Great albeit disturbing report on breastfeeding around the world

[moondog]

Here

I have often wondered if artificial milk companies pay people to frequent MN to rubbish bf.

Here is some interesting reading about obesity if you think that the physiological impact of bf has no impact, chunderella.

www.thealphaparent.com/2013/02/formula-feeding-and-obesity.html?m=1

Chunderalla, I don't think you are being paid to post that :) :)

You would have read the report properly if you had been paid!

It does not state 92 per cent of women are unable to do exclusive bf. It states " 92 million out of 136 million babies (my itals) are not able to practice WHO-recommended exclusive breastfeeding for the first six months"....just means they don't get 6 mths of excl bf.

It's a report for governments and agencies, rather than an instruction to individual women. Surely you would agree that "women need to be supported with several strategies, including protection from baby food companies, support at the workplace, support at the time of delivery and accurate information". What's not to like? :)

Testing the 'benefits' of bf is difficult, because you can't do an RCT; all you have, really, is epidemiology. Separating out the effects of bf from the effects of parenting and socio-economic background is always going to be difficult. However, there is a massive prima-facia case for species-specific nutrition winning over non-species specific nutritition. All studies support this, but naturally enough, there will be differences in the quantifiable results.

Whatever.

Most women, everywhere, want to breastfeed. It's the job of culture and society to enable this. If they do enable it, the evidence is that there will be measurable public health benefits.

Chunderella, when I said all studies show positive effects of species specific milk, I of course meant well-designed studies whose conclusions match their inputted data.

Read the whole paper when you go data mining, not just the abstract, and you get a more accurate picture. Plenty of studies show v. little clear connection between obesity and bf (very difficult to research, because of all the confounding factors).

However, the Kuwait study shows an apparent link between bf and child obesity - ie if you bf in Kuwait, your child is (slightly) more likely to be obese age 4. Odd result and at odds with other studies elsewhere.

But if you look at the data, only 7.4 per cent of the sample bf for more than 4 mths (so too short a time for any difference to show), and more than 80 per cent of mothers were overweight or obese. Given the powerful hereditary factor of obesity (maybe lifestyle factors, maybe diet, maybe genes), and the fact that the normal weight mothers in this sample were less likely to breastfeed, your results are going to be badly skewed.

I am curious, what is your point chunderella? We as the human race shouldn't bother to feed our babies species specific milk? Providing a bovine alternative makes no difference in the grand scheme of things?

I don't know about the US economy but personally I've saved a fortune bfing my babies.

Picking at the fine details of exactly how and why bfing is good and should be supported is well and good but surely it is easy to see that bfing needs more support than it currently gets? Especially in developing countries where sanitation is an issue, but even here, where from reading these boards it seems that many women would like to bfeed but due to lack of support in their choices, are forced down a different route.

Chunderella(why the passive aggressive tone? . If we're talking about 'careless phrasing', your own re-identifying '92 million babies' as '92 per cent of women' takes the cake! Difficult to know how scrupuluosly you read anything after an error like that!):

I explained that obesity studies are always problematic, as prob more than any other phenomenon it's hard to isolate obesity and infant feeding method from lifestyle and genetic factors. I think the WHO study makes a decent stab at it, but something like this has to be a work in progress rather than the last word.

I said that all studies support the prima facia case for species specific nutrition, but I agree, it's a broad claim to make, and risky....put more refinedly, all well-designed studies (strictly speaking, of the ones that I have seen, but it is my academic field so I have seen a lot - yet I would not say 'all' anywhere but a talkboard) that draw conclusions based on reliably-collected data, and that answer the question they originally posed, either show a positive effect or they show no effect. They don't show a 'positive' effect of non-species specific nutrition, and nor would anyone expect them to do.

The quality of research into infant feeding is much, much better than it used to be. Even so, there are still studies which don't define 'breastfeeding' (any bf? or excl bf? Or any length of bf?). I don't think anyone seriously argues any more that from a public health perspective alone, supporting/protecting more and longer breastfeeding is something governments and other agencies ought to be doing.

This is a paper I posted elsewhere recently about bf:obesity link in the States. It took about 3 secs of googling. I'm sure there are many since (2001 paper). There was something recently about bf:diabetes. THe info is out there.

Chunder: your critique regarding using IQ measures needs reanalysing. If there is an error of 3 points measuring one person's IQ, a study analysing many 100s or 1000s of people giving an IQ difference of 3 points or less does NOT mean the result is insignificant. You are confounding statistical significance with test accuracy. If anything, a test with random 'noise' like you describe makes it LESS likely you'll get a significant result.

The only other comment I would like to make is, that although I'm a bf advocat and would like to see more people bfing for a lot longer, I also recognise bf is much more important in parts of the world with poorer access to healthcare, clean water and abundant food supplies etc. The WHO gives out this sort of info with the whole world in mind and is thus less relevant to first worlders.

Oops, how did that face get there??

