regarding the expected "heated discussion" - here's my thoughts...

It's pretty tough to help a parent make an "informed" choice when as a HCP
we only have some vague notion of what the actual health positives and
negatives are regarding the decision of what to nourish a
newborn/infant/toddler/child with.

It's even tougher to aquire the knowledge "after the fact" [since it's not
well taught in med school - if at all] given that:
 1. Analysis of the validity [especially regarding the "methods" sections]
of many of the research articles requires a good understanding of the
mechanics of breastfeeding - which many HCPs just don't have.

2. Often for the busy practitioner, drug reps and formula reps compose a
big portion of the "new study" input that they receive - and while the
formula reps may come along with free pens/donuts/scotch tape
dispensers/mouse pads/fancy "dripping" demo toys/formula for doc & staff,
etc  - breastmilk is not a gazillion dollar industry and noone is likely to
come to your office in a well fitting suit with some breakfast, a handful
of pens and the three latest articles that show that it's rivals pale in
comparison.

3. We learn what we see and that forms our basis of what is "normal" - in
an office practice it's normal to see lots of sick kids.  You're not going
to "see" that a good proportion of your breastfeeding population don't come
in as often as your bottle feeding population.

The inadequacies of formula vs. breastmilk are accepted by the culture that
we're in because bottle feeding has been the societal norm.  When I was a
kid there were few cars that had seat belts and the "inadequacies" of a
child riding unrestrained were accepted as the societal norm.  Until recent
years smoking around children was the societal norm.
It was "of course" a parent's choice back then - few would speak up about
it because after all most kids rode around in a car without problems and
most kids didn't have horrible reactions to cigarette smoke - ok maybe more
upper resp. infections, and more ear infections but "all" kids have those
don't they, right? So the kids that weren't exposed had fewer - but what's
the "acceptable" norm?

To get to the point - it's not just "sanitarily" prepared formula vs.
whatever risk you choose to believe on Hep C transmission - there's a whole
lot less you get with formula - it all just depends on how many
inadequacies you'll accept as "the norm".

Gail
Gail S. Hertz, MD, IBCLC
Resident,  Dept. of Pediatrics
PSGHS Children's Hospital
Hershey  PA
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