Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
And yet, they didn't, and the number of children with peanut allergies skyrocketed. Is this their pediatrician's faults? The families' faults? The AAP is not at fault at all? Please, you are really twisting yourself into circles on this one.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
And yet, they didn't, and the number of children with peanut allergies skyrocketed. Is this their pediatrician's faults? The families' faults? The AAP is not at fault at all? Please, you are really twisting yourself into circles on this one.
The AAP routinely changes recommendations. People also routinely make their own choices. Is the AAP “responsible” for peanut allergies? Seems like a stretch though perhaps they contributed.
Which only supports the point that if you don’t agree with this recommendation/it doesn’t work for the solution is not to do it. Which, again, is why the recommendation is “if mutually desired”. It doesn’t sound like you’re deciding between continuing to nurse your 1 y/o or not, so this one doesn’t apply to you except insofar as you’re really upset about it. I think you’re actually upset that the AAP recommends breastfeeding at all, and I’m afraid there’s not much I can say to you on that because so does every other public health body, even in countries where women only nurse to four months.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
And yet, they didn't, and the number of children with peanut allergies skyrocketed. Is this their pediatrician's faults? The families' faults? The AAP is not at fault at all? Please, you are really twisting yourself into circles on this one.
The AAP routinely changes recommendations. People also routinely make their own choices. Is the AAP “responsible” for peanut allergies? Seems like a stretch though perhaps they contributed.
Which only supports the point that if you don’t agree with this recommendation/it doesn’t work for the solution is not to do it. Which, again, is why the recommendation is “if mutually desired”. It doesn’t sound like you’re deciding between continuing to nurse your 1 y/o or not, so this one doesn’t apply to you except insofar as you’re really upset about it. I think you’re actually upset that the AAP recommends breastfeeding at all, and I’m afraid there’s not much I can say to you on that because so does every other public health body, even in countries where women only nurse to four months.
+1 This thread should be renamed "I hate breastfeeding and anyone who says anything good about it."
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
Why is there no recommendation that pediatricians and workplaces support other feeding choices? Other feeding choices can involve a lot of time or be less common, like a vegan diet.
What evidence exists that pediatricians and workplaces routinely impose barriers to a vegan diet?
AAP should give the feeding wars a break and issue workplace recommendations on nap time for new mothers.
Like how they explicitly call for longer, paid, maternity leave as part of these recommendations?
So much public health advice seems rooted in women not even attempting to hold down a job.
Buying formula should not be a requirement to a woman having a job and a child unless her desire is to feed formula. Professional women and wealthy women are given lactation lounges at work, mandatory breaks, and other supports to breastfeeding. Those should be widely available not replaced by another consumer product.
No, they should not get “mandatory breaks” that other workers don’t get to express breast milk for their over 1-year-old CHILD (not infant).
Yeah sorry you’ve lost me. Unpaid breaks in a clean room are not to much to expect.
then I should also get a break to go grocery shopping for my 1 year old.
Why?
Because pumping after 1 is purely a matter of personal preference and not nutritionally necessary for the child. So I should also get time off during the day to work on my voluntary choices for feeding my family.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
Why is there no recommendation that pediatricians and workplaces support other feeding choices? Other feeding choices can involve a lot of time or be less common, like a vegan diet.
What evidence exists that pediatricians and workplaces routinely impose barriers to a vegan diet?
AAP should give the feeding wars a break and issue workplace recommendations on nap time for new mothers.
Like how they explicitly call for longer, paid, maternity leave as part of these recommendations?
So much public health advice seems rooted in women not even attempting to hold down a job.
Buying formula should not be a requirement to a woman having a job and a child unless her desire is to feed formula. Professional women and wealthy women are given lactation lounges at work, mandatory breaks, and other supports to breastfeeding. Those should be widely available not replaced by another consumer product.
No, they should not get “mandatory breaks” that other workers don’t get to express breast milk for their over 1-year-old CHILD (not infant).
Yeah sorry you’ve lost me. Unpaid breaks in a clean room are not to much to expect.
then I should also get a break to go grocery shopping for my 1 year old.
Why?
Because pumping after 1 is purely a matter of personal preference and not nutritionally necessary for the child. So I should also get time off during the day to work on my voluntary choices for feeding my family.
You really hate breastfeeding mothers, don't you? By all means, make sure that as few women as possible can breastfeed, simply because you thought it was awful.
While most women don't need to pump their entire second year, there might be some that need to pump during the day while working to prevent their breasts from becoming engorged. Other workplace accommodations for extended BF might includes giving daytime or morning shifts to allow nursing in the early morning or at night.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
And yet, they didn't, and the number of children with peanut allergies skyrocketed. Is this their pediatrician's faults? The families' faults? The AAP is not at fault at all? Please, you are really twisting yourself into circles on this one.
