why dont younger mums breas feed

[codswallop]

on the whole?
18 year ikd nighbour has just had a baby !) musch to her parents horror.. and isnt even trying to b feeed.
why is this?

And I suppose you could say, some people breastfeed lying down in bed and if you fell asleep then you could squash them!

Probably not but no more daft than the 'proximity to mom' hypothesis in that report!

I've really kept out of this thread, but just wanted to add my point of view - I had ds at 24, dd at 26, ds was mixed-fed from being 2 weeks - had planned to b/feed but he wasn't gaining weight, and as a first time mum didn't have the confidence to hold out for exclusive breastfeeding - mw definitely pushed for supplementary bottles. His weight really did plummet - he lost 15% of birthweight, and took 7 weeks or so to regain it. With dd, same thing happened, but had confidence to work through it, and mw was more confident in my ability to feed her! She was exclusively b/fed till 6 months, when we started solids, and has never had formula - she went straight onto cows milk at 1 year, and I finally finished b/feeding her at 14 months. So I have done both.

I wonder if the confidence you show as a parent influences the advice given by mw/hv - I certainly had a different experience second time round. I suppose the fact that ds had done the same thing reassured them there was nothing physiologically wrong with dd, but with ds there was not that experience. I don't know - it was definitely easier second time!

Statistics and their interpretation wind me up! They are often used to give 'proof' of something, but used incorrectly - however, the numbers if looked at baldly can show information. Looking at the statistics, it is true that fewer younger mothers b/feed compared to older mothers. It is also true statistically that babies who are formula-fed are more likely to have the problems outlined below. That is not to say they will have them, nor is a baby who is formula fed without those problems prove that the statistics are wrong, or a breastfed baby with asthma. Of course breastfed babies get these problems too - it is just it is less likely. And mothers should be given this information to make an informed decision. Otherwise, mothers may make a decision to bottle feed, their child may have unrelated asthma, they may then feel tremendously guilty for not having breastfed.

I can't understand why it becomes so contentious either way - it is a mother's personal decision. Sometimes it is beneficial to bottlefeed for the wellbeing of the mother, and the baby will benefit. Certainly with ds, I got so stressed about his weight loss that it was in a way a relief to see some milk flowing into him - I did try expressing, but could never get more than 0.5oz. And a stressed mother does not make for a happy baby. But that does not negate the statistics - it is a matter of balance. I think it is like having something like anti-histamines (for example) when pregnant - they won't harm the baby, but would probably be better not to take them unless the hayfever distresses the mother, in which case the baby is better off with a happy mother. (Please don't read anything medical into that, I was just trying to come up with an example but am not a medic!)

Good post!

I agree that statistics have to be interpreted intelligently - that does not mean making preposterous assertions such as 'my kids are fine and I bottle fed and my sister's are breastfed have asthma so there, that proves it's all rubbish'....not accusing anyone here of saying that, especially, but personal experience does not negate proper studies.

You will never be able to show that formula feeding directly causes increased mortality in the developed world to the standard asked here, because you can never do a randomised double-blind controlled trial, where you assign 1000 mothers to feed one way and 1000 perfectly-matched mothers to feed another, without the researchers or the mothers knowing who is doing what This is of course the way pills are tested, with placebos compared with active pills.

The research published in the Washington Post certainly does not mean 'you could correlate it to anything' because they do have an explanation for some of the excess mortality - the known facts, as they say, that formula fed babies have more infections and are more likely to die from SIDS. What they haven't done is to control for social and economic factors, but because the study looked at so many baby deaths, the sheer power of numbers does go some way to give weight to their results.

And the physical proximity argument is not saying that formula feeding mothers are less concerned about safety or feed at a distance - for goodness sake! It is, as I understand it, a reflection of the fact that breastfed babies do tend to feed more often and are therefore probably held more often, and are less often in a situation where an accident might befall them....now in any individual situation, you cannot quantify this, but when you have very many babies in a study, this might act as a perfectly rational exlanation for some of the excess mortality.

I don't see the importance of the distinction between there being 'something wrong with the formula' (in GdiG's words) and which therefore causes excesss mortality, and the whole experience of feeding. Feeding is more than just the action of getting milk into a baby. It is a complex act, a relationship, and all the circumstances of it should be taken into account when studying its effects. This means, of course, you won't get simple answers that say 'Magic ingredient X is not present in formula, and Horrid ingredient Y is, so that's why formula causes excess mortality'. Even then, is it the absence of X, or the presence of Y that's to 'blame'??

