A nice example of entwined medicine, faith, social status, and care showing: I made the mistake of idly musing about breast-feeding to a group of new mothers I’d just met. This time around, I said, I was considering cutting it off after a month or so. At this remark, the air of insta-friendship we had established cooled into an icy politeness, …
Note that the link between breastfeeding and IQ is important not only because of the significance of 6 IQ points, but also because we know of very few other interventions that can similarly boost intellectual ability.
After reading the paper that Hanson cites, my "faith in breasts" is somewhat diminished. However, I do put some stock in arguments from authority, as a "shortcut" regarding topics that I don't know much about. Thus, given the fact that so many medical organizations that claim to have reviewed the evidence strontly favor breastfeeding, I tentatively lean toward breastfeeding being superior to formula, albeit with a bit less enthusiasm. While I recognize that both might be equal, I believe that there is little chance that formula is superior, and that there's a possible chance that breast milk could be significantly superior- a possibilty that would likely scare me into breastfeeding, even given its costs. I'm not sure what I'd recommend to my patients.
"She is saying that she had a very human reaction of seething"
Oh no, I don't think she was being sarcastic. No, I did not misread her. Rather you can't seem to see the not-very-subtext that is whacking you upside the head.
You see, this is why so many OB readers don't seem to have successful relationships. Many appear to lack understanding of what constitutes dysfunctional behavior.
"Seething" is not a functional relationship strategy. It may be human, but it will destroy your love and respect for one another in an acid sea of resentment.
Don't "seethe" in your relationships. If you can't talk about X right there on the spot, respectfully and with tenderness, you're screwed. Or rather, you won't be. Ask anyone who's been married, oh 10 or 20 years.
Resenting your husband and writing about it in national magazines isn't my suggested way to go. It's the airing the ugly resentment she has carefully stored for such a monetary occasion - look! how humorous, how self-deprecating! - that indicates lack of respect for her husband as a human being. It's a tantrum, and we all know about tantrums. Don't try this at home, ok?
Resenting your husband for the choices you have made and your inability or refusal to communicate your issues around them shows a lack of maturity, a lack of accepting responsibility for your own behavior. This is repulsive man-hating victim feminism in a not-so-subtle form.
frelkins, I think that you misread her. You seem to think that she is being sarcastic when she writes, "My husband acknowledged the ripple in the nighttime peace with a grunt, and that’s about it. And why should he do more? There’s no use in both of us being a wreck in the morning." I think that she was being sincere. That interpretation seems to me to be most consistent with the following line: "Nonetheless, it’s hard not to seethe." The "nonetheless" to me implies that she grants the truth of the preceding sentence.
She is saying that she had a very human reaction of seething when she was working in the middle of the night while the person next to her slumbered, but that she saw good reasons for why it should be that way. As a male who doesn't like to be roused in the middle of the night, I can easily understand her irritation at watching her husband sleep while she has to get up. The irritation may not be rational, but I certainly don't think that her feeling it implies that she doesn't have "any respect for [her] husband as a human being."
It invalidates the blinding, not the randomization! It seems like a pretty small problem (every study has problems), though the cherry-picking multiple measures of IQ is a big problem.
Its funny how breast feeding is "medicine" and formula isn't -- when one is obviously a recent technological advancement and the other has been around for ages (Economic benefits of breastfeeding: a review and analysis. US Dept of Agriculture). Supposedly breast feeding reduces costs, and contra what some people are saying, should be easier for poorer women.
The two clearest benefits I remeber about breast feeding are reduced infections (Breast milk provides immunity to baby, by passing moms immunoglobulins on) and pair-bonding for mom and baby. Benefits to Mom and Baby are clearly summarized, along with the controversies surrounding cognitive improvement in UpToDate review articles.
As many other people have pointed out -- Robin can't be bothered to read the medical literature. He can't be bothered to find a review. He just doesn't want to hear contradictory evidence -- god help anyone who listens to Robin's medical advice.