The AAP routinely changes recommendations. People also routinely make their own choices. Is the AAP “responsible” for peanut allergies? Seems like a stretch though perhaps they contributed.
Which only supports the point that if you don’t agree with this recommendation/it doesn’t work for the solution is not to do it. Which, again, is why the recommendation is “if mutually desired”. It doesn’t sound like you’re deciding between continuing to nurse your 1 y/o or not, so this one doesn’t apply to you except insofar as you’re really upset about it. I think you’re actually upset that the AAP recommends breastfeeding at all, and I’m afraid there’s not much I can say to you on that because so does every other public health body, even in countries where women only nurse to four months.
+1 This thread should be renamed "I hate breastfeeding and anyone who says anything good about it."
In other words, you don't care that the AAP twists the evidence to support their recommendations. I do. And I don't hate breastfeeding, I hate that so many women do it based on what amounts to propaganda and lies, and I don't blame them for following the guidelines of a major medical association. You do, and I think that's incredibly offensive.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
Why is there no recommendation that pediatricians and workplaces support other feeding choices? Other feeding choices can involve a lot of time or be less common, like a vegan diet.
What evidence exists that pediatricians and workplaces routinely impose barriers to a vegan diet?
AAP should give the feeding wars a break and issue workplace recommendations on nap time for new mothers.
Like how they explicitly call for longer, paid, maternity leave as part of these recommendations?
So much public health advice seems rooted in women not even attempting to hold down a job.
Buying formula should not be a requirement to a woman having a job and a child unless her desire is to feed formula. Professional women and wealthy women are given lactation lounges at work, mandatory breaks, and other supports to breastfeeding. Those should be widely available not replaced by another consumer product.
No, they should not get “mandatory breaks” that other workers don’t get to express breast milk for their over 1-year-old CHILD (not infant).
Yeah sorry you’ve lost me. Unpaid breaks in a clean room are not to much to expect.
then I should also get a break to go grocery shopping for my 1 year old.
Why?
Because pumping after 1 is purely a matter of personal preference and not nutritionally necessary for the child. So I should also get time off during the day to work on my voluntary choices for feeding my family.
Everything about having children is voluntary, but still a public good. So you’re equally in favor of doing away with protections in the workplace for pregnant women? You’re not in support of paid parental leave? Or is it just that, as someone who dislikes women who breastfeed, you would like their lives to be a little bit worse?
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
Why is there no recommendation that pediatricians and workplaces support other feeding choices? Other feeding choices can involve a lot of time or be less common, like a vegan diet.
What evidence exists that pediatricians and workplaces routinely impose barriers to a vegan diet?
AAP should give the feeding wars a break and issue workplace recommendations on nap time for new mothers.
Like how they explicitly call for longer, paid, maternity leave as part of these recommendations?
So much public health advice seems rooted in women not even attempting to hold down a job.
Buying formula should not be a requirement to a woman having a job and a child unless her desire is to feed formula. Professional women and wealthy women are given lactation lounges at work, mandatory breaks, and other supports to breastfeeding. Those should be widely available not replaced by another consumer product.
No, they should not get “mandatory breaks” that other workers don’t get to express breast milk for their over 1-year-old CHILD (not infant).
Yeah sorry you’ve lost me. Unpaid breaks in a clean room are not to much to expect.
then I should also get a break to go grocery shopping for my 1 year old.
Why?
Because pumping after 1 is purely a matter of personal preference and not nutritionally necessary for the child. So I should also get time off during the day to work on my voluntary choices for feeding my family.
You really hate breastfeeding mothers, don't you? By all means, make sure that as few women as possible can breastfeed, simply because you thought it was awful.
While most women don't need to pump their entire second year, there might be some that need to pump during the day while working to prevent their breasts from becoming engorged. Other workplace accommodations for extended BF might includes giving daytime or morning shifts to allow nursing in the early morning or at night.
I hate to burst your bubble but at a certain point, these types of accommodations encourage discrimination against women in the workplace. Same thing happens with long maternity leaves which is why parental leave advocates call for no more than 6 months of leave and that it be available to both mothers and fathers. Pumping at work takes time and can be extremely distracting, I know because I did it for 7 months.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
And yet, they didn't, and the number of children with peanut allergies skyrocketed. Is this their pediatrician's faults? The families' faults? The AAP is not at fault at all? Please, you are really twisting yourself into circles on this one.
The AAP routinely changes recommendations. People also routinely make their own choices. Is the AAP “responsible” for peanut allergies? Seems like a stretch though perhaps they contributed.
Which only supports the point that if you don’t agree with this recommendation/it doesn’t work for the solution is not to do it. Which, again, is why the recommendation is “if mutually desired”. It doesn’t sound like you’re deciding between continuing to nurse your 1 y/o or not, so this one doesn’t apply to you except insofar as you’re really upset about it. I think you’re actually upset that the AAP recommends breastfeeding at all, and I’m afraid there’s not much I can say to you on that because so does every other public health body, even in countries where women only nurse to four months.