No - we won't get those simple answers ever - you are stuck with epidemiological research, backed up with smaller studies that look at the constituents of breastmilk or formula milk. So we end up with complex answers, which nevertheless have a clear result, showing that excess mortality in babies who are not breastfed.

Sorry Tiktok but unless a study has a properly controlled sample I don't accept that sheer numbers is enough. How were the children selected? If the study involved kids going into an ER in Washington DC you've automatically got a completely unrepresentative sample and the research is interesting in a strokey beard kind of way but not something to take particularly seriously.

DH explains this sort of thing better than me, but that's his job!

Well, I found this study, which I thought was interesting. There are of course, caveats in the summary about the fact that you cannot separate the feeding method from various demographic correlations between other characteristics. I am well aware that because X occurs alongside Y, it doesn't mean that X causes Y: For example, there is a correlation between lack of breastfeeding and dummy use, which people used to think was because sucking on a dummy made babies unable to breastfeed, but studies showed that it was more likely that women who bottlefed were more likely to use dummies (I used dummies and bottlefed AND breastfed so this isn't a judgement or attack on anyone). Anyway, this is the survey.

6 May 2004

A study published in the current edition of Pediatrics reports that babies who are breastfed have a 21% lower risk of death in their first year, compared with babies never breastfed. The reduction in risk rises to 38% if babies are breastfed for 3 months or more.
The study compares nationally representative samples of 1204 infants who died between 28 days and 1 year from causes other than congenital anomaly or malignant tumor with 7740 children who were still alive at 1 year.
Infants who were ever breastfed had 0.79 times the risk of never breastfed infants for dying in the postneonatal period (95% confidence interval [CI]: 0.67?0.93). Odds ratios by cause of death varied from 0.59 (95% CI: 0.38?0.94) for injuries to 0.84 (95% CI: 0.67?1.05) for sudden infant death syndrome. Babies who were breastfed for 3 months or more had 0.62 times the risk of death (95% CI: 0.46-0.82).
The researchers conclude that breastfeeding is associated with a reduction in risk for postneonatal death but acknowledge that the effects of breast milk and breastfeeding cannot be separated completely from other characteristics of the mother and child. Nevertheless, they note that increased breastfeeding rates would have the potential to save or delay around 720 postneonatal deaths in the United States each year.

1. Chen A & Rogan WJ (2004). Breastfeeding and the Risk of Postneonatal Death in the United States. Pediatrics 113: e435-e439 [Abstract]

Marialuisa, you have obviously made it your life's work to search out and destroy the pro-breastfeeding brigade.

Hey, why not go a step further, and make some money out of it. Why not set up an organisation to rival your old friends, the La Leche League, something like the Beautiful Bottle Brigade, get yourself a nifty little logo, say a boob with a big red line over it. I'm sure plenty people here could help out!

BTW your discussions re numbers, controlled trials and so on dont really hold water. The me could be said of heavy smokers but again we can't organise trials involving deliberately smoking and not smoking.

This thread is a joy!

Marialuisa, the report sayst 'For the study, Rogan and a colleague compared a national representative sample of 1,204 infants who died between 28 days and one year after birth in 1988 with 7,740 children who were still alive.' One imagines that a nationally representative sample is not babies who were in hospital.

I am not a statistician, but I know that is one powerful study in terms of numbers - see what your dh thinks, though.

The percentage rate of increased risk is very, very small, of course. But it could be just one more factor in any decision taken about feeding.

"but personal experience does not negate proper studies."

so from whom do the studies get their data?

could it be real people with real experiences?

Tell you what then, as long as I make up bottles with clean boiled water, in sterilised bottles that are discarded if not drunk within one hour of coming out of the fridge and that do not remain in the fridge for more than 24 hours and I watch my baby at all times ensuring no accidents befall them (which I do because I'm a SAHM, which I bet some of you breastfeeding advocates are not - are you really holding your baby more often than I do when you go back to work after 3, 4, 6, 7 or whatever months??) - the chances are my babies are OK! Oh, and they are thank you.

