Margaret,
Do you reckon you could distill this post in a letter to the editor?? You've
made some really good points.
Can you explain how you calculated the NTT for bf?
Karleen Gribble
Australia
----- Original Message -----
From: "Margaret G. Bickmore" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, September 29, 2006 7:24 AM
Subject: Re: article on medical research (bf mentioned)
> Lynnette Hafken writes:
> >http://www.slate.com/id/2150354/
> >
> >I am quoting the relevant part:
> >
> >The NNTs are astronomically high. Reasonable women might think that
> >breast-feeding isn't worth the trouble-a conclusion that you don't
> >want drawn if you're promoting breast-feeding at any cost."
>
> Wow, this is wrong on so many levels, it is hard to know where to
> start. First of all, they are casting breastfeeding as the
> "experimental" "treatment" by using NNTs to compare it to not
> breastfeeding. Breastfeeding is neither experimental nor a
> treatment. I would be interested to know if the natural state is
> ever considered the "experimental treatment" in any other NNT
> calculations? ie, breathing clean air as the experimental treatment
> vs. smoking as the norm? I am no expert on statistics but I would
> bet that NNTs generated in this way are meaningless.
>
> That said, I believe it is incorrect to say that NNTs would be
> "astronomically high". There are many illnesses and conditions that
> occur far more frequently in non-breastfed babies, such that the NNTs
> would be small numbers. A glance at the literature and some quickie
> calculations yield the following: the NNT for respiratory illness
> would be 6.5; for wheeze related to early solids, 9; for ear
> infection by 6 months of age, 3.5. Those are not "astronomically
> high" by any definition. If I had all afternoon I could compile a
> much more impressive list, but it's obvious right now that the Slate
> article cannot be taken seriously.
>
> Certainly if you combined *all* the things that artificially-fed
> children are at greater risk of, then the combined NNT for *all*
> outcomes would be ridiculously low. If we add in the increased
> health risks for non-breastfeeding mothers, the cumulative NNT would
> be even more miniscule.
>
> (By the way, NNT = Number Needed to Treat to prevent one bad outcome.
> If a treatment reduces the incidence of a bad outcome by 50%, then
> the NNT is 2. Two people need to undergo the treatment in order for
> *one* bad outcome to be prevented. If NNTs are small numbers then
> the treatment appears to be worthwhile, whereas if the NNTs are very
> large then it looks like it's not worth it to "treat" all those
> people to avert one bad outcome.)
>
> The Slate article has both the basis wrong (artificial feeding as the
> norm) and the facts wrong (NNTs astronomically high). This doesn't
> surprise me too much, unfortunately, as Slate has run some very
> slanted anti-bfdg articles in the past few years.
>
> Margaret
> Longmont, CO
>
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