I hate the AAP

[Anonymous]

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Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

The “revealed preferences” of women (of parents) is clearly not to have their kids outside for two hours a day either. Quick fire the optometrist

If an optometrist association engaged in a public health campaign to say that mothers (but not fathers) should get time off work to spend 2 hours a day physically working on their child’s vision, despite a lack of evidence showing it helped much more than glasses … I would say the same thing.

The fact that mom has the boobs doesn't lower the effectiveness of breastfeeding.
The fact that black moms are more likely to work multiple crappy part time jobs and not have paid leave does not lower the effectiveness of breastfeeding.
The truth matters.

All of this is predicated on the idea that breastmilk is better though. And it's a myth that it is. The benefits do not equal the costs in many circumstances. This is what many of us are saying.

I think this is an important way to phrase it. I think maybe breastmilk is better -- say an arbitrary unit of 1 iota better -- but if the challenges of breastfeeding make the entire family's life many iotas (or even kiloiotas) worse, that's not actually better. And I think a lot of us (and I'm a breastfeeding parent who weans sometime between one and two years, so I actually would like to have my ped not side-eye me for not instantly stopping nursing at my kid's first birthday) are annoyed by the fact that the AAP is only touching the 1 iota better without addressing any of the kiloiotas of worse. It's disingenuous.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

The “revealed preferences” of women (of parents) is clearly not to have their kids outside for two hours a day either. Quick fire the optometrist

If an optometrist association engaged in a public health campaign to say that mothers (but not fathers) should get time off work to spend 2 hours a day physically working on their child’s vision, despite a lack of evidence showing it helped much more than glasses … I would say the same thing.

The fact that mom has the boobs doesn't lower the effectiveness of breastfeeding.
The fact that black moms are more likely to work multiple crappy part time jobs and not have paid leave does not lower the effectiveness of breastfeeding.
The truth matters.

All of this is predicated on the idea that breastmilk is better though. And it's a myth that it is. The benefits do not equal the costs in many circumstances. This is what many of us are saying.

I think this is an important way to phrase it. I think maybe breastmilk is better -- say an arbitrary unit of 1 iota better -- but if the challenges of breastfeeding make the entire family's life many iotas (or even kiloiotas) worse, that's not actually better. And I think a lot of us (and I'm a breastfeeding parent who weans sometime between one and two years, so I actually would like to have my ped not side-eye me for not instantly stopping nursing at my kid's first birthday) are annoyed by the fact that the AAP is only touching the 1 iota better without addressing any of the kiloiotas of worse. It's disingenuous.

They do reference problems in their paper.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

Of course they are. What a ridiculous thing to say. Obesity, allergies, GI bugs, bonding, lower cancer risk for mom, even less picky eating. We can sit here and debate if you want, but you can't say the other side has zero scientific merit because it is simply false.

P.S. I weaned my 2nd at 16 months because I was pregnant with #3 so I'm not an angelic follower of this advice myself.

I’m sorry to tell you that all of those supposed benefits of breastfeeding are based on observational research with confounders. Ie, they can’t tell if the different outcomes are due to other factors. The research that comes closest to eliminating confounders shows very few benefits- basically the reduction in a few GI illnesses in the first year. For the second year, there is even less.

https://expectingscience.com/2018/03/21/why-is-the-american-academy-of-pediatrics-exaggerating-the-benefits-of-breastfeeding/amp/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

Of course they are. What a ridiculous thing to say. Obesity, allergies, GI bugs, bonding, lower cancer risk for mom, even less picky eating. We can sit here and debate if you want, but you can't say the other side has zero scientific merit because it is simply false.

P.S. I weaned my 2nd at 16 months because I was pregnant with #3 so I'm not an angelic follower of this advice myself.

