Monthly Archives: July 2010

Using double-sided sticky tape for speed

Welcome to the Carnival of Personal Blogging
This post was written for inclusion in the Carnival of Personal Blogging hosted by Good Goog and Blogs With Wings. This month our participants have shared their journey to personal blogging. Please visit Good Goog – Begin By Being Personal to view everyone's posts.

Sorry – had to edit the post to say that, as part of the posting conditions.  Anyway, to get back to where I was, there's a new carnival out there in Blogland. This time, it's personal.  (Damn – that joke really doesn't work any more now I've got that prologue in, does it?) Yup. The Carnival for Personal Bloggers has arrived – a carnival for anyone who 'primarily uses their own life experience as the content for their blog'. If you're really, really quick you can even join in with the first month's theme, the deadline of which is tomorrow. (OK, forget that bit – I wrote it several days ago.  Start getting ready to join in next month, instead.) 

The theme in question is 'Getting Personal – Journey to Personal Blogging'.  This is of course sort of ironic in my case, since I seem to have unintentionally spent the past seven months drifting further and further away from personal blogging.  Between the various carnivals, writing workshops, opinion posts, and meanders into long-past jobs, I've barely so much as told a cute anecdote about my children this year.  What I really need is a theme about 'Getting Impersonal – How I Totally Lost Track Of My Intentions To Be A Personal Blogger.'  Barring that, I'll take a personal bloggers' carnival.  Maybe having a carnival that requires me to write about my life will be the spur I need to actually start writing about it.  (Maybe I should stop waiting for a spur and actually just go ahead and write about it.  Yeah – that one's probably true.)

Oh, and the theme?  I'm totally cheating on that one, having already written that post five years ago when I first started out. So, here's one I made earlier.  And where do I see myself and my personal blog in the future?  Why, right here, and still with really good intentions to spend time writing about my children.

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Filed under I think this line's mostly filler

The Case Of The Lactivist Propaganda – A Reply To Ann Calandro

I do realise that I seem to be falling into a pattern lately of devoting this blog to replying to comments on the Fearless Formula Feeder's blog, but this one couldn't be allowed to pass, and the reply I wrote (even though it was shorter than the post I'm going to make here) was still too long to post as a comment, so… sorry about the déja-vu-all-over-again factor.  At least this time it's a reply to someone other than Alan.  Variety is the spice of life, and all that.

Anyway, the comment that Anonymous posted was a link to this infamous lactivist article, an essay by Ann Calandro entitled 'Even the Occasional
Bottle of Formula Has Its Risks: The Case of the Virgin Gut'.  (Alternatively, for anyone who felt that title didn't do quite an effective enough job of instilling fear into the heart of any woman daring to think of sullying the purity of her breastfed baby's body with a one-off bottle of formula, I've also seen it posted under the title 'Yes! Just 'One' Bottle Of Formula Will Hurt', by someone who apparently doesn't quite grasp the appropriate use of the subjunctive.)  The article is packed with unnerving comments:

Since my baby had received lots in her stomach
besides breast milk, her little gut was not virginal. What did this
mean? Had the hospital nurses inadvertently done some kind of damage to
her? Had I? What was going on inside my little girl?

But what happens when breast milk is not the only food in that little gut? The truth is very interesting and also very scary.

…destroying the characteristic intestinal flora of the breast-fed baby. [This one was a quote from a breastfeeding book.]

…there is very little that can be done to remedy the situation and save the virginal gut.

A huge increase in diarrheal diseases occurs in
babies who do not have optimal "intestinal fortitude," which is only
possible with guts that have never been exposed to infant formula.

Not to mention, of course, the story of the baby who had a few innocent-seeming bottles of formula and then developed a severe allergic reaction to cow's milk and was rushed into hospital and had stacks of medical tests and nearly DIIIIIIIEEEEED, all because of that scary formula.  If you can make it through that lot without being reduced to a quivering wreck at the prospect of your baby possibly ending up consuming some formula and being irrevocably damaged, you're a much more confident mother than I was in those scary first-time-around days.  It's thanks to that article, and others like it, that breastfeeding my first baby was turned from the pleasant and relaxing experience it should have been to a miserable, anxiety-ridden chore haunted by the fear of dire consequences if I fell down on the job the least little bit.