I don't buy for one second that my baby is more likely to die because I feed him with a bottle of formula rather than from the breast. It's utter crap.

cant believe this thread is still going strong

buka sarcasm is SO boring

I cannot believe I am having to explain this - personal experience is one person's experience, whereas research is the observed and studied experiences of many people - in the case of this study, 9,000 babies.

You may have a totally individual experience, and it may be very different from what the research reveals. Your personal experience does not negate the research.

Lets say I go out now and run across the main road without looking for traffic. I will probably get to the other side without being run over by traffic. Does that mean it's 'crap' that looking both ways will reduce pedestrian accidents? Actually, I could do it again and again and again, and because drivers take care to avoid the mad woman running backwards and forwards, I might still make it - or if I don't, I would get to hospital and have good treatment for my injuries and would survive, probably. Lets say I do in 100 times. Or 1000 times. I might still be ok. If 10 more of my equally mad neighbours started to do it, and we managed 10,000 crossings without looking, you would expect us to start sustaining accidents, yes? But it's 'crap' because I was ok, when I crossed the road without looking...huh?

And I am definitely not equating formula feeding with running across the road - this is to demonstrate how statsitics work

Of course the chances are that formula fed babies in the developed world will not die - the research is looking at excess mortality and just so there is no 'misunderstanding' I'll explain that, too. It means that these are 'extra deaths' that would not have happened had all the babies been breastfed. It can only be worked out with a massive sample, and does not translate well into quantifiable individual risk.

aloha - that study is the same one, which I linked to

Well said tiktok- it never fails to amaze me how people seem to think that their n=3 outweighs all published studies of huge numbers.

First of all, you don't need to be patronising. I know how statistics work and I know what excess mortality means - I did my degree in physiology and pharmacology, so did stats modules as part of that (obviously we read lots of scientific studies) and I got a first.

What I'm saying is, these studies are churning out numbers but the hypotheses around the differences don't, for me, hold any water.

As far as I can see, the main reasons so far for excess mortality among bottle fed babies is that they may have feeds made up with dirty water, bottles may not be sterile, they may not be held as much as a breastfed baby (which frankly is just a stupid thing to say). There is nothing so far to convince me that bottle feeding, when done correctly, leads to increased mortality.

Obviously if I was convinced that I was putting my baby at some risk I wouldn't do it!

Tamum - so you've never gone against ANY sort of advice and opted to base your decision on your own experience or gut instinct? You believe EVERYTHING you read and follow it to the letter?

Doubt it.

I was talking to jools, GdiG - she was the one saying it was all crap because she had had a different personal experience.

And presumably you'll be amazed by the number of people that opt for single jabs rather than MMR because most of the data tells us it's safe?

Tiktok - but don't you agree that if bottle feeding mothers in the UK follow the advice around bottle feeding that Jools talks about (cleanliness etc) the chances of their baby dying because they are bottle fed are somewhere between fat chance and no chance?

What about the known increased risk of infection in bottle fed babies, GdiG - not because of dirty water, but because of the lack of antibodies in formula?

This isn't controversial any longer - we've known this for a long time, and the studies have isolated the active protection in breastmilk.

Of course you are right that dirty water and inadequate preparation of feeds is a major cause of illness, but probably not in the developed world.

I don't believe I said that, did I?

Not in so many words Tamum but you said you couldn't believe that people disregard a wealth of studies based on their own experience of n=3.

What's wrong with that - people who believe that their children have autism due to MMR do that and they don't get a slating (and quite rightly so).

So, I know what people telling me about bottle feeding but I don't buy it because in my personal experience in my own family and from the knowledge of loads of people around me, I have never seen anything to convince me that I am putting my children at risk. If I had, I wouldn't do it!

There are people on other threads talking about whether they should start weaning before 6 months and they might quite happily go ahead and do it even though we are now being told there are risks involved. For them, the benefits of weaning early outweigh the risks being presented to them. Ditto for me and bottle feeding.

I think the chance of any individual baby in the UK dying directly because of being formula fed is absolutely minuscule, even if the feeds are not made up properly and even if the bottles are dirty. But over a large sample, I would expect a result that echoed the US ones - would probably be better, because our primary healthcare (where most infections would present themselves) is very good and would pick up seriously ill babies in time.

I think the more demonstratable risks in the UK are to do with excess morbidity, and this shows up in the stats which I won't list, but they include not very serious stuff as well as very serious stuff.