Saturday, 9 January 2010

Norweigan Scientist says breastmilk is no better for babies than formula -

Interesting report on research from Norway, where breastfeeding support is high and most women breastfeed? What's going on?

Scientist says breastmilk is no better for babies than formula -

Statue in front of hospital on Margarita Island Venezuela

UNICEF has refuted the study

Ben Goldacre from Bad Science fame posts the press release that lead to the BIG STORY which has been subsequently plastered all over the media

These articles and responses to them are well worth reading to get the full story behind the 'story'.

Essentially, what the researchers are saying is that women who have high testosterone levels in pregnancy, have trouble breastfeeding.

There is a very thoughtful informed response by Australia's Karleen Gribble PhD School of Nursing and Midwifery, UWS, reproduced below.
Karleen's post was in response to a query about the study on en-net, " a free and open resource to help field practitioners have access to prompt technical advice for operational challenges for which answers are not readily accessible" The Emergency Nutrition Network is a UK registered international charity, set up by humanitarian agencies to improve effectiveness of emergency food and nutrition interventions through rapid identification and dissemination of lessons learnt in the course of operational practice, and through research and evaluation.
The en-net forum is made possible by the support of the American People through the United States Agency for International Development/Office of Foreign Disaster Assistance (USAID/OFDA) and the support of the Irish People through Irish Aid.

Karleen wrote on the above list:

"There's a few things that you need to understand about this study (which I have read) and the context in which it was carried out. This research is from Norway, the country with the best breastfeeding rates in the Western world- 99% initiation of breastfeeding and 80% of women still breastfeeding at 6 months. Societial support for breastfeeding women in Norway is very good. The very small number of women who cease breastfeeding in the early weeks of their infant's life would include those whose have a genuine physiological problem with making sufficient milk for their babies. It was found that these women were more likely to have higher levels of androgens during pregnancy. This is not a huge surprise, it's been something that others have been suggesting for some time (see the book for mothers "Making more Milk" by West and Maracso). The researchers seem to think that androgen levels can account for pretty much every factor associated with early weaning....they are's a case of if your only tool is a hammer, everything looks like a nail. It's a bit simplistic but there's no doubt that they have found a useful priece of the puzzle.
As to the idea that formula is as good as breastmilk. Well, the references cited in the study as providing evidence for this idea are 4 from the PROBIT study (the huge RCT of the implementation of BFHI in Belarus). The 4 studies cited looked at the impact of BFHI implementation (and lower of higher artificial feeding rates) on child behaviour, growth, dental caries, allergies/asthma- that's it. You'll get few people getting all het up saying you must breastfeed otherwise you're child will have behaviour problems or holes in their teeth. And to be perfectly frank any results from the PROBIT study on allergy and asthma is going to be questionable because the issue with allergic disease is exposure to allergens- and the only way to do this properly is a longitudinal study which records the time of the infant's first exposure to anything other than breastmilk- the only study I am aware of that has done this is one by Wendy Oddy in W Australia (and indeed, the critical factor was the timing of the first exposure to cows milk protein). There was nothing in the study that addressed the most common morbidities and mortalities due to artifical feeding, that is: diarrhoeal disease and respiratory infection.
Shall I be cynical and say that the researchers wanted to get media interest in their study?? (This was just a single small paragraph in the paper) Perhaps. Or maybe they just don't see the adverse effects of formula feeding since they are in Norway, where as I mentioned, just about every woman breastfeeds for a substantial period of time and where they have one of the best public health systems in the world.
And just a note about language when we talk about infant feeding. Breastfeeding is the normal way of feeding babies. It is extremely important and in fact it is vital, essential, indispensible to the wellbeing of infants and young children. It has NO BENEFITS. It is NOT best. Rather, artificial feeding is risky and dangerous. It actively and passively harms the immune system and the health of infants. Breastfeeding does not decrease disease, artificial feeding increases it. Breastfeeding is not best, infant formula is deficient.
This may seem pedantic but we actually have a growing body of evidence that if we talk about breastfeeding as best and the benefits of breastfeeding that we fail to effectively communicate the importance of breastfeeding and the risks of formula feeding- we actually assist in the promotion of formula feeding.
I can provide more evidence on this if there is interest".

No comments: