Comment by Waterluvian
2 years ago
Nothing shook my faith in the medical system more than having kids.
Holy cow is modern medicine still as smugly wrong as it’s always been. Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
And as a result you get unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
> Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence". This is a bit like saying that things with an essence of gravity fall towards the earth, whereas things with an essence of levity float towards the sky. The examiner proudly accepts that answer and bestows upon the student the title of doctor.
This was very funny to anyone educated in the time Voltaire was writing, since they would have known that morphine puts people to sleep because... it has round molecules with no sharp edges...
Edit: correction below, thank you thaumasiotes.
> Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence".
It was Molière (<1622 - 1673), who wrote a play that featured an apothecary (explaining the functioning of opium to laymen), but no examinations.
https://en.wikipedia.org/wiki/The_Imaginary_Invalid
I used to enjoy this blog written by a person who hated US medical school:
https://web.archive.org/web/20101218031844/http://www.medsch...
People will probably find it offensive but it does explain a lot about why the stuff being taught is almost always not questioned.
This post in particular:
https://web.archive.org/web/20101211180021/http://www.medsch...
My sister wouldn't sleep. The doctor constantly gave the "sigh, you're an idiot, you just do X and Y and they sleep" talk to my mother because nothing came up on their screening, even though my mother almost wanted to scream that something was clearly wrong and abnormal. Turns out, different doctor, serious vitamin deficiency.
And medical incompetence by staff, not doctors, is also awful. My brother hated reading. He got glasses, still hated reading, my mother wondered why he could be so disobedient in that regard. They said, well, the prescription is right, he can clearly see fine. Turns out two years later that the lenses were installed on opposite sides. Right lens on left eye, left lens on right eye. A simple mistake, but the consequences...
It’s especially a problem with women and minorities. Doctors just don’t believe them. I’m neither of those and I had to convince my doctor that I had Lyme disease. I had the bullseye right where the tick had bit me. It was clearly Lyme disease. He assumed it couldn’t be because it took 8 weeks for the bullseye to show up (it’s usually a matter of days in America). He did not know that European Lyme disease takes much longer for the bullseye to appear. He at least had the tact to call me later and apologize after he did more research
I do find it bizarre they don't verify you can see with your actual glasses.
How would one have tested it instead?
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> unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
Stay away from mommy blogs/forums. Those are the most toxic cesspools I've ever witnessed. Things are changing, some of the newer ones are not nearly as bad, but man the judgement is super real.
Nurses are one thing, but personally, the worst is family members who think they know better and don't understand the data and that times have changed.
FORMULA IS PERFECTLY FINE.
Maternal milk is better than formula in every possible way and there is a perfect scientific consensus around this. Formula is the least worst substitute to maternal milk but going around and screaming that formula is perfectly fine, as if it was as good (or even better!) than maternal milk is denying some very well-established piece of science for likely ideological reasons.
> Maternal milk is better than formula in every possible way and there is a perfect scientific consensus around this.
I have not seen result like this obtained in a randomized, controlled trial, and it is almost certainly false as stated: you're almost certainly exaggerating for effect, but doing that in scientific context is bad intellectual hygiene.
All results of this sort that I have seen have been purely correlational, and as such suffer from selection bias. This might be true, but the evidence is far from conclusive, and if such consensus exists among medical professionals, it only shows how susceptible they are to groupthink and parroting the stuff they heard from the cathedra.
Milk is better than formula, but formula is better than starvation.
There are way too many instances of infants "failing to thrive" because their mothers are bullied into relying on breast milk which they simply aren't producing enough of.
And this is what I'm talking about - Clearly, you've never been a mother who can't produce milk for her child.
I've been there with my wife and I'm only the husband.
Everything you say is true, but by saying this and in this manner, you lack empathy. You sound just like the mommy blogs and their followers that I'm speaking against who spout facts with no room for life's situations. My wife sincerely believed she was less of a mother because of people like this.
I say it again: Formula is _perfectly_ fine. Use it a little or as a total replacement. You're not a lesser mother/parent for it.
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It’s like saying that you should only eat organic food. Sure, there is lots of science backing it up, but that’s besides the point. It’s not always possible or easy for everyone to get organic food. Any food is better than no food.
Formula is adequate as far as macronutrients go, but it lacks sugars present (at varying levels-about 20% of the population are FUT2 non-secretors and cannot produce the α1,2-fucosyltransferase enzyme that is used to make human milk oligosaccharides), stem cells and bacteria present in breast milk. Women in the US are often deficient in the strain that can metabolize the human milk oligosaccharides, b. infantis, and it's not clear afaik to what extent bacteria gets passed vertically in breastmilk. The microRNA present in breastmilk can modulate gene expression, but the extent and effects are unclear.
B. infantis and human milk oligosaccharides create a feedback loop that encourages the formation of a robust immune system during a critical period [1]. Some formulas contain b. infantis, and some contain 2'FL, the HMO present in breastmilk. The most robust strain is EVC001, which has been shown to be present at a year after 21 days of supplementation. In an observational study, it reduced the diagnosis of necrotizing enterocolitis in very low birth rate infants by 73% [2].
I wish this was common knowledge, but most formulas do not contain these (often they contain other pre and probiotics) and babies are missing out on the specific sugars and bacteria that we know impact the development of the immune system.
1. https://www.cell.com/cell/fulltext/S0092-8674(21)00660-7 2. https://pubmed.ncbi.nlm.nih.gov/35032555/
At least this one doesn't sound as bad as the other post, but it's still in the same vein - you've never been a mother who can't produce milk for her child.
