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Infant feeding

Get advice and support with infant feeding from other users here.

Nutritional value past 1 year - the truth please!

145 replies

muddler · 03/11/2008 21:31

So medical profession and various books say there is no nutritional value in human milk past a year. I am still bfing 1 yo ds morning and night as he loves it (and I love the cuddles) and he won't drink any other milk from any ither vessel!
Is it really nutritionally useless? Might as well wean if it s, having my boobies back would also be nice

OP posts:
sparkle12mar08 · 07/11/2008 08:09

Tiktok I've changed my mind. If I had a gram of your self restraint I'd be a better person. Tik for sainthood please! (Can I call you Tik seeing as we're on hugz terms )

princessglitter · 07/11/2008 08:19

Breastfeeding is not merely a means of giving nutrition (though it certainly continues to do that for a long as breastfeeding continues). It is also an emotional relationship. I believe that by letting my child dictate how long this relationship continues has substantial benefits beyond the nutritional.

tiktok · 07/11/2008 08:32

You can call me what you like, sparkle After all, I've been called 'bovine' and 'dangerous' already on this thread so it would be an improvement.....

Cornishzulu - there is no shame in saying 'oops, I was wrong about that' you know.

cornishzulu · 07/11/2008 09:00

Firstly, an apology for the last post. Personal attacks are out of bounds...

And now for a proper response:

  1. Generalising from your own experiences with your child/children is not valid. There are many many physiological, cultural, social influences on hwo mothers choose to feed their babies. Proper studies which sample and compare the effects of bottle and breast feeding on a large number of children in different settings is the only research that should be considered and results should always be assessed comparatively. The posting that shows the composition of breastmilk only makes sense when compared with the nutritional composition of formula.
  1. Breastfeeding is NOT the norm. After the invention of formula, most women opted for bottle feeding. Breastfeeding has experienced a renaissance only relatively recently in the west where a powerful middle class lobby, strongly tied to a feminist agenda which sought to fight against the objectification of the female body. For a long time breastfeeding was regarded as Non-U in Western countries. The main point is the neither breastfeeding nor bottle-feeding should be normative. It should be a choice and shouting about the relative nutritional/immunological benefits does not help mothers who are trying to make a choice
  1. The is a subtlety in the semantics: I said no nutritional benefit not no nutritional value. A benefit, as I understand it is a particular good. My argument is breastmilk is not a PARTICULAR good after six weeks and that the nutritional and immunological outcomes of children who are bottle-fed after six weeks in the Western World are not significantly different from children who are exclusively breast-fed or mixed fed. This is to discount, of course, the ill-effects on any genetic conditions, poor hygiene or the like.
  1. It is no good posting lists of research citations: anyone with an internet connection and the ability to cut and paste can post reams of research. The point is to discuss and debate the merits and demerits of these pieces of research: how and by whom are they funded, are they peer-reviewed, are the findings methodologically valid? This is how research should be interrogated.
  1. For the record, I am a researcher with over 10 years experience in health economics in the developing world. My last work was about trying to prevent mother to child transmission of HIV in Africa and we worked closely with BF experts who were trying to promote six months exclusive breastfeeding in these populations. There are undoubtedly initial immunological and hygiene benefits in these cases but all cases are not equal and we should not treat them as such.
MrsBadger · 07/11/2008 09:10

As a quick response to point 2, breastfeeding may not be a social norm in today's world but it is a biological norm. But then I am a biologist and know little of sociology.

cornishzulu · 07/11/2008 09:15

MrsBadger

Would like to think that as a species we have the cognitive ability to overcome biological imperatives when they don't suit otherwise we would all still be eating raw meat and submitting to assault in caves as a means of ensuring the continuation of the species.

MrsBadger · 07/11/2008 09:21

oh you are quite right, hence my qualification of it being solely a biological norm.

Our mental capacity can fend off or substitute for all sorts of biological imperatives that aren't convenient for us to submit to - substituting coffee for sleep, for example, or choosing to get protein from sources that aren't meat.
But that doesn't mean we don't need sleep or protein.

