Breastfeeding difficulties

[Eulalia]

Cam - I meant the bit, and I quote "your breast milk will have changed so that it is only a drink, not a food". I was saying that it is more than just a drink and is indeed a food and a lot more besides. Maybe you didn't mean it to come out like that.

Some more info -

Breastfeeding and Infant Caries: No Connection
www.brianpalmerdds.com/bfeed_caries.htm

Lactose
Some assume that because breastmilk contains lactose, it can be as cariogenic as any sugar solution in a bottle. However, lactose is protected by the antibacterial and enzymatic qualities of breastmilk. Furthermore, lactase enzyme splits lactose into glucose and galactose in the intestines, rather than in the mouth. There are 4,640 species of mammals, all of whom breastfeed their young. Lactose is present in most of the breastmilk of these species. Humans are but one species of mammals, but are the only species with any significant decay in deciduous teeth.

Empiric evidence does not support a causal association between breastfeeding and infant caries. Breastmilk alone, including the lactose in it, does not cause tooth decay. Infants who are exclusively breastfed, however, are not immune to decay as a number of other factors may influence the infant's risk of caries.

Tigger - good luck - not much else can be said really. Anyway I am sending my electronic support. By the way we have not moved yet. Sorry you were kind enough to ask and I didn't respond. Can get too bogged down with all this technical stuff. Various set-backs - hubbie had an operation, visitors and the bad weather. However he is getting there ....

Another word on thumb sucking, dummies etc. - the possible bad effects of using these must be outweighed against the good effects. As Tigger points out some babies can use dummies with no lasting effect. It depends on the frequency with which the child uses them and for how long. Most parents try to discourage dummy/thumb use after about 3 years of age. The dental problems arise when a child seems to have a thumb/dummy in its mouth all the time. This child is inevitably using this as a means of comfort and another means of comforting the child is advised.

Very young babies have a strong suck instinct. Traditionally this instinct is largely satisfied at the breast and there is nothing wrong with feeding on demand. Under these circumstances most babies won't feel a need to suck their thumb. Of course the sucking instinct can be stronger in some babies. However the rule of frequency of feeding will generally mean less thumb sucking. (As I stated earlier in some societies thumb sucking is unheard of). Of course putting your child to the breast every half an hour is not always practical so it is OK for these babies to satisfy themselves in-between with a thumb/dummy. Some mothers talk about being 'a human dummy' which is of course the wrong way round. Dummies are artificial nipples. Breastfeeding does not cause thumb sucking - it is quite the reverse - however some confuse cause and effect and the effect of thumb sucking is 'blamed' on the 'cause' of breastfeeding. Babies who are bottle-fed certainly don't suck their thumbs less often. Also as indicated below breastfeeding is actually good for the development of the face, jaw and palate.

In any case the sucking instinct decreases gradually as the need for milk diminishes. This is why mot babies give up thumbs and dummies and of course breasts. My son has never sucked his thumb or taken a dummy but at one time I was having to breastfeed him every hour during the daytime. He would just spit out a dummy. I trusted my instincts that I wasn't doing something 'wrong' and fed him. Fortunately this was only a phase for a few weeks, so I feel by 'indulging' him in this short period I prevented him resorting to artificial means, which can drag on much longer.

Sorry for the double post! Anyway I am off to give some 'room' for someone else...

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While nobody has definitively proven the direct link between folic acid and neural tube defects and smoking and low birth weight, there is a cogent and widely accepted medical theory for both. It is almost impossible to prove a conclusive cause and effect in these situations.

Hi Robinw - I wanted an opposing view for the sake of completeness - no point in always finding things that fit your own theory and of course a proper review of an issue requires this. I generally find the Internet very well represented and please don't poo poo my research. I have tried to only look for reputable resources and for example the last quote was written in Dec 2000 from 'The Newsletter of The Academy of Breastfeeding Medicine', and was written by a dentist. You did actually only give me one reference and I was unable to find that journal on the Internet and as I say I did look for other references. I will have another look but of course I too am unable to devote too much time to this.

Species comparisons are done because of the fact that so many animals breastfeed and have no problems thus showing that dental problems are largely due to other human practices not breastfeeding. Humans of course eat much more sugar (and diet in pregnancy is linked to streptococcus)

As Gracie said the medical establishment has widely accepted that folic acid may help the development of the neural tube and taking it doesn't do any do any harm so the mother may as well. And smoking of course is bad in many other contexts. I am not being picky just pointing out that that there are many proven benefits to breastfeeding and the link between dental caries is weak and it may be wrong to encourage mothers to give it up and perhaps run into danger of not examining other possible causes of decay.

