to wonder where my GP and midwife get their information from (re: breastfeeding while pregnant)

[BlueBubblegum]

DD is almost 1years old, still breastfeeding her 3 times a day. I'm just over 3months pregnant (15weeks).

When I went to the GP to get a referral, I told him I'm still breastfeeding and intend to continue throughout the pregnancy and up until she's two if I can manage it. He strongly advised against this, he said my supply would decrease and she wouldnt get enough. So I said I'd supplement her when that does happen and for now I think she's getting enough as she doesnt seem to be complaining, seems as content as ever when she's finished. His reply was well it still wont be good enough for her, you need to stop.

Several reasons why I want to continue for as long as I can, one of them is because DD will not take any milk (formula or expressed) from a bottle or beaker, she can drink upto 3 ounces of water from a beaker but as soon as I pour some milk in there, she wont have any, no matter how hungry she is.

Had an appointment this morning with the midwife to get results back for blood tests (all OK thankfully) and she said very firmly to stop right away from toight, apparently the milk isnt good enough for DD, because it contains pregnancy hormones. I asked if there has been research done to prove that breastfeeding is harmful and she replied 'yes I think so'.

I've done my own research and as far as I can see, its perfectly safe unless there is a history of miscarriage (which thankfully I dont). I know it will get uncomfortable as my pregnancy progresses but ofcourse if its get too much, I wont put any pressure on myself to continue.

So where do they get information from? Is there any research to prove that breastfeeding when pregnant isnt safe?

Just need a bit of reassurance really. I know I will get asked about it the next time I see my midwife.

Oh and just to add, even the dentist said I shouldn't be breastfeeding her, I should have stopped when she was 6 months old, its no good for her teeth (even though she only got her first too tooth at 10 months). Well she's only feeding three times a day for no more than 5 minutes at a time, I doubt thats going to have any last damage on her teeth. Seriosly, I thought health professionals are supposed to be encouraging breastfeeding?

There was recently a comment out from the dental association that extended breastfeeding causes tooth decay. NCT amongst many others challenged this comment asked for their research to be backed up the comment was withdrawn. I believe this is where Yummy mummy talks from.

There has been some isolated cases where breastfeeding has been claimed as being the reason for a child's tooth decay I have to admit that the poster whom mentioned that she might be open about her daugthers breastfeeding but more cagey about her chocolate button habit as this could very well be the case made me smile. There could also be other reasons like I am sure Yummy would agree with. My oldest dd whom was breastfeed for the least time of my children has terrible teeth problems she has very little emamal on her teeth appears to have inherited this from my father whom also has this problem. None of the other 3 has this issue nor any cavaties not even the who whom were fed for 19 and 21 months..

I am a BFC I could quote studies etc about where the research to support that breastfeeding whilst pregnnant and tandem feeding is fine and safe to do, I wont bother there has been plenty on this thread already (as I have taken a long time to read it lol)

OP ask your doctor to back up her comment with resarch simply state "this is now my understanding in fact from resarch I have read it is the opesite please give me your research" (If you feel like being a bit sarcy you may want to mention NCT LLL ABM and BFN plus WHO off course will need to update all their resources)

To those of you whom asked about falling pregnancy whilst breastfeeding I have once fallen pregnant whilst feeding it took no less no longer than it did with my other 3. With the others I have had m/c inbetween I didnt whilst I was breastfeeding. I continued to feed until I was 7 months pregnant when my 19 month son selfweaned. I admit I was relieved as I was finding it incresingly difficult to feed as my nipples were so sensitive and what became his little sister used to kick his ribs every time he fed chuckles.. at the time I read all I could find on tandem feeding and I have due to this kept a keen interest in the subject I have yet to see any research prove it is not safe to breastfeed whilst pregnant or to tandem feed.

to the poster whose GP suggested his research was to complex for her to read I hope you immidiatly started drooling.. Patronising so and so I would have told her calmly I was well able to read and understand medical research in my job this is part of what I do, and what she was telling me right now was not as I understood it correct so could she please back it up with relevant resaerch (may even have commented I didnt believe she could supply it hence herneed to make such patronising comments)

For those of you stating that we should not argue with the professional. Whilst I to some extend understand what you are saying there I dont agree with it. It is because people argued with the medical profession we have had so many possitive changes occur in medical (and dental I might add) practice. Also no offence or any down put placed upon yummy's ability to do her job as a dental but her expertice does NOT lie with breastfeeding. I dont even think it makes the semester list in the dental schools (I am happy to be corrected there if I am wrong)

The experts would be
NCT, LLL, ABM, BFN and WHO the last one whom reccommends we continnue to breastfeed our child until age 2.