+1 This thread should be renamed "I hate breastfeeding and anyone who says anything good about it."
In other words, you don't care that the AAP twists the evidence to support their recommendations. I do. And I don't hate breastfeeding, I hate that so many women do it based on what amounts to propaganda and lies, and I don't blame them for following the guidelines of a major medical association. You do, and I think that's incredibly offensive.
93% of Swedish mothers initiate breastfeeding. The AAP isn’t a Swedish body. Do you have this much rage for their public health body as well? Do you feel like only the AAP is promoting “propaganda and lies” or is this a global conspiracy?
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
Why is there no recommendation that pediatricians and workplaces support other feeding choices? Other feeding choices can involve a lot of time or be less common, like a vegan diet.
What evidence exists that pediatricians and workplaces routinely impose barriers to a vegan diet?
AAP should give the feeding wars a break and issue workplace recommendations on nap time for new mothers.
Like how they explicitly call for longer, paid, maternity leave as part of these recommendations?
So much public health advice seems rooted in women not even attempting to hold down a job.
Buying formula should not be a requirement to a woman having a job and a child unless her desire is to feed formula. Professional women and wealthy women are given lactation lounges at work, mandatory breaks, and other supports to breastfeeding. Those should be widely available not replaced by another consumer product.
No, they should not get “mandatory breaks” that other workers don’t get to express breast milk for their over 1-year-old CHILD (not infant).
Yeah sorry you’ve lost me. Unpaid breaks in a clean room are not to much to expect.
then I should also get a break to go grocery shopping for my 1 year old.
Why? [/ quote]
Because pumping after 1 is purely a matter of personal preference and not nutritionally necessary for the child. So I should also get time off during the day to work on my voluntary choices for feeding my family.
You really hate breastfeeding mothers, don't you? By all means, make sure that as few women as possible can breastfeed, simply because you thought it was awful.
While most women don't need to pump their entire second year, there might be some that need to pump during the day while working to prevent their breasts from becoming engorged. Other workplace accommodations for extended BF might includes giving daytime or morning shifts to allow nursing in the early morning or at night.
I hate to burst your bubble but at a certain point, these types of accommodations encourage discrimination against women in the workplace. Same thing happens with long maternity leaves which is why parental leave advocates call for no more than 6 months of leave and that it be available to both mothers and fathers. Pumping at work takes time and can be extremely distracting, I know because I did it for 7 months.
LOL! Yup you’ve found the real barrier to mothers in the workforce! It’s all those ladies taking too long to pump in their luxurious lactation lounges
The fact that it may contribute to negative attitudes towards working mothers (and I have not seen high quality studies of this hypotheses) would be symptomatic of a misogynistic culture. Giving into that culture doesn’t help anyone.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
And yet, they didn't, and the number of children with peanut allergies skyrocketed. Is this their pediatrician's faults? The families' faults? The AAP is not at fault at all? Please, you are really twisting yourself into circles on this one.
The AAP routinely changes recommendations. People also routinely make their own choices. Is the AAP “responsible” for peanut allergies? Seems like a stretch though perhaps they contributed.
Which only supports the point that if you don’t agree with this recommendation/it doesn’t work for the solution is not to do it. Which, again, is why the recommendation is “if mutually desired”. It doesn’t sound like you’re deciding between continuing to nurse your 1 y/o or not, so this one doesn’t apply to you except insofar as you’re really upset about it. I think you’re actually upset that the AAP recommends breastfeeding at all, and I’m afraid there’s not much I can say to you on that because so does every other public health body, even in countries where women only nurse to four months.
+1 This thread should be renamed "I hate breastfeeding and anyone who says anything good about it."
In other words, you don't care that the AAP twists the evidence to support their recommendations. I do. And I don't hate breastfeeding, I hate that so many women do it based on what amounts to propaganda and lies, and I don't blame them for following the guidelines of a major medical association. You do, and I think that's incredibly offensive.
93% of Swedish mothers initiate breastfeeding. The AAP isn’t a Swedish body. Do you have this much rage for their public health body as well? Do you feel like only the AAP is promoting “propaganda and lies” or is this a global conspiracy?
I'm sorry, I'm done arguing with people who will just blatantly pretend I said something I did not say, or insist that women should just ignore the AAP but themselves can't handle people critcizing the AAP or the evidence behind breastfeeding. Go take your crazy elsewhere.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
Why is there no recommendation that pediatricians and workplaces support other feeding choices? Other feeding choices can involve a lot of time or be less common, like a vegan diet.
What evidence exists that pediatricians and workplaces routinely impose barriers to a vegan diet?
AAP should give the feeding wars a break and issue workplace recommendations on nap time for new mothers.
Like how they explicitly call for longer, paid, maternity leave as part of these recommendations?
So much public health advice seems rooted in women not even attempting to hold down a job.
