lACTNETTERS, sorry, didn't mean to shout.  This is the message I sent to
Rachael for forwarding to misc.kids.  Since I took the time to write it, I
thought I'd share it widely.  Kathy D.


Greetings to the readers of misc.kids and misc.kids.breastfeeding.  Rachael
Hamlet asked me to provide citations from the medical literature for the
points she made in her earlier post about the health advantages of
breastfeeding and the very real health risks of bottle-feeding.  I have
provide just a small sample, on a variety of topics, below.  I would like to
make several additional points.  If you look at this list and wonder why
your own ob/gyn or pediatrician never mentioned this research to you, it is
probably because (1) medical schools do not, for the most part, teach
nutrition at all, let alone teach about breastfeeding, nor do they focus on
preventing illness, (2) many doctors do not read the medical journals so
they are not aware of recent research results, (3) doctors make money when
children are sick, and (4) the infant formula industry is as huge and
powerful as the tobacco industry.
        There is no question that the use of infant formula raises the risk
of getting a wide variety of diseases, both in infancy (ear infections,
gastrointestinal infections, upper respiratory infections) and in later life
(multiple sclerosis, cancer, diabetes), and that breastfed babies are at
lower risk for all of these diseases by comparison.  An important point to
remember about relative risk, and reduction of risk, is that some diseases
and conditions are very rare.  Thus, one might ask "Is it worth changing
one's behavior--breastfeeding instead of bottle-feeding--to reduce the risk
of a rare event?"  What is abundantly clear from the research comparing the
health of breastfed and bottle-fed children is that the reduction in risk
for any one disease may be small, and some of the diseases, such as
childhood lymphomas, are very rare to begin with, but that the accumulated
reduction in risk across all the diseases studied to date is substantial.  A
number of researchers think that the lower risk of many diseases in
breastfed infants is due to their stronger immune systems, rather than
specific mechanisms of protection for each condition.  Thus, lower rates of
lymphoma and multiple sclerosis in breastfed infants can probably be
attributed to successful defense of the body by a strong immune system.  In
choosing whether, and for how long, to breastfeed, parents are making
decisions that will have long-lasting consequences for their children's
health.  They need to be fully informed about the risks that may be avoided
by breastfeeding, to make informed and responsible decisions.  Just as
parents today are informed about the risks involved in not using child
safety seats, and drinking during pregnancy--dangers unknown a generation
ago--parents today need access to information about the risks of infant
formula and shortened durations of breastfeeding.  No one would suggest that
a parent whose child died in a car accident in the 1950s should "feel
guilty" for not having used a child saftey seat before such seats were
invented.  Nor should parents feel guilty for having chosen to bottle-feed
their children before knowledge of the health consequences has been made
widely available.
        As a final note, ALL of the studies that have looked at duration of
breastfeeding have found that the longer the child nurses, the greater the
benefit.  There is never a point at which the child stops receiving health
benefits from breast milk as long as his or her mother is lactating.  The
first month is obviously more critical than the 24th month or the 48th
month, but the benefits continue to accrue.  There are, of course, many
other good reasons to breastfeed -- to have a happy child, to not have
menstrual periods for many months, and it is very conveniently packaged and
ready-to-go, not to mention cheap.  I welcome private e-mail correspondence
on these topics (e-mail address at the end), or interested parties can find
up-to-date summaries of the literature on the relationship between
breastfeeding and children's health in a new book to be published in
November 1995, titled "Breastfeeding: Biocultural Perspectives," published
by Aldine de Gruyter of New York.

YOU ASKED FOR REFERENCES, HERE ARE A FEW:

On IQ (and the lead analogy is based on "average IQ deficits" in children
exposed to lead in situations like old apartment buildings where the paint
had lead in it.  I agree that IQ tests are suspect in general, but all of
these studies have found small but significant benefits to the breastfed
children.  Whatever talent it is that IQ tests measure, breastfed babies are
much better at it).

Bauer, G. et al.  1991  Breastfeeding and cognitive development of
three-year-old children.  Phychological Reports, 68:1218.

Lucas, A., et al.  1992  Breast milk and subsequent intelligence quotient in
children born preterm.  Lancet 339:261-264.

Morley, R. et al.  1988  Mother's choice to provide breast milk and
developmental outcome.  Archives of Disease in Childhood 63:1382-1385.

Morrow-Tlucak, M. et al.  1988  Breastfeeding and cognitive development in
the first two years of life.  Social Science and Medicine 26:635-639.

Rodgers, B.  1978  Feeding in infancy and later ability and attainments: A
longitudinal study.  Developmental Medicine and Child Neurology 20:421-426.

Rogan, W.J., and B.C. Gladen  1993  Breastfeeding and cognitive development.
Early Human Development 31:181-193.

Taylor, B., and J. Wadsworth  1984  Breastfeeding and child development at
five years of age.  Developmental Medicine and Child Neurology 26:73-80.