If strep bacteria are so virulent then I'd have thought that actually feeding solid food would be worse because it doesn't have the protective enzymes of breastmilk. We can't stop feeding our children food but likewise shouldn't stop feeding children breastmilk as a part of their diet and indeed these protective enzymes may be designed to allow for more frequent feeding of our young.

I do agree that there may be a link to night-time nursing and the 20% at risk babies and in this instance the mother should merely cease night-time feeds but not breastfeeding altogether.

Anyway I need to move on from this ....

Bells - regarding fertility and breastfeeding - I think it may have been the info below (bottom of post) unfortunately I've lost the original reference.

What annoys me is that (again) there is such little info on this. It is pushed constantly on us that we will get pregnant again practically the moment our baby drops out of our womb. As it turned out it was 13 months before I had a period. Despite breastfeeding frequently my doctor still wanted me to go back on the pill at the 6 week check-up. The info below shows how much you need to breastfeed for the contraceptive effect to be successful and it is quite remarkable. Many women use this method in countries where contraception is not available and it allows a natural spacing of babies of about 2 years, which allows your body time to recover and prepare for the next pregnancy. There is of course the added benefit of no periods meaning less of a drain on the body and no costs of sanitary products.

Where a woman could get caught out is if she goes straight from her first ovulation post-partum to pregnancy. Return of periods is a sign of returning fertility but of course you ovulate approx 14 days before your period. This why having no contraception and waiting for your periods is not failsafe. However using guidelines below one can make a decision about when one is likely to be at risk. If you aren't bothered about getting pregnant again anyway it is an easy method of family planning. The nice thing about it is that nature provides a simple method - quite simply the more the baby wants to breastfeed the more your fertility is suppressed ie the baby still needs its mother and isn't ready for another sibling. I guess in times of hardship this was quite vital.

Anyway here is the text:

Many breastfeeding mothers find they remain amenorrheic longer than six months, especially mothers who practice a style of nursing that Sheila Kippley calls "ecological breastfeeding." In Breastfeeding and Natural Child Spacing, Kippley describes ecological breastfeeding as the kind of nursing that most effectively spaces babies: nursing on cue, keeping baby close, providing all nourishment and liquids at the breast for the first five to eight months, and nursing to comfort the baby. It does not include the use of bottles or pacifiers, mother-baby separation, parent-imposed feeding schedules or restriction of night nursings. All of these practices limit the nipple stimulation that suppresses ovulation.

The chance of pregnancy occurring during the first three months of ecological breastfeeding are practically nil. During the second three months, there is a less than 2 percent chance of becoming pregnant before the first menstrual period. After six months postpartum there is a six percent chance of becoming pregnant before the first period. That means that an amenorrheic woman who is relying on ecological breastfeeding alone has a 94 percent chance of not becoming pregnant during the second six months postpartum.

Women who practice ecological breastfeeding average 14.6 months of amenorrhea. Seven percent experience a return of their menses in the first six months following childbirth. Thirty-seven percent get their periods back during months seven to twelve. Forty-eight percent get their periods back sometime during the second year after childbirth. Eight percent go longer than two years without periods.

Eulalia - you were the only person who could give me any concrete info on fertility & b/feeding. Even my GP just said that you could still conceive while breastfeeding but couldn't be more specific. It was frustrating for me because I wanted to continue breastfeeding our baby but was also keen to conceive another. I would have thought this was quite a common situation but like so many other areas of breastfeeding, there was just no detailed info available. Anyway, once again, thanks.

Eulalia, all interesting stuff, but just to make a small point. You said that Eskimo societies have a low indicences of tooth decay (but do have high and extended rates of breastfeeding).
You seem to be assuming a link here, but there isn't one. In that Eskimos have a low incident of tooth decay because they do not have sugar cane in their diet. In fact they chew on leather as a natural means of brushing their teeth, as it increases saliva production. Studies have shown that since the innuit people have had access to the 'western civilisation' and sugar, their teeth decay has increased substantially.

I just use this to point out that you are making lots of assumptions about connections between tooth decay and breastmilk. Some of which is not proven, and jumps in logic as you made in this eskimo example, can lead you down the wrong path.

Thanks for such thought provoking arguments though!

Bad teeth can be inherited, as in my case and my mothers, as in the fact that she has a very high cholestorol level, her brother, her sister, my 3 cousins and mine is round about 4. The rest of my family all stick to a very strict diet and are normal weight, I on the other hand am NOT normal weight, smoke, drink and eat a lot of red meat and dairy products and all the things they can't.

A lot of these studies are based on not a lot of people, but, if we listened to everything we were told, we would all be outside with my cows and sheep at the moment eating grass, sheep feeding and silage. And with rotten breath!!!!!!!

