Breast is best. Or is it?

[RubyBuckleberry]

video g by Dr Karleen Gribble exploring the damaging impact of the language we use when talking about how breast is 'best'.

yes, i can see very clearly that you take issue with it

not everyone does

i am asking you how you think we should inform people

i mean ffs, "the risks of not breastfeeding"

how is that any different? the alternative to breastfeeding is formula. people aren't stupid. it's saying the same thing but with "formula" removed and "breastfeeding" put in...

Gaelic I think (though am happy to be corrected) that some risks (eg obesity and some respitory things?) are associated with bottle feeding rather than ff.

in fact, as someone who switched to formula without knowing all the risks, and who believed all the people (HCP's included) who spewed the "happy mum happy baby" line I am actually quite offended by your view that women somehow can't handle being told that formula feeding has risks.

It's your opinion. you're clearly entitled to it.

but I happen to disagree, which I am also entitled to do.

I'd be pretty bloody cross if I wasn't informed of the risks of anything else I gave my baby (or myself for that matter). Medication I take has lists of risks and side effects... why not formula?

But there are risks to using formula - shouldn't people be able to weigh up those risks?

Obviously sometimes the risk of formula is greatly outweighed by the risk of starvation if a child can't be breastfed for whatever reason - but if you are making a choice to use formula then why not have honest information (I say that as someone who happily chooses to use formula btw).

Hmm I don't know actually, yes some risks are related to "not BFing" as opposed to "using formula" - such as the fact that not BFing means missing out on antibodies.

But some are specifically due to FFing - the way it settles in the gut due to extra iron (IIRC)

It's all semantics at the end of the day. I've no axe to grind. But to me saying that formula itself is risky means there is something inherently wrong with it - it contains a dangerous ingredient or something. Now obviously there's a problem with potential contamination, but that is dealt with by proper preparation procedures. So the fact remains, what exactly is the risk of formula.

There are in fact all kinds of alternatives to breastmilk - condensed milk, goats milk, pap, etc. We now use formula because that is believed to be the closest thing to breastmilk that mankind can manufacture. My point is, all things being equal and if a mum can't breastfeed for any reason, is she risking her baby's health by giving formula in the same way as she would if she used a more old-fashioned alternative?

Call me a pedant if you like. It's late and I'm tired and I'm struggling to get my point across. I know what I mean!

If that's the case HaveAHappyNewJung - I didn't know that - then why do they continue to add the extra iron?

Aah you've put me on the spot there

We talked about it on my course. I think it's the (essential) minerals that are in the formula, they don't get digested properly and so they just sit in the intestines, like sediment at the bottom of a river. It's apparently one of the reasons why FF babies sleep longer, because it takes longer to digest.

Not picking on you in particular, but why is that harmful? I mean it doesn't sound good to be sure, but don't they get excreted? It's the iron that causes greenish poo isn't it (ferreting around in non-existent brain, HV said this, possibly not true).

I'd guess (I'm merely a lowly peer supporter after all :)) it takes a lot longer to pass through. Cant be good for the gut lining, i would imagine. Unfortunately the course wasn't long enough to go too much into the science of it but that bit just stuck in my mind as a bit... icky.

This is a really interesting take on the idea that breast is best which I hadn't really thought about before. The difficulty with the breast is best campaign is that it is a tick box approach. Midwives simply skim over the minimum of info with expectant mothers and try to promote breastfeeding as if Its an added bonus for your baby, but not really an essential. Like when buying a new washing machine...do you buy the extra warranty? You don't really need it but there are benefits to purchasing it. To be honest I think that the nhs and others do tip toe around the issue of breastfeeding in case people are offended. We need to move beyond this. Breastfeeding is normal, its natural, its what was meant for our babies.
Perhaps campaigns and health professionals could focus on what the potential implications are if you chose not to breast feed. For example, "if you do not breastfeed your child is whatever% more likely to be...x, y and z". However, at the end of the day, facts are facts however they are dressed up. But it would be nice for breast feeding to be seem as the normal method of feeding our babies as opposed to it being an added benefit.