Temboury, M.C. et al.  1994  Influence of breastfeeding on the infant's
intellectual development.  Journal of Pediatric Gastroenterology and
Nutrition 18:32-36.

On allergies:

Jakobsson, I. and T. Lindberg  1978  Cow's milk as a cause of infantile
colic in breast fed infants.  Lancet 2:437-439.


In general:

Cunningham, A.S., D.B. Jelliffe and E.F.P. Jelliffe   1991  Breastfeeding
and health in the 1980s: A global epidemiologic review.  Journal of
Pediatrics 118(5):659-666.

Greer, F.R. and R.D. Apple 1991  Physicians, formula companies, and
advertising: A historical perspective.  American Journal of Diseases of
Children 145:282-286.  (This article talks about the history of collusion
between doctors and the infant formula industry.  The formula industry gives
hundreds of thousands of dollars to doctors and hospitals to promote their
products, sponsors doctor's attendance at medical meetings, etc.  The use of
infant formula also causes more infant sickness, thus benefitting the
doctors financially.  No one gains financially when mothers breastfeed and
children are healthy, except the parents who don't have to pay for formula
or medical care).

Howie, P.W. et al.  1990  Protective effect of breast feeding against
infection.  British Medical Journal 300:11-16.

Jelliffe, D.B. and E.F.P. Jelliffe  1986  The uniqueness of human milk
up-dated: Ranges of evidence and emphases in interpretation.  Advances in
International Maternal and Child Health 6:129-147.

Latham, M.C.  1975  Introduction.  In "The Promotion of Bottle Feeding by
Multinational Corporations: How Advertising and the Health Professions have
Contributed," edited by T. Greiner.  Ithaca, NY: Cornell International
Nutrition Monograph Series, No. 2.

Rubin, D.H. et al.  1990  Relationship between infant feeding and infectious
illness: A prospective study of infants during the first year of life.
Pediatrics 85:464-471.

Walker, M.  1993  A fresh look at the risk of artificial infant feeding.
Journal of Human Lactation 9(2):97-107.


On Sudden Infant Death Syndrome (SIDS):

Arnon, S.S.  1984  Breast feeding and toxigenic intestinal infections:
Missing links in crib death.  Reviews of Infectious Diseases 6:S193-S201.

Bernshaw, N.B.  1991  Does breastfeeding protect against sudden infant death
syndrome?  Journal of Human Lactation 7(2):73-79.

Fredrickson, D.D. et al.  1993  Relationship of sudden infant death syndrome
to breast-feeding duration and intensity.  American Journal of Diseases of
Children 147:460.  (They did a huge study, controlling for all other factors
like ethnicity and maternal smoking, and found that for every month of
exclusive breastfeeding, you cut the SIDS rate in half.  Thus children
breastfed for two months had 1/4 the rate of SIDS of bottle-fed babies, and
those breastfed for three months had 1/8 the rate of SIDS, etc).
McKenna, J.J. et al.  1993  Infant-parent co-sleeping in evolutionary
perspective: Imperatives for understanding infant sleep development and
SIDS.  Sleep 16(3):263-282.

`
On cancer:

Davis, M.K., D.A. Savitz, and B.I. Graubard  1988 Infant feeding and
childhood cancer.  Lancet 2(8607):365-368.

There are also two recent studies showing that breastfeeding protects
daughters from getting breast cancer later in life, and that breastfeeding
protects the mother from getting breast cancer.  Between the two studies,
they suggest that breastfeeding could cut a woman's breast cancer risk in
half (if she had been breastfed as a child, and then breastfed her own
children).  I don't have those references here at home, but one could find
them on a medical search program.  The main authors were Freudenheim on one,
and Polly Newcombe on the other.  Sorry I don't have the specifics, but they
were both 1994, I believe, and in major medical journals like the New
England Journal of Medicine.

On necrotizing enterocolitis (NEC), which is a very nasty disease that many
premature babies get and die from:

Lucas, A. and T.J. Cole 1990  Breast milk and neonatal necrotizing
enterocolities.  Lancet 336:1519-1523.

On ear infections:

Duncan, B. et al.  1993  Exclusive breast-feeding for at least 4 months
protects against otitis media.  Pediatrics 91(5):867-872.

On poorer response to immunizations in formula-fed children:

Hahn-Zoric, M. et al.  1990  Antibody responses to parenteral and oral
vaccines are impaired by conventional and low protein formulas as compared
to breast-feeding.  Acta Paediatrica Scandinavica 79:1137-1142.

Pabst, H.F., and D.W. Spady  1990  Effect of breast-feeding on antibody
response to conjugate vaccine.  Lancet 336:269-270.

Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology
Texas A&M University
co-editor of "Breastfeeding: Biocultural Perspectives" and specialist in
infant feeding and growth
e-mail to [log in to unmask]