Risks of Formula feeding on pre-term infants

[thisisyesterday]

how scary is that?

i read a blog which mentioned it here

it was in a piece published by the Journal of Pediatrics, so something to take seriously I think.
makes me feel so :-(

frightening for some. not for lots of others it seems. if it hasn't happened to you or yours it probably seems too far away. most ff babies are fine and people take that as the 'truth', rather than think about the poor mites whose intestinal wall has died, or the ones that have a horrible existence on this earth because of not being breastfed.

The blog says that 911 deaths are caused by breastfeeding; the article (reported via CNN) apparently argues that most of those deaths are caused by conditions for which breastfeeding may reduce the risk. I'm all for breastfeeding, but not for bandying round sensational but inaccurate statistics.

Does anyone know what the reasons behind that figure would be? For example, I was thinking human error (making up bottles incorrectly, dirty etc) must account for a lot of these deaths?

nearly all, 95 percent of these deaths, are attributed to three causes: sudden infant death syndrome (SIDS); necrotizing enterocolitis, seen primarily in preterm babies and in which the lining of the intestinal wall dies; and lower respiratory infections such as pneumonia. Breastfeeding has been shown to reduce the risk of all of these and seven other illnesses studied by the study authors.?

I read somewhere (can't remember where, politics of breastfeeding perhaps?) that there were 0 cases of necrotizing enterocolitis in breastfed babies in the US each year. Apparently it just doesn't happen to BF babies because the milk protects the gut

will see if i can find a link to that.

will see if I can find the actual report as well so we can take it in context

No that's not quite correct, if you read it again, it says 911 babies in the US that die are formula fed not that formula feeding kills the babies, quite a difference!! The main cause of death in these babies are SIDS, pre-term complications and pneumonia, babies that suffer these conditions (not necessarily SIDS) are more likely to be formula fed that is the link, not that they died because they were formula fed.

Also breast feeding only reduces the risks slightly, not by a big margin, so the majority of these babies would have died even if they had been breast fed...

I thought it meant statistical risk - so for example say the risk of a bf baby dying of pneumonia was 1 in 100000 and a ff baby 2 in 100000 then out of every 200000 babies 1 would die because of pneumonia but because of the increased risk of it? Say there are 1 million babies born then 10 die because of being formula fed (but actually from pneumonia).

Made up statistics by the way!

argh i am shit at googling. will have to see if i can find the relevant bit in Politics of Breastfeeding and find the references for it.

I presumed (and yes, just a presumption) that the big deal about this is that breastfed babies AREN'T dying.
so, they've come to the conclusion that it is the formula feeding that is killing these babies?

but I am extrapolating and really need the original piece to read, which I am struggling to find! I know it was linked on the Analytical Armadillo site too, but i can't find it on there now either

sorry, hang on a minute. if it is incredibly rare for a breastfed baby to die of NE and not for a FF baby to die of NE, then it is (indirectly maybe) the lack of breastfeeding that has caused them to die. you cannot say that it is not a blindingly obvious reason.

www.jpeds.com/article/S0022-3476(75)80835-3/abstract

those are pretty scary statistics

"InspirationalBreadbin Thu 06-Jan-11 17:41:05
Also breast feeding only reduces the risks slightly, not by a big margin, so the majority of these babies would have died even if they had been breast fed..."

breastfeeding does not "reduce" the risks. breastfeeding is the biological norm. it does what it does

formula feeding increases the risks.

and it's not only slightly. according to the FSIDS website babies who are breastfed are a third less likely to die than those who have never been. 30% isn't "slightly"

Not a brand new study and I would need to read it again, but I think it is a statistical calculation, not a diagnosis of cause and effect in individual babies.

peppa's explanation is correct. You take a bunch of infant mortality and morbditity stats, and you work out the excess mortality and morbidity in the formula feeders. If all those babies had been breastfed for whatever time you are looking at, then there would have been X fewer deaths. That's not the same as indicating a particular formula fed baby and saying 'that baby would not have died if he had been breastfed' because it would be impossible to tell.

That's why the number is small - the actual number of babies dying from those conditions is rather higher.

You can only do this sort of study well in the US where 4 million babies are born each year - something like 7 or 8 times the UK's rate. You need big numbers to compensate for the fact that infant death from anything is very rare.

It's useful to have these studies, though, as it allows the issue to be seen as a public health concern, worth putting public money behind. But its effect on individual mothers who did not breastfeed can be uncomfortable and it makes people defensive :(

thank you! i knew someone would be better at googling than I am

You (and the not very intelligent blog writer) are making a huge leap here. The study does not say that formula feeding is killing babies, it does not even say that breast fed babies have not also died from these conditions - all that it is saying is that 911 babies have died and that breastmilk is associated with providing some protection against these conditions. It could be suggested, but presumably not proven, that a few of these babies may have survived if they had been breast fed instead. So what? They are such low numbers and there are so many assumptions being made here that it proves nothing.
I don't think there is any doubt that breast is best, but this type of twaddle will just get people's backs up and does nothing to add to intelligent debate.

also from FSIDS

"(1) Several published studies have found that breastfeeding protects against the risk of Sudden Infant Death Syndrome (SIDS). One meta-analysis of 23 reports (i) concluded that formula fed infants were more than twice as likely to die from SIDS than breast fed infants with an adjusted odds ratio of 2.11 (95% CI 1.66-2.68). "

"they are such low numbers"

tell that to 911 sets of parents

But it is not saying that 911 would have lived - it is saying that some of them may have done. Very different - and impossible to prove anyway.

this is one of the studies done here on necrotizing enterocolitis

thisisyesterday - in the context of 4 million babies born in the US each year, then 911 is a low number, devastating to the individuals as it is. Infant death is rare in the developed world.

I hope people will grasp that this number is statistical - it is not saying that 911 identifiable individual babies would have each survived if they had been breastfed and that formula feeding was the cause of their death.

This number is the excess mortality - a statistical concept. And there are 911 statistical concepts.

It does not mean, as yousankmybattleship seems to think it means, that only some of the 911 might have died. It means 911 extra deaths occurred because of formula feeding.

i'll reserve that judgement for when I have read the original article thank you

apparently NEC does not even start until feeds are introduced and introducing formula to the equation will obviously compound a situation further by increasing the sick neonate's risk of dying.

youandkmybattleship its not that much of a leap really, even if you know very little about the subject. it is a total no brainer. formula contributes to the deaths of infants all over the world, including in so called developed countries. and that is a very sad thing.

oh yes, I know it's a tiny, tiny number given the amount of babies born in the US each year... but it's still 911 babies...

apparently being exclusively formula fed leaves a baby 6 to 10 times more likely to contract NEC.

that's a lot! and those mixed fed were 3 times more likely to get it.

mortality rate is between 20-40%

that's a lot of lives and families, broken. boo hiss at the formula companies.