I purchased the article from pediatrics. I read some other interesting facts from the one's you mentioned. 

1) Only 62% of the mothers stated that they wanted to breastfeed exclusively.  Of course if you only have 62% who want to breastfeed exclusively that does mean the rest are planning to give formula.

2) Once the two group were picked the 'ELF' group was instructed on how to feed infant by syringe, how much and for how long. The control group (to make the time spent evenly) was provided with 15 minutes of learning how to soothe a fussy baby.        When I saw that statement the light bulb clicked. We teach our parents signs of hunger - alert, lip and mouth action - crying is the last stage and we teach 'feed your baby before this happens'. Where as these mothers were taught other ways to sooth a crying baby so I wondered how many of these babies missed out on feedings because they weren't feeding on cue the parents were trying to sooth them in other means. This may be the reason they tended to have a higher weight loss. And we all know that once weight loss gets close to 10% parents are instructed to supplement.   Instead of 15 minutes of soothing a baby why not 15 minutes of breastfeeding education?

3) From what I could find on the internet neither of the hospitals listed (yes it took the authors 2 hospitals to be able to find 40 babies) are baby friendly. 

4) None of the mothers received breast exams to make sure there was no abnormalities in the breast. 

5) After the couplet was determined which group they would reside in a 'study doctor or nurse' assessed a breastfeeding session.    To make this fair why didn't they have a lactation consultant assess the breastfeeding session.

6) I was also impressed to see that they chose to use a hypoallergenic formula. I don't have the paper in front of me but the reasoning stated along the lines of 'high risk of cows milk protein allergy'. So the paper clearly states that there is 'side effects' of using formula but this isn't in the abstract.

Just wanted to share some more points I was thinking about when I read this article.
Jessica Callahan RN, IBCLC
NC, USA

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