Fed is Best!!!!!!

[HotDawg123]

If you choose to breast feed - good for you
If you choose to bottle feed - good for you
But if you choose to be a breast feeding warrior and look at those who choose to bottle feed as scum then I hope you slip in dog shit tomorrow.

The amount of horrible women I've come across who are like this is too many now. And as I am heavily pregnant and have hormone rage it is really pissing me off.

Thank you for listening.

Luna your experience was very similar to mine. DS (who is 19mo now) isn't a cuddly baby and is very much for his dad and I often still say he 'doesn't like me much' and wonder if it was because I couldn't feed him. His breast refusal was also the ulimate rejection of me as a mother, or at least I felt that at the time. I still blame myself when he gets bug after bug from the other kids at nursery because maybe if I had been able to breastfeed he would have a stronger immune system.

tik the thing is that lack of breastfeeding support doesn't = formula is bad. And that's the vibe that comes across sometimes.

You may have gotten off your arse. Good for you. But if the crux of the issue is about support for bfing mothers, why is ffing being dragged into it?

Your average formula feeding mother isn't to blame for poor rates. And plenty of us choose it out of free will. Educated women like myself, believe it or not.

mister I absolutely agree:

These two things seem so at odds to me, that I think something is really going wrong here in how the NHS is handling both the messages around and the support for breastfeeding.

I think it's a combination of reasons...The NHS is on it's knees and just doesn't have much money aside from that needed to keep people alive. Post natal care is rubbish because there isn't enough money for it and it isn't seen as a priority...

mister I think that too. That's 3 of us who have said how devastated and sad we were about breastfeeding, and yet the general message still doesn't really have any positive effect on anyone. If Breast is Best, how about some actual ongoing support for women?

I am happy to concede that increased BF in poorer communities would lead to lower gastro infections. I think it would also lead to more hospital admissions for dehydration, though.

I also think that focused education on the safest way to prepare formula (and perhaps thinking about using the dishwasher like they do in the US) would also lead to lower gastro infections.

I can't find a publicly accessible infant feeding survey from 2010 btw, but I did find these stats: currently 81% of babies in Knowsley are not BF at all vs. just 21% in Tower Hamlets. But infant mortality rates are higher for mums born in Bangladesh who are much more likely to BF than mums born in the UK.

Why is dehydration the result of poor postnatal care but FF leading infection not? Surely if all women were shown how to prepare a FF feed before leaving hospital (if they wanted to - obviously not if they don't) we would also have lower infections & hospitalisations?

I'm also still waiting to see that full rebuttal of the 500 excess deaths...!

Thank you Diana

I think you are right that the current media and guidance around infant feeding is not in practice helpful for anyone, because the advice is not back up with any real support whatsover. It's all well and good to tell us how important breastfeeding is, but the reality is wayy more difficult for many mothers than we can ever anticipate. A bit more clarity, transparency and support would go such a long way, for everyone!

I do want to point out that I fully intend to try really hard to BF when it comes to my turn - I really want to for many reasons (closeness to baby, cheaper, weight loss & no bottle prep).

and that I want there to be good support for me when this happens (not preggo yet, but soon I hope!)

BUT as Diana said - what does good BF support have anything to do with FF? I think some people feel that if there was no FF option BF support would have to be amazing and that's why they are kind of anti-FF (Tiktok - I know you are very pro-feeding choice which is great!).

I think that's how I feel a bit Alyosha, but not to that extreme.

As in, while I think it's necessary for formula to be easily available, at the same time the extent of the ease is so far that it can have an overlapping effect into the terrirory of discouraging breastfeeding. I was given ready made bottles of formula the moment I asked in hospital, on day one, despite expressing wishes to breastfeed. If someone had made it even a tiny bit harder to access, I could have been given the confidence to persevere with breastfeeding. It's not like I exclusively FF from day one, but it was the beginning of the slippery slop that led to it.

Glitters, you should have had more support. And I really hope you BF your new baby with no issues.

But the answer is not to deny women formula when they ask for it. I imagine in a parallel universe you might have been quite miffed if you had been denied formula with a hungry baby!

Instead you should have had a real BF expert there to help you out, and it's shit that you didn't.

Noo absolutely I agree formula should be available to anyone who needs it. I guess I mean more along the lines of, on that day one, when you're exhausted, have gone through a traumatic labour, and on top of that now have responsibility for this tiny, fragile life you love so much, instead of health care providers handing you over the formula without even batting an eye, maybe they could first ask, "why do you want to give baby formula when you said you wanted to breastfeed, are you struggling?". I know it's unfair to lay all my woes on that one day, but I do feel like it was the cataclysm for the whole sorry experience from then on, as well as the woman who was supposed to be showing me how to breast feed leaving satisfied she had done her job when I was sitting there awkwardly holding DD with no idea how to get her to latch comfortbaly!

