What is it with doctors and breastfeeding?

[bobthebaby]

My 9 mo ds has bad eczema and allergies to lots of stuff notably milk, egg and peanut. As I am bfing I avoid these too. Today I had to take ds to hospital because his skin got so bad he had to have antibiotics. His paed. gave me a jar of Neocate to wean him onto and the registrar said "I bet you will be glad to wean him" when I told her the things I couldn't eat. I don't want to wean him, in fact I'm not going to. Can anyone point me to studies which show I am helping not harming by continuing to bf him. The doctors seem convinced that if I weaned his eczema would go away, which I think is total rubbish. I think its the only thing that helps the pain and about the only useful thing I can do for him. But then this doubt comes in, because they are doctors and I am just a mum.

exactly fairymum- I almost passed out with pain when ds1 was a newborn- I remember grabbing dh and screaming as he latched on. And he wouldn't ever feed form the LHS so I ended up with mastitis. Without knowing about the benefits there is no way I would have continued (in fact as tiny babies the problems I had meant that both were mix fed- ds1 had one bottle a day until he was 3 months, ds2 had more, so I did have to compromise- the benefit being that I was able to continue for a long time).

The "breastfeeding mafia" is very important in those early days when struggling, otherwise no-one in their right mnd would continue!

I was curious about xylitol being so much better at preventing otitis media than bf. So I did a bit of hunting.

There are many, many papers looking at OM and bf, but this one is typical:

'Infants exclusively breastfed for four or more months had half the mean number of acute otitis media (ear infection) episodes as did those not breastfed at all and 40% less than those infants whose diets were supplemented with other foods prior to 4 months' say Duncan B et al. Exclusive breastfeeding for at least 4 months protects against otitis media.Pediatrics 1993; 91 (5): 867-72. (USA).

Xylitol appears in the work of a Finnish team of researchers, with a paper here: Vaccine. 2000 Dec 8;19 Suppl 1:S144-7. Xylitol in preventing acute otitis media. Uhari M, Tapiainen T, Kontiokari T.

They found a 40 per cent reduction in OM, so a rather poorer performance than excl bf....but the xylitol was given five times a day in the form of chewing gum (!) which can not, obviously, be given to a young baby.

There may be studies which show xylitol in a different form to young babies who can't manage the chewing gum, but I didn't find any.

Most mothers, would, I think, like to know that an easier and more effective way of reducing ear infection is to breastfeed, without medicating their baby in this way.

Didn't manage to breastfeed any of my three. Of course they are absolutely fine on formula, but I still wouldn't try and argue that it is as good as breastmilk! The production of breastmilk is just as complicated and perfectly judged and magical as the production of a baby from an egg and sperm and no man-made alternative is going to be anything other than adequate, I don't really think anyone can argue against that. Well, not convincingly anyway.
What I would object to is people who judged me or pronounced me as a bad mother because I failed to crack breastfeeding, but I haven't had anything other than help and support on MN. No nazis here robin.

i had problems breastfeeding dd1, not much support etc. her ezcema, altho apparent from birh flared up a lot at 6 weeks when moved onto formula. its only looking back now i can see the link.

i was listening to a radio show the other day about skin conditions, and they said that ther skin care part in medical training is a very small aprt of the training. is this true?

I can relate to the pain experience - I almost screamed for the first 12 weeks b/feeding DS2, and nobody ever got to the bottom of what was wrong. That's partly why I'm still feeding him now, at 18 months, even though I do get stick for it. I want to get my money's worth.
This is off topic, but a couple of friends are more than mildly disapproving of my b/feeding a baby who's old enough to ask for it.

What is xylitol and why should I be using it to protect his teeth?

I thought Xylitol was some kind of sweetener which you found in chewing gum. I know some dentists recommend chewing gum because it stimulates the production of saliva. I think this is supposed to kind of "wash" your teeth. I am no dentist though and I didn't know you could give it to babies ?

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Robinw, can I guess from your post that you are about 12 years old?

There is the BF mafia and the xylitol mafia

Oh, please come back, Robinw. I need another good laugh. Encore! Encore!

Robinw....why on earth would bf supporters know about allergy? It is an enormously complex subject, and a medical specialism in its own right. However, they can ask questions about it and access information.

Bf supporters are concerned to ensure that mothers who wish to bf are enabled to do so, and some of us know a bit about how to get hold of research papers. I think the level of information here has been a lot more detailed and helpful for bobthebaby, compared to the rather dismissive 'help' she has had from her medical advisers.

Personally, I am not convinced by the evidence that giving xylitol - a sugar made from birch trees - would be helpful to a young baby, whether it was in gel or granule form. I would want to see the long term effects of this, and I can't find any papers which test the effectiveness or the safety of giving the gel or granules as a preventive measure to a baby. Exceeding the dose of xylitol (which has to be given several times a day, in whatever form it is) causes abdominal discomfort and/or diarrhoea.