I've been as the husband there and are all your facts don't allow for people's situations.
Formula is perfectly fine.
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What are some good mom blogs?
Not a "mom blog," but covers pregnancy and childbirth from a scientific viewpoint plus some parenting topics - The Skeptical OB - https://www.skepticalob.com/ the author was a practicing obstetrician, professor at Harvard Medical School, and mom of 4.
Our twins were put into my wife's arms, and we were wheeled into a room to stay for 48 hrs, being woken up every 2 hours by a nurse, which would wake up our kids, making the whole thing a living nightmare. I have no idea how I drove home.
They had no care for my wife's ability to heal, rest, or anything, just subjecting us to the worst kind of institutionalized checklist torture. The medical system cares for nothing other than preventing lawsuits and providing a place for doctors to do their 1 hr of work on their 18 patients a day.
Same experience. The medical system is a reflection of pop parenting culture or vice versa. Everyone was so gung ho on breastfeeding, but when the milk didn’t come in and our son wasn’t interested in a dry breast the only advice given was “keep trying”. Then the shock and surprise when baby is losing weight. We had to demand formula, which was given grudgingly, and left the hospital a day later. If we have another we will do breast plus formula from the get go.
> We had to demand formula
I don’t understand. You can’t just go to the store and buy infant formula?
In the US (not sure about other countries), new parents often stay at the hospital where the baby was delivered for a few days after the birth. During this time, the hospital often provides them all their food and childcare supplies: diapers, swaddles, diaper cream, wipes, etc. To get formula, you have to ask the hospital for it, but if your nurse doesn’t want to give it to you because they think you should try harder at breastfeeding, you get stuck. You could sneak out and buy some, but you’re pretty exhausted, and your partner is still stuck with a screaming, hungry baby until you’re back.
(I realize after writing this out that being at the mercy of your hospital sounds draconian, but it can be really really great if you have a good nurse or midwife. They teach you how to bathe and swaddle the baby, how to nurse, how to rock them to sleep, etc. All skills you’ll need once you leave)
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Not so easy when you are in a hospital recovering from birth. They generally won't allow things from offsight into the hospital either, so even if you (dad) goes to get some you have to get it in without getting caught.
The other side is nursing is hard, and so it is easy to cheat and use formula when you could with a little effort nurse the baby just fine. (Nursing is generally slightly better for the baby, but the difference is tiny. Nursing is generally a lot better for the wallet though)
It’s not that easy to just know how parenting is going to work the first time around. You can be lactating prior to delivery and then dry up for no reason. Even worse, your baby can decide not to latch or be tongue-tied. If your husband isn’t on hand to run to the store from the hospital, things can get challenging.
We had to worry about my wife dying because they wouldn’t suggest a C-section and we didn’t think to ask for one (her induction didn’t take for several days). We’re quite confident they’d have let her die before suggesting one. Thankfully, we thought better in time.
> The medical system is a reflection of pop parenting culture
Indeed. And not just in relation to parenting. The average doctor is constantly trying to emulate TV doctors, just like the average police detective is influenced by what they see on CSI, and every archaeologist wants to be Indiana Jones or Lara Croft. It would be hilarious, if it didn't have such disastrous consequences for regular people every day.
Huh? Doctors don't base their decisions on House episodes. Not even ER episodes.
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After 5 kids in 10 years, you come to realize that the standards aren't agreed upon, and best practices/recommendations change YEAR TO YEAR without fail.
Breastfeeding is one of the worst things hoisted upon mothers who are told "you must try no matter what" - seemingly ignoring the mental and physical health of the mother and the father all the while.
There are a lot of really good benefits to breastfeeding but it's not going to work for everybody or in every situation. I wouldn't fault a doctor for recommending it, but they shouldn't make someone feel bad if it isn't working out.
I want recommendations and best practices to change as our understanding of things improve though. The alternative would mean that either no more research is being done, or doctors are just ignoring anything they didn't learn while in school.
Our doctor was fine with it. The nurse called formula poison.
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My partner is a GP who has been doing early childhood screening. One thing she learnt after doing a special training is that advice on proper breastfeeding is very difficult to find. She found that with many mothers that had problems, some small adjustments could often make a huge difference (often causing a kind of hallelujah moment for the mothers). The issue is much of the advice given at the hospital is wrong or insufficient.
The training the she did is the possums program from Australia, if somebody wants to look it up I think some resources are available for free.
Completely agree. Half the lactation consultants have never breastfed themselves. The advice my wife got from the nurses versus what she got from her own mother and my grandmother were completely at odds. Both of those women told her to just keep doing it and to ignore the nurses while the professionals were single mindedly focused on a few days of weight loss. The milk came in (as all the older women expected) and my daughter breastfed for many years after.
Really the advice given is simply ridiculous. I honestly think most men who's children have nursed can give better advice than the lactation consultants. One that always makes me roll my eyes is the idea that a breastfed child should eat for a few minutes and then be full for an hour or two. That is simply... Not how it works. Babies like eating and being with mom. Breastfeeding mothers should expect to be with their newborn all the time. We are lucky to know many breastfeeding mothers and I don't know any family where the baby is satiated after ten minutes. And yet... The professionals are convinced this is how it works
Older nurses are the best. They've seen it all.
The worst encounters I have had with nurses have been with older ones filtering information and using out of date practices because they think they have seen it all and now know best.