For the billionth time -- get a damn subscription to uptodate and read the review article before you even try to contradict anything. The review articles cite the primary literature AND the problems with the studies as well as the argument for current medical thinking.
To demonstrate how LAZY and reckless you are, I just want to highlight what happened when I went to UpToDate. For those not familiar -- uptodate is the equivalent of google for medicine. In any other setting You caa't make an argument against a popularly held belief without bothering to google counter arguments. So, I put breast feeding in the search box, and 3 of the top 10 results are1.) Maternal and economic benefits of breastfeeding2.) Infant benefits of breastfeeding3.) The impact of breastfeeding on the development of allergic disease
Each of these reviews has over 50 references. Here is an excert on the part on cognitive development:
A number of studies have shown small neurodevelopmental advantages in children who were breast-fed compared to those who received formula, as illustrated below:Cognitive development — Although there have been several reports that breastfeeding improves cognitive development later in childhood and adolescence to breastfeeding [76-79], this association remains uncertain [80].
"Trasande et al. used a value for lifetime earnings (in 2000 dollars) of $1,032,002 for males and $763,468 for females based on the work of Max et al. (2004). . . .Both the U.S. EPA and Trasande use the work of Salkever (1995) to estimate the effect that one IQ point decrement has on earnings. Because the Trasande earnings are sex specific, the authors use Salkever’s sex-specific results. For each IQ point decrement, males experience a 1.93% decrease in lifetime earnings and females experience a 3.23% decrease."
-- US EPA study on effects of IQ detriment due to mercury poisoning in children.
6 IQ points = about US$120K? Check my math, please.
But seriously, you all need to read the whole article. The chick is not actually be-otching about breastfeeding - that's an excuse. Read it with skirt-eyes and pay attention to the inter-text.
It's filled with rage against her husband, what she perceives as inequality in her marriage. The kids & breast-feeding is really an excuse to beat her husband with a stick in public. The nut graf:
"About seven years ago, I met a woman from Montreal, the sister-in-law of a friend, who was young and healthy and normal in every way, except that she refused to breast-feed her children. She wasn’t working at the time. She just felt that breast-feeding would set up an unequal dynamic in her marriage — one in which the mother, who was responsible for the very sustenance of the infant, would naturally become responsible for everything else as well. At the time, I had only one young child, so I thought she was a kooky Canadian — and selfish and irresponsible. But of course now I know she was right. I recalled her with sisterly love a few months ago, at three in the morning, when I was propped up in bed for the second time that night with my new baby (note the my). My husband acknowledged the ripple in the nighttime peace with a grunt, and that’s about it. And why should he do more? There’s no use in both of us being a wreck in the morning. Nonetheless, it’s hard not to seethe."
Yikes! Um, Ms. Rosin, if you actually stopped whining like a wimpy victim about the choices you yourself have made, accepting that you were a full moral agent, and further if you had any respect for your husband as a human being - you would just hire a nanny, get thee to couples counseling, and thus not have to castrate him in public to express your scary anger.
Articles like this make me really ashamed to be a heterosexual feminist sometimes.
Tom: See http://www.allattamentoalse... for a non-gated version of the article (originally published in "Archives of General Psychiatry"), which mentions the IQ differences.
Robin points to an article that contests the findings of these researchers (I can't find an ungated version, so I plan to read it tomorrow, when I'll have access to it at school). The article is located at http://archpsyc.ama-assn.or...
Eliezer, that is my summary of their argument. I cannot myself address the quality of the original study or its critiques. I was curious, so I had a librarian send me the two-page critique. The surrounding letters are also interesting. One notes that there are three options: breast milk from a breast, breast milk from a bottle, and formula from a bottle (Science! has yet to perfect the fourth permutation); studies often fail to separate the middle category, and may group it with "breast milk" or "bottle fed" inappropriately or unclearly. It goes on to note feeding positions and inner ear fluid, a topic that has been near and dear to OB recently.
