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"Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms

Nurses Article   (19,297 Views 174 Comments 1,461 Words)
by cjcsoon2bnp cjcsoon2bnp (Member) Writer

cjcsoon2bnp works as a ED NP and Clinical Instructor.

8 Articles; 24,198 Visitors; 1,156 Posts

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In my last article “Becoming Dad: A Humbling Birth Experience of a New Father and Nurse,” I discussed my journey to becoming a first-time parent and included some of the challenges that being a nurse and a parent present when it comes to the health of your children. This article continues on my journey with the battle we fought against the “breast is best” movement, which advocates that mothers exclusive breastfeeding babies for the first six months of life. You are reading page 6 of "Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms. If you want to start from the beginning Go to First Page.

AtHomeNurse has 16 years experience and works as a Home care RN.

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Really? You don't believe that formula carries risks? In addition to the risks I already listed that can occur with contamination, which, as I stated, has happened here in the U.S., not just third world countries with no access to clean water, there are stacks of research showing that formula feeding increases a baby's risk of developing obesity, asthma, Type I and Type II diabetes, SIDS, and even some childhood cancers. Additionally, literature show that moms are missing out on the decreased risk of breast and ovarian cancer, diabetes and metabolic disease that breastfeeding affords. Stating these risks is not guilt-tripping anyone. These are supported by research. Your argument is like saying promoting vaccinations for kids is automatically guilt-tripping anti-vaxxers, when in fact, it's just stating the science.

And before anyone jumps in with their anecdotes, yes I know plenty of formula fed babies that are healthy as horses, and plenty of breastfed babies who get sick all of the time, and I do know women who have breastfed who have had breast cancer, but that doesn't negate the fact that the large bodies of research we have support the risks to formula that I've listed, and that in no way equates to guilt-tripping anyone.

Can you specify where you are getting your information from? Everything that I have read recently published is coming to the conclusion that the benefits of breastfeeding have been overstated, the benefits over formula are small, and when taken into context things like mental health of the mother, socioeconomic status, cultural factors etc breastfeeding is not always best. Overstating risks is guilt tripping. Vaccines have vast amounts of evidence on safety and large margin of benefit vs risk. saying that choosing not to vaccinate places a child at higher risk of death is not overstating in the same way. Vaccines work in all socioeconomic conditions, all living conditions, under all variables.

As far as contamination, that has been covered. And breast feeding is not without risk.

This article is a really good example of why "breast is best" is so misleading and worth a read.

Breastfeed At Your Own Risk - Contexts

" Political scientist Joan Wolf, in the Journal of Health Politics, Policy, and Law, argues that the benefits of breastfeeding have been vastly overstated. Perhaps the largest problem is that it's impossible to conduct a controlled experiment—by asking some mothers to breastfeed and others to formula-feed—so all studies are observational. In other words, researchers have to tease out the characteristics of those who decide to breastfeed from the benefits of breastmilk itself. Mothers who choose to breastfeed may also promote a host of other health-protective and IQ-promoting behaviors in their children that go unmeasured in observational studies. The problem becomes even more pronounced when trying to examine the long-term health benefits of breastfeeding because there are even more potential unmeasured factors between infancy and adolescence that contribute to overall health"

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Spidey's mom works as a RN.

4 Followers; 76,207 Visitors; 11,286 Posts

What was your take?

When I first started reading her blog, I was surprised to find a physician who had some of the same issues with Breast is Best that I have as a L&D nurse and mom who breastfed 4 kids; 3 into toddler-hood.

But she is getting more militant and strident.

Some nurses used to take the formula from the new baby bags given to us by formula companies. It was really more militant regarding pushing breastfeeding vs formula.

Now it goes the other way. The pendulum swings . . .

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AtHomeNurse has 16 years experience and works as a Home care RN.

2,981 Visitors; 236 Posts

But what you are not doing is providing evidence beyond your opinion that formula carries enough health risks that infants should be given pasteurized donated breastmilk above formula. And I'm not going to yell, because quite frankly I'm not sure what your yelling about. I asked you to support your obviously strong feelings about the dangers of formula with something other than your opinion, that makes you angry?

