I couldn't help but reply to that webrn commentary (I misspelled that as
vommitary- Freudian?). She just sounded do smug, and was so thoroughly
dismissive of the choice to not breastfeed as a "minor decision." Was this
strong enough? Too strong?
 I wrote:
I am not an RN, but a practicing pediatrician visiting your website for the
first time. I read Barbara Bronson Gray's commentary about feeding choices,
and was surprised to find such an opinion expressed without some rebuttal.
This commentary, while clearly a personal opinion, is represented as the
position of your organization's managing editor. Perhaps a nice commentary
about how lots of infants survive back-sleeping or accidents without carseats
could be next. Perhaps you could dismiss the Group B strep recommendations.
Be sure not to include any actual information about the impact of those
"minor decisions" on infants' lives.

Ms Gray portrays the decision about infant feeding as a "minor decision." I
wonder if she has reviewed the current literature, which contains multiple
articles (scientific studies, not opinions) demonstrating fewer
hospitalizations, ear infections, respiratory infections, and
gastrointestinal infections in infants who receive breastmilk. Perhaps,
before she characterizes this choice as "relatively minor," she would be
interested in studies that show a lower incidence in childhood leukemia as
well as asthma and allergies in infants who are breastfed. Maybe she is not
familiar with studies showing a decreased risk of premenopausal breast and
ovarian cancer, as well as osteoporosis in women who have breastfed. The ACOG
position she scoffs at ("These docs even suggest breastfed children might do
better on their SATs") is based on studies showing a demonstrable decrease in
IQ in formula-fed infants. Even if unimpressed by a few IQ points, certainly
Nurse Gray would consider cancer, osteoporosis, or asthma to be "monumental
or life-changing."

As a pediatrician, I counsel new parents on carseats and immunizations, sleep
positions, normal behaviors and jaundice before they leave the hospital. I
also spend time talking to them about breastfeeding. Just as I would tell a
mother who planned to put her baby to sleep on its tummy about the studies
showing an increased risk of SIDS, I tell moms who are ambivalent about
breastfeeding about studies that support it as superior nutrition, and health
benefits to both mother and baby. I believe that a nurse or physician who
does less is giving substandard care.

The AAP, ACOG and WHO strongly endorse breastfeeding for almost all infants.
These positions are based on evidence that formula feeding is an inferior
choice for infant feeding. Of the "millions of choices" to be made when
caring for an infant, surely parents should be given information allowing
them to make an informed decision about one as critical as breastfeeding.

Surely the nurses and students who visit your website would appreciate
another opinion about feeding choices, one based on information and current
positions of respected organizations, rather than one based on personal bias.

Jennifer Cox, MD, FAAP

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