I think the BF / FF statistics could be wrong

[shirleyhyypia]

I completed a survey for the NHS recently on how DS is fed. He is exclusively BF, however the day he was born he had a 7ml syringe of formula, to help him settle, as he was sucking and sucking at my (actually rather copius) colostrum, but was still starving.

The survey asked if DS had EVER had formula, even if it was only once, and then went on to ask loads of questions, assuming he was still having it? There was a comments box where I explained, but I have a feeling that they will just look at the numbers and see that in the eyes of the survey he wasnt "exclusively" BF.

Obviously it doesnt actually matter to me, but I cant help but think that this may have something to do with why Britains BF numbers are so low???

I know FF is the trend anyway, just saying the figures might be a bit off.

Two friends had DSs at the same time as me, one BF for a few months (inc the odd bottle of F) and one FF from birth. The girl in the bed next to me in hospital BF but also gave her DS formula once (obv i dont know what happened when she went home

So even though 75% of us BF, 100% of us had given formula at some point.....
(and the OFFICIAL NHS survey doesnt distinguish between once and full blown mixed feeding)

duchesse - you say a few bits of formula shouldn't count unless 'the researchers are trying to do a longitudinal study on the effect of absolutely exclusive breastfeeding" - many of them are. The other longitudinal studies are looking at exclusivity and prevalence because they have to stick to long-term, well-established, definitions of these terms.

Messing about with the categories is no good at all!

chocolate ditto, my DS had to have formula top ups (under medical advice) for about 48 hours in his first week until my milk came in as he had jaundice and low blood sugar levels. i have exclusively BFed him since then (he's now 5 months) and am still a bit disappointed that he doesn't count as EBF for the official statistics. I hope it hasn't done any damage to his gut lining.

I'm currently trying to hold off the pressure from family to start giving him a bit of solid food over Christmas. He's not 6 months yet! grr!

Woodlands, my dad tried to give DS cucumber at THREE WEEKS

umm, no...

I read that as "chocolate formula top ups"
- didn't realise there was sucha thing :o

There has already been a perfectly decent longitudinal study of optimally fed infant growth, done by the WHO afair. Can they seriously be researching infant health in this way? There are so many variables affecting infant health I would have thought that 1 bottle of formula at 1 day of age would be difficult to spot among other environmental and genetic factors. It would seem an extremely crude way of finding anything out. Unless they were trying to spot the incidence of one or two diseases that are known to have no environmental (beyond feeding) or genetic factors. Struggling to think what they might be.

also they are going to have a job on theier hands trying to find exclusively breastfed infants, surely? With so few to choose I'm surprised they are not more proactive in chasing up the ones there are. My DD3 was EBF to 10 months (literally, she wouldn't eat any solids despite being offered them from 7 months) but no-one in health circles has taken the slightest interest in her or her health.

Mm, imagine chocolate boob milk.....

Just had to give my poorly boy calpol again. Hes easily had three times as much calpol as formula in his life, if not more! Hes officially mix fed - BM and calpol!!

I would be interested to see a study comparing the health of babies who were exclusively breastfed with that of babies who had a small amount of formula in the first couple of weeks, babies who were mix-fed long term and babies who were exclusively formula fed. Most of the info I have read compares ebf with eff and there's not much out there for Mum's who have to/choose to supplement a bit and wonder what the effects might be.

duchesse - the reasons for ascertaining exclusivity for the data that resulted in the WHO chart are indeed to check on growth. My understanding is they did not stick to 'absolutely not a drop of formula ever' when they checked for exclusivity because a small amount of formula would not impact on growth. Subjects in the study who had small amounts of formula were not kicked off the study.

This study did not look at health - other studies have done and continue to do that. Yes, the challenge is to be 100 per cent sure your subjects are exclusively breastfed, or enough of them are, but it is done.

The other reason for collecting information on exclusivity - a statistical survey rather than research investigating health outcomes - is simply to see what is happening. So you have a public health campaign to increase breastfeeding. You need to know how well this campaign is doing. You know that maternity units in the UK are notorious for supplementing bf babies with formula - and that this is a factor in early curtailment from bf (quite apart from other health outcomes). So you need to know if the initiatives put in place to combat this are working. So you ask the appropriate questions.