How large a truckload are we talking here? I only have so much freezer space.
the PROBIT study, which was conducted by Canadian and American researchers in Belarus (where most women use formula), did actually conduct an randomized controlled trial, and found that the two groups had a statistically significant 6 point difference in IQ
Where? You seem to mean the randomized PROBIT study or studies in Belarus by Kramer et al. I took a look at the abstracts of 2 papers and 2 followups (Kramer, 2001, 2002, 2004, 2007). None mention any IQ difference.
Thanks. Your response to Zubon is what I was driving at. I just didn't have the time or knowledge to articulate it properly. I'm missing more than 6 IQ points I suspect, and I was breast fed!
Naively applying Robin's usual standards for medical results more generally, I would be forced to conclude that the entire field of economics is total bunk barely better than noise, along with the majority of every other academic discipline but physics, chemistry, and mathematics. I'd probably be right in many cases to do so, but that's a lot of babies out with the bathwater.
It occurred to me that using breast pumps might be a good way to avoid some of the problems associated with breastfeeding while continuing to take advantage of breastmilk's nutritional value. Any problems?
My mother did this with some of my younger siblings. I remember feeding bottles of breast milk to my baby sister, and as an aside, human milk that's gone sour from sitting out too long smells remarkably bad.
Anecdotally, I recall that the primary downsides to this approach is that the pumps are often harsher on sensitive tissue than an infant's mouth, and that a regular schedule of expressing the milk must be maintained regardless because going too long without doing so will cause the mammary glands to produce less milk in response. Obviously benefits to mother-infant bonding are also lost, and if done too frequently the infant may become too accustomed to bottle-feeding and no longer suckle directly.
Overall, pumping and storing breast milk is probably the best balance for women who can't breastfeed directly for some reason.
>>>BillB, I would eat the kittens.>>Would you eat your mother?>Billb, like I said... don't ask.
I think the real question is "Would you eat babies?"...
Can you quantify the difference 6 points makes?
Note that the link between breastfeeding and IQ is important not only because of the significance of 6 IQ points, but also because we know of very few other interventions that can similarly boost intellectual ability.
After reading the paper that Hanson cites, my "faith in breasts" is somewhat diminished. However, I do put some stock in arguments from authority, as a "shortcut" regarding topics that I don't know much about. Thus, given the fact that so many medical organizations that claim to have reviewed the evidence strontly favor breastfeeding, I tentatively lean toward breastfeeding being superior to formula, albeit with a bit less enthusiasm. While I recognize that both might be equal, I believe that there is little chance that formula is superior, and that there's a possible chance that breast milk could be significantly superior- a possibilty that would likely scare me into breastfeeding, even given its costs. I'm not sure what I'd recommend to my patients.
@Tyrell
"She is saying that she had a very human reaction of seething"
Oh no, I don't think she was being sarcastic. No, I did not misread her. Rather you can't seem to see the not-very-subtext that is whacking you upside the head.
You see, this is why so many OB readers don't seem to have successful relationships. Many appear to lack understanding of what constitutes dysfunctional behavior.
"Seething" is not a functional relationship strategy. It may be human, but it will destroy your love and respect for one another in an acid sea of resentment.
Don't "seethe" in your relationships. If you can't talk about X right there on the spot, respectfully and with tenderness, you're screwed. Or rather, you won't be. Ask anyone who's been married, oh 10 or 20 years.
Resenting your husband and writing about it in national magazines isn't my suggested way to go. It's the airing the ugly resentment she has carefully stored for such a monetary occasion - look! how humorous, how self-deprecating! - that indicates lack of respect for her husband as a human being. It's a tantrum, and we all know about tantrums. Don't try this at home, ok?