The evidence is overwhelming for breastfeeding past babyhood. If any of you have any substantial research to back up the oposing argument I will be more than happy to read it, I may not agree with your way of reading it however as part of my training I was taught critical appraisal of resarrch I often see stuff others chose to ignore.

confuddled- Are you a pedant? I don't do pedantry at that hour, sorry!

I fell pregnant with DS when DD was only 3 months old, no way would I have stopped feeding her.

She wouldn't take a bottle, ever and went straight to a cup at 8 months and I continued to feed her night and morning until about a week before DS was born, - her choice.

Her weight gain did slow down quite rapidly at 6 months and she was well below her centile ( born 95th) but was healthy and happy and slept through from 6 weeks old.

It didn't do DS any harm, he was 9.12lb when born.

LOL sorry thebreastmilksonme! I'd rather not be a professional than be an unprofessional professional though

the advice from the American paediatric Dentists association is that breastfeeding does not lead to a higher incidence of dental caries.

My friend is training to be a GP and she has receivced no training as part of her paeds rotation on breastfeeding. Fortunately she's plenty of personal experience.

Back to the OP and her dentist's comment that she shouldn't be breastfeeding her one year old. Since babies are meant to have milk until they are 2 years of age under I believe WHO guidelines (I'm sure someone will tell me if I'm wrong) the origin doesn't matter. Breastmilk 3 times a day combined with a balanced diet that does not involve frequent snacking on sugar containing food is unlikely to cause tooth decay. Since it is about frequency of consumption of sugar not amount I cannot believe all breast milk goes straight down the babies throat, my ds certainly seems to have some in her mouth. Therefore it could cause decay if they were fed frequently on demand although in a toddler with good eating habits this would be unlikely. I have problems with statements that say never since the health profession tends to avoid these. Ok long monologue over.

MMM, breastmilk contains lactoferrin which chelates iron - it makes it unavailable for bacteria to use. Besides needing sugar they also need iron. the Iron in formula is more readily available than the iron in BM for bacteria to use because of the absence of human lactoferrin in formula. Which is also anther reason why breastfed babies suffer fewer instances of GI infection. (Cows produce their own lactoferrin but in lower quantities and of a different molecular structure).

bm also contains white blood cells which kill streptococcus mutans bacteria to common culprit of tooth decay.

just 2 of the reasons why breastmilk is not bad for teeth despite it containing lactose.

the Presentation by dr Brian Palmer says it better than I did. just look at the link and if you are up to it, the other presentations on his website.

rambling now: this morning I went for my regular check up and told my dentist about the stuff about TT I was reading on there this morning. He was surprised to hear that TT could cause digestive problems in adults if it remained unresolved.

Thanks foxytocin.

And MMM, since breastfeeding on demand isn't really just about food, but more about food + comfort + familiarity you can easily have a toddler with a good diet who also, for a variety of reasons, wants to bf frequently.

I had to make quite an effort to cut her days feeds down at 18 months and she has an excellent diet.

Foxytocin, I've had a look at the overview for Dr Palmer's presentation but without seeing the whole lecture the overheads are slightly difficult to interpret. I've been trying to read the original article by Dr Erickson to no avail and other articles I find state that breast milk in combination with other sugars is highly cariogenic and surely this is the situation we are talking about not a solely breast fed child but a weaned one with supplemental milk?

Just to clarify the WHO recommendation, it is to bf until at least two.

Well, not sure about the cariogenic properties of BM in conjunction with other sugars in the day, but surely most instances of feeding at night would occur after the child's teeth have been cleaned and that you wouldn't usually feed-back-to-sleep with a biscuit/chocolate button thrown in for good measure?

"Calcium and phosphorus are actually deposited onto
enamel powder after incubation with HBM(human breast milk).
? HBM does not cause a significant pH drop in plaque.
? HBM is not cariogenic in an in vitro model, unless another carbohydrate source is available for bacterial fermentation.

Pamela Erickson, Investigation of the role of human milk in caries
development. Pediatric Dentistry, 1999;21(2)(Mar-Apr):86-90."

this says to me is that if a child who is weaned onto solids also has his teeth brushed at night before bedtime feeds, HBM would not be a likely source of tooth decay.

