Formula Feeding Doubles Infant Deaths in America

By Linda Folden Palmer, DC
Author of The BABY BOND                    (In Spanish–Click Here)

A recent study published in the journal Pediatrics, (May 2004), titled “Breastfeeding and the Risk of Postneonatal Death in the United States,” reports a 21% reduction in infant death for having EVER breastfed, meaning 27% more infant deaths occur when no breastmilk is provided. The impact is under-reported for two reasons. First, deaths in the first month, the greatest amount of deaths, were not counted. Second, the exclusiveness of breastfeeding is a huge factor and is not part of this measurement.

When they compare 3 months of any breastfeeding to less or no breastfeeding, the reported reduction is 36%. That translates actually to 56% more infant deaths for those receiving mostly formula! If they were to compare 3 months ofexclusive breastfeeding to no breastmilk, the reduction would have been closer to 50% — meaning Double the deaths for withholding of breastmilk: The same number as in my prior analysis BELOW:

 

(ADDED April 2006): This study and my below article are about industrialized nations. A more-recent large-scale study taking place in poor areas of Ghana, India, and Peru found a shocking 10.5 times the number of deaths for those not breastfed versus those exclusively breastfed. Partially breastfed infants had 2.5 times the risk of death as those exclusively breastfed. Bulletin of the World Health Organization, 2005

 

>COMMENTS AT BOTTOM

February 1, 2004 

Infant formula was designed to be a medical nutritional tool for babies who are unable to breastfeed, and survival with today’s formulas is much higher than with some less-developed concoctions such as straight animal milks or powdered milk/syrup mixes. Just like drugs or surgeries, when it’s needed, infant formula is an extremely valuable substitute to have available. No breastmilk substitute meets the optimal nutritional needs for baby, and all artificial feeds fall quite short in providing the immunity needs of infants, leaving their tiny systems flailing. An infant’s immune system has three aspects: her own immature, developing immune system; the small component of immunities that passes through the placenta during natural childbirth (and to a lesser degree with premature births and cesarean sections); and the most vast and valuable, living portion that is passed on through mother’s milk on an ongoing basis. Remove any of these components and you take away a vital support structure.

This brings us face to face with the safety and effectiveness of breast milk substitutes. Is the withholding of breastmilk actually as safe as we have been led to believe? In fact, the answer is a resounding “no.” In fact, the use of infant formula from birth doubles the risk of infant death for American babies.

While the dangers of artificial feeding aren’t something you’re likely to hear in your doctor’s office, the conclusions can be derived through an examination of the available scientific research on infant mortality in the United States and across the world. There are studies showing formula feeding’s impact on overall infant death rates in both developing and undeveloped countries. While studies offering comparative death rates are negligibly available for industrialized regions, there are numerous studies providing comparative occurrence rates for many illnesses and disorders in the United States and other industrialized nations. Many more reports are available extolling superior survival rates and decreased illness rates among breastfed infants, but only those with solid numbers are useful here. We can assemble the statistics from these studies to build a firm picture of the ratio of infant deaths for U.S. formula-fed babies against those who are breastfed.

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The Relative Risks of Formula

It is clear that feeding infants artificially increases their relative risk of death. A number of studies point to this fact. Table 1 shows figures from two studies measuring infant mortality risks during certain age ranges. A risk number of 3 in the chart represents three times the risk of infant death for infants who are artificially fed.

While the numbers in the charts reflect any amount of breastfeeding during the study period (and not necessarily exclusive breastfeeding), nearly all studies mention that during the first six months, exclusive breastfeeding produces much higher survival rates than partial breastfeeding. No studies refute this assertion. Figures for each age range listed here do not include children who died prior to reaching that age group. Figures reflect infants who received no breast milk or had weaned prior to reaching the reported age group versus those who received any breastfeeding through that age.

Table 1 clearly demonstrates that the disadvantages of formula are most devastating in the earliest months. Significant disadvantages for formula continue throughout the year-long study period.

Suggested Relative Risks for Infant Deaths 
No Breastfeeding or Any Breastfeeding Ending Before Designated Age Ranges vs. Breastfeeding Through Designated Age Ranges1,2

Country Author 0 to 2 Months 3 to 5 Months 6 to 11 Months
Mexico Palloni 13 6 3
Brazil, Pakistan and Philippines (pooled) World Health
Organization
0 to 2 Months 2-3 Months 4-5 Months 6-8 Months 9-11 Months
6 4 2.5 2 1.5

A relative risk of 13 here means that a child who was not breastfed through the time period has thirteen times the risk of dying during his first year as a child who had received any breast milk through that period.

The studies cited in the next table compare no breastfeeding with 12 months of breastfeeding, each deriving a relative risk of death over the full first year.

Suggested Relative Risks for Infant Deaths
No Breastfeeding vs. Any Breastfeeding for 12 Months3-7

Country Author Current Infant Mortality Rate (IMR) IMR During Period Study was Performed Relative Risk To Formula-Fed Infants

United States
7 Number we wish to find
Malaysia Habicht 19 30 > 2 *
Mexico (from Table 1) Palloni 24 38 10 *

Philippines

Guilkey
28 31 > 5.5
China Tu 27 36 > 3.0
Peru Palloni 38 100 2.5
Brazil, Pakistan, and Philippines, pooled (from Table 1) WHO 48 average 4.5 *
India Srivastava 61 106 > 1.5

Infant Mortality Rates (IMR) are the number of infant deaths per 1,000 live births, from 0 to 12 months of age.
A relative risk of 5 here means that an infant who receives formula statistically faces five times the risk of dying as an infant who is partially or completely breastfed.
* These values are calculated from numbers provided in the studies, with averages weighted by percentages of total deaths occurring in each age range. More than two-thirds of deaths occur during the first month.

While the United States has a current infant mortality rate of 6.75 per thousand, many countries have rates approaching 100, with 16 of 225 reporting nations suffering well over 100 infant deaths for every 1,000 children born.8 The nations in the above table with lower infant mortality rates can thus be seen as somewhat comparable to the U.S.

Factors influencing high infant death rates include malnourished mothers, high numbers of births per mother with short spacing between births, poor weaning foods, the early use of cow’s milk, inadequate medical attention and supplies, poor sanitation leading to high infection rates and a rapid spread of infectious disease, and limited education about methods of limiting infection and the spread of disease.

Why do U.S. Babies Die?

Below are the percentages and total numbers of U.S. infants who die from various leading causes, according to the 1999 National Vital Statistics Reports.9,10

Total U.S. births in 1999: 4,000,000
Total U.S. infant deaths in 1999: 28,000

 

20% Congenital abnormalities (birth defects) 5,500
0.3% Cancer 100
0.3% Low birth weight and premature birth 100
10% Sudden Infant Death Syndrome (SIDS) 2,700
8.5% Complications during pregnancy and birth 2,400
6% Respiratory distress: lung collapse, influenza, pneumonia 1,750
3% Accidents (unintentional injuries) 850
2.5% Bacterial sepsis (infections) 700
2.4% Circulatory system diseases 650
1.4% Necrotizing enterocolitis 400
1% Intestinal inflammations (diarrhea) 300
0.3% Meningitis 100
0.3% Cancer 100

Numbers account for 70% of total infant deaths

So how does formula play into these deaths? Let’s look at some of the common causes of infant death and see what current research has to say on the involvement of infant formula.

Sudden Infant Death Syndrome (SIDS)
Sudden Infant Death Syndrome (SIDS) accounts for a full 10% of U.S. infant deaths. Several studies performed in the United States and other industrialized nations reveal increased risks of SIDS among babies who receive formula instead of breast milk. In the table below, the 2002 Scandinavian study takes into account variables thought to have affected the 2000 U.S. study, finding even stronger risks associated with formula.

The most recent U.S. study (2003) takes advantage of the lessons from these earlier studies to raise confidence in its final results. Its finding of five times the risk of infant death from SIDS for formula-fed infants seems to be the most powerful statistic yet.

Studies Demonstrating Relative Risks of Infant Death from SIDS
Formula-Fed vs. Breastfed
11-17

Country Author Year of study publication Relative risk for SIDS, formula-fed infants
United States Hauck 2003 5
Scandinavia Alm 2002 1.6 to 5.1
United States McVea 2000 2
Germany Schellscheidt 1997 7.7
England Gilbert 1995 3.1
United States Klonoff-Cohen 1995 2.7
New Zealand Ford 1993 2

A relative risk of 5 here means that an infant who receives formula statistically faces five times the risk of dying from SIDS as an infant who is breastfed.

 

Heart, Circulatory and Respiratory Failure

Premature infants and those with circulatory abnormalities often display one or more warning signs of potential death, including inadequate oxygenation of the blood, apnea (episodes where breathing stops) and high blood pressure. Studies illustrate the dangers of formula for these infants. One study observed better body temperature and superior oxygenation in pre-term infants receiving breast milk. Formula-fed infants demonstrated many episodes of inadequate oxygenation and some apnea, both of which were not seen among the breastfed infants. A Scottish study found significantly better blood pressure among naturally fed infants.

Three U.S. studies are available examining feeding methods for infants with early circulatory problems. One study reported that more than half of infants with congenital heart disease lost oxygenation during bottle feedings, while none did so while breastfeeding. Another study also dealing with heart disease found infants’ growth to be significantly inferior and their hospitalizations to be longer when they were fed formula. A third study of very low birth-weight infants found twice as many episodes of inadequate oxygenation among formula-fed infants as in those who received breast milk.

