Sunday, April 08, 2012

In Which Statistics Are Misleading

"The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months."
"WHO recommends mothers worldwide to exclusively breastfeed infants for the child's first six months to achieve optimal growth, development and health." 
"[CDC] Healthy People 2020 objectives for exclusive breastfeeding through 3 and 6 months of age are 46.2% and 25.5%, respectively."
Dear government and medical organizations: Screw you.

I am a committed breastfeeder.  Bug nursed until he was almost two.  Tatoe will probably do the same.  And neither of my children was 'exclusively breastfed' until six months.

Tatoe is now 5 months and 1 week old.  I just gave him a large baby helping of sweet potatoes, from my lunchtime soup.  (He cried when they were gone.)  Why?  Because he grabs our food and tries to put it in his mouth, and when I gave him steamed apple last week, he almost fell out of his chair with joy.   Five months, six months, who cares?

Bug got applesauce and oatmeal when he was four months old.  He would not, not not not, take a bottle.  Dr. S was home with him all day three days a week.   So we agreed to feed him a little real food and then, sometimes, he would also eat milk.  So the choices were: divorce; quit job; hungry screaming baby; applesauce.  Let's see.  Which seems best to YOU?

So I'm a failure in their statistics- even though I will almost certainly nurse both children well past 12 months- and my children will clearly never "achieve optimal growth, development and health".  (If you've seen my children, you realize this is a joke.  They are large.)  The choosing of cutoffs for statistically-determined screenings is its own mini-branch of statistics; choosing cutoffs for 'soft' guidelines is much harder.  They have to draw the line somewhere.  And yet, it seems that no child-related guideline ever manages to be expressed in an inoffensive way.  In trying to fit people into best practice guidelines, they manage to piss off even the people who wanted to do it that way.

7 comments:

  1. On the one hand, I understand the need to make public health messages simple to reach the most people, but on the other hand its super frustrating when I find myself worried about something because of public health messages and then I do a bit of reading and find out it totally doesn't apply in my case/to what I'm doing

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  2. Amen, sister! I am a true failure according to their statistics (at least you are basically following their guidelines, if not to the letter of the law). You would not be surprised how badly I wanted to breastfeed my child, and yet how badly I failed at it. I felt like the worst parent ever whenever I gave him a bottle, yet the choice was either formula or starve to death. After the one-year mark I felt less guilty, but it would not be hard to make me cry about it even today.

    As for optimal growth, development, and health, my child is 99th percentile in height and weight, healthy like an ox, and a danged genius. If I had another, I wouldn't fret nearly as much if I failed at breastfeeding again.

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  3. I nursed one of my kids exclusively for 18 months... this was NOT by choice. It took us 9 months worth of feeding therapy before he would allow even purees in his mouth. I pumped at work, and he would take enough of the bottle to not starve, but mostly nursed all evening and every 2 hours at night. (Tired? No...) My husband would have to occasionally bring him into my job (20 miles one way) because he would refuse the bottle at all. I have to think that's NOT what the "experts" were talking about though.

    Second son exclusively nursed for 4-5 months, then mostly nursed and got some food. Heck, the pediatrician was telling us to give him some food at 2 months (at 2 months he was wearing size 6 months clothes to give you an idea of baby size in our house...).

    I guess because we as a society in the US have gotten so far away from nursing as normal, nobody KNOWS what normal is... and for some kids, normal is eating regular food earlier than 6 months, and for some it is not.

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  4. Anonymous11:36 AM

    I completely agree with Mary_Flashlight that as a society in the US, we don't know what is normal in terms of feeding our babies - or what should be done.

    I'm in my 30s, and most of my mothers friends didn't try to breastfeed. Breastfeeding was considered gross in her circle. She certainly wasn't breastfed. But she had read some things suggesting breastfeeding was good for the baby, and so she gave it a try. When she was still nursing me when I was a year old, her mother got a doctor friend to call her and tell her that she should stop. Seriously. (She didn't.)

    My son also drastically prefers boob to bottle, and he doesn't drink much during the day when I'm at work (although he will drink some). I was able to arrange it so that I didn't return to work full-time until after he was six months old, and so the transition has been easier because our sitter can feed solids along with the bottle. I am not sure what would have happened if I went back to work earlier.

    My pediatrician has a good attitude about breastfeeding and feeding solids. His perspective is that breastfeeding rates are pretty low, and that breast is best, but it's complicated. He said that instead of looking to an age cut-off for starting solids, look for certain physical signs (NOT just reaching for our plates, which he did from very early on; also looking for motor development milestones). If it happened at 5 months, great; if it happened at 6 months, great. It was up to us. We were just supposed to keep in mind that his main source of nutrition is still supposed to be breastmilk for a while longer.

    Back to thinking breastfeeding is best but that it's complicated, he always asked how feeding was going during our first few visits. When I was having some trouble, he suggested that we make an appointment with their lactation consultant, which I did, and she was very supportive. He could tell that I really wanted to breastfeed, and so his feedback was always supportive of that. I'm not sure what he did for women who didn't want to breastfeed.

    I think some people give up on breastfeeding when they might have found a way to make it work if they had access to proper support. And I think some people move to solids for reasons that aren't necessarily supported by evidence (e.g., giving solids because they want their 2 month old to sleep through the night). Your baby, your choice. But it would be nice for people to be aware of their options and what the evidence actually does and does not indicate. And it would be nice if the AAP and other organizations could be more explicit regarding what the evidence actually says, but it doesn't seem to trust that we are capable of evaluating it.

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  5. It's even worse when you can't breastfeed - you feel like a massive failure. I forced myself to hook up to a pump multiple times a day for six months so my son could get breast milk most of the time, but sometimes had to be on formula...and I felt GUILTY for that! Isn't that just insane? He was then on formula from 6-12 months, but I didn't feel nearly as guilty for that (I was finding my parenting legs by that point).

    The funny thing is at about 12 months, there's a lot of advice out there to keep your child on formula and NOT move to whole milk because it's more nutritious. So, it goes from poison to gold in a matter of a week! LOL!!

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    1. ha! what an AMAZING week that must be!

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  6. Nothing has made me a bigger advocate for Experts and Meddlers BACKING THE FUCK OFF about breastfeeding like my experience of all-but exclusively bfing for 6 months and continuing to bf on demand to a year (on more of a schedule since, but with no immediate end in sight).

    i had all the "support" in the world, but you know what actually made it possible? Big Pharma, that's who. you know what was absolutely no help at all? all this fucking guilt about it, to say nothing of the preening of a certain type of "successful" breast-feeder who may eat my impure shorts.

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