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 :-(

sorry, SGB, not SGM

Ahh, sorry, I thought you were using it to evidence the point made about some communities having no issues with BF, which is why I was confused!

god now i am confused. i was i suppose. i don't know if they don't have ANY issues in the early days, but they virtually all breastfeed. i just find that fascinating. why? is it because all the grannies help them?

i think it's becasue they see it all the time

i mean, imagine you grew up sitting in the passenger seat of a car. you watched the driver drive, you were told what the pedals did... you just got a feel for how it all worked.

when the time comes for you to learn to drive yourself you already have a pretty good understanding of how it works.

if you've never even been in a car before, and you try and learn to drive... it's going to be a completely different experience.

and I think it's the same with anything, breastfeeding included. if you've grown up seeing people breastfeed you just pick up lots of little hints and tips that you then do naturally when your own baby is born.
i had problems with ds2 and ds3 with positioning! i was just holding them stupidly. it's the kind of thing that if i'd seen tons of women breastfeeding i would have probably held them more naturally

if that makes sense? I think it plays a big part, but I guess also the knowledge that there isn't an alternative? so if you physically can't feed the baby someone else has to, but if you can then you have to do it regardless of if it hurts or whatever?

i think this is why it's really important to "normalise" breastfeeding as well. so that people see it, and when it comes to feeding a baby it's what they think of

"... generally (with support) mothers can express for a preterm infant

there is also often banked milk available"

sorry, I know this quote was fairly early on in the thread, but can I just say that when I had ds, and he was whisked off to scbu, I was encouraged to express, however my milk didn't come in for several days (I pumped every 2-3 hours, but was unable to hold ds as he was in an incubator) there was no mention of banked milk being available (I don't think it is routinely offered), and because ds had very low blood sugar he was tube fed formula until I could express enough to be fed via tube.

I think the enormous difference in every aspect of life between a woman in an aboriginal tribe and a woman here make comparisons very very difficult. For example, had I been an aboriginal tribeswoman, ds would probably not have survived the birth and in fact I probably wouldn't have had any children at all taking into consideration various fertility/medical issues.

The reason why ancient societies bf more or less universally is mainly because mothers and babies are/were rarely separated - for 99 per cent of human existence there were very few safe spaces to put a non-walking infant anywhere else. Babies fed many times an hour as a result.

This is very difficult/undesirable culturally today.

hazeyjane - true. Until recently (in evolutionary terms) babies born before about 35 weeks would not have survived.

yes you are right hazeyjane, and in cases like that formula is, quite literally, a lifesaver. that's exactly what it's designed for.

I think often you have to ask/demand banked milk because some places just aren't big on giving it out. though, obvoiusly it isn't available everywhere either, so somtiems not an option at all.

can I ask... did you go on to successfully breastfeed? I'm actually quite in awe of people who overcome hurdles like a very premature baby and all the expressing and getting them to learn to breastfeed, it's amazing

oh yeah, like the iKung in Africa - they feed four times every hour round the clock. when i read that i thought jeez, whose counting??!!

I'm afraid I got to 8 weeks and breastfeeding was knocked on the head by a combination of mastitus, a second infection of my c-section scar, thrush and the fact that I have Raynauds which causes nipple vasospasm (up until 8 weeks I was on prescription painkillers, which I think masked the symptoms). I did and do feel very proud to have got that far though, because establishing b'feeding in scbu can be an uphill battle, as they are not places designed for that purpose (they were wonderful, and I wrote a letter thanking them, but also pointing out ways that they could have helped as far as b'feeding was concerned).

In communities where b'feeding is universal, surely the whole nature of giving birth, the fact that mothers may be younger, the day to day lives of the women, the fact that women who would struggle to have children probably just don't have children(I'm thinking about the relationship between something like PCOS and b'feeding) - that all these things (and probably a million other differences!) make a big difference in the rates of b'feeding.

It is not just that the mothers were close to their babies all the time or that bf is normalised but as ruby quoted 'Breastfeeding was almost universal, but where it was not possible for any reason, another female relative within the group would feed the infant.' That sort of support is not really avaiable to mothers like us is it? Even banked milk is not widely available for premature babies who need it.

that i have heard of some communities, including aboriginal communities in north west western australia who ALL breastfeed with no problems at all

Where had you 'heard' this?

The thing is, in the vast majority of cases, it actually makes very little difference in the long run whether a baby is BF or FF. Breast milk is a bit better, but formula is not poison (and indeed can actually save a baby's life when breastmilk is not available).
So people should just calm the fuck down, make their own choices and not worry about the choices other people make.

SGB, I suppose the thing is that for a lot of women it does make a huge difference to them whether they b'feed or not. Most of the women I know who have ended up f'feeding, haven't sat down and said,'right now, what am I going to feed my baby - formula or b'milk?' They have tried for weeks to b'feed and have made a long agonising switch over to formula as they realised that b'feeding wasn't going to work out. It isn't just a simple choice.

