"'Breast is best' bias blamed for hundreds of dehydrated babies"

[beef]

let battle commence!

I'm saying nowt!

Back to the topic, I am happy to be making an informed choice to bottlefeed my next baby as ds will be 14months old and I'm more interested in getting back into shape with execercise and supplements.

I think I have been pregnant every year for the last five years ecen though this will only be my second live one. I have lost my identity and just need to be me again. for my sanity at least.

breastfeeders, bottlefeeders - can't we all just get along?

I think too many babies are admitted to hospital under the banner of dehydration when in fact, with more support at home, feeding could be sorted out.

Example - baby is weighed on 4th day. Didn't feed well for first 2 days, has now got the hang of it but gets weighed on 4th day. baby has lost around 10% of birthweight. What happens? Baby is referred to paediatricians for blood tests which invariably show a higher urea than formula fed baby. Baby is admitted to hospital with dehydration. Depending on assistance given there and knowledge of mother, baby is probably discharged home bottle feeding.

I would prefer to see much more input at home or baby visits breastfeeding clinic. Could be that latching on needs corrected. Could be that mum has done demand feeding to baby's detriment ie sleepy baby (mum possibly had opiate or epidural in labour) and not demanding feeds. Baby is going long spells between feeds, more than 4 hours and mum is thinking what a great baby.

Dehydration is a serious matter, but i think there just isn't enough observation of baby's feeding ability before going home, not enough attention paid to how confident mum is.

It is totally possible to exclusively breastfeed. I did it but it was through sheer bloody mindedness. My first baby lost well over 10% of birth weight. In those days we gave babies dextrose to drink between feeds. He lost weight because he was full of crap sugar water and not demanding feeds. Babies do not need water when learning to breastfeed. They need to be at the breast frequently.

but you have to agree that level of staffing is not adequate in all regions. some are really short staffed so the level of care is not up to scratch.

Totally agree

Mears I know that baby!

Thnks to you we stood up to the well meaning paediatricians, took baby home against their advice and the rest is history.
Thanks again

Mears - excellent point.
My dd lost more than 10%, mainly because it took me a few days to work out that whenever she cried it meant she was hungry even if she'd just finished a feed 10 minutes ago. The midwife was worried about the weight loss but by the time she came I'd worked out what was going on and was able to insist that there wasn't a problem. I figured that going back into hospital to 'sort it out' was likely to have had more of a negative effect (eg the stress and cos I wouldn't have got any sleep!) than staying at home and just getting on with it. Very glad I stuck to my guns, in retrospect.

finefatmama: i know villages just like you describe and been to places where no roads, paved or unpaved lead. if a baby is exclusively breastfed, there is no need for oral rehydration salts or water etc. in the tropics even in very primitive conditions. (How did we ever emerge from caves then?) ORT only becomes useful when babies are being weaned as they would be more likely to contract vomiting or diarrehea bugs from their environment. It sounds to me that it is places like your village that UNICEF, et al ought to be pushing exclusive bf to 6 months more than ORT. I guess though, that is like saying abstinence is the best from of protection from HIV but condoms are useful prophylatics.

god this article is such a lot of old toss.
the part that annoyhs me most is the comment that getting Baby Friendly Initiative status can cost up to £15k....
as if that isn't the most incredible bargain, if bf is encouraged.
I am not even going to go into the unscientific bollox in the article. it's pure bloody propaganda, and I would be really interested to know what's behind it

has anyone linked this thread to a smarting email to the Telegraph?

Kiskidee, the need to supplement with ORT is based on the fact that they accept that women is some circumstances do not produce enough milk (otherwise the breastfed kids you see from Sudan, chad and Niger wouldn't be skin and bones).

There is poverty in some areas and undernourished mothers just don't cope (and we have loads of weak, tired ones that have problems with breastmilk supply). Ever heard of kwashiokor? It grows on trees over there. We had to be taught about food and nutrition from tha age of 11 to try to help deal with it. How much crop do you really think an isolated water logged village on stilts can grow?

Also you know of those villages, I'm FROM one and the advice up close and personal is the admission that water is needed in sweltering heat, ORT because a number of women cant cope with feeding on demand or tandem feeding.

they do say to bf for 2 years because formula is expensive and hard to get.

sorry, i just know that i come from 17 degrees north latitude where it rains 160 inches a year and the temps are regularly over 90. houses on stilts are the norm there. I believe that it is WHO who states that an exclusively bf baby does not need any ohter supplements - despite ambient temps. When you are talking about famine conditions in the Sudan, of course that is outside the scope of a medical norm and then both mother and baby will require medical intervention. Hence ort is a medical intervention. I have lived in areas where many families live effectively outside the money economy but are not necessarily living on the brink of famine - but these families are not the picture of nutrition either iyswim. yes, i know what kwaishiokor is and there are foods which grow in waterlogged conditions. we will get nowhere talking about each others particular experiences just wanted to clarify why ORT was needed.

ps who recommends bf to 2 because formula is expensive and hard to get and primarily because it is a poor substitute for breastmilk. better to address the nurtritional needs of a community than to convert Africa and elsewher to formula. that however is another thread.

Whether or not they are right about the advice is beyond me but they certainly do accept that it is possible for the women in our region to not be able to cope with demand feeding. Just like my new midwife admitted to bfing her four kids exclusively and hating it.

I meant bf the babies till the age of 2 instead of 1yr primarily because formula and cows milk are luxuries and the kids get cornstarch and cassava semisolids instead (yuck).

I agree with the ORT reason but dehydration is common due to the temperature and lack of electricity hence no fan, air conditioners or whatever. WHO definitely has general guidelines with regional variations. they recommend bf for 1yr in the west for example and that women can cope with breastfeeding etc. Thats all the western norm.
The variation in my area allows for water and home-made ORT. poverty and malnutrition (both adult and children) are the norm for this region but famine is not as bad as Sudan. The average adult will have one meal so the kids can have two or three.

ffm, WHO does not recommend bf for only one year in the west, it recommends 2. the UK gov't advises atleastoneyear_ because bf rates are so piss poor over here.

i am not aware of any WHO literature that recommends water to exclusively bf babies in any region of the world including desert and semi desert regions. in fact, it stresses its importance for example in sub-Sahara Africa for HIV+ women as it is the form of feeding which is most likely to keep a baby HIV-. Again, it is good nutrition in the mother that is key. by that i don't mean a Western diet or even a varied diet.

BTW, nothing wrong with cornstarch or cassava semisolids - both staples which i have eaten in my time and will eat again if presented to me. if B vitamin deficiency (the cause of kwaishiokor) can easily be alleviated with green leafy veg in a diet made up primarily of cassava or cornstarch. I mean locally grown greens, nothing special. Where i am from, the most abundant form of greens are the cheapest and easiest to grow - in fact, they grow like weeds.

is the cassava grown locally? if it is, then the leaves are rich in B vitamins which is missing from a diet made up of cornstarch and cassava. to remove the poison in the leaves, it has to be chopped and boiled. that's all.

from what little you have told me, solving the nutritional problems in adults and children where you are from sounds like educating the adults about what they can grow locally, that would solve some of the dietary needs.

I don't feel that it is wrong for health professionals to say 'breast is best' and encourage women to breast feed. We are, quite rightly, 'pressured' into stopping smoking as it is dangerous, advised to drink alcohol responsibly, told that 20 minutes of cardiovascular exercise three times a week will be beneficial. The government wants us to take more responsibility for our own health, in order to reduce the demand on the NHS. So why is it seen as unfair and undue pressure when health professionals say that we should breast feed if we can?