Alyosha, "I am happy to concede that increased BF in poorer communities would lead to lower gastro infections" - not just that, but respiratory infection, and ear infection, (those are the ones I know about off top of head) .

If you want to know more, just google breastfeeding and health inequalities. "I think it would also lead to more hospital admissions for dehydration, though" - eh? This is a daft argument.....you'd have to show poorer babies were more at risk of dehydration (no reason why they would be), and that the risk was comparable to the incidence of gastro etc, (highly unlikely). And it is irrelevant, if you accept that dehydration (which I think you are conflating with serious weight loss, BTW - not all serious weight loss has reached dehydration levels) is avoidable with good postnatal care.

"I also think that focused education on the safest way to prepare formula (and perhaps thinking about using the dishwasher like they do in the US) would also lead to lower gastro infections." Worth researching, for sure; fewer than half of UK households have a dishwasher, of course. Generally speaking, though, there is not a huge problem with people not using formula safely or persisting in using dirty bottles - HVs and midwives don't report this as common. Occasional horror stories, yes, but that's it.

"I can't find a publicly accessible infant feeding survey from 2010 btw,"

Look harder! I suggest Googling on UK Infant Feeding survey 2010 :)

"but I did find these stats: currently 81% of babies in Knowsley are not BF at all vs. just 21% in Tower Hamlets. But infant mortality rates are higher for mums born in Bangladesh who are much more likely to BF than mums born in the UK."

Yikes. You cannot use UK infant mortality rates in this discussion.....there are massive confounders with prematurity and intra-uterine growth restriction, especially when you start looking at ethnicity. I am not even going to explore the point I think you are trying to make.

"Why is dehydration the result of poor postnatal care but FF leading infection not?"

Because the dehydration/serious weight loss we're talking about happens in the first week, when the mother's postnatal carers should be observing and assessing breastfeeding. Hospitalisation for gastro happens later - and in the survey I referred to (UK MIllennium Cohort, Quigley et al) they analysed in terms of month by month, so you can't see what happened in the first week. Most gastro happens sometime after the baby is under midwifery care.

"Surely if all women were shown how to prepare a FF feed before leaving hospital (if they wanted to - obviously not if they don't) we would also have lower infections & hospitalisations?"

I don't know.....You'd have to really be sure that large numbers of parents are using dirty bottles and unsafely prepared feeds, and that they would somehow not do it having seen a single demonstration days or even weeks or months before.

"I'm also still waiting to see that full rebuttal of the 500 excess deaths...!"

Google New Scientist and Baby Friendly Hospital Initiative. No one sensible, who knows the subject, would take that confected figure seriously.

Ah that sounds horrible, Glitters. It does seem crazy that MWs aren't given more education on how to support BF properly.

Hope it goes better this time.

The real scandal here is that maternity services in general aren't better funded. How much better would things be if women had 1-to-1 care, access to epidural when they wanted it, guaranteed home birth if they wanted it, elective sections on demand. 1 to 1 expert BF help or FF help as required.

A truly choice led system! And I bet you it wouldn't cost any more money in the long run as there would be fewer lawsuits & lower costs on helping women harmed mentally and physically by their births.

I wasn't given formula in hospital just by asking for it. At 2.00 am a snotty mw said "well, I suppose SOME women just find it [bf] difficult. I suppose we have to give formula to THEM".
Nice.

:O That's awful support MrsDoyle :(

"If you want to know more, just google breastfeeding and health inequalities. "I think it would also lead to more hospital admissions for dehydration, though" - eh? This is a daft argument.....you'd have to show poorer babies were more at risk of dehydration (no reason why they would be), and that the risk was comparable to the incidence of gastro etc, (highly unlikely). And it is irrelevant, if you accept that dehydration (which I think you are conflating with serious weight loss, BTW - not all serious weight loss has reached dehydration levels) is avoidable with good postnatal care"

You are probably right that I am conflating the two. So instead I'll say, the incidence of serious weight loss would increase if more babies were BF than they are now. I'm not sure why this is daft, as you agreed that BFing makes it more likely babies will become seriously dehydrated. I also think there is very little evidence to show that if we increased BF we could improve perinatal or infant mortality.

It is not irrelevant. Babies are admitted with dehydration - we don't live in a perfect NHS where everyone gets great postnatal care. We live in an imperfect world, where some babies will slip through the net and end up being hospitalised, just as they are now for those FF.

