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Subject:
From:
Diane Wiessinger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 28 May 2005 10:20:54 -0400
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Ooooh, interesting!  This is nothing more than the same old Sears et al study dressed up in new clothes!  

The study was first published as Sears MR et al. Long-term relations between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study.  Lancet 2002; 360:901-907.  

Yes, it found higher levels of allergy in people who were "exclusively breastfed".  **But most of their "exclusively breastfed cohort was given formula nightly in the hospital so the mothers could sleep**.  This tiny fact was ignored in their research, which means, essentially, that all these years of work are meaningless because they contaminated what should have been called their control group with what should have been called the experimental substance, right out of the starting gate.  

Malcolm Sears pooh poohs this, saying (In JHL 2004; 20(2): 148-150) ""We do not believe this is a significant confounding factor in our study.  If one intervention (breastfeeding) were to protect from allergy and the other (formula feeding) increased allergy, then an admixture of interventions would reduce the effect of either, not increase the effect.  Clearly this did not occur."  In other words, since this portion of his results doesn't fit his world view, it can be dismissed.  My high school biology teacher would have thought otherwise, but of course the researchers now have 33 years invested in this work... 

(Anna Coutsoudis's research, as an aside, finds the highest levels of HIV transmission in mixed-feed babies and the lowest in truly exclusively breastfed babies, but never mind.  And there is a definition for "exclusive breastfed", and that definition doesn't include the phrase "with not more than one daily formula feed in the first few days of life", but never mind.)

So now I get to update my talk on why it's so critically important for researchers to recognize that *breastfeeding* is the control group and *formula-feeding* is an experimental technique that needs to be respected as such.

I envision a long-term study comparing exclusively breastfed, home-birthed babies (the closest we can get to our biological norm) with mixed-fed and exclusively formula-fed babies (most of whom would probably have been born in a hospital), using formula as the experimental substance.  *Imagine* the debate over which was linked to any problems that might show up in the experimental groups: the formula itself or the confounding variables involved in hospital birth.  Wouldn't that be *fun*?

Let's really push our researchers to get their control and experimental groups straight, and to frame and title their work accordingly.  I think we can change attitudes faster that way than any other way.  Imagine the 2004 Chen, Rogan study in Pediatrics being titled, not "Breastfeeding and the risk of postneonatal death in the United States", but "Artificial feeding and the risk of postneonatal death in the United States."  Think what the headlines would have been!

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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