Studies don't go chasing people who fit a profile of exclusive bf. If you are doing longitudinal studies (seeing what happens to a cohort of babies over time) you have to recruit long before you know they are exclusive breastfeeders.

If you are doing a retrospective study, and trying to see what effect exclusive/non-excl bf has then they might recruit you - but you'd have to be in an area where they were doing this sort of study. Vast majority of the hundreds of 1000s of babies born in the UK each year never come anywhere near being a subject of a study.

Do you think its worth a letter to someone that I was encouraged to give formula (esp as it was such a small, now seemingly pointless, amount) in the hospital?

Yes, I think that would be a good idea, shirley. They will take you seriously - and if your hospital is trying to met Baby Friendly standards, or has been accredited, they will be embarrassed.

Apple - there are several studies which show that the amount of formula makes a difference, but I don't know of any which quantify it at the level of detail you ask for.

You could google Quigley Millennium cohort for a UK study.

Another point on the stats. The question I answered at 6-8 weeks asked about feeding in the past 24 hours. I only realised this afterwards. As it happened, DD had not had a bottle the previous night so, in the context of the question, I could have quite truthfully answered that she was exclusively breastfed! It sounds like any UK wide stats compiled today will not be combining like sets of figures.

DreamTeamGirl ? I was so so close to chucking it in as well, after my HV told me thar one bottle of formula would ?destroy all the benefits of breastfeeding?. MN came to the rescue with some sanity.

shirleyhyypia - you know, I was wondering this the other day about my own experiences in hospital. It's amazing how demoralising this kind of thing is, isn't it?

For the sake of catharsis, here's my story. DD2 was early (35 weeks) and they really pushed formula from the start. Before they took any blood sugar measurements they were already talking about the SCBU and tube-fed formula. It took all my strength to persuade them to let me keep DD2 skin to skin and let her suckle occasionally (they kept putting her back in the heated cot and I kept pointing out that my skin was warmer than the cot). I'll never forget breaking down in front of the paediatrician when he scolded me for letting her latch whenever she wanted rather than limiting her to once every three hours as "she'll get too tired, getting nothing from you". So I gave in - gave a few mls of formula that evening. But the next morning I got angry and, I have to confess, began pouring their formula top ups down the sink when the midwives weren't looking . Her consistently excellent blood sugars confirmed to me that she was doing fine on colostrum but my own blood BOILED at being discharged from hospital with "MIX FEEDING" scrawled across my charts. The paed even insisted on attaching a post-it with instructions for 3oz formula to be given after every breastfeed (3oz for a 5lb 8oz baby? Not going to fit!). If only I could remember the paed's name, I would complain. Do you think it'd be worth complaining regardless?
Wow - she's ten months now, and actually breastfeeding now as I type, and my face is still flushed with anger as I remember it. I kick myself for not standing up to the paed more and, in retrospect, know that the stress of her precipitous and early birth meant that I was not my usual (pugnacious) self. I truly believe that many healthcare professionals do not know the damage they do when they push formula 'top-ups' - and my damage I am mostly talking about women's confidence and happiness rather than damage to the babies themselves.

All this to say that I actually agree that for data gathered for research purposes, exclusively breastfed needs to mean precisely that. But for every other practical purpose, there needs to be flexible rather than dichotomous thinking about how we define a 'successful' breastfeeding relationship in order that we don't end up demoralising people with all-or-nothing reasoning.

at that - I bet you felt like writing "NO SHE'S Bl&&DY NOT" underneath.

I had a similar experience...I was discharged from hospital with DS1. I had breastfed him straight away, only breastfed him, not even mentioned formula.

My notes said I was formula feeding. I was so angry with them and did just that Stealth - I scribbled it out and even rung them up . Who knows if they changed it but I BF him for 15 months yet may well be down as FF from birth.

To be fair breastfeeding is tied very heavily to my job which is why I got quite so angry but it certainly didn't do much to boost my confidence and support me!