Also chunderella the link to a blog I posted is fully referenced with peer-reviewed scientific research papers (and the references are clickable leading to the source). It is not an 'opinion piece'. Maybe you should read it and see what research studies you don't agree with.

Evolution dictates we are mammals and are designed to provide our offspring milk. Due to fundamental shifts in society in the last 50 or 60 years (Coincidentally, obesity levels have skyrocketed at the same time!), breast feeding knowledge eroded and we as the human race need to shore it up and reverse the trend.

Again, what is the point that you are trying to prove chunderella We as the human race shouldn't bother to feed our babies species specific milk? Providing a bovine alternative makes no difference in the grand scheme of things?

Can I clarify something? The link is not to a report, but a personal opinion article. The author is making the case that breastfeeding needs more aid - that's the title of the piece, written by a doctor who promotes breastfeeding in India, and who sits on an Indian government nutrition committee. The article has no policy status - he suggests all states make 10 per cent of their child health budget to strategies to support bf, which is an opinion.

That said, it seems to me to be remarkably uncontroversial. It begins "Breastfeeding stands out as the single most effective intervention to save children?s lives, improve nutrition, by reducing diarrhea, pneumonia and newborn infections. "

To take your three objections:

Its mention of bf and less obesity is fair enough, as far as I can see - the WHO report you cite does not deny the link at all, but (justifiably) it says the effect is unclear in some settings, subject to confounding in most settings, and where it exists, the effect is smaller than sometimes claimed. It absolutely backs up the connection, though.

Higher IQs - studies are variable, and no test is completely free of bias. Nevertheless, the link is there, and is even more marked if you include studies which look at cognitive and neurological development and peformance as a proxy for 'effects on brain of breastfeeding'. A difference (qua WHO report) of 3.5 IQ points is not gonna make much impact on an individual, but it could on a population.

The effect on the US economy (2 lines in the article, and not part of the main argument) is indeed highly speculative (as many studies of this type are - you'll find equally speculative studies showing the effect on the economy if more people exercised, lost x kg in weight, recycled their rubbish etc etc), but there is no doubt that more breastfeeding would benefit public health and therefore public purses.

The suggestions for action are three-fold: breastfeeding needs protection (from the commercial practices of formula manufacturers); it needs promotion (so individual women have contact with trained bf workers); it needs support (with legislation to support maternity benefits/leave, and strategies to help working mothers continue bf ).

What part of any of that are you not happy with, Chunderella?

I shan't bother explaining about statistical significance again - you don't understand it Chunder.

A sexist and racist IQ test would not have a positive or negative effect on linking IQ and bf. So even the IQ test is biased, it doesn't matter.

Given the multifactorial nature of obesity I would be surprised by a study on any scale showing an effect of early diet on teenage/adult obesity. However, obesity is much, much more common in first world counties so the link of BMI and bf in first world countries is an important finding. There are clearly huge differences in lifestyles between first and third world countries. I wouldn't expect to find easily comparable results - but finding no link doesn't mean no link exists iyswim.

As an aside, I would like to see these sorts of studies comparing on-demand FF with schedule FF, or indeed whether expressing and bottlefeeding bm has the same effect as simply bfing. I wonder if the obesity and diabetes links with bf are more to do with little-and-often nature of bf than with the milk per se.

Your first responses to the article were

i) criticising its use of the obesity, IQ and '$13 billion' links

ii) a misreading of '92 million babies' as '92 per cent of mothers' which you interpreted as a 'sinister' disregard for mothers' wishes and called 'poor reporting' (well, it would have been, if this is what it had said).

I wonder why you have not discussed the other aspects of the article which demonstrate an uncontroversial link between low rates of bf and poor health outcomes.

It's almost like you want to blur the issue.

And as for maternity leave in the US (a scandal), there are a number of studies (www.hrw.org/node/96432 is just one) showing that if the US got its act together and paid statutory maternity pay and granted maternity leave for longer, the overall effects on individuals, on business and on the economy would be positive.

And if you agree with the suggestions for action in the article, Chunderella, why is it so 'disturbing' and 'sinister' and 'worrying' that three (minor) arguments don't stack up in your eyes?

Chunderella, your 'longer maternity leave = women economically inactive = bad for economy' is a bit simplistic, no? If a woman takes longer maternity leave, the company is more likely to hire maternity cover than simply let her job slide for a few weeks, thus lifting someone else out of unemployment. You don't seem to have accounted for that in your worrying about the effects.

Do you have evidence that it wouldn't? Tiktok linked to an analysis that suggests a benefit. You simply went 13 billion benefit nonsense blah blah probably end up costing the taxpayer with the most simplistic analysis of the situation possible. It was hardly a crushing destruction of the argument for a net benefit to the economy.

Why are you apparently so determined to be down on breastfeeding? I understand that you might dispute the 13 billion figure, but to try to talk it down into a negative with nothing but a bit of hand waving is just odd.