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Infant feeding

Get advice and support with infant feeding from other users here.

Is Aptamil less likely to cause allergies?

76 replies

barlow · 19/08/2003 12:52

I am breast feeding but would like to give the occasional bottle of forumula as sometimes I find expressing enough in order to go out and miss a feed extremely tedious. I have heard from a couple of people that Aptamil is best but they can't tell me exactly why and where they heard it. Any views on this?

OP posts:
JJ · 22/08/2003 10:10

And I agree with all of your references, except Dr Greene (but I think you'll allow that... ) and, just a warning, will explain why they don't disprove this. Not so much because I want to convince you, but I've been thinking about it and, honestly, just want to put it down.

True confession time: my dream job would be science journalism (aloha, you can stop laughing now.. ) and one of my friends who is a journalist has told me to practice writing. I think that, unfortunately, that sort of writing is a learned thing or a gift -- hopefully in time I'll get the learning in. I certainly don't have the gift! Practice can't hurt though. Well, it can't hurt me. I can't speak for the people who read my next long and boring post.

mears · 22/08/2003 10:36

I have to confess JJ that as a mother (not a midwife) I absolutely hate formula milk and I would have sued anybody who gave it to my child without permission. Before having any babies I had read a lot about breastfeeding and the gut disturbance that one formula feed can do. Formula over the years has had all sorts of things in it such as peanut oil so it is not just the cow's milk factor I was concerned about. The gut has a protective coating in breastfed babies and that is destroyed by formula allowing pathogens to cross the gut.

So anyway, allergies aside, I knew that any baby of mine would not get formula. Now it was probably irrational but I was determined and stuck to my guns on a few occasions. There is just this assumption that mothers will not mind what milk their baby will get. When ds 3 was ventilated in special care I was frantic that he would need milk before I could produce any. I couldn't express anything for 5 days but in that time he was not allowed milk anyway because of the ventilator. When he was breathing himself my milk started pouring and I was so relieved that I would not have to consider formula.
When dd was born she neded exchange blood transfusions and was admitted to SCBU. The midwife said 'and you have no objection to us giving her formula milk if she needs it' and I said 'yes I do'. On no account was she to get formula milk.
Another example of my irrational thoughts (some would think) is that when ds no.2 had meningitis at 6 months and had nearly died, I nearly had a fit because a nurse was giving him a bottle when I came into the ward after leaving for lunch. It was actually my EBM he was getting out of a SMA water bottle.
Professor Cockburn in Glasgow has done a lot of research into babies nutrition. He was on TV highlighting the fact that formula milk essentally chemicals mixed together. It is not like breastmilk at all - no matter what the formula companies say.

Now let me say again, I am giving you my personal feelings on the matter of formula. My children were not going to get any and I would have been devastated if breastfeeding had not worked. I absolutely adored feeding and as a midwife I see women everyday who have a difficult time, cause IMO by professionals who have a lack of knowledge and skill. As a midwife I see instances where formula is required and the need of the baby outweighs the risks associated with formula. I would never give women my personal opinion on formula because that is personal to me. I just hate the fact that exclusive breastfeeding is seen as unachievable when it isn't.

This is clearly off the topic of the post but I wanted you to know a bit more about my beliefs as a mum. You develop your own solid beliefs that no-one will persuade you to change so I am very happy to agree to disagree on this one JJ. Hope you haven't fallen asleep

SamboM · 22/08/2003 10:48

Well I beg to differ mears. Breastfeeding was not possible for me due to drugs I am on for Crohn's disease.

And barlow, in answer to your original question, I was told (possibly erroneously) by two doctors and a midwife that if you were worried about allergies Aptamil was the best. My dd has thrived on it and so far does not appear to have any allergies.

mears · 22/08/2003 10:54

SamboM - I did say there are times where formula milk is necessary but there is no evidence that aptamil is scientifically any better than other milks. I myself prefer it because it smells less than the other ones.