Heart and Circulatory Disease in Formula-Fed vs. Breastfed18-22

Country Author Year Findings for formula-fed infants
Scotland Wilson 1998 Higher blood pressure
Taiwan Chen 2000 Apnea and many episodes of oxygen desaturation (none among breastfed infants)
Inferior body temperature regulation
USA Bier 1993 Double the episodes of oxygen desaturation
USA Combs 1993 Less growth; longer hospital stays
USA Marino 1995 Oxygen desaturation during more than half of bottle feedings (none during breastfeeding)

 

Necrotizing Enterocolitis
Necrotizing enterocolitis is a severe intestinalinflammatory disorder that affects around 4% of low birth-weight babies and 1% of full-term infants. About one-third of low birth-weight infants and 20% of full-term infants who contract this disorder die. While necrotizing enterocolitis is reported to be responsible for 1.4% of infant deaths, many more unconfirmed cases are likely to be responsible for some portion of infant deaths reported as caused by prematurity.

In the United Kingdom, it was discovered that confirmed cases of necrotizing enterocolitis occurred in three times as many infants who received no breast milk as in those who received both breast milk and formula. For infants who exclusively received breast milk, necrotizing enterocolitis occurred six to 10 times less often than among wholly formula-fed infants.

Necrotizing Enterocolitis23

Country Author Year Relative risk of necrotizing enterocolitis, formula-fed infants
United Kingdom Lucas 1990 6-10 times more often

 

Diarrhea
A World Health Organization (WHO) study revealed a risk of diarrhea for formula-fed babies in developing nations averaging more than six times that of breastfed babies. A summary article for industrialized nations demonstrated an average of triple the risk of diarrhea for formula-fed babies. The risk in China and Israel is reported as slightly less than triple (2.8); in Scotland, the risk is five-fold; and a doubled risk is measured in Canada.

While one study noted nearly twice the risk of developing diarrhea for artificially fed infants in Brazil, other studies have demonstrated that the risk of actually dying from diarrhea was an astounding 14 to 15 times greater. The latter studies demonstrated not only that the artificially fed infants suffer higher rates of illness, but also that the severity and duration of their illnesses are even greater when they do occur and result in proportionately more deaths. This same assertion is demonstrated in a study from India, where formula-fed infants suffer six times the death rate, once diarrhea occurs, as breastfed infants with diarrhea.

Four separate studies in the United States all deduce a doubled risk of diarrhea for formula-fed babies. The U.S. studies also reiterate the well-established factor of greater severity and extent of illness once diarrhea does occur among formula-fed babies. Death rates for formula-fed U.S. infants who get diarrhea may be three times higher or more than their breastfed contemporaries.

The table below collates the reported risks of diarrhea for formula-fed infants from many studies.

Diarrhea Risks for Formula-Fed vs. Breastfed24-40

Country Author Year
Relative risk of diarrheal illness (or death), formula-fed infants
Israel Palti 1984 2.7 (during the first 5 months)
Brazil
Victora
1989 14 times the death rate
Scotland Howie 1990 5 (compared with infants with 3 months of breastfeeding)
India Sachdev 1991 6 times the death rate with diarrhea during the first 6 months
Canada Beaudry 1995 1.9
Philippines Yoon 1996 9 times the death rate
Mexico Lopez-Alarcon 1997 4 to 6.3
Industrialized nations, pooled Golding 1997 3 (gastroenteritis and diarrhea)
China Fu 2000 2.8 (during the first 4 months)

6 developing nations
WHO 2000 6 (during the first 6 months)
Italy Gianino 2002 3 (rotavirus, including increased severity)
Brazil Escuder 2003 15 times the death rate (during the first 6 months)
2.2 times the death rate (from 4 to 11 months)
Brazil Vieira 2003 1.8
USA Dewey 1995 2
USA Scariati 1997 1.8
USA Wright 1998
2
USA Raisler 1999 2 (during the first 6 months)

 

Respiratory Illnesses
Numerous studies document higher numbers of respiratory infections among formula-fed infants than among those who are breastfed. It is clear that respiratory infections are at least triple in the United States for formula-fed infants. The death rate is likely to be even higher, since some of these studies note that both the severity and extent of respiratory illnesses are considerably higher once they occur.

Respiratory Illness Risks for Formula-Fed vs. Breastfed41-50

Country Author Year Relative risk of respiratory illness (or death), formula-fed infants
Israel Palti 1984 3.7 (during the first 5 months)
Brazil Victora 1987 3.6 times death
Italy Pisacane 1994 4.5
Mexico Lopez 1997 2 to 8.5 (during the first 4 months)
1.5 to 3 times as many days for each occurrence
Scotland Wilson 1998 1.9 (during the first 4 months)
Brazil Cesar 1999 17 times hospitalization for pneumonia
USA Wright 1998 2 (bronchitis)
4 (pneumonia)
USA Levine 1999 3.7 (pneumococcal disease, 2 to 11 months)
USA Blaymore- Bier 2002 6 times as many days of upper respiratory infection (during the first month)
USA Bachrach 2003 3.5 (severe respiratory tract illnesses)

 

 Cancer

A joint study between the United States and Canada on neuroblastoma, a common childhood cancer, revealed a doubled risk for children who did not receive breast milk for more than one year. This study is consistent with several other childhood cancer studies in other nations, with results ranging from 1.45 to 4 times the risk for developing various common childhood cancers for formula-fed babies.

Childhood Cancer Risks for Formula-fed vs. Breastfed51-56

Country Author Year Findings for formula feeding and cancer risks
China Shu 1995 1.5 (leukemia and lymphoma)
UAE Bener 2001 2.8 (leukemia and lymphomas for no or less than 6 months breastfed versus longer breastfeeding)
France Perrillat 2002 2 (leukemia for breastfeeding over 6 months)
U.S. & Canada Daniels 2002 2 (neuroblastoma)

 

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Low Birth-Weight and Pre-term Birth
Representing 16%
 of U.S. infant mortality totals, premature birth and low birth-weight are the second leading diagnoses on death certificates of U.S. infants. While prematurity may lay the foundation for difficulties in tiny infants, the factors that actually take their lives include infection, respiratory distress, unconfirmed necrotizing enterocolitis, circulatory deficiency and diarrhea. These diagnoses are often detectable only with a biopsy, so the listed cause in these cases is often simply prematurity. One study that performed autopsies on a group of extremely low birth-weight infants who had not survived found that infection was the actual primary cause of death for half of the infants. Prematurity was the cause of death predominantly for infants who weighed less than one pound.

Preemies in India who received only preemie formula were found to develop more than twice as many infections as those who received some human milk. Another Indian study on high-risk newborns found that those receiving human milk plus formula suffered twice the infection rate of those receiving only pasteurized human milk and triple the rate of those receiving only raw human milk. A Columbian study found a nearly doubled death rate for low birth-weight infants who were partially or completely formula fed. And a Malaysian study found a huge difference in total infant survival among extremely low birth-weight babies who received expressed breast milk as opposed to those who did not.

A U.S. study performed at George Washington University Hospital found 2.5 times the number of infections among formula-fed infants in the intensive care unit than among those receiving human milk. Another study at Georgetown University Medical Center also found more than double the number of infections in very low birth-weight infants not receiving human milk. A San Diego study found twice as many infections in pre-term, formula-fed infants compared with infants who received human milk.

As shown in many other studies, the extent and severity of infection among pre-term and low birth-weight infants are generally greater in formula-fed infants as well. One study gives a solid example for preemies, finding respiratory infections among U.S. formula-fed preemies to run six times as many days as those in their breastfed counterparts.

Pre-term Infant Illness and Death Rates57-64


Country
Author Year Relative risk for illness or death, formula-fed pre-term and low birth-weight infants
India Narayanan 1980 2.25 times the infections for no breast milk as opposed to some
India Narayanan 1984 2 times the infections for formula plus pasteurized breast milk as pasteurized breast milk alone3 times the infections as raw breast milk alone
Malaysia Boo 2000 Many times the death rate for no breast milk
Columbia Charpak 2001
2 times the death rate for any amount of formula as for exclusive breastfeeding
USA el-Mohandes 1997 2.5 times the infections
USA Hylander 1998 2 times the infections
USA Schanler 2001 2 times the infections
USA Blaymore-Bier 2002 6 times the duration of upper respiratory infections

 

Exclusive feeding of raw breast milk is not always an option for premature infants, although it is common in some hospitals with excellent support. Sometimes, less-effective pasteurized breast milk is used and often fortifiers are added. Several studies show decreased survival for infants fed milk with added fortifiers as opposed to those fed unfortified milk,65-68 but the picture is complex and the choices of fortifiers vary greatly.

And finally, it is worth noting that the eye damage that can occur in very low birth-weight infants, retinopathy of prematurity, occurs only half as often in infants who receive some breast milk.69 Even a disorder as apparently unrelated to feeding methods as inguinal hernia has been discovered to occur twice as often in artificially fed infants and even more frequently when compared with infants who are exclusively breastfed.70

Congenital Abnormalities
Twenty percent of U.S. infant deaths are attributed to birth defects. The most common potentially lethal birth defects include heart disorders, various chromosomal or genetic defects and underdeveloped lungs. In terms of infant formula’s impact, we have the least amount of statistical information in this category. However, many factors suggest that formula-fed infants with congenital abnormalities have smaller chances of survival than their breastfed counterparts.

While death certificates often list the initial abnormality as the cause of death, infection is actually the final factor in many of these deaths. We have already seen how drastically infection rates and deaths are reduced by breastfeeding. It is clear that the youngest and weakest infants are the ones who are most strongly endangered by infant formula’s inadequacies.

