We’re surrounded by a bizarre and complicated conspiracy of silence. We’re not supposed to talk about it. If it gets a mention at all, we have to gloss over the details, and, in fact, lie outright, for the sake of not making anyone feel stressed or guilty. And the last thing I want to do is make anyone feel stressed or guilty. But it seems crucial to me that we make decisions about our children’s health and well-being based on facts rather than marketing.
Earlier this year I went to a health professionals’ seminar on breastfeeding, and it contained some truly stunning information. Even one bottle of formula fed to an otherwise breastfed infant increases the risk of otitis media (ear infections), gastrointestinal infections (gastro), and allergies. Cows milk formula actually sensitises for allergies – the risk increases dramatically with exposure to formula. For children who receive formula in the first week of life, the risk of a subsequent cows milk allergy is 8 times higher than for exclusively breastfed children. That’s a single bottle of formula in the first week of life.
We are very lucky that we have the option of formula where breastfeeding is truly impossible, or too traumatic to continue. I would not for a moment criticise anyone who chose to formula feed their baby. But I do want them to have the most accurate information on which to base their decision. At the moment the prevailing message is that formula is just as good as breastmilk. It won’t do any harm. Breastfeeding is nice, but formula is fine. The truth is, it’s not, but it is hard to be explicit about that, without upsetting people who felt that they had to formula feed their babies. No-one wants to traumatise anyone. But everyone should be making their health choices based on accurate information.
We’re surrounded by a distressing number of myths, like these:
- Myth 1: formula fed babies sleep better. (Many formula-fed babies sleep worse, due to the problems created by a food that their systems are not able to cope with properly . My exclusively breastfed baby slept through when she was 6 days old.)
- Myth 2: babies should be fed by the clock, to get them used to a routine. (The best way to increase your milk supply and keep your baby fed and happy is to feed when your baby is hungry. What does the clock know about how empty your baby’s tummy is?)
- Myth 3: Supplementing with formula is helpful when supply is low. (The best way to increase your supply is to feed more often. Supplementing with formula means your baby will feed less often, and may actually lead to your supply dropping further.)
- Myth 4: If a baby is unsettled and wants to feed a lot, it means your supply is low and you need to switch to formula. (There are many reasons babies get unsettled and want to feed. It may mean your supply is low, but feeding often will fix that, as your baby’s instincts are telling you. It may mean your baby is getting an infection and needs your milk more than ever. It may be a growth spurt, or teeth coming through, or simply tiredness.)
- Myth 5: Children should be weaned by 12 months. Feeding after that is unnatural and unhealthy, and children get no further benefit from the milk. (The World Health Organisation (WHO) recommends that children breastfeed until at least 2 years of age. Immune factors in the milk continue until at least this age – no-one has actually studied the milk beyond this point, as so few children are still being breastfed at 2. Less than 1% of children in Australia are still breastfeeding at 2.)
- Myth 6: If the mother gets mastitis, she should wean immediately. (The best treatment for mastitis is to feed as much as possible from the affected breast. Sudden weaning can actually cause mastitis, and may dramatically worsen existing cases.)
A very interesting point made by one speaker at the seminar, is that we don’t actually know what normal behaviour is for a health, breastfed infant who sleeps in the same room as mum and feeds on demand. It hasn’t been studied. Most of the growth charts and behavioural recommendations are based on formula-fed infants in the US in the 1950s. Some mothers are pressured to put their children onto formula by health professionals who are using growth charts based on formula fed babies (who are heavier, on average, than their breastfed counterparts. Oh, and far more likely to be obese adults.).
Sadly, many of the myths above are spread by the very health professionals who should be informing and educating us, rather than promoting myths that can be harmful to the health of our children.
We should not feel guilty about the way we feed our children. We all want to do what’s best for our children, and there are many ways to achieve that. But we should be making our decisions based on facts, not on myths and outdated opinions.
Oddy WH, et al. BMJ 1999;319:815-819. Kull I,et al.JACI 2004;114:755-760
Marini A, et al. Acia Paediatr Suppl. 1996;414:1-21
Gdalevich M, et. al. J Am Acad Dermatol.2001;45:520-527
Gdalevich M,et al. J. Pediatrics.2001;139:261-266
Duncan–Taussig, Pediatrics Vol 91,May1993 Taussig, Pediatrics Vol 91,May1993