Benefits of breastfeeding 'wear off' by 5

[greygal]

Had 6 week check for DS today with my GP. He asked all the 'normal' questions, including how I was finding breastfeeding.

I've been really lucky and had no pain, soreness etc and DS is gaining wait incredibly well so I explained that despite my longest sleep in 6 weeks being 4 hours in one go, I felt that it was going really well and felt positive about continuing.

He then launched into a rant about there being far too much pressure on mothers to breastfeed and that by the age of 5, any benefits to a baby of being breast-fed had worn off!

AIBU to wonder why the bloody hell we're all bothering (especially people who have cracked, bloody nipples/ blocked milk ducts/ mastitis etc)?

Is it true that there is no difference between a breast fed and formula fed child by 5 years of age?

@Havingahorridtime

Ah, yes, you see, I think it should be a woman's choice how she gives birth. I'd personally prefer to avoid a c section but I don't think I should tell another woman that she must have her baby 'the proper way'. Regardless of whether it's a small number or not (in Brazil the number is very high), it's the mother who decides whether to have the baby, how to have it and how to feed it. I thought that was a basic right.

I live in Sweden - it’s 80% at four months I think.

But: 1. There’s an almost obsessive mentality here that natural is best. C section rates are low but vaginal birth injury rates are VERY high

1. Sweden has a completely different mentality towards children, babies and BF. I BFd my son in cafes, shopping malls, everywhere. It’s all seen as normal. A cafe full of people who might stereotypically be expected to tut tut in the UK (older people and builders on lunch breaks) do not bat an eyelid. It’s normalised completely. gross stereotype sorry, butcthe only time I’ve ever had an issue feeding was in a cafe in the UK with a load of older ladies looking at me (feeding discretely with not a scrap of skin showing)

1. Parental leave is better funded and most state daycare won’t take kids under one so here are very few women forced back to work early, hence BF is not needing to be interrupted as much.

1. There is a Swedish herd mentality that’s very hard for Brits to get - it’s the belief that we do it the right way, everyone else is wrong and you do what you’re told. People are told to BF so they do. Lagom and Jamte’s law are still strong here

Elcs is not available on maternal request here. I PASSIONATELY oppose that - there is a hands off approach here that works great if everything is tickety boo butcthay grossly fails women with anxiety, previous birth injuries etc. Birth injury rates here are far above what they should be and aftercare is poor. I’ve actaully switched to a private midwife in my second pregnancy because he care I received in my first (HG both times lucky me) was far below what I’d expect.

Sweden is often held up as a utopian dream and while there are many good things here, a lot of the information provided by the UK press is misleading. Sweden is not utopia.

The 2% figure I think is women with anatomical issues (eg no functional ducting) that cannot ever produce milk.

A friend works in the field and estimates that roughly 5% of women have physical issues that mean BF is almost inevitably going to fail and another 15-20% have issues (either Mum or baby) that mean that BF is unlikely to succeed without significant intervention.

Oh and another point to add to my list: poverty and inequality. Sweden has nowhere near the levels of socioeconomic inequality that the UK does. The link between bf /ff and poverty /class /education is weaker here.

Drs and scientists recently pumped a man pretending to be a woman full of unsafe drugs and hormones so they could breastfeed a baby.

But hey. Let's treat breastfeeding mothers like this.

Similar in Finland, you're just expected to breastfeed here, the idea of choosing to formula feed from the start is quite alien and I imagine there's not much support for mother's who choose that, but lots switch over after the first few months anyway.

@Anatidae so it's not as simple as saying "oh but only 2% of women can't breastfeed".

rebel no its much more nuanced.