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NicuGal has 30 years experience and works as a once a manager, now a staff nurse, preceptor, educ.

21,939 Visitors; 2,743 Posts

Truly a hot topic.

We have seen a rise in the number of readmits and admissions to us due to hyperbili or dehydration. We are trying to figure it out. We have 3 great LC for all our baby units, a lactation hotline and clinic. The one thing we have found in common is that the majority of these moms aren't producing enough or say that the baby is sleepy so therefore must not be hungry, when in actuality they are dehydrated. These are also the moms that will not give formula and tell us they would rather their baby have an IV.

That is not the answer. Fed is best. I can NOT wrap my head around the fact that you would want your baby stuck numerous times for access! Our attendings do tell these moms that we wholly support BFing and use of EBM but we will not keep an IV in a baby that is capable of eating and we will supplement as needed.

As for the use of donor milk, many insurance companies will not pay for its use in a healthy term infant. It is pretty cost prohibitive to pay out of pocket or for the unit to absorb the cost. The insurance companies need to change. This would solve a lot of the issues we have with the use of formula.

I don't believe in hounding mothers who choose not to pump or BF. I am pretty good at getting most moms to pump for at least a few weeks to provide EBM for there sick babies. I tell them the facts, how it is beneficial and give them information. Most agree. You still have the ones who won't but do agree to donor milk.

We need to be respectful and not overbearing or pushy.

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6,988 Visitors; 945 Posts

Really? You don't believe that formula carries risks? In addition to the risks I already listed that can occur with contamination, which, as I stated, has happened here in the U.S., not just third world countries with no access to clean water, there are stacks of research showing that formula feeding increases a baby's risk of developing obesity, asthma, Type I and Type II diabetes, SIDS, and even some childhood cancers. Additionally, literature show that moms are missing out on the decreased risk of breast and ovarian cancer, diabetes and metabolic disease that breastfeeding affords. Stating these risks is not guilt-tripping anyone. These are supported by research. Your argument is like saying promoting vaccinations for kids is automatically guilt-tripping anti-vaxxers, when in fact, it's just stating the science.

And before anyone jumps in with their anecdotes, yes I know plenty of formula fed babies that are healthy as horses, and plenty of breastfed babies who get sick all of the time, and I do know women who have breastfed who have had breast cancer, but that doesn't negate the fact that the large bodies of research we have support the risks to formula that I've listed, and that in no way equates to guilt-tripping anyone.

You are way off base. Formula feeding does not cause any of the things you listed. SIDS is caused by babies rebreathing their own CO2, thus the back to sleep campaign and why SIDS has been reduced greatly and why bumpers are no longer recommended on cribs as babies can push themselves into corners at night and not get proper oxygen.

Would you like a picture of my healthy, tall, skinny, 10 year old boy? He's wicked smart too. Not an ounce of fat on him. Inactivity is the reason for obesity. Type I diabetes is due to an issue with the cells in the pancreas. I'm going to go out on a limb and say numerous environmental factors contribute to asthma. I would have to study that myself though.

I'm currently pregnant and I will say, the last person that will see me is a lactation consultant. Every one I have ever met has been the same as what the OP described. They would rather me breastfeed and my epilepsy medications transfer to my baby than me do formula that was recommended to me by my OB and pediatrician with my son. Now, that I'm not on as many meds I will try breastfeeding but if my baby doesn't latch or my milk is not sufficient, I will formula feed and not lose an ounce of sleep over it either.

Fed is best.

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LibraSunCNM has 10 years experience and works as a CNM.

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Can you specify where you are getting your information from? Everything that I have read recently published is coming to the conclusion that the benefits of breastfeeding have been overstated, the benefits over formula are small, and when taken into context things like mental health of the mother, socioeconomic status, cultural factors etc breastfeeding is not always best. Overstating risks is guilt tripping. Vaccines have vast amounts of evidence on safety and large margin of benefit vs risk. saying that choosing not to vaccinate places a child at higher risk of death is not overstating in the same way. Vaccines work in all socioeconomic conditions, all living conditions, under all variables.

