>Can you walk me
>through the math on formula feeding increasing ear infections by 100%?
>     I am a dedicated lactation consultant and gifted grammarian, but
>must really be steeped in my culture, because I don't quite understand
>some of your statements concerning breastfeeding outcomes as normal.

My pleasure!  This is *indeed* slippery stuff.  I first started pondering it
in 1987, and I'm *still* uncovering layers of it in what I read and how I
think.

Any time we talk about breastfed children being "better" or "more" or
"healthier" or "sturdier" or "higher", we're saying "than normal."  That's
what comparatives mean.  And of course the "normal" in those sentences must
be "formula-feeding" because in this culture that's really the only other
way babies are fed.  So every time we do it, we're as good as saying to
mothers, "formula-fed babies are normal, and formula-feeding is normal."
That means formula-feeding must be safe, acceptable, low-risk, the standard
thing to do, the default position, the culturally acceptable thing to do,
everything that mothers perceive normal to be.  And that means they're
simply not driven to avoid it.  We've as good as told them formula is safe
and healthy.

But what if we don't talk about breastfed kids being anything different from
"normal"?  Well, we all know formula kids don't outperform them in any way.
That must mean formula is not as safe, not as healthy, not a complete food,
and on and on.  Yikes!  I think that notion is so utterly scary that we just
avoid it altogether.

Anne Altschuler sent me a couple captions from her Wisconsin paper.  The
first:  "Study finds link between breast feeding and cancer."  Well, of
course the "link" was an inverse relationship.  But that wasn't clear, so
they had to print a correction:  "A headline on Page 4A of Wednesday's paper
was misleading.  The headline was over a story about a study of breast
cancer risks for women who breast feed their babies.  The study found a
reduced risk of the cancer among women who breast feed."  But is that really
what the study found?  Didn't it find that women who don't do the
biologically normal thing are at a risk greater than the biological norm?
Don't they mean that there's an increased risk linked to formula-feeding?

It's very rare to see the f-word in print, though.  Researchers seem to
avoid it like the plague, to the point of honestly not recognizing that
they're using the formula-fed child to represent the norm.  Here's a
statement from our American Academy of Pediatrics.  "The breastfed infant is
the reference or normative model against which all alternative feeding
methods must be measured with regard to growth, health, development, and all
other short-and long-term outcomes."

Fine so far, and utterly correct.  But the very next sentence ruins it:
"Epidemiologic research shows that human milk and breastfeeding of infants
provide advantages with regard to general health, growth, and development,
while significantly decreasing risk for a large number of acute and chronic
diseases."  To be correct, it should have read, "Epidemiologic research
shows that formula and formula-feeding of infants provide disadvantages with
regard to general health, growth, and development, while significantly
increasing risk for a large number of acute and chronic diseases."  *That's*
how you say it if breastfeeding is the norm.  But using the f-word would
have been unthinkable, politically, and so they skittered around it.  And in
doing so, I would say they withheld vital decision-making information from
parents.

As to numbers:  if A is half of B, then B is twice as much as A.  If
breastfed babies have "half as many ear infections" (as formula-fed
infants), then you could just as well (and more correctly) say formula-fed
babies have twice as many as breastfed babies.  If A is 25% less than B,
then B is 33 1/3 more than A.  Maybe the easiest thing is just to assign
numbers.  In the first case, you could say A is 50 and B is 100.  In the
second, A is 75 and B is 100.  The math gets trickier for some of the
statistics.  You just have to assign 100 to the current "norm", see what the
comparative is, then figure out what you have to do to get from that
comparative back to 100.  If A is 30% less than B, or 70, then B, at 100, is
43% more than A.  And I can't do that without messing around with a
calculator.

Breastfeeding isn't the only place where we get the norm backwards.  Which
seems closer to the biological norm to you:  a modern obstetric facility or
a woman laboring with an experienced woman at hand?  Which do we choose as
the norm in our studies?  Which *should* we choose, biologically speaking,
and how would it affect how we run our hospitals?

Here are some figures from Marshall Klaus on doulas:

Having a doula results in a:
50% decrease in cesarean sections
25% decrease in length of labor
30% decrease in use of forceps
40% decrease in use of oxytocin
60% decrease in use of epidurals,
30% decrease in use of pain medications

So the mom thinks, "Okay, if I get around to it I ought to line up a doula,
to augment my normal, safe, unquestioned hospital delivery."

Now try this:  When a woman is forced to labor without a supportive woman at
her side, she experiences a:
100% increase in cesarean sections, or twice as many
33% increase in length of labor
43% increase in use of forceps
67% increase in use of oxytocin
150% increase in use of epidurals, or 2 1/2 times as many
43% increase in use of pain medications

Don't you think a woman might think, "Wait a minute!  How could the hospital
be so irresponsible as to knowingly increase my risks this way?"  (pardon
the split infinitive)  And suddenly the whole mirage of the normal, safe,
unquestioned hospital delivery evaporates.  I love it :-)
--
Diane Wiessinger, MS, IBCLC,  Ithaca, NY
www.wiessinger.baka.com

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