Q: What do Paul Offit and infant formula have in common? A: Jay Gordon's Twitter feed

December 29th, 2010 → 1:42 pm @ // 9 Comments

Earlier this morning, Jay Gordon, who is perhaps best known as the pediatrician who supported Jenny McCarthy in her belief that the MMR vaccine had contributed to her son’s autism, posted the following tweet:

It’s an obvious story for Gordon to point out: He’s not only a pediatrician, but an active proponent of attachment parenting and the importance of breast-feeding. As the father of a thirteen-month old boy and the husband of a wife who still breastfeeds twice a day, I, too, am aware of the benefits of breastfeeding on both infants and mothers. The problem is, the Reuters Health story Gordon links to doesn’t say what Gordon claims it says. If anything, it contains the opposite message:

All infant formulas may not be equal when it comes to babies’ weight gain over their first months of life, a new study finds.

In a study that followed 56 formula-fed infants, researchers found that babies on hypoallergenic formula stayed close to the “normal” weight-gain pattern seen among breastfed infants, while those on standard formula packed on pounds more quickly.

Gordon’s misrepresentation is troubling to me for two reasons. First, by overemphasizing the risks of infant formula, Gordon unnecessarily adds to the guilt of mothers who aren’t able to submit to what is only half-jokingly referred to in our household as the tyranny of breastfeeding. My wife and I have been lucky: Our families have been able to help us out and she’s been able to work at home for much of the past year, which has given her the freedom to schedule her days around our son’s mealtimes. Many families don’t have that luxury: A single mom without maternity leave isn’t going to be able to be with her child 24-hours-a-day…and there’s a good chance she won’t be able to pump four or five times a day, either. The fact that new research indicates that some formulas appear to be healthier than others is wonderful news for those mothers.

The second is that Gordon is exemplifying a disturbing trend, and one which is one of the themes of The Panic Virus: The tendency of people to blur the boundaries between facts and opinions until they disappear completely. There’s a special irony here in light of the tweet Gordon posted several minutes later:

Here Gordon is referring to an Age of Autism piece about Paul Offit, the author of the new book Deadly Choices: How the Anti-Vaccine Movement Threatens Us All. In that 1,400-word post, Dan Olmsted, one of the main proponents of the Amish don’t vaccinate and therefore don’t get autism fallacy (neither statement is accurate), writes that Offit displays a “solipsism that is quite breathtaking” and that his book is nothing but a “score-settling screed.”

Now, someone who only read Olmsted’s take would likely come away thinking that Offit does not, as Gordon claims, “act like a scientist much of the time.” People who’ve actually spent the time to research the issue–and I’ve done nothing but for the past two-plus years–know this is the opposite of the truth: While Offit is without question one of the most outspoken vaccine proponents in the country, he’s also not shy about pointing out instances when he thinks vaccines were used improperly. One example can be found in an essay he wrote several years ago titled “The Risk of Being Averse“:

In March 2003, when the United States invaded Iraq, the Department of Defense feared a biological counterattack with smallpox. So they inoculated soldiers with the smallpox vaccine; 40,000 healthcare workers were also immunized. Since December 2002 about 1.2 million people have been immunized with a vaccine to prevent a disease that was eliminated from the face of the earth in 1979. And unlike the prevention of many infectious diseases, smallpox vaccine works even when it is given 48 hours after exposure to someone with smallpox, a disease whose symptoms aren’t subtle. We could have distributed the vaccine, made sure that systems were in place to give it quickly and efficiently, and waited. But we didn’t. As a consequence, about 140 people were harmed when the vaccine virus caused inflammation of their heart muscle. Getting smallpox vaccine was riskier than waiting to get it.

Another example is The Cutter Incident, which is an entire book about the worst lapse of vaccine safety in the country’s history.

As the deaths of ten children in the recent whooping cough outbreak in California demonstrate (pdf link to California Department of Public Health report), the issue of vaccine safety and vaccination rates is one of the most important public health issues facing the country today. There are valid debates to be had–regarding compliance, risk, communication, outreach–and everyone would be better served if the most outspoken partisans on both sides found a way to have a rational discussion. Misrepresenting scientific studies and name-calling are not steps in the right direction.


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9 Comments → “Q: What do Paul Offit and infant formula have in common? A: Jay Gordon's Twitter feed”


  1. Emily Willingham, PhD

    3 years ago

    I asked Gordon (via Twitter) in what way, exactly, scientists “act” that Offit doesn’t emulate. His response? “Persistent (sic) curiousity!” While I agree that intellectual curiosity and constantly asking, “Is that true?” are key to the practice of science, some folks have obviously crossed over to,”Wow, that sounds so cool and interesting and lifesaving and natural and intuitive that it MUST be for real!” That is not the same thing as “persistent” curiosity, but I think some antivax folk probably believe it is. I also seriously doubt that Paul Offit has in any way abandoned the practice of persistent curiosity, at least not based on his recent activities.

