When my children were born, the biggest decision for me was figuring out which stuffed animal to buy for the crib. But their mother, already suffering through mental and physical anguish, had to decide whether to feed by breast, bottle, or both. The pressure to do the first can be substantial, based on the notion it is always best. Going this route means further taxing exhausted new mothers since, despite their bundle of joy status, newborns need nursed about 10 times a day. These feedings may happen at 3 a.m. or 11 p.m., and while mothers can sleep while fathers handle formula feedings, only the maternal antecedent can perform nursing duties.

The reason well-meaning folks laud breastfeeding is because infants so nourished show lower lifetime rates of asthma, cancer, and diabetes, as well as having fewer instances of infancy infections and mortality.

Similarly, Emily Oster at 538 cited a study of 345 Scandinavians which compared IQ scores for children who had been breastfed for less than three months with those who had been breastfed for more than six months. The authors found that the children who nursed for longer had higher IQ scores.

But, as always, we must consider correlation and causation. In the developed world, women who breastfeed tend more to be nonsmokers, educated, affluent, and given better access to quality health care. Mothers with those distinctions who choose formula see no more health problems in their offspring than those who breastfeed.

In the Scandinavian study, breastfeeding mothers were wealthier, better educated, and had higher IQ scores than those in the other group. Once researchers accounted for these variables, the seeming advantage of nursing evaporated.

Now let’s consider mothers in the developing world. There, breast milk substitutes are often prepared without clean water and in unsanitary conditions. Health issues for their newborns arise because of the environment and what the formula was mixed with, not the formula itself.

Because breastfeeding is wrongly presumed always be best, mothers can be guilted into acquiescing, and this can lead to further problems. Science writer Kavin Senapathy noted there is occasionally an issue with some mother’s breastmilk supply immediately after birth, especially for first-time moms. According to Senapathy, about 15 percent of mothers are incapable of producing enough milk, so if they rely entirely on this source, their baby may suffer dehydration, high blood pressure, hypoglycemia, and excess sodium in their blood.

Senapathy cited Hannah Awadzi, a Ghanaian whose daughter experienced jaundice and hypoglycemia while Awadzi exclusively breastfed her despite inadequate milk supplies. This led to the daughter’s cerebral palsy. Yet Awadzi’s only other option had been formula mixed with deplorable-quality water. Awadzi had no decent alternative, but if having a good choice, formula would be the way to go in cases like this.

To see if a perceptible difference results from breastfeeding and formula use, we can look at studies in which breastfeeding is assigned randomly to subjects, or ones where adjustments are made for differences among women being tested.

One example comes from Belarus, where women were randomized into two groups. For those in the first group, breastfeeding was encouraged; in the second group, it was not. Infants in the breastfed group had fewer gastrointestinal infections and were less likely to experience eczema. However, there were no significant differences in any other studied outcomes, such as respiratory ailments, ear infections, croup, wheezing, infant mortality, allergies, asthma, cavities, height, blood pressure, obesity, and mental issues.

Another study, published in Social Science & Medicine, compared breastfed children with their siblings who had been given formula. In the health and behavior outcomes that were examined, researchers detected no differences. This is crucial because siblings are on equal ground with regard to their environment and their mother’s parenting style, wealth, education, and health. And if breastfeeding made the difference that proponents claim, there would be universal pronounced detriments among those who were adopted at birth.

There are advantages to breastfeeding, including, cost, convenience, and bonding. But babies being nursed won’t enjoy health benefits over those given formula and they will sleep just as well next to whatever stuffed animal Daddy has chosen.