I hate the AAP

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:[b]…but I suggest not engaging the distressed anti-breastfeeding poster.

Lol 😂

Excellent advice that I am going to take.

I don’t think they are anti-breastfeeding. They were simply unable (physically and/or circumstantially) or unwilling to breastfeed for the prescribed length of time and reports like this make them feel bad. The last thing any parent wants to hear is that they could have or should have done something differently. It’s true with all topics from daycare to sensory bins to screen time (and on and on). We all want to think we raised our kids in the best way possible.

Ugh no. The whole point here is that the “prescribed length of time” is made up.

Why? It makes no sense to make up a random length of time for breastfeeding.

And no one will continue to breastfeed if they can’t or child doesn’t want to because of an AAP recommendation. Much ado about nothing.

the whole point is there IS NO specific length of time to breastfeed supported by convincing evidence. Do what you want as long as you want.

[Anonymous]

For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

[Anonymous]

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

[Anonymous]

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Oh. I think her data on school spread during COVID relied too heavily on European data while not adequately controling for the fact that European teachers have access to free healthcare and are reimbursed for the time they need to take of to quarantine, therefore have a different incentive structure when it comes to going to school sick.

But I read her ParentData on this and while she doesn’t find the evidence compelling for obesity she does accept there are reductions in the breast cancer risk, and while she doesn’t see that as justifying the AAP position, other people will weigh that differently. She also agrees it’s a positive thing for people to be supported for extended breastfeeding by their pediatricians. So she doesn’t seem to agree with it, but she definitely doesn’t seem to be taking it as personally as some. I got a good laugh out of the socks point.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Oh. I think her data on school spread during COVID relied too heavily on European data while not adequately controling for the fact that European teachers have access to free healthcare and are reimbursed for the time they need to take of to quarantine, therefore have a different incentive structure when it comes to going to school sick.

But I read her ParentData on this and while she doesn’t find the evidence compelling for obesity she does accept there are reductions in the breast cancer risk, and while she doesn’t see that as justifying the AAP position, other people will weigh that differently. She also agrees it’s a positive thing for people to be supported for extended breastfeeding by their pediatricians. So she doesn’t seem to agree with it, but she definitely doesn’t seem to be taking it as personally as some. I got a good laugh out of the socks point.

Ok, this thread is not about that so I'm not going to get into a debate about school spread of COVID, not sure why you are bringing it up. I'm referring to posts like one in this thread that literally use the name "Oster" as though it's some kind of insult, with no engagement at all with the PP's argument (that did not even mention her)

As for the breastfeeding piece, I think her point about implying there is a "best choice" is a reason why those of us who recently had babies might find this guidance particularly frustrating. It's disingenuous to say women should be supported in their choices and then clearly elevate one choice above others, a choice that can be very costly (assuming you place a value on women's time), all based on very limited data.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Oh. I think her data on school spread during COVID relied too heavily on European data while not adequately controling for the fact that European teachers have access to free healthcare and are reimbursed for the time they need to take of to quarantine, therefore have a different incentive structure when it comes to going to school sick.

But I read her ParentData on this and while she doesn’t find the evidence compelling for obesity she does accept there are reductions in the breast cancer risk, and while she doesn’t see that as justifying the AAP position, other people will weigh that differently. She also agrees it’s a positive thing for people to be supported for extended breastfeeding by their pediatricians. So she doesn’t seem to agree with it, but she definitely doesn’t seem to be taking it as personally as some. I got a good laugh out of the socks point.

Ok, this thread is not about that so I'm not going to get into a debate about school spread of COVID, not sure why you are bringing it up. I'm referring to posts like one in this thread that literally use the name "Oster" as though it's some kind of insult, with no engagement at all with the PP's argument (that did not even mention her)

As for the breastfeeding piece, I think her point about implying there is a "best choice" is a reason why those of us who recently had babies might find this guidance particularly frustrating. It's disingenuous to say women should be supported in their choices and then clearly elevate one choice above others, a choice that can be very costly (assuming you place a value on women's time), all based on very limited data.

But who is saying this? The AAP isn’t— they’re making a recommendation about breastfeeding, not about every possible choice in infant feeding. If they release recommendations about formula feeding (which I suspect after the shortage issue there will be a great deal of pressure on them to do) I don’t expect them to say “oh but also here’s something for those of you who choose to breastfeed!”