(NB is is a biological imperative to eat meat raw? )

cornishzulu · 07/11/2008 09:28

OK. I give you the raw meat one. Been up all night comforting my teething DS. Another biological imperative...

I'm off to deworm cats and spend more of my hard-earned cash on rubbish. Muddler, hope you got some clarification from these posts. Good luck with whatever you choose

sammysam · 07/11/2008 09:34

cornishzulu

BouncingTurtle · 07/11/2008 09:50

Cornishzulu - I would remind you formula has only been around for 70 years.
The human race has been around a wee bit longer than that.
Though I agree with you on point one.
Don't take this the wrong way, Cornishzulu but the fact that you have done research for 10 years in health economics does not necessarily make you more qualified than Tiktok (a fully trained breastfeeding counsellor) to make some of the very sweeping statements you have made.
Albert Einstein wasted many years of his life trying to reconcile his theory of relativity with the Steady State theory (which was popular at the time) but ended up using a fiddle factor.
Even now, 80 years on we still haven't had a definitive answer on steady state vs big bang.
Researchers every day uncover much useful knowledge. But they also make new discoveries.
So what research that has been done in the past can be overturned.
What I am tryng to say is that, with respect for you for your valuable work in the developing world, but you appear to be making the assumption that no-one else has done their research, and read the material and that we are all wrong!
I would also like to point out that you are discussing this on an informal public forum, with other members of the public and not with your peers in research - so of course Tiktok might not sound on here like a researcher - she like everyone else here, is having an informal discussion and knows, quite correctly, that what we don't want is for people to be confused with lots of medical jargon and dry, scientific language!

Good lack with the de-worming, btw - I hate that job!

Princessglitter - it is believed that babies who are allowed to self wean are generally more confident.

InTheDollshouse · 07/11/2008 09:55

Cornish, can you please elaborate on this: "My argument is breastmilk is not a PARTICULAR good after six weeks and that the nutritional and immunological outcomes of children who are bottle-fed after six weeks in the Western World are not significantly different from children who are exclusively breast-fed or mixed fed." ?

tiktok · 07/11/2008 09:59

Cornishzulu, I'll respond best by copying bits of your post and pasting in my response.

"Firstly, an apology for the last post. Personal attacks are out of bounds..."

Accepted.

"1. Generalising from your own experiences with your child/children is not valid etc etc"

Of course. This is an obvious error. The other stuff you say about influences is obvious, too. The debates on mumsnet generally show an awareness of the importance of proper studies, too.

"Proper studies which sample and compare the effects of bottle and breast feeding on a large number of children in different settings is the only research that should be considered and results should always be assessed comparatively."

Er....yes! Like the Cochrane stuff and the rest of Kramer et al's work which largely informed the WHO's Global Strategy and recommendations?

"The posting that shows the composition of breastmilk only makes sense when compared with the nutritional composition of formula."

Not at all - understanding the composition of breastmilk 'reveals' that it retains its nutrtional and immunological value.

"2. Breastfeeding is NOT the norm. After the invention of formula, most women opted for bottle feeding."

NOT TRUE. NOT TRUE. NOT TRUE. I do not apologise for shouting. Did I say it was NOT TRUE?

Formula - infant food with a milk content - has been around commercially for about 150 years (in the West). It took a long time - about 100 years - before the majority of mothers (in the UK and the USA) opted for formula rather than breastmilk ( a trend that is now reversed). Many other countries, even in Europe, have never got to the stage where the majority of newborns are formula fed rather than breastfed. I think it's true that the majority of UK and US babies have formula at some stage in their lives, but this is absolutely not the case in some European countries. Worldwide, most babies do not have formula at all, though they may have other non-breastmilk nutrition - which is where, I think, you have made your fundamental error of understanding (see below).

"Breastfeeding has experienced a renaissance only relatively recently in the west where a powerful middle class lobby, strongly tied to a feminist agenda which sought to fight against the objectification of the female body."

There has been a woman-led (only partially feminist - early feminist writings regarded breastfeeding as a patriarchal plot to keep women in maternal mode) movement 'back' to breastfeeding, but the biggest push (IMO) has been the recognition of the health impact of infant feeding. This is what has influenced governments all over the world.