I suspect I have a mild ductal defect (no duct outlets on one half of one side) so that reduced my chances but with perseverance I got it. The supply on that side was always worse and if both sides had been like that I might have been unable to sustain feeding. I will supplement next time because I suspect some of my son’s sleep issues were down to my slightly shit (but clearly delicious from his shark like feeding) milk supply

Then think of all the other issues that can combine: anatomy, both Mum and baby. Breast surgery, Mum being ill, baby not being strong enough, tongue tie, exhaustion, blood loss, shock, small jaw... lots of stuff can combine to reduce chances incrementally. Some women just don’t produce much milk (I’m one!) if you struggle at first it’s easy to switch and I don’t think anyone should be judged for that. It’s more important to recover from the birth as establish the bond - if pnd from struggling to feed isbstopping that then that’s an issue.

If women WANT to feed there should be better support. Feeding in public should be normalised. Absolutely no woman should ever be made to feel bad about giving a baby a bottle - it honestly doesn’t make that much difference. Most of the research on bf isn’t very good anyway as pps have pointed out.

There’s just a very different attitude to it here in scandiwegia (waves at natsku) it’s seen as the norm, accepted completely and no one is funny about it in public.

“A friend works in the field and estimates that roughly 5% of women have physical issues that mean BF is almost inevitably going to fail and another 15-20% have issues (either Mum or baby) that mean that BF is unlikely to succeed without significant intervention.“

Do you mean by ‘breastfeeding will fail’ that a mother simply wont be able to continue to breastfeed in any capacity?

www.therichest.com/rich-list/rich-countries/10-countries-with-the-highest-breastfeeding-rates/

Because this article suggests that 90% of Rwandan mums are exclusively breastfeeding at 6 months. I assume this must be the result of a massive drive to increase rates of exclusive breastfeeding in order to reduce the transmission of HIV (given its prevalence in sub-Saharan Africa).

“Absolutely no woman should ever be made to feel bad about giving a baby a bottle - it honestly doesn’t make that much difference. Most of the research on bf isn’t very good anyway as pps have pointed out.“

Sorry - you’ve conflated two things here.

1. Women shouldn’t be made to feel bad about giving a bottle. True - they shouldn’t. Mothers have a right to feed their babies how they wish and are doing their best on the basis of what they know and what they find possible.

1. ‘It doesn’t make much difference” - sorry, but you can’t expect to pass this one off as an accepted truth because it’s not. Many people feel the evidence shows that how a baby is fed affects them in a huge variety of ways. People have a right to believe this and express that belief without being made to feel like an extremist or naive. If the WHO, the NHS and basically every major health body in the world says that breastfeeding has important health benefits for mothers and babies, then it’s wrong for people to just casually dismiss this with a casual assurance that how a baby is fed ‘makes no difference’.

@minifingerz I doubt the Rwandan figure is due to a drive to increase bf rates - traditionally bf rates have been high in developing countries (and would have been in the UK before the advent of formula) because of the lack of alternatives.

This link suggests 99.4% of mothers in Senegal are still bf after 12 months: www.bbc.com/news/health-35438049

Also I think bf is discouraged among HIV-positive women as it can pass the infection to the baby. But I could be wrong about that?

then it’s wrong for people to just casually dismiss this with a casual assurance that how a baby is fed ‘makes no difference’.

Firstly, no casual dismissal. I’ve spent quite a bit of time poking round the primary literature. I understand it.

Secondly, Big difference between NO difference and NOT MUCH difference. Because in the West, with access to clean water, vaccines, well fed children etc it doesn’t make much difference to the individual. Look around you child’s classroom- who was breastfed? Look around your MIT classroom on advanced string theory? Who was breastfed? You can’t tell.

Because... (for the millionth fucking time) ...

On a population level you can see the differences. On an individual level the effects are so small they are impossible to quantify.

This is not a difficult concept statistically, surely? People don’t seem to be able to grasp this and it’s frustrating.

Things that are tiny in individual people add up in a population of 70 million. That means that what public health push is what’s best for the population. And it means that what the individual does is what’s best for them.

I’ve no idea what the other x % do in the third world. Probably what they used to do here, which is die of starvation. The child mortality rate in Senegal is 79 per 1000 overall (94 in rural areas and 56 in urban.)

Compare that with the Uk rate which I think is 3. Something per 1000.

