blessed feeding

Breastfeeding an infant

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It was one of those mornings. One minute I am simply getting dressed for work, the next I am hopping around with only one leg in my tights, trying to find pen and paper to grab what I can from another nutrition-related radio story.  On that particular day, it was an NPR story entitled, Some Baby Formulas May Cause Faster Weight Gain.

The story which ran on January 24, 2011, starts out by saying that breastfeeding can be challenging, so most babies are on formula. It was about a small study comparing cow’s milk formula and predigested protein formulas– which are very expensive and used mainly for babies with significant digestive issues including cow’s milk allergies. The research suggested that at 7 months of age, the cow’s milk formula babies weighed two pounds more than breastfed and predigested formula babies. The study only observed that the babies drinking the cow’s milk formula took a longer time to be satiated and therefore drank more. There was no explanation given for this.

Interviewed for the story was a Dr. Nicholas Stettler, a pediatrician at Children’s Hospital in Philadelphia. He starts out by saying that formulas have been proven safe and effective, and if infants like them and eat them, they’ll maintain their health and weight.  He then goes on to say that babies who gain too much weight in the first weeks and months of life are 5 times more prone to obesity and its inherent health risks by age 20–and that formula babies often gain too much. He concludes by advising that, “Parents should work closely with their pediatricians to make sure their babies don’t gain too much or too little. In this case, average is best.”

All in all, it wasn’t worth the hopping. None of this was exactly news to me and if anything I was surprised at the limited analysis of the results. However,  it touched on an issue that I feel quite strongly about–the dismal state of affairs regarding breastfeeding in this country and its many implications.

Ironically, on January 20th, just four days before, Surgeon General Regina Benjamin announced the “Surgeon General’s Call to Action to Support Breastfeeding“.  Outlined clearly in the announcement and its accompanying report are the many benefits of breastfeeding and the attendant health risks of not doing so. Clearly known in the medical and nursing community is that there are many physical and emotional benefits for both nursing moms and their babies, and that babies who are not breastfed are at  increased risk for diarrhea, ear infections, more serious lower respiratory infections, SIDS, childhood leukemias, asthma, diabetes and obesity. Lactation experts and women who do breastfeed understand that human milk is species specific for human babies, and its composition perfectly designed for proper and progressive growth. Mother’s milk changes composition during each feeding as well due to differences in the foremilk and hindmilk and naturally provides nutritional, immunological and satiety factors.

In the introduction to the report, Department of Health and Human Services Secretary Kathleen Sebelius writes, “For much of the last century, America’s mothers were given poor advice and were discouraged from breastfeeding to the point that breastfeeding became an unusual choice in this country.” I appreciated the admission. Tucked in the report amongst the many reasons for our pathetically low breastfeeding rates  was this paragraph:  “A recent survey of pediatricians showed that many believe the benefits of breastfeeding don’t outweigh the challenges that may be associated with it and report various reasons to recommend against it.”

This seems pretty shocking given the following. Comparing formula fed babies to those who were breastfed exclusively for four months, the rates of hospitalization for lower respiratory tract infections are 250% greater; for GI infections including diarrhea are 178% greater; and, for necrotizing enterocolitis in premature babies 138% greater for the formula fed babies. The economic impact of just these three illnesses that breastfeeding can prevent, costs this country 3.6 billion dollars per year. In cultures where babies have unlimited access to the breast and constant maternal contact, the prevalence of psycho and sociopathic behaviors are very low. What is the economic cost of  those disorders?

Though the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life, this recommendation does not translate into proper education, promotion and support. Hindering the promotion of breastfeeding in this country is the perpetuation of the idea that the decision to breastfeed is a personal one and we should not make women feel guilty for not breastfeeding. Also, as a non-breastfeeding society for a few generations now, the cultural belief system is that most babies are raised on formula and they are fine. Additionally, like nutrition, obstetricians and pediatricians– who are best poised to promote this clearly biologically superior milk–may not receive much training on breastfeeding and there is an awkwardness about women and breasts–even in the medical community.

The moment that baby opens it little mouth and receives an artificial milk, it is unwittingly committed to a different path than its breastfed nursery mate. Immediately, that baby becomes a consumer of a highly and often deceitfully marketed corporate product; is more vulnerable to various illnesses and diseases with short or long term health implications; compromises its innate ability to self regulate feedings, and now in this weighted world, must work with its pediatrician to strive for average.

The health center where I work serves a large and diverse international clientele. I feel very fortunate to encounter daily a multi-cultural perspective. Last week, as I was walking past the main waiting area, two young women were nursing their babies. One woman was Mexican and the other was Burmese. This was not shy, covered up nursing. Both, were one breast exposed unabashedly doing what women have been doing for thousands and thousands of years. Confidently nourishing their young. How challenging can it be?

In health, Elyn

Related Post:  Breastfeeding Redux

http://www.npr.org/2011/01/24/133110606/some-baby-formulas-may-cause-faster-weight-gain

http://www.surgeongeneral.gov/topics/breastfeeding/calltoactiontosupportbreastfeeding.pdf

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15 thoughts on “blessed feeding

  1. “Lactation experts and women who do breastfeed understand that human milk is species specific for human babies, and its composition perfectly designed for proper and progressive growth.”

    As an adoptive father, I tried very hard to breastfeed, but it just didn’t work out.

    Nonetheless, I feel qualified to express a concern about your assumptions that nature is perfectly designed and that the practices of other cultures result in healthier children.

