"Formula as good as breastmilk"

[GhoulsAreLoud]

www.telegraph.co.uk/health/healthnews/6942427/Breastmilk-no-better-for-baby-than-formula-scientist-c laims.html

I really wish this was true but doubt it. Seriously dreading b.fing DC2

Dawnybabe,

I disagree with your post. A mother only has choices when she has knowledge. If a mother does not have a clue on how to position the baby or does not have the necessary support then she only has ONE choice. No one should suffer cracked and bleeding nipples. Many women just cannot get the baby to latch on and if they didn't bottlefeed the baby would starve.

Breastfeeding is an art which has to be learnt. The best time to get information is when pregnant.

The problem is what is taught in NHS ante natal classes is often limited and dire quality. For example I was offered an ante natal class 2 to 3 pm. For me this was impossible with school pick up and there was no creche for mothers with toddlers. What was taught by the NCT classes was not particularly practical.

If you want to learn how to breastfeed then I suggest you go to a La Leche League meeting. There are some good links on the internet. Biological nuturing is a good way to get a newborn baby to latch on without pain. The cradle hold which is taught by many ante natal classes is fine for an older baby, but a newborn just simply does not have enough strength in their neck muscles. I think the cross cradle hold is better for a tiny baby. You can see these holds demonstrated on Youtube.

FWIW, cross cradle hold saved my sanity and allowed my first ever successful BFing experience .

In this whole discussion, not just on this thread, things so often get too emotionally charged because we all end up feeling defensive as we all want the best for our babies/children.
It is all down to good information/practical RL help, particularly in the beginning which can help establish a good BFing experience for a lot more women than currently manage to achieve this, even when they want to .
Of course formula milk is not "poison", why does this even get dragged up, it does not help a measured discussion. There is more to BFing than just the milk and any FF baby can be just as nurtured, held and loved as it is possible for a BF baby to be subjected to poor parenting.
Propped up bottles, though, whith nobody holding the baby apart from dangerous I think are a lost opportunity for physical closeness and in my eyes...lazy

Coming back to the OP, the terrible thing about how this research has been reported is that it sends out a totally wrong and misrepresented message that will be read by a heck of lot of people who will not read the whole newspaper article, nevermind the original research paper. Far, far less people will read the UNICEF reply.

"What an odd thing to say! Babies don't care whether they are bf or ff."

Breastfeeding and bottle feeding are very different experiences for a baby. Just because they can't express a preference, doesn't mean 'it's all the same' to them!

Have to say, the most interesting thing about this article is the mass of commentary it has evoked in the Daily Fail: a perfect illustration of the widespread ignorance and stupidity about breastfeeding that exists in the UK.

I'm very interested in the number of people who comment (in the Daily Fail) that their ff children have had perfect health since birth - literally not a cold or a snivel. I personally don't know ANY children, bf or ff, who have had NO minor illnesses at all in the first three years of life. I count my own children as extremely healthy and robust, but even they've had the odd temperature, a few bouts of mild viral infections, the occasional cough and cold, and been sick a few times. Am I missing something? Or are these people exaggerating?

I don't think bf and ff are very different at all having done both.

Ff for many,many mothers and babies is a lot less stressful than bfeeding and my 3 became far happier babies overall but other than that my 3 didn't bat an eyelid between the 2 actual experiences when we did mixed feeding towards the end.

You still cuddle them,gaze at them,kiss and stroke them. The teat just feels different for a baby not the whole experience.

"The teat just feels different for a baby not the whole experience."

But breastmilk is fresh and tastes different from a processed product! The taste is more complex and varied. Breastfed babies also use their mouth and jaw in a different way. Plus they also have a different rhythm to the feed. They adapt their feeding rhythm to the mother's milk being let down. Also bf tends to be more 'baby led' than ff, by necessity, as more bf mothers feed on demand. I've often wondered whether it is this as much as the superior nutritional content of breastmilk which is responsible for the better cognitive performance of bf babies. BF babies also have more skin to skin contact during feeding (as the majority of ff mums feed fully clothed).

There's a mass of research showing that bf actually reduces the sensation of pain for babies when compared to bottlefeeding. Whether this is down to the fact that in a sensory way bf is more absorbing and engaging experience for a baby than bottlefeeding (and hence a good distraction from pain) or whether it's got something to do with the fact that breastmilk contains hormones and elements which convert to opiate like substances in the baby's gut, I'm not sure. Maybe a combination of the two.

Anyway, point being, I do think that bf and ff are very different experiences for babies - from a sensory point of view!

Hi there,

It's complicated, but Ben Goldacre (of Bad Science fame - much recommended) has the whole story. There is no story. Breast is still best.

It is a pukka study, which you can read here:
informahealthcare.com/doi/abs/10.3109/00016340903318006
The study, you will note, does not recommend that we should change the health advice on breastfeeding - this is because the study doesn't provide any evidence that supports that conclusion. It wasn't even designed to examine the benefits of breastfeeding, it's about something else entirely.