Studies suggest that formula-fed infants suffer inferior blood oxygenation and higher blood pressure as well as more episodes of apnea (cessation of breathing for a short time) than their breastfed counterparts. While no studies compare the actual survival of such infants in the United States, it is obvious that some proportion of babies with congenital heart abnormalities is being seriously disadvantaged by formula feedings. Artificially fed infants with heart defects requiring surgery are less likely to live until their surgery and less likely to recover from surgery’s challenges.

A wide variety of common birth defects has been shown to have better survival rates among breastfed infants, although the actual figures are not available. Most birth defects have not been specifically studied in this regard. The background information, nonetheless, is striking.

For example, infants born with phenylketonuria (PKU), a defect in handling a certain protein in the diet, need specialized supplementation to breast milk in order to prevent mental retardation and other difficulties. Yet a study demonstrated that infants who had been breastfed before being diagnosed with PKU fared far better than those who had been fed on formula.71 The greatest complications for infants with cystic fibrosis are lung infection, decreased oxygenation and malnutrition — all of which are recognized to be complicated by formula feeding.72 The negative impact of formula on neurological development has been demonstrated in healthy infants.73-76 One study that quantified the effect reported double the amount of neurological “non-normality” in formula-fed infants.77 It is reasonable to assume that neurological damage or problems stemming from birth disorders can be exacerbated by artificial feeding.

Clearly, feeding choice may have a significant impact on the survival of infants born with various defects, although there is not enough information available to render an actual ratio of survival.

Complications of Pregnancy and Birth

Complications of pregnancy and birth produce a wide range of injuries and problems for babies. Some certainly pose no hope of survival. Infection, insufficient neurological recovery and inadequate oxygenation lead to many infant deaths. Artificial feeding certainly has some degree of impact on mortality in these cases. Based on a lack of further detailed evidence, we will apply a very modest number to figures for increased risk of death for formula-fed infants in this category.

Accidents 
It seems logical that accidents happen equally among artificially and naturally fed infants. Figures bear this out. One paper actually measured accidental injuries between breast- and formula-fed infants, finding an equal number in both.78

Examining the Numbers
So now we are left to examine artificial feeding’s actual impact on all American babies. First, we note that there should be a relationship dictating that if rates for a certain disease are doubled by formula feeding, for instance, then death rates for that disease may also be somewhere in the neighborhood of doubled when compared with rates for breastfed infants. In fact, the evidence suggests that the death rates would be even higher. While formula feeding may result in twice as many episodes of a certain illness, a great number of studies demonstrate that each of these episodes are also longer and more severe. This would suggest that the rate of death among artificially fed infants from various causes would actually be higher than the rates that the various illnesses occur.

The reported percentages of U.S. infants dying from each cause include a certain number of infants who were breastfed and a portion who were formula-fed. Because formula feeding’s impact is much more or less influential in some disorders than others, we need to weigh each category accordingly. (This exercise will account for the assumption that a lower proportion of infants who died from congenital abnormalities, for instance, were formula-fed infants than the proportion who died from SIDS.) Because two-thirds of all infants die in the first month, and because exclusive breastfeeding runs about 50% during the first month, this number can be used in the calculations to help weigh the greater or lesser impact of breastfeeding for each cause.

2001 U.S. Breastfeeding Rates79,80

Study Hospital Initiation 4 Months 6 Months 12 Months
Any BF Exclusive Any BF Exclusive Any BF Exclusive Any
Ross/Abbott Labs 69.5% 46.2% 32.5% 17.2%
National Immunization Survey 65.1% 59% 35% 24% 27% 7.9% 12.3%

An overall risk rate of infant death for formula-fed infants has been selected conservatively based on the available information presented in this paper for each cause of death in the table below. Assuming that 50% of the total infants born were breastfed, we can calculate formula-fed and breastfed infant death rates and totals for each cause.

Because one-third of the deaths actually occurred as the percentage of infants breastfeeding was dropping to a much smaller number, the use of 50% throughout the calculations keeps the resultant finding very conservative. Although the literature reiterates time and again how the extent, severity and frequency of disease is greater in formula-fed infants, I have only taken this factor into account in an extremely conservative manner in instances where the literature provides solid numerical examples. In other instances where this aspect is not clearly demonstrated, I have not used this factor at all. Again, this effort keeps the final quotient conservative. Finally, the ratios from many studies used are for full formula feeding versus any amount of breastfeeding. Some of these ratios would be much higher if formula feeding were compared to exclusive breastfeeding. This factor again keeps our final conclusion conservative.

Here’s the Crude Math
There are 4,000,000 births annual births in the United States. Using 50% as the number of infants who have actually been breastfed, the number of infants breastfed (B) equals 2,000,000. The number of formula-fed (F) infants also equals 2,000,000.

B = F = 2,000,000
R = Infant Mortality Rate (IMR) for each cause
RB = IMR for breastfed

RF = IMR for formula fed
Rel = Estimated Relative Risk for formula feeding versus breastfeeding, for each cause
RFF + RBB = Total Number of Deaths for that cause = TND
RF = Rel x RB
RF x 2,000,000 + RB x 2,000,000 = TND
Rel x RB x 2,000,000 + RB x 2,000,000 = TND
RB = __________TND___________
Rel x 2,000,000 + 2,000,000
RB x 4,000,000 = Number Deaths if all B

 


Let’s apply this formula to congenital abnormalities. Clearly, feeding’s impact in this category could be significant, but there is not enough solid statistical evidence to say for sure. If we modestly assume a 50% higher death rate for the 50% of formula-fed infants, the number of breastfed infants who died would be 2,200. The number of formula-fed who died would be 3,300. If all of the infants had actually been breastfed, then the total number of deaths would be 4,400 — a savings of 1,100 lives.

The relative risk for formula feeding in other categories was much more clearly defined by the studies. Conservative but appropriate rates were selected, as seen in the table below.

Calculating Formula’s Final Impact

Cause of death Actual U.S. infant deaths (1999) Relative risk for formula-fed infants Estimated
IMR for breastfed babies
Deaths if all were breastfed Deaths if all were formula-fed Lives saved if all were breastfed
Congenital abnormality  5500  1.5  1.1  4400  6600  1100
Prematurity  4500  2.5  .643  2570  6430  1930
SIDS  2700  4   .27  1080  4320  1620
Complications of pregnancy & birth  2400 1.25  .533 2135 2670 270
Respiratory distress & infections 1750 4 .175 700 2800 1050
Accidents 850 1 .213 850 850 0
Bacterial infection 700 3 .087 350 1050 350
Circulatory problems 650 1.5 .13 520 780 130
Necrotizing enterocolitis 400 8 .022 90 710 310
Diarrhea 300 2.5 .043 170 430 130
Meningitis 100 3 .014 55 170 45
Cancer 100 2 .02 80 160 20
SUBTOTALS 19950 2.075 3.25 13000 26970 6955
All other 8050 2 1.6 6440 12880 1610
TOTALS 28000 2 4.7 18665 37335
IMR 9.4
9335

Infant Mortality Rates (IMR) are the number of infant deaths per 1,000 live births, from 0 to 12 months of age.

Based on the current U.S. infant death rate of 6.75 and an average breastfeeding rate of 50%, the American infant mortality rate would climb to 9.4 if all infants were formula-fed and would drop to 4.7 if all were breastfed. Twenty-two nations with high rates of breastfeeding have infant mortality rates below 5, while the U.S. ranks higher in infant death than 41 other nations.81 Clearly, lower rates for the United States are a possibility.

The Ugly Truth About Formula
From the above statistics, we see that formula feeding costs American babies more than four additional lives per thousand. The final relative risk for formula feeding comes out to 2 — that’s double the risk of death for American infants who are fed with formula, compared with babies who are fed naturally.

A multitude of studies demonstrate that when breastfeeding is accompanied by formula supplementation, illness and death rates are much closer to those of babies who are fully formula-fed. Studies also reveal conclusively that the longer breastfeeding lasts, the greater the measurable difference in illness and death rates.

Answering the Detractors

Criticisms are often spread about studies that find increased illness and death rates associated with formula feeding. For just this reason, each later study aggressively attempts to take into account any factors that have been purported as distorting previous study outcomes. These research papers address as many aspects as possible, from maternal education, to smoking, to income level, to day care usage and many more possibilities. The results continue to reveal the risks of formula feeding.

It’s commonly said that formula feeding does not risk lives in industrialized nations where education and medical advances prevent increased deaths. The evidence is quite to the contrary. Some insist that the blame for the United States’ relatively high infant death rate lies with underprivileged communities. Again, it has been shown that elevated death rates among U.S. blacks cannot be attributed to poverty. Hispanic Americans rank similarly to African-American populations for socio-economic factors, but they match non-Hispanic whites in their lower infant mortality rates. The difference is not socio-economic; rather, it’s in rates of formula use versus breastfeeding.82-84

A New York study sought to establish the connection between education, income and infant survival. It concluded strongly that the number of illnesses is increased by two to three times in formula-fed babies regardless of socioeconomic status or level of parental education.85 A later study in Israel confirmed the effects of formula feeding across all classes and education levels.86 The most recent analysis of this issue, again performed in the United States, reiterated that higher illness rates among formula-fed or formula-supplemented infants “did not differ among income groups.”87

And Beyond the First Year
While the extent of breast milk’s health protection declines with age, a great number of studies demonstrate the continued survival advantage of breastfeeding through the second year and beyond. A World Health Organization study of less-developed countries found a doubled risk of death in the second year of life for those weaned prematurely or never receiving breast milk.88 A study in The Netherlands found a strong correlation between the extent of breastfeeding and the number of illnesses in children. Significant protection from breastfeeding was noted during the first three years of life.89 Other studies show a sizeable increase in illnesses throughout all of childhood for those who were never breastfed or prematurely weaned.90-92 In fact, an increased risk of death throughout life has been well documented for people who were formula-fed. Higher blood pressure, more heart disease, obesity, diabetes and artery disease, a nearly doubled rate of Crohn’s disease and tripled rates of celiac disease have all been associated with early formula feeding.93-105

What Your Doctor Doesn’t Tell You 
Pediatricians spend much time frightening parents with 1 in 100,000 risks from some vaccine-preventable diseases when parents question the utility and safety of vaccines. “Would you want to risk the life of your child?” they demand. Yet these very same professionals offer formula samples with the other hand — when the magnitude of health risks associated with the use of formula is 5 times greater.