This is a really interesting take on the idea that breast is best which I hadn't really thought about before. The difficulty with the breast is best campaign is that it is a tick box approach. Midwives simply skim over the minimum of info with expectant mothers and try to promote breastfeeding as if Its an added bonus for your baby, but not really an essential. Like when buying a new washing machine...do you buy the extra warranty? You don't really need it but there are benefits to purchasing it. To be honest I think that the nhs and others do tip toe around the issue of breastfeeding in case people are offended. We need to move beyond this. Breastfeeding is normal, its natural, its what was meant for our babies.
Perhaps campaigns and health professionals could focus on what the potential implications are if you chose not to breast feed. For example, "if you do not breastfeed your child is whatever% more likely to be...x, y and z". However, at the end of the day, facts are facts however they are dressed up. But it would be nice for breast feeding to be seem as the normal method of feeding our babies as opposed to it being an added benefit.

It makes you wonder why they add all that stuff doesn't it, if the gut can't deal with it?

It makes you wonder why they add all that stuff doesn't it, if the gut can't deal with it?

It makes you wonder why they add all that stuff doesn't it, if the gut can't deal with it?

You getting timeouts too harverina?

See that's it, I think focussing on the risks of formula as a product is far less powerful than coming out and saying "if you don't breastfeed you are taking these risks with your baby's health".

Ooh lots of multiple posts the other risk I remember is about ear infections, one reason they are more common with FFing is that the position a baby bottle-feeds in makes the milk pool near the ears - but I suppose that is a risk to do with bottles as opposed to the actual formula, it'd still happen if it were breastmilk in the bottle I guess?

Picking holes again but my breastfeeding and bottle feeding positions are very similar. Can't see that one is more risky than the other. In fact I used to keep her more upright with a bottle (used to because she now refuses to take one ).

Yeah I'm using my phone and it keeps timing out
I agree gaelic it would be more powerful to focus on the risks associated with not breastfeeding rather than the risks associated with formula feeding. But at the end of the day, aren't they the same? I mean it would be different if formula wasn't the only alternative to breast milk but it is so if you don't breast feed you formula feed, unless you express...but expressing still gives babies the majority of health benefits...arrgh, there I go, using the word benefit! I suppose focusing on the risks associated with not breastfeeding would be one step towards normalising breastfeeding though. Language is very powerful. Little changes in how a midwife or bill board communicates could send out big messages.
Not sure about the actual risks of formula feeding beyond contamination...i'd. Just know that formula is our only legitimate alternative to breastmilk, therefore using it as opposed to breastmilk is a risk in itself as you are risking losing the benefits of breastmilk...oh this could get very confusing! I suppose what I mean is that using anything other than breastmilk is risking your health as your baby is at more risk of obesity, asthma etc etc than if it was fed the normal way, i.e breastfed.

I personally don't see the issue of equating formula with risk. Calpol etc. carry risks but if used correctly, no-one is judged for it. Same approach to FF IMO.

If it's needed or people are fully aware of all the risks then they have the right to not be judged. BUT we can't not talk about the risks because we upset people. This isn't a reason for F users to feel guilty, but a reason to get angry with how things are currently done.

I agree with the sentiment that we need to normalise breastfeeding, rather than seeing it as something only done by mother earth types, as it often is. But I fo wish someone would stop equating it to smoking and cancer. Infant feeding is only a small part of the risk of obesity etc. A ff baby born to slim (good genes) parents who is weaned on healthy foods and is encouraged to take part in regular exercise is at very little risk of being obese. A bf baby with big parents who is weaned on crap, taken everywhere by car and encouraged to sit in front of the tv instead of playing out is at high risk of being obese. lung, mouth and throat cancers (as primary tumours) are exceptionally rare as is COPD in people who have never smoked or taken excess amounts of passive smoke (like Roy Castle). So from epidemiological research (as most bf research seems to be) smoking is the major factor in these cancers. On top of that cigarettes are known to contain thousands of chemicals including hundreds of known carcinogens and poisons such as arsenic. Cellular studies have also shown how smoke effects the cells in a way that promotes cancerous changes.

From what I have read and I'm sure someone will correct me there are aren't many hard scientific studies showing why bf babies have lower incidence of certain diseases. Fortunately the incidence of ear infections etc in these studies is quite small anyway so an increased risk does not necessarily mean a high risk. A bf baby who is constantly smoked over is at much higher risk of respiratory infection than a ff one who isn't but probably at less risk than a ff one who is smoked over.

Sorry rant over it just really annoys me when people equate ff a baby as the same risk as smoking.

Jung/Gaelicsheep - The iron that is in formula is non-haem iron (not animal based) and is extra difficult to absorb so more and more is added until enough is absorbed. Bm has iron in the form of Lactoferrin (literaly milkiron) which is one of the anti-microbial agents in milk as well as being the source of iron for the baby.