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Oh. I think her data on school spread during COVID relied too heavily on European data while not adequately controling for the fact that European teachers have access to free healthcare and are reimbursed for the time they need to take of to quarantine, therefore have a different incentive structure when it comes to going to school sick.

But I read her ParentData on this and while she doesn’t find the evidence compelling for obesity she does accept there are reductions in the breast cancer risk, and while she doesn’t see that as justifying the AAP position, other people will weigh that differently. She also agrees it’s a positive thing for people to be supported for extended breastfeeding by their pediatricians. So she doesn’t seem to agree with it, but she definitely doesn’t seem to be taking it as personally as some. I got a good laugh out of the socks point.

Ok, this thread is not about that so I'm not going to get into a debate about school spread of COVID, not sure why you are bringing it up. I'm referring to posts like one in this thread that literally use the name "Oster" as though it's some kind of insult, with no engagement at all with the PP's argument (that did not even mention her)

As for the breastfeeding piece, I think her point about implying there is a "best choice" is a reason why those of us who recently had babies might find this guidance particularly frustrating. It's disingenuous to say women should be supported in their choices and then clearly elevate one choice above others, a choice that can be very costly (assuming you place a value on women's time), all based on very limited data.

But who is saying this? The AAP isn’t— they’re making a recommendation about breastfeeding, not about every possible choice in infant feeding. If they release recommendations about formula feeding (which I suspect after the shortage issue there will be a great deal of pressure on them to do) I don’t expect them to say “oh but also here’s something for those of you who choose to breastfeed!”

I mean this is just a ridiculous line of argument. You can't make a recommendation about breastfeeding, repeatedly say how it is the best form of feeding infants and toddlers, and not make an implicit statement about "every possible choice in infant feeding" (really, you don't think there is one obvious alternative to breastfeeding?)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Why is Oster, a trained economist, better source than the two people who wrote the AAP technical report and paper (Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC; Lawrence Noble, MD, FAAP, FABM, IBCLC) ? Literally the announcement objective for the AAP statement is : AAP identifies stigma, lack of support and workplace barriers as obstacles that hinder continued breastfeeding. Does Oster negate this statement? No, but then she goes on to undermine the AAP.

In the article you linked she references a paper on HTN risk and only talks about the 2011 but the technical report lists two papers in 2018 and 2019.

I think she likes to be controversial and whatever gives her the most clicks.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Why is Oster, a trained economist, better source than the two people who wrote the AAP technical report and paper (Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC; Lawrence Noble, MD, FAAP, FABM, IBCLC) ? Literally the announcement objective for the AAP statement is : AAP identifies stigma, lack of support and workplace barriers as obstacles that hinder continued breastfeeding. Does Oster negate this statement? No, but then she goes on to undermine the AAP.

In the article you linked she references a paper on HTN risk and only talks about the 2011 but the technical report lists two papers in 2018 and 2019.

I think she likes to be controversial and whatever gives her the most clicks.

Honestly, I don’t think Oster is nearly as worked up about this as the poster is trying to portray. She is pretty definitive in her other material (which the pp doesn’t reference) that she thinks removing barriers like stigma and lack of workplace flexibility for women who want to breastfeed — who, once again, are the only people the AAP is talking to right now— is a good thing.

If every recommendation must be tailored to avoid hurting the feelings of people not following that recommendation there is really no point in having them. A plant- based diet recommendation which must say, for example, that eating meat is JUST AS GOOD would be pretty ridiculous. This strikes me in the same vein, and I’m a carnivore.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Why is Oster, a trained economist, better source than the two people who wrote the AAP technical report and paper (Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC; Lawrence Noble, MD, FAAP, FABM, IBCLC) ? Literally the announcement objective for the AAP statement is : AAP identifies stigma, lack of support and workplace barriers as obstacles that hinder continued breastfeeding. Does Oster negate this statement? No, but then she goes on to undermine the AAP.

In the article you linked she references a paper on HTN risk and only talks about the 2011 but the technical report lists two papers in 2018 and 2019.

I think she likes to be controversial and whatever gives her the most clicks.

Oster is a health economist - her entire job is to assess evidence and the risks/benefits.

The really funny thing she discusses is the APA recommendation that babies not wear hats, despite the evidence that socks are actually more associated with overheating! Lol. Honestly the hat part of this story just further shows the AAP is a joke. I wouldn't care, except for that they were a force in harming children during the pandemic.