So Tigger, do you recommend Scottish deep fried mars bars - or is that just a wicked Southern rumour?!

Lil - I wasn't making assumptions - read the literature that is provided here. Many anthropologists have said that it doesn't make ecological sense for breastmilk to be 'bad' for humans. As you rightly state the sugar increase and adoption of a Western diet has caused an increase in tooth decay.

There was no going down the wrong path - and I certainly didn't say that extended breastfeeding meant better teeth.

As I've been saying all along the issue of tooth decay has very little to do with breastfeeding. I was trying to point out that incidences of tooth decay are to do with other factors, diet, inheritence, and health care of the teeth.

Away woman, they are very American apparently, but, I have seen them on chippie menus!!

Tigger, going off the subject a bit.........

You mentioned on another post that you had lost a stone in about a month, what diet are you doing? Everytime I try to concentrate on what I eat and try to lose some lbs (inches) I end up eating more and putting on a bit because food is on my mind so much. Can't get any incentive to exercise either at the moment, winter blues I think................

I started eating breakfast, a bowl of cereal and a small amount of milk. Lunch was 2 slices of bread with a slice of meat and loads of salad with mayo or relish of some sort, and tea time was doing away with the butter on the tatties and veg and making some sauce (usually out of Knorr packet!!) or having Branston Pickle, it helps as it is nice and tangy. Keep the biscuits to plain ones, not the ones YOU like, keep the fruit bowl full of fruit you and the kids like and if you are hungry have some fruit, make a big pot of soup as well, it fills you up well and get a crusty loaf to have with it. One thing I did find hard was when shopping in Safeways and you get to the fresh bread and cakes aisle, avoid it like the plague!. Chicken and fish was another thing we all moved to, we are very much a red meat house, boil up a piece of gammon as well. Grill everything you can, and when roasting meat or chicken put water in the roasting tin and keep topping up as it makes good gravy. Good luck, and one more thing, buy a pair of trousers a size smaller than you wear and try them on every week until you can fit your hand comfortably in the waistband without it being tight. Good luck!

Yup I've seen deep fried mars bars and also deep fried pizzas and deep fried macaroni pies.

Heart attack on a plate.

Yum.

I used to love pinapple fritters as a kid though.

Bells - I can't believe your GP was so dismissive. However apparently they have very little training at medical school about b/feeding. I was also thinking that there is nothing on the TV about it. We seem to be deluged with scientific programmes with boffins in white coats wandering about large scale models of the human body but do they get near the breasts? No. However some programmes are very good and they discuss pregancy and birth in detail but again breastfeeding is missed out. Also there are plenty programmes about babies, particularly if there is something wrong with them. But feeding them? No. There was even a rather silly programme on once about breasts but it was purely on a cosmetic basis with these women talking about whether they liked them and what size they were and if they would have surgery etc etc. Only one mentioned that her breasts had become softer and some blue veins had come to the surface because she had breastfed, ie she didn't like what it had done to them. There was lots of shots of close up boobs but do we ever ever see anyone on TV breastfeeding? No.

Why has it become a secret practice only to be performed behind closed doors in special mother and baby rooms where you have to sit right next to other mothers changing shitty nappies? Why is it viewed as being disgusiting by some, often women themselves. How do you think they'd feel if you said - "I think you've got horrible legs and I don't think you should wear that mini-skirt" It seems that the welfare of the child is totally forgotten about - I mean the last thing you want if you have a screaming hungry child is to traipse all the way down to Boots mother and baby room ...

It seems to be OK to use boobs for advertising purposes and to attract men but heaven forbid to use them for the purposes for which they were designed! Heavens how dreadful.

I am off before I become even more sarcastic.

Eulalia, one thing that irritates me is in OK! magazine (hairdresser material!). Whenever they are presenting our nation with a new celebrity baby, you can be sure there is a full page glossy photo of baby with a bottle in its mouth. Never a boob. (Paula Yates once I think). Every time I see it (which isn't often, haircuts=rare treat!) it's there. Never a mention of a breastfeed.

Ems - I rarely buy magazines but do see the Take a Break and Chat variety in waiting rooms etc. As you say never a flash of a boob. ONly time you do see it is if it is a woman in a third world country.

I know in some societies like India it is actually seen as being done by poor women. I don't know if this is a hang up from the time when formula was introduced onto the world market as was promoted as being better than breastmilk.