Parenting is all about making choices and weighing risks and benefits. Many parents need to make the riskier choice of formula feeding in order to balance other factors that benefit the family. Yet some parents who have lost their children, possibly based on pediatric advice condoning or encouraging formula-feeding, would surely wish that they had been informed of the very real risks related to using formula.

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ENDNOTES
1. Palloni et al., “The effects of breast-feeding and the pace of childbearing on early childhood mortality in Mexico,” Bulletin of the Pan American Health Organization (Mexico) 28, no.2 (Jun 1994): 93-111.

2. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality, “Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis,” Lancet 355, no. 9202 (Feb 2000): 451-5.

3. J.P. Habicht et al., “Does breastfeeding really save lives, or are apparent benefits due to biases?” American Journal of Epidemiolofy 123, no. 2 (Feb 1986): 279-90.

4. D.K. Guilkey and R.T. Riphahn, “The determinants of child mortality in the Phillipines: estimation of a structural model,” Journal of Development Economics (US and Germany) 56, no. 2 (Aug 1998): 281-305.

5. P. Tu, “The effects of breastfeeding and birth spacing on child survival in China,” Studies in Family Planning (China) 20, no. 6 (Nov.-Dec. 1989): 332-342.

6. Palloni and M. Tienda, “The effects of breastfeeding and pace of childbearing on mortality at early ages,” Demography (US) 23, no. 1 (Feb 1986): 31-52.

7. S.P. Srivastava et al., “Mortality patterns in breast versus artificially fed term babies in early infancy: a longitudinal study,” Indian Peadrics (India) 31, no. 11 (Nov 1994): 1393-6.

8. The World Fact Book,https://www.cia.gov/cia/publications/factbook/rankorder/2091rank.html in 2004. Current stats: https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

9. National Vital Statistics Report, 49, no. 11 (Oct 12, 2001): 14.

10. National Vital Statistics Report, 50, no. 16 (Sep 16, 2002): 1-12.

11. F.R. Hauck et al., “Sleep environment and the risk of Sudden Infant Death Syndrome in an urban population: the Chicago infant mortality study,” Pediatrics (US) 111, no. 5 (May 2003): 1207-1214.

12. B. Alm et al., “Breastfeeding and the sudden infant death syndrome in Scandinavia, 1992-1995,” Archives of Disease in Childhood (Sweden) 86 (2002:400-402.

13. K.L. McVea et al., “The role of breastfeeding in sudden infant death syndrome,” Journal of Human Lactation (US) 16, no. 1 (Feb 2000): 13-20.

14. J. Schellscheidt et al., “Epidemiological features of sudden infant death after a German intervention campaign in 1992,” Eur J Pediatr (Germany) 156, no. 8 (Aug 1997): 655-60.

15. R.E. Gilbert, “Bottle feeding and the sudden infant death syndrome,” British Medical Journal (England) 310, no. 6972 (Jan 14, 1995): 88-90.

16. H.S. Klonoff-Cohen et al., “The effect of passive smoking and tobacco exposure through breast milk on sudden infant death syndrome,” JAMA (US) 273, no. 10 (Mar 1995): 795-8.

17. R.P. Ford et al., “Breastfeeding and the risk of sudden infant death syndrome,” International Journal of Epidemiology (New Zealand) 22, no. 5 (Oct. 1993): 885-90.

18. A.C. Wilson et al., “Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study,” BMJ (Scotland) 316, no. 7124 (Jan 1998): 21-5.

19. C.H. Chen et al., “The effect of breast- and bottle-feeding on oxygen saturation and body temperature in preterm infants,” Journal of Human Lactation (Taiwan) 16, no. 1 (Feb 2000): 21-7.

20. J.B. Bier et al., “Breast-feeding of very low birth weight infants,” Journal of Pediatrics (Rhode Island, USA) 123, no. 5 (Nov 1993): 773-8.

21. V.L. Combs and B.L. Marino, “A comparison of growth patterns in breast and bottle-fed infants with congenital heart disease,” Pediatric Nursing (USA) 19, no. 2 (Mar-Apr 1993):175-9.

22. B.L. Marino et al., “Oxygen saturations during breast and bottle feedings in infants with congenital heart disease,” Journal of Pediatric Nursing (USA) 10, no. 6 (Dec 1995): 360-4.

23. A. Lucas and T.J. Cole, “Breast milk and neonatal necrotising enterocolitis,” Lancet (UK) 336, no. 8730 (Dec 22-29, 1990): 1519-23.

24. H. Palti et al., “Episodes of illness in breast-fed and bottle-fed infants in Jerusalem,” Israel Journal of Medical Science (Israel) 20, no. 5 (May 1984): 395-9.

25. C.G. Victora et al., “Infant feeding and deaths due to diarrhea. A case-control study,” American Journal of Epidemiology (Brazil) 129, no. 5 (May 1989): 1032-41

26. P.W. Howie et al., “Protective effect of breast feeding against infection,” British Medical Journal (Scotland) 300, no. 6716 (Jan 6, 1990): 11-6.

27. H.P. Sachdev et al., “Does breastfeeding influence mortality in children hospitalized with diarrhoea?” Journal of Tropical Pediatrics (India) 37, no. 6 (Dec 1991): 275-9.

28. M. Beaudry et al., “Relation between infant feeding and infections during the first six months of life,” Journal of Pediatrics (Canada) 126, no. 2 (Feb 1995): 191-7.

29. P.W. Yoon, “Effect of not breastfeeding on the risk of diarrheal and respiratory mortality in children under 2 years of age in Metro Cebu, The Philippines,” American Journal of Epidemiology (Philippines) 143, no. 11 (Jun 1996): 1142-8.

30. M. Lopez-Alarcon et al., “Breast-feeding lowers the frequency and duration of acute respiratory infection and diarrhea in infants under six months of age,” J Nutr (Mexico) 127, no. 3 (Mar 1997): 436-43.

31. J. Golding et al, “Gastroenteritis, diarrhoea and breast feeding,” Early Human Development (England) 49, suppl. (Oct 29, 1997): S83-103

32. Z. Fu et al., “Exclusive breastfeeding and growth of infants under 4 months in China,” Wei Sheng Yan Jiu (Center for Public Health Information, Chinese Academy of Preventive Medicine) 29, no. 5 (Sep 2000): 275-8.

33. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality, “Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis,” Lancet 355, no. 9202 (Feb 2000): 451-5.

34. P. Gianino et al., “Incidence of nosocomial rotavirus infections, symptomatic and asymptomatic, in breast-fed and non-breast-fed infants,” Journal Of Hospital Infection (Italy) 50, no. 1 (Jan 2002): 13-7.

35. M.M. Escuder et al., “Impace estimates of breastfeeding over infant mortality,” Rev Saude Publica (Brazil) 37, no. 3 (Jun 2003): 319-25.

36. G.O. Vieira et al., “Child feeding and diarrhea morbidity,” Journal of Pediatrics (Brazil) 79, no. 5 (Sep-Oct 2003): 449-54.

37. K.G. Dewey et al., “Differences in morbidity between breast-fed and formula-fed infants,” Journal of Pediatrics (Davis, USA) 126, no. 5, pt. 1 (May 1995): 696-702.

38. P.D. Scariati et al., “A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States,” Pediatrics (USA) 99, no. 6 (Jun 1997): E5.

39. A.L. Wright et al., “Increasing breastfeeding rates to reduce infant illness at the community level,” Pediatrics (Tucson, USA) 101, no. 5 (May 1998): 837-44.

40. J. Raisler et al., “Breast-feeding and infant illness: a dose-response relationship?” Am J Public Health (Ann Arbor, USA) 89, no. 1 (Jan 1999): 25-30.

41. H. Palti et al., “Episodes of illness in breast-fed and bottle-fed infants in Jerusalem,” Israel Journal of Medical Science (Israel) 20, no. 5 (May 1984): 395-9.

42. C.G. Victora et al., “Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil,” Lancet (Brazil) 2, no. 8554 (Aug 1987): 319-22.

43. Pisacane et al., “Breastfeeding and acute lower respiratory infection,” Acta Paediatr (Italy) 83, no. 7 (Jul 1994): 714-8.

44. M. Lopez-Alarcon et al., “Breast-feeding lowers the frequency and duration of acute respiratory infection and diarrhea in infants under six months of age,” J Nutr (Mexico) 127, no. 3 (Mar 1997): 436-43.

45. A.C. Wilson et al., “Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study,” BMJ (Scotland) 316, no. 7124 (Jan 1998): 21-5.

46. J.A. Cesar et al., “Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study,” British Medical Journal (Brazil) 318, no. 7194 (May 1999): 1316-20.

47. A.L. Wright et al., “Increasing breastfeeding rates to reduce infant illness at the community level,” Pediatrics (USA) 101, no. 5 (May 1998): 837-44.

48. O.S. Levine et al., “Risk factors for invasive pneumococcal disease in children: a population-based case-control study in North America,” Pediatrics (USA) 103, no. 3 (Mar 1999): E28.