Also the choice is taken away if you have wanted to b'feed and received shit/no support or help from the people that are there to advise you after giving birth.

I always read with interest the links about b'feeding and formula, I want educate myself. I think one of the reasons I was able to establish b'feeding in scbu was because of all the stuff I had read here on Mumsnet.

Quoting that 100% of babies were breastfed in other societies and in more primitive times is unhelpful. In earlier times premature babies simply didnt survive, maternal mortality rates were higher than today. Therefore the babies who survived were healthy, the mothers who survived were healthy. All of which is undoubtedly going to result in successful breastfeeding. The studies quoted were not on babies who were the picture of health, these were babies with major health issues. Would breastfeeding have made a difference? We just dont know. Stating that two things occured is not the same as saying one thing caused the other, it can simply be coincidence.

The problem with comparing American babies who were FF or BF is that you are only comparing two things, there is no control group.

Of all the parents that were drug addicts, alcoholics, neglectful or abusive I doubt any of them breastfed.

All of these people are in the group that includes parents who did everything they could to care for their babies but chose to or needed to FF.

To make a fair comparison the babies would need to be treated the same with the exception of their feeding.

I think you can make statistics prove anything.

Lynli - you can't 'prove anything' with statistics if you use stats honestly and correctly.

The original study is here: pediatrics.aappublications.org/cgi/content/abstract/peds.2009-1616v1. This was a statistical exercise - not done on real live babies and not comparing real live babies. You don't need a 'control group' - it's not that sort of a study.

Gnome - you are right that it would be foolish to compare today's babies with babies in earlier times. The babies and mothers that survived birth were always going to be the most robust - but breastfeeding enhanced this robustness, even so. In societies (like England in the sixteenth and seventeenth centuries) where an elite did not breastfeed, maternal and infant health was very poor (hence the serial pregnancies, miscarriages, stillbirths and maternal deaths) as a direct result of no breastfeeding. Ordinary people were fitter, had fewer pregnancies, and their children were more likely to survive.

www.lactationconsultantservices.co.uk/

i just saw it on this lady's website. i have read of other such communities in TPOB. Obviously it is pretty rare. Its just that something is going really wrong in this country when 70% (ish) initiate breastfeeding and one or two weeks later, 40% (ish) have stopped. And at 6 months exclusive breastfeeding is at a few %. I am simply fascinated as I said earlier as to why this might be the case. It is very sad, particularly if women want to breastfeed but get rubbish support. Its such a basic human right for a mother and baby to enjoy successful breastfeeding that I really think the government should get their arses into gear.

Riven - yes, really. check your history.

By today's standards maternal and infant mortality was indeed high across all classes, but it was far higher among the elite - aristocratic and rich families did not breastfeed, babies were farmed out 'to nurse' with little supervision.

The lack of breastfeeding meant women became pregnant quickly again (in an era where maternity care for the rich was based on male doctors not even seeing the abdomen of the patient let alone palpating it) and the obstetric devastation of serial pregnancies took a huge toll on their health.

With the industrial revolution, infant mortality in the cities among the poor went up - perhaps this is what you are thinking of.

TikTok - again causality or coincidence?

Those 'elite' babies put out to nurse were sent out to wet nurses so were breastfed. So called ordinary people were not living in some sort of bucolic heaven. As with more primitive times the healthy babies with healthy mothers survived and breast fed. Unhealthy women who couldnt pull their weight in agricultural communities would have been less likely to marry and have children. Children who were unhealthy for whatever reason would not survive.

In past times is breast feeding a cause of good health or an effect of it?

Gnome - the babies 'put out to nurse' were not necessarily breastfed. Again, go to the history of this and read about the baby farming 'industry' of western europe which actually lasted until the middle to late 1800s in some areas. The baby farms were responsible for many deaths, even murders.

Some very rich families had 'in house' wet nurses, or else sent their babies to relatives or high-status courtiers' country houses, and they were probably at least partially breastfed - though animal milks, gruel and pap were also common infant foods. Just as significant were the serial pregnancies common among the aristocracy and the rich, and this was a direct, biological consequence of not breastfeeding - no bf means a quicker return to fertility. Pregnancy after pregnancy after pregnancy meant an increased chance of the babies who were successfully brought to term of being weak, 'sickly' and likely to die young. You can see a microcosm of this in the whole Henry VIII saga - out of many, many pregnancies, only 2 of his (legitimate) children survived to adulthood and only 1 more beyond infancy.

I deliberately explained that far from a bucolic heaven, rural families had very high infant mortality/maternal mortality rates compared to what we would think normal. But the rates were still lower than among the elite. This is a consequence of breastfeeding - the link between bf and fertility is one important thing, but bf also mitgated poverty and food shortages (not as issue among the elite). The idea that somehow artificial feeding (no formula or safe way of preparing milk for babies until well into the 20th century) would not have made much of a difference because unhealthy rural women would have had fewer children is preposterous. Not breastfeeding was a major cause of infant mortality throughout recorded history - we have a lot of evidence for this in many societies.