Emily Oster

3 min Read Emily Oster

Emily Oster

Is It Better to Breastfeed or Pump?

Q&A on benefits

Emily Oster

3 min Read

You (and others) have written extensively about formula vs. breastfeeding. But if you’re committed to feeding breast milk, are there health/developmental benefits to breastfeeding vs. exclusive pumping? Most advice books assume the former, but they don’t really give any reason for it (besides hard-to-quantify “bonding”), and we’ve found the flexibility that exclusive pumping offers to be really useful.

—Bottle-Feeding Dad

The degree to which we do not have data on this is somewhat astonishing. Several years ago, I worked on a (now-stalled; sorry, co-authors) paper on breastfeeding trends over time. Breastfeeding rates in the U.S. were very low in the early 1970s, increased rapidly through the 1980s, stagnated, and then began to increase again in the 1990s. One theory we had for this was the improvement in pumping technology — maybe women who were returning to work were able to breastfeed for longer because pumping became possible.

To evaluate this theory, we needed to find data on the use of pumps, and it more or less did not exist. Even the surveys that asked extensive information about breastfeeding duration didn’t ask about pumping. This actually makes the data difficult to interpret. If you were exclusively pumping and someone asked if you’re breastfeeding or not — with a binary answer — what do you say? I think I would say I was breastfeeding, but someone else might not. Since the questions in surveys do not distinguish, we do not know. This has gotten a little better in data over time but not much, and certainly there are no really good studies that would tell you whether any health or developmental benefits differ.

(By the way: any differences are likely to be small, since overall, the impacts of breastfeeding are small, as I have written about a lot before.)

Without data, the best we can do is theory. Is there any theoretical reason why pumping would differ from breastfeeding? As you note, there is the bonding story, but it seems difficult to argue that snuggling your infant while you give them a bottle is fundamentally different from snuggling them while you nurse them. A snuggle is a snuggle.

There is one mechanistic argument I have seen for a possible short-term health benefit of breastfeeding in infants. Infants who nurse often get milk all over their face and up their nose, because … they’re babies and still figuring it out. If there are antibodies in breast milk that get into the infant’s nose, that might have some marginal impact on preventing respiratory infections. Having said that, we have no proof of this, and it would be an extremely short-term impact, since eventually babies figure out how to eat without covering themselves with milk.

Bottom line: There is no data-based reason to think there is any difference in these activities.

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Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster

Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster
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That’s why I’m asking you to post a story, photo, or reel this week with #MyUnexpectedStory and tag me. I’ll re-share as many as I can to amplify. Let’s fill our feeds with these important stories and lift each other up. Our voices can create change. And your story matters. 💙

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We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76. 

#emilyoster #pregnancy #pregnancytips #sleepingposition #pregnantlife

Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76.

#emilyoster #pregnancy #pregnancytips #sleepingposition #pregnantlife
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#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster

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While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster
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How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months.

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