Breastfed babies are better behaved says study

[crikeybadger]

Link here if you are interested.

Feeding EBM with a bottle is more frequently found in the US among professional mothers who return to FT work very soon after giving birth. In the UK, where maternity leave is a lot longer, there isn't the same impetus to get other carers to give EBM to very young babies.

Feeding EBM with a bottle is a bloody nightmare.

DD was born with quite severe tongue tie and couldn't latch on properly. I asked the GP about having it snipped but apparently they don't snip here until they are toddlers, and only then if it has an effect on their speech. Speech clearly being more important that feeding Anyway, she was losing weight rapidly so I decided to express and feed her that way. Poor lamb, due to her tongue tie she couldn't even close her mouth properly around the bottle teat and so she used to dribble half of the feed out of the corner of her mouth (wasting half of what I'd pumped, aaargh!). It was the longest six months of my life, especially as I had two other DC aged 2 and 4, but we got there. Definitely wouldn't recommend it though!

Later I found out that if I had gone to another area I could have had it snipped privately. Wish the HV had told me that instead of telling me to switch to formula.

"I can only imagine that you were lucky enough to have a baby that was a great efficient feeder/not fussy etc"

No - not the case. One easy feeder, one non-stop guzzler and one baby who took 5 weeks to latch on well.

The point I was making is that NORMAL breastfeeding (which includes babies with annoying feeding habits or frequent feeding) isn't necessarily incompatible with NORMAL family life, as many people would have us believe.

tiktok, have there been any studies comparing EBM to breastmilk. If there were any benefits to breastmilk it would suggest that the advantages of breastfeeding were due to physiological factors. I'd like to see the formula manufacturers spin that one!

Brestmilk from the breast that should say.

Not sure what you mean - you mean outcomes in babies? Probably not - not that I know of, sorry.

Breastmilk from the breast is different from EBM, though.

• breastmilk from the breast direct picks up the need for specific antibodies because of the skin to skin contact/salivary contact between the baby and the breast, so any pathogens the baby has been in touch with 'order up' antibodies when he comes to the breast
• ebm is 'homogenised', rather than become creamier as the feed goes on (and the breast empties) so the feed becomes less 'tailor made' to the baby's specific needs
• the baby's appetite is less in control of the quantity taken
• the oral development of the baby is affected differently by the different sucking and swallowing

There may be more differences but cant think of them at the moment. You'd be hard pressed to find any of this made a real measurable difference in any individual babies and you would need a massive study to show anything up, as common sense would suggest the differences would be small - the health difference between ff babies and bf babies would be far greater.

The main difference (IMO) between ebm and bf direct is the experience for both mother and baby, and it would be quite a personal thing whether this led to a different 'outcome'. I mean, if a mother gave ebm because she really could not bear the idea of the baby bf direct, then her feelings about it would be different from the mother who gave ebm because her baby could not take milk direct from her 'cos of cleft palate or something.

Rollit, they used a statistical technique called logistic regression (stata is just a piece of stats software, tiktok). it's not perfect (there is no perfect way to adjust for confounding in an observational study) but it's standard and well understood. it means they fit a single mathematical model to relate sdq score to a bunch of potential confounders (age, socio-economic status and others) and bf (any vs none). the adjusted risk is the risk that relates to bf on top of all the other variables which may themselves relate to sdq score.

an aside to tiktok: I know there are rare conditions which mean a mother physiologically cannot produce milk. do you know if these are genetic in origin? if so there is a statistical technique called Mendelian randomisation (bad name, but I can explain if you're interested) which could be used to test whether bf associates with various outcomes, unaffected by any confounding. it has been used, for example, to look at the effect of alcohol consumption by dividing subject according to their genetically determined ability to metabolise alcohol.

Thanks Tiktok,

I was thinking that studies seem to concentrate on the health benefits and that showing that milk from the breast father than from the bottle was better would reinforce the point that ie doesn't matter what the Formula manufacturers put in it Formula will never match breastmilk.

they look at their own data, yes, but the word adjust is perhaps misleading. they estimate the odds of a range of sdq score simultaneously according to a variety of factors, in a single model. you get an estimate for how closely each factor relates to the outcome. the model doesn't know that bf is the one the researchers care most about, it just spits out numbers. they don't take the naive bf risk and "adjust" it, they just estimate everything in one go. I prefer to call it an estimate allowing for the effects of other variables.

I'm in awe, mamachoc, 'cos stats are the stuff I am flakiest on....the variables which they control for come with a bunch of evidence, is that not the case? Like they already know the effect (from other work) of poverty and deprivation (say) have on the liklihood of behaviour problems at age 5; they already know the effect that attachment difficulties have, that the mother's mental state has, and so on.

And these are the numbers they chuck into the software...is that correct?

In awe of tiktok and others again here for their calm way of discussing this report.

