Looking for information

[WinkyWinkola]

on the risks of formula feeding.

I read somewhere that a formula fed baby is 13 times more likely to end up in hospital in the first year of their lives.

Can anyone point me in the direction of such a study because I want to know it's trying to link a direct cause and effect to the use of formula. I doubt it has or can but I'm not certain.

The problem is that there are no "proper" studies on breast v formula, as I understand it no one would be able to do such a trial because it would be highly unethical, the scientist would have to select the "formula" group and "breast" group, not the mothers (and fathers).

So all studies are observational, which means they cannot prove cause and effect. Perhaps I'm wrong and someone will come along and correct me.

Even with the observational studies there are problems because it's hard to de-couple the effect of breast milk v the type of person who is likely to EBF. But we do know that breastfed infants have fewer infections than formula fed infants - there are links from this wikipedia article to some studies which might be useful.

Hope someone with some more specific knowledge can come along soon.

here is one

I think that generally studies of this type will focus on benefits of bf rather than risks of anything else and I expect causal links are hard to prove since there may be other factors at play.That goes for all sorts of health studies, I suppose.

Unicef website has links to a lot of studies.

tiktok is very on the ball with research and her explanations of it, including the stats and the "take home message" are extremely good. She might be along to help you....

Winky, I will post some links tomorrow.

Winky, like many aspects health, it can be hard to establish direct cause and effect with bf/ff, but this does not mean (as RandA says) that no 'proper' studies can be done. She means you cannot 'randomise' a trial, ensuring that an entire cohort be ff and a matching cohort be bf, 'double blinding' it so neither the parents or the front-line researchers know which of the babies is bf and which ff until the results come in.

Obviously not possible :)

But observational studies can be done perfectly respectably and there is a whole discipline of epidemiology which looks at health in this way.

With infant feeding, there are many studies that show more ff babies need hospital treatment than bf babies.

www.ncbi.nlm.nih.gov/pubmed/17403827 is a good UK study showing this for diarrhoea and respiratory infection.

There were 15,000 plus in the study - nice big study - and it looked at babies under 8 mths old, all born healthy and at term.

Diarrhoea and respiratory infection are 'good' topics to study, as you are ruling out things like meningitis, or febrile convulsion, or conditions related to disability - you're using 2 fairly common conditions known to have a plausible link with feeding from previous research, and also things which have to be pretty bad to send a young baby into hospital, so knowing if something increases the risk is worth it.

Number-crunching led the researchers in this study to remove 'confounders' which might skew the results - so you are comparing only the feeding method, not the social background (for instance) of the babies. I think the study also removed smoking in the parents, but I would have to check.

They found that if all the babies in their study had been fully or partially breastfed, 84 per cent of hospital admissions for diarrhoea could have been avoided. 52 per cent of admissions for respiratory infection could have been avoided. This does not mean direct cause and effect on individuals and it does not mean 'no breastfed baby ever goes into hospital for diarrhoea or respiratory infection'. But it does show an increased risk if you ff.They also showed that the effect was stronger if you fully ff - partial breastfeeding exerted a protective effect, though full breastfeeding was better.

This still does not link cause and effect in individual babies. And hospitalisation for babies for these reasons is still unusual - they found 1.1 per cent for diarrhoea and 3.2 per cent for respiratory infection. Most babies, ff or bf, will not need to go into hospital for either of these reasons, in the UK, according to this study.

Hope this helps.

Thank you, TikTok. Very much appreciated.

Actually TikTok, sorry to be thick bit from that study you linked and others, do they not show that breast feeding is beneficial rather than formula is not in terms of preventing hospitalisations for these conditions?

I mean, aren't there two separate conclusions there?

Winky - it depends what you are using as 'normal'.

Breastfeeding is the norm for the species - human milk is meant for human babies and human babies are 'designed' to have human milk.

So it's not so much that breastfeeding has 'benefits' but that formula feeding has risks.

If you think formula is the norm for the species, then something different from this would have 'benefits' - we usually use the term 'benefits' when we are talking about 'extras'. There are no 'extras' in breastfeeding - it's just the biological way babies feed. If a baby is not breastfed, then he encounters risks because the (normal) health protection of breastmilk is not there.

To say breastfeeding has 'benefits' is like saying 'walking on your own two legs has benefits over using a pair of crutches' or 'breathing without an oxygen mask has benefits for your lungs' - as if using crutches or an oxygen mask was what our bodies expected.

Is that what you meant to ask?!

Therefore, it is because of not using bm that the baby is hospitalised or it is because of using formula? Or can both be drawn as conclusions?

By using formula which doesn't offer the same protection as bm, the baby is hospitalised. So, formula is at fault because of it's lack? Can that be concluded?

Well.....yes, it's because of not breastfeeding that more babies are hospitalised (bearing in mind you can hardly ever point to an individual case and say 'direct cause and effect'). The only realistic and safe alternative to breastfeeding is formula, which lacks the antibodies of breastmilk (and it's the antibodies, as well as other constituents, that enable the baby to fight infection).

But it's a bit more complex than that.

Formula has its 'own' bacteria which are known to pass on infection (one of the reasons why preparation should be done in a way which zaps the bugs, so they get less chance to multiply and get into the baby. And bottles and teats can become germy with traces of stale milk, though obv this is minimised with careful cleaning. So it's not just that formula is lacking.

There's nothing that careful prep and cleaning can do about the lack of immune-system supporting components and specific antibodies in the formula. But risks of infection can be reduced by making sure bottles and teats are clean, and that the milk is prepared hygienically and with water over 70 deg C, and given to the baby within a short time.

So, yes, I suppose it's both the fact that formula is lacking, and that it has its own risks, that cause the extra admissions to hospital...does that help?:)

Massively. thank you for your time on this.

Someone was querying the cause of formula in risks as opposed to a lack of breastfeeding.

I am woefully inadequate in explaining!

You're welcome. It's good to explain from time to time as it sorts out my own thinking :)