49. M.D. Blaymore Bier et al., “Human milk reduced outpatient upper respiratory symptoms in premature infants during their first year of life,” Journal of Perinatology (Providence, USA) 22, no. 5 (Jul/Aug 2002): 354-359.

50. V.R. Bachrach et al., “Breastfeeding and the risk of hospitalization for respiratory disease in infancy: a meta-analysis,” Archives of Pediatric Adolescent Medicine (USA) 157, no. 3 (Mar 157): 237-43.

51. X.O.Shu et al., “Infant breastfeeding and the risk of childhood lymphoma and leukaemia,” International Journal of Epidemiology (China) 24, no. 1 (Feb 1995): 27-32.

52. Bener et al., “Longer breast-feeding and protection against childhood leukaemia and lymphomas,” European Journal of Cancer (UAE) 37, no. 2 (Jan 2001): 234-8.

53. F. Perrillat et al., “Day-care, early common infections and childhood acute leukaemia: a multicentre French case-control study,” British Journal of Cancer (France) 86, no. 7 (Apr 8, 2002): 1064-9.

54. J.L. Daniels et al., “Breastfeeding and neuroblastoma, USA and Canada,” Cancer Causes and Control (USA, Canada) 13, no. 5 (Jun 2002): 401-5.

55. G.P. Mathur et al., “Breastfeeding and childhood cancer,” Indian Pediatrics (India) 30, no. 5 (May 1993): 651-7.

56. M.K. Davis, “Review of the evidence for an association between infant feeding and childhood cancer,” International Journal of Cancer (USA) 11, supp. (1998): 29-33.

57. I Narayanan et al., “Partial supplementation with expressed breast milk for prevention of infection in low birth weight infants,” Lancet (India) 2 (1980): 561-3.

58. Narayanan et al., “Randomised controlled trial of effect of raw and holder pasteurized human milk and of formula supplements on incidence of neonatal infection,” Lancet (India) 2, no. 8412 (Nov 17, 1984): 1111-3.

59. N.Y. Boo et al., “The role of expressed breastmilk and continuous positive airway pressure as predictors of survival in extremely low birthweight infants,” Journal of Tropical Pediatrics (Malaysia) 46, no. 1 (Feb 2000): 15-20.

60. N. Charpak et al., “A randomized, controlled trial of kangaroo mother care: results of follow-up at 1 year of corrected age,” Pediatrics (Columbia) 108, no. 5 (Nov 2001): 1072-9.

61. A.E. el-Mohandes et al., “Use of human milk in the intensive care nursery decreases the incidence of nosocomial sepsis,” Journal of Perinatology (Washington, DC) 17, no. 2 (Mar-Apr 1997): 130-4.

62. M.A. Hylander et al., “Human milk feedings and infection among very low birth weight infants,” Pediatrics (Washington, DC) 102, no. 3 (Sep 1998): E38.

63. J. Schanler et al., “Feeding strategies for premature infants: Beneficial outcomes of feeding fortified human milk versus preterm formula,” Pediatrics (USA) 103, no. 6 (June 1999): 1150-1157.

64. M.D. Blaymore Bier et al., “Human milk reduced outpatient upper respiratory symptoms in premature infants during their first year of life,” Journal of Perinatology (Providence, USA) 22, no. 5 (Jul/Aug 2002): 354-359.

65. S. Awasthi et al., “Is high protein milk beneficial for SGA-terms?” Indian Pediatr 26, no. 1 (Jan 1989): 45-51.

66. G. Boehm et al., “[Protein utilization by premature infants with a birth weight less than 1,500 g during nutrition with MANSAN or breast milk protein],” Kinderarztl Prax (German) 59, no. 1-2 (Jan-Feb 1991): 26-30.

67. R. Quan et al., “The effect of nutritional additives on anti-infective factors in human milk,” Clin Pediatr (Phila) 33, no. 6 (Jun 1994): 325-8.

68. A. Lucas et al., “Randomized outcome trial of human milk fortification and developmental outcome in preterm infants,” Am J Clin Nutr (England) 64, no. 2 (Aug 1996): 142-51.

69. M.A. Hylander et al., “Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants,” Journal of Perinatology 21, no. 6 (Sep 2001): 356-62.

70. A. Pisacane et al., “Breast-feeding and inguinal hernia,” Journal of Pediatrics (Italy) 127, no. 1 (Jul 1995): 109-11.

71. E. Riva et al., “Early breastfeeding is linked to higher intelligence quotient scores in dietary treated phenylketonuric children,” Acta Paediatrica (Italy) 85, no. 1 (Jan 1996): 56-8.

72. Borowitz et al., “Consensus report on nutrition for pediatric patients with cystic fibrosis,” Pediatric Gastroenterology and Nutrition (USA) 35, no. 3 (Sep 2002): 246-59.

73. E. Riva et al., “Early breastfeeding is linked to higher intelligence quotient scores in dietary treated phenylketonuric children,” Acta Paediatrica (Italy) 85, no. 1 (Jan 1996): 56-8.

74. J.W. Anderson et al., “Breast-feeding and cognitive development: a meta-analysis,” American Journal of Clinical Nutrition (USA) 70, no. 4 (Oct 1999): 525-35.

75. W.H. Oddy et al., “Breast feeding and cognitive development in childhood: a prospective birth cohort study,” Paediatric Perinatal Epidemiology (Australia) 17, no. 1 (Jan 2003): 81-90.

76. M.R. Rao et al., “Effect of breastfeeding on cognitive development of infants born small for gestational age,” Acta Paediatrica (USA) 91, no. 3 (2002):267-74.

77. C.I. Lanting et al., “Neurological differences between 9-year-old children fed breast-milk or formula-milk as babies,” Lancet (Netherlands) 344, no. 8933 (Nov 12, 1994): 1319-22.

78. A.L. Wright et al., “Increasing breastfeeding rates to reduce infant illness at the community level,” Pediatrics (Tucson, USA) 101, no. 5 (May 1998): 837-44.

79. A.S. Ryan et al., “Breastfeeding continues to increase into the new millennium,” Ross Products Division of Abbott Laboratories (US) 110, no. 6 (Dec 2002): 1103-9.

80. L.R. Zhao et al., “Prevalence of breastfeeding in the United States: the 2001 National Immunization Survey,” Pediatrics (US) 111, no. 5, part 2 (May 2003): 1198-201.

81. The World Fact Book, http://www.cia.gov/cia/publications/factbook/rankorder/2091rank.html
R. Li et al., “Prevalence of breastfeeding in the United States: the 2001 National Immunization Survey” Pediatrics (USA) 111, no 5., part 2 (May 2003): 1198-201.

82. R. Li and L. Grummer-Strawn, “Racial and ethnic disparities in breastfeeding among United States infants: Third National Health and Nutrition Examination Survey, 1988-1994,” Birth (USA) 29, no. 4 (Dec 2002): 251-7.

83. R. Li et al., “Prevalence of breastfeeding in the United States: the 2001 National Immunization Survey” Pediatrics (USA) 111, no 5., part 2 (May 2003): 1198-201.

84. R. Forst et al., “The decision to breastfeed in the United States: does race matter?” Pediatrics (USA) 108, no. 2 (Aug 2001): 291-6.

85. A.S. Cunningham, “Morbidity in breast-fed and artificially fed infants,” Journal of Pediatrics (New York) 90, no. 5 (May 1977): 726-9.

86. H. Palti et al., “Episodes of illness in breast-fed and bottle-fed infants in Jerusalem,” Israel Journal of Medical Science (Israel) 20, no. 5 (May 1984): 395-9.

87. J. Raisler et al., “Breast-feeding and infant illness: a dose-response relationship?” Am J Public Health (Ann Arbor) 89, no. 1 (Jan 1999): 25-30.

88. “Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality” Lancet 355, no. 9202 (Feb 2000): 451-5.

89. C. van den Bogaard et al., “The relationship between breast-feeding and early childhood morbidity in a general population,” Fam Med (Netherlands) 23, no. 7 (Oct-Sep 1991): 510-5.

90. A.C. Wilson et al., “Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study,” BMJ (Scotland) 316, no. 7124 (Jan 1998): 21-5.

91. S.A. Silfverdal et al., “Protective effect of breastfeeding: an ecologic study of Haemophilus influenzae meningitis and breastfeeding in a Swedish population,” Int J Epidemiol (Sweden) 28, no. 1 (Feb 1999): 152-6.

92. L.A. Hanson, “Human milk and host defence: immediate and long-term effects,” Acta Paediatrica (Sweden) 88, no. 430 suppl. (Aug 1999): 42-6.

93. A.C. Wilson et al., “Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study,” BMJ (Scotland) 316, no. 7124 (Jan 1998): 21-5.

94. A.C. Ravelli et al., “Infant feeding and adult glucose tolerance, lipid profile, blood pressure, and obesity,” Archives of Disease in Childhood (UK) 82 (March 2000): 248-52.

95. S.B. Roberts, “Prevention of hypertension in adulthood by breastfeeding?” Lancet (USA) 357, no. 9254 (Feb 10, 2001): 413-9.

96. C.H. Fall et al., “Relation of infant feeding to adult serum cholesterol concentrations and death from ischaemic heart disease,” British Medical Journal (UK) 304, no. 6830 (March 28, 1992): 801-5.

97. von Kries et al., “Breast feeding and obesity: cross sectional study,” British Medical Journal (Germany) 319, no. 7203 (July 17, 1999): 147-50.

98. R.B. Elliott et al., “Type I (insulin-dependent) diabetes mellitus and cow milk: casein variant consumption,” Diabetologia (New Zealand) 42, no. 3 (Mar 1999): 292-6.