Buying formula should not be a requirement to a woman having a job and a child unless her desire is to feed formula. Professional women and wealthy women are given lactation lounges at work, mandatory breaks, and other supports to breastfeeding. Those should be widely available not replaced by another consumer product.
No, they should not get “mandatory breaks” that other workers don’t get to express breast milk for their over 1-year-old CHILD (not infant).
Yeah sorry you’ve lost me. Unpaid breaks in a clean room are not to much to expect.
then I should also get a break to go grocery shopping for my 1 year old.
Why? [/ quote]
Because pumping after 1 is purely a matter of personal preference and not nutritionally necessary for the child. So I should also get time off during the day to work on my voluntary choices for feeding my family.
You really hate breastfeeding mothers, don't you? By all means, make sure that as few women as possible can breastfeed, simply because you thought it was awful.
While most women don't need to pump their entire second year, there might be some that need to pump during the day while working to prevent their breasts from becoming engorged. Other workplace accommodations for extended BF might includes giving daytime or morning shifts to allow nursing in the early morning or at night.
I hate to burst your bubble but at a certain point, these types of accommodations encourage discrimination against women in the workplace. Same thing happens with long maternity leaves which is why parental leave advocates call for no more than 6 months of leave and that it be available to both mothers and fathers. Pumping at work takes time and can be extremely distracting, I know because I did it for 7 months.
LOL! Yup you’ve found the real barrier to mothers in the workforce! It’s all those ladies taking too long to pump in their luxurious lactation lounges
The fact that it may contribute to negative attitudes towards working mothers (and I have not seen high quality studies of this hypotheses) would be symptomatic of a misogynistic culture. Giving into that culture doesn’t help anyone.
Blame me all you want, you just hate the fact that I'm right.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
And yet, they didn't, and the number of children with peanut allergies skyrocketed. Is this their pediatrician's faults? The families' faults? The AAP is not at fault at all? Please, you are really twisting yourself into circles on this one.
The AAP routinely changes recommendations. People also routinely make their own choices. Is the AAP “responsible” for peanut allergies? Seems like a stretch though perhaps they contributed.
Which only supports the point that if you don’t agree with this recommendation/it doesn’t work for the solution is not to do it. Which, again, is why the recommendation is “if mutually desired”. It doesn’t sound like you’re deciding between continuing to nurse your 1 y/o or not, so this one doesn’t apply to you except insofar as you’re really upset about it. I think you’re actually upset that the AAP recommends breastfeeding at all, and I’m afraid there’s not much I can say to you on that because so does every other public health body, even in countries where women only nurse to four months.
+1 This thread should be renamed "I hate breastfeeding and anyone who says anything good about it."
In other words, you don't care that the AAP twists the evidence to support their recommendations. I do. And I don't hate breastfeeding, I hate that so many women do it based on what amounts to propaganda and lies, and I don't blame them for following the guidelines of a major medical association. You do, and I think that's incredibly offensive.
93% of Swedish mothers initiate breastfeeding. The AAP isn’t a Swedish body. Do you have this much rage for their public health body as well? Do you feel like only the AAP is promoting “propaganda and lies” or is this a global conspiracy?
I'm sorry, I'm done arguing with people who will just blatantly pretend I said something I did not say, or insist that women should just ignore the AAP but themselves can't handle people critcizing the AAP or the evidence behind breastfeeding. Go take your crazy elsewhere.
What evidence do you need that breastfeeding is good? Do you also need research on the benefits of walking upright, breathing, drinking water, and eating? It's a natural process and everyone agrees on that. You don't need a study on starvation to know that eating is good.
You are thinking of this wrong. Breastfeeding is ideal, but not essential if other factors make breastfeeding undesirable, whether that is lack of production, the time commitment, or just because a mother thinks it is disgusting.
Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.
"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”
The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."
These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s
That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.
Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?
There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.
baby starver!
Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.
Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?
You are off your rocker if you believe it is just as bad for you to have to hand express colostrum as it is to deny a starving baby formula. This is the problem with you sickos.
Are you not the same person who just said how much she values women’s bodies and time? Because my body sure could have used the sleep and my time would have been much happier holding my baby than doing something wholly unnecessary because someone was “old school”. But I guess woman’s bodies only have value when that’s a convenient point for you?
I absolutely value women's bodies but really? You think that's k st as bad as a starving baby? You're insane.
Please provide a single documented instance in the United States, Canada or Europe of a baby of 12-16 hours old starving to death due to lack of formula. I’ll wait.
I am not sure why you are setting this arbitrary timeline of 12-16 hours but there are absolutely documented cases of babies starving either to death or to the point of having brain damage in their first days of life because they were dined formula. All you have to do is read the link cited in the first post above which links to the documented cases. I'm sure you'll come up with another lie to justify this, and you can go to hell as far as I care.