Remember our discussion on weaning other animals? I found this: "A Natural Age of Weaning", by Katherine Dettwyler, PhD (This also mentions teeth Robinw and many other issues discussed here)

My research has looked at the various "life-history" variables (such as length of gestation, birth weight, growth rate, age at sexual maturity, age at eruption of teeth, life span, etc.) in non-human primates and then looked at how these variables correlate with age at weaning in these animals. These are our closest relatives in the animal kingdom, especially gorillas and chimpanzees, who share more than 98% of their genes with humans. I came up with a number of predictions for when humans would "naturally" wean their children if they didn't have a lot of cultural rules about it. In societies where children are allowed to nurse "as long as they want" they usually self-wean, with no arguments or emotional trauma, between 3 and 4 years of age. This interest also stemmed from the realization that other animals have "natural" ages of weaning, around 8 weeks for dogs, 8-12 months for horses, etc. Presumably these animals don't have cultural beliefs about when it would be appropriate.

Some of the results are as follows:

1. In a group of 21 species of non-human primates (monkeys and apes) studied by Holly Smith, she found that the offspring were weaned at the same time they were getting their first permanent molars. In humans, that would be: 5.5-6.0 years.

1. It has been common for pediatricians to claim that length of gestation is approximately equal to length of nursing in many species, suggesting a weaning age of 9 months for humans. However, this relationship turns out to be affected by how large the adult animals are -- the larger the adults, the longer the length of breastfeeding relative to gestation. For chimpanzees and gorillas, the two primates closest in size to humans and also the most closely genetically related, the relationship is 6 to 1. That is to say, they nurse their offspring for SIX times the length of gestation (actually 6.1 for chimps and 6.4 for gorillas, with humans mid-way in size between these two). In humans, that would be: 4.5 years of nursing (six times the 9 months of gestation).

1. It has been common for pediatricians to claim that most mammals wean their offspring when they have tripled their birth weight, suggesting a weaning age of 1 year in humans. Again though, this is affected by body weight, with larger mammals nursing their offspring until they have quadrupled their birth weight. In humans, quadrupling of birth weight occurs between 2.5 and 3.5 years, usually.

1. One study of primates showed that the offspring were weaned when they had reached about 1/3 their adult weight. This happens in humans at about 5-7 years.

1. A comparison of weaning age and sexual maturity in non-human primates suggests a weaning age of 6-7 for humans (about half-way to reproductive maturity).

1. Studies have shown that a child's immune system doesn't completely mature until about 6 years of age, and it is well established that breast milk helps develop the immune system and augment it with maternal antibodies as long as breast milk is produced (up to two years, no studies have been done on breast milk composition after two years post partum (Anyone 18-24 month or longer was lumped into big category. Presumably, the benefits continue to accrue, as your body doesn't know that the baby has had a birth day and suddenly start producing nutritionally and immunologically worthless milk.)

And on and on. The minimum predicted age for a natural age of weaning in humans is 2.5 years, with a maximum of 7.0 years.

Clearly, babies born in the U.S. don't have to contend with all the diseases and parasites and contaminated water that babies in Third World countries do. We have more supplementary foods that we can generally trust to be safe and clean. We can get our children immunized, and get them antibiotics for infections when necessary. The fact that we can does not mean that breastfeeding is unimportant.

An important consideration for the older child is that they are able to maintain their emotional attachment to a person, rather than being forced to switch to an inanimate object such as a teddy bear or blanket. I think this sets the stage for a life of people-orientation, rather than materialism, and I think that is a good thing. I also can't imagine living through the toddler years without that close loving connection to a child going through enormous changes, some of which are very frustrating to the child.

Eulalia you are definitely chipping away at my scepticism! I guess the primates are the best example, as we have to think back a long way to BEFORE domesticated animals were use dto provide us with milk. Only then is it clear that you would be breastfeeding for quite a few years to give your baby the required milk.

The real question therefore is whether formula or cows milk is better/same/ or worse than breast milk, taking into consideration the fact that toddlers have a lot of extra nutrition from their diet, that we never had pre-domesticated animals (whenever that was). As part of the generation that never saw a breast, I think I can safely say that there are no glaring health problems that have come from bottle-feeding. The problem then is in peoples snooty attitudes, like you say, rather than one milk being better than the other.

are there any BALANCED books on milk versus breastfeeding? one of the continuing problems is that these pamphlets and studies are done by proponents very for or against one option or another. e.g. La Leche, who don't do themselves any favours by not presenting the alternatives.(well they get my back up!) Eulalia, maybe you could write that book!!

I am with you on La Leche Lil. When I was having huge problems getting feeding established, their dire warnings on the impact of introducing formula terrified me. In the end I went for it and it was the best thing I ever did and certainly allowed me to ultimately breastfeed for longer than if I hadn't tried it.

Fascinating debate. Eulalia, you really are a mine of information. I'm totally pro breast-feeding babies but I'm afraid I still can't get my head around the over twos being breast-fed but I guess that is my issue. I would obviously never pass comment on an individual who chose to do this but I can come clean on this noticeboard.