99. S.G. Gimeno and J.M. deSouza, “IDDM and milk consumption: A case-control study in Sao Paulo, Brazil,” Diabetes Care (Brazil) 20, no. 8 (Aug 1997): 1256-60.

100. J. Karjalainen et al., “A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus,” N Engl J Med (Canada) 327, no. 5 (Jul 30, 1992): 302-7.

101. T. Saukkonen et al., “Significance of cow’s milk protein antibodies as risk factor for childhood IDDM: interactions with dietary cow’s milk intake and HLA-DQB1 genotype. Childhood Diabetes in Finland Study Group,” Diabetologia (Finland) 41, no. 1 (Jan 1998): 72-8.

102. S.M. Virtanen et al., “Diet, cow’s milk protein antibodies and the risk of IDDM in Finnish children. Childhood Diabetes in Finland Study Group,” Diabetologia (Finland) 37, no. 4 (Apr 1994): 381-7.

103. P. Vähäsalo et al., “Relation between antibodies to islet cell antigens, other autoantigens, and cow’s milk proteins in diabetic children and unaffected siblings as the clinical manifestation of IDDM,” Autoimmunity (Finland) 23, no. 3 (1996): 165-74.

104. G. Corrao et al., “Risk of inflammatory bowel disease attributable to smoking, oral contraception and breastfeeding in Italy: a nationwide case-control study,” International Journal of Epidemiology (Italy) 27, no. 3 (Jun 1998): 397-404.

105. Rigas et al., “Breast-feeding and maternal smoking in the etiology of Crohn’s disease and ulcerative colitis in childhood,” Annals of Epidemiology (New York) 3, no. 4 (Jul 1993): 387-92.

I believe that the below letter is a good reflection of a few other letters I’ve received since publishing this article. I’m in hopes that this lay article encourages further research within the science community.

linda

Dear Stefanie,
 
Thank you for your comments. I solicit continuous facts and am keeping files on every bit of information in this area. If you have papers demonstrating equality or superiority of imitation breastmilk, please forward them to me. My key purpose is the optimal survival of babies. Many do choose to believe differently in the face of overwhelming evidence, so I think it advantageous to pull as much evidence together in one forum as possible. While there are far more than the hundred studies I use, I have selected only those that give actual numbers/ratios in terms of mortality. The bulk measure mostly only morbidity, as smaller numbers can be used for the studies. Personally, I find a few deaths in a thousand to be quite significant and grieve for those lives lost.
 
I have made a few comments for you below. I strongly apologize for the all-caps. It’s the easiest way to make my own comments stand out so I can keep track of them and you can find them.
 
Best, linda 
—– Original Message —–
From:
Sent: Saturday, November 08, 2008 2:58 AM

Subject: Breastfeeding. Referringto the article: The deadly influence of formula in America

 

 
Dear Mrs Palmer,   (DR. PALMER)

With interest have I read you article and would like to argue with some of the ‘facts’ in there.

“Editor’s Note: This groundbreaking analysis from noted author, health educator and advocate Dr. Linda Folden Palmer is the first time a health expert has published an examination of the available scientific research comparing the death rates of formula-fed and breastfed babies. While the results hold no surprises for breastfeeding educators and advocates, the study may prove to be a rude awakening for the millions of Americans who have bought into the myth that infant formula is a perfectly safe breast milk substitute.”

Suggestive. Not the best start for a scientific article. Makes it unscientific from the first sentence.

THE EDITOR WHO FIRST PUBLISHED THIS ON HER SITE ADDED THE SENSATIONALISM. I’VE TAKEN IT OUT ON MY OWN WEBSITE. IT DOES, HOWEVER, SERVE TO SHOW UPFRONT THAT THIS IS OBVIOUSLY ONLY AN EDUCATED, LAY REVIEW ARTICLE ON A CONCERNED WEBSITE, WRITTEN FOR POPULAR CONSUMPTION — NOT A SCIENCE JOURNAL PAPER. I DO WANT TO BE SURE THAT THIS DISTINCTION SHOWS UP-FRONT. I HAVE TRIED TO HIRE AN EPIDEMIOLOGIST ETC TO WORK WITH ME ON THIS BUT IT PROVES TO BE FAR BEYOND WHAT ONE OR TWO LITTLE PEOPLE CAN DO. I AM IN HOPES THAT THIS INSTIGATES MORE TRUE SCIENTIFIC WORK ON THIS TOPIC FOR INDUSTRIALIZED NATIONS. THE BULK OF THE RESEARCH IS PERFORMED IN LESS DEVELOPED NATIONS WHERE THE DEATH DIFFERENCES ARE MUCH HIGHER — WHERE THE RISK OF MISSING THIS IMPORTANT PART OF A BABY’S IMMUNE PROTECTION BECOMES SO MUCH MORE OBVIOUS WHEN CHALLENGED WITH MUCH GREATER RISKS OF INFECTION FROM MALNOURISHED FETAL ENVIRONMENTS, TAINTED WATER, AND OTHER CHALLENGES. SO MANY BLAME THE OBVIOUSLY INCREDIBLY HIGHER DEATHS FROM FORMULA FEEDING IN UNDEVELOPED COUNTRIES ENTIRELY UPON THE WATER (THOUGH MANY MOTHERS KNOW HOW TO BOIL WATER). THIS IS WHY I WISH TO SEEK OUT THE NUMBERS FOR INDUSTRIALIZED NATIONS. THESE STUDIES ARE SO FEW AND FAR BETWEEN AS GRANTS FOR WORK IN IMPOVERISHED NATIONS ARE SO MUCH MORE ENTICING AND EASILY GAINED, AND AS THE CONSEQUENCES ARE SO MUCH GREATER.

” A World Health Organization (WHO) study revealed a risk of diarrhea for formula-fed babies in developing nations averaging more than six times that of breastfed babies. A summary article for industrialized nations demonstrated an average of triple the risk of diarrhea for formula-fed babies. The risk in China and Israel is reported as slightly less than triple (2.8 ); in Scotland, the risk is five-fold; and a doubled risk is measured in Canada.”

The WHO is famous for not cleaning their data. The difference of those results actually proves my point, not theirs. They just take a group of bf babies and another of ff babies, disregarding gestation, risk factors like smoking, age of the mother, multiple deprivation, the baby being raised by someone else but the mother (hence ff) and having been exposed to drugs, alcohol, nicotine during pregnancy. One country shows ff babies at five-fold risk, another country it is a double risk. Maybe in another one the breastfed babies are at risk? Wouldn’t be mentioned, would it? The results vary so greatly that they shouldn’t have used them at all.

 
OH, YOU NEED TO SPEND SOME TIME READING THE ACTUAL PAPERS. THEY ACCOUNT FOR ALL KINDS OF VARIABLES. EVERY NEW PAPER TAKES BETTER CARE TO DO THIS THAN THE ONE BEFORE (IN THE FACE OF CRITICISM). IT DOESN’T APPEAR TO MAKE ANY DIFFERENCES IN THE FINAL FINDINGS. THE DIFFERENCE BETWEEN DEVELOPING COUNTRIES AND INDUSTRIALIZED COUNTRIES IS POWERFULLY UNDERSTOOD AND IS THE ENTIRE REASON I WROTE THIS EXAMINATION OF THE AVAILABLE RESEARCH FOR INDUSTRIALIZED NATIONS. PEOPLE DISCOUNT SUCH AMAZING FINDINGS IN THE DEVELOPING WORLD AS BEING JUST DUE TO THE TAINTED WATER OR SUCH BUT THE TRUTH IS, THE EFFECT OF THIS LACK OF AN IMPORTANT PART OF THE BABY’S INTENDED IMMUNE PROVISIONS STILL HAS POWERFUL EFFECTS IN INDUSTRIALIZED NATIONS — JUST NOT AS HIGH, LUCKILY, AS WHERE INFECTIOUS DISEASE LURKS SO MUCH MORE UNCHECKED.

“Four separate studies in the United States all deduce a doubled risk of diarrhea for formula-fed babies. The U.S. studies also reiterate the well-established factor of greater severity and extent of illness once diarrhea does occur among formula-fed babies. Death rates for formula-fed U.S. infants who get diarrhea may be three times higher or more than their breastfed contemporaries.”

Interesting. Allergies and intolerances are often reasons for mothers to start feeding formula. That could be the reason for the diarrhoea. Or improper preparation? Or day care? FF babies are more likely to be in day care.

 
I FIND MOTHERS REDUCE ALLERGENS IN THEIR OWN DIETS TO CONTINUE NURSING. TYPICALLY THEY WILL QUICKLY FIND THAT AN ALLERGIC BABY DOES WORSE ON FORMULAS. THE STANDARD DRUG STORE HYDROLYZED FORMULAS ARE NOT COMPLETELY HYDROLYZED (BECAUSE IN PART, THE TASTE IS SO BAD IN THE COMPLETELY HYDROLYZED) AND THE TRACES OF FOREIGN PROTEINS ARE ENOUGH TO IRRITATE A CONSIDERABLE PERCENTAGE OF BABIES. EVEN THE PURELY AMINO ACID FORMULAS RECENTLY AVAILABLE STILL HAVE CORN ALLERGENS IN THEM. ANYWAY, AGAIN, YOU NEED TO READ THE STUDIES AND BECOME FAMILIAR WITH THE SCIENTIFIC METHODS. ONE MAJOR TACTIC USED IS MEASURING INTENTION TO BREASTFEED BEFORE THE BABY IS BORN — AND THEN COMPARING THOSE WHO FORMULA FEED OR BREASTFEED AFTER INTENDING TO BREASTFEED. THEY HAVE SCIENTIFIC WAYS OF SEARCHING FOR AND ACCOUNTING FOR REVERSE CAUSATIONS AND OTHER VARIABLES AND DO THIS TO GREAT EXTENTS.
 