Because my baby was 12 hours old when the nurse told me I “had” to supplement “immediately”. She was 18 hours old when the pediatrician told the nurse she was out of line. At 16 hours I passed out so I can’t take responsibility for what happened after that.
Yes there are documented cases of babies dying from dehydration because their medical providers failed them. In many cases because they are *not* following published guidelines. But bad practitioners are bad practitioners regardless of the side of this debate they fall on, and that doesn’t mean the guidelines themselves are subjective .
Oh you're making baby starving incidents about YOU specifically. Got it. Since the new guidelines place further pressure on practitioners to avoid formula for no clear reason, yes I am worried that more bad practitioners will err on the side of avoiding formula. I get why you are not concerned about this because a baby having brain damage thanks to being denied formula is apparently equally bad as you being made to hand express colostrum.
And what about the time a mother who wanted to breastfeed but is undermined from doing so will spend looking for formula in this current shortage? What about the mothers who could have— if properly supported— breastfed, but who will instead dilute their infant formula to make it stretch longer particularly in a recession. Does that baby’s malnutrition matter to you as much as yelling “Baby Starver” at a stranger on the internet? Do their experiences also not matter, as mine clearly doesn’t, because it doesn’t support your narrative?
Go back to work in Abbott PR. But please wash your hands first.
Every time you type this idiocy and accuse people of “working for formula companies,” you embarrass yourself. Just stop.
Personally I find more secondhand embarrassment in someone in 2022 thinking that the formula companies are really the people with the interests of women and babies at heart.
Omg Dyson does not have my interests at heart either! They just want to addict me to the convenience of a cordless stick vac and know I will never be able to go back to a broom and dustpan.
! Look the formula companies have a product they sell but that product fits a need. I would be much more apt to believe the WHO and medical community advise on this it did not feel like they were trying to sell me time share anytime they talk about BF.
And I’d be more apt to think of formula as a benign option if it didn’t keep getting recalled— yes there’s this current disaster but before that it was literally beetles. Trust us with your newborn baby’s nutrition, we totally only put bugs in it sometimes! Add that to situational issues like Flint— where formula-fed babies now have permanent brain damage from lead poisoning— the weeks long boil-orders parts of Texas were under this year in which moms were melting snow and boiling it over fires to make formula and I am forced to conclude that the convenience and safety factor is way oversold and the risks are understated. Which is exactly how the anti-breastfeeding moms feel about breastfeeding guidance.
Wasn’t the Abbott recall the first large scale formula recall in something like 10 years? I have no idea about the beetle thing, but if it only affected a few shipments and didn’t cause large scale supply issues that means the recall did its job IMO.
People have always had to deal with boil orders - the water plant where I grew up had a lot of issues and I can remember boil orders way back in the 80s and 90s that lasted for days. It’s nothing new. And in terms of a place in the US like Flint that had unsafe drinking water, wouldn’t the babies be affected anyway if mom drank the water and then nursed? Or if the water was used in food prep? I don’t know, I just don’t think any of these are widespread enough issues for the AAP to be so militant about BFing.
The Flint thing disproportionately affected formula-fed babies because mothers who couldn’t afford bottled water followed the instructions for tap water and boiled the water for formula, which concentrated the lead.
I am not saying the potential inconvenience and lack of safety of formula is related to the AAP guidance, I am saying that I have deep skepticism of the claims about formula (that it’s just so easy and convenient) just as people seem to about breastfeeding. I am also skeptical of the companies that make formula since they have no interest outside a profit.
It’s interesting that you mention the last point. The big 3 formula companies in the US are Enfamil, Similac, and Gerber. Enfamil is owned by Reckitt, which makes all kinds of other food and consumer products like medicines and personal care items. Similac is owned by Abbott which makes a lot of prescription drugs and medical devices. Gerber is owned by Nestle which also makes a lot of food. Point being, even if formula goes belly-up, they have a lot - A LOT - of other ways to make money. Baby formula is just one aspect.
But if not as many people breastfeed, all those little mom and pop companies that make various accessories, and independent breastfeeding consultants and nurses and a whole army of bloggers and content creators, are definitely going to be affected. I personally don’t see the “they’re pushing a product!!!” criticism as exclusive to formula, at all.
Anonymous wrote:It’s really all about the culture of safety-ism for children. Because we live in a society with a lacking social safety net, lawsuits are typically how damages are handled. The AAP is just recommending doctors to say the safest thing so they can’t be sued. In reality, this is not what it looks like on the ground.
I had a baby in 2017 and in 2020. Both times. I brought my own formula to the hospital just in case. With my youngest, I offered some because his latch was a little funky. The nurse was like “you didn’t need to bring that.” Also, both babies went to the nursery for a few hours. It was offered to me. On the website, it says that they room in. But in reality they don’t want you falling asleep holding the baby.
