Can anyone point me in the direction of some solid scientific research on the quality of breast milk over time? I really want to prove this twat wrong.

[Jackbunnysmama]

Was at a seminar yesterday for professional continuing education credits. It was presented by a medical nutritionist who has developed his own line of vitamins and supplements. All well and good (if a bit boring), until he talked about one of his supplements which has anti-inflammatory properties, and includes white willow extract. He (quite correctly) stressed that it was not to be given to children under 12 due to the risk of Reye's syndrome, but that it was otherwise very safe and effective. I asked the speaker whether there was any indication whether or not the supplement was safe for breastfeeding women. He said that, because of the difficulty in doing research to investigate (very true - who'd volunteer for a study like that??), they simply didn't know, and so it was best not to take the supplement if breastfeeding. Then he said, "but if a nursing woman needs this kind of anti-inflammatory she can always wait a few months and then take it when she's weaned". So I said, "that's fine if a woman chooses to wean early but of course, lots of women choose extended breastfeeding, so the wait could be quite long". To which he replied:

"well, if they want to do that, fine, but of course after a year or so breast milk is really nothing more than water".

I couldn't help it, I was so shocked by this kind of ignorance from a medical nutritionist that I laughed right in his face and sort of gasped, "where did you get that idea??" He countered with "show me the research that says otherwise". I responded with "I will be happy to email it to you, but in the meantime, if breast milk were nutritionally valueless, the WHO, American and Canadian Academies of Paediatrics wouldn't be recommending breast feeding until age two, would they?" He said, "I didn't know that that's what they do recommend." (Well, as a bloody medical nutritionist, you damn well should, you fuckwit!) I said, "well, they do... and I suppose my 13 month old, who could only be said to be experimenting with solids, has reached 24 pounds on animal crackers, apple sauce... and my breast water???" I left it alone at this point (and pretty much tuned the jerk out for the rest of the seminar), but I would really like to find some solid scientific research to email to him and prove that I'm not just some left-wing militant breastfeeding fanatic.

I've found a couple of sources but would be most grateful for more.

JBM, you do need to send a polite letter with references, IMO. He is a powerful and probably quite seriously rich and influential 'clinician' - his quals sound pure quackery to me, and I strongly disapprove of a clinician selling their own supplements, but whatever....he needs to know more about bf.

I wish i was a there. would have applauded you.

yes and do what TT said. he can't continue to spout rubbish based on ignorance.

You have to opportunity to teach him to shut up about things he knows nothing.

A bit odd though that you are getting CPD points for what sounds like an advertisement for his vitamin supplements?

Agree that you do need to correct him.

ilovemydog - the OP is canadian and maybe the rules are different there, or maybe she is a therapist in the CAM area herself, where in the UK at least, they are not so fussy about unethical behaviour of this sort.

actually there is very little quality peer reviewed research about breast feeding full stop!

Sal, that is totally and utterly wrong, and makes you sound daft!

You won't get an RCT, but that's inevitable.

tiktok I know its not wrong as my other half spend all of last week searching for usable research on the topic and was very surprised at the lack of it.

How does it make me sound daft exactly? There really is very little out there (I am talking about good quality peer reviewed research, discounting unscientific "studies")

He advises breastfeeding and bottle feeding mothers and needs to do "evidence based practice" and all that, however he is struggling to find proper scientific research to base his advice on. He has done a lot of academic work and knows what he's doing when it comes to evaluating the quality of research. He also know's where and how to look.

Bloody well done that woman for countering his ridiculous claims so well on the spot.

Honestly, I do despair at all these idiots who make up grand names to convince everyone they are 'professionals'. If you want to be a doctor or a nurse or a dietitian go and do the training like everyone else!

or do you think it would be less "daft" for him to give second hand advice, hearsay or use any old study regardless of the quality of the research?

He wants to give woman solid facts! He has found a shocking lack of good scientific research to base it on.

Why do you want to instantly discredit my post?

Sorry, Sal, I prob sounded ruder than I meant to be.

I am sorry your partner didn't have much luck - clearly looking in the wrong places.

Without outing myself with details of what my non-NCT breastfeeding counsellor life consists of, I know what I am talking about professionally and research-wise, too.

I will put something together for you and post it shortly

"clearly looking in the wrong places."

again with the discrediting! he know's where and how to look for peer reviewed research AND he is very experienced at reviewing the quality of research too!

could be that he is seeing the same papers you are seeing but YOU are not picking up on the scientific flaws in them that he is able to spot perhaps!

Tiktok, I am with you on being a bit on the nature of this seminar I just attended. BTW, yes, I am a chiropractor. I was a registered nurse before that, but changed careers when the health care system in the province I grew up in went down the toilet in the early 90's. I am also a self-confessed research and science nerd. (I wish MN had that Yahoo Messenger nerdy icon with the oversized glasses and buck teeth. That's so me. I am at the image of the nerdy emoticon with MN's bunny ears... but I digress.)
Anyway, here in British Columbia, where I live, chiropractors were until recently not allowed to recommend or dispense nutritional supplements. In Ontario, where I grew up, this has been allowed for a long time. The legislation in B.C. has recently changed, and this seminar was approved for 3 continuing education credits by our professional association, which is why I took it. I personally have no interest in dispensing nutritional supplements, I think that should be left to naturopathic physicians or other who have much more intensive training than I do. I just needed the CE credits. I was under the impression that it was a general lecture on supplements it would be useful for us to know about (such as ones that contribute to bone health, or help with joint-related conditions). The speaker did cover these areas rather well, but I was a bit that he was allowed to also promote his own supplement line. On the one hand, I don't see why not, as he gave the lecture. On the other hand, I wonder if that's quite on, IYSWIM. BUT I want to make it clear that this seminar was not in any way about breastfeeding. I raised the question as I stated in my OP, because of one supplement he talked about.
[butt-covering emoticon because I don't want to malign him on an internet forum, and I've probably made it fairly easy to out myself now...]

