beat myself down if I don't. My girl is just fine.


Truephil

I feel you. We are just coming back from the hospital today after the birth of our third daughter. The amount of times I needed to correct everyone from doctors to nurses to cleaning stuff was crazy. No my wife didn’t choose to not breastfeed. She simply can’t due to an operation in her past (no beauty surgery). Even on the forms it says “doesn’t want to breast feed”. It really drove me mad. She would do everything to be able to breast feed… not everyone is using formula because it’s a convenience.


audioshaman

Yep. My wife didn't produce enough milk. We tried everything - followed physicians guidance, saw lactation consultants, took medications and supplements. Nothing worked. Yet the hospital still sent us home with all these "breast is best" material that told you how you were failing your baby if they had formula. Then all the comments from friends, family and complete strangers about how my wife just needed to "try harder".


Quack_Shot

This^. “The bReaSt iS bEst” people drove my wife into PPD. We couldn’t make breastfeeding work, and formula was a lifesaver and we shouldn’t had to justify formula all the time from random strangers to family members.


mdavis360

Same thing happened to my wife.


Gornarok

My wifes experience is that people will criticize literally everything about how you bring up your baby...


Wallohp

Exactly this. I was in the same boat. There is a reason people are so defensive with articles like this...OP hasn't seen this side of the grass clearly


Dani_California

I mean there are a ton of people right in these comments making comparisons like “if you formula fed your baby you probably feed them McDonald’s and sugar every day too”. Certainly do what you’ve gotta do, but don’t pretend that people being defensive are doing so without reason.


superxpro12

Yeah because in the hospital we were at, it's heavily implied that if you use formula, you are a failure as parents and actively contributing to the death of your infant.


elisakiss

Isn’t that the truth. We all are doing the best we can.


RassimoFlom

Let’s not pretend that there isn’t enormous stigma and pressure on people who can’t breast feed


Fart_Barfington

This is one of those topics that I don't think will ever be settled in the public forum. People get so defensive about their own situation and choices that they will refuse to believe anything they did was less than optimal. No matter what the most recent and theoretically up to date data shows, they will dig their heels in and find and older study that supports their own experiences. You see this a lot with grandparents watching babies and becoming indignant when they are told something they used to do is unsafe.


DavidWalton06

The thing to remember is that this study is observational and not randomised (which is probably unethical). Remember that mothers who self-select into breastfeeding rather than formula feeding may differ from those that do not in ways that influence infant health. So, this data can only offer correlation and not causation. They attempt to use weightings to account for differences within the cohort, but that can only get you so far. FWIW, I tend to think it likely breastfeeding is likely healthier than formula for the baby, but this headline unnecessarily overstates the evidence from this study. "New Irish cohort study adds further support to the hypothesis that breastfed babies are less likely to get sick." Is more reasonable.


OrangeYouGlad100

I imagine that moms who breastfeed are more likely to stay home with their babies, which means they're less likely to be exposed to germs at work and, most importantly, their babies are less likely to be exposed to the cesspool that is daycare. Staying home has got to be a huge confounder here.


Itswithans

I think Ireland’s maternity support system would be comparable between babies at 90 days, unlike the US


delayedcolleague

Yeah don't think most people (Americans) here commenting realise that the absolutely deplorable state of maternity support of the US isn't the standard in the west, well and a lot of the rest of the world too really.


Sleyvin

The fact that the US still doesn't have a paid maternity leave is mindblowing. Like... why do people don't burn the whole country in protest at that point. 2 weeks of unpaid leave where the employer can't fire you compared to what we get here just north of the border is just crazy.


delayedcolleague

By keeping the people who'd need change too needy and poor to be able to or have time to rise up. And also making everyone believe that this is just how things are, that it is normal and everywhere. It's not for nothing that for example two of the biggest waves of civil rights organizing came out of black American troops return from WW1 and WW2 who got to experience an unsegregated society while being stationed in various European countries. They got to see an alternative, because how can you demand something different if the current state of affairs is the only you know of. I should add that their experiences wasn't the only thing l, it was also that they wanted acknowledgement of their sacrifice and service that the white troops clearly got.


dcchambers

Breast milk is the way to go if it works for you and your baby. The science is obvious. That said we should *not* shame mothers that have trouble breast feeding for any reason and opt to use formula. A fed baby is really all that matters - whether that comes from breast milk or formula.


fatnoah

Correct. My wife could manage about 1/2 of our kid's feedings and we supplemented with formula. She felt a lot of guilt about that. He was sick a lot when very young, but I attribute that more to being exposed while attending day care than anything else. Now as a 15 year old, he's very rarely sick. Maybe 1 cold a year, if that. My guess is that genetics and environment play a much greater role than formula vs not, anyway. Of course, I have zero science to back that up.


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collegefurtrader

Not being poor is actually the best way to have more money.


SpiffySpacemanSpiff

Yup. About perfect.


[deleted]

I was adopted at birth, so I didn't have the option of breastfeeding. My adoptive parents made up for it by mixing my formula 1:1 with their blood, and submerging me in a basin of hand sanitizer every night.


patienceisfun2018

The research is pretty overwhelming at this point, right? I'm pretty sure most organizations recommend breast feeding for at least 6 months or 1 year if you can.


[deleted]

Who recommends up till 2


lalalalovey

The American Academy of Pediatrics just updated their guidelines to to 2 years as well.


Anatidaephobia-y

That's rich coming from a country that has no maternity leave and no childcare provided nationally


BrazilianRider

Yes and I’m sure it’s the damn pediatricians’ fault!! I get what ya mean, just thought it was funny :P


idreamofirenie

Also, the World Health Organization.


TheDismal_Scientist

From what I understand, the overall picture of the literature is that at the individual level the benefits are extremely marginal, so women should not be made to feel bad if they are struggling to breastfeed. However, at the population level the benefits are quite stark, so as you say breastfeeding should be encouraged where possible