But I am open minded I certainly don't say that women should or should not take it....nor that they should or should breastfeed (unlike robinw who is quite happy to say what other women should or should not do )

I think the minute someone starts calling other people nazis they lose all credibility. It's just so childish and profoundly offensive. yeah, right, offering advice and help and support to breastfeeding women is EXACTLY the same as committing genocide, deliberately starving communities to death, gassing children, experimenting on babies etc etc etc isn't it? It's just so stupidly offensive that it's laughable. I feel very strongly about using a term like nazi in such a stupid way.

I agree, aloha. I have raised it before with Robinw on other boards and asked her to consider her terminology from the point of view of (say) Jewish people. I am going to report her to mumsnet.

I don't think the whole allergy debate is well understood anywhere. DS1 has atopic tendencies- had very severe eczema when younger- and an autoimmune condition and had a ridiculous number of ear infections. DS2 is completely clear- never had an ear infection (he's now 22 months) no atopic tendencies whatsoever. Both boys were mixed fed (the formula I used had LCP's)- ds1 bfed until 13 months, ds2 still going at 22 months (and droile I agree totally- my mum almost passes out when he points to the feeding chair and says Yes). I took oil supplements religiously with ds1, less so with ds2. I don't think feeding has anything to do with their different outcomes. In ds1's case I know many people here already know that I link a lot of his problems to vaccination (and I suspect even the ear infections for that- there is some research suggesting a link between the dtp and ear infections- not saying its a definite link but I certainly have my suspicions). The allergy link is very complicated. Recent research on asthma suggests that pregnant women being told not to eat shellfish may contribute (as trace minerals are not then taken in). I suspect the cause of atopy is multifactoral anyway- it would be ridiculous to say that no-one should breastfeed just because it doesn't suit absolutely everyone. In the vast majority of cases it is the "best" thing to do.

I find the allergy issue gets more and more complicated. The more I read, the less I understand. Ds2 was allergic to fish and birch trees (amongst other things) when young - would he have reacted badly to fish oils and xylitol, I wonder?

Re the bf 'nazi' issue. Ds1 has married into a Jewish family and they find casual usage of these terms appalling. They can't even bring themselves to buy a German car or household goods, such is their sensitivity. And how much worse it is, when it is people who claim to be Christian who are using the terms.

Tiktok ? that might be an idea, much as I hate the idea of reporting anyone but robinw seems determined just to upset people here. We can have a discussion without using offensive terms ? as others have said it is just childish. Also have you noticed that robinw lays out accusations of everyone else not knowing things, not looking for info etc but she doesn?t actually do it HERSELF .... where is your knowledge of atopic conditions robinw?

Also I think she stops contributing because she realises that the arguments against her are too strong. What is your problem about breastfeeding robinw ? why shouldn?t it be as good as everyone says? No-one here has told any lies, it is all well documented evidence.

I did some research on xylitol robinw so you can?t accuse me of not looking for things .... here it is..

www.drgreene.com/21_837.html
Parents need to know about this gentle, effective solution ? especially if their children get ear infections. Xylitol (pronounced zie-lit-tall) is a sweet substance found naturally in raspberries and plums. What is it, exactly, and what does it do? The xylophone is a percussion instrument consisting of a series of wooden bars of increasing lengths, which when struck makes sounds of the musical scale. The "xyl" in xylophone comes from the Greek word xylan, meaning wood. A xylophone makes sound from wood; xylitol is a sugar made from wood.
Xylitol, also called wood sugar, can be made from the cell walls of most land plants. Xylan, the naturally occurring substance that yields xylitol when refined, is found most commonly in straw, corncobs, oat hulls, cottonseed hulls, and wood. Xylitol is a common food sweetener. Unlike most sugars which have 6 carbon atoms, this naturally sweet substance has only five.
While other sugars tend to promote the growth of bacteria, xylitol has been proven to inhibit the growth of bacteria. In particular it has been shown to be effective in preventing dental cavities by inhibiting Strep mutans, the main bacteria responsible for cavities.
Since the major cause of ear infections is Strep pneumo, a species of bacteria closely related to Strep mutans, perhaps xylitol would prove effective in preventing ear infections. Researchers from Finland tested this hypothesis and published the results of their investigation in the British Medical Journal (November 1996).
The study included 306 children in day care nurseries, most of whom had a history of repeated ear infections. Half of the children chewed xylitol-sweetened gum (2 pieces, 5 times a day -- after all meals and snacks); the other half chewed ordinary gum at the same frequency. During the 2 months of the study, 21% of the regular gum chewers, but only 12% of the xylitol group, had one or more ear infections. Gum chewing by itself, by promoting swallowing and thus clearance of the middle ear, probably prevents some ear infections. The sugar in the regular-sugar-sweetened gum may have offset this effect by promoting bacterial growth in the children who chewed this ordinary gum. By contrast, in this study, xylitol dropped the incidence of ear infections by almost half!
In the xylitol group, children took a total of 8.4 grams of xylitol daily. Most experienced no side effects, but two of them developed diarrhea -- a known side effect of xylitol and other sweeteners.
A small number of children, almost all of them of Jewish descent, have a congenital enzyme defect making them unable to digest xylitol. This condition is called pentosuria. There are no associated disabilities.
No treatment, and no dietary restriction, is necessary. The xylitol is absorbed into the body and then excreted in the urine. The only problem arising from pentosuria is that children having this sugar in the urine are sometimes mistakenly diagnosed with diabetes, and receive diabetic treatment. Pentosuria has no relationship to diabetes. Children with pentosuria could still use xylitol to prevent ear infections.
This Finnish study, making use of the natural, gentle antibiotic properties of plants, is an exciting development. A similar study conducted by the same authors in 1998 (Journal of Pediatrics) confirmed the results found. While much research remains to be done (e.g. the optimal amounts and delivery systems), xylitol seems to be a safe and effective way to reduce the number of ear infections. I suspect it will also prove useful in preventing sinus infections, because the same bacteria are involved.

