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Is there evidence that exclusive breastfeeding gives greater benefits than majority breastfeeding?

(28 Posts)
artichokes Mon 05-Jan-09 19:16:18

I am considering introducing one formula feed a day once dd2 is 6 weeks. This will ensure that:
(a) I can occassionally go out without dd2 and so do activities with dd1;
(b) dd2 will learn to take a bottle early minimising problems when I have to return to work (with dd1 it was a nightmare as she had only ever known the breast).

These would be too huge benefits for us as a family. I am not worries about endangering supply as I will wait to six weeks and only do one feed a day and anyway my supply is quite amazing at the mo.

So other than the potential for nipple confusion, which I will watch for diligently, is there a downside to one FF a day? For example, is the virgin gut theory credible?

27 Mon 05-Jan-09 19:28:46

If you have an amazing supply, what about expressing the milk, and then you dont need to worry?

If you google the phrase "just one bottle" you will find lots of information.

There is a factsheet here . I havent read it in detail, but it has references, so you can check the validity of the information it contains.

artichokes Mon 05-Jan-09 19:51:31

If expressing was an option I would. However, I find it incredibly painful and also unproductive (despite the fact then when DD is on teh breast it spurts out everywhere, often chocking her, and when I sleep it leaks out so much I have to have towels underneath me as breastpads are not enough).

I have seen summaries of research like that you link to. However, I have no idea how cridible that research is and what it means (except for those with a family history of allergy and diabetes). What does it mean for people without such family histories?

For example your link asserts that the PH of a baby's gut is altered by any formula and insinuates this is a bad thing, but does not acutally explain what the consequences of a PH change are. At another point it says you should avoid formula until the gut "closes" but does not explain what this mean or when it happens.

27 Mon 05-Jan-09 19:54:19

I dont know. I read all that stuff, but for me the decider was the stuff about allergy, as I have avery strong family history, so that was enough to convince me. Sorry for not being more help.

Have you thought about using breast shells to catch the leaking milk while you are feeding, or even expressing from one side while you feed from the other?

Hopefully Mon 05-Jan-09 20:10:23

Assuming all the research in that summary is credible (which it's probably safe to assume it is), the gist seems to be that there is a small but real risk of various problem (gut flora development not happening properly, increased risk of allergy etc) if formula is introduced within the first 3-7 days of life. After that period, the number of risks mentioned in that summary seem to decrease significantly, although there are still some.

Coming from a family that as a rule doesn't suffer from allergies/asthma etc, I read a number of summaries like the one above and decided that the risks really were pretty tiny by the time I was thinking of introducing it at 6 weeks (actually made it to 9 weeks exclusively in the end), and as long as I continued BF to some degree (DS has 1 bottle a day) the risk of problems was miniscule enough for me to discount it.

bubbleymummy Mon 05-Jan-09 20:12:24

Introducing one bottle still introduces all the risks of formula such as increased likelyhood of ear infections, gastroenteritis, respiratory diseases, allergies etc as well as threatening your milk supply. Obviously, it's entirely up to you do decide if you want to take this risk. I would personally stick to expressing - I wasn't a great expresser by any means (thankfully did not have to do it that often!) but once I found a pump I was happy with and a time of day that worked best for me (first thing in the morning when I was most full and sometimes alongside DS feeding) then it got much better. You can also try expressing in the bath/shower because the warm water helps the let down. If the pumping really isn't working for you - you could try hand expression - sometimes this worked MUCH better for me than the pump. Tips here:
www.askdrsears.com/html/2/t024900.asp
Good luck with whatever you decide.

chandellina Mon 05-Jan-09 21:15:01

but surely those risks are less with one FF than exclusively FF.

and only a very small percentage of FF babies ever have those problems anyway.

tittybangbang Mon 05-Jan-09 21:17:31

With respect artichokes, what activities can you not do with your baby? I have three children - 9, 5 and 3. When my second and third were tiny babies I had no problem taking them anywhere really with dd, who was the eldest.

It's harder once they're moving around a lot, but by that time they're not feeding so much anyway and can be left with water while you're out.

artichokes Mon 05-Jan-09 21:24:54

Bubbley - is it really true that "introducing one bottle still introduces all the risks of formula"? Is there evidence about the increased risk of infections etc? If that is true then it suggests one bottle of formula negates all benefits of breast feeding other than the bonding benefits. Can that really be the case?

artichokes Mon 05-Jan-09 21:27:56

Titty - it is more about spending one on one time with DD. She has found the arrival of DD2 unsettling after a hard pregnancy that stopped me doing many things with her.

tittybangbang Mon 05-Jan-09 21:48:00

But your baby will be asleep most of the time surely? What about if you used a sling? Toddlers get used to ignoring you having a snoozing and basically inanimate lump attached to your chest. Surely it's more about the quality of the attention she gets from you than about the simple presence of a sleeping baby?

tiktok Mon 05-Jan-09 22:04:39

The evidence is that formula feeding brings about a 'dose response' - that is, its effect is heightened, the more of it you do. So partial formula feeding is has less of an impact than full formula feeding - you can see this is the studies which look at infection and hospitalisation, whereby the fully ff babies are more at risk than the partially ff babies.

