It is known that breastfed babies are at lower risk of obesity throughout
the life course than those fed ABM.  The mechanism by which this occurs is
not known.  There are 2 theories. One is that babies self regulate at the
breast but not at the bottle.  If this is the case, then babies who are
exclusively fed EBM by bottle are likely to be at higer risk of obesity than
their exclusively breastfed counterparts.  The other theory is that there is
some biophysical property of ABM that causes increased adiposity.  This
could either operate because artificially fed infants don't get the things
they need from human milk or because they are exposed to something that
causes adiposity in non-human milk or a combination of both. It is also
possible that both of these theories provide partial explanation for the
increased adiposity of artificially fed infants.  Moral to this story:
breastfeeding is important, don't mess with it. Exclusivel EBM feeding is
preferrable to exclusive ABM feeding but it is not physiologically normal -
and so it is likely to carry some risk.  The risks may not be equivalent to
those associated with ABM feeding but they do remind us that exclusive EBM
feeding should not be a lifestyle choice but a compromise when breastfeeding
is, for some reason (like a cleft palate) not possible.  In most cases, I
would hope it is a temporary solution (until the tt is clipped, the cleft is
repaired etc) but I realise that this would require the mothers of these
kids to receive good breastfeeding management support. (I have a dream ...)

Nina Berry BA/Bed(Hons) Dip Arts(Phil)
Breastfeeding Counsellor
PhD Candidate - "Ethical Issues in the marketing of 'Toddler Milks'"

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