The outside of the lactoferrin molecule mimics the exterior of a human cell so when a microbe attacks the 'human cell' it bonds permanently with it in the hope of taking it over/using it to reproduce it/whatever that particular microbe does and instead it's bound to a lactoferrin molecule and can be excreted/digested by the baby. This is how a container of bm can have less bacteria in it after a few hours of being expressed than directly after being put in the container.

Breast milk contains 0.5mg per litre and 50% of that is bioavailiable.

Formula contains 10-12mg per litre (on average though different formulas vary) and 4% of that is bioavailable.

Cows milk contains 0.5mg per litre and 0.25mg of that is bioavailable.

The iron that is not absorbed then settles in the stomach and if any bacteria are present within the gut use this excess iron as fuel to reproduce.

These are some of the reasons why babies which have formula are at greater risk for d&v illnesses - they have no human lactoferrin to 'mop' up bacteria/viruses/parasites AND have a source of fuel for bacteria to use to reproduce PLUS if the formula is prepared incorrectly (sub 70C water added to the PIF/used after 2 hours of prep/stored above 4C/etc/etc) then there may be bacteria in the formula already waiting to multiply.

Jung - I did an update on lactoferrin as part of the Colostrum Update back in November. I know you weren't there - did you want me to send a pdf out to you? Plus it was me who instigated the change re benefits -> risks of - I asked why we were doing a whole session on something that didn't exist.....cue very confused group leader and me going . I thought everyone was on board with the change in language (from a medical/support wiewpoint.

Equating formula with smoking is unhelpful.

But it doesn't help anyone to soft soap the matter. Formula is not as good as breastmilk by any measure, although it is better than, say, watered down condensed milk.

However, it is the case that a breastfed baby born to a smoking parent is statistically more likely to have better health than a formula fed baby born to non smoking parents. That's statistics, of course individuals' experience will vary.

Should we lie to and patronise mothers because we don't want to upset anyone?

Whatever you chose to do, that's fine, but would you be happy for future mothers to ff when they could have bf just because you did not want people to be honest?

jandmmum,

There are studies to show that bm contains molecules that attack microbes (see above post), cells that attack cancer cells (see here), molecules that promote healthy bacteria growth in the gut which then 'crowd out' unhealthy bacteria (see here), immune factors which are produced in response to viruses the mother has been exposed to (see here).......

None of that is available to the exclusively formula fed infant - I wish it science had the answer to making formula that acted like bm but we aren't sufficiently advanced yet to manage that. Maybe in time we will have developed a formula which ingredients change in response to a sensor that detects what the baby has been exposed to and changes according to the age/size/temperature/appetite of the baby - until then bfing is the only way we can give a baby these things. It still won't be the biological way mammalian infants expect to be fed unfortunately.

This post is in response to this part of your post 'On top of that cigarettes are known to contain thousands of chemicals including hundreds of known carcinogens and poisons such as arsenic. Cellular studies have also shown how smoke effects the cells in a way that promotes cancerous changes.' not the whole of your post.

I was comparing/contrasting the 'good' things in bm with the 'bad' things in cigarettes - studies have shown how bm contain substances that effects cells in a good way vs. studies have shown how cigarettes contain substances that effect cells in a bad way.

I am NOT saying cigarettes=formula in any way, shape or form but that if you can accept studies shown how cigarettes effect things why not studies that show how BM does?

Thanks truthsweet :) haven't made it to updates or anything, feel very guilty. :( Things have been rather stressful due to DH being off work so not been out much. He'll find out next week if his back requires surgery or whatever so hopefully then I'll be a bit more available.

Anyway back on topic - I don't see why we can't just spell out the facts individually. Add a bit more meat to it - true, not everyone would understand the more sciency bits, but those who did would be able to make a better informed decision. In all aspects of healthcare propaganda I get sick of the patronising simplicity.

What about:

• breastmilk contains antibodies which are tailor made to

your baby. If you are exposed to certain germs, your body alters the milk so that it contains the substances to fight them. Formula cannot make these antibodies, so babies are more likely to suffer from illnesses.

• ^bottle-feeding can create pools of milk near the ears, which can

lead to ear infections.^

• iron in breastmilk is easily absorbed. However iron added to formula is not, and settles in the baby's gut rather than being digested. This can aid the growth of nasty bacteria, which makes D&V more likely. (hope I understood that right - not got my science head on this morning )

What's wrong with that? Admittedly I'm no writer but AFAICS that is just facts.