Dear all: I haven't piped up because there has been some really excellent posts on the reverse causality of blaming breastfeeding for failure to thrive. This "myth" persists even in my own international nutrition circles. I was astounded to hear one friend comment on another friends small daughter and that the reason why she was small was that she was still breastfeeding at age three. Both women were from developing countries and worked for UNICEF on nutrition programs. I'm doing a talk for Cornell Medical Students and my reverse causality example was how the formula industry used to try to deflect the evidence on not breastfeeding and increased infant mortality by claiming "reverse causality" --- that infants who are ill or dying are more likely to be given formula and the fact that they were ill or dying is the real cause of the death (and specifically mentioned that powdered infant formula was the same as any other home-based concoctions that are often given the finger as the reason for the high mortality. This was debunked in a now oldie (mid1980s) but goodie study using a large data set in Malaysia on infant mortality --- the same data set that also debunked the notion that the much higher infant death rates from use of formula in developing countries was due to poorly designed studies. Within the Malaysia sample there was enough economic diversity and data to do some nice epidemiology to nail down the fact that breast milk substitutes are even more risky when you a) don't have a toilet, b) don't have enough water, and c) don't have clean water: a) is higher risk than b) which is higher risk than c). Hence the explanation for the fact that infant mortality rates really were that much higher among those who were using breastmilk substitutes in developing areas of the world. I was also going to use the reverse causality issue on blaming the bottle --- and the fact that the underlying problem that caused the mom to use the bottle (assuming a mom wants to breastfeed) never gets dealt with because you are ignoring the feeding problem --- and hence setting up the infant for later eating disorders. Best Susan Burger, MHS, PhD, IBCLC, RLC *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome