Jennifer, we obviously disagree on some key areas here, and I recognise that we may simply have to agree to differ in some ways. However, there are several points I do think worth making:

Firstly, you seem to be blaming mothers' concerns over weight loss/supply on medical professionals. I'm in no way denying that those can be a huge issue in many, many hospitals, but I also think that to imply, as you did, that the concerns are entirely due to mishandling by the medical profession is to oversimplify a complex cultural issue in which mothers receive negative messages about supply and about breastfeeding from all quarters. Medical professionals do also have to walk a fine line between frightening mothers unnecessarily and following up genuine concerns, so it's not as though we can completely gloss over issues around weight loss.

So, to what extent are the researchers at fault here in providing insufficient breastfeeding support for women? You've raised concerns there; but can I point out that we are, ultimately, speculating about units whose policies we know nothing about? And that the most dedicated and pro-breastfeeding health care professionals are still going to be up against anti-breastfeeding cultural attitudes and heavy cultural misunderstandings about supply and needs for formula supplementation? You seem to be implying that women's decisions to turn to supplementation must automatically represent failure or inadequate advice on the part of their health care providers. I'd certainly question that.

With regard to bedsharing and the physiological norm, I do have to point out that the physiological norm doesn't include modern mattresses, pillows, or bedding. Unfortunately, we do have pretty consistent evidence that sharing the kinds of beds we have in the Western world today does involve some increased risk even when the obvious high-risk cases are accounted for. I've discussed this in a lot more detail at http://parentingmythsandfacts.com/2011/12/15/the-truth-about-bedsharing-risks-and-why-it-may-not-be-what-you-think/. I brought this analogy up because, every time that a study shows increased risk associated with bedsharing, one of the standard responses is to point out that advising against all bedsharing may increase the risk of women doing so in particularly unsafe ways, and I think that's a really important message to bear in mind.

Finally, to get back to my main question in this thread, you responded for my request for cites with this statement:

<As to my review of the research on gut health, it is important to understand that epigenetics is multi-generational. If a mother was AF, if she is obese, if she had abx in labor, her own gut flora reflects that damage and her breastmilk will not be as protective as that of a mother who was born normally, nurse normally, is of normal weight, etc. Every single harmful thing we do to a mother, we do to at least the next 5 generations. So, you need to look at the pieces and how they fit together. The old paradigm no longer applies. In fact, it never did. >

So, I do have to ask - what is the 'great deal of research' that you were saying supports the idea of supplementation as 'very, very dangerous', and how strong can it be? Not only does this research have to disentangle the effects of multiple confounders, but you're claiming that it has to do so over five generations or more. If that's really true, then getting any clear research answers would require detailed accurate records of feeding method and of supplementation amount and timing in EBF babies, stretching back over more than a century. Even if such research existed (and, frankly, I don't think I'm being too sceptical or going out on too much of a limb when I say that I don't believe it does), most of it would be dealing with forms of supplementation and of hygiene/sterilisation that aren't really comparable at all to what we have today. I repeat my question: what research is available on the dangers of supplementation in EBF babies that leads you to describe it as 'very, very dangerous'?


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome