Epistemology and breastfeeding information

Just to go back a bit, should anyone be interested. The German beer is Malzbier, you can get it in alcoholic or non alcoholic varieties and it's supposed to be good for lactating women because of the high amount of carbohydrates it contains.

Germans also swear by Fennel tea for colic/gripe/wind in babies.

I can't add anything clever about BF though. I BF DS1 for 6 weeks, he just wasn't interested and DS2 for 9 months. I wish I could have gone on longer with DS2, it was so much easier, but ExTwunt decided that enough was enough....

I dont think robust scientific evidence is the problem. I think the fact that you cant subject pregnant and breat feeding women to proper scientific trials. You cant even consent to the hypothetical trial with alcohol anove if you want to as the trial wouldnt happen as it would be deemed unethical by people who fund these trials.

By the way there is a small amount of evidence that oats can increase flow early on. But u dont need a subscription for medicated flapjacks. More like eat some porridge and the odd multivitamin/ eat a varied diet with lots of veg!

Oh AHQM that's so true. Women's bodies are contested ground, as are what we do with them - all damn day.
It's possible to support breastfeeding without adding to those messages, I think.
Books like 'what to expect when you're expecting' are the worst - 'think if this is the best mouthful for your baby' sort-of thing.

Hazchem, I loved breast feeding. It seems like women are only allowed to do it if you bravely carry on through the worst experience of your life.

I agree with you about all the knowledge about caring for land that will be lost in Australian if it isn't recorded soon. That is happening in lots of places as landscape use and production methods change and older people start to die.

Personally (this is just a personal view with no science behind it) I see the alacrity of women to leap from "(breastfeeding) problem" to "I must consume less of something and police my eating and drinking even more restrictively" to be part of a culture in which women are encouraged to believe that they are always in danger of eating too liberally and too indiscriminately. And the lack of evidence for mother's diet negatively affecting breastfeeding ties in with this. Our culture is one that is deeply suspicious of women being allowed to please themselves with what they eat and drink, and this is one area it flows into.

I remember in my 20s a female friend of mine serving me and a male friend a plate of home made pasta with vegetables and cream sauce. "Oh good," he said "the first healthy thing I have eaten in a week." SHe looked utterly confused - it has cream! It has calories! We are being bad and indulgent! How can this be called healthy? I could see that he meant: real food, made with no additives and a big serving of fresh vegetables. It is sad that women think that to consume "healthily" is to be scant, whereas men think it is eating of the good stuff.

"Which means that official advice about breastfeeding is constrained by what has been studied scientifically" Yes and this is a problem. And that was the problem that the medical men a century or so ago had with women breastfeeding. There was no science (in their sense) applied. Just centuries of experience and women in control.

You are allowed to be cross with it, particularly in the context of a breastfeeding thread!

Buffy, yes, that was idiocy on my part. I misread your post. Thanks for taking the time to reply.

Sorry!

I breastfed one child for over two years and one for eighteen months. What socially supported me in that was excellent, experienced community midwives, a local culture that was pro breastfeeding, health visitors who were reasonable, and my own ability to think 'fuck it' to people saying don't eat peanuts, chocolate, drink tea etc.

That said, since then I did end up reading lots of research papers on the composition of breast milk for an assignment. If I had known while breastfeeding what I know now, maybe I would have made dietary changes (although none involving the irrelevant advice given by various well meaning people), based on evidence not generally disseminated to the general public. Or maybe I would have just doubted breast feeding and given up, not due to the diet issues themselves, but them tipping the balance on the general societal negativity to breast feeding.

There is definitely an issue (and perhaps a circular one) that formula milk is formulated based on breast milk, but the more people formula feed the smaller the breast feeding population and the less variability across great sample sizes we have to gather evidence from. How can we properly advise breast feeding mothers when the default baby is not a breastfed one? We're getting poor advice not just because breast feeding is another thing to control, but also because it has not been normal in the West for a long time. So when advice is given, it has to be some kind of generic breast feeders should do X. There's not going to be (as the breast feeding counsellor up thread said there should be) much opportunity to look at variability and the baby allergic to strawberries, because we're already the minority. The variable and nuanced advice will largely go to the mothers of the 'normal' formula fed babies, because that is what is known about. Hence weight charts for babies that were created from stats of formula fed ones.

I entirely disagree that the only thing that counts for very much scientifically is a randomised controlled trial. That isn't even the case in the very narrow area of pharmaceuticals. We have never been able to carry out RCTs of smoking, but there is a huge body of evidence that smoking causes lung cancer and other health problems.

Saying that no safe limit has been established for alcohol, an everyday substance, isn't a reason to stop drinking. What is the safe limit for carrots, water, saturated fat? At some point consuming anything becomes unsafe. The scientific evidence does not support the claim that not drinking at all is as beneficial to a foetus as drinking moderately. Some studies have shown better health outcomes for the babies of pregnant moderate drinkers than for abstainers.

What has happened is that social authority figures have decided to advise pregnant women not to drink while pregnant, and even that is recent in the UK. That was not the official health advice ten years ago. Although there are definitely major issues in the way science is conducted and its limitations, and the ethics of that as Buffy outlined, that is not the major issue with drinking in pregnancy advice. That advice is based on the social interpretation and application of the science by HCPs, which I think is not only about seeing people as stupid but also about the perception of drinking as being about fun rather than any nutritional outcome, and perceptions of pregnant women ideally being self sacrificing and controlled.

It is essential that we carry on research into breastfeeding. But the research as a whole should be led by women and should be done in an interdisciplinary context.

There is a huge problem with diet in general, of everyone, that we are given confusing messages as scientists, the diet industry and the fast food industry give us complex and conflicting messages. It is a mess and one mothers of young children will worry about most of all.

I would like to say, that just because it doesn't pass into breast milk, doesn't mean it can't put off the baby - lots of things we eat affect how we smell, and that could certainly have an effect couldn't it? I would suspect that people doing research are so focussed on the milk that perhaps they forget that a baby is snuggled right in close while feeding (or perhaps they bottle feed for these studies, and negate it entirely)

Asparagus wee, garlic breath, kipper-burps - if the baby decides it doesn't like what you smell like that could make it fussy too.

I do think there are some 'facts' that come out of someone asking a crazy question, and an expert saying that they suppose it could happen in theory and that then gets blown out of all proportion into something that does happen and we need to guard against.

I think a lot of these myths/'facts' about breastfeeding (especially in the western world) have come from men. Even in countries with traditionally high breastfeeding amongst mothers, men have a tendency to stick their oar in and come out with believable rubbish. Men took over breastfeeding in Victorian times as they felt women couldn't be trusted with it. We lost so much of women's collective knowledge about breastfeeding because of that.

So although I would normally agree with your OP in that women's experiences should matter and should be collated and listened to, we are effectively starting from scratch again on this and the information out there is unreliable at this stage (through no fault of women).