Unfortunately the Prof's own university PR dept has spun the findings in order to make them media friendly. Ben Goldacre has reproduced their press release here:
bengoldacre.posterous.com/

And finally, the anti-BF interpretation of the study (by the Daily Mail, and the university PR people) has been totally refuted by the scientific establishment - that is, paediatricians and infant health scientists (who know far more about BF than endocrinologists, of whom Prof Carlsen is one). You can read the best summary of the rebuttal on the Unicef website:

www.babyfriendly.org.uk/items/item_detail.asp?item=620

How can they say formula is as good as bm if they don't even know what constitutes a lot of bm anyway?

"better cognitive performance of breast fed babies" could you elaborate?

Breastfeeding is associated with health benefits. It is totally valid to question whether this association is because the former causes the latter, or whether they simply have a common cause (androgen levels during pregnancy). In fact, the researchers seem to conclude that it is a bit of both.

They think the benefits of breatfeeding exist but are more modest than some others think. That's fine - it departs from the scientific consensus, but scientists regulalrly challenge the consensus. So fine.

The problem is the way this is reported. Headlines saying "formula is just as good" or the like are just plain wrong. For readers to whom breastfeeding comes easily or proves impossible then this makes no odds. However, many women struggle with their supply in the early stages but breastfeed successfully once their body responds to the demand - this sort of journalism could encourage them to give up prematurely.

I also have a problem with some of the Prof's quotes (from the bbc article):

1. "When you look at the epidemiological studies and try to strip away the other factors, it is really hard to find any substantial benefits among children who were breastfed as babies."

Another way of saying the same thing: 'it is easy to find modest health benefits; there may be substantial benefits but we couldn't find them.'
The same information presented with a different bias. Why has the Prof got a bias? It's like he's trying to sell something, a bit like a used car salesman or a politician. Hmm, dodgy.

2)"Basically a mother who finds she has difficulty shouldn't feel guilty - it probably is just the way it is, and her baby will not suffer for being fed formula milk."

The first bit I agree with; of course no-one should feel guilty about being unable to breastfeed.
But the second bit is dodgy - if all women gave up at the slightest difficulty it would not be good! Breastfeeding almost always require some amount of perseverance.
He also claims 'baby will not suffer for being fed formula', well...
there is almost certainly a health benefit to being breastfed - the researchers themselves conclude that, they merely disagree with the scientific consensus about how substantial the benefit is. The health difference may not be worth worrying about too much (especially if the mother can't breastfeed and has no choice), but that subtelty should not be lost.

Most studies find a cognitive deficit in babies who are not breastfed (ie formula does not support intelligence) but there is a fairly wide range (from memory, 10 IQ points to 3 IQ points) and some studies find no difference. There are massive cultural and scientific issues in measuring intelligence, of course, and in controlling for variables, but there are some good studies that overcome these challenges, and yet still find very varying results. No study finds that breastfeeding is linked with cognitive deficit.

About 18 mths ago a study explained, or appeared to explain, why the difference is there in the results - only 9 out of 10 babies have the 'correct' genetic profile to use the 'intelligence' materials in breastmilk. In 1 in 10 babies, there will be no difference (in this aspect of development only) if breastfed or formula fed. For the other 9, there will be. So a better study would ensure the infants in the study were tested for their genes to see if they were, or were not, in the 9 out of 10, and then number crunch the results.

For details of the papers and so on, you could check the mumsnet archives or google.

Barry, since we are looking at semantics here, let's analyse this one, shall we?

"Breastfeeding is not associated with any health benefits since it is the physiological norm for the human primate. Therefore formula feeding has associated risks."

I find it amazing that a piece of research from a country where 99% of women successfully establish breastfeeding, the alleged presence of high testosterone levels in mid-pregnancy is being trumpeted as a possible major factor in much lower breast feeding rates in this one. Surely the support a woman has and a general positive breastfeeding culture (or lack of these things) are more significant determinants in establishing and sustaining breastfeeding.

It is soooo very sad that this article has appeared. It now provides ammunition for all those who don't support breastfeeding and it'll discourage many Mums to-to-be, the result being that babies will lose out on their perfect nourishment and mothers will lose out on all the health benefits of bfeeding.
The only winners will be the formula manufacturers and sellers.
I really hope there will soon be another article in the press reminding everyone that breast milk will always be superior. It cannot ever possibly be matched.

I'm sorry but we actually need far more pieces of research questioning to what extent bfing is beneficial. Yes breast is best but if the difference is minimal we NEED to know,why shouldn't we?

I'm sorry but 3-7 IQ points is not enough to get hot under the collar about. Genes,education of the mother,diet,lifestyle and upbringing will have far more impact on cognitive development. Let's keep things in perspective here. As Tiktok says some studies find no difference.