Resenting your husband for the choices you have made and your inability or refusal to communicate your issues around them shows a lack of maturity, a lack of accepting responsibility for your own behavior. This is repulsive man-hating victim feminism in a not-so-subtle form.
frelkins, I think that you misread her. You seem to think that she is being sarcastic when she writes, "My husband acknowledged the ripple in the nighttime peace with a grunt, and that’s about it. And why should he do more? There’s no use in both of us being a wreck in the morning." I think that she was being sincere. That interpretation seems to me to be most consistent with the following line: "Nonetheless, it’s hard not to seethe." The "nonetheless" to me implies that she grants the truth of the preceding sentence.
She is saying that she had a very human reaction of seething when she was working in the middle of the night while the person next to her slumbered, but that she saw good reasons for why it should be that way. As a male who doesn't like to be roused in the middle of the night, I can easily understand her irritation at watching her husband sleep while she has to get up. The irritation may not be rational, but I certainly don't think that her feeling it implies that she doesn't have "any respect for [her] husband as a human being."
invalidates the randomization
It invalidates the blinding, not the randomization! It seems like a pretty small problem (every study has problems), though the cherry-picking multiple measures of IQ is a big problem.
Its funny how breast feeding is "medicine" and formula isn't -- when one is obviously a recent technological advancement and the other has been around for ages (Economic benefits of breastfeeding: a review and analysis. US Dept of Agriculture). Supposedly breast feeding reduces costs, and contra what some people are saying, should be easier for poorer women.
The two clearest benefits I remeber about breast feeding are reduced infections (Breast milk provides immunity to baby, by passing moms immunoglobulins on) and pair-bonding for mom and baby. Benefits to Mom and Baby are clearly summarized, along with the controversies surrounding cognitive improvement in UpToDate review articles.
As many other people have pointed out -- Robin can't be bothered to read the medical literature. He can't be bothered to find a review. He just doesn't want to hear contradictory evidence -- god help anyone who listens to Robin's medical advice.
For the billionth time -- get a damn subscription to uptodate and read the review article before you even try to contradict anything. The review articles cite the primary literature AND the problems with the studies as well as the argument for current medical thinking.
To demonstrate how LAZY and reckless you are, I just want to highlight what happened when I went to UpToDate. For those not familiar -- uptodate is the equivalent of google for medicine. In any other setting You caa't make an argument against a popularly held belief without bothering to google counter arguments. So, I put breast feeding in the search box, and 3 of the top 10 results are1.) Maternal and economic benefits of breastfeeding2.) Infant benefits of breastfeeding3.) The impact of breastfeeding on the development of allergic disease
Each of these reviews has over 50 references. Here is an excert on the part on cognitive development:
A number of studies have shown small neurodevelopmental advantages in children who were breast-fed compared to those who received formula, as illustrated below:Cognitive development — Although there have been several reports that breastfeeding improves cognitive development later in childhood and adolescence to breastfeeding [76-79], this association remains uncertain [80].
@Johnathan Graehl
"6 points"
"Trasande et al. used a value for lifetime earnings (in 2000 dollars) of $1,032,002 for males and $763,468 for females based on the work of Max et al. (2004). . . .Both the U.S. EPA and Trasande use the work of Salkever (1995) to estimate the effect that one IQ point decrement has on earnings. Because the Trasande earnings are sex specific, the authors use Salkever’s sex-specific results. For each IQ point decrement, males experience a 1.93% decrease in lifetime earnings and females experience a 3.23% decrease."
-- US EPA study on effects of IQ detriment due to mercury poisoning in children.
6 IQ points = about US$120K? Check my math, please.
But seriously, you all need to read the whole article. The chick is not actually be-otching about breastfeeding - that's an excuse. Read it with skirt-eyes and pay attention to the inter-text.
