19 June 2006
Breast Feeding: Does Mother Nature Know Best?
by Angie Rankman
One of the most perplexing topics for new mothers is one that should, ideally, be the most natural of choices: breastfeeding. Controversies continue between doctors, pediatricians and infant formula manufacturers over whether mothers should rely solely on breastfeeding alone; whether they should supplement – or replace altogether – breastfeeding with infant formulas; what age babies should be weaned, and at what age solid foods should be introduced. These are not trivial decisions as the choices a mother makes can affect the child’s health for years to come.
With the quantity of infant products currently available on the market, mothers could be forgiven for believing that the controversy over breastfeeding is a relatively recent one, but historical research shows that such debates have a long history. Virginia Thorley, of the University of Queensland, Australia, looked into the history of infant feeding in the 20th century and uncovered some interesting insights. "A lot of people think the current trend back to breastfeeding is only a recent development," said Thorley, founder of the Queensland branch of the Australian Breastfeeding Association. "But as far back as the 1920s, medical experts saw artificial feeding as old fashioned and recommended breastfeeding, but only until nine months." According to Thorley’s research, many of the fears associated with breastfeeding back then were similar to today’s: "such as the fear that mothers' milk might fail or not be enough nutrition for babies on its own," says Thorley. One of the most interesting aspects of Thorley’s work is that she also looked at infant formula manufacturers and their advertising campaigns, which played on the fears associated with the anecdotal evidence passed on within families and between mothers.
Many of those fears still remain today, but infant formula manufacturers have also adopted some new tactics that draw on contemporary trends and attitudes. With increased talk of "designer babies," many so-called experts advocate supplemented infant formulas because the products promise to do everything from improving vision to making babies smarter. The supplements used in these formulas are often trace elements found naturally in breast milk, but whether they do actually provide an edge over breastfeeding alone is hotly disputed. The FDA, together with the American Academy of Pediatrics, cannot see the alleged advantages that these supplements might offer already healthy babies, let alone the idea that they could produce super-babies. They’re concerned, because mothers may be coaxed into buying supplemented formulas unnecessarily, at a significantly higher cost than normal formulas.
It is true that infant formulas and supplements have improved over the years, but a multitude of pediatricians and scientists will tell you that under normal circumstances, mother’s milk is always the best option. In fact, many of these new supplements are introduced, ironically, to offset the lack of nutrients, fatty acids and growth factors missing in standard infant formulas. Take for example the most widespread and devastating gastrointestinal disease Necrotizing enterocolitis (NEC), which affects over 10,000 babies annually in the U.S. alone, and has a mortality rate of anything up to 40 percent. Researchers from the Department of Pediatrics, University of Arizona, say that those babies most at risk are premature babies, and babies fed concentrated infant formulas.
The most telling statistic to come out of the research, however, is that over 90 percent of NEC babies had been formula fed. Astonishingly, babies fed infant formula are 6 to 10 times more likely to contract the disease than are breast-fed babies. The researchers found that by adding a growth factor commonly found in breast milk, the disease could be significantly alleviated. "Using a neonatal animal model of NEC, we have shown that when one protein found in breast milk (epidermal growth factor (EGF)) is added to formula, the incidence of NEC decreases by 50 percent compared to animals fed formula alone," said study author Jessica A. Clark. This example could either be seen as a fantastic breakthrough in medical science, or, considered a valuable lesson in how nature knows best.
People seem to be forgetting that we are extremely complex biological organisms, and as such cannot expect that artificially produced formulas will adequately substitute the nourishment of breast milk. Mother's milk is perfect because it provides the correct nourishment for infants, as well as providing immunity from many illnesses. "Breast-feeding is widely accepted internationally as the gold standard for infant feeding and has unparalleled advantages for both infants and mothers," said Cheston M. Berlin, Penn State University professor of pediatrics and pharmacology. "Advantages for infants include protection from infectious disease, optimal growth including neurodevelopment, and possible protection from certain diseases later in life. It is important to preserve breast-feeding as the best nutrition for infants."
Other studies have shown that babies brought up on formulas have a significantly higher rate of middle ear infections, intestinal disorders, bacterial infections and respiratory problems. And, contrary to the claims made by supplement manufacturers, babies who are not breast-fed can actually suffer cognitive impairment. There are also other less serious, but equally concerning, factors that include less bonding between mother and child, and reduced breast milk production proportional to the amount of formula substituted. And to top it off, infant formulas and supplements are also subject to recalls of contaminated and nutrient deficient products.
The ubiquity of infant formulas and the baby bottle image, pervasive throughout society, have perhaps given the wrong message to new mothers. But as Ms Thorley has noted in her research, there has been a significant increase in the number of new mothers now breastfeeding their newborns. There may be times when formula is the only option available, but in these cases contact with a health professional should precede the use of a formula or supplement. If you would like to receive sound advice on breastfeeding, you can visit the International Board Certified Lactation Consultants, or the U.S. Dept of Health and Human Services: Benefits of Breastfeeding.