"Yikes. You cannot use UK infant mortality rates in this discussion.....there are massive confounders with prematurity and intra-uterine growth restriction, especially when you start looking at ethnicity. I am not even going to explore the point I think you are trying to make. "

OK, I stand corrected. Of course there are also enormous confounders in every single BF study out there i.e. this website: www.bestbeginnings.org.uk/health-inequalities

"Babies who are not breastfed are at increased risk of diarrhoea and vomiting, chest and ear infections, cognitive delay, and in later life obesity and type 2 diabetes. Mothers are least likely to breastfeed if:

they are poor (20% less likely than the most affluent mothers)
they are under 20 (one-third less likely than mothers over 34)"

So BF increases risk of diarrhoea - but those who don't BF are disproportionately poorer anyway, putting them at greater risk for morbidity and mortality.

Another point I was trying to make was that simply promoting BFing is not enough to improve the health of babies and mums. That's why I used the example of a population where women have high BF rates but poor outcomes.

"Because the dehydration/serious weight loss we're talking about happens in the first week, when the mother's postnatal carers should be observing and assessing breastfeeding. Hospitalisation for gastro happens later - and in the survey I referred to (UK MIllennium Cohort, Quigley et al) they analysed in terms of month by month, so you can't see what happened in the first week. Most gastro happens sometime after the baby is under midwifery care."

Good to know! I wonder why it happens later, perhaps parents are less on the ball as the kid gets older, or the impact of BFing less becomes apparent.

"I don't know.....You'd have to really be sure that large numbers of parents are using dirty bottles and unsafely prepared feeds, and that they would somehow not do it having seen a single demonstration days or even weeks or months before. "

Surely it's not that parents are throwing caution to the wind - more that it's little slip ups (sleep deprived parents perhaps using the wrong bottle, keeping formula in the fridge for too long) - you're right that only half of homes here have dishwashers, but if 50% do and find it easier than sterilising it could be worth pursuing.

I just googled that - I found 0 actual rebuttal to the claims in the article. But I did read this which doesn't chime with the experiences of many of the women who have shared their stories:

"n the UK, the Baby Friendly programme has evolved to reflect the current evidence base and cultural context.[9] It is a holistic, parent-centred programme which includes care for breast and bottle feeding mothers and support for parents to build close and loving relationships with their baby.[10] The programme does not ban the use of formula milk as suggested, but rather supports health professionals to understand when formula is clinically required and how to provide appropriate, sensitive care to those parents who choose to bottle feed. Since its inception the programme has improved breastfeeding initiation rates[11] and is recommended in numerous national policy and guidance documents.[12],[13],[14],[15]"

Tiktok - I think you're confusing two different studies.

The one I linked to is here:

citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.782.8367&rep=rep1&type=pdf

This study implies that the core tenets of BFHI - skin to skin contact for one hour - can lead to sudden infant death.

". One recent retrospective study
indicates that the prevalence of early SUDI has not changed
in northwest England during 35 years and is considered rare
(3.5 SUDI/100,000) [11]. In contrast to the UK survey and
report, Rodriguez-Alarcon et al. [23], in their regional study,
show a significant increase in SUPC (ALTE as well as
SUDI) since December 2008. They associate the increased
SUPC incidence with altered routines in maternity wards
and encouragement of early skin-to-skin contact but without
adequate surveillance."

The study you referred to is different: jamanetwork.com/journals/jama/article-abstract/2571222

A good summary is here... sciencebasedmedicine.org/efforts-to-encourage-breastfeeding-like-the-baby-friendly-hospital-initiative-bfhi-may-have-unintended-consequences/

Implies that immediate skin to skin without monitoring can lead to SIDS.

sciencebasedmedicine.org/questioning-the-evidence-for-breastfeeding/

On the subject of counfounders which you pointed out made infant mortality & BF difficult to discuss, here is an article pointing out that a lot of BFing research has not adequately separated out the effect of parental socioeconomic status.

"Results from standard multiple regression models suggest that children aged 4 to 14 who were breast- as opposed to bottle-fed did significantly better on 10 of the 11 outcomes studied. Once we restrict analyses to siblings and incorporate within-family fixed effects, estimates of the association between breastfeeding and all but one indicator of child health and wellbeing dramatically decrease and fail to maintain statistical significance. Our results suggest that much of the beneficial long-term effects typically attributed to breastfeeding, per se, may primarily be due to selection pressures into infant feeding practices along key demographic characteristics such as race and socioeconomic status."

Alyosha

I think the problem with using statistics like mortality rates, life expectancy etc are not accurate portrayals to promote FF over BF, or even to suggest that BF does not have the health benefits people claim it does.

There are too many other, exterior factors involved in mortality and life expectancy, so a correlation between increased rates of FF and higher life expectancy/lower mortality rates cannot be trusted. It doesn't make sense logically either. Even if you argue that in more developed countries the BF rates are lower but life expectancy is longer, there are too many other factors relating to the longer life expectancy, and too many separate factors reducing life expectancy/infant mortality in less developed areas. For example, disease like dysentry being fatal to people/infants but survivable easily in the UK. Breastfeeding could not have an impact on things like that.