Which is terribly sad.  Because – surprise, surprise – despite Calandro's claim that there is 'much research to support avoiding supplementation if at all possible', the available evidence doesn't really seem to support her alarmist tone.

There's not much back-up, for example, for the claim that risks of diarrhoea are hugely increased.  A
study in New Zealand in the late '70s comparing babies receieving
various amounts of formula in their diet with exclusively breastfed
babies (Fergusson et al, the Australian Paediatric Journal, 1978, vol 14(4), pages 254 – 8) found that giving some formula supplements to breastfed babies
on an irregular basis carried slightly greater than a one in twenty
chance of causing diarrhoea. Now, those were the figures unadjusted
for possible confounders, so that will in fact be an overestimate –
and it's still hardly the 'huge risk' claimed by Calandro. And that,
of course, is more than thirty years ago, when sterilisation
techniques were poorer than today. What do more recent figures look
like? Well, a 1997 study available in Pediatrics looked at the infection rates in babies receieving different
proportions of formula in their diets. Babies getting formula
supplements up to around 10% of their total diet showed *no* increase
in rates of diarrhoea over babies who were exclusively breastfed.
Seems like all those babies were somehow managing to do just fine
despite the defloration of their precious virgin guts. Maybe getting
a bottle of formula now and again, despite what it might do to
bacterial counts, is actually not such a big deal in terms of
outcomes that actually matter?

As far as the risk of cow's milk
allergy goes, a couple of studies have indeed shown a small risk of
cow's milk allergy associated with early formula top-ups (in the one
for which I have figures
, the risk of developing some sort of later
reaction to cow's milk as a result of having had some in the hospital
was around one in forty), but the research is actually quite
conflicting – another study showed negligible effect, and a randomised controlled trial actually showed a marked decrease in risks of milk allergy in babies with a strong
family history of allergy who received formula before having any
breast milk. So that one is a possible risk, but far from
conclusive.  As for other forms of allergic disease, again, two studies into the effects of early cow's milk exposure haven't shown any increase in later risk of allergies.

The increase in risk of developing Type
1 (insulin-dependent) diabetes does seem to be backed up by better evidence, but needs to be
kept in perspective – this is effectively only going to be an issue
for children who are genetically predisposed to develop Type 1
diabetes in the first place. In other words, only a tiny minority.
If your baby has a close family relative with Type 1 diabetes, it's
probably worth trying to avoid any formula in the early months. If
not, then this one is a negligible enough risk not to be worth
bothering about.

It's fair to say that the available evidence, despite what Calandro and her ilk claim, is in fact fairly limited, and can't currently exclude a small chance that there might be risks associated with even the occasional bottle.  If so, they certainly don't appear to be wildly significant in practical terms, and neither the evidence for them nor the likely magnitude of them justify the kind of scaremongering Calandro is indulging
in. If the only reason you're giving a bottle is to get your baby
used to one, then I think it's probably worth trying to pump a couple
of ounces of milk for that, if possible, rather than giving formula,
and I would have liked to see FFF mentioning this possibility in her post. But, for those parents who've already given or need to give their breastfed babies some formula now and again,
do I think that these uncertain and largely theoretical risks are worth getting worried about? Hell, no.

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How Not To Be A Successful Lactivist

This is another comment-turned-post from the debate over at Fearless Formula Feeder's blog, once again in reply to Alan.  This time, it's in reply to the second part of this comment.

A quick bit of background: One of the features on FFF's blog is a weekly slot where women who've used formula can post their stories – their reasons for doing so and the emotional struggles that so often went into the decision.  It's a great slot not only for allowing people to vent, but also for dispelling the myth that formula is just for women who are too lazy to breastfeed and those formula-feeding mothers could have breastfed if they'd just cared more/tried harder/done a more efficient job of being Supermum.  Unfortunately, it does have one big drawback – reading so many stories of breastfeeding-gone-wrong, all collected in one place, might potentially be offputting to mothers-to-be who are considering breastfeeding but wavering about the possibility.  When FFF mentioned this concern, Alan agreed with it, and stated:

This is precisely the reason I offered a
counter-anecdote about the experience my children's mothers had (no need
even of lactation consultants, never any thrush, mastitis, etc.). At
least one person complained that posting this anecdote was insensitive
to all the readers of the blog who have had trouble; but it was
precisely for those newer readers you mention,–who have yet to attempt
breastfeeding and might start to wonder if they could ever possibly
accomplish such a seemingly Herculean task–that I wanted to provide a
competing narrative, one which happens to be just as true and accurate
as the others.