Seems like a good substance to use but hardly think it is as wonderful as robinw suggests. Also isn?t there a risk that it would upset a baby if it can make them have diarrohea? Why bother when babies have few teeth and breastmilk (surprise surprise!) has its own properties to prevent infections . ... the enzymes lactoperoxidase and lactoferrin, both found in breastmilk, reduce oral bacterial counts. Lactoperoxidase also protects both the mother's breast and the child's intestinal tract from infection.... AND of course breastmilk has antibodies to prevent infection from ear infections (assuming that they even get the ear infections in the first place) which xylitol does not ... so yes great for children maybe but would have a minimal effect on babies..

I have reported robinw to the mods for using offensive and insulting language.

So if she gets kicked off, or reprimanded, she can blame me.

Like I care

RobinW has on many occasions upset several people (and threaten to leave and not come back) - that is her style.... I just ignore it but I agree that some vocabulary is really not acceptable.
Personnally I like the debates of people are willing to debate.... most of us are

Wow, I missed a lot! Anyway, hope no one minds me going back to something I was thinking about yesterday. (This is regarding an earlier discussion on the "Breastfeeding duration is a risk factor for atopic eczema".) While I would agree that it's probably a sound result, I wanted to know if they had taken maternal diet into account. They didn't and probably couldn't, but it's an interesting question. The reason it's so relevant to me is that my youngest had eczema, not horrible but enough to see a dermatologist. At that point, I was dairy free as he was allergic to cow's milk. We discussed the strong possibility that it was something in my diet, but decided to try and manage it without me making changes. The next step (if it couldn't be managed) would have been doing an elimination diet, but it was managed. Not cured, but with active care, kept to a bare minimum. The little bit that remained wasn't enough to change my diet, much less switch to formula, even if that would have done the trick. It cleared up after a while and he's fine now, but still needs some skin care every once in a while.

Anyway, that got me thinking about how medical research is done, why no study or review has all the answers and how good doctors interpret the results. And I realized that my perception of the medical research "process" might be wrong.

In chemistry, when you want to test the effect of variables on an outcome, you design a set of experiments, do them, repeat them and repeat them again. This gives you a starting point for knowing how the different variables affect the outcome and each other. But in chemistry, you've got no ethics committees or PETC watching your every move.

The ethical considerations, to me, would be what makes doing sets of "experiments" (studies) very difficult. Not only the lack of controlled conditions, but the very limited number of subjects -- it seems like it would be impossible to set up a decent experimental design. I'm guessing that medical research is like a complicated game of 20 questions with clues and red herrings thrown in. Is this right? Yesterday doing mindless stuff, I came up with an illustrative story. It's very silly, but shows how I think things are done. (And please see that as the question, "Is this how medical research is done?" )

Thank you tiktok for sticking your neck out and drawing the line at what many consider to be an unaceptabe form of "debate".

Not sure why I'm bothering to say this... I imagine RobinW is American, like me, and for us, culturally, the word "Nazi" is not that offensive. I will ask Jewish American friends sometime, but I think they would say the same. It seems to have a lot more narrow and potent meaning on Mumsnet, and therefore I presume in Britain as a whole.

Yet another cultural educational experience for me, as Yank living in England (although the word "Yank" upsets a lot of my compatriots, too!).

That said, when I called myself a breastfeeding N--- it upset many MNers so I apologised...and it wouldn't kill Robinw to be more culturally sensitive, too.

Not sure how relevant this is but I just wanted to say that what robinw calls the 'bf mafia' are the very people who have inspired me and helped me to keep on going.

Although my mum has always been very supportive, she has no bf experience and all of my friends gave up at 2/3 months; without all the advice posted on mumsnet, I would have found it really difficult to keep on going but I have read many tips and pieces of info which meant that I managed to feed for a year (would have been longer but dd decided to stop). Just knowing that there are others bf out there helps since I find that I can go about my daily life without seeing another bf person.

So thanks everyone, you are very much appreciated.

Robin is not American and has been on mumsnet for years.