Nurse said something strange about breastfed babies

[Chocolateegg123]

My 8 week old had her jabs today. The nurse at my GP surgery was taking an awfully long time getting down to business and kept faffing around such as explaining how to use a syringe for the calpol for about ten minutes. Then, she asked me if I was breastfeeding and when I answered yes, she asked how it was going.

I was honest and explained I’d found it hard and we had to combi feed etc but that my mental health had been really awful whilst breastfeeding and so I have considered moving over to formula.

She then completely matter of factly stated… “breastfed babies are more intelligent so if you can continue feeding her your milk you should.”

I was kind of taken a back as I didn’t think this was true but also is this kind of advice ok for a health professional to give? Whenever I have gone to a local breastfeeding clinic or spoken to a professional about my struggles they have never ever said anything like this?

I guess I want to know if I would be unreasonable to complain about this nurse? She has been unprofessional in the past when I went to have a vaccine during pregnancy and now this. However - is it true that breastfed babies are more intelligent? This has added to my guilt and anxiety over my breastfeeding journey now. Help!

She wasn't saying that at all. She simply meant that if I didn't or couldn't breastfeed for whatever reason, my child wasn't going to be massively disadvantaged in the way the militant people online were making me feel he would be. I was always told that breastfeeding is best if I can and want to do it. But having health professionals tell a clearly distressed mother that information, when she clearly wants to breastfeed but can't and her mental health is absolutely shot to pieces, is actually far more detrimental.

I'm still breastfeeding my 8 month old but he also has one bottle of formula before bed and always has done. I found feeding SO difficult at first and I also struggled mentally a lot in the first 6 weeks, but all the health professionals I saw were incredibly supportive and non-judgemental. If they had made comments like the nurse the OP saw, I'd have found that really fucking upsetting. "Promoting" breastfeeding to women who desperately want to but are significantly struggling to is just being an arsehole.

A midwife should provide support not just to those breastfeeding but also to those either who could breastfeed or chose not to and are using formula. It’s not up to a midwife to be judgemental.

As a practice nurse we are trained only to give the vaccines, not advise about bf or general baby care. Sounds like she was making it up.

There is evidence - posted on this thread - which disputes that breastfed babies are more intelligent. Many of us have intelligent formula fed babies.

Agreed. I EBF and love it, it's the right choice for me and my baby. But I'd defend anyone's right to feed their baby in the way that's best for both of them. I do think the benefits are marginal and absolute best thing is a healthy, happy mum and baby, particularly as maternity care and maternal mental health are in really poor states.

I did feel really supported to breastfeed by the midwives I saw before the birth, and had aftercare in a birth centre that gave amazing breastfeeding support so felt very lucky. It's a real shame where it's promoted in the NHS but no actual support given other than guilt-tripping.
I'd always wanted to breastfeed and was hearing from family (in laws - my mum breastfed and is no longer around) that combi feeding was best for me and baby and to basically assume I'd have issues breastfeeding.

On the other hand, I've seen posts on here saying breastfeeding is somehow worse for babies... I had real pressure from family to give formula, even though my baby was feeding and gaining weight really well and all his health checks were great. It really affected me as I was anxious anyway. Someone had obviously told my MIL that babies can't survive on breast milk alone. I really feel for anyone being pressured into going against their instincts and medical advice.

And I wouldn't say breast milk is "deficient" in vitamin D, it's just that formula has it added. I take vitamin D daily and give my baby vitamin D drops. I do think things like reading, using a wide range of vocabulary around your child, affection, listening and encouraging them, cultural capital and genetics all make the real difference in terms of developing them. But I'd hope not to see the debate turn to saying breastfeeding is the wrong choice - it's an individual one.

My son was formula fed as he wouldn’t latch on and he’s so smart.
my daughter was breast fed and is equally as smart.

It depends on the child.
i also know some breast freed babies that need a little educational help.

As a midwife I have sat through breastfeeding training sessions run by the Infant feeding Specalist midwife who has done all the extended training and she has said this. I have queried it with her as I agree with previous posts just because as a group it’s been found that bf babies have a higher IQ does not mean that the BF causes the higher IQ.

There’s a multitude of reasons why these babies may have a higher IQ. So it shouldn’t be presented as a fact that breastfeeding makes babies more intelligent which is definitely how it was presented to me in the training.

the infant feeding midwife was astounded when I questioned her. Some people sadly just blindly believe what they’re told with little critical thought process.

Have to say I think it would possibly be a bit harsh to complain about the nurse. She’s repeating what she’s been told. Though I get maybe it needs bringing to her attention that what she’s saying is misleading. Could this be done without complaining?