SamboM · 22/08/2003 10:55

Yes, me too. SMA made me barf!

JJ · 22/08/2003 12:50

Aloha asked (I'm paraphrasing here) where the studies supporting the occasional bottle were. It's a great question and works well to illustrate that the studies Mears cited don't contradict what I was saying and, in fact, have led me to one (funded by the Netherlands Asthma Foundation and the Dutch "Stichting Astmabestrijding" that supports my view.

Before I start with the studies, it's important to think about what abstracts are. They are like the back of a novel, an overview of what the main work contains. Almost a teaser, except without the spin. You should read an abstract to decide if the paper is relevant to whatever you are researching. They generally list the study's aims, the general methods and the main results.

For example, in Mears's (Mears' ?) first link , the last two abstracts in the "Allergic Disease" section illustrate best her point (please correct me if I'm wrong!). Both abstracts say that exclusive breastfeeding until 4 months helps prevent asthma. The first is a more general and earlier study. Two questions to ask: why four months and exclusive breastfeeding is better than what?

I'd like to say that I'm not going to argue the merits of the studies; I'm going to assume that the science is sound. That is not to say that the papers don't warrant critical thinking. They should be analysed, taken apart and held up to the light as all papers should. It's just that I'm not going to do it here. (They do all seem to be really good papers, though; I'm not trying to imply otherwise.)

So we read the first paper to find out those things. Four months was chosen because of their statistical findings and because it's natural biologically (ie that's about the earliest people start giving solids). Exclusive breastfeeding is better than breastfeeding and supplementing with formula. Because they didn't consider how much formula people used, a valid question is if that makes any difference and what that difference is. As I said before, I am not criticizing the study: it's impossible to do a study that covers every situation because it would be impossible to do a meaningful statistical analysis. For example, in this study, they took into account many exposure characteristics . One that they did not include in the analysis was the presence of parental asthma. They mention this in the paper, saying that inclusion could be misleading. Again, it's not a sign of bad science, it's an interesting question raised.

In fact, the last paper in the "Allergic Disease" section of Mears's first link is the study, by the same people, prompted by the question: should children of mothers who have asthma be breastfed? This question was raised by information gathered in the previous study. In short, the answer is yes. The abstract gives us that basic detail. It was a much more narrowly focussed study than the first. They looked at exclusive breastfeeding to age 4 months versus non-exclusive breastfeeding to age 4 months. This study, quite rightly, uses data gathered from the first to make assumptions about which factors are important in analysis. This study did not consider the amount of formula given once introduced and again, it is not a fault of the study, it is to keep the statistics meaningful which is necessary to draw any valid conclusions. (I can only reference the abstract -- the paper I had to buy. Curiousity got the best of me!)

So we still have our question about the occasional bottle. It is at this point that the conclusion Mears reached and the conclusion I reached differed. Mears is saying that it is better to be safe than sorry. My sons' doctors are saying that, based on their knowledge of allergies and asthma and their information on the current research (in progress as well as published), the occasional bottle is ok. But it is important to note the fact that the papers do not preclude the occasional bottle being harmful. They do, however, support the idea that a much lower frequency of formula use in mothers who are breastfeeding would be better in protecting a child from allergies and asthma.

Where to go from here? Well, any study about the occasional bottle's effect on asthma will probably cite one or both of the above studies. Most likely, the study will again use the data to make basic assumptions to set up their own parameters. What we need is a list of articles that have cited one of the two. Luckily, the first paper has a list of citations at the end . One of these papers is titled: "The effect of brief neonatal exposure to cows' milk on atopic symptoms up to age 5" . (This is the paper that Robinw was referring to, I believe.)

Here is the conclusion of the abstract:
Conclusion: Early, brief exposure to cows' milk in breast fed children is not associated with atopic disease or allergic symptoms up to age 5.

Now, if you read the paper (as opposed to just looking at the abstract), you will realize that it does not prove my point. It supports it somewhat, but does not prove it. Since I'm all for my viewpoint, I'll let you figure out why.