“Numerous studies document higher numbers of respiratory infections among formula-fed infants than among those who are breastfed. It is clear that respiratory infections are at least triple in the United States for formula-fed infants. The death rate is likely to be even higher, since some of these studies note that both the severity and extent of respiratory illnesses are considerably higher once they occur.”

I’m going to scream if it says “numerous studies” once more. Respiratory infections… hmm… Premature babies often have respiratory problems. Premature babies are more likely to be ff. That could be a connection.

 

I’VE LISTED LOTS OF STUDIES. I CAN’T SPEND MONTHS GOING THROUGH TO LIST EVERY SINGLE ONE AND ITS OWN DETAILED TECHNIQUES. NO ONE WOULD READ THE ARTICLE IF IT WERE JUST A REPRODUCTION OF 500 FULL JOURNAL ARTICLES. YES, PREMATURITY IS AN OBVIOUS VARIABLE THAT IS ALWAYS ACCOUNTED FOR. STUDIES IN PREEMIES FED HUMAN MILK FORTIFIERS OR EXCLUSIVE BREASTMILK SHOW BETTER SURVIVAL WITH EXCLUSIVE BREADSTICK EVEN THOUGH THEIR WEIGHT GAIN IS SLOWER. STUDIES OF FF VS BF PREEMIES ALWAYS SHOW HIGHER SURVIVAL OF THE BREASTMILK BABIES THOUGH THE DIFFERENCE IS NOT AS GREAT AS IT IS IN TERM BABIES.

“A joint study between the United States and Canada on neuroblastoma, a common childhood cancer, revealed a doubled risk for children who did not receive breast milk for more than one year. This study is consistent with several other childhood cancer studies in other nations, with results ranging from 1.45 to 4 times the risk for developing various common childhood cancers for formula-fed babies.”

Compare a group of non-smoking parents who ff and a group of non-smoking parents who breastfeed from the same social backround. Results won’t differ much then. But blame the formula, not the smoke.

 
I’M SORRY, I’M NOT SURE WHAT YOU ARE SAYING. ARE YOU SAYING THAT THERE’S MUCH MORE SMOKING IN FORMULA FEEDERS? SMOKING IS ONE OF THE FIRST VARIABLES THAT IS COMPENSATED FOR. ACTUALLY, SMOKING HAS A GREATER EFFECT IN BREASTFEEDING BABIES AS THEY MORE OFTEN COSLEEP AND SMOKING IS A HUGE FACTOR IN COSLEEPING DEATHS, AND AS THEY’RE TAKING IN TOXINS FROM THE SMOKE THROUGH THE BREASTMILK.

“Preemies in India who received only preemie formula were found to develop more than twice as many infections as those who received some human milk. Another Indian study on high-risk newborns found that those receiving human milk plus formula suffered twice the infection rate of those receiving only pasteurized human milk and triple the rate of those receiving only raw human milk.”

Maybe they were in better hospitals? Pasteurised human milk is quite expensive, no? A few years ago “numerous” studies showed that the main factor for survival of preemies (two identical groups again) was physical contact and bonding. Wouldn’t mothers who pump every two hours in a hospital be more likely to bond with their ill child than those who are send home?

 
PASTEURIZATION IS PRETTY CHEAP ACTUALLY. ALL YOU NEED IS A MICROWAVE OR EVEN JUST A CAMP STOVE. BUT THOSE WHO RECEIVED RAW, UNPASTEURIZED MILK DID EVEN BETTER THOUGH. THE IDEA OF DESCRIBING THE MILKS HERE IS THAT OFTEN MOTHERS OF PREEMIES NEED TO USE DONOR MILK AND IN THE US, ONE IS NOT ALLOWED TO HAVE DONOR MILK THAT HASN’T BEEN HEATED TO A CERTAIN TEMPERATURE FIRST, TO KILL OFF A COUPLE POTENTIAL PATHOGENS THAT THE DONOR COULD BE CARRYING. BABIES WHO RECEIVED RAW MILK FROM THEIR OWN MOTHER OR UNPASTEURIZED DONOR MILK FARED THE BEST — AND THIS IS THE CHEAPEST BY FAR (OK, FREE) COMPARED TO THE COST OF PREEMIE FORMULAS. YES, SKIN-TO-SKIN CONTACT IS AN IMPORTANT FACTOR OF BREASTFEEDING. I HAVE ANOTHER ARTICLE ON MY WEBSITE ABOUT HOW ONE CAN “NURSE” A BOTTLE-FED BABY. I’M SURE IT BRINGS SUPERIOR RESULTS TO BOTTLE-FEEDING STRAPPED DOWN IN A CARSEAT. IF A BABY IS KEPT OUT OF PUBLIC AND PARENTS DO NOT BRING HOME GERMS, THEY COULD PROBABLY FARE PRETTY WELL THIS WAY, NOT NEEDING THE IMMUNE PROTECTION AS MUCH AS SOME OTHERS. STILL, THESE BABIES DO SUFFER MORE AND LONGER RESPIRATORY INFECTIONS ETC. AS THEY CAN’T BE KEPT IN A BUBBLE FOREVER. I GUESS IF FF MOMS GO HOME AND BF MOMS STAY IN THE HOSPITAL, THOSE POOR FF BABIES ARE SUBJECT TO MORE REDUCTIONS IN THEIR POTENTIAL FOR HEALTH THAN SIMPLY MISSING IMMUNE PROVISIONS. ACTUALLY, IN INDIA, MOMS AREN’T GOING TO GO HOME VERY OFTEN.

“Even a disorder as apparently unrelated to feeding methods as inguinal hernia has been discovered to occur twice as often in artificially fed infants and even more frequently when compared with infants who are exclusively breastfed.”

Well, that’s just absurd.

 
IT’S BEEN FOUND TO BE RELATED TO THE GREATER AMOUNT OF CONSTIPATION IN FORMULA FED BABIES. I GUESS I COULD ADD THAT STUDY.

“A wide variety of common birth defects has been shown to have better survival rates among breastfed infants, although the actual figures are not available.”

Then don’t mention it.

 

“An overall risk rate of infant death for formula-fed infants has been selected conservatively based on the available information presented in this paper for each cause of death in the table below. Assuming that 50% of the total infants born were breastfed, we can calculate formula-fed and breastfed infant death rates and totals for each cause.”

Oversimplified. Terribly, TERRIBLY wrong and suggestive.


RB = __________TND___________
Rel x 2,000,000 + 2,000,000″

Is that a joke? It’s not even the correct formula, the data isn’t cleaned AT ALL, no third factors are being taken into consideration and it proves nothing. Absolutely zero.


THE THIRD FACTORS ARE TAKEN INTO ACCOUNT IN EVERY SEPARATE ARTICLE BUT OF COURSE, THEY’RE NOT ALL ACCOUNTED FOR IN EXACTLY THE SAME WAYS. AGAIN, I CLEARLY DO NOT CLAIM THIS TO BE THE ABSOLUTELY HUGE UNDERTAKING THAT WOULD TRULY BE NEEDED TO GIVE ABSOLUTE STATISTICAL MARGINS. THIS IS ON A PINK AND BLUE WEBSITE, NOT ON PUBMED. IT SIMPLY ACTS TO DEMONSTRATE THE OVERWHELMING EVIDENCE AND TRY TO GATHER THE STATISTICS FROM THEM INTO ONE, NON-STATISTICALLY CONTROLLED, SUGGESTED NUMBER.

“Let’s apply this formula to congenital abnormalities. Clearly, feeding’s impact in this category could be significant, but there is not enough solid statistical evidence to say for sure. If we modestly assume a 50% higher death rate for the 50% of formula-fed infants, the number of breastfed infants who died would be 2,200. The number of formula-fed who died would be 3,300. If all of the infants had actually been breastfed, then the total number of deaths would be 4,400 — a savings of 1,100 lives.”

This IS a joke. I can’t believe how you still pretend to be scientific  ???

“The most recent U.S. study (2003) takes advantage of the lessons from these earlier studies to raise confidence in its final results. Its finding of five times the risk of infant death from SIDS for formula-fed infants seems to be the most powerful statistic yet.”

 

Nicely chosen, really. And what you consider to be “most powerful”.

THEY ARE LEARNING TO COMPENSATE FOR MORE AND MORE FACTORS IN THE LIGHT OF VARIOUS QUESTIONINGS AND OBJECTIONS. AS I SAY, THIS ONE ATTEMPTS TO ACCOUNT FOR EVERY POSSIBLE CONFOUNDER EVER MENTIONED.

“One study reported that more than half of infants with congenital heart disease lost oxygenation during bottle feedings, while none did so while breastfeeding.”

Which study? And how would they have measured that and got together more than 3000 babies to make it representative?

 
IT’S BEEN A WHILE BUT I BELIEVE I DIDN’T QUOTE THE STUDY BECAUSE IT IS NOT PART OF THE FINAL FINDINGS I’M MEASURING AND THIS WAS ALREADY AN EXHAUSTIVE UNDERTAKING. ALSO, IN SAYING “ONE STUDY,” THIS SHOWS THAT IT’S JUST A SUGGESTION, NOT A META-ANALYSIS OF TEN YEARS OF RESEARCH UNDERTAKINGS.