And the baby initiative thing sounds great, because it sounds exactly what I would like to see, not a deomnisation of formula which causes defensiveness and division, but a place where the pros and cons can be discussed sensitively, and for HCP's to gently provide help to support the continuation of breast feeding, rather than simply letting the transition to formula happen without intervention, if the mother would like to continue to breastfeed. That's why it leads to increased rates I reckon, because in an environment free of judgement and fear of doing "wrong" allows for much more open and honest communication.

Hmm, actually maybe they are different studies showing the same thing. Sorry for confusion!

I think the study relating to skin to skin as well is mostly irrelevant for the general population of course monitoring is important, but surely the point and findings of the study is that the issue is not the skin to skin itself, but the fact that some babies needed monitoring to pick up underlying health problems.

We need to be careful not so scare pregnant women, the who movement towards a more natural birth experience (delayed cord clamping, skin to skin) is important and we should not be discouraged to do so because of a risk, when the risk can be managed more effectively instead.

*Ayosha: you say " I also think there is very little evidence to show that if we increased BF we could improve perinatal or infant mortality."

I don't think anyone has claimed that increased BF rates in the UK (I am assuming you meant in the UK) would show reductions in infant and perinatal mortality. Happily, our infant and perinatal mortality rates are low, and as the incidence is closely linked to disability, extreme pre-term birth, complications in pregnancy or around the birth, infant feeding is irrelevant.

Of course gastro happens later in an infant's life than dehydration - it's prob nothing to do with slip ups or parents forgetting about clean bottles etc. The baby is born with a good level of immunity which is topped up if he gets some colostrum at least, and it's as he gets older he comes into contact with more pathogens, inevitably, no matter how clean his bottles are (though dirty bottles won't help)....he continues to have protection if he's breastfed, but not if he is formula fed.

Your point about Baby Friendly practices - most babies are not born in Baby Friendly hospitals, so there will not be that protocol in place anyway. But there's no doubt that just being Baby Friendly does not mean mothers will have a supportive experience. I have been in touch with mothers whose feeding experience in a Baby Friendly hospital has been woeful, and others who were not in a Baby Friendly hospital where things have been fine.

Mister I'm so sorry for your experience - it's so shit isn't it? and months and months later we still remember and feel it so clearly.

I often feel so resentful that all of this anxiety of BFing and subsequent PND stopped me from really enjoying those early weeks through to months with my baby.

I am not sure about you but I have no support IRL and no family to rely on for advice / context / perspective about these things so I was completely reliant on government messages and messages from the lactation consultants I saw telling me that 'anyone can do it' etc...

This time I will be giving BF a shot but if it isn't working within a couple of weeks I will not be putting myself and my family through the same experience as last time - I will reach for the formula without a second thought as I know it is more important to just ensure that your baby is fed - whatever you feed them - and to concentrate on bonding with your baby and enjoying the precious early days together.

Tiktok - so, in your opinion, if BF won't improve either short term or long term health outcomes for babies, why do you feel it should be promoted heavily?

Or have I got it wrong and actually you just want to make sure all women who want to BF are supported to do so with good ante & post natal care? Because hopefully everyone can agree with that!

Ayosha, step away from the research.....you're confusing everyone :)

Of course skin to skin without monitoring can have health risks.

Mothers who formula feed are routinely encouraged to offer skin to skin, anyway. It's not really solely a breastfeeding 'thing', or shouldn't be. All babies benefit from the temp. regulation, the social and emotional connection and the pleasure of being close to their mothers.

Maternity units who are encouraging skin to skin without ensuring the mothers and babies are safe are being negligent - I don't see that this should make us wary of breastfeeding support.

The second paper you link to is well-known for being a weirdly irrelevant study that has some odd outcomes - it looks at school performance in maths, ability to follow household rules (wtf?) and other strange things! It would be highly unlikely for breastfeeding/formula feeding to make a difference with this sort of stuff, and to overcome the sibling effect whereby kids who grow up in the same household are likely to share several social and health outcomes. I'm afraid when I am in discussion with someone who cites that paper I draw my own conclusions about how well they have understood the whole issue.

Alyosha

Infant mortality rates and life expectancy averages are not the only indicators of health benefits. In fact, since like I said there are so many variable factors around infant mortality/ life expectancy, it's not useful or accurate to try and draw a conclusion regarding the health benefits of breastfeeding from those figures alone.

Surely the relevant figures would be most accurate when relating to issues that feeding could have a noticable effect on, such as infection and illness rates, which breast milk is proven to have an effect on. I don't really know why you are arguing to try and prove that breast milk has no benefit whatsoever over formula?

Acknowledging the facts about breast milk doesn't mean that formula milk is not a viable feeding option if you are breast feeding is not one for you :)