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  2. Liz Ditz

    3 years ago

    I emailed (to the panic virus account) two jpgs of Dr. Jay’s statements. His twitter handle is @drjaygordonMDFAAP, plus my convo with Dr. Jay.

    Some of the Dr. Jay backstory — he has been known to show up in the comments at Respectful Insolence (a blog published by a lightly-anonymous breast cancer surgeon/researcher known as Orac.) For example:

    Oct. 20 2008 Dr. Jay Gordon: Pediatrician Warrior
    http://scienceblogs.com/insolence/2008/10/dr_jay_gordon_pediatrician_warrior.php

    Feb 2, 2009
    Dr. Jay Gordon: Get away from my alma mater!
    http://scienceblogs.com/insolence/2009/02/dr_jay_gordon_get_away_from_my_alma_mate.php

    Feb 20, 2009: Dr. Jay Gordon: Will you please stop claiming you’re not an antivaccinationist?
    http://scienceblogs.com/insolence/2009/02/dr_jay_gordon_will_you_please_stop_claiming.php

    April 30, 2010 Poor, poor pitiful me: Jenny McCarthy and Dr. Jay Gordon after The Vaccine War
    http://scienceblogs.com/insolence/2010/04/poor_poor_pitiful_me_jenny_mccarthy_and.php

    August 16, 2010 Penn & Teller deconstruct the anti-vaccine movement, not to mention an old friend of the blog, Dr. Jay Gordon
    http://scienceblogs.com/insolence/2010/08/penn_teller_deconstruct_the_anti-vaccine.php?utm_source=mostactive&utm_medium=link#comment-2729611

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    • Jay Gordon, MD, FAAP

      3 years ago

      Seth, only a very small percentage of formula used is not the “standard” variety. Hypoallergenic formula is almost always a last resort. Infant formula increases the incidence of many childhood illnesses and this Pediatrics story adds to that verified list.

      Congratulations to your wife–and to you for supporting her–as she breastfeeds your son.

      A scientist does not turn his back on an issue like this and claim that no further research should be done and that is my complaint against Dr. Offit and others. As I’ve said often, he is an honorable man who went into vaccine research to help children, not to get rich. But, like me, he is biased.

      Emily, why the “sic?” Did I mispronounce something?

      Liz, as I have mentioned, I suffer fro observational bias, confirmation bias and Iremain quite sad, many years later, about Len Bias.

      Happy New Year, you merry band of skeptics.

      Best,

      Jay

      Reply

    • Jay Gordon, MD, FAAP

      3 years ago

      Emily–

      Are you by any chance old enough to remember the “M*A*S*H” episode in which the chaplain shouted the words, “Jocularity? Jocularity!?” Just wondering.

      That infant formula dramatically increases the risk of ear infections, pneumonia, upper respiratory infection and even malignancies later in life is supported by hundreds of articles in the medical literature. The studies you cite are terribly flawed. Not the least flaw is defining exclusive breastfeeding incorrectly. And, by the way, ” Short-term exclusive breastfeeding was associated with obesity in five-year-old children (simple logistic regression: OR = 1.44; CI = 1.00-2.07; P = 0.050), but when including other independent factors in the analysis, short-term exclusive breastfeeding did not attain statistical significance.” That last clause is subject to debate, as you well know.

      Not breastfeeding increases the risk of diabetes: http://www.ihs.gov/MedicalPrograms/MCH/M/bfDiabetes.cfm

      Simply put, unless there is a strong medical contraindication to not breastfeeding, the risk of using infant formula should not be taken by any mother.

      Your “relational” comment is unusual, to say the least. You are implying that increased breastfeeding has led to an increase in obesity and that makes my, “vaccines might contribute to autism” meme pale and “scientific” in comparison.

      The AAP is, again simply stated, very much in the thrall of the pharmaceutical industry. I believe the proprietor of this site would support that idea.

      I do not endanger public health. That’s an insulting unsupported statement.

      Best,

      Jay

      Reply

      • Emily Willingham

        3 years ago

        I do not mean to insult, I am simply drawing conclusions and requesting some sobriety when discussing issues like these. When statements counter accepted findings on the efficacy of vaccines and the vaccine schedule or when you throw support (as in writing a foreward for McCarthy’s book) behind questionable (at the least) assertions about disorders and treatments, etc., the effect of your imprimatur as a physician and one with a high profile at that will be an expansion of behaviors that are counter to public health. The links Liz provides above elaborate on this.