“Also I think bf is discouraged among HIV-positive women as it can pass the infection to the baby. But I could be wrong about that?“

Not in developing countries where women don’t have ready and affordable access to formula, and also clean water.

“Firstly, no casual dismissal. I’ve spent quite a bit of time poking round the primary literature. I understand it. “

And you have come to a different conclusion than the panels of doctors and epidemiologists who work for all the major health bodies in developed countries. I suggest that’s because you have a vested emotional and social reason for interpreting the data and the recommendations in the way you do.

I’d also suggest that it’s very naive to assume we know everything there is to know about what happens to the human body when we make a population level, fast and totally experimental swerve from the evutionary norm, which is what we’ve done in the West in the feeding almost all babies bar newborns partially or wholly on processed animal milk.

Where are the well controlled trials with large populations of exclusively breastfed babies as the control group? Where are the trials controlling for the use of antibiotics in mothers and babies (over a third of all mothers and babies now having antibiotics at birth)?

We don’t know what impact artificial feeding has on babies because there simply isn’t enough evidence.

Hasn’t stopped people merrily sucking up thousands of poorly supported claims made by formula manufacturers over the years while smugly insisting that the evidence in support of breastfeecing isn’t convincing. WTF - breastfeeding shouldn’t have to prove itself. Formula feeding should!

“Secondly, Big difference between NO difference and NOT MUCH difference. Because in the West, with access to clean water, vaccines, well fed children etc it doesn’t make much difference to the individual”.

Except there is evidence of higher rates of SIDS, childhood cancers, abnormal gut flora, diabetes, and differences in brain structure identifiable by MRI. So clearly not having human milk does affect all children at some fundamental level in relation to their physiology, and some children catastrophically.

“Look around you child’s classroom- who was breastfed?”

Nope. Neither can you usually tell the children whose mums drank a bit too much in pregnancy or those who smoked, or took medications which impacted on the growth and development of their babies in the womb, nor those who lived on appalling junk food, or were exposed to horrific stress during pregnancy. And that’s because human beings are endlessly complex and not little identical boxes dropping off a conveyer belt where it is easy to identify the things that might have damaged or improved them during the process of making them.

And actually the fact that you have used that feeble argument undermines everything else you say!

minifingerz I was responding to the suggestion that this must be the result of a massive drive to increase rates of exclusive breastfeeding in order to reduce the transmission of HIV (given its prevalence in sub-Saharan Africa) - I'm not sure this is true is it? That bf helps prevent HIV?

Not sure why I'm quibbling though - I agree with pretty much everything else you've said

Wow, I take it all back. I was only aware of the old advice that HIV+ mothers shouldn't bf, but the advice has changed.

www.who.int/bulletin/volumes/88/1/10-030110/en/

i suggest that’s because you have a vested emotional and social reason for interpreting the data and the recommendations in the way you do.

I breastfed my child for 18m. What’s my vested interest, apart from pedantry over people’s inability to understand stats and how health policy is set ?

The panels of epidemiologists you refer to are making recommendations at the population level

POPULATION LEVEL

Do you not understand how that differs to what might make a better choice for an individual Mum and baby?

Let me try an analogy /scenario or two.

General recommendation is however many minutes of moderate excercise a week. Studies show on a population level this increases health outcomes. Bob is terminal with emphysema - so for him as an individual this is not a recommendation he should follow. This does not mean that excercise isn’t good for you, but it’s not good for bob just now. Bob is not telling the entire country not to excercise, but he’d be within his rights to snap back at someone insisting that all the research shows its good for you bob, get out there.

Sue has serious ptsd issues from being raped a few years back. Any touching of her breasts distresses her severely. She is feeling under pressure to breastfeed and she is close to a breakdown. In this case her individual needs differ from the population level recommendations.

I don’t understand why the idea that you can have a blanket level population recommendation and that not be right for every single individual in that population is a difficult concept to grasp. And I’m mildly peeved that people don’t understand how health policy works and how small the INDIVIDUAL effects are.