My pediatrician recommended supplementing with no hesitation. When the pediatrician asks where the baby slept, I just didn’t mention that it was mostly in my arms. No doctor is going to recommend cosleeping but moms do what works.
I wish there was some way to reach out to pregnant women and urge them to ignore the culture of safetyism from their first child. It would save so many women from immense mental suffering. I went through it with my first. He wanted nothing to do with the bassinet, so I just didn’t sleep. Raging postpartum anxiety that lasted for years impacted us both.
Parents do drop babies more often in baby-friendly hospitals. It is a thing that happens. Babies get injured because of this.
yes but it isnt solely dropped from breastfeeding. Also if they would make sidecar cribs to the bed, it would be easier. If there was more nursing staff so the ratio was 1:4, meaning if its 1 baby plus 1 mother then they only have two rooms. Or having a separate nurse for mom and baby, with mother ratio being 1:4 mothers and infants being 1:2.
The nursery option wasnt great either. In 2008 ratios of nurses to infants in the nursery was 1:8. 8 infants....newborns who need feeding, burping, rocking, diaper changes, temp checks, bilirubin checks, etc. No thank you.
It does not matter if the specific mother was breastfeeding. The policies are justified based on increasing breastfeeding. In reality it is a cost cutting measure and the victims are new mothers and babies. The AAP should get seriously slammed for this. Sorry you don't like the nursery but to me it is worth babies not getting skull fractures and developing seizures. Our country really, really hates women and babies, JFC.
Just because a hospital cuts costs and blames breastfeeding support doesn’t make actual breastfeeding support the problem. They could increase nursing staff, upgrade the equipment, add home-visits and “blame” breastfeeding support for that.
It's a breastfeeding support initiative. Make all the excuses you want, lactivism has become a cultist, misogynist religion. I think breastfeeding is a great choice when it is a choice, not when women are harangued into doing it for benefits that continue to be exaggerated by organizations like the AAP.
I am super pro breastfeeding for those who want to, but if the AAP would focus on the really important things PP suggested (more nurses per mother/infant, more nurses in the nursery, shorter hours for medical staff, etc.) instead of making all the outcomes about whether people breastfeed or not it would be better for breastfeeding moms AND formula feeding moms. I bet you'd get more people willing to try breastfeeding if they weren't so miserably stressed anyway.
Heyo, all those things cost money. Much better to act like changing the mothers' behavior is the start and end of early childhood wellbeing. After all, women's labor is free to the system! I also have long believed that public health focuses on breastfeeding because they KNOW that new mothers are a susceptible audience. Nothing to do with the actual costs and benefits of interventions; they just know that women can be pressured.
I just don’t understand WHY, I guess. What is the super important health benefit that EVERYONE has to breastfeed for 2+ years, in a developed country where we have clean water and baby formula? The last I looked into this (years ago), the only benefit that was outside of controlling for factors like family income, day care/non day care, education, etc. was a small reduction on a population - not even individual - level basis in ear infections and diarrhea. And that pumped and stored milk loses even those small benefits. Is that really worth all the hand wringing that new moms do about BFing?
The reccomendation isn’t that everyone has to nurse for two years. It’s that people who want to nurse past one, whose babies want to nurse last one, should be supported in doing so.
Also the benefits after one year primarily are a reduced cancer risk for the mother. I feel like that should matter.
Being pregnant and giving birth also reduces your risk of breast and ovarian cancer, but you don’t see these organizations telling women to get pregnant and have kids if they don’t want to. Birth control use also reduces BC risk and is a lot less invasive on your life.
They’re not saying to nurse if you don’t want to either— they’re saying if you and your infant want to nurse past one year, you should be supported in that choice by your pediatrician and your workplace. That’s what “mutually desired” means in the recommendation.
More lies. The new guidelines do not say anything about nursing for one year. They say, and I quote:
"The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond."
The old guidelines said:
"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
Where it previously recommended continued breastfeeding "for 1 year or longer", it now "supports" (wtf does that mean, is the AAP paying women for their time? No, they are just trying to use another word for recommending) breastfeeding for two years and beyond. If you are being generous you could say the AAP is reducing its "recommendation" from 1 year to 6 months, but nowhere else in the document does it indicate that, rather they are doubling down on all the previous recommendations including numerous ones that are based on flimsy evidence and/or have been shown to actually harm women and babies.
If you read your own quotes, it will help. If breastfeeding is not something you want, which it clearly isn’t, then these recommendations are not about you.
What a mother "wants" is often defined by what they think is good for their child. Many of us follow recommendations because we want what is best for our children. We power through the exhaustion and discomfort. Too bad the evidence for the recommendations suck.
Ok so now women are not capable of deciding whether they desire to breastfeed? We’re just automatons to Big Lactation? If that’s true why do we so easily disregard other AAP recommendations without starting huge, moderately deranged threads about them? Do I *want* to roomshare with my child for a year? Nope! So I didn’t. And when the AAP suggested I did I did not start a thread about how my sleep was being undervalued due to weak evidence.