        I made the “relational” aside as a dry observation on how misleading apparent correlations can be. I do not have any reason to think that increased breastfeeding is related to childhood obesity, but the way science is often interpreted, if I’d stated the reverse scenario–”formula feeding has increased, as has childhood obesity”–I do not doubt that many people would latch onto that apparent association as relevant and convincing. The news media and the public tend to see correlation as causation, and it’s difficult to unwedge that. Hence the dry observation.

        I’m a full believer in the efficacy of breastfeeding and support breastfeeding and breastfed my own three children–for one of whom I had to pump every two hours around the clock because he could not feed. That was my commitment to my children. But it was mine alone, and while I would encourage breastfeeding where possible for at least a year, I’m not going to misrepresent study findings or browbeat women about it to get that point across.

        “Dramatically increasing risk” is not demonstrating causation. It’s correlation, and it’s incorrect to say that formulas cause disease.

        My primary interest here is discussing science and making sure it’s presented and interpreted appropriately so that people who are seeking information find some accuracy in what they read. My other interest is more of a feminist one: I don’t think it’s appropriate to misrepresent findings such as these in the context of how women choose to mother. For some women, whether or not to breastfeed is not a choice, and these decisions are fraught enough without social pressures and anxieties layered on top of them. The mother-child interaction in those early periods should be an empowered one, not a bullied one.

        Regarding the studies you take issue with, I fail to see how a longitudinal, large cohort study isn’t up to snuff when the study you tweeted is and when your tweet misrepresented its findings. I’m aware of the studies demonstrating, in some cases, the benefits of breastfeeding, but I’m also aware of the inconsistent findings for many factors.

        Reply

  3. Emily Willingham, PhD

    3 years ago

    Jay–

    The examples continue to build. “Infant formula increases the incidence of many childhood illnesses.” I’d like to see the causation research on that.

    Curiosity.

    An author of the study in question herself stated in the Reuters piece that the study was not conclusive. It also clearly compared formula types–that was its focus–which was not something your original tweet indicated in any way. The study did not address breastfed infants.It also did not describe the infants as “obese” and noted that the infants on the hypoallergenic formula gained weight at a rate similar to that of breastfed babies. That does not mean much in terms of future obesity. Indeed, the most recent cohort study I can find indicates that breastfeeding does not ultimately affect obesity outcomes: http://www.ncbi.nlm.nih.gov/pubmed/20579201. These findings support those of other recent studies: http://www.ncbi.nlm.nih.gov/pubmed/18844983.

    Interestingly, back in the day when breastfeeding wasn’t “done” and many of us subsisted on standard formula because our mothers were generally told not to breastfeed, childhood obesity wasn’t the rapidly growing behemoth of an issue that it is today in our atmosphere of “breast is best.” Of course, that’s just a relational observation, but…there it is.

    I’d say that the very fact that Offit has written yet another scientific book indicates that he’s still full frontal on the issue, but perhaps that’s merely anecdotal observation.

    Jocularity et al. don’t do much to cover the absence of data in what you say, nor do they conceal the fact that as a pediatrician, you say things that militate against the science-based guidelines of the AAP without scientific evidence to back them up. And those opinions, if people harken to them (and they appear to do so) endanger public health, specifically children. I don’t find much there to make light of.

    Reply
  4. [...] Q: What do Paul Offit and infant formula have in common? A: Jay Gordon’s Twitter feed [...]

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  5. Sullivan

    3 years ago

    While I often disagree with Dr. Jay, I greatly appreciate that he takes part in the discussion and is approachable.

    Our family is very pro breast feeding. I don’t think that is the issue in this discussion here, though. It is whether the science is being correctly interpreted in this case.

    What strikes me is a contradiction inherent in this discussion. Dr. Jay chides Dr. Offit for a perceived lack of curiosity. As evidence of this he points us to a blog post by Dan Olmsted. Mr. Olmsted (and his co-author of “The Age of Autism”, Mark Blaxill) are probably the best examples of a lack of curiosity one can find in this debate. Their curiosity extends only so far as attempting to support the conclusions they reached years ago. They have zero curiosity as to whether those conclusions could be wrong (and they were, indeed, wrong).

    Reply

  6. Catherina

    3 years ago

    “The fact that new research indicates that some formulas appear to be healthier than others is wonderful news for those mothers.”

    Seth, that is not what the research finds either. The researchers just report different patterns of weight gain and call for further (and longer term) observation. They did NOT conclude that one formula is healthier than the other, and, based on 6 months observation of 35 vs 29 infants, it would be scandalous if they had.

    Jay – the study in Pediatrics does NOT add to the number of studies that show “that formula feeding increases disease incidence”. Why are you making stuff up?

    Reply

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