I have nothing helpful to add to the info on this thread, but just, the thread title made me LOL. It really seems to sum up everything I love about Mumsnet.
Enjoy proving the twat wrong Jackbunnysmama.

One further [butt-covering] thing I wanted to say - I don't think his qualifications are all quackery. He is a chiropractor (as I am one too, I'm used to medical doctors thinking we're quacks who aren't real doctors... fortunately my patients seem to diagree), and a naturopathic physician, and both those degrees as very hard work with years of study. As for the rest of his qualifications, well, I don't know exactly how they'd be attained. And I do not know how a clinical nutritionist is different from a Registered Dietician.

However, I stick to my OP - regardless of any other qualifications: as both a DC and an ND, I'm shocked that he, or really anyone, could think that breastmilk magically turns to water after a year. And I am quoting him directly on that. Sad.

"both those degrees are (not as) very hard work"... fingers got away from me

the difference in UK is dietician is a protected title and awarded after degree level study.clinical placements and academic study.in addition dieticians are registered and accountable for their practice and skills to health profession council.must underatke CPD

clinical nutritionist is not a protected title.so anyone can use that title.there is no guarantee of quality of study etc.regulation's voluntary and there are no national minimum standards,or mandatory CPD.nutritionists can also sell their recommended supplements after a "consultation" with patient.so essentially the advice is compromised by financial selling

Sal, I prob did sound as if I was discrediting your partner's searching skills, but I have no idea how good he is at searching and evaluating, and I only have your word for it that he is good at it

I have sought out some very recent studies which he may or may not have come across. I have selected 3 quantitative papers, from developed settings and in the case of the UK Millennium cohort, controls for the social and economic variables that are inevitable when studying bf in the UK, so the numbers involved are huge.

He will need an Athens log-in to read the full text of all of them, I think, but presumably that's not an issue. These are a handful of many, many studies which I could have chosen. When looking at the different health effects of infant feeding in a developed setting, you need big numbers in order to allow the controlling; you can also work out the effect on public health. It will not tell you the effect on any individual baby, but that goes for just about any nutritional or social intervention.

Cognition: a difficult area to research, but this paper is one of many that finds a negative effect of not breastfeeding:

Breastfeeding and Child Cognitive Development: New Evidence From a Large Randomized Trial
Kramer et al.
Arch Gen Psychiatry.2008; 65: 578-584.

Conclusion: These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.
(the randomisation was not to do with bf but to do with support for breastfeeding - one group had support, the other didn't).

Development: Breastfeeding and Developmental Delay: Findings From the Millennium Cohort Study

pediatrics.aappublications.org/cgi/content/full/118/3/e682

Babies never breastfed have an inc risk of gross motor delay. The odds ratios for gross motor delay were not attenuated after adjustment for biological, socioeconomic, or psychosocial factors.

Hospitalisation for diarrhoea and chest infection:
Quigley MA (2007) Breastfeeding and Hospitalization for Diarrheal and Respiratory Infection in the United Kingdom Millennium Cohort Study. PEDIATRICS Vol. 119 No. 4 April 2007
pediatrics.aappublications.org/cgi/content/abstract/119/4/e837
?Breastfeeding, particularly when exclusive and prolonged, protects against severe morbidity in contemporary United Kingdom. A population-level increase in exclusive, prolonged breastfeeding would be of considerable potential benefit for public health.?

A good source of further refs is this review

www.bmj.com/cgi/content/full/336/7649/881

focusing on developed countries

I think "Dr" Gillian McKeith describes herself as a 'nutritionist'...I have just checked her website, and noted that she has dropped the 'Dr' at last and here's why:

www.guardian.co.uk/media/2007/feb/12/advertising.food

Thank you tiktok, these are great.
You're right, I won't just let it go. Tomorrow morning I'll print all these out and send a very nice polite letter , or email, "for your further information, as requested at the seminar".

Should I ever happen to get a reply I'll let you know what he says.

(Not holding my breath, though...)

Those refs are for Sal's partner, though, Jackbubnnysmama - they won't be of much use to you, as you need the other refs which show that breastmilk does not turn to water after a year

Sal's partner had searched for good research about breastfeeding and had not been able to find it.

No, no, I did get that - didn't make myself clear - too many thoughts passing through!

Sorry, it's me (Jacksmama), quick name change, forgot to change back.

tiktok

"actually there is very little quality peer reviewed research about breast feeding full stop!" does not = "his claim that there was no good evidence that bf made a difference"

so please stop following me around mumsnet - If I'd wanted to keep going round in circles with you I'd have contined posting about it on this thread.

And a lovely weekend to you, too, Sal