It's a long time since my bf days, but I vividly remember the joys of multitasking. The event that really sticks with me is the time I found myself breastfeeding DS2 holding him on one arm, whilst trying to help DS1 get onto the potty with the other hand, whilst trying to prop a large phone next to my ear and talk sensibly to the estate agent about moving house! It can be done :)

I'm a stats geek

no, they don't assume they know the effect of anything - estimates from one study are unlikely to apply exactly in another. other studies may inform which variables are included in the current study. then they "chuck" the data on those variables from the current study into the software. so the effect of each variable will be estimated from the current data.

ie they estimate an odds ratio for age (probably for each 5 year age band) and for being poor, and for bf, and for other things. the idea is that if part of the effect of bf is explained by better off mums being more likely to bf, then if you include the variable "mum is better off (or not)" in your model, the part of the apparent benefit of bf due to mum being better off will be sucked up by that variable, and you will get closer to the "pure" effect of bf. does that make sense?

it's not perfect because you can't measure everything, and what you think you can measure you do imperfectly. but it's better than looking at bf vs sdq alone, because then you will overstate the effect of bf as it will act as some kind of proxy for various other things which associate with both bf and sdq.

[uncrosses eyes] Yes, I get you, mamachoc :)

Am I right in saying that the bigger the numbers, the better? To allow room for all the variables?

One of the reasons why it is bound to be somewhat blunt anyway is that so many of these variables work together - so the mother who's poor is already more likely to be depressed just 'cos of being poor, and if she is poor the effects of her depression on her baby are going to be greater, and so on....and it is not really possible for the stats to untangle all that. Or maybe it is?

tiktok and lambethlil , fwiw I am exclusively pumping for my 3 month old DD.

I have built up a close and nurturing bond with my Medela Swing that I think is testament to how much time we spend together. It is beautifully behaved and never steals.

Hope that helps with the research...

cordiality

That may be so now but I predict terrible problems in a few years time. That Medela Swing is going to feel so rejected!

LOL @ cordiality

This study is flawed IMHO. This is my case: My child is 8 and has several behavioural difficulties.

My understanding is that the reasons for his behavioural problems are also the same underlying reasons for why he couldn't breast-feed well and why his birth was difficult. NOT THE OTHER WAY ROUND!!!

He was almost impossible to breast feed so after a few weeks of "failure to thrive" I was advised to bottle-feed.

This same child was also difficult to give birth to and after several hours of "failure to progress" in labour he was born by emergence Caesarean.

That he then goes onto have behavioural problems is NOT because he was bottle-fed. He was bottle-fed BECAUSE his underlying issues affected his ability to breast-feed.

Luckily for us - he is alive. He probably wouldn't have made it past birth in another place or time.

Diva, the study isn't flawed - it has the inevitable limitations of an observational study where two sets of 'behaviours' are being looked at. Does behaviour A (the way a baby is fed) 'cause' behaviour B (the 'problems' in 5 years olds)....or does behaviour B 'cause' behaviour A (because probs in 5 year olds may have their origins in infancy)? This is 'reverse causation' and it is hard to avoid in this sort of study. It does not invalidate the study, though, as however you slice it, the association between infant feeding method and behaviour remains.

Some of the reverse causation might be 'mopped up' in the variable for 'admission to a neonatal unit' because many babies with early problems are readmitted.

sorry not read all posts
wanted to add
my dd1 was EBF
she is a terror !
dd2 is EBF and Im hoping she will turn out to less of a terror!

Tittok
That is really interesting about pathogens in the babies Saliva stimulating mum to produce the correct antibodies. Do you have a link about that. (could use that during GCSE biology lessons on immunity)

gateacre - you might find something in an up to date immunology textbook. It's the same scientific topic area as in this very nice referenced article about why mothers kiss their babies :)

www.unhinderedliving.com/motherkiss.html

I just had a look at the BBC article and note that these 'statistics' were put together from comments made by the breastfeeding mothers themselves, i.e. what they thought of their own children's behaviour at five years old. This is not a medical study and there is no medical study in existence that proves beyond doubt that breastfeeding has any effect whatsoever on the outcome of childhood allergies, asthma, intelligence or any other claims peddled out ad naseaum by the likes of the NCT, etc. as 'fact'. I bottle fed both my children by choice and they are now 5 and 7. We are constantly being told how polite, helpful, kind and well behaved they are by friends and family and at their last parents evening we were told they are both "extremely bright", well ahead of where they should be in the curriculum and that they could both "be held up as examples to other children" in terms of their behaviour. They are not perfect by any means (especially at home!!) but they are good kids because this is the way we have brought them up, not because they were breast or bottle fed! A mother who breast feeds can be depressed, detached, nervous, angry, scared etc. and not be bonding with her baby in exactly the same way a bottle-feeding Mum can be looking into her babies' eyes, speaking softly to it, stroking its head, etc and be really enjoying the whole experience. It's the manner in which a baby is fed that helps the bonding process, not whether the milk comes out of a bottle or a breast. Speaking as a student at The Tavistock in London, I can say with confidence that the real issue parents should spend their time worrying about is whether they are both forming a strong, positive attachment with their baby in the first year of life and this is done in many ways, but critically by responding effectively to the babies' physical needs and 'containing' them emotionally. This is what truly lays down the foundations for a mentally and emotionally healthy childhood and adult life, and that HAS been proven medically.

If you read the thread, those points about how they data was collected have been discussed in some detail. It's not based on comments made my breastfeeding mothers.