(I hope I have not made anyone giving formula to their child feel guilty. Not my intention -- I certainly don't believe you should feel guilty at all.)

mears · 22/08/2003 14:14

This is an excellent informative post JJ. We are a couple of saddos though - wish my Masters assignment had been about this
I still believe that even a single formula feed can be detrimental to an exclusively breastfed baby - not least because a single feed is not usually what happens. I firmly believe that exclusive breastfeeding for six months is the ideal for optimum health benefits, not just because of allergies. I only achieved that with my fourth baby because I was totally confident in my ability by then. Anyway, enough of breastfeeding - got to go and do some work

3GirlsMum · 22/08/2003 14:19

I have three girls, first two were bottlefed and have no allergies, tummy problems etc etc, whilst my third daughter was breastfed and suffers from excema! The point is that sometimes babies will get these things anyway regardless of how they are fed.

Poor Barlow..lol...she asked a simple question and its turned into a debate over breast v bottle.

mears · 22/08/2003 14:49

You are right 3GirlsMum. It's been an informative debate though. Very educational I think

jasper · 23/08/2003 01:34

Guess who can't sleep tonight?
It has taken me three babies to come around to fully believing the same as Mears.
I had difficulties breastfeeding the first two and they both had what started as the occasional bottle of formula from a very young age and breastfeeding ended pretty quickly after that.
Third time around It was just as hard but I was more informed, more confident, and more downright bloody minded and right from the outset there was no way a sip of formula was ever going to pass that baby boy's lips .
I am happy to admit my new anti formula stance is mildly obsessive but it is nice to give it some airing on mumsnet as you don't get much chance to express it in real life

robinw · 23/08/2003 08:23

message withdrawn

Davros · 23/08/2003 09:28

Like SamboM I take immunosuppressants and therefore I was advised categorically not to bf my second baby. It is very hard having to read all this stuff about how harmful formula is when you have no choice. It does FEEL like there is a lot of prejudice about this issue.

SamboM · 23/08/2003 11:55

Well said Davros. It does drive me crazy, it seems that people who CAN'T breastfeed are ignored in this debate and made to feel inadequate by all the breast is best literature. OK, I appreciate that it is best, but the marketing campaign could try and be a bit less aggressive, which just results in me wanting to cry every time I see one of these bloody posters.

JJ · 23/08/2003 16:42

Someone should do a study on the dangers of checking mumsnet minutes before a person needs to get ready or risk missing the train.

But, since I did and got distracted gee thanks Robinw here's a proper version of her link. adc.bmjjournals.com/cgi/content/full/archdischild%3b79/2/97 Mears, I think that even though you won't agree with the beginning, you'll appreciate the end (and I mean that you are one of the good ones, who knows how important first feeds are in establishing breastfeeding).

SamboM and Davros, I had no intention of making you feel guilty and completely and totally think there is no reason you should. I really just wanted to explain myself on that one specific point. You guys shouldn't feel guilty about not wanting to drug your babies with immunosuppressants or Crohn's Disease medicines (see how much I know?). Of course you shouldn't have breastfed. My personal view is that the benefits of breastfeeding are overstated and only moderate (in some cases slight) when compared with other actionable risk factors. Not to say one shouldn't if one can, but "can" needs to stop being defined as any mother with a newborn and breasts. (No one be offended, please! I don't mean anyone here--- just the overwhelming, unqualified "Breast is Best" motto that seems to be everywhere when having a baby.)

jasper · 23/08/2003 19:32

But breast IS best.
Sorry you can't argue with that on ANY logical grounds, and we are all intelligent enough to know that you don't need double blind crossover studies to prove this any more than you would need them to prove people feel better when the sun shines.

