Too bad she had to add that 2nd to last paragraph! Kathleen Fallon Pasakarnis, IBCLC Breast-Feeding Benefits Touted In New Study March 27, 2002 By Stephanie Whyche InteliHealth News Service Despite mounting evidence for the benefits of breast milk, American women face many challenges when it comes to breast-feeding — take it from an expert at Harvard Medical School, who is also a mother. Leann M. Lesperance, M.D., a clinical instructor in pediatrics and a staff affiliate at Boston Children's Hospital and Brigham and Women's Hospital, says the challenges range from a lack of basic instruction on breast-feeding to workplace policies, as well as social and cultural biases. Still, she's convinced, "breast is best." Her comments come in the wake of a new study that showed that full-term babies who were small at birth and who were exclusively fed breast milk for the first six months of their lives scored an average of 11 points higher on IQ tests at age 5, compared with similar-sized babies who were fed breast milk and formula, or breast milk and solid food. The study took place in Norway and Sweden and was conducted by researchers at the U.S. National Institute of Child Health and Human Development and the Norwegian University of Science and Technology. This study is not the first to tout the benefits of breast-feeding for intellectual development. An earlier study showed that full-term, breast-fed babies of average size who were exclusively breast-fed scored three points higher on IQ tests at age 5 than those who were not. "One of the benefits of breast-feeding that has long been promoted is that it may have cognitive benefits for kids," says Dr. Lesperance, who breast-fed her own child for 13 months. "We have to assume that breast milk contains the perfect ingredients that our children need to develop to their fullest potential." "People have been studying this for many years," she says. "Much research has focused on long-chain polyunsaturated fatty acids [found in human breast milk]. They are similar to compounds found in fish oils." Experts are particularly interested in DHA, docosahexaenoic acid. "Some studies suggest a link between cognitive ability and DHA. Indeed, the U.S. Food and Drug Administration has recently approved DHA as an additive for baby formula," Dr. Lesperance says. "The rewards are great, but the initial investment in time and energy can be high," Dr. Lesperance says of breast-feeding. "You've got to be motivated; it takes commitment." But Dr. Lesperance tells mothers of infants she cares for in her own practice to stay the course if possible. In most cases, breast-fed babies and their moms will be better off for the experience, she says. The latest study, reported in the March edition of the journal Acta Paediatric, took place in two countries — Norway and Sweden — where most mothers exclusively breast-feed their babies for the first six months. (In the United States, only 16 percent of mothers are still nursing their babies at six months.) The researchers compared 220 full-term babies who were small with 229 full-term babies of average size. The infants were examined at birth, 6 weeks of age, 3 months, 6 months, 9 months and 13 months. At each visit, the babies were weighed and mothers were asked what they were feeding their children. Development was measured at each of those visits, and intelligence tests were given at age 5. In addition to the difference in IQ tests, researchers noted that the early introduction of formula or food did not increase the growth of either the small or average weight babies compared to those who were exclusively breast fed for six months. The American Academy of Pediatrics recommends exclusive breast-feeding of infants until 6 months of age, then breast-feeding to the age of 1 year, if possible, supplemented by solid food. Most babies do not need any type of solid foods before 6 months of age, Dr. Lesperance says. So why do so few American moms breast feed for more than a few months, if at all, compared to women in other countries? One reason is work. When it comes to meeting the competing demands of work or breast-feeding, work wins out for many women. One big factor, Dr. Lesperance says, is that workplace maternity-leave policies in the two Scandinavian countries are more conducive to prolonged breast-feeding than policies in the United States. To wit: In Norway, a woman can get up to 42 weeks of fully paid maternity leave (and 52 weeks at 80 percent pay) if she has worked six months out of the previous 10 months. In Sweden, a woman can get 15 months of maternity leave with pay and job protection. In that country 70 percent of moms are exclusively breast-feeding at 4 months. The United States Family and Medical Leave Act only guarantees 12 weeks of maternity leave with job protection, not pay, for women who work for companies with 50 or more employees. Whether they are paid is up to individual employers. Other factors likely play a role in the lower percentages of breast-feeding mothers in the United States, according to Dr. Lesperance. These include: Few or no role models — Many women have no prior experience with breast-feeding. They have no role models, since their mothers, aunts or friends did not breast-feed. "If breast-feeding is not prevalent in your community you will have very few social supports," Dr. Lesperance says. Poor prenatal training — "I think if a mom doesn't receive appropriate prenatal counseling then she often has unrealistic expectations about breast-feeding and may not even try or may quit because she encounters difficulties and is unprepared," she says. Lack of encouragement — Mothers are not necessarily encouraged to breast-feed by the hospital where the baby is delivered or by their pediatricians. Poor postpartum training — Very few hospitals in this country are considered breast-feeding friendly, she says. Most moms are discharged after only 48 hours, limiting the time that can be devoted to breast-feeding education. Misunderstanding about when breast-feeding should be avoided — "Some of the things that people think are contraindications to breast-feeding are not," Dr. Lesperance says. Moms who have nipple problems (such as flat or inverted nipples) still can nurse their babies, she says. True contraindications are actually rare. For instance, it is not recommended that a mother who has tested positive for HIV breast-feed her baby since the virus can be transmitted through the milk to the child and infant formula is a safer alternative. Pro baby-formula images in media — One study showed that most advertisements, television shows and movies don't show mothers breast-feeding but, instead, show mothers feeding bottled formula to their babies. "No one should feel bad about switching to a bottle," Dr. Lesperance says. "Formula is an excellent alternative for moms who cannot or chose not to breast-feed." What's important is that moms who decide to give formula " do so for the right reasons, she says, "not because of myths or misinformation." "My advice to expectant moms is to think about breast-feeding before the baby is born," Dr. Lesperance says. "Be prepared. Get enough information: attend a class, read books. Explore your own viewpoints and biases. When the baby is born, don't be discouraged if it seems difficult, because it can be challenging. In the long run, however, it usually gets even easier than bottle feeding and may have lasting rewards for your baby." *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html