"For a long time breastfeeding was regarded as Non-U in Western countries."

???? Please read the literature on this. You have got it wrong. I suspect you are misunderstanding terms.

I also think you are confused by research that shows very few cultures breastfeed exclusively to six months and you think this means 'most women bottle feed' so 'bottle feeding is the norm'. I have been told by people in certain countries 'we have a breastfeeding problem, as only a few women breastfeed here' and when you find out what is really happening, virtually everyone breastfeeds, but they introduce other foods as well before 6 mths. But they are still breastfeeding!

" The main point is the neither breastfeeding nor bottle-feeding should be normative. It should be a choice and shouting about the relative nutritional/immunological benefits does not help mothers who are trying to make a choice"

I think it should be a choice, too, but this should not just be at an individual level. Whole societies have a responsibility to support happy breastfeeding, with changes in employment law, restrictions on unethical marketing of formula, acceptance of bf in public and so on.

"The is a subtlety in the semantics: I said no nutritional benefit not no nutritional value. A benefit, as I understand it is a particular good. My argument is breastmilk is not a PARTICULAR good after six weeks and that the nutritional and immunological outcomes of children who are bottle-fed after six weeks in the Western World are not significantly different from children who are exclusively breast-fed or mixed fed. "

This is NOT TRUE and again, I have many references for this - just ask!

" It is no good posting lists of research citations: anyone with an internet connection and the ability to cut and paste can post reams of research."

Ah! Lets not bother with references, then, shall we? We'll just make things up or speak to a couple of GPs and other experts and then say something, shall we?

"The point is to discuss and debate the merits and demerits of these pieces of research: how and by whom are they funded, are they peer-reviewed, are the findings methodologically valid? This is how research should be interrogated."

Er.....yes. Ad your point is? I can assure you that any research or references I post will be peer reviewed and methdologically valid, ok? I have them in abundance.

"For the record, I am a researcher with over 10 years experience in health economics in the developing world. My last work was about trying to prevent mother to child transmission of HIV in Africa and we worked closely with BF experts who were trying to promote six months exclusive breastfeeding in these populations. There are undoubtedly initial immunological and hygiene benefits in these cases but all cases are not equal and we should not treat them as such."

You will be aware of Coustoudis in this field, then, won't you? The reason why she and her colleagues have pioneered 6 mths excl bf for HIV is because of the putative immunological benefits to 6 mths, (not 6 weeks).

You are confused and not as well-informed as you think, sorry.

wastingmyeducation · 07/11/2008 10:09

Noone ever answers me when I challenge them on a point!
cornishzulu - are you telling us that the WHO lie in order to get the poor Africans to feed their babies safely?
Really, if we're wasting our time, I'd really like to see some evidence.

xx

tiktok · 07/11/2008 10:12

wasting - cornishzulu gave the evidence. She spoke to two (count 'em...) GPs and then after that some 'old colleagues', who confirmed what the GPs had said.

It's funny, isn't it, that her later posts emphasise the importance of peer-reviewed and methodoligically-sound published research, though.....

tw70 · 07/11/2008 10:32

Umm... not going to get into the real technical debate (although Tiktok, you do seem very knowledgeable, wish I had you around instead of my dopey HV when I was experiencing problems!!)

Op, if breast feeding had no nutritional value, why are the formula companies coming up with new formulas for 1-3 year olds? My DS has been on formula since he was 3 months old, but even now at 19 months I dont' want him to rely on cow's milk - I just don't think it has all the required nutrients, and also I would prefer my son to not develop any food sensitivities which is what can happen if you give them things too early.

I think other posters are correct in interpreting the statement to mean that the 'professionals' don't think there is nutritional benefit over and above what they could get from other products. And in a way they're right, your child will be healthy, happy and you probably won't see a huge difference if you don't breastfeed. BUT.... it is those little things that you can't quantify in isolated cases that could well make the difference to your child in the future.