As far as contamination, that has been covered. And breast feeding is not without risk.

This article is a really good example of why "breast is best" is so misleading and worth a read.

Breastfeed At Your Own Risk - Contexts

" Political scientist Joan Wolf, in the Journal of Health Politics, Policy, and Law, argues that the benefits of breastfeeding have been vastly overstated. Perhaps the largest problem is that it's impossible to conduct a controlled experiment—by asking some mothers to breastfeed and others to formula-feed—so all studies are observational. In other words, researchers have to tease out the characteristics of those who decide to breastfeed from the benefits of breastmilk itself. Mothers who choose to breastfeed may also promote a host of other health-protective and IQ-promoting behaviors in their children that go unmeasured in observational studies. The problem becomes even more pronounced when trying to examine the long-term health benefits of breastfeeding because there are even more potential unmeasured factors between infancy and adolescence that contribute to overall health"

I'm getting my sources from the American Academy of Pediatrics, the World Health Organization, and peer-reviewed publications like Pediatrics, Obestetrics & Gynecology, and The Lancet. Where are you getting your sources that the benefits of breastfeeding are overstated, (other than the political scientist you quoted in the end of your post, whose opinion is just that, an opinion, unless she cites sources you didn't)?

I can't possibly list them all, but here are some of mine:

"The Risks of Not Breastfeeding for Mothers and Infants," by Stuebe, 2009, published in Obstetrics and Gynecology.

"Cost Analysis of Maternal Disease Associated With Suboptimal Breastfeeding," Bartick et. al, 2013, published in Obstetrics and Gynecology.

"Breastfeeding and the Reduced Risk of Sudden Infant Death Syndrome," Hauck et. al, 2011, published in Pediatrics

Sorry these are not cited in any correct format, but I am too tired for that right now.

I agree that the health benefits of breastfeeding and the risks of formula are multifactorial and that ultimately, how you choose to feed your infant is deeply personal. I can agree with everyone that a fed baby is better than a starved baby, 100%, while still maintaining there are benefits to breastfeeding and risks to formula.

Edited by LibraSunCNM
punctuation

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LibraSunCNM has 10 years experience and works as a CNM.

24,451 Visitors; 1,098 Posts

You are way off base. Formula feeding does not cause any of the things you listed. SIDS is caused by babies rebreathing their own CO2, thus the back to sleep campaign and why SIDS has been reduced greatly and why bumpers are no longer recommended on cribs as babies can push themselves into corners at night and not get proper oxygen.

Would you like a picture of my healthy, tall, skinny, 10 year old boy? He's wicked smart too. Not an ounce of fat on him. Inactivity is the reason for obesity. Type I diabetes is due to an issue with the cells in the pancreas. I'm going to go out on a limb and say numerous environmental factors contribute to asthma. I would have to study that myself though.

I'm currently pregnant and I will say, the last person that will see me is a lactation consultant. Every one I have ever met has been the same as what the OP described. They would rather me breastfeed and my epilepsy medications transfer to my baby than me do formula that was recommended to me by my OB and pediatrician with my son. Now, that I'm not on as many meds I will try breastfeeding but if my baby doesn't latch or my milk is not sufficient, I will formula feed and not lose an ounce of sleep over it either.

Fed is best.

See my source above for reasons why they think breastfeeding may reduce the risk of SIDS. It's actually pretty interesting.

No, I do not need a picture of your skinny son to try to convince me that formula does not cause obesity. I myself am 5'9" and 125 lbs, and was formula fed. As I stated in a prior post, anecdotes are great, but unfortunately mean nothing in the overall conversation. I maintain that the research I have come across points to a link between formula feeding and obesity in children.

I'm sorry that every LC you've ever met has been an asshat. That is unacceptable. I'm glad you are comfortable with your feeding choices for your children.