[Anonymous]

"Hats

The final change I wanted to discuss is a new prohibition on infant hats.

In prior iterations of its guidelines, the AAP has noted concerns with overheating as a risk of SIDS. I talked about that evidence in this post a month ago. The evidence on heat overall is a bit sparse, but in this iteration, the organization has taken it one step further to express concern about the heat generated by infant hats.

The data cited is from a single paper. This is a case-control study in Australia that looked at a large number of possible relationships between clothing and bedding and SIDS. The paper finds that in 8.3% of SIDS cases, a hat (“bonnet”) was worn, versus only 5.2% of control infants. This difference is statistically significant.

However: the paper runs a lot of tests, and this raises concerns about overinterpreting any one result. The authors find, for example, a much stronger statistical link between SIDS and wearing socks than between SIDS and wearing hats. They also find that wearing a nightgown is protective, but wearing “stretch and grow” leggings is associated with an elevated SIDS risk. It’s not clear what any of this means.

In fact, the authors do not make much of any of these results. They note: “Significant differences in the type of products used by case and control infants occurred, and may be related to the difference in season of interview between cases and controls.” Basically, they may have observed more SIDS infants in the winter, when hats (and socks) are more common.

Without belaboring the point, to take from this paper the conclusion that infants shouldn’t wear hats seems … a stretch. The data would more strongly support a “no socks” conclusion. Put differently: if the AAP is convinced by this one study that hats are dangerous, it should also be convinced that socks are dangerous, and nightgowns are protective. "

https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Why is Oster, a trained economist, better source than the two people who wrote the AAP technical report and paper (Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC; Lawrence Noble, MD, FAAP, FABM, IBCLC) ? Literally the announcement objective for the AAP statement is : AAP identifies stigma, lack of support and workplace barriers as obstacles that hinder continued breastfeeding. Does Oster negate this statement? No, but then she goes on to undermine the AAP.

In the article you linked she references a paper on HTN risk and only talks about the 2011 but the technical report lists two papers in 2018 and 2019.

I think she likes to be controversial and whatever gives her the most clicks.

Ahhh. A person who is capable of nuanced thought. I said this earlier in the thread, and it is clearly lost on the anti-breastfeeding poster, but the AAP did not recommend extended breastfeeding as the best option. They SUPPORT it, note studies showing health benefits, especially to the mother, and advocate for the elimination of barriers for those who choose to breastfeed beyond six months. That's it. Nowhere in the paper does it say that they recommend extended breastfeeding for everyone.

[Anonymous]

Anonymous wrote:"Hats

The final change I wanted to discuss is a new prohibition on infant hats.

In prior iterations of its guidelines, the AAP has noted concerns with overheating as a risk of SIDS. I talked about that evidence in this post a month ago. The evidence on heat overall is a bit sparse, but in this iteration, the organization has taken it one step further to express concern about the heat generated by infant hats.

The data cited is from a single paper. This is a case-control study in Australia that looked at a large number of possible relationships between clothing and bedding and SIDS. The paper finds that in 8.3% of SIDS cases, a hat (“bonnet”) was worn, versus only 5.2% of control infants. This difference is statistically significant.

However: the paper runs a lot of tests, and this raises concerns about overinterpreting any one result. The authors find, for example, a much stronger statistical link between SIDS and wearing socks than between SIDS and wearing hats. They also find that wearing a nightgown is protective, but wearing “stretch and grow” leggings is associated with an elevated SIDS risk. It’s not clear what any of this means.

In fact, the authors do not make much of any of these results. They note: “Significant differences in the type of products used by case and control infants occurred, and may be related to the difference in season of interview between cases and controls.” Basically, they may have observed more SIDS infants in the winter, when hats (and socks) are more common.

Without belaboring the point, to take from this paper the conclusion that infants shouldn’t wear hats seems … a stretch. The data would more strongly support a “no socks” conclusion. Put differently: if the AAP is convinced by this one study that hats are dangerous, it should also be convinced that socks are dangerous, and nightgowns are protective. "

https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding

The AAP addresses this : " should be noted that because there are no randomized controlled trials related to SIDS and other sleep-related deaths, case-control studies are the best evidence available."...."Physicians and nonphysician clinicians are encouraged to have open and nonjudgmental conversations with families about their sleep practices. Individual medical conditions may warrant that a clinician recommend otherwise after weighing the relative risks and benefits."....