If you're happy breast feeding, then why not continue?

tiktok · 07/11/2008 10:45

tw - ta for nice words I think your distinction between what you can see at a population level and what you can see in an isolated (ie individual) case is important.

It's only by doing large-scale studies involving thousands of babies that we really see what's happening. Even then, you cannot say for certain that one individual baby's individual health condition is 'caused' by or even related to the way he was/is fed.

We have some very interesting published cohort studies in the UK - take the Millennium Cohort, for instance. 15,000 or thereabouts babies, all born in 2000-2001, and being tracked with tons of info about health, social background, family health, feeding and so on and on. Number crunching shows us that even when socio-economic background is controlled for, babies who are not breastfed or who are not breastfed for long, or who are not excl bf, have a higher risk of hospitalisation in the first year, for conditions which we know are directly related to their immunity. There is absolutely no evidence that the immunity effect of bf stops at 6 weeks anywhere.

Ditto the Dundeed cohort - smaller cohort, slightly different questions asked. Showed the protective effect was measurable into toddlerhood, if the infant had got breastmilk (any breastmilk) to 13 weeks.
Again, not consistent with an immunity effect that ceases at 6 weeks.

None of this is obvious in one single baby, of course.

tiktok · 07/11/2008 10:45

Dundeed = Dundee

ermintrude13 · 07/11/2008 11:00

In addition to the nutritional benefits we're discussing here, it's important to remember that breastfeeding is also a bonding/comforting activity for many babies and toddlers and their b/f mums.

And comparing b/f to something like eating raw meat is a bit daft. Cooking meat is safer for the gut and humans have developed all sorts of rarified culinary tastes during our evolution. Introducing formula milk was initially a scientific investigation which became a commercial cash-in on Victorian-style social embarrassment surrounding bodily functions. (this remains to some extent - even in the 21st century we are used to breasts being a solely sexual emblem, hence some women's - and men's - difficulties with b/f). The side-saddle was invented to protect ladies' modesty but we see how ludicrous it was and we've moved on since then, just as we've moved on from thinking that formula is or should be the 'norm'.

StealthPolarBANG · 07/11/2008 11:07

"Muddler, don't let Tiktok and her 'know it all attitude' scare you off.
She's often wrong and regularly dishes out inappropriate and dangerous advice herself. "
Utter rubbish!

wastingmyeducation · 07/11/2008 11:14

She's a danger to falsehood!

xx

StealthPolarBANG · 07/11/2008 11:16

Right read thread now
cornish your posts show an amazing lack of ignorance of the facts!

PuzzleRocks · 07/11/2008 11:17

I totally refute the suggestion it has no nutritional value. Plenty of evidence to the contrary has already been posted here. But even if it were true it would not stop me from breastfeeding DD (18mths). She loves the comfort it provides. And when she is teething or feeling poorly it settles her far better than Calpol ever could.

combustiblelemon · 07/11/2008 11:24

Nice to know that they let her out occasionally Nancy's still around.

tiktok · 07/11/2008 11:32

Puzzle, cornishzulu makes a distinction between 'nutritional value' which she agrees is a property of breastmilk, and 'nutritional benefit' which she says (having talked to a couple of GPs and some former colleagues) ceases at 6 weeks.

I find this a bit odd, as just about anything edible has nutritional value - if I start chewing on my computer keyboard, I'd probably get a few biscuit crumbs in with it

I think what we mean by 'benefit' is that babies are better off, nutritionally and immunologically, on breastmilk rather than formula milk or any other type of milk and that this distinction persists and does not cease at 6 weeks - I am amazed this is remotely controversial, as there is a lot of good evidence from a variety of settings including the West, that this is the case. It's this that cornishzulu disagrees with (after her convo with a couple of GPs and her old colleagues - I don't think she can have read the literature on it).

The comfort and relationships aspects are also real and valuable, but the research to actually measure this isn't as robust. Would be great if someone somewhere did more population studies on it, too.

tiktok · 07/11/2008 11:34

lemon - it's not just me that Nancy plays 'mad woman in attic' games with, then?

I notice she doesn't return when anyone says 'back that statement up, please'