Breastfeeding is a doddle for some and a stressful time for others.
I would breastfeed if you can, do both if you need to but you can still do perhaps the morning feed as a breast feed whilst bottle at night and most of the day.
I 'failed' at breast feeding but I did keep it up as much as I could so babies were getting some breast milk if not a full feed. By doing that I was giving them some breast milk for a month or more.
In my day there was actual discouragement from breastfeeding - 'baby's hungry' , 'they need to gain weight' comments. I'm a DGM but with my DDs babies I said just keep going if you can and when the breast milk stops you've still done the best you can. Don't see it as having to move from breast to formula because you are struggling. Hormones are high and the guilt is upsetting.

If the OP doesn’t complain how will the training materials get changed nationally?

Like I said you can do it without lodging a formal complaint 🤷🏻‍♀️. Crazy idea but an email to the practice manager stating something like “this isn’t a personal complaint about the nurse as I understood she may have previously been taught this to be true, however I would like to flag that I believe xyz may no longer be considered up to date advice and is misleading “.

rather than being “I want to complain about what nurse x told me”

she wasn’t being rude, she wasn’t being lazy all of which I think definitely warrants complaints. She wasn’t even saying something she’s made up off the top of her head. Like I said earlier there’s every chance she has been taught this.

@NigelPonsonbySmallpiece @Parker231 Except that the more recent studies actually do show a correlation even after other aspects have been controlled for? I’ve linked to at least four large studies upthread from four different countries. You could have a look at these if you want to keep up with more recent research. It looks like recent and better designed studies are actually tending to show more effect from bf rather than less.

They do IQ testing on babies?! I don't even see how that's possible.

I breastfed for nine months, and am very happy to share the evidence around breastfeeding, which is that by the time a child is 1yr, there are no discernible benefits left. I would be wary of assuming that just because people are engaging with the evidence and pushing back against the breast is best ideology they haven't breastfed.

But your comment about 'tell them their efforts were pointless' is quite telling. I get that it's hard to realise breastfeeding makes no different to your child in the long run, if you had a particularly difficult time with it. Obviously it's going to sting when you look back and realise you did it all for no real benefits. Makes it all the more important to advise people the true evidence around infant feeding so they're not forcing themselves and beating themselves up to feed their baby a certain way based on myths and misinformation.

If you wanted to bf your baby and did, that's not for nothing. That isn't pointless. You kept them fed! And you might have enjoyed bonding from it, the closeness, maybe it was more convenient for you once you got into the swing of things. Nobody is putting down mums that breastfeed. Thankfully we're moving towards a more balanced discussion around infant feeding so people can make the right choice for them and their baby.

It's because well educated mothers are more likely to breastfeed so not the actual milk.

😂😂😂

Not sure if this is a genuine misunderstanding - the limited evidence on this suggests there is a few IQ points difference on average between breastfed and ff babies. That is not the same thing as saying that ff babies are “not intelligent”.

Also:

• your IQ is mainly determined by numerous other factors
• IQ points are a quite meaningless indicator of intelligence anyway
• the only way of really testing this would be to get identical twins, raise them in identical conditions keeping everything the same except that one is bf and the other ff - obviously impossible
• anecdata about how smart or dumb your child is by ref to how they were fed is totally irrelevant and not “evidence”

The fact remains that studies have shown an IQ difference, but honestly who cares. Literally nobody is breastfeeding their child because they think it will make them smarter. Not breastfeeding your child does not mean they won’t have a high IQ.

Not one piece of research on the relationship between intelligence and breastfeeding asserts that only babies who are breastfed can be intelligent. In fact not one piece of research suggests that the possible impact of breastfeeding on IQ might be discernible to individual parents. I'm not sure what point you're making here?

Sure but I still don’t think it’s very clear cut and there is conflicting studies.
even in the study using the millennium cohort data one thing which stands out to me is

Longer breastfeeding durations were associated with higher verbal and spatial cognitive scores up to ages 14 and 11, respectively.

Is it the breastmilk itself which might cause those higher cognitive scores or is it the fact that mothers who breastfeed are likely to focus on their babies more than mothers who bottle feed maintain more eye contact, all of which promotes synapse development. The fact that the longer the feed duration the higher the score ties in with this?

though in fairness to the nurse sounds like she didn’t actually say breastmilk increases IQ but breastfeeding 😁.