If we're not going to twist research to makes headlines on one side of the argument lets do the same for the other please.

The difference of early nutrition with regard to cognition is only one of many factors, I agree, MilaMae....I don't know where in the hierarchy it is, but I can imagine if someone has a rubbish upbringing with an unintelligent mother, it might be good to give some boost

A difference of 10 points or even 7 if such it be will certainly make a difference at the lower end - the difference between independent living and living all your life with support, for instance. Why would we not want all our children to have the development they were 'intended' to have?

The public health message about breastfeeding is best focussed not so much on intelligence, though, but on overall physical health, where there is no doubt that feeding makes a difference. Though it would be good if we had an overall more intelligent population as well...I can't see that this is controversial.

Who was twisting research? I told it like it was, didn't I? In answer to your question? Where is my hot collar?!

Guys, please read the Unicef piece - it answers all of your questions. The research has been done. The research is comprehensive, it answers all of these questions. Please check it out ...

www.babyfriendly.org.uk/items/item_detail.asp?item=620

The public health message is (and always has been) based on physical health. For example, one of the studies quoted by Unicef (with a sample size of 15,890 normal infants - against Prof Carlsen's 118!) finds that breastfeeding would prevent thousands of babies being hospitalised every year due to infection. Intelligence is an added side benefit but is not the reason why it is promoted. Breastfeeding is a serious issue for public health.

Honestly, there is no debate here, whatever the journalists decide to tell you in the name of selling newspapers. Talk to any child health scientist and they will tell you, THERE IS NO DEBATE!

Prof Carlsen's sample was looking at hormones in the mother and related it to bf, though, mess....he did not study the health of these infants at all, let alone compared them as a group or as individuals to each other.

His views on the relative health of bf and ff infants are not a part of the study or the sample.

And a quote from Unicef ...

"Although the protective effects of breastfeeding on gastroenteritis and respiratory infections have not been questioned, attempts have been made to dismiss these in developed countries as mere ?tummy upsets? or ?coughs and colds?, whereas in reality a reduction in severe infection resulting in hospitalisation has been found.

The Millennium Cohort Study is a nationally representative longitudinal study of 18,819 infants who were born in the UK in 2000-2002. Data on infant feeding, infant health, and a range of confounding factors were available for 15,890 healthy, singleton, term infants who were born during this period. This study found that 53 per cent of diarrheal hospitalisations each month could have been prevented by exclusive breastfeeding and 31 per cent by partial breastfeeding. A total of 27 per cent of lower respiratory tract infections could have been prevented each month by exclusive breastfeeding and 25 per cent by partial breastfeeding.

Quigley M et al (2007) Breastfeeding and Hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. The full paper can be found here: pediatrics.aappublications.org/cgi/content/abstract/119/4/e837"

Exactly tiktok - his research is about hormone levels, not the impact of BF on infant health, for which it presents no evidence either way. That's why the interpretation of the study by the newspapers (aided by his PR team) is so insidious. There is still no question that BF is best for infant health, although the Daily Mail et al would like to persuade us otherwise.

I'm a bit pissed off about the University press office spinning it this way actually. I wonder if there is the same pressure in Norway that has just arrived here to demonstrate the 'impact' of research? Stirring up this kind of media controversy is exactly the sort of thing they would want, to show funders their research is 'making an impact'.

Yet to do so, so very misleadingly, is surely utterly unethical. I wonder if UNICEF should pursue that legally?

I am a bit unclear and why this thread has developed into the usual debate about whether/how much benefit BF/FFing provides or how much the two differ.

In my eyes the very annoying thing is how badly what this study investigated has been represented to the public. The more I have had a chance to think about it the angrier I actually am: this is going to provide the nudge that some women who have difficulty with Bfing to "allow" them to stop.

Not for a minute do I think anybody who for whatever reason did not BF/not EBF feel guilty as long as this decision on infant feeding has been reached after the right information AND (crucially) support.

Gah!

And breathe!

There are literally thousands of studies comparing BF to FF Milamae. The majority support breastfeeding, some have no difference, a few may appear to support formula feeding.

The thing with research is that one study alone means very little. It is the combined impact of research - from different researchers using different samples and different methods - that gives it any weight.

Of course individuals are going to experience different outcomes. The research shows that on average a BF baby will be healthier than a formula fed baby. That does not mean that every formula fed baby is doomed to a life of ill health. Nor is breastfeeding a miracle product that will ensure every exclusively breastfed baby will have perfect health. Simply, on average, a FF baby is more at risk of certain health problems. The environment it grows up in will also interact with this.

Personally I was formula fed pretty much from birth and have just submitted my PhD. I am fairly healthy. However I see that as being lucky and chose myself to exclusively breastfeed my babies.

I am off to track down the paper...