Sara, I wrote a letter to the editor of the Lancet in November. The Lancet refused to publish it but they did send the letter on to Dr. Malcom Sears, author of the study. And he did write to me. Here's a shortened version of the letter to the editor(if anyone wants the full length version with footnotes, I can send by attachment). Valerie W. McClain, IBCLC To the Editor: As an international board certified lactation consultant, I read with interest the Sears et al. study on the long-term relationship between breastfeeding and the development of atopy asthma.(1) There is a long history of observation and studies that suggest that breastfeeding, particularly exclusive breastfeeding is protective agianst atopy and asthma. I was therefore astounded to read this study that attempts to show breastfeeding as a risk rather than a protective factor. The first problem I found with this research is there is no definition of breastfeeding. Studies that compare breastfeeding and infant formula feeding without an operational definition of breastfeeding are seriously flawed (2) The authors' report that newborns classified as 'breastfed' actually received nightly formula feeds while in the hospital. Thus, these newborns received doses of foreign proteins besides breast milk from the beginning. It is quite possible that it is these foreign proteins introduced to an immature gut that is the trigger for atopy and asthma in these children. The authors state, "No duration of exclusive breastfeeding had a protective effect against development of atopy and asthma in later childhood." This research clearly did not test the effects of exclusive breastfeeding, if newborns were given nightly formula feeds. I believe that it is next to impossible to be certain that a method of feeding is a risk or protective, when the feeding method is mixed--particularly in the newborn period..... Casting doubt about the protective factors in breastfeeding, could easily mean that more women decide that breastfeeding is not worth the effort. If the study is wrong but influences enough women (it certainly got quite a bit of media attention), we could easily end up with more atopic and asthmatic children dependent on the pharmaceutical industry. I am disturbed that this study was published in The Lancet. Sincerely,........... I mentioned the Royal New Zealand Plunket Society (I stated the New Zealand Plunket Nurse program might be biased--records maintained by them on infants for the study) was founded by Truby King on the need to provide safe formulas to infants. Dr Sears states that the Medical Research Council (now called the Health Research Council) funded the study. I also mentioned a news release (June 18, 2002) from McMaster University that states that GlaxoSmithKline Inc. was donating $1 million to establish a McMaster University Research Chair in pediatric asthma at the Firestone Institute for Respiratory Health St Joseph's Healthcare Hamilton Ontario Canada (Malcolm Sears is from this Institute). Dr. Sears in his letter to me says, "Your statements regarding GlaxoSmithKline and the suggestion that our study was biased because of pharmaceutical input are totally unfounded." He goes on to further state in his letter to me that, "There are many good reasons for breastfeeding, and all that our study has done is to remove one alleged reason which was based on short-term studies rather than adequate long-term studies examing whether or not breastfeeding was protective against atopy and asthma. We have not suggested that women use formula feeding as a means of reducing asthma and atopy." *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html