Junk food and stress doesn’t do a whole lot of damage either to be honest, unless the junk food is accompanied by a metabolic issue like GD. Mums who have HG (and I know, I am one) live off whatever they can take. Often nothing, often just licking the salt off chips - baby is usually fine.

Stress needs to be extreme - loads of cortisol based studies knocking around but few have any solid long term follow up.

However, both diet and stress are used to berate women over their choices, just like bf/ff.

And FASD... well that’s a whole other matter. And unfortunately then you can often tell, due to the symptom spectrum and in more severe cases the characteristic facies :(

Secondly, Big difference between NO difference and NOT MUCH difference. Because in the West, with access to clean water, vaccines, well fed children etc it doesn’t make much difference to the individual. Look around you child’s classroom- who was breastfed? Look around your MIT classroom on advanced string theory? Who was breastfed? You can’t tell.

I don’t get this point at all.

BF is better for BABIES as in when they are babies. I didn’t BF my kids because I think they’ll have overall better life outcomes. But because research shows that breast milk is the best food for babies and so while they are consuming it they benefit from antibodies, reduced risk of gastro issues, and also just my general wish not to rely on multinational corporations with dubious ethics for my infants nutritional needs.

You can’t tell by looking lots of things about a person, doesn’t mean anything honestly.

Why aren’t people understanding that minute differences that are only visible at a population level may be overridden by individual circumstances?

If you take a pool of 100,000 kids and say bf and ff half each, then investigate how many times they’re ill in year one, you’d have a huge spread of data. Some bf kids won’t get ill, some will be ill ten times. Ditto ff kids.

Then you plot all that out and it turns out that say the bf kids, on average, get sick one fewer time than the ff ones. So on a population level you see the difference but if you pick any one individual child out, the other factors VASTLY outweigh whether bf or ff.

The difference is only visible at the higher level and the variation in the sample is huge. It does NOT mean that every child in that sample has an exactly x% chance of one fewer illness.

Bf is great but it’s not right for everyone, and to use the population level statistics to berate women for ff is done with wild abandon, and it’s such poor understanding. It just shows a total lack of comprehension.

Anyway, bf is great, crack on if it’s working for you, just don’t use ‘the WHO says..’ as ammo to berate an individual.

I understand finding Backenette but to get population level benefits, individuals have to make certain choices. It’s the same with vaccination. One individual child not getting vaccines isn’t a major issue but in aggregate it is.

In the UK the vast majority of women are NOT breastfeeding their children exclusively to six months. Therefore we’re not looking at an individual mum and her specific reasons for using formula. It’s a societal issue. It’s simply not possible that most women in the UK aren’t capable of successfully breastfeeding.

If every FF baby on average gets sick once more than BF babies - add that up and it’s loads more sick babies, GP visits, missed work for parents, etc.

In my experience, the "benefits" wore off the minute I stopped. My perfectly healthy never had an illness in her life (even in her first 6 months at nursery) picked up every cough and cold going the minute I stopped.

I'd still do it again though, although I wouldn't put the ridiculous pressure on myself that I did when it seemed it wasn't working (NNICU is a difficult place to establish BFing) I am a huge advocate of BFing, regardless of the supposed long term benefits, when it works properly, it is a brilliant thing to experience and is MUCH simpler than faffing with bottles and stuff. But, it is just as important that mums who are struggling with it and are miserable with it and for whom it just isn't working, are not made to feel they are doing something terrible and poisoning their child. Maybe in a clumsy way, this is what the GP was trying to do.

eeanne, I find your comparison of not breastfeeding and non-vaccination deeply offensive. It's not the same thing at all and you're just conflating and it's wrong.

Thank fuck for Beckenette on this thread; I wouldn't have the patience or stamina she has.

If every FF baby on average gets sick once more than BF babies

Except they don't.

Loads of things are better for babies in far greater ways. Breast feeding is the last thing I'd focus in and worry about.

Processed food,language opportunities in the home,screens,exercise,10 a day,red meat,processed meat,cleaning products...

the list is endless.

Most of those have no relevance to newborns, though . So why not do the best you can (if you can) at every stage?