In other words, you don't think the AAP should be held accountable for making burdensome recommendations based on flimsy evidence. I do, I don't think that is "deranged" (and I also don't need to call you "deranged" express my opinion).
So far on this board I have seen one poster call people bonkers, psychotic, insane and every permutation whenever they are opposed. That behavior is deranged. The board stopped engaging with them, they were so distressed. If that poster isn’t you, my comment is not in reference to your posts.
How do you propose “holding the AAP accountable” for their opinions other than applying our own common sense and doing what we think is sensible for our families? It’s a group of people. Different pediatricians in this area will give different opinions on all sorts of things, we “hold them accountable” by seeing pediatricians whose practices align with our families needs.
The AAP is not some random mommy blogger that you can ignore. It is the national advocacy and trade group for pediatricians. It’s recommendations have great weight and result in material changes to pediatrician, hospital, and insurance practices. During Covid their opinion swayed some very important public policies. They are a powerful org making public health recommendations. So yeah, I think they need to be accountable. It’s honestly flabbergasting to me that they do not have a transparent control process rating the strength of evidence they base their recommendations on, like eg the US Preventative Task Force. The peanut allergy debacle ought to have triggered organizational reform, but it did not.
It really is though, and on every other subject people ignore it routinely without this degree of agitation.
I know not one single person who sleeps with their baby in their room until one. My pediatrician suggested moving my baby at 5M and that’s what we did. My insurance company still covered that visit.
I know several parents who co-sleep. No one has repossessed their babies. Two such parents are themselves physicians and they did not have their licenses revoked.
Formula, both RTF and canned, was sent to my house days after I had my baby, in 2020. Which means hospitals still share data with formula companies and the AAP hasn’t intervened to stop them. We handed it off to a family with new twins and moved on with our day.
Breastfeeding is only being treated as a bigger deal because people are emotionally attached to their side, but that’s just another choice.
It’s amazing you continue to refuse to understand why women are “emotional” about BF. It’s because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it. And this uneccesary stress started in the “baby friendly” hospital that sent them on their “breastfeeding journeys” completely exhausted.
I actually don't think the emotionality necessarily has much to do with the evidence-based (not moral) exhorting of organizations but I think it is more biological than that. I am someone who was totally FED IS BEST pre birth, I'll just breast feed shortly and then stop if I need to resume my medications (all of which i still think are much more rational positions than breastfeeding at any costs) to someone who ended up doing much much much more to try to make breastfeeding work than I EVER thought I would. (I did the whole triple feeding, using an SNS, bodywork, trying to pump all day (total craziness) etc.) It's like my rational brain completely changed in the process of giving birth and trying to breastfeed. Even now that my DC is almost 14 months emotionally the thought of giving up breastfeeding is too difficult even though it would be better for my work productivity to resume my medication. (but maybe not since I suspect I would have a hard time with the hormonal shifts and at risk of depression for stopping before DC and I am ready.) I was talking to my doctor about that yesterday the cost benefit analysis still tilted towards continuing to breastfeed (AAP didn't even come up ) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
It is an emotional topic and why I am SO HAPPY that the AAP is supporting women who want to breast feed longer. FINALLY!
I didn't follow the AAP advice re: bedsharing and while there was a little angst there I felt confident in my understanding of the data and the risks and benefits involved. I feel if I were someone who decided not to breastfeed the data can also be interpreted to support that choice. There are so many health organization advices that are impossible to folllow to a T so I take what works and leave the rest.
Unlike some people on this thread, I do believe that women are capable of making the best and rational choices for themselves and putting AAP in context. I see it happening all the time in my mom's groups. Nobody is going to feel guilty about not feeding for 2 years if they planned to stop earlier just because the AAP says that women who want to feed that long should be supported.
Sorry you have such a low opinion of women's agency and don't support supporting them.
There are a lot of reasons why I think the AAP guidelines are terrible, and none of them have anything to do with having a " low opinion of women's agency". I find it ironic that you feel so "supported" by the AAP's statement, but insist that those that don't should not care what they say. Either what the AAP says matters, or it doesn't. I'm sorry you only care about your perspective and think anyone who thinks otherwise is not "supporting" you. You're not "supporting" me either.
DP, but are you not the poster who said:
“because many, many women suffered pushing themselves to do it based on the moral exhorting of organizations like the AAP, only to realize later it was not worth it”
If so…that’s an example of a very low opinion of women’s agency. As above posters have said, people decide AAP recommendations are not right for them all the time. This one even comes with instructions to only follow it if you want to. I have no idea how much more “support” for not breastfeeding to two you can get than a statement about breastfeeding that says to do it only if you want to.
No, I am not that poster, but I absolutely agree with that statement and I think it is ridiculous and offensive to suggest that women following medical advice somehow means that they don't have agency.