It's filled with rage against her husband, what she perceives as inequality in her marriage. The kids & breast-feeding is really an excuse to beat her husband with a stick in public. The nut graf:
"About seven years ago, I met a woman from Montreal, the sister-in-law of a friend, who was young and healthy and normal in every way, except that she refused to breast-feed her children. She wasn’t working at the time. She just felt that breast-feeding would set up an unequal dynamic in her marriage — one in which the mother, who was responsible for the very sustenance of the infant, would naturally become responsible for everything else as well. At the time, I had only one young child, so I thought she was a kooky Canadian — and selfish and irresponsible. But of course now I know she was right. I recalled her with sisterly love a few months ago, at three in the morning, when I was propped up in bed for the second time that night with my new baby (note the my). My husband acknowledged the ripple in the nighttime peace with a grunt, and that’s about it. And why should he do more? There’s no use in both of us being a wreck in the morning. Nonetheless, it’s hard not to seethe."
Yikes! Um, Ms. Rosin, if you actually stopped whining like a wimpy victim about the choices you yourself have made, accepting that you were a full moral agent, and further if you had any respect for your husband as a human being - you would just hire a nanny, get thee to couples counseling, and thus not have to castrate him in public to express your scary anger.
Articles like this make me really ashamed to be a heterosexual feminist sometimes.
6 points gets you another correct answer on an iq test, obviously. That's worth a lot of kittens.
Tom: See http://www.allattamentoalse... for a non-gated version of the article (originally published in "Archives of General Psychiatry"), which mentions the IQ differences.
Robin points to an article that contests the findings of these researchers (I can't find an ungated version, so I plan to read it tomorrow, when I'll have access to it at school). The article is located at http://archpsyc.ama-assn.or...
Billb, like I said... don't ask.
Eliezer, that is my summary of their argument. I cannot myself address the quality of the original study or its critiques. I was curious, so I had a librarian send me the two-page critique. The surrounding letters are also interesting. One notes that there are three options: breast milk from a breast, breast milk from a bottle, and formula from a bottle (Science! has yet to perfect the fourth permutation); studies often fail to separate the middle category, and may group it with "breast milk" or "bottle fed" inappropriately or unclearly. It goes on to note feeding positions and inner ear fluid, a topic that has been near and dear to OB recently.
How large a truckload are we talking here? I only have so much freezer space.
the PROBIT study, which was conducted by Canadian and American researchers in Belarus (where most women use formula), did actually conduct an randomized controlled trial, and found that the two groups had a statistically significant 6 point difference in IQ
Where? You seem to mean the randomized PROBIT study or studies in Belarus by Kramer et al. I took a look at the abstracts of 2 papers and 2 followups (Kramer, 2001, 2002, 2004, 2007). None mention any IQ difference.
Eliezer: Really? What do you think 6 points gets you? Would you eat your mother?
Eliezer,
Thanks. Your response to Zubon is what I was driving at. I just didn't have the time or knowledge to articulate it properly. I'm missing more than 6 IQ points I suspect, and I was breast fed!
Naively applying Robin's usual standards for medical results more generally, I would be forced to conclude that the entire field of economics is total bunk barely better than noise, along with the majority of every other academic discipline but physics, chemistry, and mathematics. I'd probably be right in many cases to do so, but that's a lot of babies out with the bathwater.
It occurred to me that using breast pumps might be a good way to avoid some of the problems associated with breastfeeding while continuing to take advantage of breastmilk's nutritional value. Any problems?
My mother did this with some of my younger siblings. I remember feeding bottles of breast milk to my baby sister, and as an aside, human milk that's gone sour from sitting out too long smells remarkably bad.
Anecdotally, I recall that the primary downsides to this approach is that the pumps are often harsher on sensitive tissue than an infant's mouth, and that a regular schedule of expressing the milk must be maintained regardless because going too long without doing so will cause the mammary glands to produce less milk in response. Obviously benefits to mother-infant bonding are also lost, and if done too frequently the infant may become too accustomed to bottle-feeding and no longer suckle directly.
Overall, pumping and storing breast milk is probably the best balance for women who can't breastfeed directly for some reason.