Dear all:

So Heather eloquently pointed out what I see as the obvious "elephant in the room" about the "little bit of formula" study.

To provide another example:

Not that long ago there was an article that designed an intervention to prevent obesity in children.  Again, I wonder where the human ethics researchers were when that study was designed as well.  The study provided two interventions -- Harvey Karp style soothing techniques with later training for solids introduction.  Like the study on "a bit of formula" this study did not provide the details I would need to understand how exactly they were dealing with the solids introduction.  

So, the big elephant in the room -- coupling Harvey Karp style soothing with their training in solids introduction led to failure to thrive.  No one writing the article noticed this.  The average weight for age in the untreated group was at the 50th percentile.  The after weight in the group that had Harvey Karp style soothing and training in solid introduction was significantly lower -- and if I remember correctly was way down in the 20s.  No one commented on this fact.  This means that some slow gaining babies may very well have been undernourished.  Since they did not measure length it is difficult to tell what this might mean for skeletal development.  And since we know that failure to thrive early in life leads to increased risk of obesity later in life -- their conclusions that they prevented overweight may actually be dead wrong.  

What was interesting to me is that babies were OK if they only had one, but not two of these interventions.  Presumably babies who were over soothed could recuperate if they had free access to food later on and presumably babies who were fed, but not soothed would manage to eat enough later even with whatever techniques they used for solids introduction.  

So, given that the vast majority of breastfeeding problems I see are iatrogenically induced by over enthusiastic use of formula to treat breastfeeding problems that could be easily solved with breast switching and breast compressions and more frequent feeding than 8 times a day and that the vast majority of breastfeeding problems that emerge after the hospital are due to the enthusiastic adoption of "soothing techniques" I don't see how this study tells us anything.  

Two bad interventions don't make a right intervention.  Soothing may be worse for breastfeeding duration, but that doesn't mean that using formula, when there are many other interventions that could be applied is not without harm.  Neither is ideal.

Best regards, 
Susan E. Burger, MHS, PhD IBCLC.  

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