    Nature takes plenty of design shortcuts, and unless some error in genetic reproduction offers a better lactation result, nature gets by with the first working solution — not “perfect [design] for proper and progressive growth.” I am not in a position to compare breastmilk to formula, but I am confident if nature made it, it was not designed “perfectly.”

    Furthermore, we of Western guilt assume that if something is done in “less developed” cultures, it is closer to nature and thus purer and healthier. This is malarkical thinking. Much in “less developed” cultures is harsh and unhealthy, and it is not reasonable to assert that God or nature created these patterns making them automatically superior.

    Finally, you note that studies demonstrate that breastfed babies are healthier than formula eaters. This may be true, but it doesn’t describe why these children have better outcomes, and doesn’t by itself show that a breastmilk advantage caused the better outcomes. Something else (poor maternal health? babies’ physiological challenges?) might have led to both poorer health and the choice (or necessity) to use formula.

    I have no doubt that breastfeeding is superior to formula for most babies. Nonetheless, if you are going to persuade the health community to take stronger action in the face of the profit-seeking pressures imposed by the formula industry and its commercial allies, it will be especially useful to stick with bulletproof arguments.

    Thanks for all the good work you do, and the heart you put into your work.

    Dave

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    • hi david, thanks for your response. of course i appreciate that there are different situations where breastfeeding is not an option (or a very difficult one) and of course adoption is one of those situations. i could/should have made mention of this but i think i chose not to because most discussions about breastfeeding make that disclaimer. i don’t know if this is an appropriate analogy but the food pyramid next to its grain category does not have an asterick saying unless you have celiac disease. people with that condition would know they need to make an adaptation. if breastfeeding was the cultural norm that would be an appropriate notation. with only 33% of babies being breastfed at three months (and i have reason to believe our national statistics are inflated) and only 13% at six months the promotion of breast feeding here is colored with apology. with 50% of babies who were brought to the breast in the hospital receiving supplemental formula, initial immunological benefits of breastmilk are compromised.
      there are many factors that have contributed to the drastic reduction in breastfeeding in this country that are complex. i disagree with your comment that our guilt makes us think if poor women in “less developed”countries are nursing we believe it is healthier. the opposite had greater impact. women abandoned breastfeeding seeing it as a lower class/base practice. breastmilk has afforded babies in with unsanitary conditions an immunological chance at survival. the encroachment of formula companies into such areas was disastrous.
      given that human milk is species specific (we don’t take healthy puppies away from their moms at birth and give them an alternative formula) and our clear knowledge of its benefits, it is very telling that we as a culture and as a practice of medicine give so much latitude or such lack of education regarding breastfeeding and endorse so whole heartedly a feeding method that should be a secondary choice when required.
      love to your little beautiful girl.

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      • just one more little addition. many might consider the application of epidural medicated births an improvement on the “imperfect” design of the birthing pelvis, with birth being considered a painful event that we can now mitigate. the widespread use of epidurals at birth interferes with the initiation of breastfeeding for the baby compromising the establishment of an easy and successful breastfeeding relationship between mom and baby. an improvement in nature’s design??? also, most women who opt for (or who are given)epidurals are not told that and then feel badly that breastfeeding did not initiate well and they are sad and frustrated.

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  2. Elyn,
    Brilliant article! Such an important issue. It is amazing that while everyone is screaming about obesity in this country that this issue hasnt received more attention and research! Could it be that once again the greed of corporate America is thwarting the research necessary on this important topic? Once again what is simple,natural and unadulturated is pushed aside. Whoa is me my friend.I am growing weary of this earth!

    Your friend(since kindegarten)

    Janet

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    • thanks so much janet. glad you got the thread that this is also about the story of weight and also weight fear. managing infant weight by manipulating formula feedings in a young baby is virtually unrealistic as well as dangerous. another landmine of parent anxiety about weight. there are so many pieces to this connection, but as soon as that baby has gotten its first bottle it has gotten its first processed food. formulas are essentially just a mix of some sugar commonly as corn sweetener, some various oils and some vits and mins. and an altered cow or soy milk protein. not to mention the effects of bpa/plastics, animal hormones etc. yes, it is wearing. just as we woke up and said after mindlessly adopting a processed food diet and said yikes, we’re fat!, when will we realize the folly of abandoning mother’s milk yes, largely in the name of corporate manipulation and greed. fun stuff huh? here’s to the moms and babies. love you.

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  3. Our sexual mores are pretty screwed up. Look no further than all of the malls which have banned breastfeeding. Aslo, the power of corporaste dollars skews the whole debate, even within the supposedly scientific medical community.

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    • thanks for this comment. unbelievable we are still fighting for a women’s right to breastfeed r/t cultural boob fixation. where is the tipping point where a society acknowledges the loss of the maternal art of breastfeeding. like antibiotic resistance, obesity, etc. when will it say that was a big boo boo. in light of increasing natural disasters, lack of access to food, heat, home etc. could be a disaster for babies on formula. wonder what happened during post katrina.

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  4. Elyn…… saw two women breastfeeding on the #1 subway going uptown. Inspired and relieved to see that the Mall censorship does not pervade the underground of NYC. Their act softened what could have been my hard commute.

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    • joel, thanks for sharing that. yes, seeing babes nursing does make for a kinder and gentler world. when you see a baby nursing you can appreciate that it is more than just the milk. it is like having a taste of heaven. elyn

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