I was part of a discussion about the 4/1000 stat on a debate board a few
years ago. I am hesitant to post because my memory of the discussion has
faded a bit. ;-)

It has not been clear to me when I've seen the stat whether it is 4/1000
infants born in the US die as a result of formula, or 4/1000 infants who
died in the US die as a result of formula.

Granted the statistic doesn't appear to be a recent one but going by recent
infant mortality statistics that is over half the infants who die in the
US, dying of formula.  So perhaps the statistic is 4/1000 infants who died,
died because of formula.

At any rate, in trying to get to the bottom of this statistic a friend of
mine who was participating in this discussion emailed Dr. Rogan.  The
"study" of Rogan's that is often cited as a source of this statistic is
nothing more than an abstract where he says:  "We estimate the decision to
breast feed decreases mortality in the first year by 40 per 10 [to the 4th
power], but adds a lifetime extra cancer risk of 2 per 10 [to the 4th
power]."

In asking Dr. Rogan where that statistic came from he referred my friend
back to the following study (sorry for poor formatting of the cite; I have
the actual article here):

Rogan, W et al. Should the Presence of Carcinogens in Breast Milk
Discourage Breast Feeding?  Regulatory Toxicology and Pharmacology 13,
228-240 (1991).

This study is rather technical/mathematical and a bit over my head. But I
can't find the 4/1000 statistic in this study. I do see this sentence
however:  "These numbers are of the same order of magnitude and slightly
smaller than the excess risk of postneonatal mortality from forgoing breast
feeding, which we estimate to be 256 per 100,000 infants."

From a rather dubious article: ["The Politics of Breastfeeding: Risk,
Reproduction, and the Gendered Division of Labor," forthcoming in Signs:
Journal of Women in Culture and Society. (Winter 2000) 53 pp.]

Comes the following analysis of the statistic:

<<<<<<All references to it extrapolate from a single 1989 "study"
conducted by the National Institute of Environmental Health Sciences
(NIEHS).
But the actual source is simply a one-- paragraph abstract of a study of
carcinogens in breast milk (Rogan 1989). 11 Neither the abstract nor the
study itself purports to analyze formula feeding. Nonetheless, in order
to contextualize the relative risk of carcinogens in breast milk, the
abstract
postulates an alternative risk of 4-in-1,000 deaths attributable to formula
feeding. The figure is never mentioned again -- let alone explained or
corroborated -in any of the subsequent publications by the research group
(the North Carolina Breast Milk and Formula Project). Only one subsequent
publication arising from the project even mentions a mortality rate for
formula-fed babies, and here the figure is almost 40 percent lower: 2.56
deaths per 1,000 (barely distinquishable from the 2.45 cancer deaths per
1,000 that the study attributes to a nine-month course of breastfeeding
[Rogan et al. 1991]).12 For the formula-feeding mortality figure, the
reader
is referred to astudy on "unexpected infant deaths" in Sheffield between
1973 and 1979. The British study, however, is not a study of infant-feeding
methods: it presents no data or analysis of actual infant-feedin practices
(methods, rates, durations, etc.) but simply correlates demographic trends
in women's declared "intention to breatfeed" (when leaving the hospital)
with demographic changes in the rate of unexpected infant deathes
(Carpenter
et al. 1983).13 As Rogan's own study observes, "it is not possible to know
whether such deaths are prevented by breast milk as opposed to the
motivation
and care giving indicated by the intention to breast feed" (Rogan et al.
1991). Thus breastfeeding advocates have cited a misreported figure,14
which, moreover, was derived from a study that did not collect or examine
any data on actual infant-feeding practices. Yet this figure now circulates
in breastfeeding-advocacy literature as the scientifically established
"result" of a "study" by NIEHS.15>>>>>

Whether this author's analysis of the figure is correct. There are quite a
few points in the entire article I disagree with and the person's
credentials don't strike me as being an expert in this field. However some
of his points about this statistic match what we found in researching it.

One of my friends who was involved in this discussion may remember more of
the details - and she was the one who actually corresponded with Rogan - so
I could ask her to post more information if needed.


Heather
Mom to Bridget Megan (7/31/96) & Elinor Jane (8/5/00)

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