AND YET AGAIN SHE ONLY LINKS THE ONE PAPER NOT BOTH CITED IN THE REPORT. She picked the 2008 Bristol paper and not the NICU paper that found that hypothermia was not a risk for infants who didnt have hats. The paper further goes on to say "It is unclear whether the relationship to overheating is an independent factor or merely a reflection of the increased risk of SIDS and suffocation with blankets and other potentially asphyxiating objects in the sleeping environment. Head covering during sleep is of particular concern. In 1 systematic review, the pooled mean prevalence of head covering among SIDS victims was 24.6%, compared with 3.2% among control infants.274 Although head covering usually refers to bedding or bed clothes, 1 study found significantly more SIDS cases in infants wearing hats compared with controls.321 It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing. A study on the aerodynamics of rebreathing exhaled gases demonstrated that with higher temperature and humidity, the exhaled gas is denser and does not escape the vicinity of the nostrils.429 In this in vitro model, the result was increased rebreathing of CO2-rich gas, suggesting that both overheating and rebreathing are important components in the association between head covering and SIDS." Going back to the NICU study on hats, suffocation was a concern ".

Hats have multiple risks and have no discernable benefit. Thats the equation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For the Emily Oster haters, here is her blog post on the new breastfeeding (and other) AAP guidelines and why they are not evidence-based and potentially harmful (https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding ). If you have an actual rebuttal, feel free to share it. If you want to bash her credentials, of course you are free to do so, but know that that will just show you don't actually have a real argument.

I find some of these changes frustrating (obviously). This is true for two reasons.

First: in many cases, these guidelines (new and old) fail to acknowledge other family considerations. Breastfeeding for two years has practical costs and may have mental health costs, or physical downsides. Sharing a room with a child may have negative impacts on both child and adult sleep. There is little, if any, help given to families in navigating these trade-offs. Even when there is acknowledgment of the existence of a trade-off, the framing is often set up to imply that there is a “best” choice, and then some other worse choices if you cannot do that.

This is especially problematic when the benefits are so tentatively supported in the data. People are being told to make choices that may be very costly to them because of some theoretical risk, or some risk demonstrated only in very biased samples. It’s hard to see how this is a good trade.

A second issue is that as more and more restrictions on behavior are added, it becomes less and less easy to prioritize. There are some behaviors that are important for safe sleep — putting a child down on their back, for example. And then there are some, like not giving your kid a hat, that do not matter. When these are all presented together as a package, it can be challenging for parents to identify which things are important (I’ve written more about that here). And as the list gets longer and longer and starts to include things that seem ridiculous (like hats), it makes the good recommendations seem less important.

I believe it is possible to create a more coherent, more data-based set of guidelines that would help parents prioritize better. For now, what we have is flawed.

I am confused by your post. Are you suggesting someone who doesn’t agree with Emily Oster is incapable of a real argument? Because she herself has said otherwise, which is one of the reasons I like her…

I'm referring to the fact that lots of posters here like to bash her without offering any arguments as to why or how her conclusions are wrong.

Why is Oster, a trained economist, better source than the two people who wrote the AAP technical report and paper (Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC; Lawrence Noble, MD, FAAP, FABM, IBCLC) ? Literally the announcement objective for the AAP statement is : AAP identifies stigma, lack of support and workplace barriers as obstacles that hinder continued breastfeeding. Does Oster negate this statement? No, but then she goes on to undermine the AAP.

In the article you linked she references a paper on HTN risk and only talks about the 2011 but the technical report lists two papers in 2018 and 2019.

I think she likes to be controversial and whatever gives her the most clicks.

Ahhh. A person who is capable of nuanced thought. I said this earlier in the thread, and it is clearly lost on the anti-breastfeeding poster, but the AAP did not recommend extended breastfeeding as the best option. They SUPPORT it, note studies showing health benefits, especially to the mother, and advocate for the elimination of barriers for those who choose to breastfeed beyond six months. That's it. Nowhere in the paper does it say that they recommend extended breastfeeding for everyone.

DP. The criticism of the AAP is not that the cite some support for breastfeeding, but that they overstate the positive benefits and completely ignore the costs. And of course, stating the support for extended breastfeeding is akin to discouraging formula. That's obvious; you're just playing ridiculous language games. If all AAP wanted to do was support autonomy in infant feeding, this would be worded MUCH differently.