I’m sorry to tell you that all of those supposed benefits of breastfeeding are based on observational research with confounders. Ie, they can’t tell if the different outcomes are due to other factors. The research that comes closest to eliminating confounders shows very few benefits- basically the reduction in a few GI illnesses in the first year. For the second year, there is even less.

https://expectingscience.com/2018/03/21/why-is-the-american-academy-of-pediatrics-exaggerating-the-benefits-of-breastfeeding/amp/

…unless you include the benefits to the mother. Some people consider a significant reduction in the risk of cancers that impact women a positive public health outcome. When you consider their disproportionate impact on women of color it becomes and even more significant public health benefit. But if we assume women aren’t people and their health outcomes are irrelevant compared to the child— well then we’re just republicans

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

The “revealed preferences” of women (of parents) is clearly not to have their kids outside for two hours a day either. Quick fire the optometrist

If an optometrist association engaged in a public health campaign to say that mothers (but not fathers) should get time off work to spend 2 hours a day physically working on their child’s vision, despite a lack of evidence showing it helped much more than glasses … I would say the same thing.

The fact that mom has the boobs doesn't lower the effectiveness of breastfeeding.
The fact that black moms are more likely to work multiple crappy part time jobs and not have paid leave does not lower the effectiveness of breastfeeding.
The truth matters.

All of this is predicated on the idea that breastmilk is better though. And it's a myth that it is. The benefits do not equal the costs in many circumstances. This is what many of us are saying.

I think this is an important way to phrase it. I think maybe breastmilk is better -- say an arbitrary unit of 1 iota better -- but if the challenges of breastfeeding make the entire family's life many iotas (or even kiloiotas) worse, that's not actually better. And I think a lot of us (and I'm a breastfeeding parent who weans sometime between one and two years, so I actually would like to have my ped not side-eye me for not instantly stopping nursing at my kid's first birthday) are annoyed by the fact that the AAP is only touching the 1 iota better without addressing any of the kiloiotas of worse. It's disingenuous.

For many parents, the costs are what the AAP is trying to get at. The cost is not getting time off from work to establish breastfeeding. The cost is inadequate support from their pediatrician who maybe gives them a referral to an LC (maybe covered by insurance, maybe not) or maybe just tells them to use formula instead even if they want to breastfeed. Their support is trying to make it a less costly choice for more families.

[Anonymous]

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Anonymous wrote:I am not sure what the AAP is trying to achieve with this. Most women do not want to breastfeed past 12 months. Many of us worked really hard to get to the 12 month point because that is what was recommended, not because we love breastfeeding so much. Those that do nurse past 12 months are going to continue to face people who don't want them to do so, just as I got the side eye from my MIL for nursing my infant. If you do something most people don't want to do, you're going to get some people being d$cks about it. Welcome to parenthood.

This statement really strikes me as a doubling down on "breast is best" and I think it's ridiculous. The tell is the idea that we should give more parental leave so women can breastfeed. That's absurd, there are so many more important reasons we we need paid parental leave for everyone, and it should not matter whether they are breastfeeding or not. The statement about how most babies should be EBF through 6 months is just...really? Like, a lot of babies do need formula, and solids are recommended at 4 months. This is lactivism, it is not medical advice.

Where are the stats on the bolded? Everyone I know who made it to one without issues kept going (though not as far as two).

See the link in the Twitter post above with stats from Sweden where support parents is not an issue

That’s still not a statistic about U.S. women not wanting to nurse past one. Heck it’s not even a stat about Swedish women not wanting to nurse past one, only evidence that they don’t. WHO and others have been recommending this for years and it hasn’t harmed anyone who wants to use formula…

The point the Twitter poster was making is that at best 30% of women nurse past 12 months if all the government supports are there. Lack of support is not the reason that the majority of women do not nurse past 12 months.

I see your point, but even if only 30% of American mothers wanted to breastfeed to a full year, I would still consider it wise of the AAP to support more assistance for the thousands of women and babies that represents. Again, I don’t see how that takes away from anyone.

Why? Honest question. The evidence of benefits is weak. Should we also "support" families that choose not to sleep train? We should support all families and this statement is all about supporting families solely for the purpose of breastfeeding. That's messed up.

Because what the AAP recommends as support is currently only available to comparably well-off, disproportionately white, women. Removing more of the barriers of breastfeeding at a policy level is a step toward evening the playing field. I can nurse to 3 or 4 and take all the pumping breaks I want and no one would say boo, but that’s not a right afforded to a woman working three jobs to make her rent.

