The UK BFHI people have put out this press release as an answer to the recent surge of media articles devaluing breastfeeding. I bet if we dig a bit deeper we can find out who funded some of these strange articles - but - the release sent out is pretty good - I only hope the same people who read the strange stuff read this as well.
 
Evi Adams
 
 
BFHI response to recent media coverage of breastfeeding

A number of newspaper articles have recently made allegations that the research into many of the protective effects of breastfeeding is ‘weak’. Some have also extrapolated that breastfeeding should not be promoted strongly, citing mothers who feel guilty for bottle feeding, and alleging that such promotion is inappropriate due to the weak evidence base.
The body of evidence for the benefits of breastfeeding is very large and comes from a wide range of studies into many different illnesses, carried out by numerous researchers in many different universities. Systematic reviews of the literature have also been carried out and are especially useful, as they are able to eliminate weak studies and combine the findings of all the high-quality papers in order to demonstrate with the greatest reliability whether a protective effect truly exists. It is important to note that there is variability in the quality and depth of evidence in relation to some illnesses which is why the authors of these reviews tend to call for further research to clarify the finding. It remains the case, however, that the evidence for the advantages of breastfeeding is strong.
The two most recent and influential reviews were carried out by the Agency for Health and Research Quality and the World Health Organization and are summarised below:
Ip S, et al (2007) Breastfeeding and Maternal Health Outcomes in Developed Countries. AHRQ Publication No. 07-E007.Rockville, MD: Agency for Healthcare Research and Quality.
This review carried out in the USA screened over 9,000 papers and used evidence from 400. It refers only to health outcomes in developed countries. The review found that breastfeeding is associated with a significant reduction in the incidence of: acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, obesity, type 1 diabetes, type 2 diabetes, childhood leukaemia, sudden infant death syndrome, necrotizing enterocolitis, maternal breast cancer and ovarian cancer. Link.
Horta B et al (2007) Evidence on the long-term effects of breastfeeding. WHO.
This paper reports on a series of systematic reviews to assess the effects of breastfeeding on blood pressure, diabetes and related indicators, serum cholesterol, overweight and obesity, and intellectual performance. It found a significant reduction in the incidence of obesity and overweight and type 2 diabetes. It also found that breastfed babies had lower systolic blood pressure, lower cholesterol and better performance in intelligence tests. Link.
Although the protective effects of breastfeeding on gastroenteritis and respiratory infections have not been questioned, attempts have been made to dismiss these in developed countries as mere ‘tummy upsets’ or ‘coughs and colds’, whereas in reality a reduction in severe infection resulting in hospitalisation has been found. The Millennium Cohort Study is a nationally representative longitudinal study of 18,819 infants who were born in the UK in 2000-2002. Data on infant feeding, infant health, and a range of confounding factors were available for 15,890 healthy, singleton, term infants who were born during this period. This study found that 53 per cent of diarrheal hospitalisations each month could have been prevented by exclusive breastfeeding and 31 per cent by partial breastfeeding. A total of 27 per cent of lower respiratory tract infections could have been prevented each month by exclusive breastfeeding and 25 per cent by partial
 breastfeeding. Quigley M et al (2007) Breastfeeding and Hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. Link.
It is important to be aware that the protective effect of breastfeeding is stronger in relation to some illness, notably gastroenteritis, than it is for other illnesses such as allergies. This does not mean that there is no protective effect against those other illnesses, rather that the risk to the bottle-fed baby is greater for some illnesses than for others. Importantly, where the evidence shows a slight protective effect of breastfeeding, this can still be the result of well performed research. Therefore, to describe the evidence as weak because of a lower degree of protection is inaccurate and misleading. It is important to note that a small protective effect of breastfeeding against a significant illness will have a dramatic effect across a population.
The role of the Baby Friendly Initiative and of health professionals is to give pregnant women and new parents the full facts about infant feeding based on the best available evidence in an objective and non-judgemental manner in order to allow informed decision making. We then need to help mothers to make decisions appropriate to their circumstances and to support them in their decision whatever that may be. 

 

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