I think it’s an interesting topic which isn’t black and white.

one thing though is the nurse was promoting breastfeeding which obviously aligns with current advice. She was being nice and supportive, taking a holistic approach and overall interest to the OP. And yet the OP is thinking of complaining. 🤷‍♀️. It does sound like the OP has issues over her feeding choices, she mentions guilt, etc…..I think maybe she just needs to work through that rather than try and trip HCPs up over something which isn’t very clear cut. I agree it does sound like it was maybe clumsily worded, didn’t go into detail…..but that wasn’t what the appointment was for!

The research is really complicated and contradictory. There is evidence on breastfeeding and intelligence that controls for mothers education and social class. But it's complicated - it's not just about social class and level of education. Even within a specific social class and education brackets, women with higher IQ's are more likely to choose to breastfeed, and to breastfeed for longer. There is also research which controlled for parenting skill - and found that parents who chose to breastfeed were also the group most likely to have good parenting skills, and once parenting skills were controlled for, the impact of breastfeeding on IQ disappeared.

It's also worth considering that most of the significant differences in IQ associated with breastfeeding were observed only in infants fed for longer than 2 months, and most obviously in exclusively breastfed babies. As prolonged, exclusive breastfeeding is really rare in the communities being studied, it might be that the small number of mothers who continue with this way of feeding their babies are different in some way that is hard to control for, and that it's this quality that is responsible for the impact on IQ rather than the breastmilk.

The study I find really interesting is this one: https://engineering.brown.edu/news/2013-06-06/breastfeeding-benefits-babies-brains by a group of researchers at Brown University (link is to article about study, not the abstract itself).

The study involved doing MRIs on the brain growth of a group of children under four. It found "by age 2, babies who had been breastfed exclusively for at least three months had enhanced development in key parts of the brain compared to children who were fed formula exclusively or who were fed a combination of formula and breastmilk. The extra growth was most pronounced in parts of the brain associated with language, emotional function, and cognition, the research showed." It's the first imagining study that looked for differences by feeding method in brain development in young, healthy children and babies.

I'd still be asking the question re the study above, whether the differences in brain structure observed on MRI were the result of breastmilk, or were the result of responsive feeding practices, which I suspect are far more likely among parents who are exclusively breastfeeding (responsive breastfeeding practices are the most physiologically supportive of functional and prolonged exclusive breastfeeding). In other words, is it highly cued care (perhaps more common in women who are exclusively breastfeeding) that is good for babies' brain development.

@NigelPonsonbySmallpiece

"Is it the breastmilk itself which might cause those higher cognitive scores or is it the fact that mothers who breastfeed are likely to focus on their babies more than mothers who bottle feed maintain more eye contact, all of which promotes synapse development."

We cross posted - we're both thinking along the same lines!

Not heard of the eye contact point before. When you give your baby a bottle, easy to maintain eye contact, talk to them, cuddle. Bonding is no different bf v formula.

I don’t think that’s true. I’ve seen many or three month four month old baby propped up on a cushion with a bottle in its mouth.
Often Twins, But sometimes Singleton’s

I have DT’s - they were never propped up on a cushion with a bottle. Always held. Although have seen plenty breastfeeding and bottle feeding paying little attention to their baby because they were on their phone all the time.

But the supposed benefits as regards IQ and point difference is negligible -0.02 points which maternal anxiety and stress from breast feeding got tjose that loath it would surely wipe out.

The author of the newspaper article looked at many studies and found them similar to the example below:-

“The authors also found, however, that women who breastfed were better educated and richer than those who did not. To separate out the impacts of breastfeeding from these other factors, their first step was to control for these factors, using a statistical method called regression analysis. In effect, they asked whether IQ scores for breastfed children were still higher among mothers with the same levels of education and income.They found that they were, although the effects were much smaller – more like 1.6 points higher rather than four. But they also observed that, even among mothers with the same level of education, the IQ scores of the mothers differed. Once the authors controlled for the mother’s IQ score, the effect of breastfeeding was even smaller, at 0.5 points.
But even this may not be fully sufficient. It would be useful to compare children with the same mother, with and without breastfeeding. This study was able to do that, by looking at a sample of siblings where one sibling was breastfed and one was not. This analysis – sometimes called a “sibling fixed effects” analysis – is able to fully control for all characteristics of the mother and is a more convincing way to isolate the impacts of breastfeeding. When the authors did this, they found that the effect of breastfeeding on IQ was 0.02 points – basically, zero.
This is by no means the only study on the relationship between breastfeeding and IQ, and it is not the only study that uses this method. Looking across all the available studies, I find that the best data on the relationship between breastfeeding and IQ doesn’t support a link. A huge number of papers show a correlation between breastfeeding and IQ, but those that are able to adjust for differences across mothers – by comparing siblings or, in one case, with a randomised trial – do not show evidence for causal effects.”