SamboM · 24/08/2003 10:57

Jasper, I did say that I agree that breast is best. I just feel that the marketing could be less agressive, ie not always imply that bottle feeding will make your child come out in green hives and grow two heads. It makes those of us who can't b/f feel paranoid and unhappy

Dinny · 24/08/2003 23:40

Jasper, your post makes me (who failed to bf) feel even more crap than ever. Those of us who would have loved to have breastfed but didn't, for whatever reason, don't need salt rubbed into the wound.

Davros · 25/08/2003 00:17

Why is is that every time a question is asked or comment made about formula (sorry, poison) or bottle feeding it gets twisted into a Breast Is Best rant? I am finding the BF Police quite scary, never mind superior, and enough to put anyone off BFing who is lacking confidence rather than encouraging them. SamboM and I are ?lucky? because we can be tolerated due to taking drugs that are counter-indicative for BFing but, quite honestly, I don?t want to be tolerated and don?t feel that I should be treated differently to anyone who failed at or chose not to BF. Furthermore, I don?t think its true that Breast Is Best, what is actually meant is that breast MILK is best. One of the main obstacles to the BF lobby is that the process of bottle feeding has many differences other than purely the white substance in the bottle. These differences are often the reasons people choose to bottle feed, not because they don?t understand or care that breast milk is best.

rainbow · 25/08/2003 00:55

I haven't heard that aptamil is any better than any other, Barlow. You just need to find a milk that suits your baby.
Mears, just to jump on the BF band wagon. I succesfully mixed fed DS1 and DS2 both were big babies (9lb 5oz and 9lb 13oz) I just couldn't always produce enough milk to satisfy them. DS3(10 mths) was a different matter, he did not want to be bottle fed and I have BF him until last week when he decided a training cup was OK and he would take that! In my opinion if you can bf and want to then do and if you can't for what ever reason, medical or otherwise, then as long as your baby is happy, healthy adn contented what does it matter

rainbow · 25/08/2003 00:59

I forgot to add that DS3 (Exclusively bf) has the allergies, brown chocolate and oranges, and not the other two (mixed fed)!

mears · 25/08/2003 01:07

There is absolutely no argument that a mother chooses whatever way is right for her to feed her baby based on an informed decision.

SamboM · 25/08/2003 11:01

Huh, try telling THAT to all the midwives at C&W who kept asking me why I was bottle feeding in an agressive way.

mears · 25/08/2003 11:11

I think that is appalling SamboM. That is nothing to do with promoting breastfeeding but to do with inappropriate communication skills of certain midwives

paranoidmum · 25/08/2003 22:16

Barlow, after bf'g for 4 months I decided like you to switch to the occasional bottle of formula, and chose Aptamil - again like you heard it was "better". DD had severe allergic reaction, which the medics say is due to the cows milk protein, & therefore would have developed with any of the usual formulas. Doctor prescribed Nutramigen which I am happy to use, usually 1 feed a day.

Have just read JJ's post and now concerned about next feed (breast)as I have just eaten peanuts!

JJ · 25/08/2003 22:40

Paranoidmum, don't worry too much. It's repeated exposure that makes things bad and if you've had peanuts once or only occasionally, then simply don't have them again and he'll most likely be fine. And I only say "most likely" because you can never be sure, but I'd be willing to bet large amounts of money that if he is allergic to peanuts, it's not to due to a snack of peanuts today. I ate peanut butter and jelly sandwiches constantly when pregnant. I'm not sure I stopped while breastfeeding. Again, frequency counts. (The not worrying is easier said than done, I know.)

If she reacted to her first bottle of formula, she was already allergic to milk. The first exposure might "create" the allergy, but a child won't react as there's nothing there yet to react with (no IgE or IgG). Are you on a dairy free diet? If not and you are worried about the milk allergy, please feel free to email me. Actually, if you're worried about the milk allergy at all, feel free to email me at goochersmomatyahoodot-com. (That's my huge effort at avoiding spam, although it's my spammable account. )

And, just to warn you all, because I've been in high procrastination mode, I've been working on what I'd like from medical professionals regarding breastfeeding. I know, yes, I'm a saddo and need to get what I believe is known as a "real life".

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