Also, while the benefits are frequently overstated, they are not non-existent. Many of the benefits to many AAP recommendations (such as room sharing) are on the margins. That doesn’t mean they’re bad recommendations. Also, and I feel this one in particular, breastfeeding unlike so many other baby-related issues has documented health benefits to the mother. Yeah, I am ok with supporting a policy that reduces a woman’s chance of getting cancer over her lifetime, particularly given how many other recommendations come at the expense of mothers.

Where did the AAP say they centered communities of color by reaching out to them to understand their perspectives on breastfeeding? it's obvious that they didn't which means they are just using them to promote something they would have done anyway. This is not my area of expertise but from what I have read there are a lot of concerns about how the medical establishment treats mothers and babies of color, with fatal consequences. They need to focus on fixing that, which this statement does zilch to to address.

Would it be okay for a person to have to work 3 jobs if they were able to breastfeed? No. That's sick. Not being able to breastfeed is far from the worst health-related consequence of having to go back to work days after giving birth and working 3 jobs.

Where? In footnote six:

Trent M, Dooley DG, Dougé J; Section on Adolescent Health; Council on Community Pediatrics; Committee on Adolescence. Policy statement: The impact of racism on child and adolescent health. Pediatrics. 2019;144

What I mean by centering communities of color I mean LISTENING to them, not putting out a statement about "minorities" (barf) that seems focused out racism outside of healthcare as though pediatricians have no role in perpetuating racism.

Does hearing that breastfeeding is difficult lower the benefit of breastfeeding? Not sure how you're linking the two logically.

What?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

Revealed preferences?! What?! I prefer not to exercise but o don’t hate the America Heart Association for recommending I get 150 minutes of exercise a week. And I follow their recommendation because there is heart disease in my family. And sorry, but the science has shown benefits to breastfeeding whether you like it or not. That’s not to say that other issues may outweigh true benefits of breastfeeding, but all things being equal, it is the healthiest option.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

Of course they are. What a ridiculous thing to say. Obesity, allergies, GI bugs, bonding, lower cancer risk for mom, even less picky eating. We can sit here and debate if you want, but you can't say the other side has zero scientific merit because it is simply false.

P.S. I weaned my 2nd at 16 months because I was pregnant with #3 so I'm not an angelic follower of this advice myself.

I’m sorry to tell you that all of those supposed benefits of breastfeeding are based on observational research with confounders. Ie, they can’t tell if the different outcomes are due to other factors. The research that comes closest to eliminating confounders shows very few benefits- basically the reduction in a few GI illnesses in the first year. For the second year, there is even less.

https://expectingscience.com/2018/03/21/why-is-the-american-academy-of-pediatrics-exaggerating-the-benefits-of-breastfeeding/amp/

…unless you include the benefits to the mother. Some people consider a significant reduction in the risk of cancers that impact women a positive public health outcome. When you consider their disproportionate impact on women of color it becomes and even more significant public health benefit. But if we assume women aren’t people and their health outcomes are irrelevant compared to the child— well then we’re just republicans

+1 Did people even read the policy statement? They recommend exclusive breastfeeding for the first six months and support breastfeeding up to two years or beyond as long as mutually desired by mother and child. The policy states that the benefits of exclusive breastfeeding in the first six months are supported by evidence, which should be discussed without judgment. Beyond the first six months, the policy mostly notes health benefits to the mother, which is why the AAP urges that providers and others support those who opt to breastfeed beyond the first six months.

Are people saying that pediatricians should not discuss the health benefits of breastfeeding for the first six months with families simply because some can't or don't want to do it?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

Of course they are. What a ridiculous thing to say. Obesity, allergies, GI bugs, bonding, lower cancer risk for mom, even less picky eating. We can sit here and debate if you want, but you can't say the other side has zero scientific merit because it is simply false.

P.S. I weaned my 2nd at 16 months because I was pregnant with #3 so I'm not an angelic follower of this advice myself.