The AAP statement does not once say "to do it only if you want to'". It emphasizes babies should receive absolutely nothing other than breast milk in the first six months of life barring what they characterize as extremely rare problems or contraindications. It also goes on and on exaggerating the benefits of continued breastfeeding. It supports practices in hospitals that are dumb and in some cases harmful. I would love it if it would just once clearly state that breastfeeding initiation or continuation of breastfeeding should be entirely up to the mother, and that it is her choice what she does with her body, but it does not say that, and that is not how medical providers treat women.
No the poster said they were following medical advice that went against their best interest. That implies that women don't have the capacity to evaluate medical advice and appropriately apply it to their situation. I mean there are a TON of medical guidelines out there. NOBODY follows all of them. Women are more than capable of reading AAP guideline, reading emily Oster, reading fed is best and figuring out what actually works best for them. If you think otherwise then you think women are not very intelligent and don't have agency.
Also even women who may not be so literate and working a minimum wage job can quickly ascertain that breastfeeding may not be feasible economically. Ie. not in their best interest regardless of their personal desire.
AAP is an important voice to change these job conditions so women have the option of breastfeeding.
Do you get that working minimum wage jobs is bad in and of itself? Wto make it about breastfeeding is not just dumb, it implies that the economic system is only bad insofar as it prevents women from breastfeeding.
All I can say about your point about medical advice is that you're a hypocrite if you think these guidelines are "supporting" you but think anyone who doesn't like them should just disregard them. Either the guidelines matter, or they don't. Pick one.
I do get that working minimum wage jobs sucks independently of breastfeeding but that is irrelevant to this thread. The point just because someone has to take unpaid breaks in a minimum wage job making it unrealistic to breastfeed shouldn't affect recommendations based on best medical evidence. It just means we need to work harder to make sure all women have the opportunity to feed their babies like they want to regardless of their employment.
The guidelines matter and are based on the best evidence available (some of which is not great). When I disregard a guideline I don't try to say that it is wrong. I evaluate the "gold standard" with reality. The "gold standard" is that breastfeeding has some health benefits over formula for both baby and mother (parent.) However reality is that those benefits may not outweigh the negative effects of breastfeeding on mental health, employment, etc. So reality says ok I accept that breastfeeding may be a bit better in general but in my case it is not so much better that it is worth losing my job, experiencing PTSD, etc.
I accept that not bedsharing is the safest "gold standard." But if as a solo parent I don't have the enough support to avoid falling asleep while feeding my baby and if I'm so sleep deprived it is unsafe to drive, then in my circumstances bedsharing may actually be better and safer. But in general, in the absence of specifics I do accept that not bedsharing is safer. I am not posting rants about bedsharing (at the most I may point some risk data that help people realistically assess the risk of bedsharing for their specific circumstances.)
I could go on but it really is ok to accept that a guideline represents "best practice" while determining that it is not best practice for your specific situation. Just because something is not right for my individual circumstances doesn't mean its not the best practice in general. Guidelines are meant for the generic person.
Individual agency and discussions of personal circumstances with physician help determine what is best for one's specific situation.
Nothing hypocritical about it. I have faced a lot of discouragement and questions regarding STILL breastfeeding and it is helpful to have the AAP guidelines to point out the benefits (more helpful than just having the WHO and Candadian guidelines where this is old news.)
I wonder if that's how you feel about all the kids that have severe peanut allergies thanks to the AAP issuing recommendations on that without sufficient evidence. Should those families have just decided the recommendation wasn't best practice for their specific situation? The AAP policy statement suggests that breastfeeding reduces neonatal mortality by 21% and in Black women a whopping 31%. Yet another more recent study claims that the reduction in risk is actually lower for Black babies, acknowledging that other factors impact infant mortality in that population. Yet the AAP doesn't acknowledge this discrepamcy. All this based on observational studies that cannot control for all factors. If you look at randomized trials, there is no difference in infant mortality.
You really can't imagine some women might go to extreme lengths, like triple feeding, to save their children's lives? This is propaganda, pure and simple. The AAP has no business making guidelines, they clearly have no idea how to interpret studies or what is sufficient evidence to make a recommendation.
Their doctors absolutely could have. In our family it’s tree nut, but our pediatrician made a different recommendation for introduction than the AAP and in consultation with a pediatric allergy specialist we followed that recommendation. Not a single healthcare provider even mentioned the AAP recommendation.
That’s probably because you had your kids after 2008, when there was clear evidence that the AAP was wrong about peanut allergies. This was confirmed in a 2015 randomized trial.
The AAP never reckoned with it’s mistaken peanut allergy recommendation. In fact they did not change their guidelines until 2017, almost TEN YEARS after there was significant evidence that their recommendations were CAUSING allergies.
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) I don't know if its the oxytocin, the preciousness of bonding in this way or what but it's definitely not the AAP that is driving my emotionality.
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