I think it's obvious that a one-off bottle of formula does have an effect, but for the vast majority of babies, this will be temporary, ad I don't think there can be any practical way of testing whether this single bottle translates into increased infection etc in reality.

A daily bottle at six weeks risks undermining breastfeeding, though - less so if the mum's supply is excellent, of course, but the risk is that one bottle becomes an offer of formula each time the baby squeaks a bit or doesn't settle after a brestfeed.

One thing is clear, though: the health effects of breastfeeding are not wiped out by formula

giantkatestacks Mon 05-Jan-09 22:11:30

At risk of deviation from OP I feel really upset (all over again) about that any formula in the first few days of life research as I ended up in itu after the birth of dd and she was cup fed one feed overnight (after strict instructions that she was not to be and ITU staff saying that we could pump or bring baby up). sad

I now feel that the 26 weeks of exclusive bf has been completely undermined - in fact I cant even make that statement angry

Pannacotta Mon 05-Jan-09 22:15:51

Can you hand express artichokes, that shouldn't be painful?
I did this when DS2 was small, usually in the shower or bath (and gave the expressed milk to DS1) and I found it quite easy, much more comfortbale than using a pump.

Hopefully Mon 05-Jan-09 22:23:02

Definitely right about the temptation to offer extra bottles *TikTok - I have an almost daily struggle with DP (and myself, tbh) at the moment not to offer a top up of formula after each feed, as DS is growth spurting and feeding like a beast. I am adament that for the time being the formula is purely to give me a guaranteed few hours sleep at night, not for anything else.

Hopefully Mon 05-Jan-09 22:25:10

kate you poor thing, what a frustrating thing to have happen. Try to remember that even that study states that for many of the ff 'risks', a couple of weeks of exclusive bf eliminates them again, returning the gut to an EBF state, as it were.

treedelivery Mon 05-Jan-09 22:31:35

Can you come live with me when I have dd2 TikTok? grin Or at very least be on permanent mumsnet patrol till dd 1? Ta x

giantkatestacks Mon 05-Jan-09 22:34:56

Thanks Hopefully - I will read the research at some point when am ready smile

Hopefully Mon 05-Jan-09 22:47:48

I am convinced that what ever single BF mother needs to succees is a little pocket TikTok to carry round with them at all times!

tiktok Mon 05-Jan-09 23:00:49

kate - why do you think your bf has been undermined? It's not logical, really...

bubbleymummy Mon 05-Jan-09 23:09:03

Sorry for the delayed response - DH's family and DS called!
I'm not saying that formula will undo all the good benefits of breastmilk just that formula carries risks so you would be introducing those risks by introducing a bottle of formula.
GKS, It's awful that you feel this way - your 26 weeks of breastfeeding has most definitely NOT been undermined and it's fantastic that you were able to establish feeding after your difficult start. Studies have shown that if exclusively breastfed again after being given formula, a baby's gut will return to its original state after 2-4 weeks.

fledtoscotland Tue 06-Jan-09 00:10:43

I have no personal experience of FF causing these infections (DS1 was FF and is the healthiest little boy you could ever come across). DS2 is BF with one bottle of Hipp formula a day. DH wanted to help feed and i couldnt express (lots of different reasons). DS2 has never experienced nipple confusion. he will suck anything in his mouth - nipples, teat, dummy, finger, etc etc. He has never had any illness (is now 4months old) so obviously the BFing is helping as he escaped the family's dose of the cold back in early december. My milk supply has definitly not been affected and we have settled into a routine of DS2 getting 4ozs formula at 8pm. if he is still hungry, he gets boob.

HTH and good luck

giantkatestacks Tue 06-Jan-09 07:52:00

tiktok I know its not logical and I havent posted about it before because I was worried it would identify me but never mind I have now...

I suppose I was really happy about what I had achieved - as bubbleymummy says but then if ff can indeed affect the gut in the first week then I feel as if I have let my dd down - irrational and stupid yes as there was nothing I could do about it I should just feel grateful to be here for her full stop.

Grendle Tue 06-Jan-09 15:44:30

Kate -I think understand why you might feel that way. You did everything you could to follow the recommendation of what you felt was best for your baby, but nevertheless your baby was exposed to a risk (no matter how small) that was unacceptable to you at a time when you were powerless to intervene. I don't think logic always comes into one's feelings on something so important to you, tbh.

I was in a different position, but for a long time was very distressed that ds hadn't been exclusively breastfed as I had planned and that even a relatively small amount of formula introduced to him early on might have had effects on him. In the end, the only thing that helped me come to terms with it was properly debriefing what happened, right from birth onwards. I eventually came to genuinely accept that what happened was beyond my control at the time.

Did you complain?

giantkatestacks Tue 06-Jan-09 16:31:52

yes but could only take it so far - meetings with consultant and letters to postnatal sister etc because it was doing me more harm than good in the end.

Everyone was doing what they thought best for me and for my baby - it just differed as to what I thought was best. Had I been up on the postnatal with her or if my dp had 'allowed' to have been with her somewhere then it would have been different.

The head of obs said he would review the procedures and thats all you can hope for really.

am not sure I have reached genuine acceptance though - well done smile

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