Dear all:

It is one thing to have a different point of view and it is another to ignore evidence.  It is one thing to pick and choose what you tell parents. It is another thing to provide evidence to parents and let them pick and choose.

In Manhattan, parents have to watch a horrible shaken baby video (either I zoned out or they weren't doing this when my son was born) if they deliver in the hospital.  It is apparently mandatory and leaves most parents very upset.  Yet they have to watch it.

So, what is wrong with providing full information to parents so they can decide?  Thinking you know better than a parent what might upset them is PATRONIZING. You can give the full information about what is recommended and still get parents to focus on the here and now.  I get that question often -- what do YOU recommend.  I say I don't recommend and I say how long I fed my baby is irrelevant.  I say -- here is what the research suggests, but we are focusing on the problems you are having right now and taking it a day at a time.  We will help you optimize how much breastmilk you can get into your baby and optimize how much your baby can drink from the breast.  

And EVERY single bit of evidence I have seen on formula versus donor milk has shown it to be worse or the same. Even Schanler'ts study in which they used a sample size that was half has big as they should have because the infant death rates dropped by 50% actually had a very clear difference in the rates of necrotising enterocolitis. Buried in my very old copy of Lawrence was a study that RANDOMLY ASSIGNED pooled donor milk or formula to premature infants and there was a significant difference of 10 IQ points.   Women are tested up the wazoo for HIV and CMV in the United States. I can't even remember how many variants of the virus I was tested for.  It is hard not to get out of the process tested up the wazoo.

Every day the news media perpetuates scares about all sorts of "threats" that are not yet proven.  Scares about plastics and plastic liners in cans and ingredients in toddler foods and growth hormones.  Most of the research is extrapolated from petri dishes, mice or rats.  We don't shut down the news media for publicizing these threats. Because these threats actually might turn out to be real.  The threats from formula have been shown to be real and actually bigger than any of these proposed threats that have some plausible, but not yet conclusive evidence.  The burden of proof is NOT on the normal state.  The burden of proof is ALWAYS on the artificial state to be proven safe.  Not the other way around.

Now, just because you pastuerize milk doesn't mean that you take out all the nutritional ingredients that are not included in formula.  Just because you add a few extra UNTESTED combinations of ingredients doesn't mean that you have compensated for all the other ingredients that are missing.

And as for HIV, there is an accumulating body of evidence that we have done significant and permanent harm in developing areas of the world by dumping formula on the problem of HIV transmission.  If a baby has HIV and the formula is prepared in unsanitary conditions -- that baby is going to die much faster than if the baby had donor milk.  If the baby doesn't have HIV and the mother formula feeds that baby is much more likely to die than if the baby is exclusively breastfed or fed human donor milk particularly if the mother is given appropriate antiretroviral treatment.  Yes, one must assess the particular circumstances.  But that should be done with FULLY INFORMED CONSENT -- which means all the options and risks discussed.

When did we decide that MOTHERS are too FRAGILE to know what current research says --- including areas where we are not entirely sure?  

Sincerely,

Susan E. Burger

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