I’m sorry to tell you that all of those supposed benefits of breastfeeding are based on observational research with confounders. Ie, they can’t tell if the different outcomes are due to other factors. The research that comes closest to eliminating confounders shows very few benefits- basically the reduction in a few GI illnesses in the first year. For the second year, there is even less.

https://expectingscience.com/2018/03/21/why-is-the-american-academy-of-pediatrics-exaggerating-the-benefits-of-breastfeeding/amp/

…unless you include the benefits to the mother. Some people consider a significant reduction in the risk of cancers that impact women a positive public health outcome. When you consider their disproportionate impact on women of color it becomes and even more significant public health benefit. But if we assume women aren’t people and their health outcomes are irrelevant compared to the child— well then we’re just republicans

+1 Did people even read the policy statement? They recommend exclusive breastfeeding for the first six months and support breastfeeding up to two years or beyond as long as mutually desired by mother and child. The policy states that the benefits of exclusive breastfeeding in the first six months are supported by evidence, which should be discussed without judgment. Beyond the first six months, the policy mostly notes health benefits to the mother, which is why the AAP urges that providers and others support those who opt to breastfeed beyond the first six months.

Are people saying that pediatricians should not discuss the health benefits of breastfeeding for the first six months with families simply because some can't or don't want to do it?

Yes because its lactivism according to many PPs.

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Anonymous wrote:It’s really, really weird that AAP continues to say solids not until 6 months, when 4 months is now perfectly well supported by the evidence. Almost as if … their true agenda is to push breastfeeding for 6 months, not actual research-based communication to help women weigh the costs and benefits for themselves.

if you actually read the paper they include the fact that it's complementary foods so foods that reduce allergy risk like peanuts and eggs should be introduced at 4 months if you have a history of allergy or eczema in the family and they actually talk about this so maybe you should read the actual paper.

maybe they should just stop trying to control women based on flimsy research that utterly disregards women’s autonomy. women are not breastfeeding engines.

Breast is best but if you can't or won't formula is available. That isn't a lie. Choices are made every day. It is best for baby. Infant mortality is lower in breastfed babies. That doesn't mean that it's the only item that goes into the calculus of what's best for a mother. If what's best for the mothers at odds of what's best of the baby having a mother who's healthy is ideal since the baby is dependent on a mother.
When you don't have those problems there is no reason to not be able to say I chose formula that was the best choice for me and the best choice therefore for our family and also be able to recognize that breast milk is best for infants. It has lots of things that formula does not have.

+1. Couldn’t have said it better myself. Not sure why everyone is being so defensive.

Feeding your kids a diet of all organic meats and vegetables freshly cooked each day with no processed foods is best. I am not able to fully adhere to that. Sometimes I’m tired or busy so we get Chick Fil A or pizza. It’s okay, there are trade-offs in life.

I don't understand why people don't understand that it is a goal. Nobody is sending you to mommy hell for not crossing the finish line. My optometrist told me to get my kids outside for 2 hours a day and we rarely do. Am I going to go rage about the recommendation on the internet?

The issue is that the recommendations are not science based and they are not based on women’s revealed preferences either. Totally inappropriate for a public health recommendation.

Of course they are. What a ridiculous thing to say. Obesity, allergies, GI bugs, bonding, lower cancer risk for mom, even less picky eating. We can sit here and debate if you want, but you can't say the other side has zero scientific merit because it is simply false.

P.S. I weaned my 2nd at 16 months because I was pregnant with #3 so I'm not an angelic follower of this advice myself.

I’m sorry to tell you that all of those supposed benefits of breastfeeding are based on observational research with confounders. Ie, they can’t tell if the different outcomes are due to other factors. The research that comes closest to eliminating confounders shows very few benefits- basically the reduction in a few GI illnesses in the first year. For the second year, there is even less.

https://expectingscience.com/2018/03/21/why-is-the-american-academy-of-pediatrics-exaggerating-the-benefits-of-breastfeeding/amp/

…unless you include the benefits to the mother. Some people consider a significant reduction in the risk of cancers that impact women a positive public health outcome. When you consider their disproportionate impact on women of color it becomes and even more significant public health benefit. But if we assume women aren’t people and their health outcomes are irrelevant compared to the child— well then we’re just republicans

+1 Did people even read the policy statement? They recommend exclusive breastfeeding for the first six months and support breastfeeding up to two years or beyond as long as mutually desired by mother and child. The policy states that the benefits of exclusive breastfeeding in the first six months are supported by evidence, which should be discussed without judgment. Beyond the first six months, the policy mostly notes health benefits to the mother, which is why the AAP urges that providers and others support those who opt to breastfeed beyond the first six months.

