"A multitude of studies demonstrate that when breastfeeding is 
accompanied by formula supplementation, illness and death rates are 
much closer to those of babies who are fully formula-fed..."

My friend Darillyn voiced her concerns about this paragraph, and 
wondered if adoptive breastfeeding mothers might become discouraged if 
they learned that breastfeeding combined with supplements did not have 
the power that exclusive breastfeeding has.

It’s true that Americans in general struggle with the concept of risk.  
If formula-feeding were associated with 100% fatality, we would have no 
trouble convincing people to breastfeed.  Certain death is a concept 
most understand.  But because the outcome of not breastfeeding is much 
more variable than that, it is hard for many to understand that there 
is any risk at all.  How many times have we heard someone say, “But I 
wasn’t breastfed, and I’m fine,” meaning “I wasn’t breastfed, and yet I 
am alive.  Since I can see that there isn’t 100% mortality, there must 
be no risk at all.”

In a culture where most moms hear that breastmilk is only marginally 
better than a can of dried milk from a cow, the concept of comparative 
risk may be even harder to communicate.  That adoptive breastfeeding 
mothers may initially be discouraged is a real possibility.  However, 
this group has faced great adversity to choose what they know to be the 
lowest risk for their children.  They seek out information about 
relative risks, and the fact that they are maximizing their children’s 
chances for health has not changed.

I believe that with sufficient knowledge, empowerment will be the end 
result, rather than discouragement.  Today, many adoptive breastfeeding 
mothers rely on supplemental formula.  We can hope that accurate 
information about the risks of artificial baby milk will help to 
empower all mothers to demand access to safe and affordable donor human 
milk when needed.

All that any of us can hope for is to have enough knowledge and control 
over our lives to be able to act to decrease risk--not eliminate it.  
All of our lives are filled with risk.  The safest course lies in 
having accurate information about risk,  so that we can reduce our 
exposure to it.


Arly Helm, MS, IBCLC

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