“Diet, cow’s milk protein antibodies and the risk of IDDM in Finnish children. Childhood Diabetes in Finland Study Group,” Diabetologia (Finland) 37, no. 4 (Apr 1994): 381-7.”

Awesome. Diabetes occurs between 1.5 and 64.2 (in 2005) children out of 100 000. The population of people is roughly 5.3 million people. That would make around two million children. At best. If they got ALL Finish children with diabetes in that study which I doubt it wouldn’t have been representative.
Interestingly enough, Diabetes Type I rockets in Finland, even though more and more mothers breastfeed? Shouldn’t it go down then?

 
I WOULD EXPECT DIABETES TO BE VERY HIGH IN FINLAND AS IT’S ONE OF THE GREATEST DAIRY CONSUMERS IN THE WORLD AND DAIRY IS ALWAYS PERMEATING OUR DIETS MORE AND MORE DEEPLY, OUTSIDE OF THE TRADITIONAL GLASS OF MILK. COW’S MILK PROTEINS GO RIGHT THROUGH THE BREASTMILK AND THIS IS THE REASON FOR INCONGRUENCY AMONG MANY BREASTFEEDING VS FORMULA DIABETES STUDIES.

“93. A.C. Wilson et al., “Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study,” BMJ (Scotland) 316, no. 7124 (Jan 1998): 21-5.”

In Dundee. I do wonder how many children of that seven year study they had. Twenty? Fifty? No more than that, surely. I’ll find a study about social status and diet and social status and feeding. I am quite sure that that would be variable missing.

 
THEY USED 545 INFANTS. I DO QUOTE ONE OR TWO STUDIES THAT SHOW THAT SOCIAL STATUS DOES NOT MAKE MUCH DIFFERENCE. THAT WOULD TAKE A WHOLE ‘NUTHER ARTICLE TO DISCUSS SUFFICIENTLY ALTHOUGH BREASTFEEDING STUDIES ALWAYS TAKE SOCIOECONOMIC FACTORS INTO ACCOUNT ANYWAY.

“9. National Vital Statistics Report, 49, no. 11 (Oct 12, 2001): 1-12.

10. National Vital Statistics Report, 50, no. 16 (Sep 16, 2002): 1-12.”

They have raw data, too. No other factors are included.

 
CLEARLY.

“100. J. Karjalainen et al., “A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus,” N Engl J Med (Canada) 327, no. 5 (Jul 30, 1992): 302-7.”

That is not a convincing source. Also, they had 82 children and 44 adults in this study. ANY connection between anything is most likely to be accidental with a small number like that.

 
THIS IS JUST THE BEGINNING OF THE DEVELOPING SCIENCE AROUND THE APPARENT CONNECTIONS BETWEEN FOREIGN PROTEINS AND DIABETES. THERE ARE OTHER STRONG CONNECTIONS TOO, SUCH AS THE FACT THAT SOY FORMULA FED BABIES ALSO HAVE GREATER INCIDENCE OF DIABETES (NOT AS HIGH AS COW FORMULA). THE ANSWERS HERE ARE NO WHERE NEAR COMPLETE; THE RESEARCH IS VERY YOUNG AND, IN MY OPINION, VERY FLAWED BY NOT COMPENSATING FOR THE BREASTFEEDING MOTHER’S DIET.

“6. Palloni and M. Tienda, “The effects of breastfeeding and pace of childbearing on mortality at early ages,” Demography (US) 23, no. 1 (Feb 1986): 31-52.”

Here their own conclusion from their study:

“Conclusions: Different determinants of mortality (decline) were important in infant and early childhood mortality and they acted on different causes of death. Therefore, infant and childhood mortality should be studied separately. International comparison of the results showed that findings with respect to determinants of mortality (decline) for one country do not necessarily apply to other countries. The results for The Netherlands with respect to infant mortality differed from England and Wales.”

“What your doctor doesn’t tell you
Pediatricians spend much time frightening parents with something like a 1 in 100,000 combined risk from vaccine-preventable diseases when parents question the utility and safety of vaccines. “Would you want to risk the life of your child?” they demand. Yet these very same professionals offer formula samples with the other hand – when the magnitude of health risks associated with the use of formula is 500 times greater.”
2=500*X  2/500=X
FIVE HUNDRED! Where does that come from?

 
DOUBLE THE RISK OF DEATH, OR A FEW MORE DEATHS PER THOUSAND, VS .004 SUPPOSED INCREASED RISK OF DEATH FROM NOT VACCINATING FOR A PARTICULAR DISEASE (AS QUOTED IN FRENCH MEASLES VACCINE STUDY), 0R 1 IN 500,000. ACTUALLY, THAT FRENCH RISK WAS DEATH OR PERMANENT DISABILITY SO I DIDN’T QUOTE IT HIGH ENOUGH, BUT IT’S JUST AN EXAMPLE. AGAIN, THAT WOULD BE A WHOLE ‘NUTHER HUGE REVIEW (I’M WORKING ON IT). I’LL CHANGE THE ABOVE TO 100 SO IT MATCHES WITH THE 1 IN 100,000 EXAMPLE I GAVE.

Also, every single “proof” you use is from five pages of each study. Sometimes four, sometimes six, but never much. Talk about “taking out of context” here. It is a jumbled up collection of studies from all over the world to prove their point. I am quite sure someone could take another jumbled up collection and prove the opposite.

 
I’D LOVE TO SEE A COLLECTION OF STUDIES SHOWING THE OPPOSITE.

It gets worse. This is from the “final” table.

“Lives saved if all were breastfed”

It’s serious as well.

That’s it done. The facts are: more than 99% of the babies who are ff do NOT die. More than 99% of the breastfed babies do not die either. That means that it’s less than 1% difference. Statistically, this means, the difference is insignificant and there CANNOT BE a cause-and-effect relationship. CAN’T be. Please read up how to read, use and create statistics, it is fairly straightforward.

 
A FEW DEATHS IN A THOUSAND IS VERY SIGNIFICANT TO ME. PLEASE READ THE STUDIES.

Also, do note that the lower the social status (income, status, education) the less likely is a mother to breastfeed. That is NOT the formula’s fault, the formula plays no role in this at all.

 
AND THIS IS THE FIRST THING COMPENSATED FOR IN STUDIES. THERE IS A REASON MORE EDUCATED WOMEN BREASTFEED MORE, AND IT’S CERTAINLY NOT COST.

The material in this website is provided for information purposes only. No part of this text should be taken as, or considered a substitute for, medical diagnosis, medical advice, or medical treatment prescription.

7 Comments

  • Like Abs | What the Experts Didn’t Tell Me About Formula: A Dad’s Story August 13, 2014 at 10:41 am

    […] headlines of that era — “Breast-feed or Else!” “Formula Doubles Infant Deaths!” — felt a little like Donald Rumsfeld’s post-9/11 color codes, a kind of terrorism in […]

    Reply
  • Trish July 8, 2015 at 4:29 am

    Do all of the studies include all external factors that occur in life which have nothing to do with being formula or breastfed? If not then wouldnt all results be incomplete as it is not a full study? Yes formula can make a baby constipated, too much iron. And if people honestly believe that formula is as good as breast then they dont know much because it is very publicly known they can not replicate all that occurs in breastmilk but it has what is need to sustain life and keep a baby alive when they cannot yet eat to get what it needed to stay alive! For people to go round saying it is dangerous to formula feed is stupid. I may not live in America but in Australia you can still be very well educated and be in the low socioeconomic wher you stated is more likely to ff and educated bf so where is the cross over for the educated low socioecomnomic? And you can be as educated as possible with the highest IQ but if you cant bf or have any issue that makes you feel you need to ff it is going to be in the best interest for mother and child. It is not a light hearted decision when it is made and it is not only made because someone is uneducated!

    Reply
  • Voordelen en nadelen | Eurolac! October 22, 2015 at 12:52 am

    […] van welke ziekten en aandoeningen dit kunnen zijn: Newman J: Risks of artificial feeding; Folden Palmer L: The Deadly influence of formula in America; LLLI: Outcomes of Breastfeeding.) In de groep die geen of weinig borstvoeding kreeg zullen dit er […]

    Reply
  • What ever April 1, 2016 at 5:01 am

    my both nice and nephew fed formula they are very healthy happy smarts now. My first daughter too, she is very smart and healthy. I know that breastfeeding is the best but it doesn’t mean that formula fed babies will die. I think this personal decision.moreover, putting mom’s in pressure to breasfeed is not good idea. I am sure that all the mothers want to breastfeed their babies but when they don’t do that defenetly they have a strong reason.So, society have provide good mental and social environment to mom’s to breastfeed. When a woman has to back work because of economy reasons this articles just cause that she feels guilty, depress.

    Reply
  • coco May 19, 2016 at 7:56 am

    why are they still giving babies formula knowing it gives higher death rates for preemies…im sooooooo hurt and numb if i knew it was so deadly i would of nevvvveeeerrrrrr allowed them to feed that bs to my baby

    Reply
  • Eurolac Lactatiekunde | Voordelen en nadelen May 25, 2016 at 11:10 am

    […] van welke ziekten en aandoeningen dit kunnen zijn: Newman J: Risks of artificial feeding; Folden Palmer L: The Deadly influence of formula in America; LLLI: Outcomes of Breastfeeding.) In de groep die geen of weinig borstvoeding kreeg zullen dit er […]

    Reply
  • কুরআনের কথা June 12, 2016 at 4:26 pm

    […] [৩৬৯] Palmer, L. (2004). Formula Feeding Doubles Infant Deaths in America | Baby Reference. Babyreference.com. Retrieved 12 June 2016, from http://babyreference.com/formula-feeding-doubles-infant-deaths-in-america/ […]

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