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I applaud hospitals and doctors for taking a stand as it relates to breast milk...........Breast milk is a non-negotiable when it comes to positive healthcare outcomes for infants.

With that being said, there is nothing stopping anyone in a similar situation from going over the head of a hospital or doctor and renting a pump machine from a DME themselves. I would only use formula as a last resort scenario.

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Spidey's mom works as a RN.

4 Followers; 76,207 Visitors; 11,286 Posts

You are way off base. Formula feeding does not cause any of the things you listed. SIDS is caused by babies rebreathing their own CO2, thus the back to sleep campaign and why SIDS has been reduced greatly and why bumpers are no longer recommended on cribs as babies can push themselves into corners at night and not get proper oxygen.

Would you like a picture of my healthy, tall, skinny, 10 year old boy? He's wicked smart too. Not an ounce of fat on him. Inactivity is the reason for obesity. Type I diabetes is due to an issue with the cells in the pancreas. I'm going to go out on a limb and say numerous environmental factors contribute to asthma. I would have to study that myself though.

I'm currently pregnant and I will say, the last person that will see me is a lactation consultant. Every one I have ever met has been the same as what the OP described. They would rather me breastfeed and my epilepsy medications transfer to my baby than me do formula that was recommended to me by my OB and pediatrician with my son. Now, that I'm not on as many meds I will try breastfeeding but if my baby doesn't latch or my milk is not sufficient, I will formula feed and not lose an ounce of sleep over it either.

Fed is best.

Hi - I am not going to try to guilt-trip you into anything but wanted to add that as a L&D nurse, we relied on Dr. Thomas Hale and his book Medications and Mothers Milk. It was interesting because many OB docs didn't realize there were studies on medication and breastfeeding and some of the medications could safely be continued. I'm not saying your seizure medication is one of them but I really wish there was more in-depth information given to new moms.

One mom was dedicated to breastfeeding and in order to do so was going to stop a medication she was taking which would have been unwise for mom. I emailed Dr. Hale and he called me back at work! He talked about the medication, the research/testing, and then sent me the information to give to the OB and new mom. She stayed on the medication and breastfed her child.

One of the other things I added to new mom discharge orders was Safe Co-Sleeping Rules. I knew parents would be co-sleeping (I did) so wanted them to know the dangers and the safe way to do so. But that's another subject altogether.

Medications and Mothers Milk Online

InfantRisk Center

Non-Drug Treatments for Depression | InfantRisk Center

Edited by Spidey's mom
Forgot links . . .

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Spidey's mom works as a RN.

4 Followers; 76,207 Visitors; 11,286 Posts

"Breastfeeding and the Reduced Risk of Sudden Infant Death Syndrome," Hauck et. al, 2011, published in Pediatrics

Thanks for the link. I read the study. It seems inconclusive to me.

There are many physical and emotional

benefits to breastfeeding, including

a reduced risk of postneonatal

mortality. However, it is unclear

whether breastfeeding specifically

lowers the risk of sudden infant death

syndrome (SIDS). Physiologic sleep

studies have shown that breastfed infants

have lower arousal thresholds

than formula-fed infants, which may

provide a mechanism for protection

against SIDS. However, epidemiologic

studies have been inconsistent in

showing a protective effect of breastfeeding

on the risk of SIDS; some study

results have supported a protective effect,

and others have not

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LibraSunCNM has 10 years experience and works as a CNM.

24,451 Visitors; 1,098 Posts

Sorry, I actually posted the wrong link! I agree with you that this study seems inconclusive, although when talking about SIDS I don't think we're really talking about something IN breastmilk that reduces the risk (at least that wasn't what I was trying to say), but rather factors that go along with it, like the fact that breastfed babies sleep less deeply, etc.

But the study I meant to post is "Does Breastfeeding Reduce the Risk of Sudden Infant Death Syndrome?" by Venneman, et al, published by AAP in 2009. They do control for confounding factors like SES, smoking status.[h=1][/h]

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