It is almost too late to call today Tuesday, but I’m squeaking this post in anyway! Breastfeeding articles have been catching my eye this week, specifically this one about the life-saving benefits of human milk for the critically injured:
But one exciting question is still unanswered: can breast milk be used medicinally as treatment in babies –and even older children and adults– who may not have been breastfed? There is a growing body of evidence suggesting all sorts of uses for breastmilk as treatment of adult disease. Ads may say, “Milk: Does a Body Good” but in all likelihood, human milk can do a body, any body, better.
Baby Charlotte Rose wasn’t breastfed. Until the age of 11 months, she was a happy, healthy little girl. All that changed radically when she suffered a traumatic brain injury…
And, since the politics of breastfeeding are endlessly fascinating to me, I was curious to read this article by the mother who caused an unanticipated media stir last year with her breastfeeding-in-uniform pictures:
Whoever said a picture can speak a thousand words was right, even when I could speak none. A group of breastfeeding women, including myself, all took part in a photo shoot with the intentions of letting others know breastfeeding is possible regardless of your situation. My main contribution, or so I thought, was that I happened to have twins. Boy was I wrong. Another woman and I, who both served in the Air National Guard, also took pictures in our uniform to show that even those serving could also breastfeed. We were both prior active duty so we knew the struggles of both being full-time and part-time military. Contrary to popular belief, we did get permission to take the pictures. After the pictures were taken, we were going to consult the law office on base and get permission for the photos and positive quotes to go along with them with the goal of having them put into women’s exam rooms…
While some recent breastfeeding research with a very limited sample is making headlines under the misleading title that “supplementing newborns with small quantities of formula may improve long-term breastfeeding rates,” The Academy of Breastfeeding Medicine published a helpful post breaking down the research and drawing more accurate conclusions:
A small study published in Pediatrics suggests that supplementing newborns with small quantities of formula may improve long-term breastfeeding rates. The results challenge both dogma and data linking supplementation with early weaning, call into question the Joint Commission’s exclusive breastfeeding quality metric, and will no doubt inspire intimations of a formula-industry conspiracy. Before we use this study to transform clinical practice, I think it’s worth taking a careful look at what the authors actually found.
First, I think it’s very important to be clear about what the authors meant by “early limited formula.” The authors used 2 teaspoons of hypo-allergenic formula, given via a syringe, as a bridge for mothers whose infants had lost > 5% of their birthweight and mom’s milk had not yet come in. At UNC, we use donor milk in a similar way, offering supplemental breast milk via a syringe as a bridge until mom’s milk production increases.
This is very different from the way that formula supplementation is handled in many US hospitals. We know that in the US overall, 1/4 of breastfed infants are given formula by day 2 of life, and that number reaches as high as 40% in some areas. Typically, when a family member expresses interest in giving the baby some formula, a hospital staff member plunks a 6-pack of 2-oz bottles of ready-to-feed formula in the baby’s bassinet with no instruction about how much to feed. A neonate whose stomach holds one to two teaspoons gets 2 ounces (12 teaspoons) of milk poured into him. The baby then sleeps for the next four to six hours, like someone who’s just over-indulged at a Thanksgiving buffet. In this scenario. Mom doesn’t get any breast stimulation, and family members all express relief that “finally the baby is happy.” When baby finally wants to eat again, there are five more convenient, ready-to-feed, six-hour-nap-inducing bottles sitting in the bassinet. This does not tend to help mothers breastfeed successfully. I worry that the headlines from this study — such as “How Formula Could Increase Breastfeeding Rates (TIME)” and ”How Formula Can Complement Breastfeeding (NYT)” — will translate into “a six pack of formula back in every bassinet!”
Note that the benefit of this very specific type of early supplementation can also be achieved via donor milk. The research does not actually “prove” that formula is helpful for breastfeeding, but that for certain mother-baby dyads, supplementation of some kind via syringe is helpful. This is NOT the same thing at all as supplementing with a two ounce bottle of formula!
I was glad to see Dr. Newman chiming in on the comments with his no-nonsense opinion: “I also love it how they say their results may not be applicable elsewhere because they live in a community where women are eager to breastfeed and 98% initiate breastfeeding. So surely they must find ways to give these babies formula…”
Speaking of Dr. Newman, the conference registration form and website are finally available for the upcoming LLL of Missouri conference in June. I learn so much at LLL conferences and I’m very much looking forward to this one as well. Dr. Newman is the special speaker. I heard him speak at the CAPPA conference last year and he is not to be missed! I’m also speaking twice at this conference, but Dr. Newman is much more exciting than me!