I still can't make head nor tail of Dr Palmer's power point; slides 2 and 3 do not recommend demand feeding once the child has teeth. I was under the impression that human milk contains far higher levels of lactose than any other mammmal and was taught that was a potential reason for decay. There is obviously low levels of decay in the skulls which were examined and no way of catagorising those that had mixed dentition. I really need to see the full articles as still

more on bf and tooth decay

slides 3 and 4 which are what I am thinking you are referring to are illustrating the out-of-date information from the AAPD's journal. he then goes on to demonstrate why these recommendations are invalid.

he recommends printing out [[http://www.brianpalmerdds.com/caries.htm this page to read along while viewing each slide so that they make better sense.

sorry, this page

Foxytocin my point is; saying that bf does not cause caries is misleading. Exclusively bf yes but most children preweaning don't have teeth anyway. Once they are weaned, have teeth they have a mixed diet with additional substrates therefore they are then at risk of the bm being a cofactor in the decay unless given exclusively at night according to the synopses I've looked at so far.

and no one here has been advocating not brushing a child's teeth at night because they are still breastfed.

the presentation also raises the interesting historic evidence that until 8 - 10,000 years ago children did not suffer caries like they do now.

for 92,000 yrs we did very well without flouridated toothpaste and water.

this age of caries also tie in with the settlement of populations and agriculture. Our diet and other social interactions changed with it alongside other relationships with food and bacteria too.

And we are not even yet looking at the processed sugars that is hidden in the most unlikely places in our foods today.

Blaming breast milk is a part of the a wider distaste for feeding toddlers. Brush their teeth at night and see if that improves things.

but MMM you could equally argue that it's not the bf that causes the caries but the food ingested alongside.

And it would be equally il/logical to say that a child should not be allowed other carbohydrates in their diet, as to say they should not be allowed BM.

The point is, surely, that it's the combination that causes problems and you can't blame either factor in isolation.

The other point is that it's not that hard (with appropriate dental hygiene) to ensure that they are kept separate. There should be no need for a child to have other sources of carbohydrate in their mouth after they've gone to bed.

That is what I'm saying; BM is a cofactor when consumed with other carbohydrates. My point is simply that to say BM does not cause decay is misleading. It doesn't cause decay when the infant is BF exclusively but when you start weaning the child is at an increased risk according to the articles quoted when these are combined. Except at night when BM only. I am going to do a bit of research into this as Immunoglobulins are already secreted in the mouths of adults but no-one would suggest they are wholly protective against strep mutans and I don't know enough about lactoferrin to comment. Will post back when I've read a bit more.

No - I don't think you can say from the available evidence that they are necessarily at increased risk.

All we know is that teeth immersed in BM plus sugar solution fare worse than worse than teeth immersed in either BM alone or sugar alone.

We don't know how that plays out in real life where a) the teeth of a breastfed child are unlikely to be immersed in the solution in the same way and b) in practice are highly unlikely to encounter a co-equal solution of both at the same time.

We also don't know how that compares to, say, a solution of formula milk plus sugar, or orange juice plus sugar, or how the delivery of the milk (breast vs cup vs bottle) plays into that.

All we can say from the evidence here is that breast milk alone is fairly benign, and that consequently dental hygiene is extremely important. That's it. Any further extrapolation is just speculation - unless you have found further research?

Agree though it is really a fascinating question and I would be v interested to read any further info that you come up with.

I mean sorry, to expand my "no" - what I meant is that you can certainly say that weaning puts the child (any child) at increased risk.

What you cannot say is whether a weaned breastfed child is at increased risk compared to a weaned child fed with other types of milk.

None of the papers linked to so far comment on that.

I actually took DD to the dentist when she was just about 10 months old, she'd only just got her first two teeth, dentist obv knew this and even then she said 'you should have stopped when she was six months'. I just thought, well if BM was going to cause decay, how can it when there were no teeth to cause decay to? Hence why I decided to ignore her advice. She didnt even bother asking or advising about sugary drinks.

DD only drinks BM and water, has never had sugary drinks and I wont be offering any until she's 2 (well thats the plan). She's hardly ever had any refined sugar in her diet, she has plenty of youghurt but its sweetened with pure fruit smoothies (those Innocent ones) and if she has fromage fraise, I only get sugar free ones (those Plum ones are a but pricey but brilliant). I know fruit isnt that good for teeth either, but everything in moderation. She's always offered a beaker of water after every meal. Her teeth are brushed twice daily.

Will take some of the advice and probably wont mention that Im still BFing to HCP's.

Thanks again

Actually the British Dental Health Foundation recently changed their guidelines on this - they used to recommend weaning off both breast and bottle at 6 months.

Now they specifically do not recommend weaning off the breast, but state that you should continue to breastfeed past 6 months, while maintaining dental hygiene.

There was a thread a few months back about this as some dentists were still giving out out-dated guidance on the issue.

www.ncbi.nlm.nih.gov/pubmed/19145723
Youngvisitor this answers one of mine and your questions. I'm now really interested so trawling pubmed rather than doing the ironing.