Are people saying that pediatricians should not discuss the health benefits of breastfeeding for the first six months with families simply because some can't or don't want to do it?

Yes because its lactivism according to many PPs.

Honestly the fact that that is considered “lactivism” by anyone speaks to the truly appalling amount of support provided for mothers, that they are perciceving, experiencing and internalizing so much judgment that it triggers this kind of response when other recommendations (about exercise, sceeen time, room sharing) are blissfully ignored. This is why we need to take maternal health seriously, not stop six weeks after birth.

[Anonymous]

The six months recommendation is not based in science starting with the notion that even solids are off the table. GTFOOH.

[Anonymous]

Also which other recommendation requires 8-12 hours of labor per day by one parent (with the expectation that we consider this method of feeding to be "free")? Makes it extremely difficult for that parent to separate from their baby for more than a few hours unless you are one of those unicorns that doesn't find pumping to be a hellish experience?

[Anonymous]

Anonymous wrote:Also which other recommendation requires 8-12 hours of labor per day by one parent (with the expectation that we consider this method of feeding to be "free")? Makes it extremely difficult for that parent to separate from their baby for more than a few hours unless you are one of those unicorns that doesn't find pumping to be a hellish experience?

We get that your triggered by the mirror mention of breast-feeding, but it does not take 8 to 12 hours a day.

[Anonymous]

Anonymous wrote:Also which other recommendation requires 8-12 hours of labor per day by one parent (with the expectation that we consider this method of feeding to be "free")? Makes it extremely difficult for that parent to separate from their baby for more than a few hours unless you are one of those unicorns that doesn't find pumping to be a hellish experience?

Um. Every recommendation related to pregnancy except the unpaid labor is 24/7.

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Anonymous wrote:I am not sure what the AAP is trying to achieve with this. Most women do not want to breastfeed past 12 months. Many of us worked really hard to get to the 12 month point because that is what was recommended, not because we love breastfeeding so much. Those that do nurse past 12 months are going to continue to face people who don't want them to do so, just as I got the side eye from my MIL for nursing my infant. If you do something most people don't want to do, you're going to get some people being d$cks about it. Welcome to parenthood.

This statement really strikes me as a doubling down on "breast is best" and I think it's ridiculous. The tell is the idea that we should give more parental leave so women can breastfeed. That's absurd, there are so many more important reasons we we need paid parental leave for everyone, and it should not matter whether they are breastfeeding or not. The statement about how most babies should be EBF through 6 months is just...really? Like, a lot of babies do need formula, and solids are recommended at 4 months. This is lactivism, it is not medical advice.

Where are the stats on the bolded? Everyone I know who made it to one without issues kept going (though not as far as two).

See the link in the Twitter post above with stats from Sweden where support parents is not an issue

That’s still not a statistic about U.S. women not wanting to nurse past one. Heck it’s not even a stat about Swedish women not wanting to nurse past one, only evidence that they don’t. WHO and others have been recommending this for years and it hasn’t harmed anyone who wants to use formula…

The point the Twitter poster was making is that at best 30% of women nurse past 12 months if all the government supports are there. Lack of support is not the reason that the majority of women do not nurse past 12 months.

I see your point, but even if only 30% of American mothers wanted to breastfeed to a full year, I would still consider it wise of the AAP to support more assistance for the thousands of women and babies that represents. Again, I don’t see how that takes away from anyone.

Why should the way you feed your baby entitle you to more assistance?

Ask WIC— they give you a larger monthly stipend if you breastfeed.

The formula that would be provided instead of the extra food for the mother costs far more.