I never thought I’d end up writing about the UN, breastfeeding, and political spats, but it’s 2018, and that’s what we get to talk about today.

The New York Times broke a story in early July, claiming that the United States tried to block a U.N. resolution brought by Ecuador that “called on governments to ‘protect, promote and support breast-feeding’ and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.”

According to the same article: “The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced”

So, right off the bad, we have a super-weird article.

First, all of the sources are anonymous.

Second, in this article, and in many similar articles, the “experts” brought in to comment on the case seem to be in the crowd that believes that nature (breastfeeding) is good, and manufactured products (formula) are awful. They appear to be part of or related to the “humans are a part of nature” crowd. We know from experience that this line of thinking isn’t strictly true.

Third, the article suggests that companies that make formula, such as Nestlé or Abbot Laboratories may have had a role in challenging the resolution. The New York Times provides zero evidence for this and consequently is peddling a conspiracy theory.

Fourth, the article is written in such a way as to fit into two narratives: The Trump administration is anti-science and an international bully. This appears to be a calculated attempt to make the article go viral, which it did.

So, we can’t really trust this article.

But, I’m always on a quest to figure out what’s actually going on, and this article, despite its untrustworthiness, did leave a single, important clue. According to the same article, the Trump administration sought to get the words “evidence-based” added to the resolution.

It’s impossible to know exactly what this is referring to, as the resolution is not yet passed, and the text is, as far as I am aware, unavailable online.

However, it does give us a thread to follow, and it implies a lot of things.

Like, for instance, that there’s a paradigm of supporting breastfeeding as the best route without evidence, and that there might be a scientific challenge to such a platform.

If we want to understand this situation, we’re going to have to dig into the science behind the breastfeeding vs. formula debate.

Now, I’m not a doctor, and I’m not giving specific medical advice here, but there is enough on the Internet to make some general statements.

Starting with WebMD and the Mayo Clinic’s articles on this debate gives us a pretty clear picture of the situation. Breastfeeding is better in most* situations.

The first and most important reason is that breast milk contains antibodies that reduce the chance of “gastrointestinal, ear and respiratory tract infections” by “25%-75%” Additionally, breast milk may reduce the risk of sudden infant death syndrome.

The reduced chance of disease alone is enough to springboard breast milk ahead, in my opinion.

There are a few other positives that are frequently mentioned that I find less compelling.

Formula might cause constipation, though that usually isn’t serious. There are claims that breastfeeding has health benefits that continue into the teenage and adult years, though those have been contested. This is further complicated by the fact that parents that have the time and resources to breastfeed also tend to have the time and resources to do other activities that improve their kids’ health, which makes the causation less certain.

Finally, breastfeeding is said to increase IQ. The best studies show the benefit to be about 1.76 points, while less reliable studies suggest that it might be as great as 5.9 points. Either way, it doesn’t make that big of a difference in real life as the standard deviation in IQ is 15 points, and at the low end, the studies fall within the standard error of measurement, which is 3 points.

Furthermore, breast milk might not contain enough vitamin D, making supplements necessary.

There are also situations in which a mother shouldn’t breastfeed. Mothers with untreated HIV, herpes, or tuberculous shouldn’t breastfeed, nor should mothers that have used alcohol or illicit drugs. Also, some babies are galactose-intolerant, meaning they respond poorly to breast milk and will need a special formula.

It’s a toss-up in poor countries with dirty water, however.

That’s the big downside to formula—if the local water is dangerous, the formula will be too. It’s easy to get around this by breastfeeding, but it’s not the formula giving babies the sometimes-lethal diarrhea that you hear about, it’s the water the formula is made with. Dirty water is a problem that affects people of all ages, so it’s weird that it gets conflated with formula here. Dirty water should be tackled as a separate issue.

It’s important to note that both WebMD and the Mayo Clinic establish formula as an acceptable alternative to breastfeeding, while also lauding breastfeeding as the best option available.

So, maybe this was what the Trump administration was getting at when it asked that the words “evidence-based” get added to the resolution. I don’t see that as anti-science. Like I pointed out, some of the commonly-claimed evidence is weak, and there are genuine reasons that formula would be better in some situations.

And yet, there seems to be a prevailing movement to push people to breastfeed, which is good, unless it isn’t for any of the reasons that I listed above. There’s nuance to the situation. Every situation should be handled on a case-by-case basis as there are variables that depend on both the mother and the child.

Well, okay, but what about the bullying of other countries and the conspiracy by formula companies to kill this resolution?

I can’t tell you if those are real or not, but I can say that they appear, at least on some level, to be explanations used to try and explain why the Trump administration is wrong even though science and medicine might actually be on their side.