And I think that's actually a good idea – if properly and sensitively done.
Unfortunately, this is how Alan actually did it. Alan, what I want to explain here is why the way you went about it didn't work, why it annoyed people, and why it is, in fact, practically a case study in how not to do it. 

The first thing you said in that comment, after the
basic information about number and ages of your children, is that
none of them ever had/is planned to have 'a drop' of formula.
Subtext (whether intentional or not): You disapprove of formula to
the extent that you think it worth avoiding even in the smallest
quantities, and speak approvingly of the fact that you have managed
to do so. Problem with this: It potentially alienates any woman
who's already used formula (with either their current baby or a
previous one). They may become concerned about the possibility of
you criticising them for their formula use, and this may put them off
speaking to you for any help or advice that they might have felt able to seek from you had you
handled the conversation differently. (And, unfortunately, this may extend to making them that bit less likely to seek advice from pro-breastfeeders in general, for fear of criticism.  I think the effect of that one line would be a small one, but, when that's within the context of a very anti-formula-feeding society, these effects can add up.)

Following a quick detour onto the topic
of your ex-wife's horrible labours (ooops! just lost anyone who wants
to steer clear of labour scare stories), you make the point you were
trying to make in the first place about how easily breastfeeding all went, and
then promptly move on to boasting about how long your two older
children breastfed for. Now, look at that for a moment through the
eyes of a mother-to-be who's wavering badly on the issue of whether
to breastfeed at all and who isn't too keen on the idea because she
thinks it's sort of icky. How do you think she's going to feel on
hearing about breastfeeding for two or three years? Yes, it might be
inspiring – or it might be daunting to the
point of putting her still further off the whole idea.  (And let's face it, the women who'd find that story inspiring are the ones who are pretty keen on the idea of breastfeeding anyway.  With a comment like that, you're likely to end up preaching to the choir and putting off the very women you actually most want to preach to.)

That gets
even worse when you write about the child who wouldn't take anything
*but* breastmilk for an entire year. The reason many women give for not wanting to breastfeed is that they want somebody else
to be able to feed the baby now and again.  For women who feel this way, you've just confirmed their
worst fears about breastfeeding.

Your comment then hits its nadir in the next paragraph, where, in a moment of truly staggering
tactlessness, you let us all know that you don't believe your
children's IQs would have been as high had they been formula fed, despite the fact that this was in response to a post in which a
woman had been talking about how guilty and distressed she felt about
having to feed her baby formula. 
Without, apparently, the least thought about how that might make the original poster, and the many other blog readers in the same situation as her, feel.  Does that answer your question about who you attacked?

[In
all fairness, as Alan has pointed out to me in comments, he has since
stated his regret for choosing that particular post to comment on
.]

Following that, there were three
more paragraphs of fairly random points related to general themes of
breastfeeding, formula feeding, and lactivism, by which time I think everybody was at a bit of a loss as to
where you were trying to go with this and
the point you'd originally been trying to make was pretty much lost
in the general rambling.

Alan, you asked why anecdotes of problem-free breastfeeding wouldn't be welcome on the blog.  Well, I don't think your anecdote of problem-free breastfeeding was actually the part of your comment that wasn't welcome.  I think that if you'd just sympathised with
the OP, made your point, and shut up (“I'm so sorry to hear things
went so badly for you. Sounds like you were really unlucky – that
sort of problem really is unusual. I know my wife and my ex-wife
both managed to breastfeed easily, and really enjoyed it. What you
went through must have been awful.”), nobody would have minded.  Instead, you had to not only make it into Random Ramblings Of A Lactivist, but do this so tactlessly that it was completely counterproductive to your cause.  And, if you want to be a successful breastfeeding advocate, you just can't get away with that kind of clumsiness.  You stated in another thread that it would all be worthwhile if your comment could convince even one person to breastfeed.  What you've failed to take into account with that argument is the very real risk that going about it so badly will put off rather more than one person in the process.

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